bluuebunny/crossref_metadata_2025 huggingface dataset:
The pulpal response to citric acid in cats
Authors: Ryan P. C. , Newcomb G. M. , Seymour G. J. , Powell R. N.
Published: December 2005

Abstract Citric acid conditioning of dentine has been proposed as an efficacious treatment for promoting re‐attachment after periodontal surgery. This study investigated the pulpal reactions to periodontal surgery combined with citric acid (pH 1) demineralization of exposed dentine for 3 min. 9 cats were used as the experimental animals, with each cat providing 1 negative and 1 positive control and 2 experimental canine teeth. Evaluation was over 3 observation periods, with 3 cats in each period being sacrificed at 4, 21 and 83 days.

Positive control teeth, which underwent periodontal surgery combining the removal of approximately 3 mm2 of labial bone and vigorous root planning of the exposed root surfaces, displayed mild to moderate pulpal reactions during the short‐ and intermediate‐term periods and only mild to no reactions in the long‐term period. The addition of citric acid demineralization, however, resulted in 5 experimental teeth (28%) becoming abscessed or totally necrotic in the intermediate‐ and long‐term periods. At 21 days, the frequency of adverse pulpal responses to surgery and citric acid conditioning was significantly (p<0.05) greater than to surgery alone. Although 4 experimental teeth were relatively uninflamed at the long‐term period of observation, all showed irritational dentine formation. Penetration of exposed dentinal tubules by plaque bacteria was observed only in the citric acid treated teeth.
Reproducibility of pocket depth and attachment level measurements when using a flexible splint
Authors: Isidor Flamming , Karring Thorkild , Attström Rolf
Published: December 2005

Abstract Pocket depth, attachment level and bone level assessments were carried out using flexible splints to produce readily identifiable reference points and to standardize the probing spot and the direction of probe insertion. The pocket depth and attachment level measurements were carried out twice at intervals of 3 weeks, both before and 3 months after periodontal treatment. The level of alveolar bone was measured by transgingival probing (“sounding”) and again following elevation of a mucoperiosteal flap. The measurements were made with a periodontal probe to the nearest higher millimeter. Complete agreement was found between the first and second measurements of pocket depths and attachment level for approximately 60% of the examined surfaces, both before and after periodontal treatment. A deviation of 1 mm or less was found for approximately 95% of the surfaces, and the difference between the first and second measurement never exceeded 3 mm. When transgingival probing measurements were compared to the measurements of the periodontal bone level assessed after elevation of a mucoperiosteal flap, complete agreement was found for 60% of the surfaces, and a deviation of 1 mm or less was found for 90% of the surfaces. No discrepancy exceeding 3 mm was observed.

The results of this study indicate that readily identifiable reference points can be produced by flexible splints in assessments of pocket depth, attachment level and bone level alterations in studies on the effect of periodontal treatment.
Metronidazole: its use in clinical dentistry
Authors: Mitchell D. A.
Published: December 2005

Abstract The increasing awareness of the role of obligate anaerobic bacteria in the aetiology of oral disease has led to an interest in their chemotherapeutic control. Many drugs are capable of eliminating anaerobes but in instances where these bacteria are acting as sole or major pathogens it is desirable to remove these specifically. The nitroimidazole group of drugs is specifically anti‐anaerobic in nature and includes metronidazole, nimorazole and tinidazole. This paper reviews the literature on metronidazole. This drug is absorbed well from the gastrointestinal tract and can be detected at batericidal levels in blood and saliva within 1 h of ingestion. The mode of action of metronidazole is unknown but thought to concern intracellular reduction of the molecule. The drug acts specifically against anaerobes and does not disturb the commensal aerobic flora; resistance very rarely develops. The dosage recommended for use in dentistry would appear to be very safe. Metronidazole has important interactions with alcohol, disulfiram and warfarin and there are containdications to its use. Metronidazole has been proved to be efficacious in treating: acute ulcerative gingivitis may infections, some cases of osteomyelitis and infected socket. The drug may be of use in cases of chronic progressive periodontitis where anaerobes are implicated as pathogens.
Effect of age on the periodontium
Authors: van der Velden U.
Published: December 2005

AbstractIt is generally known that the degree of periodontal breakdown increases with increasing age. The extent to which aging of periodontal tissues plays a part in this respect poses a question which is yet to be answered. Aging proves to be accompanied by a variety of periodontal changes. The periodontal tissues themselves show evidence of aging, there are indications that the composition of the plaque changes, and the reaction of the periodontium to the presence of plaque probably changes as well. There is as yet no sufficient evidence of a physiological apical migration of the epithelial attachment in human subjects. It seems plausible that periodontal breakdown can occur only in the presence of plaque with consequent inflammation of the periodontium, or as a result of trauma. Whether changes in plaque composition with age exert any influence on the course of periodontal breakdown is uncertain: the data available are not yet sufficient to warrant definite conclusions. The same applies to the influence which a changing reaction of the periodontium to the presence of plaque may have on the course of periodontal breakdown. Research findings do suggest that the degree of periodontal breakdown increases with age, that with increasing age inflammation of the periodontium tends to develop more rapidly and that in the process of aging the periodontium shows a slower rate of wound healing. However, these phenomena are overshadowed by the patients’ susceptibility to periodontal disease. This implies that (1) the susceptibility lo periodontal disease is more significant for the rate of periodontal destruction than the length of time plaque is present (the age effect) and (2) the greater the susceptibility to periodontal disease, the slower the rate of wound healing and the more rapidly inflammation of the periodontium tends to develop.
Comparison of the immediate effects on the sub‐gingival microflora of acrylic strips containing 40% chlorhexidine, metronidazole or tetracycline
Authors: Addy M. , Langeroudi M.
Published: December 2005

Abstract In the management of chronic periodontitis, there has been a renewed interest in the local delivery of antimirobial drugs into periodontal pockets. This study assessed the effects of the acrylic strip delivery system containing chlorhexidine, metronidazole or tetracycline on subgingival microflora assessed by dark field microscopy. Strips containing 40% chlorhexidine, metronidazole or tetracycline were placed for 2 to 3 days into pockets >6 mm which bled on probing. Plaque samples were obtained before and after treatment and counts of morphological and motile groups of organisms were made by dark field microscopy. Prior to treatment, the dark field microscopic counts were similar to those previously reported for diseased sites with motile bacteria, in particular spirochaetes, present in high numbers. Following treatment, all 3 antimicrobial drugs produced a significant increase in the proportion of cocci and significant decreases in all other types of organisms. Motile organisms, in particular, were markedly reduced and spirochaetes could not be recovered from some sites treated with metronidazole and tetracycline. Metronidazole was significantly more effective than tetracycline or chlorhexidine on spirochaetes. The results indicate that acrylic strips may be useful in the management of chronic periodontitis as an adjunct to routine mechanical methods.
Effects on dental health of spacing of teeth in anterior segments
Authors: Silness John , Røynstkand Torgeir
Published: December 2005

Abstract The purpose of the study was to examine the relationship between spacing and dental health in 15‐year‐old adolecents. The whole sample consisted of 156 subjects. Out of them, 74 females and 73 males with 6 anterior teeth made up the study group for examination of the upper jaw. 75 females and 75 males had 6 anterior teeth in the lower jaw and made up the study group for examination of the lower jaw. The Plaque Index (PII) and the Gingival Index (GI) were recorded. Probing depths (PD) were measured as explained by Glavind & Løe. Filled surfaces (FS) were taken from the individual ease sheets and controlled clinically. The spacing of the individuals was assessed by counting the number of proximal surfaces without visible contact with the adjacent proximal surfaces, on model casts. The sum of proximal surfaces without contact made up the Space Index (SpI) of the individual jaw. Parametric and non‐parametric statistical methods were used to analyze the data. In both sexes and both jaws proximal surfaces without interdental contact had a more favourable periodontal condition than surfaces with contact. In the upper jaw of both sexes, proximal surfaces without interdental contact had a reduced number of filled surfaces compared to surfaces with contact. The linear relationship between SpI and FS was significant, i.e., an increased number of surfaces without contact was accompanied by a reduced number of filled surfaces. In the lower jaw, the differences between the SpI groups and the linear relationship between SpI and FS did not reach significance. In both sexes and both jaws, proximal surfaces without fillings had a more favourable periodontal state compared to surfaces with fillings. Indications are that the summation effect of the presence of interdental contact and the presence of fillings contributed to the differences in periodontal condition between surfaces with and without interdental contact.
An investigation into the response of subjects to a plaque control programme as influenced by friends and relatives
Authors: Lim C. S. , Waite I. M. , Craft M. , Dickinson J. , Croucher R.
Published: December 2005

Abstract The aim of the present study was to assess the response of patients to a course of instruction in plaque control as influenced by friends and relatives. The subjects in the study were 41 patients who had been referred to a dental hospital for treatment.

There was a major reduction in plaque and gingivitis levels in the subjects at both the 10th and 14th weeks of the study. There was a greater proportional reduction in gingivitis levels in those subjects who had a higher number of reported discussions with their friends. The effect of discussions with members of the family was less clear. Lower values for gingivitis levels at 10 weeks were associated with a higher number of discussions with parents. However the levels of gingivitis tended to be adversely affected by discussions between the subjects and their spouses.

The importance of recognising the influence of family and friendship networks needs to be understood when preventive programmes are designed, especially where high levels of self‐care are sought as outcomes.

Further work is in progress on a group of office workers being treated in a dental practice environment. This will allow the type of advice being obtained from the various contacts to be investigated in more detail.
Use of dental floss by Finnish students
Authors: Murtomaa Heikki , Turtola Lauki , Rytöumaa Inkeri
Published: December 2005

Abstract In order to elucidate dental care behavior related to interdental cleaning, a group of first‐year students were invited to a free dental examination. 186 of the students invited (76%) were examined clinically and roentgenologically. The mean DMFS‐index of the students was 22.6 (± 12.6). They were also asked about their use of dental floss. 35% of the students reported using dental floss, but only 2% reported daily usage. 45% of the students had been taught how to use dental floss, and 83% of these had been taught by dental personnel. Teaching had no effect on the reported frequency of use.

There were no statistically significant differences in the occurrence of dental plaque and gingivitis between those who used dental floss and those who did not. The subjects were unable to use dental floss on 1 out of every 3 filled proximal surfaces of the first molars. No correlation could be found between dental caries experience and the reported use of dental floss.
Reproducibility of probing attachment level measurements
Authors: Badersten Anita , Nilvéaus Rolf , Egelberg Jan
Published: December 2005

Abstract The reproducibility of probing attachment level measurements in incisors, cuspids and premolars was studied in 2 groups of patients with severely advanced periodontal disease. The results showed that approximately 90% of the recordings could be reproduced within ± 1.0 mm difference. This was found for intra‐exammer as well as inter‐examiner comparisons of 2 examiners. Measurements using onlay margins for reference point demonstrated somewhat less variability than the use of cemento‐enamel junction for reference. The level of reproducibility varied notably between patients and was improved following non‐surgical periodontal therapy. Also, the reproducibility varied significantly between tooth types, tooth surfaces and probing pocket depths. It was concluded that in clinical studies, the evaluation of the healing response of individual lesions should include consideration of the variability of repealed measurements for each of the investigated tooth sites.
Relation between wound healing after surgery and susceptibility to periodontal disease
Authors: Abbas F. , van der Velden U. , Hart A. A. M.
Published: December 2005

Abstract.In the present investigation wound healing was studied clinically in 8 younger (mean age 33.5 years) and 8 older patients (mean age 48 years), who were surgically treated for the same amount of severe periodontitis. This implies that the patients in the younger age group represented individuals with a higher degree of susceptibility to periodontal disease than the patients in the older age group. After surgery all patients were subjected to a carefully controlled oral hygiene program. Patients were recalled weekly until 8 weeks post surgery and again after 15 weeks for a final examination. At every recall session oral hygiene measurements were carried out and the bleeding tendency of the pockets was determined after probing with a standardized pressure. Bleeding on the basis of mechanical trauma after probing was considered to be a clinical parameter for wound healing in a plaque free environment.

Results indicate that the oral hygiene program resulted in equally low plaque scores in both age groups. However, in a period from 5–15 weeks after surgery younger patients showed significantly more bleeding pockets than older patients. Furthermore it was found in both groups that the more loss of attachment there was, the slower the rate of wound healing.

It was concluded that the time span for wound healing is longer in patients who are more susceptible to periodontal disease, than in those who are less susceptible.
Effect of periodic tooth displacement on healing of experimental furcation defects in dogs
Authors: Klinge Björn , Nilveus Rolf , Egelberg Jan
Published: December 2005

Abstract This study compared the healing response, following reconstructive surgery, between teeth subjected to periodic displacement and teeth which were splinted during the postoperative healing period.

Through‐and‐through furcation defects were created in the mandibular second, third, and fourth premolars of 6 beagle dogs. Bone was surgically removed from the furcation and around each root to 3 different levels: 3, 6, and 9 mm. Reconstructive surgery included demineralization of the root surface and coronally positioned flaps. During the postoperative healing period, the premolars on one side were subjected to periodic mesiodistal displacement by orthodontic elastics attached to splints. Corresponding teeth on the contralateral side were splinted to serve as non–mobile controls.

The results demonstrated that reattachment occurred in 12 of 14 displaced teeth and in 14 of 16 splinted teeth. There was no difference in the amount of interradicular bone fill or frequency of ankylosis between displaced and splinted teeth.

Our findings indicate that the healing response was not affected by tooth displacement in this dog furcation model.
Investigation of the relationship between clinically detected loss of attachment and radiographic changes in early periodontal disease
Authors: Mann J. , Pettigrew J. , Beideman R. , Green P. , Ship I.
Published: December 2005

Abstract A total of 183 students, ages 12–16, were examined clinically to determine periodontal attachment loss by a trained examiner, utilizing standard techniques. 70 of these were selected, for whom bitewing radiographs were available for assessment of early alveolar bone loss by 2 radiologists and a general dentist, utilizing 4 criteria. The results indicate poor agreement between clinical and radiographic diagnoses by the 3 examiners. Variations were also found in the diagnosis of pathologic sites utilizing radiographs. The data indicate that bitewing dental radiographs were a poor screening or diagnostic procedure for the assessment of early periodontal disease in adolescents.
Candidal carriage and plaque distribution before, during and after removable orthodontic appliance therapy
Authors: Arendorf T. , Addy M.
Published: December 2005

Abstract Candidal counts at 6 mucosal sites in 33 subjects were estimated by imprint culture before, during and after removable orthodontic appliance therapy. Additionally, dental plaque scores and salivary pH were measured at each stage.

Whole mouth and site prevalence of candida rose significantly during therapy before falling to levels approximating initial values. A similar pattern was seen for candidal counts for the whole mouth and at individual mucosal sites, although post‐treatment densities were usually lower than originally seen. The number of sites colonised by Candida and salivary pH also increased significantly during treatment and fell significantly afterwards.

Only the upper palatal plaque scores rose during therapy and most other dental sites showed a gradual decrease in value during the course of the study. This could be attributed to regular monitoring of the patient's oral hygiene procedures.

This investigation demonstrated a direct relationship between the presence of an acrylic appliance, candida and low salivary pH levels. Furthermore, removable appliance therapy had a positive, though transient influence upon the prevalence and density of oral candidal carriage, suggesting that the appliance may initiate the carrier state.
The effect of supragingival plaque control on the subgingival microflora
Authors: Kho Pearlin , Shales Frederick C. , Hardie Jeremy M.
Published: December 2005

Abstract The effect of plaque control on the apical microflora of deep periodontal pockets was studied. 8 subjects exhibiting signs of chronic periodontitis were chosen for the study, each subject having at least one pocket 6 mm. These subjects were placed on a plaque control programme consisting of 3 visits, during which oral hygiene instructions were given. On two visits, the teeth of these subjects were scaled and polished. Bacteriological samples from the apex of a deep pockets from each subject were collected before the commencement of the plaque control programme and again at 8 and 16 weeks after the last scale and polish. No significant difference in the microbial flora was observed before and after plaque control, but marked fluctuation in bacterial composition was noted at the 3 samplings. It was concluded that supragingival plaque reduction was not sufficient to produce significant changes in the subgingival plaque composition of deep periodontal pockets.
Efficacy of Listerine antiseptic in inhibiting the development of plaque and gingivitis
Authors: Gordon J. M. , Lamster I. B. , Seiger M. C.
Published: December 2005

Abstract A 9‐month double‐blind controlled clinical study was conducted on adult subjects using either Listerine antiseptic, its vehicle control, or a water control in order to determine the efficacy of the antiseptic mouth rinse in inhibiting the development of plaque and gingivitis. Following screening examinations for minimal entry levels of plaque and gingivitis, all subjects received a complete prophylaxis. Subjects then continued their usual oral hygiene habits for a 3‐week normalization period and were examined for soft tissue abnormalities and baseline measurements of plaque, gingivitis, and tooth stain. 2 additional prophylaxes were then performed, followed by a second baseline gingival examination. Zero plaque was re‐established by rubber cup polishing and twice daily rinsing was begun. Soft tissue, plaque, gingivitis, and extrinsic tooth stain were evaluated after 1, 3. 6 and 9 months of rinsing with the randomly assigned mouthrinses.

Results demonstrated that Listerine antiseptic significantly reduced the development of plaque at 1,3.6 and 9 months and the development of gingivitis at 9 months, as compared to its vehicle control or water control.
Age‐related expression of juvenile periodontitis
Authors: Saxén Leena , Murtomaa Heikki
Published: December 2005

Abstract To test the hypothesis that localized and generalized juvenile periodontitis is one disease entity, the localization of bone loss was measured from orthopantomograms of 88 patients with untreated juvenile periodontitis. Linear regression analysis showed a significant correlation between the age of the patient and the number of teeth with bone loss. Similarly, a correlation was found between the Gingival Bleeding Index scores, the age of the patient, and the number of affected teeth. It is concluded that juvenile periodontitis, known to be genetically controlled, is a disease entity which starts as a localized form with affected first molars and/or incisors and develops, if not treated, gradually to the generalized form of the same disease, which resembles the adult periodontitis.
New attachment formation on teeth with a reduced but healthy periodontal ligament
Authors: Karring Thorkild , Isidor Flemmino , Nyman Sture , Lindme Jan
Published: December 2005

Abstract The present investigation was undertaken to examine whether a new connective tissue attachment will form on previously periodontitis‐involved roots when a reduced but healthy periodontal ligament tissue persists following periodontal treatment and the epithelium is prevented from migrating into the wound.

In each of 4 monkeys, periodontal tissue breakdown was induced around one maxillary and one mandibular second premolar or first molar by placing orthodontic elastics around the teeth. The elastics were kept in situ until about 50% of the supporting tissues had been lost. 3 months following removal of the elastics, the crowns of the teeth were resected. The pocket epithelium and subjacent granulation tissue were excised and the cementum of the periodontitis‐involved part of the roots was removed using a diamond bur. The roots were covered with a mucosal flap. The animals were sacrificed after 3 months of healing. The jaws were removed and histological sections of the experimental roots including their surrounding periodontal tissues were produced.

The microscopic analysis disclosed that in all roots, new cementum with inserting collagen fibers had formed in the apical portion of the previously exposed root surfaces. It was always in continuity with the original cementum layer apical to the instrumented part of the root and was thickest in its apical portion, becoming gradually thinner in the coronal direction. In the roots, which for the entire length of the study remained covered by the oral mucosa, the extension in the coronal direction of this newly formed fibrous attachment amounted to an average of 1.0 mm with a range from 0.1 mm to 2.6 mm. These findings were interpreted to mean that new attachment in formed by coronal migration of cells originating from the periodontal ligament.
Effects of short‐term administration of metronidazole on the subgingival microflora
Authors: Giedrys‐Leeper Elaine , Selipsy H. , Williams B. L.
Published: December 2005

Abstract The effect of a 5‐day course of systemic metronidazole was investigated in 11 recall maintenance patients over a period of 3 months. Crevicular fluid flow, bleeding on probing, pocket depth, and composition of the subgingival microbiota as observed by dark‐field microscopy, were measured.

The study design allowed patients to act as their own controls. At baseline 1 (day 0), each patient had a randomly assigned quadrant scaled and root‐planed, and received oral hygiene instruction. Microbiological and clinical parameters were measured at baseline 1 (before treatment) and at 3, 6, and 12 weeks in both the root‐planed and a designated no‐treatment quadrant. At baseline 2 (12 weeks), the contralateral quadrant was scaled and root‐planed, and the oral hygiene instruction was reinforced. At this appointment, each patient was given 15 metronidazole tablets (250 mg), 1 to be taken 3 times per day for 5 days. At the end of this period, patients were seen 1–2 h after taking their last tablet, and blood and crevicular fluid samples were taken lo determine the concentration of metronidazole by microbiological assay in the serum and crevicular fluid. Microbiological and clinical parameters were measucd at baseline 2 (before treatment) and at 13, 15, 18, and 24 weeks in both the root‐planed and designated non‐root‐planed (metronidazole only) quadrants.

Results demonstrated, that in this group of recall maintenance patients, metronidazole was no more effective than root‐planing alone in reducing the relative % of total motile organisms and spirochetes in 5–8 mm pockets. Crevicular fluid flow was, however, significantly reduced for 11 weeks; serum and crevicular fluid levels of metronidazole were similar 1 to 2 h after drug ingestion.
Lactate dehydrogenase activity in gingival crevicular fluid collected with filter paper strips: analysis in subjects with non‐inflamed and mildly inflamed gingiva
Authors: Lamster Ira B. , Mandella Rosemary D. , Gordon Jeffriv M.
Published: December 2005

Abstract A previous study of lactate dehydrogenase (LDH Jin gingival crevicular fluid (GCF) suggested that the concentration is 10 to 25 times that of serum (X=2300 international units/I versus 100 IU/1 for serum). That study used capillary tubes to collect microliter amounts of GCF. Since invasive collection techniques can influence GCF flow, we evaluated LDH activity in GCF collected by filter strips. GCF was collected in a standardized fashion from 10 subjects with mild inflammation (GI=0.5–1.0) and 10 subjects without evidence of gingival inflammation (GI=0). Our results indicate that LDH volume activity was greater for subjects with GI=0 x= 105.529 IV/l) than for subjects with GI=0.5–1.0 (X;=77,66 1 IU/1). but the difference was not significant. LDH total unit activity was significantly greater in subjects with GI=0.5–1.0 versus GI=0 (X=0.048 IU versus X=0.0242 IU. P<0.0001). The relationship of LDH volume activity to GCF volume, the regression lines fit to the data, and calculation of LDH total unit activity were important for analysis of enzyme activity in GCF.
Periodontal conditions in adolescents with cleft lip, alveolus and palate following treatment in a co‐ordinated team approach
Authors: Brägger U. , Schürch E. , Gusberti F. A. , Lang N. P.
Published: December 2005

Abstract The aim of the present investigation was to evaluate the oral hygiene habits and the periodontal conditions of a group of cleft lip, alveolus and palate patients at the end of a longitudinal multidisciplinary treatment. From a total of 120 patients who had been supervised at the University of Berne, Clinic for Pediatric Surgery for at least 18 years in a co‐ordinated team approach, 80 were selected on the basis of availability. Plaque control record (PCR), calculus index (CI), gingival bleeding index (GBI), pocket probing depth (PD), loss of attachment (LA) and furcation involvement were recorded. Using the technique and the ruler described by Schei et al., the radiographic height of the alveolar crest from the cemento‐enamel junction was determined.

Between the different groups of deformities, no statistically significant differences were found for all the clinical parameters with the exception of the mean PD orally and the mean PD bucally which were shallower in the isolated cleft lip group. These differences were attributed to the long‐term orthodontic therapy with fixed appliances.

When the PD and the LA at the sites adjacent to the cleft region were compared to two “unaffected” control sites, no statistically significant differences were found, whereas the comparison with the radiographic bone loss showed a statistically significant lower bone height. These results may indicate the presence of a long connective tissue attachment without bony support in the cleft region.

As a result of inadequate oral hygiene, the patients with cleft lip, alveolus and palate showed beginning periodontitis with loss of attachment and beginning furcation involvement in most of the cases. Since these patients need long‐term orthodontic therapy with fixed appliances, they should be incorporated in intensive prophylaxis programs as early in age as possible.
Healing after treatment of periodontal intraosseous defects
Authors: Durwin A. , Chamberlain H. , Garrett Steven , Renvert Stefan , Egelberg Jan
Published: December 2005

Abstract 2 regenerative surgical approaches using citric acid conditioning, were compared in the treatment of deep intraosseous periodontal defects. The first approach was non‐resective in that no osseous tissue was removed. The second, a partially resective approach, involved reduction of the osseous defect depth by removal of some supporting bone. 16 patients and a total of 26 defects, with probing pocket depth ≥7 mm. were included in the study. The depths of the corresponding osseous defect, as revealed during surgery were ≥5 mm.

The results demonstrated mean gains in probing attachment level of 0.7 mm for the partially resected group and 1.1 mm for the non‐resected group. Corresponding gains in probing bone levels were recorded in the defect sites for each group. Probing pocket depth was reduced from 7.5 mm to 4.0 mm in the partially resected group and from 7.9 mm to 5.3 mm in the non‐resected group. Both procedures caused loss of attachment and bony support from adjacent tooth surfaces involved by the surgical procedure. Slightly more loss of attachment and bone was experienced by the partially resected group (range 1.2–1.5 mm) than by the non‐resective group (range 0.1–0.9 mm).
Healing after treatment of periodontal intraosseous defects
Authors: Renvert Stefan , Garrett Steven , Nilvéus Rolf , Chamberlain A. Durwin H. , Egelberg Jan
Published: December 2005

Abstract 84 periodontal intraosseous defects treated with mucoperiosteal replaced flap surgery and citric acid root conditioning were used to study the relationships between various defect characteristics and the healing response as expressed by change of probing attachment level, change of probing bone level and residual probing depth. More gains in probing attachment and probing bone levels were observed in deep defects than in shallower lesions. Other defect characteristics showed weak or no correlations to defect fill. The findings of this study seem to indicate that the outcome of treatment of intraosseous defects may be difficult to predict based upon evaluation of defect characteristics.
Healing after root reimplantation in the monkey
Authors: Houston Frank , Sarhed Gun , Nyman Sture , Lindhe Jan , Karring Thorkild
Published: December 2005

Abstract The aim of the present investigation was to evaluate the regenerative potential of the periodontal tissues following tooth reimplantation using a model which excluded the dentogingival epithelium from the process of healing. Maxillary and mandibular incisors, premolars and molars of 5 monkeys were used. Following root filling of all experimental teeth, the teeth were divided into 3 experimental groups. In I group, the teeth were extracted following the elevation of full thickness flaps. The crowns were separated from the roots at the level of the buccal cementoenamel junction and the roots immediately reimplanted into their sockets. The flaps were replaced and sutured to accomplish complete coverage of the roots. In a 2nd group, the teeth were subjected to the same experimental procedure, but in addition, the buccal alveolar bone was removed to about half its original height prior to root reimplantation. The teeth of the 3rd group were subjected to identical experimental procedures as for group II with the addition that the buccal root surfaces were planed to the level of the surgically created bone crest. The animals were sacrificed after 6 months of healing. The jaws were removed and histological specimens prepared for microscopic examination.

The results showed that a complete fibrous re‐attachment formed onto roots on which the original periodontal ligament tissue was preserved. This occurred irrespective of whether the roots were reimplanted into sockets with normal (group I) or reduced (group II) bone height. When the original periodontal ligament tissue was removed by root planing before reimplantation (group III), healing resulted in a significant amount of new connective tissue attachment. However, coronal to the newly formed fibrous attachment, the root surface frequently showed signs of resorption and particularly so in those roots which remained covered by the soft tissue during the entire course of healing. In the majority of the roots which perforated the covering soft tissue during the early phase of healing, the dentogingival epithelium had migrated apically into contact with the coronally generated fibrous attachment. In these cases, root resorption was never discernible. New bone formation occurred to a variable extent in the roots of groups II‐III. No relationship was found, however, between the amount of connective tissue reattachment or new attachment and newly formed alveolar bone, which in turn indicates that bone tissue regrowth and periodontal ligameni regeneration are unrelated phenomena.
The effect of Keyes' method of oral hygiene on the subgingival microflora compared to the effect of scaling and/or surgery
Authors: Greenwell H. , Bakr A. , Bissada N. , Debanne S. , Rowland D.
Published: December 2005

Abstract. The present study was conducted on 18 individuals to determine if Keyes' method of oral hygiene would present an alternative to traditional periodontal therapy in terms of establishing a subgingival microflora compatible with periodontal health. Oral hygiene, gingival conditions and subgingival microbial proportions assessed by dark field microscopy were measured at baseline, then once every 2 weeks for the remainder of this 8‐week study. In addition, probing depths and bleeding on probing were evaluated. Group I (9 patients) was treated non‐surgically, while Group II (9 patients) had received surgical therapy within the last 4 years. Both groups received routine scaling and root planing (Sc/RP) on one arch at time 0. and both were instructed To use Keyes' method of oral hygiene on one side of the mouth while the other side served as a control. This yielded a split‐plot experimental design which permitted examination of the effects of Keyes' method of oral hygiene. Sc/RP and surgery.

The results revealed no statistically significant differences between Keyes' method of oral hygiene and conventional oral hygiene in patients treated with a single session of Sc/RP, When scaling was not employed, Keyes' method was more effective than conventional oral hygiene. Surgical status was found to be the most significant factor in reducing clinical indicator values and establishing control of the subgingival microflora.

In summary, oral hygiene alone had only minimal effects on subgingival microbial proportions. The primary antimicrobial effect observed, as evidenced by shifts in subgingival morphotype proportions, was produced by the Sc/RP procedure. This effect was enhanced by improved access (surgical status).
The condition of the soft tissues at tooth and fixture abutments supporting fixed bridges A microbiological and histological study.
Authors: Lekholm Ulf , Ericsson Ingvar , Adell Ragnar , Slots Jörgen
Published: December 2005

Abstract In 10 partially edentulous patients provided with fixed bridgework supported by the combination of tooth and titanium fixture abutments, the condition of the soft tissues surrounding the abutments was examined. Sampling of supra‐and subgingival plaque was performed from both teeth and fixtures. The samples were analyzed regarding the total bacterial counts, the relative distribution of bacterial morphotypes and the cultivable microflora. From each patient, soft tissue biopsies were obtained from 1 tooth and 1 fixture abutment, and the specimens were analyzed for the presence and extension of inflammatory cell infiltrates. The microbiological examination showed that the distribution of bacterial morphotypes in the supra‐and subgingival plaque both at teeth and fixtures were similar, irrespective of localization and type of abutment. Non‐motile rods dominated the microflora, whereas spirochetes were either not detected or occurred in very low proportions. From the histological analysis, it was found that a majority of the soft tissue biopsies (75–80%) from both tooth and fixture sites contained only very small inflammatory cell infiltrates.
In vitro polishing effectiveness of interdental aids on root surfaces
Authors: Smith Billy A. , Shanbour Gregory S. , Caffesse Raul G. , Morrison Edith C. , Dennison Joseph D.
Published: December 2005

Abstract The purpose of this study was: (1) to determine whether polishing standardized proximal root surfaces with dental floss, Superfloss, wood and plastic interdental cleaners, using a polishing paste, produces any significant change on root surface roughness; and (2) to determine the effectiveness of different number of strokes in polishing. 80 tooth specimens were prepared, 10 in each of 8 sample groups. Each proximal root surface was standardized with 600A grit silicone carbide paper and polished with either waxed dental floss, Superfloss, wood or plastic interdental cleaners, using alkali aluminum silicate polishing paste. All specimens were mounted on a flossing machine and polished with 10 or 20 strokes. Before and after polishing, measurements were recorded with the Surfanalyzer 150 System to produce profile and average roughness tracings. Average maximum peak heights, mean number of peaks, and mean average roughness values were calculated from the tracings. The data were analyzed statistically by paired t‐test and Student t‐test. No significant mean differences were found between the number of strokes used. No significant differences were found for waxed dental floss in relation to the values analyzed. Significant differences were found for maximum peak heights for Superfloss following 20 strokes of polishing. However, no significant differences were found for Superfloss for mean number of peaks and average roughness. Significant differences were found for average roughness values, maximum peak heights, and mean number of peaks for the wood and plastic interdental cleaners. It was concluded that root surface roughness increased significantly with the use of wood and plastic interdental cleaners but not with waxed dental floss or Superfloss.
Frequency distributions of periodontal attachment loss Clinical and microbiological features
Authors: Haffajee A. D. , Socransky S. S.
Published: December 2005

Abstract The present investigation attempted to determine if the pattern of past periodontal destruction could be (1) concisely summarized, and (2) related to other clinical and microbiological parameters. 61 subjects between the ages of 12 and 61 years with destructive periodontal disease were evaluated at 6 sites per tooth for redness, plaque, suppuration, bleeding on probing, pocket depth, and attachment level. The frequency distribution of baseline attachment level measurements was computed for each individual. A curve fitting algorithm was used to fit the frequency distribution to 1‐, 2‐, and 3‐term normal distributions. The parameters of the fit could be used to summarize concisely all of the frequency distributions.

3 major patterns of attachment loss could be distinguished. Pattern I required a two‐term distribution with localized destruction at < 34% of sites and was further divided into 3 groups, depending on average attachment loss at diseased sites. The means of the second peak for the subgroups were 2.7, 5.3, and 8.6 mm, respectively. Pattern II exhibited more widespread disease (>33% of sites affected) with multiple peaks in the frequency distribution requiring a 3‐term distribution for satisfactory fit. However, a significant proportion of sites was not affected. Pattern III exhibited a single‐peaked normal distribution in which virtually all sites were affected. Mean attachment levels of the peaks in this group ranged from 2.7 to 8.4 mm.

23 of the 61 subjects showed significant attachment loss at 1 or more sites during the course of bi‐monthly monitoring, as determined by the tolerance method of analysis. Subgingival plaque samples were taken from these active sites and matched with control sites prior to therapy. The proportions of Fuso‐bacterium nucleatum, Streptococcus intermedius, and Eikenella corrodens were significantly elevated in active and control sites of subjects in groups II and III combined (the widespread disease groups), and proportions of Actinobacillus actinomycetemcomitans and Propionibacterium acnes were elevated in active and control sites of the more localized disease group I subjects. Group I subjects showed a 13‐to 15‐fold decrease in hazard rates of periodontal sites after Widman flap surgery and systemic tetracycline, whereas groups II and III subjects showed 2‐to 6‐fold decreases.
Gingival salivary gland choristoma
Authors: Moskow Bernard S. , Baden Ernest
Published: December 2005

Abstract A unique example of a gingival salivary gland choristoma together with a gingival cyst is described in a human autopsy specimen of periodontal tissues. A choristoma is a tumor‐like growth which is derived from primordial cells which have been displaced from their original tissue or organ. Only 6 other examples of the gingival salivary gland choristoma have been described in the world literature.
Identity of limulus amoebocyte lysate‐active root surf ace materials from periodontally involved teeth
Authors: Wilson M. , Moore J. , Kieser J. B.
Published: December 2005

Abstract A new approach has been developed to circumvent the problems of false positive reactions in the Limulus Amoebocyte Lysate (LAL) assay for lipopolysaccharide (LPS) in root surface materials. These LAL‐reactive materials include thrombin, thromboplastin, ribonuclease, ribonucleic acid, lipoteichoic acid and peptidoglycan fragments. In the present study, hot phenol/water extraction of these substances followed by ultracentrifugation of the resulting aqueous phases reduced their concentrations to very low levels. Furthermore, the application of Polymyxin B/Sepharose 4B affinity chromatography to these extracts enabled their intrinsic LAL‐activity to be determined. Use of these techniques to assay root surface materials has identified LPS as being the major LAL‐reactive material present. The mean LPS yield for the periodontally involved teeth was 4.13 μg/tooth. representing 2.82 μg/root. In contrast, the mean yield of LPS for the periodontally uninvolved teeth was 3.12 ng/tooth.
The distribution of bacterial lipopolysaccharide (endotoxin) in relation to periodontally involved root surfaces
Authors: Moore J. , Wilson M. , Kieser J. B.
Published: December 2005

Abstract The distribution of lipopolysaccharide (LPS) in periodontally involved root surface associated materials has been investigated using improved methods of identification and quantification. 39% of the LPS could be removed by gently washing in water for 1 min and 60% by brushing for 1 min with a slowly rotating bristle brush. The finding that 99% of the LPS can be removed by comparatively gentle procedures suggests that effective root surface debridement may be achieved by methods other than traditional hand instrumentation.
Failure of a microbial assay to reliably predict disease recurrence in a treated periodontitis population receiving regularly scheduled prophylaxes
Authors: Listgarten M. A. , Schiller C. C. , Sullivan P. , George C. , Rosenberg E. S.
Published: December 2005

Abstract The purpose of this study was to evaluate the reliability of differential dark‐field microscopy (DDFM) of subgingival bacteria to correctly predict the recurrence of periodontitis in treated patients on 2 different recall schemes. The results are based on data from 51 patients on 3‐month recalls (C group) and 39 patients (T group) who received periodontal prophylaxes according to a customized regimen based on DDFM of subgingival bacterial morphotypes. No significant differences were detected in the rate of recurrence of periodontitis between the 2 groups, although the incidence of disease recurrence tended to be greater in the C group. The proportions of spirochetes and motile rods observed at base line, or the average of the values observed at base line, 3 months and 6 months, were compared between subjects with and without disease recurrences. Significantly elevated proportions of these bacterial morphotypes were observed in patients of the T group who demonstrated evidence of disease recurrence during the first year as compared to subjects without disease recurrence. No significant differences could be detected in bacterial morphotypes between patients resistant to disease recurrence and those who developed recurrences at some time during the 3‐year period covered by this report.

The ability of DDFM of subgingival bacterial morphotypes to predict future disease occurrence was tested for 1‐ and 3‐year periods, in both the C and T groups. The test appears to be reliable only for subjects on the experimental maintenance regimen (group T) and for prediction of disease recurrence for the initial 1‐year period. The reliability of the test to predict disease recurrence over a 3‐year period fails off significantly in the T group. The test was not reliable in predicting disease recurrence in the C group, presumably because of the disrupting effect of regularly scheduled tri‐monthly prophylaxes on the composition of the subgingival microbiota.