bluuebunny/crossref_metadata_2025 huggingface dataset:
Checkerboard assessments of serum antibodies to oral microbiota as surrogate markers of clinical periodontal status
Authors: Papapanou Panos N. , Neiderud Anne‐Marie , Sandros Jens , Dahlén Gunnar
Published: August 2010

Background: This study addresses whether checkerboard assessments of serum IgG antibodies to oral bacteria may serve as surrogate markers of clinical periodontal status in epidemiologic studies.

Method: The analysis involved data from 205 subjects, 132 periodontitis patients and 73 periodontally‐intact controls, from whom full‐mouth clinical periodontal data and serum IgG titers against 19 periodontal bacterial species were available.

Results: A logistic regression model involving titers against 6 species (Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Eubacterium nodatum, Eikenella corrodens, Capnocytophaga ochracea and Actinomyces naeslundii genospecies 2) classified correctly 74.5% of the subjects examined, with 84% sensitivity, 57.5% specificity, 78% positive predictive value and 66.7% negative predictive value.

Conclusions: Checkerboard serology may be useful in providing surrogate markers for clinical periodontal status when such data are not readily available and, thus may serve as a valuable complement in the armamentarium of epidemiologic tools suited for the study of periodontal diseases.
Absence of a specific subgingival microflora in adults with Down’s syndrome
Authors: Reuland‐Bosma W. , Van Der Reijden W. A. , Van Winkelhoff A. J.
Published: August 2010

Background: Periodontal disease in Down’s syndrome (DS) is generally characterized by a high degree of bone loss. Bone loss of 5 mm or more is observed in 70% of these subjects. Among DS subjects, considerable differences in disease progression occur. So far, no studies have been conducted in which specific properties of the subgingival microflora have been related to the condition observed.

Aims: To investigate (1) the subgingival microflora in DS subjects and other mentally retarded (control) individuals which were matched to the utmost and (2) to investigate the subgingival microflora of a “low‐risk” and a “ high‐risk” group formed in DS subjects.

Material and Methods: 17 DS subjects and 17 control subjects were matched with respect to age, plaque level and bleeding on probing. In addition, the DS group was divided in a “low‐risk” group (0–2 teeth lost due to periodontal disease n=6) and a “high‐risk“group (6–13 teeth lost due to periodontal disease n=11). Prevalence and proportions of the putative periodontal pathogens Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Bacteroides forsythus, Peptostreptococcus micros, Fusobacterium nucleatum and Campylobacter rectus in the subgingival plaque were determined using anaerobic culture techniques. No differences in the prevalence of distinct suspected periodontopathic bacteria and bacterial subgingival composition between the DS group and the control group could be established. Also no differences in the prevalence of the seven investigated microbial species between the “low‐risk” and the “high‐risk” group were observed.

Conclusions: Because of the lack of differences in microflora between the DS group and the control group, a specific effect of the microbiological composition in the periodontal status of subjects with DS can be excluded in this population. Host factors constitute the more likely explanation of the differences observed in DS.
The effect of chlorhexidine acetate/xylitol chewing gum on the plaque and gingival indices of elderly occupants in residential homes
Authors: Simons D. , Brailsford S. , Kidd E. A. M. , Beighton D.
Published: August 2010

Aim: A randomised, controlled, double‐blind, clinical trial was conducted to investigate the effect of a chlorhexidine acetate/xylitol gum (ACHX) on the plaque and gingival indices of 111 elderly occupants in residential homes. A gum containing xylitol alone (X) and a no gum (N) group was included. Participants’ opinions about chewing gum were also investigated.

Methods: Subjects chewed 2 pellets, for 15 min, 2× daily for 12 months.

Results: In the ACHX group, the plaque and gingival indices significantly decreased (p<0.001) over the 12 months. In the X group, only the plaque score significantly decreased (p<0.05) and in the N control group, both indices remained high and did not change significantly. The acceptance of both chewing gums was high but more participants in the ACHX group felt that the gum kept their mouth healthy (p<0.05). The effect of the ACHX gum on plaque and gingival indices was significantly greater than for the X gum.

Conclusion: The long‐term use of a chlorhexidine acetate/xylitol chewing gum may therefore support oral hygiene routines for an elderly dependent population.
The use of PVP‐iodine as an adjunct to non‐surgical treatment of chronic periodontitis
Authors: Rosling B. , Hellström M.‐K. , Ramberg P. , Socransky S. S. , Lindhe J.
Published: August 2010

Objective: The present study was performed to assess the effect of topically‐applied PVP‐iodine, used as an adjunct both during basic non‐surgical therapy and at re‐treatment during the long‐term maintenance of patients with advanced periodontal disease.

Material and Methods: 223 patients with advanced destructive periodontitis were recruited. The participants met the following inclusion criteria: (i) a minimum of 8 non‐molar teeth, (ii) probing pocket depth of 6 mm at 2 teeth in each dentate quadrant, and radiographic bone loss exceeding 40% at the same teeth. A baseline I examination included assessment of plaque, gingivitis, probing pocket depth (PPD), probing attachment level (PAL) and radiographic bone height (R×BL). Following baseline I, the patients were stratified into 2 treatment groups; 2 subjects out of 3 were included in a control group and 1 in a test group. All participants, on an individual basis, received a case presentation and were instructed in proper self‐performed plaque control measures. Non‐surgical therapy was performed by the use of an ultrasonic device. The instrumentation in the test group was combined with the administration of 0.1% PVP‐iodine. All subjects were recalled for comprehensive examinations 3, 6 and 12 months (baseline II) after baseline I and then after 3, 5 and 13 years of maintenance therapy. PAL determinations were performed annually. Subjects (losers) who at the re‐examinations after 1, 2 and 3 years of maintenance demonstrated an annual further loss of PAL 2 mm at 4 teeth were exited from the study and referred for re‐treatment. There were 9 losers in the test and 31 in the control group. In addition, 8 subjects in the test and 25 subjects in the control group withdrew from the trial for reasons unrelated to the study. These 73 subjects were not included in the data presentation from the various examinations.

Results: It was demonstrated that non‐surgical periodontal therapy resulted in (i) improved gingival conditions, (ii) reduced PPD, (iii) gain in PAL. It was also documented that the topical application of 0.1% PVP‐iodine in conjunction with the mechanical root debridement established conditions which further improved the outcome of therapy. This was evidenced by the fact that at the 3, 6, and 12 months re‐examinations after baseline I, the test group had significantly lower mean PPD values and significantly more gain of PAL than the control group. During the 12 years of SPT, it was possible for most subjects in both groups to maintain shallow pockets and to avoid marked further loss of PAL. There were, however, a larger number of losers in the control than in the test group.

Conclusion: PVP‐iodine, topically applied during subgingival instrumentation, may improve the outcome of non‐surgical periodontal therapy.
The effect of polyvinyl pyrrolidone on the clinical activity of 0.09% and 0.2% chlorhexidine mouthrinses
Authors: Claydon N. , Manning C. M. , Darby‐Dowman A. , Ridge D. , Smith S. , Addy M.
Published: August 2010

Background: Previous studies have shown that polyvinyl pyrrolidone (PVP) added to a chlorhexidine rinse reduced extrinsic dental stain but at the expense of a reduction in plaque inhibitory activity. This effect appeared due to a reduction in the effective chlorhexidine dose to levels where dose response studies show plaque inhibition falls off rapidly. The aim of these 2 clinical studies was to determine if PVP could be added to chlorhexidine rinses to maintain efficacy and reduce staining.

Method: Study 1 involved 42 healthy dentate volunteers and was a blind, randomised, 7 treatment, crossover design balanced for residual effects. The rinses were: 1. 0.09% chlorhexidine to which was added, 2. 1% PVP, 3. 3% PVP, 4. 5% PVP, 5. 7% PVP, 6. Placebo, 7. Essential oil product. Rinses were used 2× on day one of each period after a prophylaxis. Subjects suspended tooth cleaning for 24 h and were then scored for plaque area. Study 2 used the experimental gingivitis model, involved 24 healthy dentate subjects and was a blind, randomised, 3 treatment, crossover design balanced for residual effects. The rinses were 1. 0.2% chlorhexidine, 2. 0.2% chlorhexidine/10% PVP, 3. Placebo. At baseline and the end of each study period subjects were rendered plaque, stain and calculus free, suspended oral hygiene and rinsed 2× per day. Plaque, gingivitis and stain were scored at baseline, 1, 2, and 3 weeks. Calculus was scored at baseline and 3 weeks.

Results: Study 1: Buccal plaque scores were significantly lower with all rinses compared to placebo. Also all buccal plaque scores were significantly lower with chlorhexidine and chlorhexidine/PVP rinses compared to the essential oil/phenolic rinse. There were no significant differences between the chlorhexidine rinse and the chlorhexidine/PVP rinses. Analyses for buccal and lingual plaque combined produced, with one exception, the same results for rinse comparisons as for buccal plaque alone. Thus the essential oil/phenolic rinse just failed to reach significance compared to placebo. Study 2: Plaque and gingivitis scores were significantly lower with positive control and test rinses compared to placebo but with no difference between these rinses. Tooth and tongue stain was significantly higher with the positive control and test rinses compared to placebo but not significantly different between these 2 rinses. Calculus scores were not significantly different between the three study rinses.

Conclusion: Taken with previous data, the balance of evidence does not support PVP as an inhibitor of staining associated with chlorhexidine. These data are further evidence that chlorhexidine oral hygiene products, which, do not or claim not to cause staining, are most probably lacking efficacy.
PMN responses following use of 2 biodegradable GTR membranes
Authors: Buchmann Rainer , Hasilik Andrej , Heinecke Achim , Lange Dieter E.
Published: August 2010

Objectives: In the present prospective trial, the PMN response following resorbable GTR barrier placement was evaluated in mandibular class II furcation lesions.

Materials and Methods: In 10 patients with treated chronic periodontitis, we randomly selected the 1st molars in the mandible with buccal degree II furcation involvement for either polylactic‐citric‐acid‐ester (PLA) or glycolide‐lactic‐copolymer (PGL) GTR membrane therapy. We examined contralateral healthy molar sites as untreated controls. We then evaluated the PMN‐derived inflammatory tissue response at baseline, weekly up to 6 weeks post‐therapy and at 12 and 24 weeks using GCF myeloperoxidase (MPO), beta‐glucuronidase (βG) and beta‐N‐acetyl‐hexosaminidase (βNAH).

Results: The enzyme levels increased from baseline to the 6‐week examination. After the 6‐week reappointment, enzyme levels dropped reaching the baseline scores at both the 12‐ and 24‐week visit. At PGL sites, the enzyme levels decreased earlier. Compared with healthy control sites, the MPO, βNAH and βG tests revealed different maximum levels at week 2 and 3 (PGL) and week 4, 5 and 6 (PLA). For both of the barriers the clinical parameters revealed a sustained improvement following therapy.

Conclusion: The release of PMN enzymes following placement of bioabsorbable membranes reflects the early soft tissue healing process. Our results suggest that the PMN response is barrier‐dependent with the maximum response occuring at different times. However, the host response did not measureably affect the course of clinical healing.
Generalized cervical root resorption associated with periodontal disease
Authors: Beertsen Wouter , Piscaer Mahé , Van Winkelhoff Arie Jan , Everts Vincent
Published: August 2010

Background and description of case:The etiology and pathogenesis of generalized cervical root resorptions is not well understood. In the present report, a case of severe cervical root resorption involving 24 anterior and posterior teeth is presented. The lesions developed within a period of 2 years after the patient had changed to an acid‐enriched diet. They extended far into the coronal dentin and were associated with gingival inflammation and crestal bone resorption. However, no generalized clinical attachment loss had occurred. Culturing of subgingival plaque revealed the presence of several putative periodontal pathogens among whichActinobacillus actinomycetemcomitansandPorphyromonas gingivalis.Treatment consisted of mechanical debridement supported by systemic antibiotics (amoxycillin plus metronidazole) and dietary advice.

Results:Within 1 year after the onset of treatment, all resorptive lesions had repaired by ingrowth of a radio‐opaque mineralized tissue. The crestal areas showed radiological evidence of bone repair. 3 years after the onset of therapy, one premolar was extracted and examined histologically. It appeared that irregularly‐shaped masses of woven bone‐like tissue had invaded into the domain of the resorbed coronal dentin and were bordered by thin layers of acellular cementum.

Conclusion:It is concluded that, in this patient, the cervical resorptions were likely the result of an osteoclastic response extending into the roots because the root‐protective role of the junctional epithelium did not develop. We hypothesize that this was due to the combined effects of a periodontopathogenic microflora and a dietary confounding factor.
Effect of an enamel matrix protein derivative (Emdogain®) on ex vivo dental plaque vitality
Authors: Sculean Anton , Auschill Thorsten M. , Donos Nikolaos , Brecx Michel , Arweiler Nicole B.
Published: August 2010

Background: A common clinical observation following surgical periodontal therapy with an enamel matrix derivative (Emdogain®) is the improved healing of the soft tissues and the limited inflammation of the operated areas. These clinical observations are empirical and difficult to explain. One of the factors influencing the early wound healing might be a potential antimicrobial effect of Emdogain®.

Aim: To investigate the effect of Emdogain® on the vitality of ex vivo supragingival dental plaque and to compare this effect to that of a standard 0.2% chlorhexidine solution.

Materials and Methods: 24 patients suffering from adult periodontitis were included in the study. At the beginning of the experiment, all participants were given a professional tooth cleaning. For the following 4 days, they had to refrain from any kind of oral hygiene measures. At day 5, from each of the volunteers, a voluminous plaque biofilm sample was taken with a sterile curette from the vestibular surfaces of the 1st lower molars and divided into 5 equal parts. Each part was mounted with 5 μl of the following solutions: (1) NaCl, (2) enamel matrix derivative dissolved in water (EMD), (3) enamel matrix derivative dissolved in the vehicle (Emdogain®), (4) vehicle (propylene glycol alginate, PGA), (5) 0.2% chlorhexidine digluconate (CHX). After a reaction time of 2 min the test solutions were sucked off, and subsequently the biofilm was stained with a fluorescence dye. The vitality of the plaque flora after the treatments was evaluated under the fluorescence microscope (VF%).

Results: Plaque samples treated with NaCl showed a mean vitality of 76.8±8%. The EMD, Emdogain®, PGA and CHX showed VF values of 54.4±9.2, 21.4±10.6%, 19.6±11.6% and 32.3±11.8%, respectively. Emdogain®, PGA and CHX showed statistically highly significant reductions (p<0.0001) in terms of bacteria vitality when compared to water (negative control) and EMD. Both Emdogain® and PGA were found to be statistically significantly different compared to CHX (p<0.001) (positive control).

Conclusion: The results of this study indicate that Emdogain® might have an antibacterial effect on the vitality of the ex vivo supragingival dental plaque flora.
Clinical crown height (length) – a review of published measurements
Authors: Volchansky Alfred , Cleaton‐Jones Peter
Published: August 2010

Background, aims: Clinical crown height is an objective measure of the position of the gingival margin which could be used in determining the ‘normal’ position of the gingival margin. The aim of this study was to do a systematic review of published clinical crown heights in the human permanent dentition to compare the measurements and to see if a clear trend with age exists.

Material and Methods: An on‐line literature search was done using the key words clinical crown height (or) clinical crown length. From January 1975 to August 2000, 11 published papers have listed measurements; three of these report on all tooth types, the remainder on anterior teeth.

Results: All studies used the same measuring technique but age group reporting differed as did the tooth types measured. Measurements from the 10 acceptable studies of the clinical crown height of the same teeth are comparable at similar ages, so published values are reasonable estimates of ‘normality’ for diagnosis. There is a statistically significant increase in clinical crown height of central and lateral incisors with age that slows as age increases.
Survival analysis for degree of compliance with supportive periodontal therapy
Authors: Ojima M. , Hanioka T. , Shizukuishi S.
Published: August 2010

Background, aims: The purpose of this investigation was to evaluate the degree of compliance for supportive periodontal therapy (SPT) and to determine factors in relation to patients who failed to continue SPT programs.

Method: A sample of 1896 patients who were treated between 1988 and 1999 was studied. The patients were classified by gender, age group and the distance between their house and the hospital. The number of visits was counted based on an electronic patient record for SPT. Data were analyzed by survival analysis. Survival probabilities in SPT were estimated by the Kaplan‐Meier method and compared by the generalized Wilcoxon test.

Results: 28% of patients did not comply with the first visit for SPT. The older patients had higher tendencies to continue the SPT program than the younger patients. No significant differences in compliance were found between males and females or between short‐distance and long‐distance groups. However, when these factors were adjusted by age, significantly different patterns were shown on the curves of survival probability: in males, significant differences were found between the 20 s and 30 s (p<0.00001) and between the 50 s and 60 s (p<0.01). In females, significant differences were found between the 40 s and 50 s (p<0.001) and between the 60 s and 70 s (p<0.001). The differences of the survival probability by age group were greater in the short‐distance group than in the long‐distance group.

Conclusions: The results suggest that age is the most important factor for compliance of the patients with SPT, not only alone but also in relation to the other factors.
Effect of different chlorhexidine formulations in mouthrinses on de novo plaque formation
Authors: Quirynen Marc , Avontroodt Pieter , Peeters Wouter , Pauwels Martine , Coucke Wim , Van Steenberghe Daniel
Published: August 2010

Background: Chlorhexidine (CHX) 0.2% solution, still the golden standard as mouthrinse for the prevention of plaque formation and development of gingivitis, has some limited side‐effects such as extrinsic tooth staining, poor taste, taste disturbance, sensitivity changes in tongue, pain, and the content of alcohol. These side effects led to the search of new formulations.

Methods: In this double‐blind, randomised, cross‐over study, 16 young dental students with a healthy periodontium, abolished all means of mechanical plaque control during 4 experimental periods of 11 days (separated from each other by a washout period of 3 weeks). During each experimental period, they rinsed 2× daily with one of the following mouthrinses in a randomised order: CHX 0.2% + alcohol (Corsodyl®), CHX 0.12% + alcohol (Perio.Aid®), CHX 0.12% + sodium fluoride 0.05% (Cariax Gingival®) and CHX 0.12% + CPC 0.05% (Perio.Aid®, new formulation). After 7 and 11 days of undisturbed plaque formation, clinical parameters were recorded, questionnaires completed and plaque samples (supragingivally and saliva) collected.

Results: The CHX 0.12% + alcohol and the CHX 0.12% + CPC 0.05% formulations were as efficient as the CHX 0.2% mouthrinse in retarding de novo plaque formation (proven by clinical observations as well as by anaerobic and aerobic culture data), and always superior (p<0.001) to the CHX 0.12% + sodium fluoride 0.05% solution. The subjective ratings were in favour of the new CHX formulation when compared with the other CHX formulations, especially for taste (p<0.05).

Conclusions: The results of this study demonstrated the potential of a new CHX 0.12% + CPC 0.05% non‐alcoholic formulation as an effective anti‐plaque and anti‐inflammatory agent with reduced unpleasant subjective side‐effects.
A longitudinal study of interleukin‐1 gene polymorphisms and periodontal disease in a general adult population
Authors: Cullinan Mary P. , Westerman Bill , Hamlet Stephen M. , Palmer Janet E. , Faddy Malcolm J. , Lang Niklaus P. , Seymour Gregory J.
Published: August 2010

Background: Cross‐sectional studies have demonstrated that a specific polymorphism (allele 2 of both IL‐1A +4845 and IL‐1B +3954) in the IL‐1 gene cluster has been associated with an increased susceptibility to severe periodontal disease and to an increased bleeding tendency during periodontal maintenance. The aim of the present study was to investigate the relationship between IL‐1 genotype and periodontitis in a prospective longitudinal study in an adult population of essentially European heritage.

Methods: From an ongoing study of the Oral Care Research Programme of The University of Queensland, 295 subjects consented to genotyping for IL‐1 allele 2 polymorphisms. Probing depths and relative attachment levels were recorded at baseline, 6, 12, 24, 36, 48 and 60 months using the Florida probe. Periodontitis progression at a given site was defined as attachment loss 2 mm at any observation period during the 5 years of the study and the extent of disease progression determined by the number of sites showing attachment loss. Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Prevotella intermedia were detected using ELISA.

Results: 38.9% of the subjects were positive for the composite IL‐1 genotype. A relationship between the IL‐1 positive genotype and increased mean probing pocket depth in non‐smokers greater than 50 years of age was found. Further, IL‐1 genotype positive smokers and genotype positive subjects with P. gingivalis in their plaque had an increase in the number of probing depths 3.5 mm. There was a consistent trend for IL‐1 genotype positive subjects to experience attachment loss when compared with IL‐1 genotype negative subjects.

Conclusion: The results of this study have shown an interaction of the IL‐1 positive genotype with age, smoking and P. gingivalis which suggests that IL‐1 genotype is a contributory but non‐essential risk factor for periodontal disease progression in this population.
The quantification of dental plaque using an image analysis system: reliability and validation
Authors: Smith R. N. , Brook A. H. , Elcock C.
Published: August 2010

Aim: Established clinical indices used to measure dental plaque have limitations. The aim of this study was to develop and evaluate a new method of quantitative plaque measurement, with increased sensitivity and reproducibility, using a purpose designed image analysis system.

Method: After plaque disclosure, the patient was positioned in a cephalometric head holder mounted in a custom‐built frame with standard lighting and camera position. A 32‐bit Digital Camera grabbed the image of the patient’s teeth, which was analysed using Adobe Photoshop (V5.02, Adobe Systems Ltd, Europe) and Image Pro Plus software (V4.0, Media Cybernetics, USA). Measurements were made on 120 incisors in 15 patients and reproducibility was assessed using Fliess’ Coefficient of Reliability. Sensitivity was assessed by comparison of results of treatment effects from a clinical trial involving 30 patients. Analysis of covariance was used to compare the image analysis system with the Turesky modification of the Quigley and Hein plaque index and the Addy plaque area index.

Results: The results were within the ‘Excellent Reliability’ category, for inter‐operator reproducibility and intra‐operator repeatability.

Conclusions: This new system provided accurate quantitative measurements of dental plaque and labial tooth surfaces and was shown to have increased sensitivity when compared with the Turesky modification of the Quigley and Hein plaque index and the Addy plaque area index. The stored images can be re‐measured for reliability and comparability between studies.
Distribution of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in an Australian population
Authors: Hamlet S. M. , Cullinan M. P. , Westerman B. , Lindeman M. , Bird P. S. , Palmer J. , Seymour G. J.
Published: August 2010

Background, aim: The present study describes (i) the natural distribution of the three putative periodontopathogens Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans in an Australian population and (ii) the relationship between these organisms, pocket depths and supragingival plaque scores.

Methods: Subgingival plaque was collected from the shallowest and deepest probing site in each sextant of the dentition. In total, 6030 subgingival plaque samples were collected from 504 subjects. An ELISA utilising pathogen‐specific monoclonal antibodies was used to quantitate bacterial numbers.

Results:: A. actinomycetemcomitans was the most frequently detected organism (22.8% of subjects) followed by P. gingivalis and P. intermedia (14.7% and 9.5% of subjects respectively). The majority of infected subjects (83%) were colonised by a single species of organism. A. actinomycetemcomitans presence was over‐represented in the youngest age group but under‐represented in the older age groups. Conversely, P. gingivalis and P. intermedia presence was under‐represented in the youngest age group but over‐represented in the older age groups. Differing trends in the distribution of these bacteria were observed between subjects depending upon the site of the infection or whether a single or mixed infection was present; however, these differences did not reach significance. Bacterial presence was strongly associated with pocket depth for both A. actinomycetemcomitans and P. gingivalis. For A. actinomycetemcomitans, the odds of a site containing this bacterium decrease with deeper pockets. In contrast, for P. gingivalis the odds of a site being positive are almost six times greater for pockets >3 mm than for pockets 3 mm. These odds increase further to 15.3 for pockets deeper than 5 mm. The odds of a site being P. intermedia positive were marginally greater (1.16) for pockets deeper than 3 mm.

Conclusions: This cross‐sectional study in a volunteer Australian population, demonstrated recognised periodontal pathogens occur as part of the flora of the subgingival plaque. Prospective longitudinal studies are needed to examine the positive relationship between pocket depth and pathogen presence with periodontal disease initiation and/or progression.
Quantitative analysis of MRP‐8 in gingival crevicular fluid in periodontal health and disease using microbore HPLC
Authors: Lundy Fionnuala T. , Chalk Rod , Lamey Philip‐John , Shaw Christopher , Linden Gerard J.
Published: August 2010

Background: The protein components of GCF can be separated by reverse‐phase microbore HPLC on a C18 column with detection on the basis of 214 nm absorbance. A single major symmetrical protein peak eluting with a retention time of 26 min (50% acetonitrile) was evident in gingival crevicular fluid (GCF) from periodontitis patients but not in healthy GCF. This protein was identified as human MRP‐8 by N‐terminal amino acid sequencing and liquid chromotography quadropole mass spectrometry.

Aims: To quantify the amount of MRP‐8 detectable in GCF from individual healthy, gingivitis and periodontitis affected sites and to study the relationship, if any, between the levels of this responsive protein and periodontal health and disease.

Methods: GCF was sampled (30 s) from healthy, gingivitis, and periodontitis sites in peridontitis subjects (n=15) and from controls (n=5) with clinically healthy gingiva and no periodontitis. Purified MRP‐8 was sequenced by Edmann degradation and the phenylthiohydantoin (PTH) amino acid yield determined (by comparison of peak area with external PTH amino acid standards). This value was subsequently used to calculate the relative amount of protein in the peak eluting with a retention time of 26.0 min (MRP‐8) in individual GCF chromatograms.

Results: Higher levels of MRP‐8 were detected in inflammatory sites: periodontitis 457.0 (281.0) ng; gingivitis 413.5 (394.5) ng compared with periodontally healthy sites in diseased subjects 14.6 (14.3) ng and in controls 18.6 (18.5) ng, p=0.003. There was at least 20‐fold more MRP‐8 in the inflammatory compared with the healthy sites studied.

Conclusions: The preliminary data indicate that MRP‐8 is present in GCF, with significantly greater amounts present at diseased than healthy sites. A systematic study of the relationship of this protein to periodontal disease could prove useful in further clarifying whether MRP‐8 could be a reliable GCF biomarker of gingivitis and periodontitis.
Correlation between early perforation of cover screws and marginal bone loss: a retrospective study
Authors: Van Assche Nele , Collaert Bruno , Coucke Wim , Quirynen Marc
Published: August 2010

Aim: This retrospective study aimed to determine the consequence of early cover screw exposure on peri‐implant marginal bone level.

Material and Methods: Sixty Astra Tech® MicroThread implants installed in partially edentulous jaws were compared: 20 implants were placed following a two‐stage procedure and were unintentionally exposed to the oral cavity (two‐stage exposed), 20 implants were placed following a two‐stage procedure and were surgically exposed after a subgingival healing time of 3–6 months (two‐stage submerged), and 20 implants were placed following a one‐stage surgical protocol (one‐stage). Digital radiographs were taken at implant placement for all implants, and after abutment surgery for the two‐stage exposed and two‐stage submerged groups or after 3 months for the one‐stage group. Bone loss mesially and distally was measured with an on‐screen cursor after calibration.

Results: Mean bone re‐modelling was 1.96 mm (range: 0.2–3.2 mm) around the two‐stage exposed implants, 0.01 mm (range: 0.0–0.3 mm) around the two‐stage submerged implants and 0.14 mm (range: 0.0–1.2 mm) around the one‐stage implants.

Conclusion: The unintentional perforation of two‐stage implants resulted in significant bone destruction, probably because the biological width was not considered.
Two‐year clinical results following treatment of peri‐implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane
Authors: Schwarz Frank , Sculean Anton , Bieling Katrin , Ferrari Daniel , Rothamel Daniel , Becker Jürgen
Published: August 2010

Objectives: The aim of the present case series was to evaluate the 2‐year results obtained following treatment of peri‐implantitis lesions using either a nanocrystalline hydroxyapatite (NHA) or a natural bone mineral in combination with a collagen membrane (NBM+CM).

Material and Methods: Twenty‐two patients suffering from moderate peri‐implantitis (n=22 intra‐bony defects) were randomly treated with (i) access flap surgery (AFS) and the application of NHA, or with AFS and the application of NBM+CM. Clinical parameters were recorded at baseline and after 12, 18, and 24 months of non‐submerged healing.

Results: Two patients from the NHA group were excluded from the study due to severe pus formation at 12 months. At 24 months, both groups revealed clinically important probing depth (PD) reductions (NHA: 1.5±0.6 mm; NBM+CM: 2.4±0.8 mm) and clinical attachment level (CAL) gains (NHA: 1.0±0.4 mm; NBM+CM: 2.0±0.8 mm). However, these clinical improvements seemed to be better in the NBM+CM group (difference between groups: PD reduction: 0.9±0.2 mm; CAL gain: 1.0±0.3 mm).

Conclusion: Both treatment procedures have shown efficacy over a period of 24 months, however, the application of NBM+CM may result in an improved outcome of healing.
Penetration depths with an ultrasonic mini insert compared with a conventional curette in patients with periodontitis and in periodontal maintenance
Authors: Barendregt Dick S. , Van Der Velden Ubele , Timmerman Mark F. , Van Der Weijden Fridus
Published: August 2010

Aim: The aim of the study was to test whether a slim Ultrasonic Tip reaches a more apical position when penetrating a periodontal pocket compared with the working blade of a conventional Gracey Curette in both untreated periodontitis and periodontal maintenance patients.

Material and Methods: Twenty untreated and 15 periodontal maintenance patients were selected based on the presence of at least one site a pocket of 5 mm in each quadrant. Recordings were made at the four approximal sites of four experimental teeth in each patient. First, the probing pocket depth was measured with the Jonker Probe®. Second in randomized order, the penetration depth was assessed with an EMS PS Ultrasonic Tip and a Gracey Curette.

Results: In the periodontitis group, the Ultrasonic Tip penetrated significantly deeper than the Jonker Probe and the Gracey Curette. In the maintenance group, no differences were observed. Comparing the penetration of the instruments between groups, as related to the Jonker Probe measurements, only in the periodontitis group did the Ultrasonic Tip reach a significantly more apical level.

Conclusion: The results of the present study show that in untreated periodontitis patients, the Ultrasonic Tip penetrated the pocket deeper than the pressure‐controlled probe and the Gracey Curette.
Subgingival microbial profiles in chronic periodontitis patients from Chile, Colombia and Spain
Authors: Herrera David , Contreras Adolfo , Gamonal Jorge , Oteo Alfonso , Jaramillo Adriana , Silva Nora , Sanz Mariano , Botero Javier Enrique , León Rubén
Published: August 2010

Aim: To investigate the subgingival microbiota of distinct periodontitis patient populations, in Chile, Colombia and Spain, using identical clinical and bacteriological methods.

Material and Methods: In this multicentre study, 114 chronic periodontitis patients were selected. Patients were examined using an identical clinical protocol and pooled subgingival samples were obtained from each patient. Samples were processed in the three laboratories by means of culturing under identical clinical and microbiological protocols. Total anaerobic counts and frequency of detection and proportions of nine periodontal pathogens were calculated. Variables were analysed by means of anova, χ2, Kruskal–Wallis and Dunn's multiple comparison tests.

Results: The Colombian population demonstrated greater severity of periodontitis, with significantly deeper mean probing pocket depth, and had a significantly lower percentage of current smokers. When comparing samples from the three patient populations, the total counts were significantly higher in the Colombian patients. The numbers of putative pathogens differed among groups. Tannerella forsythia was found less frequently in Chilean samples, while Parvimonas micra and enteric rods differed significantly among the three population groups.

Conclusion: Significant differences among Chile, Colombia and Spain existed regarding the frequency and proportions of specific periodontal pathogens in the subgingival microbiota of periodontitis patients.
Self‐reported gingivitis and tooth loss poorly predict C‐reactive protein levels: a study among Finnish young adults
Authors: Ylöstalo Pekka V. , Järvelin Marjo‐Riitta , Laitinen Jaana , Knuuttila Matti L. E.
Published: August 2010

Objectives: Our aim in this cross‐sectional study was to investigate whether self‐reported gingivitis and tooth loss were associated with elevated levels of C‐reactive protein (CRP) using the same study population where these dental conditions have earlier been associated with prevalent angina pectoris.

Material and Methods: The study population consisted of those Northern Finland birth cohort 1966 members who lived in Northern Finland or in the Helsinki region (n=8463) at the time of the survey (1996–1997). The participation rate in a health examination was 71% (n=6033). Gingivitis and tooth loss were determined on the basis of self‐reported questions. Prevalence proportion ratios (PPR) and 95% confidence intervals (CI) were estimated using multivariate regression models.

Results: The results showed that self‐reported gingivitis and tooth loss were weakly associated with elevated levels of CRP (>3 mg/l): adjusted PPR 1.1, CI 1.0–1.3 and PPR 1.1, CI 0.7–1.7, respectively. The proportion of variation in CRP explained by self‐reported gingivitis and tooth loss was small, being <1%.

Conclusion: The results suggest that self‐reported gingivitis and tooth loss have a miniscule effect on CRP levels among a general population of young adults.
Fibre retention osseous resective surgery: how deep is the infrabony component of the osseous‐resected defects?
Authors: Carnevale Gianfranco , Cairo Francesco , Nieri Michele , Tonetti Maurizio S.
Published: August 2010

Background: The Aims of this retrospective study were: (i) to describe the applicability of Fibre Retention Osseous Resective Surgery (FibReORS) to infrabony defects with different radiographic depths and (ii) to identify significant anatomical elements associated with the decision of tooth extraction or application of FibReORS in the context of a treatment approach aimed at pocket elimination.

Material and Methods: Baseline radiographs with detectable infrabony defects were collected from 68 periodontal patients. Selected teeth with radiographic evidence of infrabony defects had probing depths (PD) >4 mm at revaluation following non‐surgical periodontal therapy. Teeth were then surgically treated with FibReORS or extracted on the basis of the decision making of an experienced periodontist and in the context of the overall treatment plan. The total root length and the defect depth were quantified for each selected tooth using radiographic reference points.

Results: A total of 324 teeth with infrabony defects were identified. Fifty‐three (16%) teeth with a mean radiographic infrabony defect of 8.5±1.7 mm (range 6–12 mm) were extracted; 271 (84%) teeth with a mean infrabony defect of 3.0±1.4 mm (1–8 mm) were surgically treated, achieving PD 3 mm in all sites at 6‐month follow‐up. Surgically treated teeth showed baseline radiographic infrabony defects 4 mm in 86% of the cases. Logistic multilevel modelling indicated that the probability of extraction was influenced by root length (p=0.0230) and by the radiographic defect depth (p=0.0112).

Conclusion: FibReORS is applicable in the treatment of shallow to moderate bony defects and deeper defects associated with longer roots.
Tooth loss after active periodontal therapy. 2: tooth‐related factors
Authors: Pretzl Bernadette , Kaltschmitt Jens , Kim Ti‐Sun , Reitmeir Peter , Eickholz Peter
Published: August 2010

Objective: To assess tooth‐related factors contributing to tooth loss over a period of 10 years after completion of active periodontal therapy (APT).

Material and Methods: All patients who had received APT by the same experienced periodontist, 10 years before beginning the research, were recruited until 100 patients were re‐examined. Examinations included, at the patient level: test for interleukin‐1 polymorphism, compliance to supportive periodontal therapy (SPT), mean plaque scores during SPT; at the tooth level: assessment of baseline bone loss (type, amount), tooth type, furcation status and abutment status. Logistic multilevel regression was performed for statistical analysis.

Results: Hundred patients with 2301 teeth at the baseline (completion of APT) were retrospectively examined. One hundred fifty‐five teeth were lost over 10 years after APT. Logistic multilevel regression identified high plaque scores, irregular attendance of SPT and age as patient‐related factors significantly accounting for tooth loss. Tooth‐related factors significantly contributing to tooth loss were baseline bone loss, furcation involvement and use as an abutment tooth. However, in patients with regular SPT, 93% of teeth with 60–80% bone loss at the baseline, survived 10 years.

Conclusion: The following tooth‐related risk factors for tooth loss were identified: baseline bone loss, furcation involvement, and use as an abutment tooth.
A lack of significantly increased incidence of regression in second primary melanomas does not support an ‘immunization effect’
Authors: Zoller Lilach , Mayer Elisa , Itzhak Ofer Ben , Bergman Reuven
Published: August 2010

Objective: To compare the incidence of regression in first and second primary melanomas as a possible indication of an ‘immunization effect'.

Methods: The first and second primary melanomas of 18 patients were studied histopathologically for signs of regression. At least 1 month elapsed between the removal of the two primary lesions.

Results: Histopathological evidence of regression was found in 7 of the 18 (38.8%) first melanomas and in 8 of the 18 (44.4%) second melanomas [p = non‐significant (N.S.)]. Among the nine patients in whom the removal of the second primary melanoma was >6 months after the removal of the first primary melanoma, one (11%) first melanoma and three (33%) second melanomas showed regression, respectively, but this difference did not reach statistical significance. Among the nine patients in whom the removal of the second primary melanoma was ≤6 months after the removal of the first primary melanoma, six (67%) first melanoma and five (56%) second melanomas showed regression (p = N.S.).

Conclusions: Our study does not provide evidence for a statistically significant increased rate of regression in second primary melanomas compared to the first primary melanomas, but larger groups of studied cases may be needed.

Bergman R, Zoller L, Mayer E, Itzhak OB. A lack of significantly increased incidence of regression in second primary melanomas does not support an ‘immunization effect’.
The endangered Attwater's prairie chicken and an analysis of prairie grouse helminthic endoparasitism
Authors: Peterson Markus J.
Published: August 2010

Although managers have speculated that parasitism might have contributed to the endangerment of the Attwater's prairie chicken Tympanuchus cupido attwateri, no data are available to evaluate this hypothesis Because time is constraining, I attempted to determine whether Attwater's praine chicken are likely to harbor helminthic endoparasites known to cause disease m other grouse so that a more informed decision regarding whether to commit time and other resources to field studies and expenmental trials can be made Using polar ordination, I found a gradient among 10 surveys of helminthic endoparasites of praine grouse collected from several midcontinental ecoregions of the USA (1931–1977) A regression model including variables representing 1) normal annual precipitation and 2) normal winter (Dec–Feb) temperature and the proportion of normal annual precipitation received during the winter could account for this gradient When meteorological data from areas inhabited by the remaining 3 Attwater's praine chicken populations were incorporated, the models predicted that Attwater's praine chicken might be expected to harbor helminthic endoparasite communities similar to those of greater praine chicken T c pinnatus populations surveyed in Illhnois, Kansas, and Missoun Two parasite species associated with disease in North Amencan grouse Dispharynx nasuta, Heterakis gallmarum were found during these studies Additionally, Attwater's pratrie chicken might be expected to maintain parasites not found during any of the surveys I evaluated This study suggests that it would be worthwhile to survey free‐living Attwater's pratrie chicken to determine whether individuals harbor helminthic endoparasites shown pathogenic to other grouse species, even if the methodologies employed must be somewhat constrained
A GIS approach to identifying territorial resource competition
Authors: Palmer S. C. F. , Bacon P. J.
Published: August 2010

Computer simulations using a geographical information system were developed to investigate the relationships between the habitat composition of red grouse territories and the alignment of territory boundaries in relation to vegetation patterns. Field data were from a fifteen year study on Kerloch Moor, north‐east Scotland, between 1963 and 1977.

In order to determine whether observed territories were arranged randomly with respect to a number of habitat characteristics, they were compared with many simulated sets of possible territory arrangements by translation of the territory boundaries to a number of different positions relative to the vegetation mosaic. A suite of summary statistics was calculated for the simulated configurations, against which the observed configurations were tested.

There was little evidence for territorial resource competition by red grouse. The positions of territories were not strongly influenced by their composition in terms of vegetation types or heather edge. Neither was there any obvious preference for territory boundaries to lie within particular vegetation types. However, there was clear evidence that physical features of the habitat (fences, walls, tracks, etc.) had a strong influence on the position of territory boundaries.

Temporal and spatial habitat heterogeneity led to a number of technical and analytical problems, and the implications of these are discussed.
Consequences of dispersal for the quantitative study of adaptation in small‐scale plots: a case study of an avian island population
Authors: Lambrechts M. M. , Visser M. E. , Verboven N.
Published: August 2010

Lifetime recruitment of breeding offspring estimated in small‐scale study plots (i.e. local recruitment) is considered to be the best available ecological measure of contributions to following generations, and sufficient for the quantitative study of adaptation in natural populations. Recent investigations suggest that local recruitment of breeding offspring does not always reflect the total recruitment in the whole population, especially in small‐scale plots where the majority of locally‐born offspring leave these plots to breed elsewhere. We examined in an avian island population whether study plot size has an important impact on different population and fitness measures. We defined around a central nestbox seven plots, varying in radius from 100 to 700 m. We show that in the smallest plots, the local replacement rate of adults by breeding offspring is low, the number of locally‐born offspring settling beyond the limits of a plot is high, and relationships between local and total recruitment are weak. This is especially true for daughters as more daughters than sons settle beyond the limits of local plots for breeding. Our interpretation is that the lifetime recruitment of breeding offspring in local plots does not necessarily reflect the lifetime recruitment of breeding offspring in the whole population, especially when plots do not cover the natal dispersal distance. Consequences of dispersal for the quantitative study of adaptation are discussed.