bluuebunny/crossref_metadata_2025 huggingface dataset:
The immediate effects of smoking on gingival fluid flow
Authors: McLaughlin W. S. , Lovat F. M. , Macgregor I. D. M. , Kelly P. J.
Published: December 2005

Abstract The aim of the present study was to examine the immediate effect of smoking a cigarette on gingival crevice fluid (GCF) flow‐rate. The study involved 17 healthy volunteers (6 male, 11 female) aged 19–57 years (mean 34.5 years) who regularly smoked cigarettes. All were periodontally healthy. GCF was collected at the mesio‐buccal aspects of the right and left maxillary 2nd premolar teeth, using filter‐paper strips left in place for 3 min. Samples were taken at baseline and subsequently at 10 min intervals for 70 min. Each subject sham smoked an unlit standard cigarette for 7 min after the 20 min recording, and smoked the same cigarette for 7 min to within 1 cm of the filter, following the 40 min recording, The results showed that following sham smoking (30 min recording) GCF volume increased by a mean of 16.7% (p=0.057), and following smoking (50 min recording) GCF volume increased by a mean of 89.7%, over the previous recording (p<0.0001). The increase following smoking was greater than that following sham smoking (p<0.0001). Flow‐rate returned to near resting levels within the experimental period. The results indicate that smoking produces a marked transient increase in GCF flow‐rate, which might reflect changes in blood flow known to be produced by nicotine.
Evaluation of the efficacy of interdental cleaning devices How to design a clinical study
Authors: Kleisner Jaroslav , Imfeld Thomas
Published: December 2005

Abstract A review of the literature was made, focusing on experimental designs used in clinical studies for assessment of the efficacy of interdental cleaning aids with regard to plaque removal and the prevention of caries and gingivitis. After careful consideration of the pros and cons of published procedures, an experimental design for such studies is proposed.
The potential use of CO2‐laser ginagivectomy for phenytoin‐induced gingival hyperplasia in mentally retarded patients
Authors: Roed‐Petersen Bjarne
Published: December 2005

Abstract Patients with hyperplastic states of the gingiva, i.e., phenytoin hyperplasia, nifedipine hyperplasia. cyclosporin hyperplasia, gingival fibromatosis and others may be treated by laser gingivectomy as no bone surgery is involved in these cases. Patients who are mentally retarded may represent special care problems postoperatively after conventional surgical gingivectomy i.e., unintentional removal of surgical dressing, postoperative bleeding etc. Therefore, the potential use of CO2‐laser gingivectomy for mentally retarded persons was evaluated in a prospective study comprising 15 patients with fenytoin hyperplasia of the gingiva. No intra‐ or postoperative bleeding occurred and no surgical dressing was applied. The majority of the patients did not need any analgesics postoperatively. Healing was uncomplicated and the time needed for healing was of the same order of magnitude as after surgical gingivectomy.
Epidemiology and transmission of Porphymmonas gingivalis and Actinobacillus actinomycetemcomitans among children and their family members
Authors: Petit M.D. A. , van Steenbergen T. J. M. , Scholte L. M. H. , van der Velden U. , de Graaff J.
Published: December 2005

Abstract The distribution and transmission of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in 4 families were studied. The families were included, based on the isolation of P. gingivalis from a young child or adolescent. The probands of these 4 families were: a 5‐year old periodontally healthy boy; a 17‐year old girl with severe generalized juvenile periodontitis; an 11‐year old girl with prepubertal periodontitis; 2 sisters, 5 and 17‐years old, with untreated severe periodontitis as a component of the Papillon‐Lefèvre syndrome. All members of the 4 families were examined clinically and microbiologically for the presence of P. gingivalis and A. actinomycetemcomitans. Most of the parents appeared to be adult periodontitis patients; the parents of one proband were edentulous. Results showed that in all cases at least one of the parents was positive for P. gingivalis. On the basis of indistinguishable restriction endonuclease patterns (REPs) of P. gingivalis and A. actinomycetemcomitans isolates from parents and their children, and distinct REPs from unrelated individuals, the present study indicates that P. gingivalis and A. actinomycetemcomitans were transmitted between parents and their children.
Marginal bone loss in the primary dentition of patients with juvenile periodontitis
Authors: Sjodin Bengt , Matsson Lars , Unell Lennart , Egelberg Jan
Published: December 2005

Abstract 118 patients with juvenile periodontitis (JP), diagnosed when the patients were 13–19 years old, were studied retrospectively with respect to radio‐graphic marginal bone loss in the primary dentition, experienced when the patients were 5–12 years old. 168 other 13–19 year old patients without any signs of bone Joss in the permanent teeth were used as a reference group. The JP patients were classified into 2 groups according to the number of sites with bone loss in the permanent dentition: JP group I having 1 site with bone loss (n=45) and JP group II having 2 sites with bone loss (n=73). It was found that 35 patients (52%) of JP group II displayed 1 or more sites with bone loss in the primary dentition during the age of 5–12 years. The corresponding numbers for JP group I and the reference group were 9 (20%) and 8 (5%) respectively. These findings indicate that juvenile periodontitis, at least in some individuals, may have its onset already in the primary dentition.
The effect of a mouthrinse containing chlorhexidine and fluoride on plaque and gingival bleeding
Authors: Joyston‐Bechal S. , Hernaman N.
Published: December 2005

Abstract The aim of this study was to test the effect of a rinse with 0.05% sodium fluoride and 0.05% chlorhexidine on plaque and gingival inflammation compared with a placebo without these agents. In a double‐blind study, 47 adults with >20 teeth and a CPITN score >1 but <4 were randomised into test and control groups. After baseline assessments for plaque, bleeding and stain, teeth were professionally cleaned. Subjects were asked to rinse for 30 s with 10 ml of the respective test or placebo rinse after normal oral hygiene for 8 weeks. 39 subjects completed the study. There was no significant difference in the 2 groups at baseline with respect to cither plaque or bleeding scores. After scaling and 8 weeks use of the test rinse, there were significant reductions (p <0.001) in both plaque and bleeding. The control group showed no significant reduction in plaque scores after 8 weeks, but a significant (p <0.05) reduction in bleeding. However, this reduction was significantly greater (p <0.001) in the test group than in the control. The test group had a significantly greater (p <0.05) stain score than the control at baseline. After scaling and rinsing for 8 weeks, stain scores were lower for both groups compared to baseline but reached significance (p <0.05) only for the control group. It is concluded that, as an adjunct to normal oral hygiene, the chlorhexidine/fluoride rinse had a significant inhibitory effect on plaque and bleeding but its effect on staining is uncertain.
Multiple forms of gelatinases/type IV collagenases in saliva and gingival crevicular fluid of periodontitis patients
Authors: Ingman Tuula , Sorsa Time , Lindy Otso , Koski Hannele , Konttinen Yrjö T.
Published: December 2005

Abstract The aim of the present study was to characterize the eventual presence and molecular forms of gelatinase/type IV collagenase activities in gingival crevicular fluid (GCF) and saliva in different forms of periodontitis: patients with clinically healthy periodontiura served as controls. Enzyme activities were monitored electrophoretically by zymography using gelatin and type IV collagen as substrates and analyzed visually and/or densitometrically. Both saliva and GCF collected from adult periodontitis, localized juvenile periodontitis and type II diabetes mellitus periodontitis patients contained species moving identically with gelatinase isolated from human neutrophils or MMP‐9 (mean 98 kD), and species with mobility similar to gelatinase in fibroblast cell culture supernatants or MMP‐2 (mean 76 kD). Hitherto, undescribed high molecular weight forms (mean 128 kD), were found, possibly representing polymerized or complexed enzyme active/activated in situ in the gel matrix. Small molecular forms of gelatinases (mean 51 kD and 46 kD), unable to cleave type IV collagen, were also found, most likely representing in vivo proteolytically activated, truncated enzymes. Although multiple forms of gelatinases/type IV collagenases in saliva and GCF may take part in the tissue destruction in periodontitis, their profile judged according to molecular weights does not differentiate between different forms of periodontitis.
Studies on the relationship between changes in radiographic bone height and probing attachment
Authors: Hausmann E. , Allen K. , Norderyd J. , Ren W. , Shibly O. , Machtei E.
Published: December 2005

Abstract The aim of this investigation was to determine the relationship between loss of radiographic crestal bone height and probing attachment loss. As part of this aim, we are introducing a new method for determination of a threshold for significant probing attachment loss which takes into account the error contributed by alteration in tissue tone. 57 adults with established periodontitis were selected. Radiographs were taken using the Rinn alignment system. Crestal change was determined from bone height measurements on digitized images of pairs of radiographs using the “side‐by‐side” technique of analysis developed recently by us. Probing attachment loss was measured using the Florida electronic probe system. Radiographic and probing measurements were made at baseline and after 1 year. No treatment was given during this period. A direct and significant relationship was observed between radiographic bone loss and probing attachment loss on a site basis (p= 0.0001, r2= 0.018) and between subject means (p= 0.0014, r2= 0.16). Radiographic and probing attachment change at all categories of sites, dichotomously classified as to not changing or loosing indicated 13% of sites were loosing by measurement of radiographic change and 9.6% were Loosing by measurement of attachment change. Concordance in radiographic and attachment level change was found in 82% of sites examined. The relative diagnostic import of change in probing attachment or change in radiographic bone height requires treatment outcome studies based on use of diagnostic information of the 2 measuring techniques used singly and in combination.
Ex vivo studies of polymorphonuclear neutrophils from patients with early‐onset forms of periodontitis (I).
Authors: Mouynet P. , Delamaire M. , le Goff M. C. , Kerbaol M. , Yardin M. , Michel J. F.
Published: December 2005

Abstract The polymorphonuclear neutrophil (PMN) appears lo be an important cell in the protection of the host from pathogenic periodontal microorganisms and, despite some reports to the contrary, it is generally assumed that early‐onset forms of periodontal disease including both juvenile and rapidly progressing periodontitis are associated with a defect in PMN chemotactic behaviour. The purpose of the present study was to examine the peripheral PMN chemotactic behaviour, using the under agarose method, in 4 groups, namely healthy periodontium group (n= 7), gingivitis group (n= 8), early‐onset periodontitis group (n= 17) and adult periodontitis group (n= 8). PMN from early‐onset periodontitis patients showed normal random and chemotactic locomotory behaviour when compared with those of PMN from subjects of the other groups. No statistically significant difference could be found among the 4 studied groups, with regard to spontaneous and oriented migration.
Host enzymes in gingival crevicular fluid as diagnostic indicators of periodontitis
Authors: McCulloch C. A. G.
Published: December 2005

Abstract Host responses to periodontal infections include the production of several families of enzymes that are released by stromal, epithelial or inflammatory cells. Study of these enzymes in gingival crevicular fluid may lead to insights into pathogenesis and may provide a rational basis for the development of novel diagnostic tests. However, analogous to other diagnostic interventions in dentistry and medicine, validation of host enzymes as diagnostic indicators is dependent on clear‐cut demonstrations of the identity of the enzyme, reproducibility, diagnostic accuracy and clinical utility. The enzyme of interest should be readily measured over a broad range of disease severity and in varied clinical settings. Ideally, the enzyme should also be an essential component of proposed pathogenic mechanisms. In this context, the connective tissue matrix degrading enzymes elastase, collagenase and gelatinase are promising because of their apparently central role in periodontal attachment loss and disease progression. Sensitive and specific assays are also available to quantify these enzymes. Other work on enzymes associated with cell death (aspartate aminotransferase, lactate dehydrogenase) and several neutrophil lysosomal enzymes (beta glucuronidase, arylsulphatase, cathepsins) has demonstrated positive associations between enzyme levels and attachment loss and inflammation. While numerous cross‐sectional studies have indicated that the levels of hydrolytic enzymes in gingival crevicular fluid parallel the severity of periodontal lesions, there are much less data on reproducibility, diagnostic accuracy and clinical utility in longitudinal studies. As appropriate study design is an essential prerequisite for establishing the efficacy of host enzymes as diagnostic tests, future clinical investigations should include: (1) individuals who would most likely benefit by early diagnosis, i.e., rapidly progressive and recurrent periodontitis cases; (2) longitudinal, cohort study designs to show that attachment loss is temporally linked with large increases in enzyme activity; (3) the use of a battery of tests to overcome intrinsic problems of low predictive values when prevalence of active disease is low. In the final analysis, the utility of host enzymes as diagnostic indicators will need to be examined in randomized controlled trials in which the question is asked: are patients better off as a result of testing?
Extraoral root lengthening with titanium screws
Authors: Bühler Hans , Blomlöf Leif , Lindskog Sven
Published: December 2005

Abstract The aim of the present study was to experimentally evaluate marginal and periapical healing in extracted and subsequently replanted teeth following extraoral cementing of apically exposed titanium root screws in the root canal. In 5 out of 6 replanted teeth, the periodontal tissues had healed with a normal periodontal membrane or healed surface resorptions indicating that only minor trauma had been inflicted during the extraoral procedure. In 3 out of 6 teeth, total or partial osseoeintegration of the titanium screws was seen, while a connective tissue capsule had formed around the remaining 3 screws. It was concluded that both of the healing results described in the present study, osseointegration and connective capsule formation, may be regarded as acceptable as long as inflammation is prevented, although it remains to be shown which one represents the end‐point.
Marginal bone loss in the primary dentition
Authors: Sjödin Bengt , Matsson Lars
Published: December 2005

Abstract. The present study was designed to determine the prevalence of bone loss in the primary dentition of children. Radiographs from children aged 7–9 were collected from 25 out of a total of 26 Public Dental Clinics in the County of Örebro, Sweden. These radiographs, representing 36.0%, 50.3% and 48.7% of all 7‐, 8‐ and 9‐year‐old children (n= 8666) living in the districts of the participating clinics, constituted a primary sample. In addition, the 9‐year‐olds were subjected to a more comprehensive sampling procedure to obtain a more complete sample (sample of 9‐year‐olds), resulting in a group of 2017 children (71.9%). The radiographs were evaluated with respect to presence of marginal bone loss (CEJ‐MBL: distance between the cemento‐enamel junction and the marginal bone level >2 mm), proximal calculus and number of decayed and filled proximal surfaces (dfsp) in the posterior areas of the primary dentition. In the primary sample, the prevalence of bone loss for 1 proximal surfaces of the primary dentition in the 7‐, 8‐ and 9‐year‐old children was 2.0%, 3.1% and 4.5%, respectively. The corresponding figures for proximal calculus were 2.5%, 3.1% and 4.2%. Mean number of dfsp amounted to 2.3, 2.5 and 3.0. The prevalences of bone loss and proximal calculus as well as the mean number of dfsp in the sample of 9‐year‐olds corresponded to the findings for the 9‐year‐old children in the primary sample. The analyses of the sample of 9‐year‐olds showed that most of the children with bone loss had 1 affected surface only. The largest CEJ‐MBL distance for each individual with bone loss ranged from 2.5 to 6.0 mm. Children with bone loss displayed calculus more often than children without bone loss. The children with bone loss also showed higher mean dfsp compared to children without bone loss.
The effect of prebrushing mouthrinse solutions on the desorption of albumin from apatite
Authors: Haikel Y. , Voegel J. C. , Meurman J. H.
Published: December 2005

Abstract. This study evaluated the desorption of radiolabelled albumin from synthetic hydroxypatite by 4 commercial prebrushing solutions: Lysoplac (containing chlorhexidine), Plax (sodium benzoate), Acti‐Brush (triclosan), and Sanogyl (sodium fluoride). In 3 min, Lysoplac and Plax were found to desorb about 90% of albumin while Acti‐Brush and Sanogyl failed to desorb hardly any albumin in 15 min. The desorbing effectiveness of the test solutions was not due to their pH, because when buffer solution was being tested in different ionic strengths at pH range 6–8, it appeared to desorb less than 3% of adsorbed albumin, irrespective of the pH used. The results obtained cannot, however, be directly applied to the clinical situation where much more complex interactions occur than what were tested under the present in vitro conditions.
Utility of radiographic crestal lamina dura for predicting periodontitis disease‐activity
Authors: Rams Thomas E. , Listgarten Max A. , Slots Jørgen
Published: December 2005

Abstract. The relationship between radiographic crestal lamina dura and periodontitis disease‐activity was studied longitudinally in 51 treated adult patients on a systematic 3‐month maintenance program. The presence or absence of crestal lamina dura at 1809 interproximal sites was scored from periapical and bitewing radiographs taken at baseline of a 36‐month maintenance care period. Semi‐annual clinical evaluations by 2 independent examiners were carried out on each patient, with disease recurrence defined as sites revealing a 3 mm increase in probing depth from baseline, or a 2 mm increase in probing depth together with a 2 mm loss of relative attachment level from an occlusal stent. Over the 36‐month study period, 23 (45%) patients exhibited disease recurrence at 55 (3%) interproximal tooth sites scored for baseline crestal lamina dura. Absence of detectable baseline crestal lamina dura yielded high sensitivity (87–100%), but low specificity (17%) and low positive predictive values (0.8–3.2%), for localized periodontitis recurrence. In contrast, no sites exhibiting an intact baseline crestal lamina dura demonstrated periodontitis recurrence up to 24 months from baseline (100% positive predictive values). Presence of radiographic crestal lamina dura was positively associated with clinical periodontal stability (summary odds ratio for sites = 2.6, P= 0.0004), and negatively associated with periodontitis recurrence (summary odds ratio for sites = 0.4, P= 0.0004), for the 36‐month study period. Evaluation of radiographic crestal lamina dura status appears valuable for assessing the risk of periodontitis disease‐activity at interproximal tooth sites in patients on maintenance care programs.
Treatment of subjects with refractory periodontal disease
Authors: Magnusson I. , Low S. B. , McArthur W. P. , Marks R. G. , Walker C. B. , Maruniak J. , Taylor M. , Padgett P. , Jung J. , Clark W. B.
Published: December 2005

Abstract. The aim of the present study was to evaluate the effect of non‐surgical periodontal therapy with the adjunct of a selected antibiotic in subjects diagnosed with refractory periodontal disease. 21 subjects were selected for the study; all had a history of periodontal surgery, tetracycline therapy, and regular maintenance by a periodontist. When disease activity was detected, a bacterial sample was taken and a whole plaque susceptibility test was performed. Before the outcome of the susceptibility test the subjects were assigned to either antibiotic or placebo therapy. All subjects received scaling and rootplaning prior to antibiotic or placebo therapy. Based on the susceptibility test, subjects in the antibiotic group were treated either with Augmentin® or clindamycin. The results demonstrated that in subjects with refractory periodontal disease there was no significant difference (N.S.) in the proportion of sites losing attachment before and after treatment (11.3% and 12.4%, respectively) over a 2‐year post therapy observation period. However, the proportion of sites showing gain of attachment increased from 0.9% before therapy to 5.1% (p=0.029) following selective antibiotic therapy when combined with scaling and rootplaning. The remainder of sites showed no change between pre‐ and post‐therapy monitoring periods. The progression of attachment loss in the active sites could not be completely stopped over the entire 2‐year period. After 12–15 months following therapy, there was a tendency towards new loss of attachment and an increase of pocket depth. However, all 4 subjects treated with placebo drug demonstrated continuous deterioration and had to be retreated. Although the proportion of sites losing attachment decreased from 5.1% to 2.3% (N.S.), the proportion of sites gaining attachment also decreased from 2.0% to 1.0% (N.S.). The results suggest that scaling and rootplaning together with selected antibiotic therapy repeated every 12–15 months may be beneficial for these subjects although it may not completely stop progressive attachment loss.
Trypsin‐like activity levels of Treponema denticola and Porphyromonas gingivalis in adults with periodontitis
Authors: Pederson E. D. , Miller J. W. , Matheson S. , Simonson L. G. , Chadwick D. E. , Covill P. J. , Turner D. W. , Lamberts B. L. , Morton H. E.
Published: December 2005

Abstract Treponema denticola (Td) and Porphyromonas gingivalis (Pg) are associated with human moderate and severe adult periodontal diseases. This study Quantifies these two anaerobes and their trypsin‐like (TL) activities in subgingival plaque collected from both clinically healthy and periodontally diseased sites of human periodontitis patients. Antigen levels of the microorganisms were determined by monoclonal antibodies and TL activities were measured by the fluorescent substrate Z‐gly‐gly‐arg‐AFC in a disc format. Significant positive correlations were observed between the antigen levels and the TL activities when the data were subjected to statistical analyses both on a site‐specific and on a patient basis. Anaerobe synergism was found between Td and Pg in a continental US population, and positive correlations were found between anaerobe levels (individually and total) and clinical indicators of adult periodontitis.
A survey of endpoint characteristics in periodontal clinical trials published 1988–1992, and implications for future studies
Authors: Hujoel P. P. , DeRouen T. A.
Published: December 2005

Abstract Endpoints are conditions or events that are associated with individual study subjects and that are used to assess treatment efficacy. 2 types of endpoints can be distinguished: “true” endpoints (reflect unequivocal evidence of tangible benefit to the patient) and “surrogate” endpoints (usually a measure of disease process). The purpose of this study was to survey four aspects of endpoint usage in randomized controlled trials (RCTs) on the treatment of periodontitis: (1) the typical number of endpoints per RCT. (2) the proportion of RCTs using the same endpoint, (3) the proportion of RCTs using true endpoints, and (4) whether treatment choice influenced endpoint choice. 92 publications (1988–1992) reporting on 82 RCT's were identified. The typical number of endpoints per RCT was 6 (range: 1–28). The 3 most frequently used endpoints were mean probing depth (78% of the trials), mean probing attachment level (66%), and the plaque index (37%). In total, 153 distinct surrogate endpoints were defined. Most of these were used infrequently; over 80% of the 153 endpoints were used in fewer than 5 of the 82 trials. No trials used tooth loss as a true endpoint. In the design of an RCT, treatment choice influenced surrogate endpoint choice. Surrogate endpoints based on re‐entry surgery were exclusively used for regenerative procedures and microbiological surrogate endpoints were mostly used for RCT's on antimicrobials. The conclusion is that the typical RCT used multiple surrogate endpoints. some of which were used infrequently by other trials. Such endpoint usage characteristics are suitable for exploratory RCTs (designed to identify active treatments or to elucidate treatment mechanisms). The question is raised as to whether periodontal research has reached the point of needing properly designed definitive studies, whose purpose it would be to provide unequivocal evidence of tangible benefits to the patient by the various treatments. If a need for definitive randomized controlled trials is perceived, then the use of (multiple) surrogate endpoints as primary outcomes should be questioned. Surrogate endpoint usage has led to both false positive and false negative conclusions in other chronic disease studies. Endpoint selection and validation in RCTs may be an important element in resolving controversies about periodontal treatments.
Simultaneous isolation of Actinobacillus actinomycetemcomitans from subgingival and extracrevicular locations of the mouth
Authors: Müller H.‐P. , Eickhoíz P. , Heinecke A. , Pohl S. , Müller R. F. , Lange D. E.
Published: December 2005

Abstract In the present study, a total of 619 subgingival and extracrevicular samples from 66 early‐onset periodontitis, 42 adult periodontitis/gingivitis and 36 treated Actinobacillus actinomycetemcomitans‐associated periodontitis patients were selectively cultivated for presence of A. actinomycetemcomitans. The organism was recovered from 68% cases with early‐onset periodontitis, 24% cases with adult periodontitis/gingivitis and 50% of treated patients. Associations between recovery from pooled subgingival plaque and samples from extracrevicular locations as well as between different extracrevicular samples, were not heterogeneous with regard to different groups with the exception for cheek/saliva comparisons (odds ratios: early‐onset periodontitis 825; adult periodontitis 8.1; treated patients 117; 0.05<p<0.1). For associations between recovery of A. actinomycetemcomitans from pooled subgingival plaque/extracrevicular samples, Mantel‐Haenszel's odds ratios of between 12.2 and 21.6 were calculated (p<0.0001). The organism was isolated from 17 cheek mucosa samples of 18 patients identified as still harboring the organism after therapy. Present results point to the considerable value of cheek mucosa samples especially in treated patients to diagnose persistent A. actinomycetemcomitans colonization of the oral cavity.
Comparison of digitised and visual plaque vitality measurement
Authors: Walsh T.F. , Ünsal E. , Varella‐Centelles P.
Published: December 2005

Abstract. Plaque samples from 12 patients suffering from adult periodontitis (8 male, 4 female), aged 32–58 (mean age 44.3) years were stained using the technique of vital fluorescence described by Netuschil and co‐workers. The proportions of vital plaque was then assessed by 2 techniques: the visual methods previously described and by an image capture system linked to a computerised image programme. A total of 94 plaque samples were included in the study. Analysis of the data from the 2 sets showed that there was no significant difference between the two methods (p =0.26).
The width of radiologically‐defined attached gingiva over deciduous teeth
Authors: Saario Maarit , Ainamo Anja , Mattila Keijo , Suomalainen Kimmo , Ainamo Jukka
Published: December 2005

Abstract The aim of the present cross‐sectional study was to radiologically investigate the continuous eruption process in the deciduous dentition by assessing the difference in the width of radiologically‐defined attached gingiva (RAG) in 6‐year‐old and 10‐year‐old children. The group of 6‐year‐olds had predominantly deciduous teeth and the 10‐year‐olds were in their mixed dentition period. The mucogingival junction was revealed with Schiller's iodine solution and marked mid‐labially along the long axis of each tooth with a piece of metal wire prior to taking panoramic radiographs. The width of RAG over deciduous canines and molars was measured from the cementoenamel junction to the mucogingival junction. A significant increase in the width of RAG was found from 6 to 10 years of age.
The comparative effects on plaque regrowth of phenolic chlorhexidine and anti‐adhesive mouthrinses
Authors: Moran J. , Addy M. , Newcombe R. , Warren P.
Published: December 2005

Abstract The inhibition of bacterial attachment to the tooth surface is one possible approach to plaque control. This study evaluated in vivo the plaque inhibitory action of a novel copolymer reported to have considerable antiadhesive properties in vitro. The study was a single blind. 5‐treatment. randomised Latin square crossover design, incorporating balance for carry‐over effects. The rinses were the antiadhesive (1%), the antiadhesive with 0.02% chlorhexidine, a 0.2% chlorhexidine rinse product, an essential oil/phenolic rinse product and water. 15 volunteers participated and on day 1 of each study period were rendered plaque‐free, ceased toothcleaning and rinsed 2x daily. under supervision, with the allocated formulation. On day 5, plaque was scored by index and area. Washout periods were 21/2 days. Alone or combined with chlorhexidine, the antiadhesive agent showed no effects greater than water. The chlorhexidine rinse was significantly more effective than the essential oil/phenolic rinse which in turn was significantly more effective than the other rinses.
Effect of gingival wall on resistance to probing forces
Authors: Keagle J. G. , Garnick J. J. , Searle J. R. , Thompson W. O.
Published: December 2005

Abstract This study was conducted to determine whether the gingival tissue lateral 10 the periodontal sulcus contributes resistance to the advancement of a periodontal probe tip into the sulcus under different applied pressures. An electromechanical device was used to advance a probe tip 0.6 mm in diameter into the facial sulcus at a constant speed until resisting forces of 0.70 N were encountered. The device registered the resisting force and probe advancement simultaneously. The gingiva of all 2nd incisors, 2nd premolars, and 1st molars of 4 young adult male beagle dogs were tested. After the first measurement, the buccal gingiva of experimental sites were incised mesiodistally from the gingival margin to the alveolar crest and the sulcus was reprobed. 2 experimental and control quadrants were selected randomly resulting in 6 sets of both experimental and control data from each animal. The data were analyzed with analysis of variance. The analysis demonstrated significant variation from site to site, and dog to dog; therefore, only changes between the 1st and 2nd probings at the same sites could be compared. Less variability of probing distance in different animals occurred at higher forces; however, the incision had a significant effect on probing distance at these forces. The pressure at which probing distance had less variability among animals and least affected when the gingival sulcular wall was incised was estimated to be 106 N/cm2. This corresponds to 30 g force on the 0.6 mm diameter probe.
Effects of polyglactin mesh combined with resorbable calcium carbonate or replamineform hydroxyapatite on periodontal repair in dogs
Authors: Moon Ik‐Sang , Chai Jung‐Kiu , Cho Kyoo‐Sung , Wikesjo Ulf Me , Kim Chong‐Kwan
Published: December 2005

Abstract This study evaluates periodontal repair and biomaterial reaction following implantation of a polyglactin mesh with or without porous resorbable calcium carbonate (RCC) or porous replamineform hydroxyapatite (RHA) in conjunction with reconstructive surgery. Ligature‐ and surgically‐induced interproximal periodontal defects of left and right mandibular premolar teeth in 7 dogs were used. Bilaterally, mesial defects of the 2nd, 3rd and 4th premolar teeth were treated with polyglactin mesh, polyglactin mesh and RHA. or polyglactin mesh and RCC. respectively. The polyglactin mesh, shaped according to the contour of the defect, was adapted to the experimental teeth: its coronal margin positioned immediately apical to the cemento‐enamel junction. Gingival flap margins were adapted and sutured to cover the polyglactin mesh completely. Clinical healing was generally uneventful. The dogs were sacrificed to provide block sections for histologic evaluation at 1, 3, 6, 12, 26, 32 and 56 weeks following wound closure. Generally, cementum regeneration was observed beginning at week 6 in all groups. Bone regeneration was observed from week 3 in polyglactin mesh‐treated groups, and from week 6 in polyglactin mesh + RCC or polyglactin mesh + RHA treated groups. Bone regeneration appeared enhanced in polyglactin mesh + RCC or polyglactin mesh + RHA treated defects at week 12 and 26, with little difference between the three experimental conditions at week 56. Polyglactin mesh degradation was observed at week 3 and appeared complete at week 12. The RHA did not appear to resorb, while the RCC was gradually replaced by bone from week 3. Within limitations of the study conditions, periodontal regeneration was observed following implantation of a polyglactin mesh with or without RCC or RHA in conjunction with reconstructive surgery. As a conclusion, there seems to be no significant difference in periodontal regeneration after 12 months of healing between the group treated with the membrane only, and the group treated with the membrane and the bone substitution material. Changes in connective fiber orientation over the 1st 12 weeks of healing may suggest that “fibrous encapsulation” observed in earlier studies may only represent a transient stage in periodontal regeneration.
Some characteristics of the ridge mucosa before and after implant installation A prospective study in humans
Authors: Liljenberg B. , Gualini F. , Berglundh T. , Tonetti M. , Lindhe J.
Published: December 2005

Abstract The aim of the present investigation was to study some tissue characteristics of the ridge mucosa before and after implant installation. 9 partially edentulous patients were included in the study. At the time of fixture installation, 1 recipient site in each patient was selected for soft tissue biopsy. Abutment connection and restorative therapy were performed after 3–6 months. When the implants had been in function for about 6 months, a soft tissue sample was obtained from the keratinized peri‐implant mucosa at the 1 implant site from which the first biopsy was obtained. Each biopsy was divided into 1 mesial and 1 distal portion. The mesial tissue portion was fixed in a buffered fixative and embedded in EPON®. Sections were produced, stained in PAS and toluidine blue and used for histometric and morphometric analyses. The distal portion of the biopsies were embedded, snap frozen in liquid nitrogen and stored in a freezer at −70°C. From each tissue portion, 15 sections were prepared in a cryostat and exposed to immunohistochemical staining. A panel of monoclonal antibodies was used and the avidin‐biotin method for staining was applied. The sections were examined morphometricalty. Both tissues harbored a well keratinized oral epithelium and a connective tissue, the composition of which was close to identical in terms of collagen, cells and vascular structures. The peri‐implant mucosa. however, also included a junctional epithelium which evidently allowed the penetration of products from the oral cavity. As a consequence, the periimplant mucosa in comparison to the masticatory mucosa was found to contain significantly enhanced numbers of different inflammatory cells.
Longitudinal evaluation of the development of periodontal destruction in spouses
Authors: Van der Velden U. , Van Winkelhoff A.J. , Abbas F. , Arief E.M. , Timmerman M.F. , Van der Weijden G.A. , Winkel E.G.
Published: December 2005

Abstract The aim of the present investigation was to study longitudinally the periodontal condition of married couples. The data are derived from a longitudinal study in a young population living in a remote village in Indonesia and showing a relatively high prevalence of periodontal destruction. In 23 married couples, clinical measurements were carried out in 1987 and 1994. During the latter examination, a pooled gingival sample was obtained for microbiological evaluation. In 1994. the mean age of the group was 29.1 years and the couples were married for on the average 10 years. In each couple, the partner showing in 1994 the highest score for mean loss of attachment (LA) was classified as the diseased proband and the other partner as the spouse. Evaluation of the clinical data showed that: (11 the diseased probands already had in 1987 a worse periodontal condition compared to that of the spouses; (2) in both groups the mean LA increased during the 7‐year period;13) the difference in mean LA between diseased probands and spouses increased between 1987 and 1994. The microbiological evaluation revealed a relatively high prevalence of Actinobadllus actinomycetemcomitans (50%). Porphyromonas gingivalis (67%) and Prevotella intermedia 61%. Analysis showed no differences in microbiota between diseased probands and spouses. The 23 Actinobadllus actinomycetemcomitans positive subjects included 2 positive couples. Furthermore, the 31 Porphyrormmas gingivalis and 28 Prevotella intermedia positive subjects included 9 and 7 positive couples respectively. In conclusion, 10 years of cohabitation showed no influence on the periodontal condition of the spouses.
Dark field microscopy of the subgingival microflora in insulin‐dependent diabetics
Authors: Seppälä B. , Ainamo J.
Published: December 2005

Abstract The subgingival microflora was assessed by means of dark field microscopy in 106 pockets of 47 subjects with long‐term insulin‐dependent diabetes mellitus (IDD). The microbiota of 55 healthy sulci (probing depth<4 mm) and 51 periodontally diseased (probing depth ≥4 and 6 mm) pockets were analyzed. The mean duration of the IDD of the diabetic subjects was 23.7 years (range from 10 to 41 years). The diabetic patients, aged 30–65 years, were under medical treatment at the III Department of Medicine. University of Helsinki Central Hospital, and at 2 clinics of the Helsinki Health Centre. Based upon their long‐term medical records. 26 subjects were assessed to have poorly controlled insulin‐dependent diabetes meilitus (P1DD) and 21 had controlled insulin‐dependent diabetes (CIDD). The P1DD subjects exhibited higher mean blood glucose levels (12.9±4.6 mmol/l, x̄± S.D.) than the CIDD subjects (7.9±3.6 mmol/1) (p<0.001), The mean glycosylated hemoglobin HBAl (HBAlc) levels were 11.2±4.6% (10.3±1.2%) and 8,8±1.8% (7.7±1.4%) for PIDD and CIDD subjects, respectively. These differences were statistically significant (p<0.01 and p<0.001, t‐test). For each individual, site‐specific recordings were made for plaque index and bleeding index scores, probing depth, loss of attachment and radiographic loss of alveolar bone. Dark field microscopy analysis of the presence of spirochetes, motile rods, cocci, non‐motile rods, filaments and fusiforms was performed in the total of 106 pockets. According to the results of the dark field microscopy, the % of spirochetes and motile rods in the periodontally diseased pockets was significantly higher in the PIDD than in the CIDD subjects (9.2±13.4% and 10.8±14.3% versus 4.0±5.2% and 3.1 ±3.2%, p<0.01 and p<0.001, x2‐test, respectively). Moreover, the PIDD subjects had lower mean %s of coccoid cells in periodontally diseased sites than the CIDD subjects (52.1 ±20.8% versus 60.7±9.0%, p<0.001, x2‐test).
Human gingival crevicular fluid keratin at healthy, chronic gingivitis and chronic adult periodontitis sites
Authors: McLaughlin W. S. , Kirkham J. , Kowolik M. J. , Robinson C.
Published: December 2005

Abstract The present study was designed to determine, in a cross‐sectional study, whether there was any relationship between the keratin‐positive material in gingival crevicular fluid and the clinical periodontal status. Keratins were selected as putative indicators of degradation of epithelial cells cytoskeletal proteins. Keratin positive material was determined by enzyme‐linked immunosorbent assay‐in 42 subjects exhibiting clinical sites of health, chronic gingivitis and chronic periodontitis. The concentration of keratin in parotid saliva was also measured for each subject. Keratin concentration in gingival crevicular fluid samples was significantly greater at sites exhibiting signs of gingivitis and periodontitis compared with healthy sites. No differences were detected between sites exhibiting gingivitis and periodontitis. No differences were found between the 3 groups for the saliva keratin‐positive material which was significantly less than that detected in gingival crevicular fluid. These results suggest that gingival crevicular fluid keratin concentration may serve as a marker of gingival damage.
Efficacy of CPITN sextant scores for detection of periodontitis disease activity
Authors: Rams Thomas E. , Listgarten Max A. , Slots Jørgen
Published: December 2005

Abstract The relationship between CPITN sextant scores and periodontitis recurrence at individual tooth sites was evaluated in a longitudinal study in 83 treated adult periodontitis patients receiving systematic 3‐month maintenance care. At baseline and semi‐annual examinations over 36 months. CPITN scores were assigned to each dentition sextant using probing depths and gingival index scores, and relative periodomal attachment level was assessed at individual tooth sites using an occlusal reference stent. Periodontitis recurrence was defined as any periodontal site exhibiting either a probing depth increase of ≥3 mm from baseline, or a probing depth increase of s 1 mm from baseline together with a loss of relative periodontal attachment of ≥2 mm from baseline. 49 (59.0%) subjects developed periodontitis recurrence in 147 (29.8%) sextants at 181 (2.2%) individual periodontal sites during the 36‐month study period. Baseline CPITN scores of 4 were more common in disease‐active subjects than clinically‐stable subjects (p= 0.003. /‐test), and were associated with a statistically significant 1.66 relative risk of periodonlitis recurrence within 36 months. CPITN sextant scores of 3 or 4 showed low specificity and low positive predictive values as indicators of periodontitis recurrence at s= 1 individual sites within the affected sextant. In comparison, low CPITN sextant scores (0‐2) provided high specificity (96.2‐100%). high positive predictive values (99.5‐100%), and a summary odds ratio of 24.2 as an indicator of clinical stability at all periodontal sites within a given dentition sextant. Changes in sextant scores for CPITN over 6‐month periods showed no relationship with periodontitis recurrence at individual periodontal sites. This study suggests that while CPITN is inadequate for detection of periodontitis recurrence, low CPITN scores provide rapid presumptive identification of clinically‐stable sextants in adult periodontitis patients on maintenance care.
The distribution of gingival overgrowth in organ transplant patients
Authors: Thomason J. Mark , Kelly Peter J. , Seymour Robin A.
Published: December 2005

Abstract The distribution of gingival overgrowth was investigated in a cohort of organ transplant patients, who were medicated with cyclosporin or the combination of cyclosporin and a calcium channel blocking drug. Gingival overgrowth scores were significantly higher at buceal sites than lingual‐palatally (p<0.0001). There was no significant difference between upper and lower overgrowth scores (p=0.88). The most severe overgrowth was seen in the canine region. Overgrowth between the central incisors was significantly less than in the canine region (p>0.044) and was similar to that in the molar and premolar region. Although raised overgrowth scores were associated with increased levels of plaque and gingival inflammation, the distribution could not be explained by this observation.
Bacterial morphotypes of 3‐day old plaque in Chinese
Authors: Zee Kwan‐yat , Pang Kam‐man , Samaranayake Lakshman P. , Attstrom Rolf
Published: December 2005

Abstract The aim of the this study was to estimate the % distribution of bacterial morphotypes of supragingival plaque in Chinese subjects after 3 days of no oral hygiene. 36 dental students, hygienists or dental surgery assistants (mean age: 24.3 years) were recruited. Prophylaxis and oral hygiene reinforcement were given 1X a week for 3 weeks to obtain gingival health and a 3‐day period without any plaque control started afterwards. Al the end of the 3‐day period, the plaque along the gingivul margin of the upper right central incisor was removed and direct Gram stained smears were prepared for light microscopy. Bacteria were classified as gram‐positive or gram‐negative cocci, rods, filaments, fusiform organisms, spirilla or spirochetes. A differential count of 200 organisms from 3‐6 microscopic fields was performed and the results expressed as a‘M, of the organisms counted. Results from the 36 direct smears showed approximately 83% (range: 52%‐96%.) of the organisms to be gram‐negative while gram‐positive bacteria comprised only a minority of about 12% (range: 0.7%‐43%). This result is remarkably different from previous reports from the West where gram‐positive bacteria were the predominant bacterial types noted in early supragingival plaque. Further longitudinal studies involving both microscopy and bacteriological culture will be necessary to confirm this finding.
An investigation of the validity of attachment level measurements with an automated periodontal probe
Authors: Ahmed Naseer , Watts Trevor L. P. , Wilson Ronald F.
Published: December 2005

Abstract There is a need for information on the validity of probing depth and attachment level measurements made with automated probes. In this study. 34 teeth in 9 patients were measured with the Florida probe from points marked with a bur prior to extraction. After extraction, connective tissue attachment levels were measured from the same points with a dissecting microscope. Mean measurements of attachment level were similar with probing (5.13±2.08 mm) and laboratory (5.18±2.26 mm) assessments. The correlation between these measurements was 0.72 (p<0.001), and a t‐test of the paired measurements showed no difference (t=0.44: p=0.66). The Florida probe thus showed satisfactory validity for this group of measurements of advanced periodontitis. However, there was substantial lack of agreement between individual probing measurements and the validity criterion of laboratory attachment level measurements, and the intra‐class correlation coefficient was 0.46. It was concluded that the Florida probe was suitable for studies in which measurements were averaged, but not for longitudinal study of individual sites.