bluuebunny/crossref_metadata_2025 huggingface dataset:
Subgingival metronidazole in dialysis tubing and subgingival chlorhexidine irrigation in the control of chronic inflammatory periodontal disease
Authors: Wan Yusof W. Z. A. , Newman H. N. , Strahan J. D. , Coventry J. F.
Published: December 2005

Abstract The present investigation compared subgingival metronidazole in dialysis tubing and subgingival chlorhexidine irrigation in the control of chronic inflammatory periodontal disease. 10 patients with 4 mm or deeper periodontal pockets were divided into 2 groups. Both received baseline scaling, root planing, subcontact area cleaning and instruction in the Bass technique of tooth brushing, but not in interdental cleaning. One group with 80 pockets received 0.2% chlorhexidine subgingival irrigation for 28 days and the other with 86 pockets received 0.5 % metronidazole solution incorporated in subgingivally placed dialysis tubing. The tubings were replaced with freshly filled ones at days 7, 14 and 21. Active treatment ceased at day 28. Plaque Index, Sulcus Bleeding Index, pocket depth and gingival shrinkage were recorded at days 0, 7, 14, 21, 28, 56 and 84.

Subgingival 0.5% metronidazole in dialysis tubing and 0.2% chlorhexidine irrigation were found to be equally effective in reducing chronic periodontitis. Metronidazole reduced Plaque Index less but pocket depth more than chlorhexidine. Improvements were maintained significantly below baseline levels for at least 8 weeks after the end of the 4‐wcek treatment period.
Recolonization of a subgingival microbiota following scaling in deep pockets
Authors: Magnusson I. , Lindhe J. , Yoneyama T. , Liljenberg B.
Published: December 2005

Abstract The present investigation was carried out to study some aspects of the recolonization of a subgingival microbiota following subgingival instrumentation in sites with deep pockets. 16 patients were recruited for the study. From each patient 4 inflamed gingival sites with deep pockets were selected. These sites were examined for plaque, overt gingivitis, bleeding on probing and probing depth. Samples of the subgingival microbiota were obtained and examined in the darkfield microscope and in a Neubauer chamber.

Following the Baseline examination the teeth of all 4 jaw quadrants were carefully scaled and planed. Subgingival instrumentation was carried out under local anesthesia and required between 2–4 appointments. The patients were subsequently divided into 2 groups (Groups A and B) consisting of 9 and 7 subjects, respectively. During the first 16 weeks of maintenance the patients of Group A were not supervised regarding their self‐performed plaque control measures and they accumulated supragingival plaque. The patients of Group B, however, were during these 16 weeks recalled once every 2 weeks for professional tooth cleaning. In addition they rinsed twice daily with a 0.2% solution of chlorhexidine digluconate. Reexaminations including assessments of the same parameters as those studied at Baseline were performed after 2, 4, 8, 12 and 16 weeks. After the 16‐week examination the patients of Group A received a new sequence of subgingival scaling and root planing. During the subsequent 16 weeks the patients of Group A were also recalled for professional tooth cleaning. They were reexamined 18, 20, 24, 28 and 32 weeks after the Baseline examination.

Subgingival scaling followed by carefully supervised oral hygiene measures resulted in a marked improvement of periodontal conditions. This improvement was accompanied by a pronounced and sustained reduction in the motile segments of the subgingival microbiota. In the presence of supragingival plaque (Group A), however, a subgingival microbiota containing large numbers of spirochetes and motile rods was soon (4–8 weeks) reestablished. A small number of sites with deep pockets ( 8 mm) was not substantially reduced in depth following subgingival instrumentation. In these sites which were kept free from supragingival deposits a subgingival microbiota with a large proportion of motile bacteria soon recurred.
Periodontal repair after surgical debridement with and without cartilage allografts
Authors: Chodroff Richard E. , Ammons William F.
Published: December 2005

Abstract The effect of a cartilage allograft on healing in intrabony defects treated by open flap curettage was investigated at 130 surgical sites in 4 patients. Thinned mucoperiosteal flaps were elevated and the intrabony defects were debrided. A stem with stainless steel pins was used to measure defect depth at fixed locations adjacent to the root surfaces. The bony defects treated ranged from 0–9 mm with a mean intraosseous depth of 2.4 mm. 62 sites received cartilage implants and 68 sites were treated by surgical debridement only. The flaps were readapted and sutured to the level of the alveolar crest. After 16 weeks the defects were remeasured. Both treatment methods resulted in a mean apical shift of –0.09 mm of the base of the defects that were <3 mm and a mean coronal shift of 0.9 mm in defects that were >3.5 mm in depth. The repair in deeper lesions increased with the number of intrabony walls. Mean pocket depth at flap curettage sites was reduced from 5.4–3.3 mm (P<0.01) at 16 weeks. At sites receiving the cartilage, the mean pocket depth decreased from 5.6–3.6 mm (P<0.01). Pocket reduction resulted from a combination of surgical recession and a mean gain of 1 mm in clinical attachment (P<0.05 for flap curettage sites only). The cartilage implants provided no statistically significant advantage in either bony or soft tissue repair over flap debridement alone. Although bony repair is influenced by depth and configuration of the intrabony defects, significant gains in attachment and reductions in pocket depth may occur independently of changes at the base of the intrabony defects.
Toothbrushing efficiency in smokers and non‐smokers
Authors: Macgregor I. D. M.
Published: December 2005

Abstract The present study was conducted to determine whether smokers have more plaque than non‐smokers, and whether higher plaque scores subsequently found in smokers could be explained by differences in toothbrushing time, efficiency and frequency. Plaque was scored from photographs, before and after toothbrushing, in 64 smokers and 64 non‐smokers, aged 20–40 years, matched for age and sex. The results showed that in both sexes smokers had more plaque than non‐smokers. Male smokers brushed for a shorter time, and had more plaque alter toothbrushing, than male non‐smokers. A similar, though non‐significant trend was found in females. There was no association between tobacco consumption and frequency of toothbrushing. It was concluded that the poorer oral cleanliness found in smokers both before and after toothbrushing may be explained, in part at least, by their shorter toothbrushing time.
Changes in salivary peroxidase activity observed during experimentally‐induced gingivitis
Authors: Smith A. J. , Smith G. , Bash M. K. , Walsh T. F.
Published: December 2005

Abstract Gingivitis was experimentally induced in 8 human subjects using an acrylic overlay to cover the teeth in the experimental area during any oral hygiene procedures. The overlays were used for a period of 3 weeks, after which the subjects received a scale and polish and then practised normal oral hygiene. At regular intervals during the experimental period, mixed saliva was collected for assay of peroxidase activity by spectrophotometric and test‐strip procedures and plaque and gingival indices were assessed clinically. A considerable increase in peroxidase activity was observed during the experimental period, which declined after normal hygiene was resumed. This procedure may allow assessment of the progression of gingivitis under experimental conditions.
The topography of papillary gingiva in health and early gingivitis
Authors: Bergströum Jan
Published: December 2005

Abstract Using stereo‐images, topographical features within the maxillary papillary gingiva between the lateral and central incisors were investigated in 36 healthy young adults. The features studied were surface stippling, presence of a gingival groove, papillary length and papillary area.

The prevalence of stippling was found to be 95%. The intensity of stippling varied considerably between individuals, the mean being 2.6 depressions/mm2. A gingival groove only occured in 19% of the cases examined. The maximum length of the papilla from the base to its most incisal tip was measured in relation to the length of the crown of the lateral incisor. This ratio was found to be close to 0.5, indicating a healthy papilla reaching about halfway to the incisal edge. The surface area of the papilla was measured in relation to the labial surface area of the lateral incisor. This ratio was close to 0.25, indicating that the papillary surface under healthy conditions amounts to about 1/4 of the labial surface of the lateral incisor crown.

Changes resulting from 20 days of plaque accumulation were also investigated. A mean GI of 0.8 was recorded at the end of the experimental period; however, no measureable changes in stippling intensity or papillary shape could be established. These findings suggest that the early stages of gingivitis are characterized mainly by changes in gingival colour, while changes in surface texture and shape are secondary characteristics of clinical inflammation.
Local immunoglobulin synthesis in juvenile and adult periodontitis
Authors: Sandholm Leena , Saxen Leena
Published: December 2005

Abstract Local immunoglobulin synthesis by the gingival plasma cells in 5 patients with juvenile Periodontitis (JP) was compared to that in 5 patients with adult periodontitis (AP). The peroxidase‐antiperoxidase method was used with specific antisera to α, γ, and μ heavy chains and K and κ and λ light chains. The following relative distribution of plasma cells in JP/AP was found: IgA 22.7/19.5, IgG 75.6/78.5 IgM 1.7/2.0, K 55.5/53.5 and λ 44.5/46.5, calculated as a % of their sum, indicating that the relative distribution of the different immunoglobulin chains was similar in both patient groups. The ratio light: heavy chains was 1.78 in JP and 1.72 in AP. The ratio K: λ was 1.28 in JP and 1.17 in AP, similar to the known free K:free λ chain ratio in normal serum (1.2). This indicates that the excessive staining for light chains is caused by a physiological overproduction of light chains rather than a Pathological imbalance in the synthesis of immunoglobulins.
Simple bacteriological methods to assess changes in subgingival microflora produced by metronidazole‐containing acrylic strips placed into periodontal pockets
Authors: Addy M. , Alam L. , Rawle L.
Published: December 2005

Abstract Dark field microscopy is perhaps the simplest microbiological technique to monitor the effects of treatment methods on bacterial plaque. However, the method provides qualitative rather than true quantitative data. This study attempts to measure changes in flora by a number of methods following the Placement of 40% metronidazole acrylic strips into periodontal pockets. 10 patients with periodontal Pockets greater than 6 mm which bled on probing had acrylic strips placed for 2 to 3 days. Prior to msertion and after removal, subgingival plaque samples were collected into 1 ml of saline and processed as follows, (a) Dark field microscopy for qualitative shifts, (b) Gram stain for differential counts, (c) Counting chamber for total counts, (d) Serial dilution and culture for total cultivable counts.

After treatment the significant changes were as follows, (a) % increase in cocci and decreases in other forms, particulaly motile organisms, (b) Gram‐positive cocci increased and Gram‐negative bacilli decreased, (c) Total counts obtained by the sampling method decreased greater than 80%. (d) Total cultivable counts decreased greater than 75%. (e) The efficiency of culturing appeared low and the Potential problems of sampling to quantification were identified.
Plaque and systemic disease: a reappraisal of the focal infection concept
Authors: Thoden van Velzen S. K. , Abraham‐Inpijn L. , Moorer W. R.
Published: December 2005

Abstract. The review presented here covers metastatic local and systemic disease secondary to the accumulation of plaque or the formation of other pathogenic microbial depots in the mouth. At least 3 pathways may link oral infection to secondary disease, to wit metastatic infection due to transient bacteremia, metastatic immunological injury, and metastatic toxic injury. The available evidence is presented and examples are provided. They concern among others such divergent diseases as acute bacterial myocarditis, infective endocarditis, brain abscess, uveitis and iridocyclitis, trigeminal and atypical facial neuralgia, unilateral facial paralysis, fever of ‘unknown’ origin, and neutrophil dysfunction.
Calcium and periodontitis: Clinical effect of calcium medication
Authors: Uhrbom Erik , Jacobson Lars
Published: December 2005

Abstract. In contrast to the generally held concept that periodontal disease is caused by microorganisms, Henriksson (1968) suggested that a nutritional deficiency of calcium might be the cause. He elicited secondary hyperparathyroidism in beagles from a low calcium/high phosphorus diet and found that the osteolytic demineralization of bone that followed seemed to involve alveolar bone more than other bones. In a report on 10 persons with advanced periodontal disease, Krook et al. (1972) stated that the disease was reversed when they were given 1 g Ca/day for 180 days. These results have been disputed.

The present study is an attempt to repeat the experiment performed by Krooket al. (1972) under more stringent conditions. The hypothesis that calcium supplementation reverses destructive periodontal disease is tested.66 persons referred to our clinic for periodontal problems were prescribed at random calcium (1 g) or placebo tablets daily during a trial period of 180 days. Their periodontal status was examined at day 0 and at day 180. The parameters used for comparison were Plaque Index, Gingival Index, probing depth, mobility and furcation involvement. The radiographically registered level of alveolar bone was also recorded, but subsequently discarded since no change could be ascertained. The patients were interviewed as to their consumption of calcium via milk and cheese at days 90 and 180. This was in order to estimate roughly whether or not their dietary calcium consumption was adequate. The recommended allowance of 800 mg/day was used as a reference.

During the trial period 7 persons withdrew – 2 from the test group and 5 from the control group. This was due mainly to digestive disorders, reported by the patients.

A comparison at day 0 between the 31 test and 28 control patients revealed no statistical differences concerning the periodontal parameters studied. At day 180 both groups showed a slight improvement in Plaque Index, Gingival Index and probing depth; however, there was still no statistical difference between them. The dietary analysis established a low calcium consumption among 1/3 of the patients. Even in these cases calcium supplementation had no effect.

It is concluded that calcium supplementation for 180 days does not influence the periodontal status of patients with moderate to advanced periodontal disease. Secondly, patients on a low calcium diet do not differ from those receiving an adequate supply. Finally, the study cannot support the hypothesis that calcium deficiency is a main cause of destructive periodontal disease.
Oral cleanliness and gingival health following oral hygiene instruction by selfed‐educational programs
Authors: Glavind Leif , Zeuner Ella , Attsträm Rolf
Published: December 2005

Abstract. The aim of the present study was to determine the motivational effect of using a periodontal self‐examination manual prior to a self‐instructional manual in oral hygiene and to examine whether instruction provided at a later time than the scaling procedure improves the effect of the instruction. 74 patients with periodontal disease were divided into 3 groups: (1) A group of 23 patients who performed a self examination of their periodontal condition prior to self‐instruction in oral hygiene; (2) a control group of 27 patients who used only the self‐instructional oral hygiene manual; and (3) a group of 24 patients who were not given the self‐instructional oral hygiene manual before 6 weeks after the baseline examination. All these patients had their teeth scaled at the start of the study and after 3 and 7 months. The effect of the various modes of instruction was evaluated by assessments of plaque and gingival bleeding scores. These parameters were determined at the baseline and after 2 and 6 weeks and 3 and 7 months. The results demonstrated a significant improvement in plaque and gingival bleeding scores following the use of the self‐instructional manual in oral hygiene. The use of the periodontal self‐examination manual or a delay of the instruction had no additional effect on oral cleanliness. The level of oral hygiene and gingival health achieved at 3 months was maintained in all 3 groups for an additional period of 4 months. After that time, they were divided into 2 other groups depending on whether or not their plaque score was less than 20%. A total of 26 in the group who had a plaque score higher than 20% demonstrated a plaque score of less than 20% after having performed the tooth brushing test. 10 of the remaining patients, who still had a plaque score of more than 20% after the tooth brushing test, received additional instruction in oral hygiene which subsequently resulted in improved oral cleanliness after 6 months.
Juvenile periodontitis: healing following autogenous iliac marrow graft, long‐term evaluation
Authors: Mattout P. , Roche M.
Published: December 2005

Abstract. A case of junvenile periodontitis treated by autogenous bone grafting is reported. The patient, an 18‐year‐old female, presented with periodontal lesions around the incisors and the first lower left molar. The first molar was severely affected with bone defects at the mesial aspect and in the furcation region and, for this reason, was selected for grafting. Minced fragments of bone with its marrow, obtained from the patient's iliac crest, were implanted into the diseased periodontium. 1 year after treatment, clinical and radiological inspection revealed the presence of boned. This bone completely filled the furcation area of the tooth but only partially the mesial aspect. There was, also, significant bone fill in the supracrestal region.
Susceptibility of human oral anaerobic bacteria to antibiotics suitable for topical use
Authors: Baker Pamela J. , Evans Richard T. , Slots Jørgen , Genco Robert J.
Published: December 2005

Abstract 17 antibiotics, with potential for topical use, were tested for their activity against the human oral flora. Concentrations (μol/1) required to inhibit 90% of test strains are presented and drug activities are compared. The total cultivable oral flora was susceptible to the tetracyclines including tetracycline itself, minocyline, doxycyline, and oxytetracycline and to erythromycin. On the other hand, actinobolin, kanamycin, neomycin, streptomycin, spiramycin, tythricin, vancomycin, clindamycin, and chloramphenicol were ineffective against may of the human oral anaerobic bacteria even at high concentration. Penicillin was effective at high concentrations but could not be recommended because organisms which are not inhibited by low concentrations are penicillinase producers. Carbenicillin was effective against all organisms except Actinobacillus actinomycetemcomitans. The gram‐negative organisms involved in adult periodontitis were most susceptible to the tetracylines, tyrothricin, carbenicillin and clindamycin, while those associated with localized juvenile periodontitis were susceptible to the tetracylines or erythromycin. These data, combined with the previous findings that some teracylines exhibit marked to good choices in the treatment or prevention of oral diseases.
Sampling of subgingival microbiota for dark‐field microscopy
Authors: Magnusson I. , Lilienberg B. , Yoneyama T. , Blomqvist N.
Published: December 2005

Abstract The aim of the present investigation was to study the validity of 2 different methods of sampling the subgingival microbiota. The composition of the flora was estimated using the dark‐field microscope. Subgingival samples were obtained using either a curette or a Hamilton microsyringe for a subgingival washing. The method of determination of the composition of the subgingival microorganisms was found to be very reproducible when the same investigator performed the counting.

Samples obtained by the washing technique had a slight but significantly higher proportion of coccoid cells when compared to samples obtained by curette. The calculation of the reproducibility of the washing technique as assessed in 6 immediately repeated samples from the same sites yielded a coefficient of variation of 40% for spirochetes and motile rods.

When 9 repeated samples from each of 28 sites (14 with a curette, 14 with washing) were studied over a period of 32 days, no systemic alterations were observed in the % of spirochetes and motile rods. The variation within each individual site was high. For curette samples and washing samples, the coefficients of variation for spirochetes and motile rods were 85% and 63%, respectively. The present investigation clearly demonstrated that care should be taken in the interpretation of single samples of subgingival microbiota. A more relevant picture of the actual situation is achieved when trends of repeated samples over time are studied.
Intraclass correlations of periodontal measurements
Authors: Haffajee A. D. , Socransky S. S. , Goodson J. M. , Lindhe J.
Published: December 2005

Abstract Components of variance and intraclass correlation coefficients were computed for changes in attachment level, pocket depth, gingival and plaque index scores for 5 groups of treated periodontal disease patients and 1 group of untreated subjects with periodontal disease. The intraclass correlation coefficients for attachment level change ranged from 0.011 to 0.165 (median 0.067), while intraclass correlation coefficients for pocket depth changes ranged from ‐0.009 to 0.178 (median 0.071). These intraclass correlation coefficients were much lower than those computed for changes in measurements of plaque which ranged from 0.086 to 0.568 (median 0.268) or gingival inflammation which ranged from 0.119 to 0.522 (median 0.264). Intraclass correlation coefficients at baseline for pocket depths ranged from 0.000 to 0.199 (median 0.053). for plaque accumulation from 0.121 to 0.531 (median 0.222) and for gingival inflammation from 0.229 to 0.596 (median 0.391). The differences in the intraclass correlation coefficients between packet depth and attachment level on the one hand and plaque accumulation or gingival inflammation on the other could not be explained on the basis of differences in the measurement scale employed, since collapsing measurement scales had little effect on the intraclass correlation coefficients.

The observed larger intraclass correlation coefficients for changes in plaque and gingival indices suggest a larger rôle for host contribution to these measurements. In contrast, the data suggest that the major but by no means the sole factor determining the variability of attachment level or pocket depth changes is the nature of the local factors.
3‐year longitudinal study of the periodontal status of an adult population with gingivitis
Authors: Listgarten M. A. , Schifter C. C. , Laster L.
Published: December 2005

Abstract 69 adults ranging in age from 20 to 73 (mean age: 37) were randomly assigned to a control (C) and a test (T) group. Of these, 61 completed the 3‐year longitudinal study. All subjects had varying degrees of gingivitis at the start, but no overt periodontitis. Following a base line examination for PII, GI, probing depth (PD) and recession, a differential darkfield microscopic (DDFM) count of subgingival bacterial morphotypes was carried out on a pooled sample originating from one tooth surface in each sextant with the greatest probing depth. Examinations were repeated every 6 months for 3 years. The C group received regular prophylaxes every 6 months. The T subjects received prophylaxes according to a previously described schedule, and on the basis of the DDFM test outcome.

Recall intervals at the end of the study for the T group ranged from 1 to 24 months (mean: 15.7 months). Of 30 subjects in the T group at the end of the study, one half had not had their teeth cleaned for periods of 18 to 36 months without any detectable deterioration in their periodontal status by comparison with the other T subjects or the patients in the C group. Both C and T subjects exhibited increased mean PII and GI scores as compared to base line during the first half of the study. However, mean PD measurements remained unchanged.

Increases in PD from base line of 3 mm or more were observed only in approximately 1 out of a 1000 individual tooth surface comparisons, a frequency comparable to that expected to occur by chance alone. This observation indicates that in this population, little if any pocket formation occurred during the study period. GI score increases of 2 units or more occurred in relatively few subjects. 2 of 31 C patients accounted for 42 of the affected dental units, while 5 out of 30 T subjects accounted for 40.8 % of the affected dental units in that group. These observations suggest that despite the relatively high prevalence and incidence of gingivitis, the subjects were relatively resistant to periodontitis. Neither preventive schedule was effective in eliminating gingivitis. The lack of significant destructive disease in this population prevented any meaningful comparison of the relative effectiveness of the two preventive maintenance regimens in preventing recurrences of periodontitis.
Scaling and granulation tissue removal in periodontal therapy*
Authors: Lindhe Jan , Nyman Sture
Published: December 2005

Abstract The present clinical trial was performed 10 study whether subgingival scaling is a method of therapy which is equally effective as “access” Haps in reducing gingivitis and probing depths and in improving probing attachment levels. The study was also designed to assess whether granulation tissue removal is a determining factor for proper healing in the treatment of periodontal disease.

15 patients with advanced periodontal disease were included in the study‐ Each patient had at least 4 sites in each quadrant of the jaws with probing depths exceeding 6 mm. A baseline examination was performed to assess the following parameters: the oral hygiene status, the gingival conditions, the probing pocket depths and the probing attachment levels. In addition, in each quadrant, 3 approximal sites were selected for analysis of the subgingival microbiota. All of these sites showed signs of gingivitis. One site had a probing depth of <4 mm, another a probing depth between 4 and 6 mm and the third site had a probing depth exceeding 6 mm. The subgingival bacterial samples were‐ studied by dark‐field microscopy and the % of spirochetes and motile rods was assessed.

By random selection the 4 jaw quadrants in each patient were treated for periodontal disease by the use of < 11 the modified Widman flap procedure, (2) the modified Kirkland flap procedure or by (3) non‐surgical scaling and root planing. In all, 20 quadrants were treated with each of the 3 procedures.

After the termination of active periodontal treatment, all patients were recalled for professional tooth cleaning once every 2 weeks during a 12‐week period, Subsequently, they were recalled for prophylaxis every 3 months. The patients were examined 6 and 12 months after treatment using the same parameters as used at baseline.

The data from the examinations demonstrated that subgingival scaling is an effective measure in the treatment of periodontal disease. Both in terms of average gingivitis resolution and average probing depth reduction, non‐surgical therapy appeared to be equally effective as a surgical approach to treatment. It was also observed, however, that following non‐surgical treatment, a larger number of sites with pockets exceeding 6 mm remained than following surgical therapy. Most of these deep pockets in non‐surgically treated quadrants bled on probing to the base of the pocket. In addition, the subgingival microbiola of such sites were found to harbor more than 20% spirochetes and motile rods.

The present investigation also demonstrated that granulation tissue removal in conjunction with flap surgery is not a critical measure for the establishment of conditions which are conducive for proper healing of the periodontal tissues.

No attempts were made in the present study to assess the effect of treatment in furcation areas. This means that conclusions drawn from the results obtained are valid only for tooth surfaces devoid of furcation involvements.
Effects of the degree of overbite and overjet on dental health
Authors: Silness John , Roynstrand Torgeir
Published: December 2005

Abstract The purpose of the study was to examine whether any combination of vertical overbite (OB) and horizontal overjet (OJ) may be more favourable than others to dental health in anterior segments. The study group consisted of 74 females and 70 males. The participants were 15‐years‐old and had 6 anterior teeth in both jaws. The following parameters were assessed: plaque index, gingival index, probing depth, space index, filled surfaces, the number of non‐aligned proximal tooth surfaces (NONAS) and the OB/OJ ratio. The results demonstrated that participants with a relatively high OB/OJ ratio (OB/OJ 1.21) had a more favourable periodontal condition than participants with lower ratios. This was so in both sexes and both jaws. The OB/OJ ratio had little relation to the prevalence of filled surfaces.
Root resorption leading to linkage of dentinal collagen and gingival fibers?
Authors: Stahl S. S. , Tarnow D.
Published: December 2005

Abstract A maxillary central incisor in a 55‐year‐old Caucasian female was extracted in modified block as part of a histologic study of gingival responses to subgingival crown placement. The facial portion of this block showed preclinical pocket depth of 1.0 mm with moderate gingival inflammation. The block was extracted 2 weeks after crown placement and prepared for histologic evaluation. Histologic responses to subgingival crown placement were, among others: gingival recession (1.0 mm), reformation of crevicular depth (0.7 mm) and remodelling of the gingival and periodontal attachment apparatus. Histologic evaluations of the gingival unit using cellular and connective tissue stains revealed an area of root resorption immediately apical to the junctional epithelium at a portion of the facial surface. Root resorption had progressed into demin. Gingival connective tissue abutted the dentinal surface. Collagen stains showed the presence of tufts of collagen fibrils which appeared to arise from the dentin. These fibrillar elements seemed to splice with collagen fibrils found in the gingival connective tissue. The specimen thus suggests the possibility of a fiber linkage attachment involving exposed dentinal fibers as part of gingival repair following injury.
Healing after treatment of periodontal intraosseous defects
Authors: Renvert Stefan , Nilvéus Rolf , Egelberg Jan
Published: December 2005

Abstract The present study compared surgical therapy to root planing atone in the treatment of periodontal intraosscous defects. 25 defects in 14 patients were subjected to root planing only and another 25 defects in the same patients were surgically exposed and citric acid treated. The healing response was evaluated 6 months after treatment The mean gain of probing attachment level was 0.8 mm in the root‐planed defects as compared to 1.3 mm for the surgically exposed and acid‐treated defects. The probing bone level improved an average of 0.2 mm for the root‐planed areas as compared to 0.6 mm for the acid‐treated defects. The mean preoperative probing pocket depths of 6.7 mm and 6.7 mm for the 2 groups were reduced to 5.2 mm and 4.1 mm, respectively. The differences in these parameters were statistically significant between the 2 groups. However, both groups demonstrated limited regeneration.
Antimicrobial irrigation of deep pockets to supplement non‐surgical periodontal therapy
Authors: Braatz Linda , Garrett Steven , Claffey Noel , Egelberg Jan
Published: December 2005

Abstract 106 sites with probing pocket depths 7 mm or greater from 14 patients were treated with plaque control instruction and I episode of root planing. Sites in each patient were either irrigated with 2% chlorhexidine or left as non‐irrigated controls. Irrigation immediately followed root planing and was repeated daily, by the patient, for 24 weeks. Clinical measurements were made at 12 and 24 weeks, as were gingrval washings for determining the number and % of spirochetes. Results at 24 weeks demonstrated that bleeding scores decreased from 91% to 9%; the % of spirochetes dropped from approximately 9% to less than 1 %; probing pocket depths decreased from 7.5 to 4.5 ram, and probing attachment levels gained 1.1 to 1.4 mm. The chlorhexidine irrigated experimental group and the non‐irrigated control group did not differ significantly in any of the studied parameters. Thus, daily patient‐administered chlorhexidine irrigation of deep pockets did not augment the effects of non‐surgical periodontal therapy.
Periodontal conditions, remaining teeth and oral hygiene habits in a group of Vietnamese refugees in Norway
Authors: Selikowitz Harry‐Sam , Gjermo Per
Published: December 2005

Abstract Since 1975, about 3500 Vietnamese refugees have come to Norway. The purpose of the present study was to report on remaining teeth and periodontal conditions in a population of 200 adolescent and adult Vietnamese refugees.

The mean number of remaining teeth ranged from 27.8 in the youngest age group to 24.6 in the oldest. This number of teeth is slightly lower than reported from Norwegian populations, but similar to other Asian populations.

Almost all index teeth showed dental plaque, and subgingival calculus was observed in 9 of 10 teeth after the age of 20. Gingival bleeding was seen on all index sites of 26.5% of the subjects and all subjects above the age of 40 had gingivitis adjacent to one or more index teeth.

There was a progression of probeable pocket depths with increasing age. In the oldest age group, 72.7% had pockets between 3.5 mm and 5.5 mm.

The data indicated that if optimal gingival conditions should be obtained, substantial resources would be required. In populations with limited resources and with relatively few subjects with severe periodontal breakdown, it is suggested that an identification of subjects “at risk” to be dentally handicapped through loss of teeth, should be a priority.
A direct technique with a double lateral bridging flap for coverage of denuded root surface and gingiva extension
Authors: Marggraf E.
Published: December 2005

Abstract We are introducing a new surgical technique which enables us to cover gingival recessions and extend the gingiva with a one‐step procedure. This method can be described generally as a combination of a coronally repositioned flap and a modified vestibulum plastic. So far this method has been applied to 55 teeth of 19 different patients. The results have been observed for 2 years. After this time, 54.5% (30 teeth) still had complete coverage of the previously denuded root surfaces. The results show that it is possible to cover gingival recessions without increasing the zone of keratinized gingiva.
Periodontal ligament areas and occlusal forces in dentitions restored with cross‐arch bilateral end abutment bridges
Authors: Laurell Lars , Lundgren Dan
Published: December 2005

Abstract The aim of the present investigation was to find out to what extent the magnitudes of chewing and biting forces in dentitions restored with cross‐arch bilateral end abutment bridges are correlated to the areas of the periodontal ligament supporting the abutment teeth.

12 subjects whose dentitions had been periodontally treated and prosthetically restored participated in the study.

The chewing and biting forces were measured in various parts of as well as over the entire dentition simultaneously using 4 strain gauge transducers bilaterally placed in pontics of the posterior (first molar/second premolar) and anterior regions.

Based on calculations of the periodontal ligament areas, a new periodontal support index. PSI1, is introduced. This index expresses the relation between the total remaining periodontal ligament area supporting the bridge abutments and total maximal periodontal ligament area if all teeth were preserved as abutments. It is compared with the index of Ante. PSIA, which expresses the relation between the total remaining periodontal ligament area of all abutments and the total maximal periodontal ligament area of all replaced teeth.

Within the present group of subjects. PSIL varied from 10 to 44% and PSIA from 17 to 118%.

Based on the results of the correlation analyses, it is suggested that in dentitions restored with cross‐arch bilateral end abutment bridges, the magnitude of the chewing forces is positively correlated to the areas of the periodontal ligament supporting the bridge abutments, whereas the periodontal ligament areas have no influence on the comparatively larger biting forces.

The relevance of the 2 periodontal support indices and the clinical implications of the results of the study are discussed.
Bleeding/plaque ratio
Authors: van der Velden U. , Winkel E. G. , Abbas F.
Published: December 2005

Abstract The purpose of the present study was to investigate the clinical differences between individuals highly susceptible and individuals insusceptible to periodontal breakdown. The susceptible group consisted of 7 patients with a diagnosis of juvenile periodontitis. The insusceptible group consisted of 7 individuals selected on the basis of age (52 years or older), presence of at least 18 teeth, no evidence of extractions due to periodontal breakdown, no loss of attachment, shallow pockets, gross amounts of plaque and no history of interdental cleaning. Results showed that the susceptible group had more bleeding, less plaque and deeper pockets than the insusceptible group. Since the 2 groups seem to behave differently with regard to bleeding upon probing and amount of plaque, bleeding plaque ratios were calculated. Testing showed a highly significant difference between the 2 groups. The same results were obtained if only sites with shallow pockets were included in the analysis. On the basis of these results, it is hypothesized that a high value of the ratio between bleeding and plaque may act as a prognostic indicator for periodontal breakdown.
Some effects of a Sanguinarine‐containing mouthrinse on developing plaque and gingivitis
Authors: Wennström Jan , Lindhe Jan
Published: December 2005

Abstract The present clinical trial was performed to assess the effect of a Sanguinarine‐containing mouthrinse on developing plaque and gingivitis in man. The trial was designed as a blind cross‐over study. The active mouthrinse consisted of a 0.03% aqueous solution of Sanguinaria extract; an aqueous solution With similar color and taste as the active rinse was used as the placebo preparation. 14 dental students participated in the trial. At the start of each of 2 test phases, their gingival conditions were normal and their tooth surfaces free from dental plaque. Following a baseline examination, the participants refrained from mechanical tooth cleaning measures for 2 weeks. They rinsed twice daily with either the active or the placebo mouthrinse. Clinical examinations of plaque and gingivitis were repeated after 4, 7 and 14 days use of the mouthrinse preparation. During the second test phase of no mechanical tooth cleaning, the subjects who previously had rinsed with the placebo solution now used the active compound and vice versa. The results demonstrated that the Sanguinarine‐containing mouthrinse was effective in reducing plaque formation and retarding the development of gingivitis.
Analysis of change – are base‐line measurements needed? Some statistical comments on a common experimental design
Authors: Blomqvist N. , Dahlen G.
Published: December 2005

Abstract In experiments where the treatment effect is denned as the change of a variable during treatment, one may. under certain circumstances, obtain a higher precision by basing the statistical analysis on the after‐treatment measurements alone instead of the change during treatment. The conditions for this are derived and an empirical illustration involving bacterial counts is presented. In the case of a crow‐over trial it is found in this particular case that not using the base‐line measurements reduces the number of patients needed by approximately 40%, In the case of a completely randomized design, about the same precision is obtained whether or not one utilizes the base‐line values.
Periodontal and prosthetic treatment in patients with oral lichen planus
Authors: Erpenstein Heinz
Published: December 2005

Abstract The problems of periodontal and prosthetic treatment are demonstrated with a typical case of oral erosive lichen planus with gingival involvement. The results attained suggest that oral lichen can be improved by optimum plaque control and periodontal treatment. Prosthetic treatment should be based on bridgework and not on removable partial dentures owing to the isomoarphous irritant effect that characterizes lichen planus. Once the plaque situation is firmly under control, even teeth with advanced destruction of the supporting tissues may be used as abutments. In the event of all molars being absent, cantilever bridges should be fitted. In this case it is not essential to replace all the molars provided that the masticatory function is subjectively adequate.
The composition of the subgingival microflora of young adults suffering from juvenile periodontitis
Authors: Müuller H.‐P. , Flores‐de‐Jacoby L.
Published: December 2005

Abstract The composition of subgingival plaque, from healthy and periodontally diseased regions, as well as the clinical periodontal condition of 6 patients, 17 to 24‐years‐old suffering from juvenile periodontitis were examined. 6 older patients with rapidly progressive periodontitis served as a control. Samples of subgingival plaque were taken from first molars and central incisors and were analysed morphologically by dark‐field microscopy. In the control group in healthy regions the ratio between non‐motile and motile bacteria was 27‐1 and about 1:1 in deep pockets. In the juvenile periodontitis group in diseased regions, motile bacteria made up only 1/1 of the bacteria present. The results clearly show that our relatively old patients with juvenile periodontitis had a completely different microflora in their periodontally diseased regions than patients with common periodontitis. As regards our observations by dark‐field microscopy, one can assume, however, that with increasing age there might be a shift of the flora associated with juvenile periodontitis lesions from a rather simple composition to a more complex composition very similar to the flora seen in rapidly progressive adult periodontitis lesions.
Effect of periodontal therapy on spontaneous lymphocyte response and neutrophil chemotaxis in localized and generalized juvenile periodontitis patients*
Authors: Suzuki Jon B. , Risom Laurel , Falkler William A. , Collison Christine , Bowers Gerald
Published: December 2005

Abstract The etiology and pathogenesis of juvenile periodontitis may involve dysfunctions of the host response. In particular, the neutrophil and the lymphocyte have been implicated in the disease. The purpose of the present study was to examine the in vitro spontaneous lymphocyte response and neutrophil chemotaxis in populations of localized juvenile periodontitis (LJP) and generalized juvenile periodontitis (GJP) patients and age‐ and sex‐matched healthy subjects (HS). These laboratory values were also evaluated immediately following and 1 year after periodontal therapy. The results show that spontaneous lymphocyte responses reflecting the autologous mixed lymphocyte reaction (AMLR) are depressed for GJP patients. The decreased AMLR in the GJP group appears to represent an abnormal T‐cell function which may reflect activity of the periodontal lesion. LJP patients have an increased AMLR response, although h was not statistically significant. I year following active periodontal therapy, spontaneous lymphocyte responsiveness returned to normal in most GJP patients. The increased spontaneous lymphocyte responsiveness of LJP patients was not changed either immediately following active periodontal therapy or 1 year later, LJP and GJP patients exhibited a neutrophil chemotaxis defect when compared lo cells from HS. This neutrophil defect was still observed I year following active therapy.
Assessment of plaque by image analysis
Authors: Eaton K. A. , Kieser J. B. , Baker R.
Published: December 2005

Abstract The uneven distribution and pattern of staining, revealed on root‐planed, periodontally‐involved root surfaces by the application of a plaque‐disclosing solution, precludes the use of conventional plaque scoring indices or other methods of assessment based on planimetric and gravimetric techniques. A method has been developed and evaluated to quantify stained areas using image analysis. The method is reproducible, with an error factor of 1.32%, and represents a comparatively simple yet effective technique for quantifying plaque on irregular root surface areas.
Effect of self‐administered daily irrigation with 0.02% SnF2 on periodontal disease activity
Authors: Boyd R. L. , Leggott P. , Quinn R. , Buchanan S. , Eakle W. , Chambers D.
Published: December 2005

Abstract To determine the effect on periodontal health of a daily self‐administered irrigation with 0.02% stannous fluoride (SnF2) solution, 28 subjects who had moderate to advanced periodontitis were randomly divided into 3 groups: a control group (n= 9) which used no irrigation, a group (n= 8) which used a self‐administered water irrigation device (Water Pik) daily with water (H2O group) and a group (n=11) which used the Water Pik in a similar manner but with SnF2 solution (SnF2 group). All subjects were instructed in routine tooth brushing and flossing but received no other periodontal treatment. 4 study sites were selected from each patient which had pocket depths greater than 4 mm and bleeding upon probing.

Plaque index, gingival index, bleeding tendency, pocket depth, loss of attachment, and microbiologic samples of subgingival plaque for morphologic determinations were collected from all study sites at baseline, 2, 6, and 10 weeks. A cross‐over was then initiated for 2 additional monthly checks in which the H2O group changed to SnF2 and the SnF2 group was divided into 2 subgroups which either continued to use SnF2 or changed to H2O. The control group completed the study at the beginning of the crossover.

The clinical data showed significantly more improvement in periodontal health during the first 10 weeks for the SnF2 group (p < 0.01). After cross‐over, the clinical data indicated the group that changed from H2O to SnF2 significantly improved their periodontal health, while the group that changed from SnF2 to H2O became worse. The microbiologic data showed trends which agreed with the clinical data during the first 10 weeks but were less significant. After cross‐over, the %s of motile rods and spirochetes were too small (0–7%) to establish statistically significant changes considering the accuracy of the technique used.