bluuebunny/crossref_metadata_2025 huggingface dataset:
6‐month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo (II). Effect on plaque and salivary microflora
Authors: Hase J. C. , Edwardsson S. , Rundegren J. , Attström R. , Kelty E.
Published: December 2005

Abstract. This double‐blind, randomised, 6‐month clinical trial with parallel group design in 68 subjects with gingivitis was conducted to study the effects on the oral flora of delmopinol hydrochloride 2 mg/ml (0.2% w/v, Decapinol Mouthwash), when used for partly supervised mouthrinsing in comparison with placebo and chlorhexidine digluconate 2 mg/ml (0.2% w/v, Hibitane Dental, ICI Pharmaceuticals, UK). Apart from estimating the total cultivable microbial dental plaque flora and salivary flora, analyses were focused on bacterial groups associated with gingivitis/periodontitis and dental caries. Furthermore, the presence of staphylococci, Gram‐negative enteric bacteria and yeasts in saliva were evaluated. The minimal inhibitory concentration (MIC) was determined for isolates belonging to the predominating micro‐organisms in samples of both dental plaque and saliva. In relation to the findings in the placebo group, the use of delmopinol during the rinsing period did not produce an undesirable shift in the bacterial populations considered to be related to dental caries or periodontal diseases. These groups remained virtually unchanged during the study. In relation to the observations in the placebo group, slight reductions in the total cultivable plaque and salivary flora were observed during the study and no change was found in the ratio total anaerobically/aerobically cultivable microbial flora. Furthermore, no increased growth in staphylococci, enteric bacteria or yeasts was observed in the saliva samples. The pattern of changes taking place in the composition of the plaque and salivary microbial flora in samples from the participants rinsing with chlorhexidine were in most aspects similar to that observed in the delmopinol group. In the delmopinol group, no microbiologically significant changes were observed over time in the MIC‐values for the isolates, neither in the plaque nor in the saliva samples, which indicates that no adaptation to delmopinol had taken place during the rinsing period. Similar observations were made for the plaque isolates in samples from the participants in the chlorhexidine group. On the other hand, when Gram‐positive and catalase‐negative cocci from the saliva samples of the latter group were tested against chlorhexidine, 4–6 times higher MIC‐values were obtained at 3 and 6 months both when compared to baseline and in comparison with the other two rinsing groups (p<0.01 or p<0.05). Neither delmopinol nor chlorhexidine showed any residual effect on the studied microbial groups in the plaque and the saliva samples 3 months after the end of treatment. In conclusion, delmopinol was accompanied by a composition of the plaque and salivary flora associated with healthy conditions in the oral cavity.
Reliability of linear alveolar bone loss measurements of mandibular posterior teeth from digitized bitewing radiographs
Authors: Hildebolt C. F. , Pilgram T. K. , Yokoyama‐Crothers N. , Fletcher G. , Helbig J. L. , Bartlett T. Q. , Gravier M. , Vannier M. W. , Shrout M. K.
Published: December 2005

Abstract. Observer reliability in performing linear measurements between the cementoenamel junction and alveolar crest was determined for mandibular posterior teeth from digitized clinical bitewing radiographs acquired during recall examinations. 6 measurements (corresponding to traditional probing measurements were made per tooth by 3 observers. Mesial and distal measurements made to the most coronal aspects of the alveolar crest were the most reliable and least biased, As was anticipated, intra‐observer reliability was better than inter‐observer reliability although the 3 observers of our study were able to detect a significant mean change (0.1 mm. p < 0.0001) in alveolar bone height over a 1‐year period for 10 patients. For our most reliable and unbiased measurements (mesial measurements to the alveolar crest), a change of 0.54 mm (90th percentile) would be required to indicate change at a site from one time to the next. Based on the reliability of our digital radiographic measurements, with the α error rate set at 0.05 and β at 0.20. a difference in alveolar bone height of 0.3 mm could be detected with a patient sample size of between 13 (best case) and 54 (worst case).
Additional clinical and microbiological effects of amoxicillin and metronidazole after initial periodontal therapy
Authors: Winkel E. G. , van Winkelhoff A. J. , van der Velden U.
Published: December 2005

Abstract. The aims of this study were to evaluate the clinical and microbiological effects of initial periodontal therapy (IT) and to determine the additional effects of systemic amoxicillin (Flemoxin Solutab®) 375mg TID plus metronidazole 250mg TID therapy in patients with adult. Actimobacillus actinomycetemcomitans (Aa) Associated periodontitis in conjunction with either Porphyromonas gingivalis (Pg) Bacteroides forsythus (Bf) and or Prevotella intermedia (Pi). In addition the adverse effects of the antimicrobial therapy were also documented. A total of 22 patients were enrolled. The deepest, bleeding pocket in each quadrant was selected and at these 4 experimental sites clinical measurements and microbiological testing was carried out at baseline, after (IT), i.e., 21 weeks after baseline, and after antimicrobial therapy (AM), i.e. 35 weeks after baseline. At baseline, the mean plaque index (PI) amounted 0.5, 0.1 after IT and 0.3 after systemic AM. The mean bleeding index decreased from 1.6 to 1.2 after IT and a further decrease to 0.7 Lifter AM was noted. Suppuration was completely eliminated after AM. The mean change of probing pocket depth (PPD) after IT amounted 1.4 mm and was further reduced with an additional mean change of 1.1 mm after medication. Clinical attachment gain was 1.1 mm after IT and an additional 0.9 mm was observed after AM. One of the 22 Aa positive patients and 4 of 17 Pg positive patients became negative for these species after IT. The number of patients with detectable Pi decreased from 16 to 10 after IT. After AM in comparison to baseline, suppression below detection level for Aa was achieved in 19 out of 22, for Pg in 9 out of 17, for Bf in 13 out of 14, and for Pi in 11 out of 16 patients. By contrast, higher frequencies of Peptostreptococcus micros and Fusobacteriam nucleation were found after AM. On the basis of the microbiological results the study group was separated into 2 subgroups: group was consisted of subjects who had no detectable levels of Aa, Pg, Bf and <5° of Pi after AM. Group B consisted of those who will showed presence of one of these 3 species and or ≥5° levels of Pi. After AM group B had significantly higher PI, BI, PPD and CAL scores then group A. It is concluded that group A showed low plaque scores and no detectable periodontal pathogens. This microbiological condition has been associated with a long‐term stable periodontium.
Relationship between C‐telopeptide pyridinoline cross‐links (ICTP) and putative periodontal pathogens in periodontitis
Authors: Palys Michael D. , Haffajee Anne D. , Socransky Sigmund S. , Giannobile William V.
Published: December 2005

Abstract. Crevicular fluid pyridinoline cross‐linked carboxyterminal telopeptide of type 1 collagen (ICTP) is predictive for future alveolar bone loss in experimental periodontitis in dogs. The present study sought to relate ICTP to a panel of subgingival species in subjects exhibiting various clinical presentations such as health (n= 7), gingivitis (n= 8) and periodontitis (n=21), 28 subgingival plaque and GCF samples were taken from mesiobuccal sites m each of 36 subjects. The presence and levels of 40 subgtngivai taxa were determined in plaque samples using whole genomic DNA probes and checkerboard DNA‐DNA hybridization. GCF ICTP levels were quantified using radioimmunoassay (RIA). Clinical assessments made at the same sites included: BOP, gingival redness, plaque, pocket depth, and attachment level. Differences among ICTP levels in the 3 subject groups were sought using the Kruskal‐Wallis test. Relationships between ICTP levels and clinical parameters as well as subgingival species were determined by regression analysis. The results demonstrated significant differences among disease categories for GCF ICTP levels for healthy (1.1+0.6 pg/site (mean±SEM)) gingivitis (14.8±6.6 pg/site) and penodontitts subjects (30.3 + 5.7 pg/site) (p= 0.0017). ICTP levels related modestly to several clinical parameters. Regression analysis indicated that ICTP levels correlated strongly with mean subject levels of several periodontal pathogens including B. forsythus, P. gingivitis, P. intermedia, P. nigrescens and T. dentcola (p < 0.01). The data indicate that there is a positive relationship between the putative bone resorptive marker ICTP and periodontal pathogens.
A dental implant: aluminium trioxide exhibited no effect on mouse reproductive and mutanogenic potential
Authors: Zelic O. , Dimitrijevic B. , Vasilijevska M. , Dujic A. , Lekic P. C.
Published: December 2005

Abstract. Several diseases as well as trauma can affect the composition and integrity of periodontal tissues leading eventually to the destruction of connective tissue matrix and cells, loss of attachment and resorption of alveolar bone, often followed by tooth loss. Replacement of the missing tooth could then be provided by endosseous dental implants healing in a form of osseo‐ or fibrosteal integration to the alveolar bone. Aluminium oxide ceramics, a form of endosseous implant, allows osseointegration type of healing and has demonstrated excellent biocompatibility. However, potential aluminium toxicity has been implicated in the pathogenesis of a number of clinical disorders and for this reason we examined the reproductive and mutagenic effect of aluminium trioxide ceramic implant in experimental mice. 720 female and 45 fertile male BALB‐cAn NCR mice were included in the study, 3 experimental groups of fertile male mice (15 for each group) were treated with an intraperitoneal injection of aluminium trioxide (1 g/kg of body weight, group I). with ethyl‐methane‐sulphonate as a positive control (200 mg/kg. group II) and with Tween‐80 (10 mg/kg as a negative control. Group III). Each of the labeled male mice fertilized previously uncoupled female mice during 8 weeks (a pair per week) to facilitate appropriate pre‐ and post‐meiotic conditions of spermatogenesis to occur. Female mice were sacrificed with cervical dislocation at day 13 after fertilization. Immediately upon sacrifice the uterus was removed and the number of alive and healthy, or alive but mutated and/or dead embryos was computed to determine the dominant lethal or mutagenic effect. Animals treated with aluminium trioxide demonstrated similar effects on the reproductive and mutagenic capacity as the negative control, whereas the animals treated as positive controls exhibited significantly reduced reproductive and mutagenic capacity. Collectively, we concluded that aluminium trioxide has a very low rate of embryonal mortality and mutagenicity in mice. This finding is in general agreement with the biocompatibility of aluminium trioxide as an implant material.
Clinical and microbiological findings in elderly subjects with gingivitis or periodontitis
Authors: Schlegel‐Bregenzer Bettina , Persson Rigmor E. , Lukehart Sheila , Braham Pamela , Oswald Teresa , Persson G. Rutger
Published: December 2005

Abstract. The objective of the present study was to study the supra‐ and subgingival microflora by culture and cDNA probe methods in 20 elderly subjects who were between 62 and 93 years of age, 10 of them had gingivitis only, and 10 had periodontitis. B. forsythus (BF). P. gingivalis (PG), P intermedia (PI), P. nigrescens (PN), A. actinomycetemcomitans (AA), T. denticola (TD), and pathogen‐related oral spirochetes (PROS) were studied. Oral hygiene was similar and poor in both groups. The mean probing depth at sample sites was 6.7 mm (S.D±1.3) in the periodontitis group and 2.2 mm (S.D.±1.5) in the gingivitis group (F=17.75, p < 0.001). Mean clinical attachment levels (CAL) were 4.3 mm (S.D.±2.0) and 1.7 mm (S.D.±0.9) respectively (p < 0.001). Total viable counts >1.0×105 in supra‐gingival plaque samples were found in all periodontitis and in eight gingivitis subjects, 70× more black‐pigmented organisms were found in supra‐gingival and 185 times more in sub‐gingival plaque from the periodontitis group (p < 0.01). Culture data showed P nigresecens in 10% periodontitis and 50% gingivitis subjects (p < 0.03). In supra‐gingival samples by the Affirm™ DP test, BF was present in 50% periodontitis and 60% gingivitis while culture data were negative for all subjects, PG was found in 30%. periodontitis and 50% gingivitis subjects with TD in 70% periodontitis and in 30% gingivitis subjects. In the ub‐gingival plaque samples 80% periodontitis and 70% gingivitis subjects had >1×105 anaerobes. The total count of black‐pigmented organisms was significantly greater in the periodontitis elders (p < 0.001). cDNA probes by the Affirm™ DP test identified subgingival presence of BF (80%) PG (80%), PI(80%), AA (0%), TD (50%) in periodontitis subjects with BF (70%), PG (40%), PI (30%) and TD (20%) in gingivitis subjects. PROS were found in (80%) samples from periodontitis and in (60%) of gingivitis elderly. Only the quantities of PI (r=0.48, p < 0.01) and TD (r=0.37, p < 0.01) were associated with the disease definition. The smoking habit in the periodontitis group was significantly higher (p < 0.01). A history of smoking may contribe significantly to periodontitis in the presence of pathogens.
Guided tissue regeneration in the treatment of human infrabony defects Clinical, radiographical and microbiological results: a pilot study
Authors: Bratthall G. , Söderholm G. , Neiderud A. M. , Kullendorff B. , Edwardsson S. , Attström R.
Published: December 2005

Abstract. The aim of the study was to evaluate the clinical, radiographical and microbiological outcome after using guided tissue regeneration (GTR) with a bioabsorbable membrance, Resolut$$. Subjects with bilateral infrabony defects at single rooted teeth were selected. A total of 22 teeth, 2 in each 1 of 7 patients and 4 in 2 patients, with probing pocket depth ≥5 mm, 3 months after scaling, participated. At baseline, assessments of plaque and gingival indices, bleeding on probing, probing pocket depth and probing attachment level were recorded and reproducible radiographs for computer‐based bone level measurements were taken. Bacterial samples were collected to investigate the presence of periodontitts‐assoctated bacteria, e.g., Porphyrnmonas$$Prevotella‐and Fusobactrium‐like micro‐organisms. One tooth was randomly treated with GTR and the contralateral With an open debridement procedure as a control. Clinical, radiographical and microbiological examinations were repeated 6 and 12 months postoperatively. Both procedures demonstrated a siatistically significant improvement of gingival conditions, reduction of pocket depths and gain of attachment. When evaluating the differences between test and control teeth, none of the clinical parameters yielded statistical differerence. Computer‐based bone‐level measurements showed only small differences in the majority of both test and control sites. The differences were not significant. Periodontitis‐associated bacteria were present at baseline, but the appearance was not related to any specific site or patient and did not demonstrate and unwanted change in the 6‐ and 12‐ month samples. The findings suggest that the clinical, radiographical and microbiological improvements were not significantly enhanced with the GTR therapy.
Presence of cortisol in gingival crevicular fluid A pilot study
Authors: Axtelius B. , Edwardsson S. , Theodorsson E. , Svensäter G. , Attström R.
Published: December 2005

Abstract. Cortisol is one of the primary mediators of the stress response, in the main having immunosuppressive effects. An important component of the host response in periodontal inflammation is gingival crevicular fluid (GCF), with constituents mainly derived from serum, Cortisol like many other steroids, is present in saliva but its occurrence in GCF does not seem to be documented, Unstimulated whole saliva was collected and GCF was sampled on filter disks. The samples were analysed by a modified RIA method for serum in such a way that small volumes and low concentrations could be measured. Our findings suggest that the total concentration of cortisol in GCF might be estimated to levels below 1/10 of that in serum. However, what appears as a distinctive feature is the considerable variation of the cortisol concentrations for individual teeth. To our knowledge, this is the first time cortisol has been measured in gingival crevicular fluid, and this opens Ihe prospects for further in vivo research.
The use of locally‐delivered doxycycline in the treatment of periodontitis. Clinical results*
Authors: Drisko Connie Hastings
Published: December 2005

Abstract. The clinical safety and effectiveness of a subgingivally‐delivered biodegradable drug delivery system containing doxycycline hyclate (DH) has been evaluated in 3 large 9‐month multicenter randomized parallel‐design controlled clinical trials. A total of 1002 patients having at least 2 quadrants with a minimum of 4 qualifying pockets ≥5 mm that bled on probing were enrolled. Each subject had ≥7 mm probing depths in 2 of the qualifying pockets. Study 1 (n= 180) compared DH to sanguinarine chloride (SC) and vehicle control (VC). Study 2 (n=411) and study 3 (n=411) compared DH to VC, scaling and root planing (SRP), and oral hygiene (OH). Clinical measurements included probing depth reduction (PDR), attachment level gain (ALG), bleeding on probing reduction (BOP) and plaque index (PI). Analysis of efficacy data from these 3 trials show all treatments gave significant positive clinical changes from baseline at most time points. Study 1 results indicate that DH was superior to SC and VC in PDR at all time points. Similar results were obtained for ALG when DH was compared to SC and VC, For BOP reductions, DH was superior to VC al all time points and to SC at months 5 through 9. For DH, mean ALG in deep (≥7 mm) pockets was 1.4 mm; mean PDR for DH was 2.6 mm. For moderate (5 to 6 mm) pockets, ALG was 0.8 mm and PDR 1.5 mm. Studies 2 and 3 reported mean month 9 ALG for SRP as 0.7 mm and 0.8 mm, respectively. For DH, ALG was 0.8 mm in both studies 2 and 3. At month 9 in studies 2 and 3, 29%, and 31%, of DH sites and 27% and 34% of SRP sites showed ALG ≥2 mm. Probing depth reductions followed the same pattern, with 32% of DH sites and 32% of SRP sites showing ≥2 mm PD reductions in study 2, and 41% of DH and 43% of SRP sites showing PDR of ≥2 mm in study 3. Comparisons between DH, VC, and OH treatment groups in studies 2 and 3 showed DH treatment was statistically superior to VC and OH at most time points. Results of these 3 large clinical trials demonstrate that treatment of periodontitis with 10% doxycyline hyclate in a bioabsorbable delivery system is equally as effective as SRP and superior in effect to VC and OH in reducing the clinical signs of adult periodontitis.
The use of locally‐delivered chlorhexidine in the treatment of periodontitis. Clinical results*
Authors: Killoy William J.
Published: December 2005

Abstract. Since the advent of a nondegradable controlled local delivery of antibiotics in 1979, several second generation systems have been developed. Second generation systems have attempted to improve on the early system. Chlorhexidine has been used effectively for over 30 years as an antiseptic. In the early 1970s, chlorhexidine gluconate was incorporated at 0.2% into mouthrinses in Europe and in 1986 it was incorporated at 0.12%, in a mouthrinse in the United States. Since these mouthrinses were effective in reducing the supragingival flora, had a high safety margin, and had no reported bacterial resistance, chlorhexidine offered a therapeutic advantage for a local delivery system. This system was developed and studied. This report will discuss this new biodegradable system containing chlorhexidine gluconate as the active agent (PerioChip®). Parmacokinetics of the system and a review of the multicenter studies in Europe and the United States are discussed. In these randomized clinical trials the chlorhexidine chip has been shown to enhance the effects of scaling and root planing. Chlorhexidine chip in conjunction with scaling and root planing, when compared to scaling and root planing alone, has shown significant improvement in probing pocket depth reduction, probing attachment level and bleeding on probing. This delivery system, in combination with scaling and root planing, has also resulted in significantly more probing depth reductions of 2 mm or more. The system is safe and efficacious. Placement of the chip is usually done in less than 1 min, it requires no retention system, biodegrades, and does not require a follow‐up dental appointment.
The use of locally‐delivered minocycline in the treatment of chronic periodontitis. A review of the literature*
Authors: Vanderkerckhove B. N. A. , Quirynen M. , Van Steenberghe D.
Published: December 2005

Abstract. Tetracyclines are frequently used in the treatment of periodontitis; however, emergence of resistant bacterial strains has decreased the utility of these drugs. At present, there are a lot of data in the literature from which one can draw conclusions regarding the use of local drug delivery. This paper reviews the utility and different systems of local delivery of minocycline, a semisynthetic tetracycline, in the treatment of periodontitis.
Treatment of deep and shallow intrabony defects A multicenter randomized controlled clinical trial
Authors: Cortellini Pierpaolo , Carnevale Gianfranco , Sanz Mariano , Tonetti Maurizio S.
Published: December 2005

Abstract. This prospective multicenter intra‐individual randomized controlled clinical trial was designed to compare the efficacy of guided tissue regeneration (GTR) with bioresorbable barrier membranes versus access flap surgery, in intra‐bony defects. 2 similar defects were selected in each of 23 patients and randomly assigned to 1 of the 2 treatments. Surgery consisted of an identical procedure except for the omission of the barrier membrane in the flap control sites. At 1‐year. probing pocket depth reductions were 4.3±2.3 mm in GTR treated sites and 3.0±1.5 mm in the flap control sites (p=0.02. paired t‐test). Clinical attachment level (CAL) gains were 3.0± 1.7 mm in the GTR sites and 1.6±1.8 mm in the control sites (p=0.009. paired t‐test). A subset analysis, performed according to the initial depth of the intrabony component of the defects (INFRA), indicated that in shallow defects (INFRA ≤3 mm) treated with the access flap alone. CAL gains were 1± 1.5 mm. while in deep ones (INFRA ≥4 mm) they were consistently greater (1.9±1.9 mm). The % CAL gains, calculated as the % of the baseline intrabony component depth, however, were almost identical in the 2 subpopulations (45.8±64.7% in shallow and 43.8±37.6% in deep defects). Similarly, in the GTR sites, linear CAL gains were greater in deep (3.7±1.7 mm) than in shallow defects (2.2±1.3 mm), but no differences were observed in terms of % CAL gains (76.1±27.7% and 75.8±45%. respectively). The frequency distribution of CAL changes expressed as %s of the baseline INFRA indicates that most of the sites treated with GTR (73% in shallow and 92% in deep defects) gained 50% or more CAL. Furthermore, many defects (64% of shallow and 33% of deep defects) reached 100% of CAL gain. The present study demonstrated that: (i) GTR with bioresorbable barrier membranes resulted m a significant added benefit in comparison with access flap alone; (ii) the linear amounts of CAL gains were greater in deep than in shallow defects; (iii) CAL gains expressed as %s of the baseine depths of the intrabony component, were similar in shallow and deep defects; (iii) the regenerative procedure tested in the present study resulted in CAL gains equal to the depth of the intrabony component of the defect in some, but not in most of the instances.
Sonic and mechanical toothbrushes
Authors: MacNeill Simon , Walters Douglas M. , Dey Anjana , Glaros Alan G. , Cobb Charles M.
Published: December 2005

Abstract. The purpose of the present study was to compare the in vitro effects of a mechanical and a sonic toothbrush on the viability of Actinomyces viscosus, the rationale being that induction of irreparable microbial damage resulting from aggressive mechanical action or sonic energy, may inhibit or disrupt the process of successional colonization. Cultures of A. viscosus were grown to a standardized optical density and subdivided into 3 treatment groups of 20 specimens each. Treatment groups consisted of an untreated control and exposure to a mechanical or sonic toothbrush for 15, 30, 45, and 60 s. Subsequent to the prescribed treatment, samples were taken from each specimen dish, subcultured, and the number of CFUs determined. Additional samples were obtained for negative staining and examination by electron microscopy. The mean number of CFUs for each treatment group at each treatment interval were statistically analyzed by ANOVA and multiple pairwise comparisons. Results showed a significant main effect for toothbrushes (p < 0.0001) and exposure time (p < 0.01), but only marginal significance for the interaction of toothbrush with exposure time (p 0.055). Posthoc tests showed a significantly greater number of CFUs for the sonic toothbrush compared to both the untreated control and mechanical toothbrush groups. Electron microscopic examination revealed a decrease in aggregation tendency and loss of fimbriae in the sonic toothbrush group. Based on the lack of morphologic evidence that would indicate cell damage and the increase in CFUs over that of the control group, it appeared that neither the mechanical or sonic toothbrushes affected cell viability.
Analysis of serum antibody responses to periodontopathogens in early‐onset periodontitis patients from different geographical locations
Authors: Çelenligil H. , Ebersole J. L.
Published: December 2005

Abstract. Serum antibody specificity to oral micro‐organisms was used to delineate the pathogens associated with early‐onset periodontal diseases in a Turkish population. Additionally, comparison of the findings to those derived from a clinically similar US patient population described differences in bacterial specific antibody between these 2 geographic regions. Serum from 89 (LJP), 86 (RPP) and 94 (normal) subjects was analyzed (ELISA) to determine IgG antibody to 14 oral micro‐organisms. All LJP patients from Turkey exhibited elevated antibody levels to A. actinomycetemcomitans (serotypes c and a significantly increased), while antibody levels to A. actinomycetemcomitans Y4 and JP2 (serotype b) were significantly higher in US LJP patients. 50% of the Turkish RPP patients also showed elevated anti‐A. actinomycetemeomitans antibody, although the US RPP patients exhibited significantly higher antibody levels and frequency of elevated antibody to the A. actinomycetemcomitans serotypes. Healthy subjects and LJP and RPP patients from the US exhibited higher antibody levels to all 3 P. gingivalis serogroups compared to those from Turkey, although, the frequency of elevated antibody to the P. gingivalis serogroups was significantly higher in LJP and RPP patients from Turkey than from the US. Interestingly, 87% and 77% of the LJP patients in the Turkish population had elevated antibody responses to P. gingivalis and E. corrodens, respectively, which was not observed in the US LJP patients. These data suggested that considerable variation exists in the systemic antibody levels to periodontopathogens between these 2 countries. This supports potential differences in subgingival colonization or antigenic composition of these pathogens between patient populations from different geographical regions.
Changes in the prevalence of residual pockets and tooth loss in treated periodontal patients during a supportive maintenance care program
Authors: Tonetti Maurizio S. , Muller‐Campanile Veronique , Lang Niklaus P.
Published: December 2005

Abstract. Bleeding on probing and the presence of deep periodontal pockets are considered to be the best site‐specific indicators for periodontal disease progression during the maintenance phase of periodontal therapy. A major emphasis of supportive periodontal care (SPC) programs, therefore, has been the control of bleeding pockets. This investigation retrospectively evaluated the changes in the prevalence of bleeding on probing, periodontal pockets, bleeding periodontal pockets and the prevalence of tooth loss in a random sample of 273 periodontal patients participating in a supportive maintenance care program at a University Clinic. During an observation period of 67±46 months (range 5 months to 23 years), the overall incidence of all causes of tooth mortality was 0.23 ±0.49 teeth per patient per year of observation. 56% of subjects, however, did not experience any tooth loss, while less than 10% of patients lost more than 3 teeth. Thus, participation m the SPC program was effective in preventing tooth loss in the majority of patients. During the SPC period, however, a significant increase in the prevalence of periodontal pockets, and of bleeding on probing positive periodontal pockets, in particular, was observed. At completion of active periodontal therapy. 56.4% of patients were free from bleeding pockets. This decreased to a mere 13.6% at the latest SPC evaluation. The observed increases in the number of bleeding pockets was significantly associated with: longer times since completion of active periodontal therapy, more advanced periodontal diagnosis, higher %s of bleeding sites in the dentition, cigarette smoking, lack of inclusion of periodontal surgery in the active treatment phase, tooth loss, and the response to the active phase of periodontal treatment. The data presented in the paper indicate that the observed increase in the prevalence of bleeding pockets and tooth loss was not homogeneously distributed in the studied SPC population. better knowledge of risk indicators may lead to improved and more efficient risk management efforts during periodontal maintenance care.
An in vivo Study of the chlorhexidine release profile of the PerioChipTM in the gingival crevicular fluid, plasma and urine
Authors: Soskolne W. A. , Chajek T. , Flashner M. , Landau I. , Stabholtz A. , Kolatch B. , Lerner E. I.
Published: December 2005

Abstract. The release profile of chlorhexidine from the PerioChipTM (Chip), a biodegradable local delivery system that contains 2.5 mg of chlorhexidine gluconate (CHX) in a cross‐linked hydrolyzed gelatin matrix, into the gingival crevice, was evaluated in an in vivo, open label, single‐center. 10‐day pharmacokinetic study conducted on 19 volunteers with chronic adult periodontitis. Each volunteer had a single chip inserted into each of 4 selected pockets, with probing pocket depths of between 5–8 mm. at time 0. Gingival crevicular fluid (GCF) samples were collected using filter paper strips prior to Chip placement and at 2 h, 4 h, 24 h and 2, 3, 4, 5, 6, 8, and 9 days post‐Chip placement. The GCF volume was measured using a calibrated PeriotronTM 6000. Blood samples were collected at times 0, 1, 4, 8, 12 h and 5 days post‐dosing. Urine was collected as a total 24‐h specimen immediately post‐dosing and 2 single samples at time 0, prior to dosing, and 5 days. The CHX was eluted from the paper strips and the CHX levels in GCF. blood and urine quantified using HPLC. The results indicate an initial peak concentration of CHX in the GCF at 2 h post‐Chip insertion (2007 μ/ml) with slightly lower concentrations of between 1300–1900 μg/ml being maintained over the next 96 h. The CHX concentration then progressively decreased until study conclusion with significant CHX concentrations (mean=57 μg/ml) still being detectable at study termination. CHX was not detectable in any of the plasma or urine samples at any time point during the study. These results indicate that the PerioChipTM can maintain clinically effective levels of CHX in the GCF of periodontal pockets for over 1 week with no detectable systemic absorption.
Risk of severe periodontal disease in a Swedish adult population
Authors: Norderyd Ola , Hugoson Anders
Published: December 2005

Abstract. In this study, potential risk factors for severe periodontal disease were identified in a cross‐sectional sample from the county of Jönköping, Sweden, 547 adults 20–70 years of age were categorised clinically and radiographically by level of periodontal disease experience. These levels were used to divide the sample into groups – individuals without any reduction in periodontal bone level (60%) and those with severe periodontal bone loss (13%) – which were then used in univeriate and multivariate logistic regression analyses as dependent variable. Demographic, socio‐economic, general health, smoking habits, clinical, and dental care variables were used in the different regression analyses. In the univariate model, age (20–70 years) was found to be correlated with more severe periodontal disease experience (odds ratio: 1.13; 95% CI; 1.10–1.17). The association with periodontal disease was more pronounced for the older age groups (50, 60, and 70 years), A negative financial situation was also related to severe periodontal bone loss when regressed univariately (odds ratio 2.20 [95%: 1.04–4.68]). Moderate‐heavy smoking (3=10 cigarettes/day) appeared to be associated with severe periodontal destruction with an odds ratio of 9.78 (95% CI: 3.62–36.42), Of the clinical variables in the univariate model, higher mean levels of supragingival dental plaque and the presence of subgingival calculus were related to more severe periodontal disease with odds ratios of 1.02 (95%: 1.01–1.03) and 2.96 (95% 1.50–5.88), respectively When the same variables were regressed multivariately, age (continuous) (odds ratio 1.17 [95% CI: 1.12–1.22]). moderate‐heavy smoking (odds ratio 11.84 [95% CI: 4.19–33.50]), and higher mean levels of plaque (odds ratio 1.02 [95% CI: 1.00–1.03]) remained significant. Light smoking (1–9 cigarettes/day) was not significantly associated with severe periodontal disease in the 2 regression models. The present study demonstrated that smoking, greater age, and higher mean levels of plaque are potential risk factors for severe periodontal disease in this specific population.
Long‐term stability of the mucogingival complex following guided tissue regeneration in gingival recession defects
Authors: Scabbia Alessandro , Trombelli Leonardo
Published: December 2005

Abstract. The purpose of the present study was to evaluate the stability of soft tissue conditions in gingival recession defects treated with guided tissue regeneration (GTR). The study population was selected among those patients who had been treated with GTR procedures for Miller's class I or II, deep (≥3 mm), buccal gingival recession defects. Defects were included only when they had revealed recession depth reduction ≥2 mm and root coverage ≥60% at 6 months following GTR treatment. These defects were regarded as successfully treated and scheduled for further monitoring. 20 patients, 11 male and 9 female, aged 23 to 57 years (mean age: 33.2 years), each contributing 1 defect, were selected. 9 patients were smokers (≥10 cigarette per day). Recession depth (RD), probing depth (PD), clinical attachment level (CAL), and width of keratinized gingiva (KG) were assessed immediately before surgery at 6 months post‐surgery (baseline examination), and at 4 years post‐surgery (4‐year examination). At baseline examination. RD reduction was 3.6±0.9 mm (mean root coverage: 80%). CAL gain amounted to 4.2± 1.3 mm. 60% of the defects showing CAL gain ≥4 mm. KG increased from 1.9±1.2 mm at presurgery examination to 3.1±0.9 mm at baseline examination. At 4‐year examination, no significant changes from baseline RD, CAL and KG recordings were observed. Differences in baseline‐4 year changes between smokers and non‐smokers were not statistically significant. The results of the present study demonstrate that clinical outcome achieved following GTR procedure in gingival recession defects can be maintained over periods up to 4 years.
Microbial complexes in subgingival plaque
Authors: Socransky S.S. , Haffajee A.D. , Cugini M.A. , Smith C. , Kent R. L.
Published: December 2005

Abstract. It has been recognized for some time that bacterial species exist in complexes in subgingival plaque. The purpose of the present investigation was to attempt to define such communities using data from large numbers of plaque samples and different clustering and ordination techniques. Subgingival plaque samples were taken from the mesial aspect of each tooth in 185 subjects (mean age 51 ± 16 years) with (n= 160) or without (n= 25) periodontitis. The presence and levels of 40 subgingival taxa were determined in 13.261 plaque samples using whole genomic DNA probes and checkerboard DNA‐DNA hybridization. Clinical assessments were made at 6 sites per tooth at each visit. Similarities between pairs of species were computed using phi coefficients and species clustered using an averaged unweighted linkage sort. Community ordination was performed using principal components analysis and correspondence analysis. 5 major complexes were consistently observed using any of the analytical methods. One complex consisted of the tightly related group: Bacteroides forsythus. Porphvromonas gingivalis and Treponema denticola. The 2nd complex consisted of a tightly related core group including members of the Fusobcterium nucleaturm/periodonticum subspecies, Prevotella intermedia. Prevotella nigrescens and Peptostreptucoccus micros. Species associated with this group included: Eubacterium nodatum, Campylobacter rectus, Campylobacter showae, Streptococcus constellatus and Campylobacter gracilis. The 3rd complex consisted of Streptococcus sanguis. S. oralis, S. mitis, S. gordonii and S. intermedius. The 4th complex was comprised of 3 Capnocytophaga species, Campylobacter concisus, Eikenella corrodens and Actinobacillus actinomycetemcomitans serotype a. The 5th complex consisted of Veillonella parvula and Actitwmyces odontotylicus. A. actinotnycetemcomitans serotype b, Selenomonas noxia and Actinomyces naeslundii genospecies 2 (A. viscosus) were outliers with little relation to each other and the 5 major complexes. The 1st complex related strikingly to clinical measures of periodontal disease particularly pocket depth and bleeding on probing.
Molecular size distribution analysis of human gingival proteoglycans and glycosaminoglycans in specific periodontal diseases
Authors: Yamalik Nermin , Kilinç Kamer , Çaǧlayan Feriha , Eratalay Kenan , Çaǧlayan Gürhan
Published: December 2005

Abstract. In order to determine the molecular‐size distribution of gingival proteoglycans (PGs) and glycosaminoglycans (GAGs) both in periodontal health and disease states, gingival tissues were obtained from patients with early onset periodontally (EOP) and adult periodontitis (AP) and also from periodontally healthy subjects. Gel filtration chromatography of gingival PGs revealed different profiles for periodontally diseased and healthy gingiva. Healthy gingiva was mainly composed of high‐molecular size proteins and PGs. while diseased gingival tissue presented a decrease in high‐molecular size PG forms and a shift towards low‐molecular size proteins and PGs. This indicates the degradation of PG macromolecules during periodontal disease activity. Furthermore, this shift towards low‐molecular size forms was more intense in EOP patients when compared to AP patients. Gel filtration of gingival GAGs also demonstrated depolymerization of GAGs, with low‐molecular size GAGs being more intense in periodontally diseased gingival, while healthy gingival GAGs profile was mainly composed of high‐molecular size GAGs. Similar to the profile of gingival PGs. low‐molecular size gingival GAGs. were more prominent in gingival tissue from patients with EOP, These findings suggest that both PGs and GAGs. essential components of the extracellular matrix (ECM). are depolmerized during eriodontal disease activity, which is more prominent in EOP, Since the basie feature of periodontal disease is matrix degradation. ECM components, more specifically PGs and GAGs, are likely to provide valuable information for a better understandi ng of periodontal disease activity.
The clinical and microbiological effects of non‐surgical periodontal therapy in smokers and non‐smokers
Authors: Renvert Stefan , Dahlén Gunnar , Wikström Maude
Published: December 2005

Abstract. 28 patients, 13 smokers and 15 non‐smokers with untreated advanced periodontal disease, were subjected to a series of oral hygiene instructions and treated with non‐surgical periodontal therapy. Baseline values regarding clinical data did not differ significantly between the groups. 6 months following therapy the full‐mouth bleeding score among smokers was 36.5% as compared to 22.7% for non‐smokers (p<0.05). Probing depth was reduced by 1.9 mm for smokers and by 2.5 mm for non‐smokers. This difference was statistically significant (p<0.05). The level of P. gingivalis and P. intermedia/nigrescens was reduced in both groups as compared to baseline. A. actinomycetemcomitans, however demonstrated a slight increase in mean values at 6 months. This was especially notable for smokers in which A. actinomycetemcomitans were more difficult to eradicate. Conclusively, the microbiological response found in this study seems to be in conformity with the clinical response with little influence of the smoking habits
The effect of working parameters on root substance removal using a piezoelectric ultrasonic sealer in vitro
Authors: Flemmig T. F. , Petersilka G. J. , Mehl A. , Hickel R. , Klaiber B.
Published: December 2005

Abstract. This study assessed defect depth and volume resulting from root instrumentation using a piezoelectric ultrasonic sealer with a slim scaling tip in vitro. Combinations of the following working parameters were analyzed: lateral forces of 0.5 N, 1 N, and 2 N; tip angulations of O°. 45°. and 90°; power settings of low. medium and high: and instrumentation time of 10 s. 20 s. 40 s. and 80 s. Defects were quantified using a 3D optical laser scanner. Overall, lateral force had the greatest influence on defect volume compared to instrument power setting and tip angulation (β‐weights 0.49±0.04, 0.25±0.D4, and 0.14±0.04, respectively). The effects on defect depth were highest for tip angulation followed by lateral force and instrument power setting (β‐weights 0.48±0.04. 0.34±0.04, and 0.25±0.04, respectively). Interestingly, al all power settings, the highest defect volume and depth by far were found after combining 45° tip angulation with 2 N of lateral force. The efficacy of the assessed piezoelectric ultrasonic sealer may be adapted to the various clinical needs by adjusting the lateral force. tip angulation, and power setting. To prevent severe root damage it is crucial to use the assessed sealer at a tip angulation of close to 0°.
Clinical and microbiological features of refractory periodontitis subjects
Authors: Colombo A. P. , Haffajee A. D. , Dewhirst F. E. , Paster B. J. , Smith C. M. , Cugini M. A. , Socransky S. S.
Published: December 2005

Abstract. The purpose of this investigation was lo compare the clinical parameters and the site prevalence and levels of 40 subgingival species in successfully treated and refractory periodontitis subjects. 94 subjects received scaling and root planing and if needed, periodontal surgery and systemically administered tetracycline. 28 refractory subjects showed mean full mouth attachment loss and/or >3 sites showing attachment loss >2.5 mm within 1 year post‐therapy. 66 successfully treated subjects showed mean attachment level gain and no sites with attachment loss >2.5 mm. Baseline subgingival plaque samples were taken from the mesial aspect of each tooth and the presence and levels of 40 subgingival taxa were determined using whole genomic DNA probes and checkerboard DNA‐DNA hybridization. The mean levels and % of sites colonized by each species (prevalence) was computed for each subject and differences between groups sought using the Mann‐Whitney test. Most of the 40 species tested, including Actinobacillus actinomycetemcomitans. Porphyromonas gingivalis, Treponema denticola and Bacteroides forsythus, were equally or less prevalent in the refraclory group. Prevotella nigrescens was significantly more prevalent in successfully treated subjects, while refractory subjects harbored a larger proportion of Streptococcus species, particularly Streptococcus constellatus. The odds of a subject being refractory was 8.6 (p<0.001) if S. constellatus constituted ≤3.5% of the total DNA probe count. Since few microbiological differences existed between treatment outcome groups using DNA probes to known species, the predominant cultivable microbiota of 33 subgingival samples from 14 refractory subjects was examined, 85% of the 1649 isolates were identified using probes to 69 recognized subgingival species. The remaining unidentified strains were classified by analyzing 16S rRNA gene sequences. Many sequenced isolates were of taxa not considered a common part of the oral microbiota such as Acinetobacter baumanni, Gemella haemolysans, Enterococcus faecalts, Staphyhcoccus warneri, Pseudomonas aeruginosa and novel species in the genera Bartonella, Ralstonia, Neisseria, Eubacterium, Rothia, Gordona, Gemella, Corynebacterium, Leptotrichia, and Actinomyces. Refractory subjects constituted a heterogeneous group based on their subgingival microbiota. As a group, they did not harbor more of the “classic” periodontopathogens, although elevated proportions of S. constellatus were found.
The relationship of health beliefs and psychological mood to patient adherence to oral hygiene behaviour
Authors: Borkowska E.D. , Watts T.L.P. , Welnman J.
Published: December 2005

Abstract. Patient adherence to oral hygiene instructions (compliance) is important for the success of periodontal treatment. However, there are many different definitions and measures of what constitute patient adherence. Also, many different models of patient behaviour have been studied, with inconsistent or conflicting findings. The purpose of this study was to explore the relationships between health beliefs (three aspects of dental health locus of control, health values and adherence intent), psychological mood and periodontal outcomes. Complete periodontal data were obtained for 47 untreated patients prior to instruction in oral hygiene, and again 4–6 weeks later. Psychological variables were measured by questionnnaire and adherence was measured by reductions in clinical variables (plaque and inflammation). Data were analysed using an item analysis of the questionnaire to assess the internal consistency of the subscales. The results showed overall stability in the psychological variables and reductions in the clinical variables. The main result was a series of negative associations between plaque scores and adherence intent. Inflammatory variables showed some association with psychological constructs related to dependence on external factors.