bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone loss of furcated mandibular molars
Authors: Björn Anna‐Lisa , Hjort Peter
Published: December 2005

Abstract Periodontal bone destruction adjacent to furcations of molar roots has been considered to be unfavourable for the prognosis of the involved teeth. Several alternative modes of treatment have been reported. The objective of this study was to find out how important the furcation problem is.

A study was conducted on the prevalence, degree and development of bone destruction between the roots of furcated mandibular molars in a sample of 221 individuals observed over a period of 13 years.

The state of the interradicular bone septa was assessed from orthopantomographs and bite‐wing radiographs. Radiographs were available from 1965, 1971, 1974 and 1978. The degree of bone destruction was measured in relation to the root length.

About 90% of remaining molars (in 1965) were furcated. The frequency of bone destruction increased from 18% in 1965 to 32% in 1978.Only 1.1‐2.7% of the molars had bone loss affecting more than 50% of the distance vertex to apex. About 9%) of the furcated molars were lost during the observation period. However, the percentage of teeth lost due to progressive furcation involvement during the 13 years was estimated to be only 2.5%.
Scaling and root planing in shallow pockets
Authors: Lindhe Jan , Nyman Sture , Karring Thorkild
Published: December 2005

Abstract The present study was undertaken to enable histological assessment of attachment level alterations following repeated scaling and root planing in periodontal sites with “normal” sulcus/pocket depth. Two monkeys (Macaca cynomolgus) were used. During a period of 6 months, scaling was carried out once every 2 weeks at the buccal surfaces of premolars and molars on the right side of the jaws. The contralateral teeth served as untreated controls. Six months after the completion of treatment (1 year after the start of the experiment), the animals were sacrificed and histological sections of all test and control teeth were produced. In these sections the distances between the cemento‐enamel junction (CEJ) and the apical extent of the junctional epithelium (JE) and between the JE and the alveolar bone crest (BC) were measured.

The results revealed that repeated scaling and planing resulted in an average loss of connective tissue attachment amounting to 0.39 mm and in a corresponding recession of the alveolar bone crest. The findings are discussed in relation to recent observations from clinical trials demonstrating loss of clinical attachment following repeated scaling and root planing in sites with shallow gingival pockets.
Sutureless gingival grafting
Authors: Miller Neal A.
Published: December 2005

Abstract Suturing a gingival graft is often the most time‐consuming stage of the grafting procedure, especially in regions of difficult access. Previously, it has been suggested that a combination of adhesive cellophane and cyanoacrylate may be used to immobilise the graft without suturing. The technique presented here attempts to simplify further sutureless grafting with the following modifications:

Bandage tape is used instead of adhesive cellophane.

The tape is not placed on the teeth but on the attached gingiva on either side of the graft site.

The use of cyanoacrylate is discarded.

The success of the procedure depends on complete haemostasis as any moisture will prevent the tape from adhering to the gingiva. Inherent advantages of sutureless grafting accomplished with the use of bandage tape are:

The graft lies flat on the recipient site and is kept under slight pressure by the tape.

Minimal blood clot is present between the graft and the recipient site.

The “wick” effect of the sutures is eliminated.

The chair side time is greatly reduced.

A shorter appointment and no sutures to remove imply less discomfort for the patient.

The technique is contraindicated should the patient present an allergic background to bandage tape.
Measurements of alveolar bone height at tooth and implant abutments on intraoral radiographs
Authors: Larheim T. A. , Eggen S.
Published: December 2005

Abstract A short review of various radiographic methods for quantitation of marginal bone changes is given. With the method suggested by Eggen (1973) alveolar bone heights on intraoral paralleling radiographs of tooth and implant abutments could be determined directly in ‘true’ values. A calibrated measuring film (increments adjusted in accordance with the approximately constant magnification) was utilized with a magnifying (x 2) viewer. The reproducibility of this direct method was tested, with and without a bite impression, and found to be high. The use of an impression did not seem to have any significant influence on the reproducibility of the method when measuring bone heights at teeth. However, regarding bone height measurements at implants, the impression seemed to bring about a small but significant improvement. The main source of error seemed to be the recognition of the reference points in the alveolar bone. The discussion of available quantitation principles indicated that radiographic bone height should be evaluated in absolute values in clinical studies of comparative nature. The present method seems to be suitable for comparative, clinical examinations of aveolar bone height at teeth and implants.
Effects of a carbohydrate‐free diet and sugar substitutes on dental plaque accumulation
Authors: Rateitschak‐Plüss Edith M. , Guggenheim Bernhard
Published: December 2005

Abstract Plaque accumulation and characteristics were determined gravimetrically, planimetrically, visually, and microbiologically in 24 human subjects who consumed a carbohydrate‐free diet for 4 days. In addition, the effects of xylitol‐, sorbitol‐ and sucrose‐containing can dies upon plaque formed during consumption of the diet were ascertained. Experimental design was such that all 24 subjects traversed each 4‐day test period; a 9‐day interval between test periods was observed. All plaque measurement methods demonstrated that the subjects in all groups, including a control group which received no candies, accumulated significant amounts of dental plaque. No significant differences in plaque amount could be detected among the xylitol, sorbitol and control groups. However, subjects receiving sucrose‐containing candies clearly exhibited larger amounts of plaque.

The bacteriological investigations corroborated the clinical observations. The number of microbial colonies from plaque samples taken from the sucrose test group was clearly higher than in the other three groups. In addition, the number of bacteria in plaque samples from the sorbitol group was higher than in the xylitol group. A statistically significant increase in the proportion of anaerobic sorbitol‐and xylitol‐fermenting bacteria was detected in the sorbitol and xylitol test groups during the 4‐day test periods.
Histological assessment of periodontally involved cementum
Authors: Daly C. G. , Seymour G. J. , Kieser J. B. , Corbet E. F.
Published: December 2005

Abstract Contamination of periodontally involved cementum by bacterial substances such as lipopolysaccharide (LPS) is considered a major reason for root planing. The purpose of the present study was to investigate the presence and location of lipid and polysaccharide within involved cementum as compared with uninvolved cementum. Frozen sections were prepared from the decalcified roots of 36 periodontally diseased and two control teeth. Serial sections were stained for either lipid (Oil‐Red‐O) or polysaccharide (Alcian Blue ‐ PAS) and also with haematoxylin & eosin (H & E) or Huberstone's gram stain. Specimens of involved and uninvolved cementum were then examined under the light microscope for assessment of differences. Involved cementum from 12 of the periodontally diseased teeth exhibited strongly PAS‐positive stained processes penetrating 3‐7 μm into the surface of cementum from overlying plaque. Such processes were not observed in uninvolved cementum, suggesting a possible bacterial origin. Lipid granules were noted in only one involved specimen where they were situated up to 10μm beneath the cemental surface. Similar granules were observed within plaque deposits but never in uninvolved cementum, again suggesting a possible bacterial origin. H & E and gram‐stained specimens revealed the presence of microbial deposits in surface defects and within defects at the cemento‐dentinal junction (CDJ), as well as penetration of micro‐organisms into cementum in the absence of any surface defects. The results indicate that although lipid and polysaccharide of possible bacterial origin may be present within the 10μm surface zone of involved cementum, the finding of microbial deposits down to the level of the CDJ suggests that all periodontally involved cementum should be removed during root planing, in order to achieve a root surface free of bacterial contamination.
Effects of extended systemic and topical folate supplementation on gingivitis of pregnancy
Authors: Thomson Maria E. , Pack Angela R. C.
Published: December 2005

Abstract A former double‐blind study evaluated the effect of a 14–day period of systemic and topical folate supplementation on gingival inflammation during pregnancy (Pack & Thomson 1980). The current experiment was similar to the earlier one except that supplementation was for 28 days during the eighth month only. Thirty women during their 32nd week of pregnancy were randomly divided into three equal groups. Control Group A received placebo mouthwash (MW) and placebo tablets; Group B received placebo MW and one 5 mg folate tablet daily; Group C received placebo tablets and rinsed with folate MW twice daily for 1 min. At the beginning and end of the experimental period, oral status was determined using a plaque index (PII) and a gingival index (GI). Each subject furnished a 1–week diet record which was analysed for dietary folate. No differences in parameters existed between groups at the commencement of the study except for folate levels which were lower in Group B.

Results confirmed the findings of the former experiment. Group C showed highly significant improvement in Gl despite no significant changes in PII (0.00 < p < 0.01), whilst in Group B, changes in gingival health were not statistically significant (0.05 < p < 0.10). No significant changes were demonstrated in Group A. Folate levels increased significantly in Groups B and C. Dietary folate was similar in all groups.
Gingival reattachment on carious tooth surfaces
Authors: Fourel Jean
Published: December 2005

Abstract This paper reports the healing after4 years of a flap coronally repositioned over carious lesions on teeth 23 and 24. Four years postoperatively, the gain of clinical gingival attachment was 4 mm for tooth 23 and 3.6 mm for tooth 24. The carious lesions were covered by soft tissue and a gain of clinical gingival attachment was obtained.
Association between plaque accumulation and Langerhans cell numbers in the oral epithelium of attached gingiva
Authors: Newcomb G. M. , Seymour G. J. , Powell R. N.
Published: December 2005

Abstract After gingival health had been achieved in four subjects they were instructed to cease all oral hygiene measures. At 0, 8 and 21 days Plaque and Gingival Indices were recorded and gingival biopsies were removed from the buccal aspect of a first molar. Frozen sections of the gingival oral epithelium were stained for ATPase and 5′‐nucleotidase to determine the number of Langerhans cells in a defined cross‐sectional area. It was found that, as plaque accumulated, there was a statistically significant increase in the number of Langerhans cells in oral epithelium, particularly in the stratum spinosum. These results indicate that dental plaque can elicit a response in Langerhans cells located in the oral epithelium of the gingiva.
Differential dark field microscopy of subgingival bacteria as an aid in selecting recall intervals: results after 18 months
Authors: Listgarten and M. A. , Schifter C.
Published: December 2005

Abstract Differential dark field microscopic examination of subgingival microbial forms has been used to assign customized recall intervals to a population of adults with minimal periodontal disease, Results after 18 months indicate that a substantial proportion of the test subjects remained in good periodontal health despite the absence of regular biannual prophylaxes. One half of these subjects, who had not received a prophylaxis for periods of 15–18 months, did not demonstrate any detectable worsening of their periodontal status. No correlation could be established in this population between proportions of certain microbial forms and susceptibility to gingivitis.
“Critical probing depths” in periodontal therapy
Authors: Lindhe J. , Socransky S. S. , Nyman S. , Haffajee A. , Westfelt E.
Published: December 2005

Abstract The present investigation was carried out on 15 individuals who were referred for treatment of moderately advanced periodontal disease. All patients were first subjected to a Baseline examination comprising assessment of oral hygiene and gingival conditions, probing depths and attachment levels. Following case presentation and instructions in oral hygiene measures, the patients were given periodontal treatment utilizing a split mouth design. In one side of the jaw scaling and root planing were performed in conjunction with a modified Widman flap procedure while in the contralateral jaw quadrants the treatment was restricted to scaling and root planing only. The period from initial treatment to 6 months after treatment was considered to be the Healing phase and from 6–24 months after treatment the maintenance phase. During the healing phase the patients were recalled for professional tooth cleaning once every 2 weeks. During the maintenance phase the interval between the recall appointments was extended to 3 months. Reexaminations were carried out 6, 12 and 24 months after the completion of active treatment.

The results revealed that treatment resulted in loss of clinical attachment in sites with initially shallow pockets, while sites with initially deep pockets gained clinical attachment. With the use of regression analysis “critical probing depths” were calculated for the two methods of treatment used. It was found that the critical probing depth value for scaling and root planing was significantly smaller than the corresponding value for scaling and root planing used in combination with modified Widman flap surgery (2.9 vs 4.2 mm). In addition, the surgical modality of therapy resulted in more attachment loss than the non‐surgical approach when used in sites with initially shallow pockets. On the other hand, in sites with initial probing depths above the critical probing depth value more gain of clinical attachment occurred following Widman flap surgery than following scaling and root planing.

The data obtained from the reexaminations 12 and 24 months after active treatment demonstrated that the probing depths and the attachment levels obtained following active therapy and healing were maintained more or less unchanged during a maintenance care period which involved careful prophylaxis once every 3 months. However, the data also disclosed that the level of oral hygiene maintained by the patients during healing and maintenance was more critical for the resulting probing depths and attachment levels than the mode of initial therapy used. Thus, sites which during the maintenance period were found to be free from supragingival plaque were associated with shallow pockets and maintained attachment levels. In contrast, sites which harboured plaque exhibited increasing probing depths and further attachment loss.
Effect of root surface alterations on periodontal healing.
Authors: Polson A. M. , Proye M. P.
Published: December 2005

Abstract A companion study reported that new connective tissue attachment did not occur to a surgically denuded root surface when transplanted into a normal periodontium. It was the purpose of this study to evaluate periodontal healing adjacent to a citric acid treated denuded root surface. In four squirrel monkeys, 12 teeth were extracted and reimplanted after surgical denudation and citric acid conditioning of the coronal root surface. The study design provided three teeth for histologic analysis at 1, 3, 7 and 21 days after reimplantation. One and 3 days after reimplantation a zone of fibrin containing inflammatory cells and erythrocytes was interposed between the root surface and remaining periodontal fibers. The fibrin network appeared to be attached to the root surface by arcade‐like formations. The apical termination of the epithelium was located at the coronal extent of the fibrin zone. Granulation tissue and new fibers were aggregating along and perpendicular to the root surface at 7 days; and new connective tissue attachment had been established at 21 days. Extensive root resorption was present along the intra‐alveolar part of the root surface. Epithelium had not migrated apically along the denuded root surfaces. The results indicated that citric acid treatment of denuded root surfaces resulted in new connective tissue attachment, and the response appeared to be dependent upon early establishment of fibrin linkage with the root surface.
Patterns of progression and regression of advanced destructive periodontal disease
Authors: Goodson J. M. , Tanner A. C. R. , Haffajee A. D. , Sornberger G. C. , Socransky S. S.
Published: December 2005

Abstract Attachment level at two sites on each tooth in 22 untreated subjects with existing periodontal pockets was measured every month for 1 year. Regression analysis was then applied to the data from each periodontal site to determine if statistically significant trends in attachment level change could be detected. 82.8 % of the sites monitored did not significantly change during the year. 5.7% of the sites became significantly deeper and 11.5% of the sites became significantly shallower (P< 0.01) during the period. Among those sites in which pocket depth increased, approximately half exhibited a cyclic deepening followed by spontaneous recovery to their original depth. In 15 of the subjects, sites were found which became significantly deeper while other sites within the same subject became significantly shallower. In six subjects, who might be considered to have an arrested form of periodontal disease, virtually no sites became deeper during the monitoring period whereas 11–36% of their sites became significantly shallower. The results of this investigation suggest that a dynamic condition of disease exacerbation and remission as well as periods of inactivity may be characteristic of periodontal disease.
Effects of anti‐epileptic drug treatment with carbamazepine or phenytoin on the oral state of children and adolescents
Authors: Lundström ÅSa , Eeg‐Olofsson Orvar , Hamp Sven‐Erik
Published: December 2005

Abstract Oral conditions were studied in 48 children and adolescents who, during short or long periods, had been assigned to anti‐epileptic drug treatment with carbamazepine or phenytoin. The individuals were diagnosed as suffering from partial seizures or generalized tonic‐clonic seizures and were distributed between three test groups according to the drug selected for treatment; patients on active carbamazepine (I) or phenytoin (II) medication, and patients previously treated with phenytoin (III). Untreated, newly diagnosed epileptics served as controls.

The results showed that individuals treated with carbamazepine for an average of 3 years displayed no intra‐oral side‐effects from the drug treatment. Compared with those on carbamazepine medication the subjects treated with phenytoin demonstrated a significantly greater number of gingival units with increased probing depths, lower saliva secretion rates and lower salivary buffer capacities. In all groups a majority of the individuals showed unsatisfactory plaque control. As a consequence of the results of the investigation it appears justified, from a dental point of view, to support carbamazepine as the first drug of choice for treatment of the types of seizures mentioned.
A 3‐year study of hemisectioned molars
Authors: ERPENSTEIN HEINZ
Published: December 2005

Abstract Over a period of 1–7 (average 2.9) years, 34 hemisectioned molars were examined clinically and radiographically. All patients were kept on a 3–6 month recall system.

The indications for hemisectioning were periodontal in 9 cases and endodontic in 20 cases. In 4 cases extensive carious destruction, and in 4 case an external granuloma led to hemisectioning. Mainly mandibular molars were treated (27). Root resectioning was carried out on only 7 maxillary molars. 22 of the treated teeth were used as distal abutments for small fixed bridges. For a further 3 the same was planned. The remaining treated teeth were singly crowned.

Of the 34 treated molars, 7 were considered failures, 6 for endodontic reasons (apical periodontitis) and only 1 for periodontal reasons. No correlation between failure and the length of the follow‐up period was found.

With 17 of the 34 molars a significant reduction in periodontal pocket depths was recorded between commencement of treatment and the final examination. No difference in periodontal pocket depth or in the height of the alveolar crest was found between hemisectioned and non‐hemisectioned surfaces.

The mobility of hemisectioned molars was difficult to judge because 22 of the 31 crowned teeth were used as abutments for bridges. 17 of the 22 bridges were firm, 4 showed mobility of 1°, and 1 mobility of II°. Of the singly crowned teeth, only 1 exhibited mobility of III°.

This study indicates that the prognosis for hemisectioned teeth is favourable. Failures were primarily endodontic in origin rather than periodontal. Periodontal damage can be kept to a minimum by regularly reviewing oral hygiene standards. Treated teeth may be used as abutments for small bridges if attention is paid to achieving optimal articulation.
A radiographic study of chronic periodontitis in 15 year old Queensland children
Authors: Latcham N. L. , Powell R. N. , Jago J. D. , Seymour G. J. , Aitken J. F.
Published: December 2005

Abstract A retrospective study was carried out to determine the frequency of early periodontal bone loss in 15 year olds as seen in bite‐wing radiographs. A total of 468 radiographs of 15 year olds was examined, 246 from 1970–74 and 222 from 1978–80. The alveolar bone crest on the mesial and distal of the first permanent molar teeth was examined for radiographic evidence of early chronic periodontitis. The condition of the adjacent proximal tooth surfaces was also recorded. No significant difference was found between the two groups; 39% of the 1978–80 and 43% of the 1970–74 group showed radiographic evidence of early chronic periodontitis (p<0.05). Males and females showed a similar frequency of periodontal disease levels. The mesial interproximal space of the first molars had significantly higher frequencies of radiographic evidence of chronic periodontitis than the distal interproximal spaces in the two groups examined. Fewer proximal restorations with overhangs were noted in the 1978–80 group, however more proximal subgingival calculus was found in this group than the 1970–74 group.
Blastogenic responsiveness of peripheral blood mononuclear cells from individuals with various forms of periodontitis and effects of treatment
Authors: Osterberg Stig K. , Page Roy C. , Sims Tom , Wilde Greggory
Published: December 2005

Abstract Experiments were done to learn whether or not the blastogenic responsiveness of peripheral blood mononuclear cells (PBM) from 34 patients to mitogens and homogenates of a panel of periodontal bacteria differs significantly from that of cells from 16 normal individuals. Groups of control individuals and patients with juvenile (JP), rapidly progressive (RP) and adult periodontitis (AP) were formed. Blastogenic responsiveness was assessed after 72 and 120 h incubation by measuring the uptake of radioactive precursor into DNA. Bacterial preparations and mitogens used as stimulators included Bacteroides melaninogemcus (BMEL), Capnocytophaga (CAPNO), Fusobacterium nucleatum (FUSO), Actinomyces viscosus (AVIS), phytohemagglutinin (PHA), and pokeweed mitogen (PWM). When the data were calculated as Stimulation Index (E/C), responsiveness of cells from patients with AP and JP was enhanced relative to that of cells from normal control subjects, but the enhancement was not statistically significant. In contrast, responsiveness of cells from RP patients to FUSO and AVIS was significantly suppressed. Except in the case of AP cells activated with PHA, mitogenic responsiveness of all patient cells was significantly suppressed. When responsiveness was calculated as E minus C, these differences between patient and control cells disappeared except for suppression of the level of blastogenesis by AP and RP cells exposed to AVIS. After 120 h incubation, unstimulated cultures of AP cells incorporated significantly less, and RP cells significantly more, radioactivity than did unstimulated cultures from normal individuals indicating an abnormal autologous mixed lymphocyte reaction. Cells were harvested and tested from a group of AP patients before, during and following periodontal therapy. PBM responsiveness to horaogenates of CAPNO did not change significantly during therapy, but responsiveness to all of the other bacterial preparations including autologous plaque increased following initial therapy. Values for AVIS, FUSO, and PLAQ were statistically significant. Responsiveness to the bacterial preparations either remained at the enhanced levels or increased to even greater levels following completion of therapy, except in the case of autologous plaque, where the values had begun to return toward pretreatment levels. In addition, responsiveness to PWM and PHA dropped to about one‐half the pretreatment values and responsiveness of unstimtilated cultures increased significantly to levels observed in cultures of ceils from normal donors.
Effect of toothpaste rinses compared with chlorhexidine on plaque formation during a 4‐day period
Authors: Addy M. , Willis L. , Moran J.
Published: December 2005

Abstract Evidence suggests that brushing with a toothpaste may slow plaque reformation over 24 h. This study measured the effect of toothpaste alone on plaque regrowth over a 96 h period and compared the effect with water and the known antiplaque agent chlorhexidine. At 9 a.m. at the beginning of 7,4‐day no oral hygiene periods, 10 volunteers were scaled and polished. Al 5 p.m. subjects brushed their own teeth with water until plaque free. Each subject rinsed for I min with 10 ml of a randomly allocated rinse. Rinsing was repeated at 10 a.m. and 10 p.m. on subsequent days. The rinses were water, chlorhexidine 0.2% or 3 g/10 ml slurries of toothpastes containing (1) monofluorophosphate(MFP), (2) monofluorophosphate + sodium fluoride (MFP+NaF) (3) monofluorophosphate + zinc citrate (MFP+ZCT) (4) stannous fluoride (SnF2) (5) sodium fluoride (NaF). At 16, 24, 48 and 72 h plaque on the buccal surface of the upper and lower premolars, canines and incisors was scored by the Gingival Margin Plaque Index (GMPI) and gram films of plaque samples made. At 96 h plaque was recorded diagraromatically and areas of coverage measured visually (Debris Index) and by planimetry. Progressive plaque formation to a Gingival Margin Plaque Index of 100% at 72 h was observed for toothpaste and water rinses. For chlorhexidine the Gingival Margin Plaque Index at 72 h was 6%, At 96 h plaque areas were significantly less with toothpaste rinses compared with water. Chlorhexidine very significantly reduced plaque areas compared with toothpaste and water. The bacteriological assessment of smears revealed essentially similar plaque development during toothpaste and water rinses and was consistent with previous reports. However, with chlorhexidine the densities of organisms in the smears were greatly reduced. It was concluded that the small effect of toothpaste rinses on plaque accumulation compared with chlorhexidine would not alone represent a true antiplaque effect resulting in therapeutic benefit.
Comparison of statistical methods of analysis of data from clinical periodontal trials
Authors: Haffajee A. D. , Socransky S. S. , Lindhe J.
Published: December 2005

Abstract Data from clinical trials have commonly been analyzed by seeking differences between means of clinical measurements in groups treated in different ways. Such differences may be difficult to interpret clinically and fail to impart meaningful information to the research worker or clinician.

Attachment level measurements taken from a group of well‐maintained patients, initially treated by either scaling or Widman flap surgery, were artificially manipulated to impose known changes on the scaled group. Data from individual sites were analyzed by the t‐test and Mann‐Whitney test; and frequency distributions by the Kolmogorov‐Smirnov 2‐sample lest and ridit analysis, Extreme changes were sought by the Moses test for extreme reactions and by creating contingency tables in which changes below arbitrary thresholds of change were eliminated. Examination of the results indicated that the mean was sensitive to small changes in large numbers of sites but insensitive to major changes in a smaller number of sites. Since the latter changes may be of significance to the research worker and clinician, it is recommended that the mean (or median values) be supplemented with the presentation of the frequency distribution of changes and an analysis seeking large changes in few sites.
Clinical parameters as predictors of destructive periodontal disease activity
Authors: Haffajee A. D. , Socransky S. S. , Goodson J. M.
Published: December 2005

Abstract The purpose of the present investigation was to evaluate the usefulness of clinical measurements of periodontal disease in predicting destructive periodontal disease activity. Periodontal status was monitored at 3414 sites in a total of 22 subjects. Repeat attachment level measurements recorded at 2‐month intervals were analyzed by the tolerance method to detect destructive periodontal disease activity. The number of sites that showed or did not show activity and the absence or presence of a clinical parameter before and after the monitoring period were computed. The diagnostic sensitivity of a clinical parameter in predicting disease was expressed as the proportion of sites showing attachment loss which exhibited that parameter. Diagnostic specificity was expressed as the proportion of sites not exhibiting the clinical parameter and not showing attachment loss. In addition, the probability of false positive and false negative diagnoses were computed, using the assumption that the destructive periodontal disease activity rate of sites at risk was 3%.

The sensitivity of clinical measurements of gingival redness, plaque, suppuration and bleeding on probing ranged from 0.03 (suppuration) to 0.42 (plaque). Specificity of these measurements was better, ranging from 0.71 for plaque to 0,97 for‐suppuration. Disease activity was most often. associated with shallow pockets, but shallow pockets by far dominated she‐sites at risk‐. Thus; pocket‐depth: of <4mm was a sensitive diagnostic test for disease activity (0.69), but the measured specificity of 0.25 indicated that it would be a poor predictor of disease activity. Molar teeth and interproximal surfaces were more likely sites of disease activity than other teeth or surfaces with sensitivity values of 0.52 and 0.83, and specificity values of 0.2S and 0.34, respectively. The probability of detecting false positives was high using any of the clinical parameters ranging from 0.95–0.97. Because no clinical parameter demonstrated high sensitivity and high specificity values, none of the clinical parameters used individually or in combination were found useful in predicting disease activity at individual sites.
Plaque‐induced gingival inflammation in the absence of attached gingiva in dogs
Authors: Wennström Jan , Lindhe Jan
Published: December 2005

Abstract The purpose of this experiment was to evaluate the effect of plaque infection an gingival units (1) with or without support of attached gingiva and (2) with different height of the attachment apparatus. 7 beagle dogs were used. Prior to the initiation of the study 4 different types of “dentogingival” units had been established in each dog by the use of excisional and grafting procedures, namely (I) normal non‐operated free gingival units supported by a wide zone of attached gingiva and normal height of the attachment apparatus, (2) regenerated free gingival units supported by loosely attached alveolar mucosa and normal height of the attachment apparatus, (3) regenerated free gingival units supported by loosely attached alveolar mucosa and reduced height of the attachment apparatus and (4) regenerated free gingival units supported by a wide zone of attached gingiva and reduced height of the supporting apparatus. A baseline examination involved assessments of plaque, gingivitis, gingival exudate, probing depth, clinical attachment level, position of She “soft tissue margin” and width of attached gingiva. Following this examination 2 of the dogs were scheduled for biopsy and sacrificed. The remaining 5 dogs were for 40 days placed on a diet regimen which allowed plaque accumulation. The clinical examination was repealed and biopsies sampled at the end of this period. Following preparation the biopsy material was subjected to histometric and morphometric analysis. The results showed I hat the free gingiva which regenerated following surgical excision of the entire gingiva or following soft tissue grafting, was in most respects, clinically as well as histologically, similar to the “normal” free gingiva. The data obtained after 40 days of plaque accumulation did not reveal any differences between the various “dentogingival” units regarding size and apical extension of the infiltrated portion of the connective tissue. It was concluded that a free gingival unit which is supported by loosely attached alveolar mucosa is not more susceptible to inflammation than a free gingival unit which is supported by a wide zone of attached gingiva.
Regeneration of gingiva following surgical excision
Authors: Wennström Jan
Published: December 2005

Abstract The present clinical trial was carried out in order to analyze whether a zone of keratinized and attached gingiva may regenerate following surgical excision of the gingiva. In addition the alterations occurring in the position of the “soft tissue margin” and the clinical attachment level were assessed. 6 patients, scheduled for periodontal surgery in the canine‐premolar regions of both quadrants of the lower jaw, participated in the trial. A Baseline examination performed prior to surgery comprised assessments at the buccal surface of the teeth of dental plaque, gingivitis, probing depth, clinical attachment level, position of the “soil tissue margin” and width of the zones of keratinized and attached gingiva. The entire zone of keratinized and attached gingiva was removed surgically using either a “gingivectomy” or a “flap‐excision” procedure. In the “gingivectomy” procedure the wounded area was left to heal by second intention, while in the “flap‐excision” procedure the alveolar mucosa was repositioned in a coronal position to achieve complete coverage of the surgically exposed alveolar bone, During healing the patients' oral hygiene status was carefully supervised. All parameters included in the Baseline examination were assessed at reexaminations performed 1, 3, 6 and 9 months following surgery.

Already 1 month after surgery all “gingivectomy” units and 9 out of the 14 “flap‐excision” units demonstrated presence of a zone of keratinized gingiva. At the final examination (9 months following surgery) all surgically treated buccal areas had regained a zone of keratinized gingiva. However, a zone of attached gingiva reformed less frequently. The examination performed 3 months after surgery revealed that the “soft tissue margin” and the clinical attachment level had become displaced in apical direction, 0.9 and 0.4 mm, respectively. Between the 3‐month and the 9‐month examinations, however, no further alterations were observed and the gingival units were healthy, independent of the presence or absence of attached gingiva or the width of the zone of keratinized gingiva.
Dentine hypersensitivity ‐ A review
Authors: Addy M. , Dowell P.
Published: December 2005

Abstract A large number of compounds have been employed in the management of dentine hyper‐sensitivity. The symptomatic nature of the condition and its variability poses many problems to any evaluation of effect. Several semi‐quantitative methods of response have been used; however, at this time it is uncertain what advantages they hold over the patients' subjective assessment of improvement. A review of the clinical studies reveals that a positive result for every agent tested to date may be found. Nevertheless considerable placebo responses have been obtained and equivocal results are occasionally reported. The fluorides and metal salts, particularly of strontium, have been mast studied when used either in solution or delivered in toothpaste formulations. For these compounds the literature contains considerable information concerning the reaction with dental hard tissues which can be extrapolated into hypotheses for the modes of action in relieving dentine hypersensitivity. Moreover, some in vitro studies provide useful information concerning the effects of certain compounds on dentine, and are consistent with the clinical data. Unfortunately, contradictory findings and anomalies between clinical and in vitro effects still prevent the development of a sound clinical basis for the treatment of the condition. Moreover, there is a need to recognise those factors which predispose to dentine exposure, if the prevention of the occurrence or re‐occurrence of hypersensitivity is to be achieved.
Osseous repair in the presence of active tooth hypermobility
Authors: Polson Alan M. , Adams Roland A. , Zander Helmut A.
Published: December 2005

Abstract The present investigation was undertaken to evaluate the periodontal response after resolution of inflammation in a situation of established marginal periodontitis, but in the presence of active, continued tooth hypermobility. Periodontitis was induced unilaterally around mandibular second and third bicuspids in 4 squirrel monkeys by tying plaque retentive silk ligatures at the gingival margins. Jiggling trauma to the periodontium between these bicuspids was begun 5 weeks later and continued for the remaining 20 weeks. Ligatures were removed 15 weeks after placement, whereupon regular oral hygiene was begun and continued. Periodontitis and trauma were produced around the corresponding contralateral teeth (control) so that the interproximal area represented the situation immediately prior to ligature removal. Infiltrated connective tissue, loss of connective tissue attachment and alveolar bone, and percentage of bone were determined histometrically for each coronal interproximal periodontium. In control specimens, 58 % of the supracrestal tissue was infiltrated with inflammatory cells compared to 19% in experimental specimens. There were no differences in levels of connective tissue attachment or crestal alveolar bone. However, bone repair occurred in the experimental specimens which increased bone volume from 11 to 18% (P < 0.05). It was concluded that osseous repair occurred in the presence of active, continued tooth hypermobility after resolution of inflammation.
Progression of periodontal disease in adult subjects in the absence of periodontal therapy
Authors: Lindhe J. , Haffaiee A. D. , Socransky S. S.
Published: December 2005

Abstract Progression of periodontal disease in adult subjects in the absence of periodontal therapy was monitored in 2 populations. One group of 64 Swedish subjects (mean age 40.5 years at entry) with mild to moderate periodontal attachment loss was monitored for attachment level changes at baseline, 3 and 6 years. A second group of 36 Americans (mean age 34.3 years at entry) with advanced destructive periodontal disease was monitored for attachment level changes at baseline and 1 year.

Of 4101 sites examined at baseline and at 3 years in the Swedish subjects, only 158 sites (3.9%) showed attachment loss of more than 2 mm. No measurable change was found in 1440 sites (35.1 %). Of 4097 sites examined at 3 and 6 years, 67 sites (1.6%) showed attachment loss greater than 2 mm; 57.4% of sites showed no measurable change; and 19 sites (0.5%) showed a decrease in probeable attachment level of more than 2mm. During the 6‐year interval, 523 sites (11.6%) showed attachment loss of more than 2 ram; 20% of sites showed no measurable change and II sites (0.2%) showed more than 2 mm of attachment “gain”. Approximately 50% of sites that showed no measurable change in the first 3‐year period showed loss in the next 3 years. In contrast, of the sites which showed some level of attachment loss in the first period, approximately 2/3 showed no loss in the second monitoring period.

Of 3210 sites monitored in the American subjects, 102 sites (3.2%) exhibited more than 2 mm of additional attachment loss; 26% of sites showed no measurable change and 138 sites (4.3%) showed a decrease in probeable attachment level of more than 2 mm.

The association between attachment level changes and initial attachment level (baseline) was examined by regression analysis. The slopes of the regression lines for both populations were not consistent with a hypothesis that sites with more advanced attachment loss are more prone to additional destruction, in the absence of treatment, than sites with initially less attachment loss. In the American group, some sites with initially advanced attachment loss, exhibited a decrease in probing attachment level.
Correlations among Papilla Bleeding Index, other clinical indices and historically determined inflammation of gingival papilla
Authors: Engelberger Thomas , Hefti Arthur , Kallenberger Alice , Rateitschak Klaus ‐H.
Published: December 2005

Abstract The Papilla Bleeding Index (PBI) was measured on 95 interdental papillae, after which the results were compared to Sulcus Bleeding Index (SBI) scores, sulcus fluid (SF) amounts and pocket depth (PD) measurements. In 52 of the papillae, a histological evaluation of the degree of inflammation was also made, in which not only the expanse of the infiltrate but also its intensity were of interest. The PBI was positively correlated with all of the other clinical indices. Obvious and highly statistically significant correlations were demonstrated among PBI, SBI and SF. In contrast, between PBI and PD, and between SBI and PD, only weak correlations were found. The comparison of the PBI with the histological determination of inflammation revealed a clear increase in the absolute amount of inflammatory infiltrate as PBI scores increased. In addition, there was a definitive shift in the intensity of the infiltration; moderate and severe areas of infiltration became more common as PBI scores went up.
Bacterial invasion of the periodontium; an important factor in the pathogenesis of periodontitis?
Authors: Allenspach‐Petrzilka G. E. , Guggenheim B.
Published: December 2005

Abstract Tissue samples from 2 humans suffering from severe periodontitis were investigated by transmission electron microscopy. Confirming earlier observations in gnotobiotic rats, bacteria were found in various regions of gingival tissues. We observed bacteria invading the pocket epithelium, the underlying connective tissue, and microorganisms were also present deep in the connective tissue. The bacterial invasion of the periodontium was accompanied by different stages of tissue degradation. Various morphologically distinct types of Gram‐negative and Gram‐positive bacteria were evident. These microorganisms were found in the apical part of the periodontium. More coronally, a heavy infiltrate consisting predominantly of plasma cells was present. It is suggested that bacteria cannot invade regions of connective tissue protected by a massive cellular infiltrate. It seems that they rather circumvent this strong defense by penetrating more apically through the pocket epithelium while producing as camouflage leucochemophobic compounds which paralyze the chemotactically regulated mobile defense. It seems to us that bacterial invasion is a consistent feature of advanced periodontitis, leading to focal necrosis or microabscesses, and may well explain the cylic nature of this disease.
Longitudinal radiographical study on the rate of alveolar bone loss in patients of a dental school
Authors: Rohner F. , Cimasoni G. , Vuagnat P.
Published: December 2005

Abstract Two sets of radiographs, taken at an interval of 4–14 years in 105 patients of a dental school, were examined in order to determine the rate of resorption of alveolar bone. The percentage loss of maximum alveolar bone height was measured in the interproximal and interradicular sites by means of the Schei ruler.

The average percentage of interproximal bone resorption was 0.51 % (0.07 mm) per year. Age, sex, professional status, type of periodontal treatment and general state of health did not seem to affect the annual resorption rate. However, crowned teeth had a significantly greater rate of resorption than uncrowned teeth.

Loss of bone tended to be more rapid in interdental as compared to interradicular areas. A positive and statistically significant correlation was found between initial resorption and annual tooth loss.
Techniques for assessing alveolar bone mass changes in periodontal disease with emphasis on 125I absorptiometry
Authors: Hausmann E. , Mchenry K. , Christersson L. , Rosling B. , Ortman L. F.
Published: December 2005

Abstract. No practical methods are presently available for measurement of alveolar bone activity at one instant of time. However, roentgenological methods making measurements at 2 different times can be used to assess alveolar bone activity. The most sensitive, specific and accurate method for this purpose presently in use is 125I absorptiometry. This method has the further advantage of giving the patient minimal radiation exposure. New methodology is under development which obviates the need for fixed geometry and could provide a 3‐dimensional image of alveolar bone.
Embryogenesis of the gingival cyst
Authors: Moskow Bernard S. , Bloom Arthur
Published: December 2005

Abstract. The embryogenesis of gingival cysts derived from the dental lamina was studied histologically in paraffin prepared sections of 10 pairs of human fetal jaws and in individual celloidin sections of human fetal skulls. Cystic degeneration in the dental lamina was noted as early as 10 weeks in utero prior to the separation of the developing tooth bud. Rapid proliferation and growth of such cysts was seen in 15–20 week old embryos during the morphodifferentiation stage of tooth development after fragmentation of the lamina had occurred. Islands, strands and nests of dental lamina epithelium were dispersed into extraosseous locations and demonstrated historaorphologic characteristics similar to odontogenkally related epithelium seen in adult gingiva. Dental lamina epithelium appears to have a particular predisposition for cystic degeneration and is probably the source of other neoplasms and hamartomas seen in the gingiva.