bluuebunny/crossref_metadata_2025 huggingface dataset:
High concentrations of bioactive glass material (BioGran®) vs. autogenous bone for sinus floor elevation
Authors: Tadjoedin Ette S. , De Lange Gert L. , Lyaruu D. M. , Kuiper Luit , Burger Elisabeth H.
Published: March 2003

Abstract: In this study, high concentrations of bioactive glass (BG) particles were compared with autogenous bone in their capacity to augment maxillary bone when grafted in the human sinus floor using a split mouth design. Three female patients with severe maxillary atrophy underwent bilateral sinus floor elevation and bone grafting using 80–100% BG particles (300–355 μm in size) mixed with 20% to 0% iliac crest bone particles at one (experimental) side, and 100% iliac crest derived bone particles at the other (control) side. A total of 22 bone biopsies was taken at the time of fixture installation; that is, at 4, 6 and 15 months after grafting, and processed for histology and histomorphometry. At the control (autogenous bone) sides, trabecular bone amounted to 39% of the biopsy volume in the graft (site) at 4 months, almost 41% at 6 months, and 42% at 15 months. This bone contained viable osteocytes and was mostly of mature, lamellar type. At the experimental (BG particles) sides, the graft consisted of 27% of mostly woven (and some lamellar) bone at 4 months, 36% (woven and lamellar) bone at 6 months, and 39% (mainly lamellar) bone at 15 months. The grafted BG particles started to excavate at 4 months and their centers gradually filled with bone tissue. As a consequence, the volume of BG particles in the biopsy decreased from 29% at 4 months to 15% at 6 months and 8% at 15 months. The BG particles appeared to resorb within 1–2 years by dissolution rather than by osteoclastic activity. Parameters for bone turnover (% osteoid surface, % resorption surface) indicated that bone remodeling was very active at both experimental and control sides, during more than 6 months. These results suggest that mixtures of mainly (80–90%) BG particles and some (10–20%) autogenous bone are effective for bone regeneration in the augmented sinus offer 6 months healing time, while about 12 months healing time is needed for 100% BG particles.
Dynamics of mucosal dimensions after root coverage with a bioresorbable membrane
Authors: Müller Hans‐Peter , Stahl Marianne , Eger Thomas
Published: March 2003

Background: So far, the clinical effects of the placement of a resorbable membrane for guided tissue regeneration have not been studied in humans in great detail. The dynamics of the resorptive processes, in particular, appear to be rather speculative. In the present longitudinal study, specific alterations of the dimensions of the dentogingival mucosa were explored after surgical root coverage by using a bioresorbable membrane and a coronally‐repositioned flap.

Methods: The study population consisted of 14 patients with a total of 31 predominantly shallow, Miller class I, II or III recessions. The thickness of the masticatory and lining mucosa before and after surgical intervention was measured with an ultrasonic device.

Results: Mean (±sd) recession depth and width were 2.85±1.29 and 4.46±1.14 mm, respectively. After 12 months, 51±29% of the recession depth (p<0.001) and 13±35% of its width (n.s.) were covered. Root coverage seems to be rather defect‐type sensitive with best results obtained at canines with relatively shallow recessions. Mucosal thickness was considerably increased after surgery with a gradual decrease during the following 9 months. Thus, thickness of the marginal tissue rose from 0.82±0.27 mm to 1.49±0.54 mm 3 months after placement of the membrane (p<0.001). After 12 months, a mean thickness of 1.03±0.40 mm was observed (p<0.001). Even more pronounced alterations were noted for the alveolar lining mucosa with a threefold increase of thickness 3 months after surgery and a gradual decrease to about 1 mm after 12 months.

Conclusions: The present results point to the considerable space making capacity of the bioresorbable membrane which probably allows for the ingrowth of a granulation tissue derived from the underlying structures. The gradual decline in mucosal thickness between months 6 and 9 after surgery may be paralleled by the maturation of the granulation tissue while complete resorption of the membrane had been accomplished.
Attributions to dental and diabetes health outcomes
Authors: Kneckt Mirka C. , Syrjälä Anna‐Maija H. , Knuuttila Matti L. E.
Published: March 2003

Previous studies have proposed common psychological factors between oral health behavior and diabetes self‐care. The aim here was to describe and analyse more comprehensively the relationships between dental and diabetes health behavior on the basis of attribution theory. The likeness between subjects' own assessments, similarities of the causes given to success and failure, and the predictive power of own dental assessments concerning the metabolic balance of diabetes were studied. The research population was composed of 149 IDDM patients. Data were collected by means of a quantitative questionnaire, a clinical oral examination and from patient records. It was found that from the patients reporting success with avoiding gingivitis 82% also reported success with metabolic status and they also had lower mean HbA1c levels than patients assessing failure with gingivitis. There were some correlations between causes of failure: not bothering to clean approximal surfaces correlated with non‐adherence to diabetes treatment instructions, and laziness as the cause of caries correlated with non‐adherence to diabetes treatment instructions and with poor motivation for diabetes care. It can be concluded that there are some common determinants for both dental health behavior and diabetes self‐care. This connection should be taken into account in health education by health care professionals.
Comparison of a double‐textured prototype manual toothbrush with 3 branded products
Authors: Claydon N. , Leech K. , Addy M. , Newcombe R. G. , Ley F. , Scratcher C.
Published: March 2003

Background: The consensus has been that there is no one superior design of manual toothbrush for plaque removal, despite, in some cases, encouraging findings from laboratory studies. The user appears the major variable and may mask differences in brush efficacy.

Aims: The aim of this study was to compare 2 new double‐filament texture brushes with 3 established brands for plaque removal, under standardised conditions of professional brushing.

Method: The study was a blind, randomised crossover design, balanced for residual effects. A panel of 15 subjects suspended tooth cleaning for 3 days. On day 4, plaque was scored from 6 sites per tooth before and after a 2‐min professional toothbrushing. A washout period of at least 3 days was allowed between study periods.

Results: Overall plaque removal was 50% with no significant differences between brushes, a 3% absolute difference in average total mouth plaque separating brushes. However, at upper‐ and mid‐buccal sites, a not significant 8% and a significant 9% difference, respectively, in plaque removal were recorded in favour of one of the prototype brushes, and at the mid‐lingual site, there was a non‐significant 10% difference in favour of one branded brush. Other sites were cleaned similarly by all brushes except for reduced plaque removal from buccal compared to lingual surfaces and interproximal compared to mid‐surface sites. Highly significant subject differences in plaque removal were noted which may be relevant to inherent anatomical difficulties in tooth cleaning for some individuals. Period effects were not significant, supporting the consistency in brushing by the professional brusher.

Conclusion: The method appeared capable of detecting small benefits of brush design. However, the benefits reported must be taken within the context of an overall lack of difference between brushes. The method could be used to set and record a minimum level of efficacy for toothbrushes.
Resolution of interdental inflammation with 2 different modes of plaque control
Authors: Kocher Thomas , Sawaf Hazem , Warncke Michael , Welk Alexander
Published: March 2003

Background, aims: The aim of the study was to assess the effect on existing plaque and gingivitis of an oral hygiene regimen which utilizes triclosan/copolymer and to compare it with a regimen which uses interdental cleaning devices to control the interdental inflammation.

Method: For this investigation, 39 subjects were recruited. They were examined for plaque and gingivitis using the criteria of Turesky modification of the Quigley‐Hein index and the papillary bleeding index. Plaque and gingivitis were only scored interdentally. Following the baseline examination, the subjects were randomly assigned into 2 groups. The control group used a dentifrice identical to the test dentifrice but without triclosan/copolymer; subjects in this group were taught to brush their teeth with the modified Bass technique and were instructed to additionally use appropriate interdental cleaning devices. The test group used a dentifrice containing triclosan/copolymer (Colgate Total). They were not instructed to use interdental cleaning devices.

Results: Both groups were re‐examined after 4 weeks, and 4 and 7 months. In both groups, plaque and gingivitis levels were modestly reduced, more pronounced in the anterior and less in the posterior teeth.

Conclusions: This investigation demonstrated that a dentifrice containing triclosan in combination with a copolymer can reduce plaque and gingival inflammation to levels comparable to regular interdental cleaning.
Intra‐examiner reproducibility of 4 dental plaque indices
Authors: Matthijs S. , Sabzevar M. Moradi , Adriaens P. A.
Published: March 2003

Background, aims: The aim of the present study was to assess the intra‐examiner reproducibility for 2 established ordinal plaque indices and 2 newly proposed interval plaque indices.

Method: 15 subjects received a professional tooth cleaning and interrupted all oral hygiene measures for 48 to 62 hours. Plaque accumulation was scored 2× for all canines, premolars and 1st and 2nd molars in the 1st and 3rd quadrants with the visual plaque index (VPI), the modified navy plaque index (mNPI), the axial plaque extension index (APEI) and the proximal plaque extension index (PPEI). 147 teeth (57 molars, 60 premolars, 30 canines) were scored.

Results: No statistically significant differences were found for duplicate measurements with all indices, except for buccal and lingual VPI (p<0.05, Wilcoxon test) and for buccal APEI (p<0.01, t‐test). High correlations existed between all duplicate measurements with r‐values ranging from 0.76 to 0.94. For the VPI, 78% of buccal (κ=0.70) and 89% of lingual (κ=0.75) scores were identical, whereas this was the case for 88% of buccal (κ=0.81) and for 73% of lingual (κ=0.62) mNPI scores. For APEI and PPEI scores a linear regression was found with slopes ranging between 0.76 and 1.00. For these indices, the mean measurement error ranged between 0.4 and 9.1%. Results were comparable for VPI, mNPI and PPEI, whereas APEI appeared slightly less reproducible.

Conclusion: In conclusion, a high intra‐examiner reproducibility was found for all plaque indices tested, both the ordinal and the interval indices.
Failure to detect an association with IL1 genotypes in European Caucasians with generalised early onset periodontitis
Authors: Hodge P. J. , Riggio M. P. , Kinane D. F.
Published: March 2003

Objectives: In order to elucidate the genetic background to EOP it is useful to investigate associations with genetic polymorphisms of immune response genes, whose products play a rôle in the inflammatory process. The aim of this study was to examine IL1A and IL1B genetic polymorphisms in unrelated European white Caucasian patients with generalised early‐onset periodontitis (GEOP).

Material and methods: Polymerase chain reaction (PCR) amplification of the IL1A (−889) gene and IL1B (+3953) gene (56 patients, 56 controls) was carried out and PCR products subjected to restriction fragment length polymorphism (RFLP) analysis.

Results: There were no significant differences between patients and controls for any of the genotype or allele frequencies investigated (p=1.0). Smoking status was also included as a covariate but this did not alter the results. Furthermore, expression of the composite genotype described by Kornman and coworkers was also investigated in these subjects. No significant differences were found between patients and controls whether smoking was included as a covariate or not.

Conclusion: The lack of any association between the IL1 polymorphisms and GEOP, in the population presented here, brings into doubt the usefulness of these candidate genes as markers of susceptibility to this form of periodontitis.
Periodontal disease status of an indigenous population of Guatemala, Central America
Authors: Dowsett S. A. , Archila L. , Segreto V. A. , Eckert G. J. , Kowolik M. J.
Published: March 2003

Objectives: This study was designed to determine the periodontal disease status of an indigenous Indian community of rural Central America (San Juan La Laguna, Guatemala), for comparison with results of similar studies in other populations, and with a view to performing future studies to address familial clustering of adult periodontitis.

Methods & Results:

An initial screen of 239 subjects aged 12–75 years from extended families suggested a high disease prevalence according to full‐mouth pocket probing depths (PPDs), with more than 75% of subjects with one or more pockets of PPD 5 mm. A more detailed study was performed in 125 unrelated subjects 18 years, recording full‐mouth PPDs and clinical attachment levels (CALs). The high prevalence of pocketing was confirmed and 90% of adults 35 years had at least one site with CAL 6 mm. However, extensive disease was restricted to a small minority, with only 10% of adults 35 years having 20% or more sites with CAL 6 mm.

Conclusion: The study results highlight the importance of performing a detailed examination and appropriate analysis. In both studies, tooth retention was high (mean number of teeth recorded was 26.4 and 28.0 respectively), smoking unusual, and families large and localised to the village. This community thus affords several advantages over populations in developed countries when considering familial studies of adult periodontitis.
Tumor necrosis factor‐α gene polymorphisms in relation to periodontitis
Authors: Craandijk Jeroen , Van Krugten Michiel V. , Verweij Cor L. , Van Der Velden Ubele , Loos Bruno G.
Published: March 2003

Background: Genetic polymorphisms for cytokines have been proposed as potential genetic markers for destructive periodontal disease. The present aim was to investigate 4 bi‐allelic polymorphisms in the TNF‐α gene in relation to susceptibility for and severity of periodontitis. The polymorphisms were all transitions from G to A, 3 in the promoter positions: −376, −308, −238; and one in the first intron at position +489.

Methods: 90 periodontitis patients and 264 reference control subjects were genotyped and frequencies of genotypes and alleles were analyzed. Also genotype frequencies among severe and moderate periodontitis patients were explored, and the % of teeth with 50% bone loss and the % of teeth without any bone loss for patients with the A allele (A+ genotype) and patients without (A− genotype) were compared.

Results: The distributions of genotypes and frequencies of A allele carriage rates for the 4 TNF‐α polymorphisms were not different between patients and reference controls; Hardy‐Weinberg equilibrium criteria were fulfilled. Also the distribution of A+ and A− genotypes, alone or in combinations, were not different for severe periodontitis compared to moderate periodontitis patients. None of the A+ genotypes showed a significant different bone loss pattern compared to A− genotype patients. Smoking status of the patients did not influence the results.

Conclusions: Genetic polymorphisms in the TNF‐α gene at positions −376, −308, −238 and +489 could not be identified as susceptibility or severity factors in periodontitis, irrespective of the smoking status of the patients.
Peripheral calcifying odontogenic cyst
Authors: Orsini Giovanna , Fioroni Massimiliano , Rubini Carrado , Piattelli Adriano
Published: March 2003

Background: Calcifying odontogenic cyst (COC) is a rare lesion representing about 1% of jaw cysts. It may occur in a central (intraosseous) or peripheral (extraosseous) location.

Method: A case of peripheral COC located on the gingiva, appearing as a painless, circumscribed, pink nodule has been reported.

Results: Peripheral, in contrast to central, COC tends to affect older patients. Peripheral COC is a less aggressive lesion than the central counterpart, and a simple excision biopsy is curative.

Conclusion: The histological finding of a keratinized epithelium rich in ghost cells has helped in making the diagnosis.
Gingival recession in smokers and non‐smokers with minimal periodontal disease
Authors: Müller Hans‐Peter , Stadermann Sabine , Heinecke Achim
Published: March 2003

Background/aims: Smoking is a major risk factor for destructive periodontal disease. There is limited information with regard to effects of smoking in subjects with minimal periodontal destruction. The aim of the present investigation was to assess the development of gingival recession in young adult smokers and non‐smokers.

Methods: 61 systemically healthy young adults, 19 to 30 years of age completed the final examination. 30 volunteers smoked at least 20 cigarettes per day, whereas 31 subjects were non‐smokers. Clinical periodontal conditions were assessed 4× within a time period of 6 months. Site‐specific analyses considering the correlated structure of data were performed.

Results: At the outset, 50% of subjects presented with gingival recession at 1 or more sites. There was no significant difference in the prevalence of gingival recession between non‐smokers and smokers. Severe recession in excess of 2 mm affected about 23% non‐smokers but only 7% smokers. Some further gingival recession developed during the 6‐month observation period. In a multivariate logistic regression analysis, the risk for recession development appeared not to be influenced by smoking status after adjusting for periodontal probing depth, recession at baseline, tooth brushing frequency, gender, jaw, tooth type and site.

Conclusions: Present data did not support the hypothesis that smokers are at an increased risk for the development of gingival recession.
Quantification of gingival edema using a new 3‐D laser scanning method
Authors: Rosin M. , Splieth Ch. , Hessler M. , Gärtner Ch. , Kordaß B. , Kocher T.
Published: March 2003

Objectives: The aim of the study was to investigate the suitability of measuring volume differences in the gingival tissue for monitoring changes in the inflammatory status of the gingiva.

Materials and Methods: Data for this investigation were obtained from a mouthrinse evaluation which was performed as a 4‐week, double‐blind, placebo‐controlled, cross‐over study in which localised experimental gingivitis was induced. 24 volunteers were enrolled in the study. Only the data from the placebo period of each subject were used in the current investigation. During the plaque accumulation periods, plaque guards were worn during routine performance of oral hygiene measures to prevent any plaque removal from the experimental area (1st and 2nd premolars and molars in one upper quadrant). Clinical examinations with assessment of plaque and gingivitis were performed on days 0, 4, 7, 14, 21, 28 and 42. Volume differences in the gingival papillae were determined between day 0 and days 21, 28, and 42, and between days 28 and 42 by taking measurements from replicas of the respective clinical situations using a 3‐D laser scanner and reference‐free automated 3‐D superimposition software. Data were analysed with the Wilcoxon signed ranks test.

Results: Plaque accumulation in the experimental area resulted in a highly significant increase (p<0.001) of inflammation of the gingival papillae. The mean (standard deviation) papillary GI at baseline was 0.23 (0.34) as compared to 1.22 (0.27) and 1.2 (0.31) on days 21 and 28, respectively. The mean increase in volume of all papillae as compared to baseline was 25,478 μm3 after 21 days and 24,210 μm3 after 28 days. After resuming a normal oral hygiene regimen, mean volume of the papillae decreased between days 28 and 42 by 19,250 μm3.

Conclusion: With this novel method, gingival papillary edema can be quantified in vivo from replicas of the clinical situation.
Evaluation of the effectiveness of a pre‐brushing rinse in plaque removal: a meta‐analysis
Authors: Angelillo Italo F. , Nobile Carmelo G. A. , Pavia Maria
Published: March 2003

Objectives: A meta‐analysis technique was used to pool data from studies to assess the effectiveness of the pre‐brushing rinse PLAX on existing plaque and gingivitis.

Methods: Studies were identified using MEDLINE and other sources, and grouped according to whether PLAX was used in short‐ or long‐term treatment. The quality of trials was assessed by 2 independent readers. The DerSimonian and Laird random effects model was used. Meta‐analyses were performed according to duration and type of PLAX treatment. In “1‐day” studies, the effect of PLAX after rinsing and after rinsing and brushing was evaluated, whereas in longitudinal studies, this was done at several follow‐up times.

Results: A total of 19 studies were included and mean quality scores ranged from 0.13 to 0.60, for the study protocol from 0.18 to 0.70 and for data analysis and presentation from 0.05 to 0.53. In “1‐day” studies, PLAX significantly reduced plaque after rinsing (difference=0.143; 95% CI=0.02–0.27;p=0.022), whereas no significant reduction was observed in post‐brushing measures. In “longitudinal” studies, plaque was significantly reduced at 1–2 (difference=0.168; 95% CI=0.09–0.24; p<0.0001), 3–4 (difference=0.179; 95% CI=0.01–0.35; p=0.043), 12 (difference=0.288; 95% CI=0.21–0.37; p<0.0001) and 24 (difference=0.377; 95% CI=0.19–0.57; p=0.0001) weeks. The meta‐analysis that evaluated gingivitis showed a significant reduction in inflammation with PLAX treatment at 12 (difference=0.209; 95% CI=0.17–0.25; p<0.0001) and 24 (difference=0.257; 95% CI=0.22–0.29; p<0.0001) weeks follow‐up.

Conclusions: Although PLAX use appears to offer some benefit in plaque and gingivitis reduction, the clinical magnitude of the difference and the benefit on oral health are likely to be small.
Soft tissue reactions to plaque formation at implant abutments with different surface topography
Authors: Zitzmann N. U. , Abrahamsson I. , Berglundh T. , Lindhe J.
Published: March 2003

Background: The mucosal attachment that forms to titanium implants, uncontaminated by bacterial plaque comprises, independent of the surface characteristics of the abutment, one barrier epithelium and one zone of connective tissue attachment. It was suggested that abutments with a rough surface may accumulate more plaque than abutments with a smooth surface and that such an enhanced rate of plaque build‐up may favor the development of inflammatory lesions in the periimplant mucosa.

Objectives: The aim of the present experiment was to study some reactions of the periimplant mucosa to plaque accumulation on implant abutments designed with either a rough or a smooth external surface.

Material and Methods: In five beagle dogs, four fixtures were placed and submerged in the premolar region. In a second stage procedure performed after 3 months, abutments with two different types of surface topography, one rough, acid‐etched (OA) and one smooth, turned abutment (TA), were installed in a random order. After 6 months of undisturbed plaque formation, the animals were sacrificed and biopsies obtained. Tissue samples were prepared for light microscopy and exposed to histometric and morphometric measurements.

Results: Six months of plaque accumulation resulted in the establishment of an inflammatory lesion (pl‐ICT) in the connective tissue of the periimplant mucosa, the location, size and composition of which did not differ between OA and TA sites. In addition, most OA and TA sites harbored a second inflammatory cell infiltrate in the tissue lateral to the abutment/fixture junction (ab‐ICT). While pl‐ICT was dominated by plasma cells and lymphocytes, ab‐ICT contained a comparatively large number of polymorphonuclear leukocytes.

Conclusion: The different surface characteristics of abutment made of c.p. titanium failed to influence plaque formation and the establishment of inflammatory cell lesions in the periimplant mucosa.
Changes in vasoactive intestinal peptide in gingival crevicular fluid in response to periodontal treatment
Authors: Linden Gerard J. , Mullally Brian H. , Burden Donald J. , Lamey Philip‐John , Shaw Christopher , Ardill Joy , Lundy Fionnuala T.
Published: March 2003

Aims: To evaluate the role of the anti‐inflammatory neuropeptide vasoactive intestinal peptide (VIP) in periodontal health and disease and to determine the effects of periodontal treatment, resulting in a return to periodontal health, on the levels of VIP in gingival crevicular fluid (GCF).

Methods: At baseline, 10 subjects with periodontitis (nine females, one male, mean age 43.0, SD 7.3) started a course of non‐surgical periodontal treatment. Clinical indices were measured at one periodontitis and one clinically healthy site at an initial visit and at 8 weeks after the completion of treatment in each subject. A 30‐s sample of GCF was collected from each test site using perio paper strips. The volume of GCF was measured and each sample subsequently analysed for VIP by radioimmunoassay. One healthy site was sampled from each member of a control group (10 females, mean age 29.9, SD 8.2 years) with clinically healthy gingiva and no periodontitis.

Results: The clinical condition of all periodontitis sites improved as a result of periodontal treatment. The levels of VIP (pg/30 s sample) in periodontitis‐affected sites fell significantly from 302.0 (SD 181.2) at the initial visit to 78.0 (54.4) after treatment, p = 0.007. The reduction in the concentration of VIP (pg/µL) in GCF from 524.3 (322.3) to 280.8 (280.2) was not statistically significant. The levels of VIP in clinically healthy sites fell from 115.5.5 (74.3) to 77.8 (32.3), n.s. and the concentration changed little from 883.8 (652.1) to 628.7 (323.3), n.s. There were substantially smaller amounts of VIP (25.8, SD 12.8) pg in healthy sites sampled from control subjects.

Conclusions: VIP is present in GCF in greater quantities in periodontitis‐affected than clinically healthy sites. In addition, the reduction in inflammation resulting from effective periodontal treatment is associated with a reduction in the levels of VIP in gingival crevicular fluid.
The involvement of nervous and some inflammatory response mechanisms in the acute snuff‐induced gingival hyperaemia in humans
Authors: Mavropoulos Antonios , Aars Harald , Brodin Pål
Published: March 2003

Background and Aim: Tobacco users and especially cigarette smokers are at higher risk than non‐smokers for periodontal disease. The pathogenic mechanism has been proposed to be the vasoconstrictive properties of nicotine, with reduced gingival blood flow (GBF) as a contributing factor in the development of periodontal disease. However, in a previous study in humans, we found GBF to increase in response to acute exposure to snuff. The present study was designed to investigate whether the tobacco‐induced acute GBF increase is dependent on intact nervous conduction. We further investigated the effect of piroxicam (NSAID) and dexchlorpheniramin (DCPA) (antihistamine) on the snuff‐induced responses in the gingiva, to see if chemical mediators of inflammation also influenced the response.

Material and methods: Laser Doppler flowmetry (LDF) was used to measure gingival blood flow bilaterally in the buccal maxillary gingiva, in the forehead skin and in the thumb. Also arterial blood pressure (BP) and heart rate (HR) were monitored. Infraorbital nerve block anaesthesia (INB), superficial mucosal anaesthesia, 20 mg piroxicam or 2 mg DCPA were used in combination with snuff to study the vascular responses to 500 mg snuff (1% nicotine).

Results: Snuff induced a rapid increase in GBF that was higher than the increase in BP, indicating an active vasodilatation. The snuff‐induced vasodilatation was partly blocked by INB and more so by superficial mucosal anaesthesia. Piroxicam and DCPA exerted diverse effects on vascular homeostasis but had no effect on the snuff‐induced vasodilatation in the gingiva.

Conclusions: The results of this study confirm that snuff induces local gingival vasodilatation, and imply that this vasodilatation most likely is a summation of responses due to both autonomic and antidromic reflex mechanisms. We further discuss the possible involvement of the nervously mediated effects of tobacco and nicotine on vascular homeostasis and in tobacco‐associated periodontitis.
Oral myofibromatosis: an unusual cause of gingival overgrowth
Authors: Corson M. A. , Reed M. , Soames J. V. , Seymour R. A.
Published: March 2003

Background:  This case report describes a rare benign tumour, which presented as discrete areas of gingival hyperplasia affecting both the mandible and the maxilla.

Method:  Surgical excision of the lesions was carried out under local anaesthetic. Histopathological examination confirmed the diagnosis of oral myofibromatosis.

Results: The condition responded to surgical excision and appears to have limited growth potential. It affects a wide spectrum of ages and can be alarming due to rapid enlargement and ulceration, so careful diagnosis is important to avoid unnecessary aggressive treatment.
Root defects following air polishing
Authors: Petersilka G. J. , Bell M. , Mehl A. , Hickel R. , Flemmig T. F.
Published: March 2003

Aim: Air‐polishing devices (APDs) are highly effective in removing plaque and extrinsic staining. Their application on root surfaces, however, may result in clinically relevant substance removal, limiting the use in patients with periodontitis, where denuded root surfaces are frequently found. Therefore, the purpose of the study was to assess the influence of different working parameters on root damage and to identify those minimizing root damage.

Material and methods: Defect depth and defect volume after instrumentation of roots with an APD (Dentsply Prophy‐Jet®) using conventional NaHCO3 powder at instrumentation times of 5, 10 and 20 s, combinations of low, medium and high powder and water settings, distances of 2, 4 and 6 mm, and angulations of 45° and 90° were quantified laseroptically. A total of 297 roots were instrumented and parameter combinations were performed in triplicate. The influence of each working parameter on substance loss was determined by multiple regression analysis.

Results: Time had the greatest influence on defect volume and depth (β‐weights 0.6 and 0.57, respectively), when compared with powder setting (β‐weights 0.49 and 0.3) and water setting (β‐weights 0.28 and 0.3). Variations in distance affected defect depth (β‐weight 0.44), but not volume (β‐weight 0.04). No major differences were found at 45° and 90°. Various parameter combinations led to maximal defect depths of 473.5 ± 26.2 µm within 20 s.

Conclusion: Root damage varies among combinations of working parameters. Using the APD with the assessed NaHCO3 powder, all parameter combinations led to substantial root damage. Thus, APDs using NaHCO3 may not be safely utilized on exposed root surfaces.
Contribution of changing diagnostic criteria toward reduction of caries between 1971 and 1997 in children attending the same school in Florianopolis, Brazil
Authors: Marcenes Wagner , Freysleben Gloria Ribeiro , Aurelio de Anselmo Peres Marco
Published: March 2003

Abstract – Aim: To assess the relative impact of changing diagnostic criteria on changes in the prevalence and severity of caries between 1971 and 1997. Material and methods: All 12‐ and 13‐year‐old children attending the same school, “Padre Anchieta Primary School”, in Brazil in 1971 (n=202) and 1997 (n=175) were examined by a single dentist. The criteria for the diagnosis of caries proposed by Radike in 1968 were used in both 1971 and 1997. In 1997, a second clinical examination was conducted and the WHO criteria proposed in 1987 were used. Results: Comparison of caries experience expressed as changes in the mean DMFT scores indicated a 67.7% reduction between 1971 and 1997 from 9.2 to 3.0 when Radike’s criteria were used in 1971 and the WHO criteria were used in 1997. The reduction in caries was independent of the diagnostic criteria adopted in the 1997 dental examination, but the reduction of caries was smaller, from 9.2 to 6.2 (31.8%), when caries experience in 1971 and 1997 was measured using Radike’s criteria. Conclusion: The observed reduction of caries is not a statistical artifact. However, while 47.2% of this reduction is real, 52.8% of it is a statistical artifact due to changes in the criteria for measuring caries used by epidemiologists.
Relationship between oral hygiene practices and oral status in dentate elderly people living in residential homes
Authors: Simons D. , Brailsford S. , Kidd E. A. M. , Beighton D.
Published: March 2003

Abstract – Objectives: To investigate the relationship between the oral hygiene practices of dentate elderly people living in residential homes, their requests for assistance and their oral health status. Methods: 164 people (81.2±7.4 years) participated in an interview and oral examination, and provided a stimulated saliva sample. Results: The mean number of coronal decayed surfaces (CDS) was 2.4±5.9, stimulated salivary levels (log10cfu/ml) of mutans streptococci, lactobacilli and yeasts were 1.6±2.1, 3.0±2.2, 2.1±1.7, respectively, and 53% had root decayed surfaces (RDS). Plaque (PI) and gingival (GI) Indices were 2.3±0.7 and 1.6±0.4 and denture debris scores (DDS) were high. 31% of the population cleaned their mouths twice daily without requesting help and they had significantly fewer yeasts, RDS, restorations on root surfaces, lower PI, GI (P<0.005) and DDS (P<0.0001) than the 69% who cleaned less often. 50% of those who cleaned less frequently requested assistance with oral hygiene but only 5% said that their carers supported them. Those residents who requested help had significantly higher levels of yeasts, lactobacilli (P<0.001), retained roots, DDS, RDS (P<0.005), PI and GI (P<0.0001). Conclusion: The elderly residents’ perceived need for assistance with oral hygiene was related directly to oral hygiene status and to clinical indicators of mucosal and dental diseases.
Enamel fluoride uptake from mouthrinse solutions with different NaF concentrations
Authors: Inaba Daisuke , Kawasaki Koji , Iijima Youichi , Taguchi Nobuhiro , Hayashida Hideaki , Yoshikawa Tadashi , Furugen Reiko , Fukumoto Emiko , Nishiyama Takashi , Tanaka Keiko , Takagi Okiuji
Published: March 2003

Abstract –

Objectives: The influence on enamel fluoride uptake of reducing the NaF concentration of a mouthrinse solution by half, from 0.05–0.025%, was examined in elementary school children.

Methods: The participatory elementary school had employed school‐based fluoride mouthrinse with 0.05% NaF solution since 1983, and in 1993, the NaF content was lowered to 0.025%. Dental examination and enamel biopsy of maxillary central incisors were performed just before the NaF content reduction for children who had received the daily 0.05% NaF mouthrinse for 2–5 years since 6 years of age. During 1993–95, dental examination and enamel biopsy were undertaken for newly enrolled 6‐year‐old children, and the same subjects were re‐examined after 2 years. The same series of examinations were conducted for the control group, which consisted of children belonging to another elementary school without a fluoride program.

Results: The enamel fluoride concentration of 8‐year‐old children who used the 0.025% NaF mouthrinse for 2 years was 1810 ± 535 ppm, reaching the same order as that in children who continued using the 0.05% NaF mouthrinse (1863 ± 1358 ppm), and was significantly higher than that of children without fluoride programs (1113 ± 303 ppm). There was no considerable increase of mean DMFT values due to the NaF content reduction.

Conclusions: It was concluded that a daily 0.025% NaF mouthrinse provides the similar fluoride content for enamel as 0.05% NaF mouthrinse as long as the rinsing frequency is maintained.
Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population
Authors: Tsai Carlene , Hayes Catherine , Taylor George W.
Published: March 2003

Objective: We investigated the association between glycemic control of type 2 diabetes mellitus (type 2 DM) and severe periodontal disease in the US adult population ages 45 years and older.

Methods: Data on 4343 persons ages 45–90 years from the National Health and Nutrition Examination Study III were analyzed using weighted multivariable logistic regression. Severe periodontal disease was defined as 2 + sites with 6 + mm loss of attachment and at least one site with probing pocket depth of 5 + mm. Individuals with fasting plasma glucose > 126 mg/dL were classified as having diabetes; those with poorly controlled diabetes (PCDM) had glycosylated hemoglobin > 9% and those with better‐controlled diabetes (BCDM) had glycosylated hemoglobin ≤ 9%. Additional variables evaluated in multivariable modeling included age, ethnicity, education, gender, smoking status, and other factors derived from the interview, medical and dental examination, and laboratory assays.

Results: Individuals with PCDM had a significantly higher prevalence of severe periodontitis than those without diabetes (odds ratio = 2.90; 95% CI: 1.40, 6.03), after controlling for age, education, smoking status, and calculus. For the BCDM subjects, there was a tendency for a higher prevalence of severe periodontitis (odds ratio = 1.56; 95% CI: 0.90, 2.68).

Conclusion: These results provide population‐based evidence to support an association between poorly controlled type 2 diabetes mellitus and severe periodontitis.
4 cases of photocontact dermatitis due to ketoprofen
Authors: Sugiura Mariko , Hayakawa Ritsuko , Kato Yoshimi , Sugiura Keiji , Ueda Hiroshi
Published: March 2003

We report 4 cases of photocontact dermatitis due to ketoprofen, a non‐steroidal anti‐inflammatory drug derived from propionic acid. We carried out a skin biopsy to examine the amount of ketoprofen in the eruptive skin. We investigated the cross‐reactions between tiaprofenic acid, suprofen and ketoprofen by patch and photopatch testing. In case no. 1, 17 days after the discontinuance of Mohrus poultice (containing ketoprofen as an active ingredient), we detected ketoprofen 312.5 ng/g in the area of skin where the poultice was applied. All 4 cases reacted positively to the causative medicaments containing ketoprofen and ketoprofen 1% pet. 3 out of 4 cases reacted positively to tiaprofenic acid 1% pet. Only 1 case out of the ketoprofen and tiaprofenic acid positive cases reacted positively to suprofen 1% pet. Vehicles of patients' medicaments were negative in all 4 cases. We suspected that the key structure of the cross‐reaction between ketoprofen and tiaprofenic acid and suprofen was the benzoyl radical.
Hand eczema in metalworker trainees – an analysis of risk factors
Authors: Berndt Undine , Hinnen Urs , Iliev Dimiter , Elsner Peter
Published: March 2003

The present study, as part of PROMETES (Swiss Prospective Metal Worker Eczema Study), was performed to examine risk factors for the development of occupational hand dermatitis in metalworker trainees. Since this disease is very common, a high standard of preventive measures is necessary, especially for persons with an endogenous disposition for the development of eczema, e.g., atopics. Within the cohort of 201 healthy young men, 47 (23%) showed at least mild signs of hand eczema at 1 point of the 2.5 year observation period. Various occupational and domestic exposures, skin protection behaviour, regeneration time, and smoking habits, as well as atopic disposition, were studied with regard to their influence on the skin condition of the metalworker trainees. By multivariate analysis, we determined 3 important risk factors for the development of hand eczema in the cohort. (i) We showed once more the important influence of an atopic disposition as a major risk factor for occupational contact dermatitis. (ii) Furthermore, the results suggest that, apart from chemical irritants, mechanical factors should not be underestimated in their role as irritants to the epidermal barrier. (iii) Additionally, an insufficient amount of skin recovery time seems to support a cumulative sub‐irritant effect on the skin, which may lead to irritant contact dermatitis.
Occupational airborne contact dermatitis caused by thyme dust
Authors: Spiewak R. , Skorska C. , Dutkiewicz J.
Published: March 2003

The aim of the study was to assess occupational hazards to the farmer’s skin associated with processing thyme (Thymus vulgaris L.). 46 farmers were studied during the threshing of dried thyme. They were questioned about work‐related skin problems and examined before and after work. In all persons, serum thyme‐specific IgE was measured. Skin prick tests, the Ouchterlony test and the migration inhibition test were carried out with allergens of airborne bacteria and fungi present in the working environment. Of the 46 farmers studied, 4 showed skin symptoms after 5–30 min of exposure to thyme dust. Thyme‐specific IgE was found in 1 person with work‐related symptoms, but also in 2 asymptomatic farmers. Therefore, the importance of IgE seems to be questionable in eczema related to thyme dust. Skin and blood tests with microbial allergens also showed no significant differences between the symptomatic and asymptomatic farmers. To our knowledge, this is the 1st description of occupational airborne contact dermatitis caused by thyme dust. The etiology of thyme‐related skin symptoms remains obscure, although an irritant mechanism seems probable.
Effects of alkalinity of household dishwashing liquids on hand skin
Authors: Park Kyoung Sik , Kim Yong Su , Cho Yang Hee , Lee Min Young , Chung Myung‐Sub
Published: March 2003

The objective of this research was to investigate the effects of alkaline pH conditions of dishwashing liquids on hand skin of Korean panelists after repeated exposure. A group of 30 persons with normal hands immersed their hands, for a total of 15 min a day for 4 days, into household cleansing solutions adjusted to pH 7.4, 10.0 and 10.8, respectively. The effects of alkalinity of household cleansing solutions on hand skin were evaluated by measuring overall and dry hand‐skin grades, as well as the degrees of hand‐skin hydration estimated before and after the repeated immersion exposures to the 3 test products. No statistically‐significant difference (p>0.05) was found among the parameters from the repeated immersion exposures to the test products. These findings indicate that increases of pH up to 10.8 of household cleansing solutions did not worsen either overall, dry hand‐skin conditions or the level of hand‐skin hydration.
Contact urticaria caused by heat‐sensitive raw fish allergens
Authors: Porcel Sergio , León Francisco , Cumplido José , Cuevas Manuela , Guimaraens Dolores , Condé‐Salazar Luis
Published: March 2003

Patients allergic to fish usually present with skin reactions after handling raw fish. Less frequently, these reactions are seen without symptoms after oral intake, often in chefs and food handlers. We have attempted to explain the skin selectivity of such reactions in a 36‐year‐old woman with contact urticaria after handling raw fish. We obtained aqueous extracts of raw and cooked fish (sole and hake) for in vivo (prick test) and in vitro (SDS‐PAGE, IgE Immunoblot) tests. Prick‐by‐prick test, 20‐min closed patch test, rub test with fresh and cooked fish (sole, hake and cod) and specific IgE (CAP‐system) to sole, cod and hake were performed. The strength of positive reaction to raw fish was greater than to cooked fish on both prick and prick‐by‐prick testing. Rub tests showed positive responses only to raw fish. Specific IgEs to sole (45 KU/l), hake (66.9 KU/l) and cod (18.7 KU/l) were obtained. IgE immunoblot recognized 3 antigens of 25, 48, 56 kDa in raw sole and 1 of 42 kDa in raw hake extracts. No IgE binding was observed with the cooked extracts or control sera. Our findings strongly suggest a Type‐I hypersensitivity to fish. Immunoblot analyses demonstrated a loss of specific IgE binding to cooked extracts. We have reported a case of contact urticaria caused by heat‐sensitive raw‐fish allergens in a patient who probably became sensitized via the cutaneous route.
Testing with fine fragrances in eczema patients
Authors: Johansen J. D. , Frosch P. J. , Rastogi S. C. , Menné T.
Published: March 2003

The frequencies of contact allergic reactions to 2 fine fragrances were studied by patch testing. Further, a comparison was made of test results before and after evaporation of the solvent. A total of 480 consecutive eczema patients were included, 100 in the Dortmund clinic and 380 in the Gentofte clinic. Patch testing was done with 2 international brand prestige fragrances. Each fragrance was tested in duplicate. One was applied immediately and the other was allowed to dry for 5 min before application. Testing procedures and assessment of reactions followed the international recommendations. In Dortmund 11% (11/100) and in Gentofte 5.8% (22/380) gave a positive patch test reaction to one or both of the fine fragrances. Assessments done in Gentofte showed that in 73% of the cases the positive reaction indicated a clinically relevant fragrance allergy. More irritant reactions were found to the wet, non‐evaporated form of the fragrances compared with the dried form, while the method of testing did not significantly influence the number of positive reactions. It is recommended that patch testing be performed with hydro‐alcoholic fragrance products after evaporation of the solvent.
Type IV hypersensitivity to vitamin K
Authors: Sommer Sabine , Wilkinson S. Mark , Peckham Daniel , Wilson Caroline
Published: March 2003

The day after intramuscular injection of vitamin K1 (phytomenadione) into her thigh, a 27‐year‐old‐woman with normal liver function developed a relapsing and remitting eczematous reaction localized to the injection site, and later a further eczematous reaction under an adhesive dressing (Duoderm®). On patch testing, she was positive to vitamin K1 and cross‐reacted to vitamin K4; she was also positive to colophonium and to ester gum rosin, the dressing adhesive. Recurrent angioedema persisted for several months and, 2 years later, symptoms were still occurring over the injection sites. Structure‐activity relationships among vitamin K allergens are discussed.
Hair dye‐sensitized hairdressers: the cross‐reaction pattern with new generation hair dyes
Authors:   Rolf Fautz, Fuchs Anne , Van Der Walle Henk , Henny Vida , Smits Luuk
Published: March 2003

Hair dye allergies are a frequent cause of occupational skin disease among hairdressers. Conventional hair dyes contain 4‐phenylenediamine (PPD), 2, 5‐diaminotoluene sulfate (DTS) and 2‐nitro‐4‐phenylenediamine (ONPPD) as allergens. In new generation hair dyes, FD & C and D & C dyes are used in the hair dye formulations. This study investigated the cross‐reaction pattern of new generation hair dyes among hairdressers (n = 40) with a known allergy to PPD and/or DTS and/or ONPPD. In the 40 hairdressers no positive reactions were observed to the single FD & C and D & C dyes. In two hairdressers, doubtful reactions were observed to one or more of the hair dye formulations. The data from this study suggest that for hairdressers sensitized to PPD and/or DTS and/or ONPPD this new generation of hair dyes is a safe alternative for use in their salons.