bluuebunny/crossref_metadata_2025 huggingface dataset:
An XPS and SEM evaluation of six chemical and physical techniques for cleaning of contaminated titanium implants
Authors: Mouhyi Jaafar , Sennerby Lars , Pireaux Jean‐jacques , Dourov Nicolas , Nammour Samir , Van Reck Jack
Published: March 2003

The purpose of the present study was to analyse clinically failed and retrieved implants prior to and after cleaning by means of scanning electron microscopy (SEM) and X‐ray induced photoelectron spectroscopy (XPS) as compared to unused controls. Six different chemical and physical techniques for cleaning of contaminated titanium implants were evaluated: 1) rinsing in absolute ethanol for 10 min, 2) cleaning in ultrasonic baths containing trichloroethylene (TRI) and absolute ethanol, 10 min in each solution, 3) abrasive cleaning for 30 s, 4) cleaning in supersaturated citric acid for 30 s, 5) cleaning with continuous CO2 laser in dry conditions at 5 W for 10 s, 6) cleaning with continuous CO2 laser in wet conditions (saline) at 5 W for 10 s. SEM of failed implants showed the presence of contaminants of varying sizes and XPS showed almost no titanium but high carbon signals. XPS of unused titanium implants showed lower levels of titanium as previously reported, probably due to contamination of carbon which increased with time in room air. Cleaning of used implants in citric acid followed by rinsing with deionized water for 5 min followed by cleaning in ultrasonic baths with TRI and absolute ethanol gave the best results with regard to macroscopical appearance and surface composition. However, as compared to the unused implants the results from an element composition point of view were still unsatisfactory. It is concluded that further development and testing of techniques for cleaning of organically contaminated titanium is needed.
Highly crystalline MP‐1 hydroxylapatite coating Part II: In vivo performance on endosseous root implants in dogs
Authors: Burgess Ann V. , Story Brooks J. , Wagner William R. , Trisi Paolo , Pikos Michael A. , Guttenberg Steven A.
Published: March 2003

The in viva integration strength and degree of bone apposition were compared for oral endosseous implants with different plasma‐sprayed hydroxylapatite (HA) coatings. Pullout strength measurements and histological analysis were used to compare two different commercially available coatings from the same manufacturer. One coating does not receive a post‐plasma‐spray treatment and contains about 75% crystalline HA. The other coating is treated with the MP‐l process, a pressurized hydrothermal post‐plasma‐spray process, which increases the coating composition to approximately 95% crystalline HA without changing the coating's adhesive or cohesive strength. Comparisons were made in dogs after healing times of 3 and 15 weeks in the mandible. No significant differences were found in either case between the two coatings. Two different methods were used to determine the degree of bone apposition at 15 weeks. Both methods confirmed that the MP‐1 process does not affect the osseointegration rate of plasma‐sprayed HA coatings. Qualitative histology data suggest that the treated coating is more stable than the control coating, especially in cases of direct soft tissue attachment to the implant. The present data suggest that extensive dissolution of calcium phosphate components into surrounding tissue is not a necessary precursor for direct 1 apposition of bone to HA‐coated implants.
Standardization of radiographs for mandibular implant‐supported overdentures: review and innovation
Authors: Payne Alan G. T. , Solomons Yvette F. , Lownie John F.
Published: March 2003

Radiographic monitoring of marginal peri‐fixture bone is mandatory during prospective evaluation of different dental implant systems. Unyielding, uni‐directional focus towards identifying the credlbdlty of implant‐supported overdenture therapy for the management of the edentulous predicament, has often neglected correct standardization of follow‐up radiographs. Techniques for truly accurate location of film‐holding devices have often not been applied to both unicentre and multicentre reports on mandibular implant‐supported overdentures using Brinemark implants. An innovative improvement on existing methods using conventional and custom‐made components, shows a procedure to accurately and simply standardize follow‐up radiographs, for both free‐standing and bar designs for mandibular implant‐supported overdentures.
A prospective split‐mouth comparative study of two screw‐shaped self‐tapping pure titanium implant systems
Authors: Van Steenberghe Daniel , De Mars Greet , Quirynen Marc , Jacobs Reinhilde , Naert Ignace
Published: March 2003

Clinical data indicate different medium and long‐term outcomes of endosseous implants for different implant configurations and in particular implant surfaces. The present study compares 2 very similar implant systems but with different surface characteristics in a split‐mouth‐randomized design. The Astra‐Tech (A) system (Astra‐Tech AB, Mölndal, Sweden) consisted of selftapping TiO2‐blasted screw‐shaped implants made of commercially pure titanium, and the Brånemark (B) System (Nobel Biocare, Gothenburg, Sweden) comprised selftapping Mark II implants with machined surface irregularities. Throughout the 2‐years' observation period, no significant differences could be found concerning probing depths, presence of plaque or change in marginal bone level. A statistically significant difference in location of the marginal bone level in relation to the shoulder of the implant was found in favor of the A system both at baseline and after 2 years. Cumulative success rates of 100% (A) and 97.7% (B) were not statistically different. From a prosthetic point of view, more soldering points were needed for A compared to B to reach clinical acceptable fit. More years of observation are needed to compare the fate of the soft and hard tissues surrounding two different implant surfaces.
Quality of fixed restorative treatment on Brånemark implants
Authors: De Bruyn Hugo , Lindén Ulf , Collaert Bruno , Björn Anna‐Lisa
Published: March 2003

The aim of the present prospective study were to describe the quality of implant supported reconstructions made by dentists previously inexperienced with implant prosthodontics and to evaluate alterations and complications from the moment of insertion to 3 years later. Before starting with the prosthodontic work, the dentists had participated in a 2‐day postgraduate course focusing on planning and practical training. Forty‐nine patients were clinically examined within 4 months after insertion of the fixed implant supported prosthesis. Three years later 39 of the 49 participants underwent a second examination by the same independent examiner. Thirty‐one patients had a complete rehabilitation (25 with resin teeth bonded to a metal framework and 6 ceramo‐metal bridges); 8 patients had partial ceramo‐metal reconstructions. The parameters assessing the quality of the restoration were design, fit, occlusion/articulation and esthetics. Oral hygiene and health of the peri‐implant tissues were also examined. Each parameter was scored as perfect, acceptable, to be corrected or to be redone. These scores were a modification of “The guidelines for the assessment of clinical quality and professional performance of the Californian Dental Association”. The initial prosthodontic quality was rated perfect to acceptable except for one restoration which had an unacceptable fit and had to be modified. After 3 years of function the quality did not change except for esthetics which worsened for resin bonded teeth (P<0.05). The esthetic appearance of ceramo–metal reconstructions were unaltered. The peri‐implant condition was predominantly healthy and stable during 3 years. The conclusion of the present study is that dentists previously inexperienced with implant prosthodontics implemented the information from a training course satisfactorily. They were able to make a clinically acceptable restoration with a quality that was stable after 3 years except for discoloration in resin bonded teeth. This, however, had no effect on patient's opinion and satisfaction.
Prosthodontic considerations Note
Authors: Taylor Thomas D. , Belser Urs , Mericske‐Stern Regina
Published: March 2003

The prosthodontic section of the 1997 ITI Consensus Conference in Vitznau, Switzerland, examined a broad spectrum of issues related to the prosthodontic phase of dental implant therapy. Topics included diagnosis and treatment planning, considerations for the use of ITI prosthodontic components, management of the partially edentulous patient, management of the edentulous patient, implant occlusion, and the use of narrow‐ and wide‐body implants. The management of partially and totally edentulous patients will be discussed in separate papers. This paper is written so that each major consensus point discussed by the prosthodontic section is the first sentence of a paragraph. The remainder of each paragraph serves as background information or justification for the consensus statement. It should be noted that agreement on all points was reached by voting within the prosthodontic section. Many of the consensus statements were reached unanimously, while some were reached through compromise and split vote. Not all of the points presented here were presented to the plenum session on the final day of the conference.
In vitro and in vivo evaluation of e‐PTFE and alkali‐cellulose membranes for guided bone regeneration
Authors: Salata Luiz A. , Hatton Paul V. , Devlin A. Jane , Craig Geoffrey T. , Brook Ian M.
Published: March 2003

Abstract: Guided bone regeneration (GBR) is employed to encourage the formation of new bone in osseous defects by restricting the infiltration of soft tissues. While a variety of membranes have been evaluated for this surgical procedure, the non‐resorbable material of choice is currently expanded polytetrafluoroethylene (e‐PTFE). A new alkali‐cellulose membrane produced by a biotechnological process has been developed as an alternative to e‐PTFE for GBR. In this study, the biocompatibility of this novel alkali‐cellulose membrane and e‐PTFE was compared using tissue culture and an in vivo GBR model. In vitro both materials supported the attachment, migration and differentiation of osteoblast‐like cells in culture for up to 3 weeks. The in vivo model was based upon full‐thickness transcortical bone defects in the mandibular rami of Sprague–Dawley rats. The right rami were used as controls, contralateral defects being covered bucally and lingually with either e‐PTFE or alkali‐cellulose membranes. Pathological and histomorphometric analysis was undertaken at 4 and 10 weeks post‐implantation. Bone regeneration associated with alkali‐cellulose membranes was predominantly endochondral in type in contrast to e‐PTFE which induced direct bone formation (intramembranous ossification). The amount of new bone formed in defects was similar for both types of membrane, but alkali‐cellulose membranes induced significantly greater inflammatory response; characterized by lymphocytes, macrophages and multinucleated giant cells. Degradation and possible exposure of individual cellulose fibres may account for the poor performance of alkali‐cellulose membranes in vivo. This animal and in vitro study indicates that when choosing a non‐resorbable membrane for GBR, e‐PTFE membranes are likely to perform better than those produced from alkali‐cellulose.
Freestanding and tooth‐implant connected prostheses in the treatment of partially edentulous patients
Authors: Naert Ignace E. , Duyck Joke A. J. , Hosny Mahmoud M. F. , Quirynen Marc , Van Steenberghe Daniël
Published: March 2003

Abstract: A total of 123 patients were followed between January 1983 and July 1998 with 140 tooth‐implant connected prostheses. The age of the patients at prosthesis installation ranged from 20 to 79 years (mean 51.8). 339 (Brånemark® system) implants were connected to 313 teeth. The loading time ranged from 1.5 to 15 years (mean: 6.5). 123 patients were randomly selected as a control group with freestanding implant‐supported prostheses only. The age of the patients at prosthesis installation ranged from 22 to 78 years (mean 52.3). The loading time for the 329 freestanding (Brånemark® system) implants ranged from 1.3 to 14.5 years (mean: 6.2). Evolution of the marginal bone stability around the implant in the tooth‐implant connected as well as the freestanding group was studied with respect to the prognosis of the implants. Over the period from 0 to 15 years, there was significantly more marginal bone loss (0.7 mm) in tooth‐implant connected versus freestanding prostheses. No significant difference in marginal bone loss was found between the non‐rigid tooth‐implant connected prostheses versus freestanding prostheses. However, there was a significant difference in marginal bone loss for rigid and multi‐connected tooth‐implant connected prostheses versus freestanding ones. The results of this study indicate that more bone is lost around implants which are rigidly connected to teeth. This suggests that bending load, which is increased in tooth‐implant connected prostheses, might be responsible for this phenomenon. These observations favor the use of freestanding prostheses whenever possible. However, the clinical significance of greater bone loss in rigid versus non‐rigid connections might outweigh the annoying phenomenon of tooth intrusion in the case of non‐rigid tooth connection, when connection is considered.
Clinical evaluation and prosthetic complications of single tooth replacements by non‐submerged implants
Authors: Mericske‐Stern R. , Grütter L. , Rösch R. , Mericske E.
Published: March 2003

Abstract: The aim of the present study was to evaluate single tooth replacements by non‐submerged implants. In the time period from 1990 to 1998, 72 patients were consecutively admitted for treatment with a total of 109 solid screw ITI‐implants supporting single crowns. All crowns were ceramic to metal fused with a ceramic occlusal surface and mounted to the octa‐abutment. The mean observation time was 4.3 years, ranging from >1 to 9 years. The implants were monitored regularly by periimplant parameters. Periapical radiographs using the parallel technique were taken after the healing period and in 1999 for comparative measurements. No implant was lost during the healing phase, while 3 failures occurred after a loaded period of 2.5 and >5 years, respectively. The 5‐year cumulative survival rate was 99.1%. In the course of the study, only 2 implants exhibited marginal inflammation that required treatment. The radiographically measured distance (DIB) from the implant shoulder to the first implant‐bone contact was significantly increased in 1999 and different between the two readings. However, this difference in DIB was not significant between implants with a short (1 year) and long (>5 years) observation period. It was concluded that changes in the crestal bone level occur mostly in the first postsurgical year. Prosthetic complications were rare, mostly encountered in the first year after loading and often limited to re‐tightening of the occlusal screw.
Clinical application of a new compact CT system to assess 3‐D images for the preoperative treatment planning of implants in the posterior mandible
Authors: Ito Koichi , Gomi Yumehiro , Sato Shuichi , Arai Yoshinori , Shinoda Koji
Published: March 2003

Abstract: When treatment planning before placing dental implants in the posterior region of the mandible, the locations of the inferior alveolar nerve and mental foramen need to be ascertained, as they determine the bone height available and the implant length selected. The purpose of this study was to introduce the clinical application of a newly developed compact computed tomography system (Ortho‐CT) to assess three‐dimensional (3‐D) images for the preoperative treatment planning of implants in the posterior region of the mandible. To evaluate the 3‐D images, we scanned using the Ortho‐CT system the mandible with a radiopaque template placed in the posterior region. The Ortho‐CT images provided excellent information for evaluating the morphology of the mandible, and for showing the location of the inferior alveolar nerve, mental foramen and the relationship of the template to the bone. We consider that Ortho‐CT is a useful aid to preoperative treatment planning of implant therapy in the mandible.
Overdenture attachment selection and the loading of implant and denture‐bearing area. Part 2: A methodical study using five types of attachment
Authors: Heckmann Siegfried Martin , Wichmann Manfred Gerhard , Winter Werner , Meyer Martin , Weber Hans‐Peter
Published: March 2003

Abstract: In general, an implant is loaded via axial and horizontal forces. Besides this, moment loading can also occur. The aim of this study was to investigate how different prosthetic connectors with overdentures develop force transfer to implant and bone as well as to the denture‐bearing alveolar ridge. Five connectors were investigated on a stereolithographic model fabricated according to a real patient situation. The model was fitted with strain gauges on the “bone” distal and medial to the implants and with vertical force transducers in the alveolar “bone” under the denture‐bearing area. The parallel‐sided rigid telescopic connector developed the highest moment loading of the implant (P<0.001), which would suggest restraint in the use of this connector. The bar construction also showed somewhat high moments but these may have been at least partly exaggerated by the individual patient situation. Loading results through the non‐rigid telescopic copings, single spherical attachments and magnet overdentures demonstrated a low level of implant moment loading which would in part result from horizontal forces caused by denture forward shift during force application. The denture‐bearing area loading was different with all attachments (P<0.001) and was related to the rigidity of the connector and reached the highest values with the non‐rigid telescopic coping. The clinical implications of the various findings are discussed.
The palatal advanced flap: a pedicle flap for primary coverage of immediately placed implants
Authors: Goldstein Moshe , Boyan Barbara D. , Schwartz Zvi
Published: March 2003

Abstract: The placement of implants immediately after tooth extraction has become a relatively common event. This approach has gained popularity because it reduces the time between tooth extraction and placement of the final prosthetic restoration. One problem that remains unresolved with this procedure, however, is that there is usually space left in the area surrounding the coronal portion of the implant. As none of the techniques published to date is completely satisfactory, we developed an approach that is a modification of the palatal pedicle flaps used for closure of oro‐antral fistulas. This technique allows for precise rotational advancement of the palatal tissue in a coronal direction, thus facilitating complete coverage of the extraction site. The procedure was used on 38 patients treated for primary coverage of postextraction placed implants. Thirty‐two of the patients required single tooth replacement, three patients received two implants each, and three patients received three implants each. In 27 of the cases, the procedure was performed in conjunction with barrier membranes; of the 38 cases, 25 patients required the use of DFDBA to fill the defect created by the extraction procedure. The average defect width was 4.70 ± 0.2 mm. Complete primary coverage was obtained in all cases without any changes in the size or anatomy of the buccal vestibule; complete coverage was maintained over the entire healing period of 6–8 months (mean ± SEM, 6.49 ± 0.10 months). Even with guided tissue regeneration cases, there was no exposure of the barrier membrane or cover screw of the implant during healing. After a period of 1–5 years (mean ± SEM, 39.35 ± 2.69 months), none of the implants was lost. We conclude that the palatal advanced flap procedure is useful, fast, and easy to perform in cases of immediate implant placement after tooth extraction.
Reduction in gingival overgrowth associated with conversion from cyclosporin A to tacrolimus
Authors: James J. A. , Boomer S. , Maxwell A. P. , Hull P. S. , Short C. D. , Campbell B. A. , Johnson R. W. G. , Irwin C. R. , Marley J. J. , Spratt H. , Linden G. J.
Published: March 2003

Background: Unsightly gingival overgrowth affects many individuals immunosuppressed with cyclosporin A (CsA). Current management involves repeated periodontal surgery and intensive hygienist support. Tacrolimus is an effective alternative immunosuppressive agent for renal transplantation which does not appear to produce gingival enlargement.

Aims:

The purpose of the present study was to monitor the gingival response of 4 renal transplant patients (RTPs), with clinically significant CsA‐induced gingival overgrowth, after their immunosuppressive therapy was switched to tacrolimus.

Methods: Intra‐oral photographs and alginate impressions were taken both prior to the drug conversion and again, 6 to 9 months later. Gingival overgrowth scores were determined, from plaster models on both these occasions.

Results: All of the RTPs experienced significant resolution of their gingival enlargement within the time period studied; however, only one had complete regression.

Conclusion: It is concluded that conversion of RTPs with gingival overgrowth from CsA to tacrolimus may provide an effective management strategy for this clinical problem.
Risk factors for drug‐induced gingival overgrowth
Authors: Seymour R. A. , Ellis J. S. , Thomason J. M.
Published: March 2003

Background/Aims: Drug‐induced gingival overgrowth remains a significant problem for the periodontologist. Many patients medicated with the drugs implicated in this unwanted effect experience significant, recurrent gingival problems that require repeated surgical excisions. In this review, we attempt to identify and quantify the various “risk factors” associated with both the development and expression of the drug‐induced gingival changes.

Method: The risk factors appraised include age, sex, drug variables, concomitant medication, periodontal variables and genetic factors. Elucidation of such factors may help to identify “at risk patients” and then develop appropriate treatment strategies.

Results: Of the factors identified, the only one that can be affected by the periodontologist is the patents' periodontal condition. However, drug variables and concomitant medication do impact upon the expression of gingival overgrowth.

Conclusion: The identificatioin of risk factors associated with both the prevalence and severity of drug‐induced gingival overgrowth is important for all parties involved with this unwanted effect. Both periodontologist and patient have an important rôle to play in improving oral hygiene and gingival health. Likewise, there is always an opportinity to establish a close liaison between the patient's physician and the periodontologist to try and identify alternative drug regimens that can help reduce the impact of this unwanted effect.
Rehabilitation of a periodontal patient with rapidly progressing marginal alveolar bone loss: 1‐year follow‐up
Authors: Sewón Liisi A. , Ampula Liisa , Vallittu Pekka K.
Published: March 2003

Background: The present case report describes a 1‐year follow‐up of functional rehabilitation of a young periodontal patient with severely advanced, rapidly progressing marginal bone loss treated by using a new splinting material, i.e., glass fiber‐reinforced composite (FRC). Apart from one single tooth, the young man had retained all his natural teeth.

Treatment:

Periodontal treatment was based on cleaning and root planing enabled by partial‐thickness‐flap operations. This method was selected to avoid further damage to the remaining alveolar bone. After healing for 6 months, a cavity retained internal FRC splint was constructed and 1 missing lower molar was replaced by an inlay‐retained FRC resin‐bonded fixed partial denture (FPD). A 12 months follow‐up period revealed a healthy periodontium and good functional and esthetic results.

Conclusions: The new material allows the use of periodontal treatment methods instead of prosthetic alternatives, which until now have been a more generally used approach in the treatment of severely advanced periodontal cases. Internal fiber‐reinforced composit splinting being affordable for the patient, easy for the clinician to construct and giving good esthetic and functional results, suggests that the method may be a valuable aid in periodontal treatment.
Interleukin‐1 and IL‐1 receptor antagonist in gingival crevicular fluid
Authors: Rawlinson Andrew , Dalati Mohammed Hani Nouri , Rahman Shamim , Walsh Trevor F. , Fairclough Angela L.
Published: March 2003

Background/aims: This study aimed to investigate the cytokine IL‐1β and its receptor antagonist IL‐1ra in gingival crevicular fluid (GCF), in patients with adult periodontitis.

Method: A total of 40 GCF samples were harvested from 10 subjects with moderate to severe adult periodontitis and 10 healthy controls. Subjects were selected from both genders, with all the upper anterior teeth present, and with no relevant systemic illness, pregnancy or recent medication. All subjects were non‐smokers and had not received any periodontal therapy within the preceding 3 months. Deep bleeding sites, deep non‐bleeding sites and healthy sites were investigated in relation to upper anterior teeth. Clinical measurements were recorded for each site, after obtaining a GCF sample. IL‐1β and IL‐1ra were quantified using new commercially available ELISA kits (QuantikineTM), and could be detected in all samples.

Results: The mean concentration for IL‐1β was 0.11 (SD 0.14) pg/μl for bleeding periodontitis sites, 0.04 (0.05) pg/μl for non‐bleeding periodontitis sites, and 0.01 (0.03) pg/μl for healthy sites (p<0.001). In contrast, the mean concentration for IL‐1ra was 6.99 (9.78) pg/μl for healthy sites, 0.59 (0.44) pg/μl for non‐bleeding periodontitis sites, and 0.44 (0.36) pg/μl for bleeding periodontitis sites (p<0.001, except for comparisons between bleeding and non‐bleeding periodontitis sites, p>0.05). For healthy sites, a strong inverse relationship was found between IL‐1β and IL‐1ra levels in GCF.

Conclusions: The results suggest a strong relationship between the severity of adult periodontitis and the increasing GCF levels of IL‐1β and decreasing levels of IL‐1ra.
Disease progression in periodontally treated and untreated patients – a retrospective study
Authors: Kocher Thomas , König Jörgen , Dzierzon Uwe , Sawaf Hassem , Plagmann Hans‐Christian
Published: March 2003

Background, aims: The aim of this retrospective study was to assess the effect of regular supportive periodontal treatment on disease progression in patients with moderate to advanced periodontitis.

Method: We compared radiographic change of interdental bone level and number of teeth at 2 time points in 3 patient groups (mean age 46 years): group A, periodontally untreated patients (n=14) who dropped out during initial therapy; group B, non‐compliant patients (n=26), who discontinued supportive periodontal therapy after ca. 2 years of maintenance; group C, compliant patients (n=27), who regularly attended the maintenance program for 7 years. Periodontal treatment was performed as scaling and root planing or flap surgery in groups B and C. All 3 groups were re‐examined ca. 7 years after the initial examination.

Results: Patients in group A lost 3.8 teeth (0.5 teeth/year), those in group B 3.2 (0.4 teeth/year), and in group C, patients lost 2.0 teeth (0.2 teeth/year). About half of the patients lost no teeth (group A 43%, B 42%, C 55 %), and only 17 subjects lost more than 3. At the 2nd examination, an increase in interdental bone was found only in group C (+0.13 mm), while groups A and B lost 0.57 mm and 0.31 mm of alveolar bone level, respectively (p<0.05 group C versus A and B).

Conclusions: Systematic periodontal treatment stops interdental bone loss and decreases the rate of tooth loss in most cases. Periodontal surgery without regular follow‐up care cannot prevent further periodontal destruction, but it can delay it.
Morphology, chemical structure and diffusion processes of root surface after Er:YAG and Nd:YAG laser irradiation
Authors: Gašpirc B. , Skalerič U.
Published: March 2003

Objectives: The aim of this in vitro study was to evaluate the effects of Er:YAG and Nd:YAG lasers on morphology, chemical structure and diffusion processes of the root surface.

Material and methods: 60 root samples were irradiated for 1 min each either with 60 mJ/p, 80mJ/p and 100mJ/p using Er:YAG laser or with 0.5W, 1.0W and 1.5W using Nd:YAG laser. Scanning electron microscopy (SEM) was used to determine the morphology, infrared (IR) spectroscopy to assess the alterations in chemical structure and one dimensional electron paramagnetic resonance imaging (1‐D EPRI) was used to estimate the diffusion coefficients in dental root samples.

Results: Er:YAG laser treatment resulted in deep crater formation with exposed dentin. Morphological alterations of root surface after Nd:YAG laser irradiation included cracks, crater formation, meltdown of the root mineral and resolidified porous globules formation. Er:YAG laser failed to alter the intensity of Amide peaks I, II or III. In contrast, treatment with Nd:YAG laser, using the highest power setting of 1.5W, reduced the intensity of Amide peak II and III in comparison to the control. The diffusion coefficients were increased significantly in all Er:YAG and Nd:YAG treated root samples.

Conclusion: This study demonstrated that Er:YAG laser influences only on morphology and diffusion processes of root surfaces, while Nd:YAG laser also alters the chemical structure of root proteins.
Initial outcome and long‐term effect of surgical and non‐surgical treatment of advanced periodontal disease
Authors: Serino G. , Rosling B. , Ramberg P. , Socransky S. S. , Lindhe J.
Published: March 2003

Aim: A clinical trial was performed to determine (i) the initial outcome of non‐surgical and surgical access treatment in subjects with advanced periodontal disease and (ii) the incidence of recurrent disease during 12 years of maintenance following active therapy.

Material and Methods: Each of the 64 subjects included in the trial showed signs of (i) generalized gingival inflammation, (ii) had a minimum of 12 non‐molar teeth with deep pockets (6 mm) and with 6 mm alveolar bone loss. They were randomly assigned to 2 treatment groups; one surgical (SU) and one non‐surgical (SRP). Following a baseline examination, all patients were given a detailed case presentation which included oral hygiene instruction. The subjects in SU received surgical access therapy, while in SRP non‐surgical treatment was provided. After this basic therapy, all subjects were enrolled in a maintenance care program and were provided with meticulous supportive periodontal therapy (SPT) 3–4 times per year. Sites that at a recall appointment bled on gentle probing and had a PPD value of 5 mm were exposed to renewed subgingival instrumentation. Comprehensive re‐examinations were performed after 1, 3, 5 and 13 years of SPT. If a subject between annual examinations exhibited marked disease progression (i.e., additional PAL loss of 2 mm at 4 teeth), he/she was exited from the study and given additional treatment.

Results: It was observed that (i) surgical therapy (SU) was more effective than non‐surgical scaling and root planing (SRP) in reducing the overall mean probing pocket depth and in eliminating deep pockets, (ii) more SRP‐treated subjects exhibited signs of advanced disease progression in the 1–3 year period following active therapy than SU‐treated subjects.

Conclusion: In subjects with advanced periodontal disease, surgical therapy provides better short and long‐term periodontal pocket reduction and may lead to fewer subjects requiring additional adjunctive therapy.
Relative effectiveness of powered and manual toothbrushes in elderly patients with implant‐supported mandibular overdentures
Authors: Tawse‐Smith A. , Duncan W. J. , Payne A. G. T. , Thomson W. M. , Wennström J. L.
Published: March 2003

Aim: The aim of this study was to compare the clinical effectiveness of a powered toothbrush (Braun Oral‐B Plaque Remover 3‐D) and a manual soft toothbrush (Oral‐B Squish‐grip brush) for the control of supragingival plaque and soft tissue inflammation around implants supporting mandibular overdentures.

Material and methods: The study sample involved 40 edentulous subjects, aged 55–80 years, having 2 unsplinted mandibular implants supporting a complete removable overdenture opposed by a maxillary complete denture. In this single‐blinded, randomised, cross‐over clinical trial, two 6‐week experimental phases were separated by a 2‐week wash‐out period. 2 weeks prior to each experimental phase (pre‐entry visits), implant abutments were polished to remove all plaque and a standardised instruction in the use of the toothbrush was given. Modified plaque and bleeding indices were recorded at the start and end of each experimental period. Mean index scores at each phase were analysed using paired t‐test, and the mean number of sites showing a change in plaque or mucositis were compared using the Mann‐Whitney U‐test. Combined data from 2 different implant systems were considered after controlling for implant type.

Results: Only minor changes in plaque and bleeding scores were observed following the two test periods. There were no statistically significant differences between the manual and powered toothbrushes.

Conclusion: Manual and powered brushes were found to be of comparable efficacy with regard to improvement in peri‐implant bleeding and plaque indices.
Treatment of Papillon‐Lefèvre syndrome periodontitis
Authors: Pacheco J. J. , Coelho C. , Salazar F. , Contreras A. , Slots J. , Velazco C. H.
Published: March 2003

Background, aims: Conventional mechanical treatment of Papillon‐Lefèvre syndrome periodontitis has a poor prognosis. This report describes an effective antimicrobial treatment of rapidly progressing periodontitis in an 11‐year old girl having Papillon‐Lefèvre syndrome.

Method: Clinical examination included conventional periodontal measurements and radiographic analysis. Occurrence of major suspected periodontopathic bacteria was determined by selective and non‐selective culture and by polymerase chain reaction (PCR) identification. Presence of cytomegalovirus and Epstein‐Barr type 1 virus was determined by a nested‐PCR detection method. Therapy included scaling and root planing, oral hygiene instruction, and systemic amoxicillin‐metronidazole therapy (250 mg of each/3 times daily/10 days) which, based on follow‐up microbiological testing, was repeated after 4 months. Supportive periodontal therapy took place at 2 visits during a 16‐month period.

Results: At baseline, 10 of 22 available teeth demonstrated severe periodontal breakdown. At 16 months, probing and radiographic measurements revealed no teeth with additional attachment loss, and several teeth exhibited significant reduction in gingivitis and pocket depth, increase in radiographic alveolar bone height and clinical attachment level, and radiographic evidence of crestal lamina dura. Baseline subgingival microbiota included Actinobacillus actinomycetemcomitans (3.4% of total isolates), Prevotella nigrescens (16.4%), Fusobacteriumnucleatum (14.3%) and Peptostreptococcus micros (10.6%), as well as cytomegalovirus and Epstein‐Barr type 1 virus. At termination of the study, culture and PCR examinations showed absence of A. actinomycetemcomitans,P. micros and herpesviruses, and P. nigrescens and F.nucleatum each comprised less than 0.1 % of subgingival isolates.

Conclusion: This study suggests that controlling the periodontopathic microbiota by appropriate antibiotic and conventional periodontal therapy can arrest Papillon‐Lefèvre syndrome periodontitis.
Periodontal diseases in the child and adolescent
Authors: Oh Tae‐Ju , Eber Robert , Wang Hom‐Lay
Published: March 2003

Background: Periodontal diseases are among the most frequent diseases affecting children and adolescents. These include gingivitis, localized or generalized aggressive periodontitis (a.k.a., early onset periodontitis which includes generalized or localized prepubertal periodontitis and juvenile periodontitis) and periodontal diseases associated with systemic disorders. The best approach to managing periodontal diseases is prevention, followed by early detection and treatment.

Methods: This paper reviews the current literature concerning the most common periodontal diseases affecting children: chronic gingivitis (or dental plaque‐induced gingival diseases) and early onset periodontitis (or aggressive periodontitis), including prepubertal and juvenile periodontitis. In addition, systemic diseases that affect the periodontium and oral lesions commonly found in young children are addressed. The prevalence, diagnostic characteristics, microbiology, host‐related factors, and therapeutic management of each of these disease entities are thoroughly discussed.
Prevalence of aggressive periodontitis in school attendees in Uganda
Authors: Albandar Jasim M. , Muranga Munanura B. , Rams Thomas E.
Published: March 2003

Aim: The prevalence and severity of early onset periodontitis (EOP) among students attending secondary schools in two regions of Uganda was studied.

Material and methods: 690 students (393 males and 297 females) aged 12–25 years (mean 17 years), representing a range of tribal groups, were recruited from six schools in the peri‐urban Central and rural Western regions of Uganda. The study subjects were clinically examined in field conditions by a single calibrated examiner to measure gingival recession and probing depth at six sites per tooth, with subsequent calculation of clinical periodontal attachment level for each site. Subjects exhibiting ≥ 4 mm of clinical periodontal attachment loss at approximal surfaces of one or more teeth were classified with EOP. A structured written questionnaire obtained demographic characteristics of the study subjects.

Results: 199 (28.8%) study subjects showed clinical features of EOP, of which 16 (2.3%) subjects exhibited generalized EOP, 29 (4.2%) localized EOP, and 154 (22.3%) incidental EOP. The percentage of EOP‐affected males was significantly higher than females (33.8% vs. 22.2%, P < 0.001). EOP prevalence tended to increase with increasing age, but no association was found between EOP prevalence and socioeconomic status or residency in urban vs. rural areas of Uganda. Molars and mandibular incisors generally demonstrated the highest occurrence of ≥ 4 mm attachment loss. Clinical periodontal attachment loss of ≥ 5 mm was mainly seen at first molars and incisors, suggesting that these two tooth types are first affected with attachment loss. Approximal tooth surfaces showed greater probing depth and attachment loss than buccal and lingual surfaces. Gingival recession was most prevalent at mandibular anterior teeth, whereas gingival margin coronal to CEJ was most frequently observed at second molars and maxillary incisors.

Conclusion: A relatively high prevalence of EOP (28.8%) was found in young Ugandan school attendees, with 6.5% of these showing severe disease. EOP in Uganda was significantly more prevalent in males than females, and most frequently characterized by approximal involvement of molars and mandibular incisors. Etiologic and predisposing factors associated with the high occurrence of EOP in Uganda, as well as therapeutic and preventive measures of the disease in this population, remain to be delineated.
The fractional urinary fluoride excretion in young children under stable fluoride intake conditions
Authors: Villa Alberto , Anabalón Mireya , Cabezas Lorena
Published: March 2003

Abstract – The purpose of this study was to determine the fraction of the total daily fluoride intake that is excreted through the urine (FUEF) of children aged 3–5 years under usual intake conditions. Participating children were residents of an area with a fluoride (F) concentration of 0.5–0.6 mg/L in their drinking water. Assessments were made on two successive 24‐h periods on 20 children, measuring the total amount of fluoride ingested through liquid and food consumption, and from ingestion of fluoridated toothpaste (500 μg F/g), together with the determination of the amount of fluoride excreted through urine. Fluoride retention was also estimated assuming a constant average F fraction of 10% excreted through faeces. It was found that the average proportion of liquids, solid foods, and toothpaste to the daily fluoride intake (1.02‐mg F/day on average) were 40.8, 34.6, and 24.5%, respectively. The average FUEF value was 35.5% (95% C.I.=31.7–39.3%), and the estimated fractional F retention was 54.5%. The present data suggest a slight relationship between FUEF values and the inverse of the daily fluoride dose (1/dose) (r=0.513; P=0.021). When the present results are combined with those from previous studies on F‐retention and urinary excretion, the correlation between both FUEF and fractional retention and 1/dose are very strong and highly significant (r=0.98, P<0.0001, and r=− 0.986, P<0.0001, respectively). A possible mechanism is suggested in order to explain this latter finding. The potential usefulness of the current FUEF value for the estimation of daily F intake (or dose) from urinary F excretion data is also discussed.
Nutritional variables related to gingival health in adolescent girls
Authors: Petti Stefano , Cairella Giulia , Tarsitani Gianfranco
Published: March 2003

Abstract – In order to study the nutritional variables associated with gingival health, a case‐control study was designed to control strong variables whose effect on gingival status may obscure the potential effect of weaker ones, such as nutrition. Two groups of 27 gingivitis‐affected and ‐unaffected female adolescents were selected. All were aged 17–19 years, with mean age of the two groups statistically not different. All were non‐smokers, all reported daily toothbrushing frequency of twice/day or more, and none had clinical signs of hyponutrition. Mean DMFT of the two groups was statistically not different. The effect of nutritional variables, obtained by a three‐day food record and by assessing the nutritional status of the girls, on presence/absence of gingivitis was evaluated by a variety of stepwise logistic regression analyses. Age (positive correlation), riboflavin, calcium and frequency of fibre intake (negative correlations) significantly explained the risk for gingivitis. Strong intercorrelation between riboflavin and calcium was also found, due to the high quantity of milk consumed by the girls, since this food provided the main source of riboflavin and calcium. The data suggest that some dietary measures may be useful for the maintenance of healthy gingival status.
Using partial recording to assess tooth wear in older adults
Authors: Steele James G. , Walls Angus W. G.
Published: March 2003

Abstract – Objectives: To establish whether partial recording can be used for the measurement and reporting of tooth wear data in samples of adult populations, whilst maintaining the usefulness of the index. Methods: Using whole mouth coronal tooth wear data from a large random population sample of 1200 dentate older adults in England, several different partial recording systems were investigated to establish which teeth would maintain a high level of sensitivity for the most economic use of codes and index teeth. Tooth wear data were recorded on a surface‐by‐surface basis on all teeth in the sample using the tooth wear index. Results: Five different partial mouth recording systems were assessed, including half‐mouth scoring, assessment of just upper or just lower anterior teeth, assessment of all anterior teeth and use of six index teeth. The 12 anterior teeth were the ones most often affected by moderate or severe wear, and when all 12 teeth were used as the index teeth few wear cases were missed, and all the most extensive and severe cases of coronal wear were classified as having some wear. A limited index of only six anterior teeth (three uppers and three lowers) was almost as sensitive, but allowed less flexibility when reporting the extent of coronal wear. Other systems for partial recording were less sensitive. Conclusions: Partial recording using six or 12 anterior teeth is appropriate for measuring and reporting tooth wear data in large population surveys.
Dentists’ decisions on prophylactic removal of mandibular third molars: a 10‐year follow‐up study
Authors: Knutsson Kerstin , Lysell Leif , Rohlin Madeleine
Published: March 2003

Abstract – Objectives: In recent years, several critical outcome studies concerning the prophylactic removal of mandibular third molars have been published. These would appear to motivate a more restrictive approach today as compared with 10 years ago. The aim of the present study was to examine dentists’ decisions on the prophylactic removal of impacted mandibular third molars over a 10‐year period. Methods: Thirty‐six cases were selected so as to represent an equal distribution of males and females, ages, angular position and degree of impaction of the molar. Twenty‐six general dental practitioners (GDPs) and 10 oral surgeons judged the same cases on two occasions 10 years apart. Results: Calculated for each category of dentists, there was no significant difference in the mean number of molars designated for removal between the two occasions. Two GDPs and three oral surgeons presented a higher removal rate, whereas five GDPs presented a lower removal rate on the second occasion as compared to the first one. The dentists presented a considerable interindividual variation in removal rate, between 0 and 22 molars on the first occasion and between 0 and 25 molars on the second occasion. Conclusion: In the decisions on prophylactic removal of mandibular third molars, there has been no change over the last 10 years towards a more non‐interventionist attitude. Thus, the dentists seem not to have been influenced by the evidence that this intervention is not cost‐effective.
Exposure to fluoridated drinking water and dental caries experience in Australian army recruits, 1996
Authors: Hopcraft Matthew Scott , Morgan Michael Vivian
Published: March 2003

Abstract –

Objectives: The purpose of this study was to investigate a group of young Australian adults to determine their caries experience and measure associations between caries experience and age, gender, socioeconomic status, education level and lifetime exposure to fluoridated water.

Methods: This was achieved through a cross‐sectional study involving Australian Army recruits seen for their initial dental examination on enlistment into the Australian Army. A total of 499 recruits had a clinical examination with the aid of bitewing radiographs and an orthopantomograph (OPG). Sociodemographic and fluoride exposure data were obtained via a questionnaire.

Results: This study showed that subjects with a lifetime exposure to fluoridated water reported a 23% lower level of caries experience than subjects with no exposure to fluoridated water, with a greater effect on proximal surfaces compared to smooth and occlusal surfaces. Female subjects had a level of caries experience 25% higher than male subjects, while subjects from the lowest socioeconomic background had a level of caries experience 89% times greater than subjects from the highest socioeconomic group.

Conclusions: Although it is not possible to directly establish a causal relationship from a cross‐sectional study such as this, the results from this study show a dose–response relationship which suggests that there are benefits of lifetime exposure to fluoridated drinking water through young adulthood.