bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of mechanical oral hygiene procedures on bleeding on probing
Authors: Abbas F. , Voss S. , Nijboer A. , Hart A. A. M. , Van der Velden U.
Published: December 2005

Abstract The purpose of the present study was to investigate the effect of mechanical oral hygiene procedures on bleeding on probing in relation to age and periodontal status. The study was carried out on 49 indivuals divided into 7 experimental groups according to age and having been either treated for destructive periodontal disease or having an intact healthy periodontium. In order to eliminate any pre‐existant gingival inflammation, all subjects received a carefully controlled oral hygiene program. At the start of the experiment, all subjects were instructed to abstain from oral hygiene procedures for 24 h. Thereafter, clinical baseline measurements were carried out, including bleeding on probing (BOP) using a standardized probing pressure. Next, all subjects cleaned their teeth according to their normal oral home care protocol using a multitufted toothbrush, toothpicks and interdental brushes. BOP scores were again assessed 30 min after completed tooth cleaning procedures. The results revealed a significant increase in BOP after the mechanical oral hygiene procedures in every individual in all experimental groups (p <0.05). Further analysis showed that the increase in BOP was independent of the periodontal status of the subjects. However the BOP scores after mechanical oral hygiene procedures were higher in the young age groups. It was concluded that the diagnostic predictability of BOP in the treatment of periodontal diseases might be affected by temporarily elevated BOP scores shortly after mechanical oral hygiene procedures.
Studies on root enamel
Authors: Moskow Bernard S. , Canut Pedro Martinez
Published: December 2005

Abstract Enamel pearls are one of a number of different enamel structures that can be found on the roots of deciduous and permanent teeth. They have a distinct predilection for the furcation areas of molar teeth, particularly the maxillary third and second molars. They can consist primarily of enamel, but in most instances, a core of dentin is contained within them. On rare occasions, even pulpal tissues can be found. Enamel pearls usually occur singularly, but up to 4 enamel pearls have been observed on the same tooth. Depending on the study, enamel pearls on permanent molar teeth have an incidence rate of between 1.1%‐9.7% with distinct differences among racial and national groups. The incidence of enamel pearls increases greatly in histological studies, suggesting that they are often obscured by a covering of cementum.
A retrospective analysis of the perio‐prosthetic aspect of teeth re‐prepared during periodontal surgery
Authors: Carnevale G. , di Febo G. , Fuzzi M.
Published: December 2005

Abstract This paper describes a retrospective study in which the gingival and periodontal status was assessed at crowned and natural teeth. 510 crowned teeth and 510 natural teeth in 109 subjects were examined. The time elapsed between active therapy and the clinical examination was: (i) 1 to 3 years for 270 teeth; (ii) 3 to 5 years for 168 teeth; (iii) 6 to 9 years for 72 teeth. 90% of the patients were on a recall schedule that required prophylaxis once every 3 months; 8% returned every 6 months and 2% once a month. Plaque index and gingival index were assessed at 4 sites per tooth and pocket depth at 6 sites per tooth, the highest reading per tooth being used for the statistical analysis. The results indicated that there was no difference in plaque and gingival indices between crowned and natural teeth. In addition, the gingival status of the crowned teeth was good, irrespective of the position of the crown margin (subgingival, at the gingival margin or supragingival).
The periodontal status of patients with Sjögren's syndrome
Authors: Tseng C. C. , Wolff L. F. , Rhodus N. , Aeppli D. M.
Published: December 2005

Abstract Sjögren's syndrome (SS) is a chronic inflammatory disease characterized by xerostomia. Although a common observation in SS is increased susceptibility to caries, the level of periodontal disease has not been described in these individuals. The purpose of this study was to determine the periodontal status of 14 SS female subjects who had a mean age of 52.9±11.6 years. Plaque, gingival, and calculus indices as well as probing depth (PD) and attachment level (AL) were determined on 7 index teeth in each subject. Result indicated that individuals with Sjögren's Syndrome did not exhibit significant periodontal disease.
Plaque and chronic inflammatory Periodontal disease A question of ecology
Authors: Newman H. N.
Published: December 2005

Abstract The nature of the relationship between dental plaque and chronic inflammatory periodontal disease (CIPD) remains unclear, although there is no doubt that plaque is the direct cause. Non–specific, specific and exogenous hypotheses have been proposed to explain plaque‐host relationships. Current evidence indicates that plaque is part of the natural human microflora, one of many such in nature, and that disruption of oral microbial ecology, due primarily to diet texture changes, leads to gingivitis and periodontitis. These result in increased plaque accumulation, and particularly in increased interdental effective plaque thickness. The latter leads to alterations in plaque ecology, particularly increasing anaerobiosis, with resultant shifts in proportions of its constituent species. These shifts are responsible for the increased counts of, for example, Bacteroides gingivalis, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Wolinella recta, spirochaetes and others, associated with chronic periodontitis in its various forms. Measures to prevent or control chronic periodontitis should aim, not to eliminate plaque, which ignores ecology and would compromise host defence, but to restore the species distribution in plaque to that compatible with health.
Temperature as a periodontal diagnostic
Authors: Kung Robert T. V. , Ochs B. , Goodson J. M.
Published: December 2005

Abstract Elevated temperature, normally a characteristic of inflammation, is a potential indicator of periodontal disease. Conversely, local periodontal site temperatures within normal variation could suggest relative periodontal health. To evaluate this potential, a temperature probe was designed with rapid response (< 1 s), high accuracy and reproducibility (± 0.1°C), good transducer thermal isolation and physical dimensions approximating those of a conventional periodontal probe. To compensate for subject‐to‐subject variations in core temperature, site temperatures were measured and expressed as differences relative to the sublingual temperature. A cross sectional study was conducted using this instrument in which pocket temperatures of 14 subjects with advanced adult periodontitis were measured and compared with the sulcus temperatures of 11 healthy subjects. Overall, the mean site temperature of the diseased subjects was 0.65°C higher than that of the healthy subjects. A natural posterior‐to‐anterior temperature gradient was observed with the posterior sites being hotter than the anterior sites. Tooth‐by‐tooth analysis showed that diseased teeth have higher temperatures than anatomically equivalent healthy teeth (p<0.01). Threshold temperatures for differentiating diseased and healthy teeth were determined to optimize sensitivity and specificity. The results suggest that site temperature is a diagnostic of inflammatory activity associated with periodontal disease. The specifically designed instrument detected significant disease‐related departures from normality.
Comparative effects of 2 mouthrinses on the development of supragingival dental plaque and gingivitis
Authors: Overholser C. Daniel , Meiller Timothy F. , DePaola Louis G. , Minah Glenn E. , Niehaus Carol
Published: December 2005

Abstract A 6‐month double‐blind, controlled clinical study was completed with 124 healthy adult subjects to determine the efficacy of 2 mouthrinses, Listerine (LA) and Peridex (PX), used as supplements to regular oral hygiene measures in reducing supragingival dental plaque and gingivitis. Following screening examinations for entry levels of existing gingivitis and plaque, baseline gingival and plaque area indices, extrinsic tooth stain, supragingival calculus, bleeding and soft tissue condition were recorded. All subjects then received a complete dental porphylaxis to remove plaque, calculus and extrinsic stain. Subjects were randomly assigned to 1 of 3 groups and performed supervised rinses twice daily for 30 s in addition to their normal oral hygiene, for 6 months. All indices were again evaluated at 3 and 6 months. After 6 months, LA and PX significantly (p < 0.001) inhibited development of plaque by 36.1% and 50.3%, respectively, and the development of gingivitis by 35.9% and 30.5%, respectively, compared to a hydroalcohol control. PX was more effective in inhibiting plaque and both mouthrinses appeared to be equally effective in inhibiting gingivitis. LA patients did not develop significant levels of stain or supragingival calculus at 6 months, compared to baseline or control. PX patients developed significant levels of extrinsic stain and supragingival calculus compared to baseline and control. Though PX was more effective than LA in the control of plaque, this study indicates that both LA and PX were effective agents in a regimen for the control of plaque and gingivitis.
The relationship of serum IgG antibody titers to periodontal pathogens to indicators of the host response in crevicular fluid
Authors: Lamster Ira B. , Celenti Romanita , Ebersole Jeffrey L.
Published: December 2005

Abstract. In this study, the relationship of indicators of the local host response in gingival crevicular fluid (GCF) to the serum antibody titer to periodontal pathogens was examined. 15 patients with chronic adult periodontitis were studied. GCF was collected and analyzed for the total amount of IgG, IgM, the lysosomal enzyme B‐glucuronidase (BG) and α‐2‐macroglobulin (α2M). At the same examination, serum from these patients was collected, and enzyme‐linked immunosorbent assays used to determine the serum IgG antibody titer to a panel of 17 periodontal pathogens (Actinobacillus actinomycetemcomitans (3 strains), Bacteroides gingivalis (4), Eikenella corrodens (2), Wolinella recta, Bacteroides intermedius (3), Fusobacterium nucleatum, and 3 Capnocytophaga species). Using Spearman rank order correlation analysis, correlation coefficients were calculated to relate the 4 indicators of host response in GCF to the serum IgG antibody titer to each of the 17 micro‐organisms. The mean correlation between total IgG in GCF and the serum IgG antibody liter was positive (r=+0.30), and statistically significant correlations between total IgG in GCF and serum IgG antibody titer were observed for one strain of B. intermedius and C. ochracea. A weaker positive correlation was observed for IgM (r= 0.18). In contrast, the mean correlation between total BG in GCF and the serum antibody titer was negative (r= 0.34). Statistically significant negative correlations were observed for all 3 strains of A. actinomycetemcomitans, one strain of E. corrodens and W. recta. The mean correlation for α2M was r= ‐0.06. These data suggest that elevated BG activity in GCF, believed to be a marker for lysosomal enzyme released from polymorphonuclear leukocytes in the crevicular environment, may be associated with a reduced serum IgG antibody response to suspected periodontal pathogens. Furthermore, these findings imply that the development of a serum IgG antibody response to suspected periodontal pathogens is consistent with a protective host response.
Intracrevicular application of tetracycline in white petrolatum for the treatment of periodontal disease
Authors: Eckles Terry A. , Reinhardt Richard A. , Dyer John K. , Tussing Gerald J. , Szydlowski Wieslaw M. , DuBous Lnda M.
Published: December 2005

Abstract. In vitro tests in our laboratory have shown that 40% tetracycline HC1 in a white petrolatum carrier (TTC‐WP) has potential as a sustained release, auto‐dissipating system. The present study tested subgingival placement of TTC‐WP via syringe in vivo. Quadrants (2 diseased sites in each) in 9 patients with moderate/severe periodontitis were randomly assigned to receive the following treatments: (1) TTC‐WP; (2) WP only; (3) scaling and root planing; (4) untreated control. TTC release into gingival crevicular fluid (GCF) over time (baseline, 1, 8, 24, 72 and 168 h) was measured using an agar diffusion bioassay. Clinical parameters and subgingival bacterial morphotypes (darkfield analysis) were also evaluated over time (baseline, 2, 4, 8, 12 weeks). Results indicated that TTC‐WP was easily placed into periodontal pockets and biologically effective TTC was released into GCF for at least 3 days (mean concentration = 115.8 ± 43.1 μg/ml at 3 days). TTC‐WP reduced probing pocket depths and bleeding on probing relative to baseline measurements for 8–12 weeks post‐treatment, and reduced %s of motile rods and spirochetes, with an accompanying increase in cocci, for 2–8 weeks. Similar effects were noted in the scaled and root‐planed sites, but for a longer duration. TTC‐WP and WP were clinically dissipated after 2 weeks and no adverse tissue reactions were observed. From these findings, subgingival TTC‐WP cannot replace scaling and root planing therapy, but has characteristics useful in subgingival plaque control.
Reproducibility of attachment level measurements with two models of the Florida Probe®
Authors: Marks R. G. , Low S. B. , Taylor M. , Baggs R. , Magnusson I. , Clark W. B.
Published: December 2005

Abstract Clinical assessment of the progression of periodontitis is based on the measurement of periodontal probing attachment levels over time. In calculating these changes, duplicate measurements from fixed reference points, including cemento‐enamel junctions and acrylic stents, have been used to assist in detecting progressive disease. The Florida Probe® has been previously shown to improve the reproducibility of these measurements when used with an acrylic stent. The objective of the present study was to evaluate the reproducibility of 2 models of the Florida Probe®, the original stent model and the modified disk model, in measuring attachment level. The disk probe differs from the stent probe in that it uses the occlusal surface of the tooth as a static reference point in calculating changes in attachment level measurements. In 10 subjects, sites were probed 2 × by 2 examiners using both types of probe. Standard deviations and intra‐ and inter‐examiner correlations were calculated. These results demonstrate that the new disk probe yields reproducible measurements similar to the stent probe and is therefore suitable for use in longitudinal clinical studies.
Cathepsin B‐ and L‐like activities at local gingival sites of chronic periodontitis patients
Authors: Eley B. M. , Cox S. W.
Published: December 2005

Abstract The cysteine proteinases cathepsins B and L have the potential to degrade connective tissue in chronic periodontitis and this may progress episodically at individual tooth sites. The activities of cathepsin B‐ and L‐like proteinases in homogenised gingival tissue from control and periodontitis patients were measured biochemically using the selective peptide substrate Z‐Phe‐Arg‐AFC and the selective cathepsin L inhibitor Z‐Phe‐Phe‐CHN2. Each tooth site was divided, where appropriate, into gingival tissue and granulomata. These were assayed separately and the measurements related to the DNA and protein contents of the tissues. Enzyme activity in healthy control tissue was significantly lower than in diseased tissue. Enzyme activity in gingival tissue and total tissue from periodontitis patients decreased with increasing pocket depth, clinical attachment level, gingival index and bleeding index whilst cathepsin B activity in granulomata increased with increasing pocket depth and clinical attachment level but not with increasing gingival index or gingival bleeding index. Mean enzyme activity in gingival tissue was 1.6–2.8 times greater than in granulomata. Mean patient enzyme activity in diseased patients did not correlate positively with their mean pocket depth, clinical attachment level, gingival index or gingival bleeding index. These results are best explained by the probable cellular origins of the enzymes and the likely influence of their serum and tissue inhibitors during the disease process.
Marking width, calibration from tip and tine diameter of periodontal probes
Authors: Van der Zee E. , Davies E. H. , Newman H. N.
Published: December 2005

Abstract The present study comprises an investigation of 7 different probe types, representing currently‐marketed major designs (WHO‐CPITN, Williams, Michigan), as well as available calibration systems (engraved, etched and painted markings). Width of markings, accuracy of calibration from probe tip, and tine diameter at the tip and at specified points along the tine were assessed, using a stereomicroscope at a magnification of × 40. Blind duplicate measurements of these probe tine characteristics were 100% reproducible to within 0.01 mm. There was an overall range in marking width from 0.00–1.13 mm. The best marking, in that it had no appreciable width and the highest accuracy, was the discrete transition between normal and engraved parts of probes with engraved bands. Mean inaccuracies of different probe sets varied from 0.06 to 0.22 mm. Probes from the same batch from the same production line could differ by more than 0.5 mm in calibration. Mean tip diameter ranged from 0.28 to 0.70 mm. It was concluded that probe tine diameter and calibration should be considered in addition to other variables of periodontal probing. Standardisation of tine characteristics and avoidance of the use of different types or batches in a single study should enhance the accuracy and reproducibility of periodontal probe‐dependent measurements.
Immunohistological study of neuronal markers in inflamed gingiva obtained from children with Down's syndrome
Authors: Barr‐Agholme Monica , Modéer Thomas , Luthman Johan
Published: December 2005

Abstract The histological appearance of the gingiva in children with Down's syndrome (DS) was studied with special reference to inflammatory involvement and innervation. A dense infiltration of inflammatory cells was seen in the propria of most of the DS patients, including a few polymorphonuclear leucocytes. A hyperplasia of the epithelium was also found. The innervation of the gingiva was studied using immunohistochemistry. Nerve fibers as well as nerve bundles immunoreactive to neurofilament (NF) were seen in the propria, while occasionally intraepithelial NF fibers were observed. Calcitonin gene‐related pep tide (CGRP)‐immunoreactive fibers and fiber bundles were also visualized, but they were less abundant than NF fibers. The density of NF and CGRP fibers and fiber bundles was estimated by semiquantitative evaluation. A higher density of NF and CGRP immunoreactive structures was observed in the propria of DS patients compared to the control subjects, while no obvious alteration was seen in their distribution in the propria. In addition, sparsely distributed fibers immunoreactive to peptide histidine isoleucine amide (PHI) and vasoactive intestinal polypeptide (VIP) fibers as well as neuropetide Y (NPY) and tyrosine hydroxylase (TH) were seen, mainly surrounding blood vessels. A few substance P (SP) fibers were also found, mostly close to the epithelium. No obvious differences of these sparsely distributed fibers were seen in the DS patients compared to controls. Thus, a profound inflammatory involvement of the gingiva of DS patients is seen concomitant with a hyperinnervation of the presumed sensory component of the gingival innervation. In contrast, no alterations were seen in the density of neuronal markers related to autonomic nerve fibers. The sensory hyperinnervation observed is probably not specifically related to DS, but may be due to a sprouting of afferent nerves induced by the inflammatory reaction. However, factors released from the sensory afferents could contribute to the gingival inflammation seen in DS.
The effect of a cognitive behavioral intervention on oral hygiene
Authors: Stewart James E. , Jacobs‐Schoen Marlene , Padilla Michael R. , Maeder Linda A. , Wolfe Gary R. , Hartz Gary W.
Published: December 2005

Abstract Several medical areas that require patient compliance have successfully used psychological interventions emphasizing cognitive behavioral components. However, there are no published reports on the effect of cognitive behavioral interventions on oral hygiene in adults using an experimental design. For this study, 100 male veterans age 21–65 years were randomly assigned to 4 groups (cognitive behavioral, education, attention control, and control); to compare the effectiveness of these interventions on oral hygiene, a 5‐week pre‐test‐post‐test design was utilized. The dependent variables were self‐report of brushing and flossing behavior and dental plaque levels utilizing the plaque index. After the interventions, there was only one significant difference between the control and the experimental groups for brushing frequency. There were no significant differences among the experimental groups for this intervention. The self‐report of flossing frequency significantly increased in all 3 treatment groups, but there were no significant differences between these groups. In addition, plaque levels decreased significantly in all 3 experimental groups. Plaque levels in the cognitive behavioral group were significantly lower than those of the educational group. It was not possible to determine whether the greater plaque reduction in the cognitive‐behavioral group could be attributed to the nature of the intervention or to the extra time spent with patients in the cognitive behavioral group.
Short‐term effects of initial periodontal therapy (hygienic phase)
Authors: Hämmerle Christoph H. F. , Joss Andreas , Lang Niklaus P.
Published: December 2005

Abstract The aim of the present study was to evaluate the effect of non‐surgical periodontal therapy on probing pocket depths and probing attachment levels using a patient group with moderate to advanced periodontitis. 68 patients with moderate to advanced periodontitis underwent hygienic phase therapy including oral hygiene instructions, scaling and root planing and elimination of plaque retentive factors. Assessments of the plaque control record (PCR), bleeding on probing (BoP), probing depths and probing attachment levels were performed at baseline examination and 3 to 5 months following active treatment. The measurements were obtained at 4 interproximal aspects of each tooth with a thin calibrated probe. Mean BoP values decreased from 63.2±21.9% at baseline to 16.6±7.3% after therapy, and mean PCR decreased from 78.6±16.4% to 12.7±7.1%, respectively. A reduction in mean probing pocket depth from 3.96±1.39 mm at baseline to 3.30±1.16 mm after therapy was noted. Sites with initial probing depths of 1–3 mm showed no change, sites with initial values of 4–6 mm revealed a reduction of 1.03±1.04 mm, while initial pockets of 7–9 mm decreased in depth by 2.28±1.62 mm. A gain in the mean probing attachment level from 4.16±1.80 mm to 3.74±1.71 mm was observed as a result of treatment. The group with the shallow initial probing depths of 1–3 mm showed no alteration in probing attachment level. Pockets with baseline values of 4–6 mm showed gain of clinical attachment of 0.69±1.43 mm. The greatest gain in clinical attachment of 1.51±1.75 mm was obtained in sites with initially deep pockets of 7–9 mm. From the results of this study, it can be concluded that non–surgical periodontal therapy is an effective means to reduce probing pocket depths and to improve clinical attachment levels in patients with moderate to advanced periodontitis.
Periodontal tissue reactions to orthodontic extrusion
Authors: Berglundh T. , Marinello C. P. , Lindhe J. , Thilander B. , Liljenberg B.
Published: December 2005

Abstract Orthodontic tooth extrusion is used at crown lengthening procedures or in conjunction with periodontal therapy aimed at eliminating or reducing angular bone defects. A technique for orthodontic extrusion combined with resection of the supracrestal attachment fibers (fiberotomy) was recently proposed as an adjunct to certain restorative procedures. The aim of the present investigation was to analyze reactions of the periodontal tissues to orthodontic extrusion when combined with fiberotomy. In 5 beagle dogs, the mesial roots of the 2nd, 3rd and 4th hemisected mandibular premolar were used as target roots while the distal roots served as reference units. After a baseline examination, an orthodontic extrusion device (stent) was installed and reactivated at 2‐week intervals during an 8‐week period of active tooth movement. Immediately following the installation of the stent and once every 2nd week, the target roots were exposed to fiberotomy. After the active period, the teeth were retained in their new position for a period of 8 weeks. Clinical, radiographical and histological measurements were performed. The results from the investigation demonstrated that orthodontic extrusion combined with supracrestal fiberotomy resulted in a coronal displacement of the tooth and was associated with pronounced recession of the gingival margin and extensive loss of connective tissue attachment. The degree of gingival recession and the amount of loss of connective tissue attachment were, however, less extensive than the amount of tooth extrusion. Thus, repeated fiberotomy obviously failed to entirely prevent coronal migration of the attachment apparatus. It was also observed that undesired attachment loss had occurred at the reference roots.
Specific antibody responses to subgingival plaque bacteria as aids to the diagnosis and prognosis of destructive periodontitis*
Authors: Wilton J. M. A. , Johnson N. W. , Curtis M. A. , Gillett I. R. , Carman R. J. , Bampton J. L. M. , Griffiths G. S. , Sterne J. A. C.
Published: December 2005

Abstract We have reviewed the recent literature on the humoral immune responses to a variety of subgingival plaque bacterial species in patients with destructive periodontal diseases. We do not feel that the information presently available on the specific antibody responses to proposed pathogens such as Bacteroides gingivalis and Actinobacillus actinomycetemcomitans allows antibody responses to be diagnostic. All control subjects without periodontal destruction have antibodies to candidate pathogens but the generally higher levels in patients are not sufficiently elevated to be diagnostic. Nor can they be used to predict the initiation of disease or the onset of new episodes of destruction where disease had previously occurred. Successful treatment of patients may lead to lower levels of antibodies to some organisms, including possible pathogens, and thus support a given species in the aetiopathogenesis of disease. It appears that unsuccessful treatment may be accompanied by continuing high antibody levels to some organisms and further studies may enable this observation to be used to monitor therapy. There is some evidence from serological studies that each destructive episode may be induced by a different bacterial species or consortium. The start of studies using single antigens and the techniques of molecular biology will provide not only antibody‐based diagnostic methods but also allow us to determine which bacterial antigens are virulence factors and thus the role of the antibody responses, whether protective or damaging, in the periodontal diseases.
Scanning electron microscopic investigation of changes in the dentogingival area during experimental gingivitis
Authors: Walsh T. F. , Walmsley A. D. , Carrotte P. V.
Published: December 2005

Abstract The purpose of this study was to investigate the changes that occur in the dentogingival area during experimental gingivitis using a replication technique and scanning electron microscopy (SEM). The upper 1st premolars of 20 subjects were examined prior to plaque accumulation, after plaque had become clinically visible and after 3 weeks plaque accumulation. 3 distinct zones were examined: the tooth surface and its integuments, the gingival crevice and the oral gingiva. Surface features such as perichymata, pits, depressions and cracks were rapidly covered by plaque deposits. These had a raised globular surface with occasional embedded desquamated epithelial cells. Raised plaque colonies were frequently seen by the end of the study. Initially, the gingival crevice presented a layered undulating appearance. With plaque accumulation many desquamating epithelial cells were seen and variations occurred in the width of the crevice. These changes were mirrored in the oral gingiva. The junctional epithelium was initially smooth with occasional pores and emigrating leucocytes. As plaque accumulated, the presence of pores and leucocytes increased and considerable disruption by desquamating epithelial cells was noted. No subject proved resistant to the influence of plaque‐induced changes.
Triclosan and sodium lauryl sulphate mouthrinses
Authors: Jenkins S. , Addy M. , Newcombe R.
Published: December 2005

Abstract Toothpastes have been shown to exert some plaque inhibitory effects probably due to the action of detergents such as sodium lauryl sulphate (SLS). Recently the antimicrobial, triclosan, has been added to experimental and commercial toothpaste products to enhance activity against plaque. There is, however, little information as to the plaque inhibitory effects alone of ingredients such as SLS and triclosan. This investigation compared the effects on 4‐day plaque regrowth of a 1% SLS, 0.2% triclosan and 0.2% chlorhexidine rinse with a 0.9% saline rinse. The study was a single blind, latin square, four‐period crossover design, balanced for residual effects and employing 16 healthy dentate volunteers. During each period, normal oral hygiene ceased and plaque regrowth from a zero baseline was measured by score and area after 2 × daily rinses with 10 ml volumes of each rinse. Washout was a minimum of 60 h. Plaque scores and areas were significantly lower with chlorhexidine than the other preparations and significantly higher with saline. There were no significant differences between SLS and triclosan. The results were essentially consistent with the similar substantivity of SLS and triclosan demonstrated from the salivary bacterial count investigation. Taste acceptability may, however, explain the small reverse trends noted between the two studies. It is concluded that both SLS and triclosan would individually confer plaque inhibitory properties to toothpaste formulations. However, when combined in a single formulation, their effects may not be additive.
Quantification of periodontal attachment at multi‐rooted teeth
Authors: Hujoel P. P. , Bollen A.‐M. , DeRouen T. A.
Published: December 2005

Abstract The purpose of the present study was to estimate the lost attachment surface area (LAS) and the remaining attachment surface area (RAS) of molars from a combination of clinical and radiographic measurements. Clinical and radiographic measurements on 32 maxillary and 26 mandibular molars were correlated with the post‐extraction measurements of LAS and RAS. The results indicate that linear models may increase the precision of the estimate of LAS by a factor of 1.2 for maxillary molars and 1.4 for mandibular molars when compared to estimates of LAS using only attachment level measurements. A diagnostic model for RAS predicts the square root of the remaining attachment surface area with the information obtained from the remaining radiographic attachment area and a gingivitis index. It is concluded that modeling of periodontal data may provide a method for predicting lost and remaining periodontal attachment area of molar teeth.
Diagnostic characteristics of crevicular fluid aspartate aminotransferase (AST) levels associated with periodontal disease activity
Authors: Persson G. Rutger , Page Roy C.
Published: December 2005

Abstract During a 2–year period pocket depth, probing attachment level, gingival index, and crevicular fluid aspartate aminotransferase (AST) levels were monitored in 25 previously treated periodontitis patients. Probing attachment level change was used retrospectively to identify sites where active periodontal destruction had occurred. The ability of crevicular fluid AST activities at 600, 800, 1000, and 1200 μIU levels to recognize active disease was investigated. Probing attachment level changes observed support the concept that the pattern of periodontal disease activity is episodic and infrequent. A loss of ≥2 mm was found at 11% of all studied sites, whereas a gain of ≥2 mm was noticed for 15% of sites. 2 subjects had 3 teeth that lost ≥2 mm of attachment, whereas 15 subjects demonstrated no teeth with disease activity. The remaining 8 subjects had 1 or 2 sites that lost ≥2 mm of attachment. Bayes's theorem and ROC curves were used to exemplify the sensitivity and the specificity of AST assessments. The AST 800 μIU demonstrated a sensitivity of 0.93 and specificity 0.68 and an odds ratio of 15.4 for attachment loss ≥2 mm. Under the conditional probability of either 50%, 25% or 10% active disease prevalence, AST 800 μIU has a predictability of 73%, 50%, and 24%o respectively.
Buccal attachment loss in Swedish adolescents
Authors: Källestål Carina , Uhlin Stig
Published: December 2005

Abstract A case referent study was performed to identify factors connected with loss of buccal attachment in adolescents. The study group was identified among 18‐year‐olds who had participated 2 years earlier in a study of periodontal conditions in adolescents. The criterion for inclusion in the case group was buccal attachment loss (≥ 1 mm) in one or more sites. Information on 28 variables, identified earlier as being related to recessions, was collected in a clinical examination, interview and observation. The referent group consisted of 66 subjects and the case group of 71 subjects. The case group comprised 2 subgroups, one identified as having buccal attachment loss in 1987 and the other with attachment loss occurring in the years 1987–89. Statistical analyses, using the 71 test, logistic regression and a variance component model, were performed to detect factors related to buccal attachment loss. These factors were thin alveolar tissue, narrow width of the attached gingiva and presence of teeth with buccal displacement. The results indicate that the anatomy of the buccal alveolar process is related to the presence of buccal attachment loss in populations with a high level of oral hygiene. To evaluate the importance of possible risk factors or etiological factors for development of buccal loss of tooth support, prospective epidemiological or experimental studies are needed.
Gingivectomy versus flap surgery: the effect of the treatment of infrabony defects
Authors: Proeslakis George , Soderholm Göran , Bratlhall Gunilla , Kullendorff Boel , Gröndah1 Kerstin , Rohlin Madeleine , Attström Rolf
Published: December 2005

Abstract The aim of this paper was to compare the short‐term results of gingivectomy (GV) and modified Widman flap (MWF) surgery in the treatment of infrabony defects. 14 patients with 68 bilateral infrabony defects were selected. A1 baseline, and 3 and 6 months postoperatively. assessments of oral hygiene, gingival conditions, bleeding on probing, probing pocket depth and attachment level, were recorded. Conventional radiograps were obtained in a way that assured a reproducible projection geometry. In a split‐mouth design, one jaw quadrant was randomly treated with GV. while the contralateral with a MWF. The changes of the bone tissue were assessed by means of conventional and subtraction images by 2 observers. The interobserver agreement of the conventional and subtraction technique was studied. The majority of the sites demonstrated a significant improvement in gingival conditions and a reduction in bleeding. For both treatments, probing depths were reduced by an average of 3 mm. while a mean of 1.22–1.35 mm of probing attachment gain was obtained. The GV resulted in slightly more gingival recession (1.90 mm) than the MWF (1.60 mm). The radiographic examination demonstrated gain of bone in 7 defects treated with GV and in 9 defects treated with MWF. This study demonstrated that pockets associated with infrabony defects can be successfully treated by both treatment modalities. Furthermore, bone gain can occur after treatment but not in a predictable manner.
Endodontic infection and calcium hydroxide‐treatment. Effects on periodontal healing in mature and immature replanted monkey teeth
Authors: Blomlöf Leif , Lengheden Annelie , Lindskog Sven
Published: December 2005

Abstract Large experimental defects with marginal communication, and small isolated experimental defects were created on the root surfaces of extracted monkey lateral incisors with either open or closed apices. The pulp tissue was either infected or removed, and calcium hydroxide placed in the root canal. The teeth were then replanted and the healing pattern evaluated histomorphometrically after 20 weeks. From the results, it was concluded that (1) an intrapulpal infection promotes marginal epithelial down‐growth on a denuded dentin surface irrespective of tooth developmental stage, and that (2) the periodontal healing potential after calcium hydroxide‐treatment appears to be higher in teeth with open apices compared with teeth with closed apices, where ankylosis was promoted as opposed to teeth with open apices where significantly more reparative cementum was found.
The effect of using a pre‐brushing mouthwash (Plax) on oral hygiene in man
Authors: Chung L. , Smith S. R. , Joyston‐Bechal S.
Published: December 2005

Abstract The aim of this study was to investigate whether the use of a pre‐brushing mouthwash (Plax) improved subjects' oral hygiene over a 2‐week period. In a double‐blind placebo controlled cross‐over study, 33 adult subjects (mean age 35.3 years) used either Plax or a placebo mouthwash for 30 s prior to tooth brushing during a 2‐week period. After a washout period of 4 weeks, the subjects used the other mouthwash in the same way. The modified plaque index of Quigley and Hein (QHI) was recorded for 16 teeth (16, 14, 13, 11, 21, 23, 24, 26, 36, 34, 33, 31, 41, 43, 44, 46) at each visit. The bleeding index (BI) was recorded at the beginning and end of the study. Results were analysed using a paired one‐tailed t‐test. Neither plax nor placebo mouth washes reduced plaque scores significantly (p>0.05) below baseline. There was no statistically significant difference between the mean BI at the beginning of the trial (0.42) and at the end (0.44). These results suggest that the routine use of Plax is not a useful adjunct to toothbrushing.
Crossover trials comparing several treatments
Authors: Newcombe Robert G.
Published: December 2005

Abstract. Designs exist for crossover studies in which the possibility of distortion by carryover effects is minimised. A novel design including 5 treatments and 15 subjects with this property is presented, along with existing designs. These designs incorporating balance for carryover effects should be used in preference to cyclical permutation designs. Statistical analysis of the resulting data is readily performed.
Topical application of fluorides on teeth
Authors: Rølla Gunnar , Øsard Bjørn , de Almeida Cruz Roberval
Published: December 2005

Abstract Prevention of caries in exposed root surfaces constitutes an important clinical problem. It is thus important that clinicians involved with periodontology have an insight into fluoride prophylaxis. The understanding of the cariostatic mechanism of fluoride has improved during recent years. The aim of the present review is to give a short account of the present concept. Calcium fluoride appears to be the only product which is formed on enamel, dentin or cementum during brief topical treatments with fluoride or use of toothpaste containing fluoride. This calcium fluoride is stable in the oral environment: this is contrary to what was believed until recently. The calcium fluoride constitutes a pH‐dependant reservoir of fluoride which releases fluoride when pH drops. The practical consequences of this concept is discussed.
Epithelial remnants in the crestal periodontium of the dog
Authors: Sterrett J. D. , Lindhe J. , Berglundh T.
Published: December 2005

Abstract The purpose of this study was to access the effect of age on the epithelial remnants (EPRs) of the crestal periodontal tissues of beagle dogs. The material consisted of 10 beagle dogs; 5 were 1‐year‐old (young dogs) and 5 were 9‐years‐old (old dogs). All animals belonged to the same dog colony and had been raised under similar conditions. Since birth, the dogs had been subjected to professional prophylaxis 4 ×/per year. Biopsies were obtained from the man‐dibular 3rd and 4th premolar regions and were prepared for histologic analysis. 2 areas, (1) the supracrestal region and (2) the marginal periodontal ligament region, were identified. The supracrestal region was further divided into 4 compartments of equal height. The histologic parameters studied included: the (i) number of EPRs/mm root length; EPR frequency; (ii) size of EPR; (iii) distance between the root surface and the EPR; (iv) distance between the alveolar bone and the EPR; (v) epithelial cell area. The supracrestal region (total and various compartments) of old dogs harbored significantly fewer yet larger EPRs than epithelial remnants of young dogs. Similarly, the EPR's of the periodontal ligament region were significantly larger and closer to the root surface in old dogs compared to young dogs. No difference was noted in the cell area of EPRs between young and old dogs for cither region. Epithelial remnants of the supracrestal region in both groups of dogs were somewhat more frequent, larger and positioned further from the root surface than the EPRs of the periodontal ligament region. Within the 4 compartments of the supracrestal region, the EPR frequency was less and the EPR size larger in old than in young dogs, with the most dramatic difference occurring in the most coronal compartment. It was concluded that EPRs are a normal constituent of the periodontal tissues of the permanent dentition of the beagle dog which undergo distinctive changes with age.
In vitro determination of the forceps level for extraction of teeth for periodontal reasons
Authors: Klock Kristin Solveig , Haugejorden Ola
Published: December 2005

Abstract The aim of the present study was to validate dentists' periodontal reasons for extraction by comparison with the in vitro periodontal status of extracted teeth. A national systematic random sample of Norwegian dentists (n= 500) was requested to record primary, secondary and tertiary reasons for tooth extraction for a period of 2 weeks in 1988. The response rate was 70%. The extracted permanent teeth from the first 2 patients of each dentist were collected. Of the 365 teeth, 329 satisfied the criteria for assessment of periodontal attachment after staining. Using a dissecting microscope (10 ×), 4 to 8 linear measurements were recorded per tooth. 159 of the 329 teeth had loss of periodontal support. Of the 93 teeth for which the dentists' reason for extraction included periodontal considerations, 1% had 1–10% loss of attachment, 59% had 11‐50% loss and 40% had 51–76% loss of periodontal support. There was a significant correlation between in vitro measurements of attachment loss and a ranking of teeth on a scale from 1 to 3 based on the dentists' emphasis on periodontal reasons for extraction (The Spearman Rs = 0.29, p<0.01). The results suggest that the forceps level for removal of teeth for periodontal reasons was set at a relatively early stage of the disease process by Norwegian dentists, and that there was a weak association between attachment loss and the dentists' emphasis on periodontal reasons for extraction.
Significance of some variables on interproximal alveolar bone height based on cross‐sectional epidemiologic data
Authors: Wouters F. R. , Salonen L. W. E. , Frithiof L. , Helldén L. B.
Published: December 2005

Abstract The objective of the study was to analyze the significance of some variables on interproximal alveolar bone height, based on cross‐sectional epidemiologic data from a Swedish survey conducted in 1983–1984, in the northern medical care district of Älvsborg county. 723 dentate individuals (92% of the randomly selected dentate individuals) with complete anamnestic, clinical and radiographic documentation were included in the statistical analyses. The computerized method used to measure interproximal alveolar bone height as a % of root length (B/R) provided data at each measurable interproximal surface of the individual teeth. On the population basis, a multivariate linear regression analysis showed that: (i) mean B/R values did not differ significantly between men and women, (ii) B/R value decreased with increasing age at a linear rate of 0.26% (0.04 mm) per year of age, (iii) the higher the calculus index value, the lower the mean B/R value, (iv) the higher the plaque index value, the higher the mean B/R value, (v) level of education, dentist attendance frequency and prevalence of defective margins of dental restorations did not show any statistically significant association with B/R, (vi) individuals attending the dental hygienist less than once every 2 years had higher mean B/R value than individuals attending the dental hygienist at least once every two years, and (vii) current smokers exhibited significantly lower mean B/R value than former and non‐smokers. Individuals smoking more than 5 g of tobacco per day had lower mean B/R values than individuals smoking between 1 and 5 g of tobacco per day. There was no statistically significant relationship between snuffing and B/R.
Levels of salivary IgA antibodies reactive with bacteria from dental plaque are associated with susceptibility to experimental gingivitis
Authors: Schenck Karl , Poppelsdorf Dirk , Denis Christine , Tollefsen Tore
Published: December 2005

AbstractSerum IgG, IgA and IgM and salivary IgA antibody levels reactive with extracts fromActinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Eubacterium saburreumandStreptococcus mutans, were measured by enzyme‐linked immunosorbent assay in samples from 12 persons before, during and after experimental gingivitis. The participants refrained from cleaning their teeth until 50% of their gingival units showed bleeding after gentle probing, but not longer than 15 days. Samples were taken from serum and saliva, before and during the period of experimental gingivitis, and up to 8 weeks after the start of the experiment. A pattern with minor fluctuations in specific serum and salivary antibody activities was consistently found in all patients. This indicates that immunoregulatory mechanisms succeed in maintaining unchanged antibody levels when plaque load increases. A subgroup of participants with low mean numbers of bleeding gingival units after plaque accumulation, showed significantly higher salivary IgA antibody levels reactive withS. mutans, A. actinomycetemcomitansandE. saburreum, as compared with the subgroup reaching high bleeding after probing scores (p< 0.05). When 1 person with outlying values (p< 0.05) forP. gingivaliswas excluded from the tests, the former group also showed statistically significant higher salivary antibody levels to this bacterial species. High levels of salivary IgA directed against bacteria in dental plaque might thus protect against the development of gingivitis.