bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of antiepileptic drugs use at a university hospital in Croatia
Authors: Prpic I. , Vlahovic‐Palcevski V. , Skarpa‐Prpic I. , Palcevski G. , Boban M.
Published: May 2005

To analyse the consumption rate of new generation antiepileptic drugs (AEDs) compared with traditional AEDs at a university hospital in Croatia. Antiepileptic drugs use was analysed retrospectively for two consecutive years, 2001 and 2002 at Departments of Neurology, Paediatrics, Psychiatry and Neurosurgery at the University Hospital Centre (UHC) Rijeka. The results obtained are expressed as number of defined daily doses (DDDs) per 100 bed days, as proposed by the WHO. The use of new generation AEDs was represented by 2% in 2001 and 5% in 2002. Majority of AEDs administered was taken by the barbiturates in both years. A wide spectrum of AEDs has been used at the Department of Paediatrics. At the Department of Neurology and Psychiatry use of barbiturates and carbamazepine predominated. The use of new AEDs at UHC has increased during the investigation period but it is still rather low compared with traditional AEDs. The similarity of our results with the result of the leading Croatian university hospitals might represent general routine AED prescription in country. Nationally based guidelines may bring more appropriate and rational approach for usage of modern AED. This task should be supported and promoted by international and national neurology associations.
The influence of alcohol and time on the S‐100B levels of patients with minor head injury
Authors: Enochsson L. , Carlsson‐Sanz S. , van der Linden J.
Published: May 2005

The present study aimed at evaluating the S‐100B serum level's reaction to (i) alcohol consumption and (ii) time elapsing between head injury and blood sampling. Nineteen patients with minor head trauma and with at least one of the following symptoms: amnesia, transient loss of consciousness or severe headache, were included in the study. Immediately after arrival venous blood samples were drawn for determination of alcohol concentration and S‐100B level. Four hours later a new blood sample was taken for repeat analysis. Twenty‐one healthy volunteers drank a moderate amount of alcohol. Blood samples were taken just before alcohol intake and 4 h later. Patients – After 4 h the mean S‐100B level had fallen from 0.26 to 0.21 ng/ml (P < 0.01), i.e. a mean decrease of 0.05 ng/ml, 95% confidence limits: 0.02–0.09 ng/ml. The alcohol concentrations also decreased significantly from 2.00 ± 0.27‰ to 1.31 ± 0.20‰, P < 0.001, mean difference = 0.69‰, 95% confidence limits: 0.27–1.11‰. No difference was found between the S‐100B levels of patients whose serum did contain alcohol and the levels of those whose serum did not. Volunteers – The serum alcohol level reached a mean value of 0.81‰ ± 0.09‰. The mean S‐100B level rose from 0.077 ± 0.02 ng/ml before alcohol intake to 0.103 ± 0.06 ng/ml, 4 h later (P < 0.01). These data indicate that the time that elapses between trauma and blood test has an effect on the S‐100B level. The same goes for the drinking of even a very moderate amount of alcohol. The relative importance of these two sources of error remains to be determined.
Doppler ultrasound and clinical findings in patients with acute ischemic stroke treated with intravenous thrombolysis
Authors: Thomassen L. , Waje‐Andreassen U. , Naess H. , Aarseth J. , Russell D.
Published: May 2005

The aim of this study was to assess cerebral hemodynamics in patients with acute ischemic stroke undergoing thrombolytic therapy and to assess the relationship between cerebral hemodynamics and outcome. Forty‐one unselected patients admitted to hospital within 3 h received intravenous thrombolytic therapy and were examined by extracranial and transcranial Doppler ultrasound examinations. Their strokes were clinically graded with the National Institute of Health Stroke Scale. Outcome after 3 months was graded with the modified Rankin Scale. Amongst the 27 patients who had an additional ultrasound examination 24 h after treatment, favorable outcome was significantly more common amongst patients with recanalization than amongst those without (P < 0.004). Thirteen patients with middle cerebral artery occlusions were continuously monitored during thrombolysis and frequently up to 5 h after start of thrombolysis. Early recanalization occurred in nine (69%), at a median delay of 178 min (range 140–287) after stroke onset. All of these nine patients had a favorable outcome. Recanalization within 24 h was associated with favorable outcome. Subgroup analysis suggests that this effect is mostly related to early recanalization within the first 5 h after stroke. Transcranial Doppler may therefore help to identify those patients most probably to benefit from thrombolysis, especially in those patients with a higher potential risk of complications.
A pilot double‐blind placebo‐controlled trial of low‐dose pramipexole in sleep‐related eating disorder
Authors: Provini F. , Albani F. , Vetrugno R. , Vignatelli L. , Lombardi C. , Plazzi G. , Montagna P.
Published: May 2005

Sleep‐related eating disorder (SRED) is characterized by recurrent arousals from sleep associated with compulsive ingestion of food. No controlled therapeutic trials are available for SRED. We assessed the safety, tolerability and efficacy of pramipexole, a dopamine D3‐receptor agonist, in the treatment of SRED. Eleven consecutive patients with SRED in the absence of concurrent daytime eating disorders underwent actigraphic recording and subjective sleep diary evaluation for a week before and every week for 2 weeks of treatment with pramipexole 0.18–0.36 mg or placebo, administered in a double‐blind crossover randomized sequence. The primary outcomes of the trial were actigraphic measures of night sleep parameters (sleep efficiency, motor activity mean and median, number and duration of wake episodes), secondary outcomes were the number of good sleep nights/weekly, number and duration of nocturnal awakenings/night, and visual analogue preference score. Pramipexole was well tolerated without any patient withdrawing from the study. Pramipexole reduced night‐time activity median (P = 0.02) and increased the number of nights of good sleep/week (P = 0.02). All other measurements remained unaffected. Pramipexole at low doses was well tolerated, improving some measures of sleep quality and reducing median night activity in SRED. Further studies with higher dosages and for longer time‐periods are warranted.
Preserved painting creativity in an artist with Alzheimer's disease
Authors: Fornazzari L. R.
Published: May 2005

Creativity in any of its forms, either visual, musical, literary or performing arts, may be conceived as a cognitive capability, and should be actively explored in relation to patients with Alzheimer disease and related dementias, even when other cognitive functions do not allow us to even communicate with them. We are reporting the case of a talented artist with the diagnosis of early onset Alzheimer disease (AD) with progressive cognitive impairment but with preservation of her creativity until very late in the course of the disease.
Seronegative myasthenia gravis: disease severity and prognosis
Authors: Romi F. , Aarli J. A. , Gilhus N. E.
Published: May 2005

Around 10–20% of myasthenia gravis (MG) patients do not have acetylcholine receptor (AChR) antibodies (seronegative), of whom some have antibodies to a membrane‐linked muscle specific kinase (MuSK). To examine MG severity and long‐term prognosis in seronegative MG compared with seropositive MG, and to look specifically at anti‐AChR antibody negative and anti‐MuSK antibody negative patients. Seventeen consecutive seronegative non‐thymomatous MG patients and 34 age and sex matched contemporary seropositive non‐thymomatous MG controls were included in a retrospective follow‐up study for a total period of 40 years. Clinical criteria were assessed each year, and muscle antibodies were assayed. There was no difference in MG severity between seronegative and seropositive MG. However, when thymectomized patients were excluded from the study at the year of thymectomy, seropositive MG patients had more severe course than seronegative (P < 0.001). One seropositive patient died from MG related respiratory insufficiency. The need for thymectomy in seronegative MG was lower than in seropositive MG. None of the seronegative patients had MuSK antibodies. This study shows that the presence of AChR antibodies in MG patients correlates with a more severe MG. With proper treatment, especially early thymectomy for seropositive MG, the outcome and long‐term prognosis is good in patients with and without AChR antibodies.
Couples' Relationships: Questioning Assumptions, Beliefs, and Values
Authors: Imber‐Black Evan
Published: May 2005

I want to express my deep appreciation to Howard J. Markman and Kim Halford for their excellent work as guest editors of the special section, Couple Relationship Education in an International Context.
International Perspectives on Couple Relationship Education
Authors: Markman Howard J. , Halford W. Kim
Published: May 2005

This article introduces the special section on international perspectives on couple relationship education. We first describe the theory and research underlying the increased interest in relationship education, with a strong emphasis on social policy issues. We include a discussion of both the benefits and controversies resulting from governments being involved in promoting healthy relationships. We then provide an overview of the four articles included in the special section and show how they illustrate trends occurring in a diverse set of cultural and national contexts. We conclude by highlighting issues and future directions for the relationship education field.
Couple Relationship Education in Australia
Authors: Halford W. Kim , Simons Michele
Published: May 2005

In Australia, the strengthening of marriage through relationship education has received strong governmental policy support and some modest financial support. Couple relationship education services are offered by a variety of community‐based, church‐affiliated, and church‐based providers. There is a strong emphasis on providing programs that are developed locally in response to perceived couple needs and government policies. Available evaluations show that most couples who attend education value the service, but relationship education providers need to do a better job reaching out to couples at high risk for future relationship problems, and more research is needed on the effects of education on long‐term marital outcomes. There is significant scope for building on current initiatives to incorporate evidence‐based approaches and to expand the program reach to more couples.
An Asian Perspective on Relationship and Marriage Education
Authors: Huang Wei‐Jen
Published: May 2005

The goal of this article is to provide couple therapists and relationship educators with information to enhance the cultural relevance of their work with Asian populations. Because of the rapid social, economic, cultural, and gender role changes, the various Asian interpretations of the institution of marriage are undergoing major transformation. This article describes the general trends in marriage in several Asian nations, with a focus on the swiftly rising divorce rates and changing cultural attitudes to marriage, and discusses current relationship education initiatives in these nations. Finally, based on my experiences working with Asian populations, I present a few humble insights regarding adaptation of marriage education to render it more culturally appropriate for Asians.
A Public/Private Partnership in Offering Relationship Education to the Norwegian Population
Authors: Thuen Frode , Lærum Kristin Tafjord
Published: May 2005

This article is an overview of the relationship education field in Norway. We explain the roles of the national authorities and private organizations in education, and analyze achievements and challenges in the field. Involvement and economic support from the national authorities have made relationship education available to large groups of the population, though the characteristics of those who choose to attend are largely unknown. To ensure recruitment of those most in need of education, new strategies based on systematic information on barriers among different groups of the population must be developed. A variety of relationship education programs are offered by public and private organizations, with the U.S.‐developed Prevention and Relationship Enhancement Program (PREP) being the most widespread. We present preliminary data of an effectiveness evaluation of PREP workshops in Norway. In general, participants evaluate the workshops positively. It is important to tailor relationship education to fit the various customs, beliefs, and challenges of couples attending programs.
Dissemination and Evaluation of Marriage Education in the Army
Authors: Stanley Scott M. , Allen Elizabeth S. , Markman Howard J. , Saiz Christopher C. , Bloomstrom Glen , Thomas Ronald , Schumm Walter R. , Bailey Albert E.
Published: May 2005

The effectiveness of marriage education was evaluated in two separate samples of primarily married couples in which at least one member of the couple was on active duty in the U.S. Army. The intervention was delivered by Army chaplains. Effects replicated well in the two samples, and demonstrated that marriage education was well received by this population and resulted in improvements in relationship functioning. Changes in relationship quality were examined separately for males and females, and also for couples in which both members of the couple were Caucasian as compared with all other couples. There were no significant differences in changes over time (i.e., from pre‐ to postmarriage education) among males and females or among couples with different ethnic makeup. These results have important implications for the generalizability of marriage education to diverse samples in nontraditional contexts.
Family Connections: A Program for Relatives of Persons With Borderline Personality Disorder
Authors: Hoffman Perry D. , Fruzzetti Alan E. , Buteau Ellie , Neiditch Emily R. , Penney Dixianne , Bruce Martha L. , Hellman Frederic , Struening Elmer
Published: May 2005

This study assessed changes in family members who participated in Family Connections, a 12‐week manualized education program for relatives of persons with borderline personality disorder (BPD). Family Connections, led by trained family members, is based on the strategies of standard Dialectical Behavior Therapy (DBT) and DBT for families. The program provides (a) current information and research on BPD, (b) coping skills, (c) family skills, and (d) opportunities to build a support network for family members. Forty‐four participants representing 34 families completed the pre‐, post‐, and 6‐month postbaseline self‐report questionnaires. Analyses employing hierarchical linear modeling strategies showed significant reductions in grief and burden, and a significant increase in mastery from pre‐ to post‐group assessment. Changes were maintained at 6 months post baseline.
Influence of alcohol in mouthwashes containing triclosan and zinc: an experimental gingivitis study
Authors: Almerich J. M. , Cabedo B. , Ortolá J. C. , Poblet J.
Published: May 2005

Objectives: An experimental gingivitis model was used to analyse the influence of alcohol in mouthwashes containing 0.15% triclosan and zinc chloride on the formation of supragingival plaque, the development of gingivitis and the appearance of adverse events.

Material and Methods: Using a double‐blind crossover design, 30 subjects underwent two consecutive experimental phases with two 0.15% triclosan and zinc chloride mouthwashes, differentiated mainly by their excipient (hydroalcoholic or aqueous). In each phase, the subjects discontinued all oral hygiene measures and were treated solely with the randomly assigned experimental mouthwash for 21 days. Each experimental phase was preceded by a 14‐day washout period in which, after receiving a complete oral prophylaxis, the subjects were instructed to perform thorough oral hygiene procedures. Gingivitis and plaque levels were assessed at the start and end of both the experimental phases.

Results: The evolution of the gingivitis and plaque indices showed no statistically significant differences between both treatments. The mean gingival index increased from 0.30 to 0.38 with the non‐alcoholic mouthwash and from 0.32 to 0.42 with the hydroalcoholic mouthwash. The respective changes in plaque index were from 0.88 to 1.93 and from 0.94 to 1.92. The hydroalcoholic mouthwash produced a larger number of fresh symptoms (p=0.033), oral itching being the most reported.

Conclusions: Alcohol does not influence the effectiveness of a 0.15% triclosan and zinc chloride mouthwash against gingivitis development and supragingival plaque formation. The absence of alcohol significantly decreases the incidence of adverse events produced by the mouthwash.
Tobacco smoking and periodontal microflora in a Saudi Arabian population
Authors: Natto Suzan , Baljoon Mostafa , Dahlén Gunnar , Bergström Jan
Published: May 2005

Objectives: To explore the subgingival periodontal microflora in a Saudi Arabian population with a special focus on its relationship with various smoking habits.

Material and Methods: A total of 198 individuals in the age range 17–60 years were included in the study. 29% were water‐pipe smokers, 18% cigarette smokers, 13% smokers of both water pipe and cigarettes (mixed smokers) and 40% non‐smokers. For each individual, a subgingival plaque sample from the deepest site in each quadrant was obtained. The checkerboard DNA–DNA hybridization technology was used to determine the presence of Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Tannerella forsythensis, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Treponoma denticola, Peptostreptococcus micros, Campylobacter rectus, Eikenella corrodens, Selenomonas noxia and Streptococcus intermedius. Two cut‐off levels for detection were used, score 1(105 bacteria) and score 3 (106 bacteria).

Results: The prevalence of individuals positive for the different microorganisms at score 1 cut‐off varied from 7% to 95%. At score 3 cut‐off the prevalence varied from 0% to 30%. The depth of sample site was a key factor for detection. When the depth of sample site was taken into account, no statistically significant differences were observed between cigarette smokers, water‐pipe smokers, and non‐smokers with regard to occurrence of the microorganisms studied.

Conclusions: No major differences were observed between cigarette smokers, water‐pipe smokers, and non‐smokers regarding the occurrence of the periodontal microorganisms studied suggesting that this portion of the subgingival periodontal microflora is independent of tobacco smoking.
Implant‐supported single‐tooth restorations: a 5‐year prospective study
Authors: Wennström Jan L. , Ekestubbe Annika , Gröndahl Kerstin , Karlsson Stig , Lindhe Jan
Published: May 2005

Background: Comparatively few studies are available reporting at least 5 years of follow‐up data of implant‐supported single‐tooth replacements.

Objective: To evaluate prospectively the 5‐year outcome of implant‐supported single‐tooth prosthetic restorations.

Material and Methods: Forty subjects (mean age 41 years), 23 males and 17 females, who required single‐tooth prosthetic replacement for a missing tooth were recruited. A total of 45 self‐tapping implants (Astra Tech® ST‐implants) – 40 in the maxilla and five in the mandible – were installed in a two‐stage procedure. Abutment connection was performed 3–6 months after implant installation. Clinical and radiographic examinations were performed at the completion of the prosthetic treatment and once a year during a 5‐year follow‐up period. The analysis of peri‐implant bone level alteration was performed on subject and implant levels and by the use of analysis of variance and binary logistic regression.

Results: Three patients were lost during the 5 years of follow‐up. One implant was lost after 2.5 years in function and another four implants could not be accounted for at the 5‐year follow‐up examination. The overall failure rate at 5 years was 2.6% (subject level) and 2.3% (implant level). The mean loss of marginal bone at the implants during the first year in function was 0.06 mm (SD 0.67) on the subject level and 0.02 mm (0.65) on the implant level. During the subsequent 4 years the annual change in peri‐implant bone level amounted to −0.02 mm (0.22) on both subject and implant levels. Thus, the mean total bone level change over the 5‐year interval was −0.14 mm (1.04) on subject level and −0.11 mm (1.00) on the implant level of analysis (p>0.05). The frequency of implants with a 5‐year bone loss of 1 mm was 13%. Approximately 50% of the implants demonstrated no bone loss.

Conclusion: The present clinical trial on single‐tooth replacements with the Astra Tech® implant system demonstrated that the bone loss during the first year of function as well as annually thereafter was small.
Effectiveness of a transmucosal lidocaine delivery system for local anaesthesia during scaling and root planing
Authors: Perry Dorothy A. , Gansky Stuart A. , Loomer Peter M.
Published: May 2005

Objective: This study compared the efficacy of transmucosal anaesthetic patches containing lidocaine (46.1 mg/2 cm2) to placebo for local anaesthesia during quadrant scaling and root planing using periodontal clinical indices and patient perception of pain.

Material and Methods: Forty healthy adults with moderate periodontal disease and moderate subgingival calculus were scaled at weekly intervals, two quadrants randomized to treatment patches and two quadrants randomized to placebo patches. Bleeding, probing depths and attachment levels were evaluated prior to treatment and 1 month after quadrant scaling was completed. Subjects completed 100 mm visual analogue pain scales 15 min. after patch placement and at the end of treatment, and were asked for verbal assessment of perceived pain.

Results: Subjects' verbal ratings demonstrated consistently greater pain relief with active patches than placebo (p<0.0001). Visual analogue scales demonstrated significantly greater pain relief with the treatment patches after 15 min. (p=0.0003) and at the end of treatment (p=0.0149). Efficacy of periodontal therapy was equivalent for treatment and control groups. No adverse events were observed; localized minimal gingival irritation was noted in three subjects.

Conclusion: Transmucosal lidocaine patches provided sufficient anaesthesia for therapeutic quadrant scaling and root planing procedures.
Efficacy of a 0.15% benzydamine hydrochloride and 0.05% cetylpyridinium chloride mouth rinse on 4‐day de novo plaque formation
Authors: Herrera David , Santos Sagrario , Ferrús Jorge , Barbieri Germán , Trombelli Leonardo , Sanz Mariano
Published: May 2005

Abstract Objective: To evaluate the effect of a mouth‐rinse formulation combining benzydamine hydrochloride and cetylpyridinium chloride (BNZ+CPC) in preventing de novo plaque formation, in comparison with CPC and placebo mouth rinses.

Patients and Methods: This was a controlled, observer‐blind, cross‐over study. In this model of plaque re‐growth, subjects received a session of oral prophylaxis and were directed to withdraw oral hygiene measures for the next 4 days, using only the mouth rinse assigned. The outcome parameters were the plaque index (PlI) and gingival index (GI). In addition, microbiological evaluation of the subgingival microflora, by means of culture, was performed, as well as patient‐based variables. Data analysis was carried out using anova for Latin‐square design.

Results: The analysis of variance showed a significant statistical difference between the BNZ+CPC association and placebo (p<0.0001). No differences between CPC and placebo were detected considering multiple comparisons between treatments. The 90% confidence interval of the differences between BNZ+CPC and CPC showed no equivalence between treatments, being the PlI lower in the BNZ+CPC group. No significant difference between groups in GI was observed. Mean anaerobic colony‐forming units (CFU) demonstrated a significant increase between visits in all groups (p<0.001) and differences among groups were not significant. Subjects treated with BNZ+CPC frequently reported “tingling mouth” and “numbness mouth”.

Conclusion: Within the limitations of the study model, the BNZ+CPC combination showed a statistically significant plaque‐inhibitory capacity, as compared with the placebo mouth rinse, and an additive effect as compared with CPC. No relevant clinical or microbiological adverse effects were detected.
Quality of bristle end‐rounding on replaceable heads of powered toothbrushes
Authors: Jung Martin , Soydan Nuran , Rubbert Felix , Wetzel Willi‐Eckhard
Published: May 2005

Objectives: The aim of this study was to evaluate the geometry and the quality of bristle tip‐rounding using 14 different heads from powered toothbrushes.

Material and Methods: Six powered toothbrushes for children and eight for juveniles and adults were included. Five replaceable heads of each product were randomly selected. Of each sample, 35 bristles were used for examination. This resulted in 175 bristles from each product being evaluated. The quality of end‐rounding was assessed by scanning electron microscopy at an original magnification × 80 in two categories of acceptable and five categories of unacceptable rounding according to Silverstone & Featherstone (1988).

Results: The portion of acceptable end‐rounding varied strongly between the products (18.9–94.3%). There were significant differences regarding the products for children (p<0.001) and for adults (p<0.001) with respect to end‐rounding quality. Only one product achieved more than 90% and eight products had between 68% and 86% acceptable end‐rounding. Two products for children and one for adults had less than 25% acceptable end‐rounding.

Conclusion: A high standard of bristle tip‐rounding is an important feature with respect to the safety of powered toothbrushes. Those products with a greater portion of unacceptably rounded bristles might cause more harm to oral soft tissues during use. The end‐rounding quality of some of the products should be improved.
Lipoprotein‐associated phospholipase A2 and plasma lipids in patients with destructive periodontal disease
Authors: Lösche W. , Marshal G. J. , Krause S. , Kocher T. , Kinane D. F.
Published: May 2005

Objectives: Periodontitis is believed to be an independent risk factor of cardiovascular disease (CVD) and to be associated with a moderate systemic inflammatory reaction and hyperlipidaemia. Lipoprotein‐associated phospholipase A2 (Lp‐PLA2) is an enzyme that has been shown to be a risk factor of CVD and that is involved in the degradation of the phospholipid mediator platelet‐activating factor (PAF), a potent mediator of inflammation.

Material and Methods: In the present study, we measured concentrations of plasma lipids and plasma activity of Lp‐PLA2 in 32 patients (mean age 43±11 years) with moderate‐to‐severe periodontitis before and 3 months after local treatment.

Results: Periodontal therapy resulted in a significant reduction of local inflammation and tissue destruction as reflected in reduced pocket depths and reduced bleeding indices. Pre‐ and post‐treatment plasma lipid levels were (median and range, mmol/l): total cholesterol (C) 5.01 (3.94–7.15) and 4.91 (3.32–8.01); low‐density lipoprotein‐cholesterol (LDL‐C) 3.14 (2.40–4.84) and 2.96 (1.39–5.04); HDL‐C 1.27 (0.73–2.17) and 1.25 (0.74–2.55); triglycerides 1.37 (0.48–5.11) and 1.14 (0.38–792). Using the Wilcoxon's rank test, neither parameter showed a significant change. In contrast to the lacking response of plasma lipids, we observed a significant reduction in the activity of Lp‐PLA2. Local treatment lowered the enzyme activity by about 10% from 3.61±0.99 to 3.29±0.94 μmol/ml/h (mean±SD; p<0.001). The pre‐treatment values of Lp‐PLA2 and LDL‐C significantly correlated with clinical parameters of inflammation and periodontal destruction.

Conclusion: This study indicates that treatment of periodontitis significantly reduces the serum activity of Lp‐PLA2, which is believed to be an independent cardiovascular risk factor.
Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog
Authors: Araújo Mauricio G. , Sukekava Flavia , Wennström Jan L. , Lindhe Jan
Published: May 2005

Objective: To study dimensional alterations of the alveolar ridge that occurred following implant placement in fresh extraction sockets.

Material and Methods: Five beagle dogs were included in the study. In both quadrants of the mandible, incisions were made in the crevice region of the third and fourth pre‐molars. Buccal and minute lingual full‐thickness flaps were elevated. The mesial root of the four pre‐molars root was filled and the teeth were hemi‐sected. Following flap elevation in 3P3 and 4P4 regions, the distal roots were removed. In the right jaw quadrants, implants with a sand blasted and acid etched (SLA) surface were placed in the fresh extraction sockets, while in the left jaws the corresponding sockets were left for spontaneous healing. The mesial roots were retained as surgical control teeth. After 3 months, the animals were examined clinically, sacrificed and tissue blocks containing the implant sites, the adjacent tooth sites (mesial root) and the edentulous socket sites were dissected, prepared for ground sectioning and examined in the microscope.

Results: At implant sites, the level of bone‐to‐implant contact (BC) was located 2.6±0.4 mm (buccal aspect) and 0.2±0.5 mm (lingual aspect) apical of the SLA level. At the edentulous sites, the mean vertical distance (V) between the marginal termination of the buccal and lingual bone walls was 2.2±0.9 mm. At the surgically treated tooth sites, the mean amount of attachment loss was 0.5±0.5 mm (buccal) and 0.2±0.3 mm (lingual).

Conclusions: Marked dimensional alterations had occurred in the edentulous ridge after 3 months of healing following the extraction of the distal root of mandibular pre‐molars. The placement of an implant in the fresh extraction site obviously failed to prevent the re‐modelling that occurred in the walls of the socket. The resulting height of the buccal and lingual walls at 3 months was similar at implants and edentulous sites and vertical bone loss was more pronounced at the buccal than at the lingual aspect of the ridge. It is suggested that the resorption of the socket walls that occurs following tooth removal must be considered in conjunction with implant placement in fresh extraction sockets.
Adjunctive subantimicrobial dose doxycycline in smokers and non‐smokers with chronic periodontitis
Authors: Preshaw Philip M. , Hefti Arthur F. , Bradshaw Mark H.
Published: May 2005

Objectives: Previous studies have demonstrated the clinical benefits of sub‐antimicrobial dose doxycycline (SDD) in the treatment of chronic periodontitis (CP). The aim of this study was to retrospectively evaluate the role of SDD as an adjunct to scaling and root planing (SRP) in the treatment of smokers and non‐smokers with CP.

Material and Methods: A meta‐analysis of two previously reported clinical studies was undertaken. Both were 9‐month, double‐blind, randomized, placebo‐controlled, multi‐centre clinical trials that investigated the efficacy of SDD (20 mg doxycycline twice daily) in combination with SRP in subjects with moderate–severe CP. 36.9% of the combined study population were smokers. Three hundred and ninety‐two subjects were included in the meta‐analysis, which evaluated per‐subject mean changes in clinical attachment level (CAL) and probing depth (PD) from baseline and the total number of sites with attachment gains and PD reductions 2 and 3 mm from baseline in four subgroups: smokers/SDD; smokers/placebo; non‐smokers/SDD; non‐smokers/placebo.

Results: A hierarchical treatment response was observed, with non‐smokers who received SDD demonstrating the greatest CAL gains and PD reductions. Smokers who received placebo demonstrated the smallest clinical improvements following treatment. Smokers who received SDD demonstrated an intermediate treatment response that was broadly equivalent to that seen in non‐smokers who received placebo. In sites with baseline PD 4–6 mm, month 9 CAL gains were 19–45% better in non‐smokers who received SDD compared with all other subgroups (p<0.05), and were 21% greater in smokers who received SDD compared with smokers who received placebo (p<0.05). Furthermore, month 9 PD reductions were 21–53% greater in non‐smokers who received SDD compared with all other subgroups (p<0.01), and were 26% greater in smokers who received SDD compared with smokers who received placebo (p<0.05).

Conclusion: Adjunctive SDD enhances therapeutic outcomes compared with SRP alone, resulting in clinical benefit in both smokers and non‐smokers with CP.
Optimal rinsing time for intra‐oral distribution (spread) of mouthwashes
Authors: Paraskevas S. , Danser M. M. , Timmerman M. F. , Van der Velden U. , Van Der Weijden G. A.
Published: May 2005

Aim: To investigate the intra‐oral spread of an erythrosine mouthwash in relation to the rinsing period.

Material and Methods: Thirty subjects were randomly divided into two equal groups and asked to rinse with 10 ml erythrosine mouthwash for cumulative periods of 15, 30 and 60 s (Group I) and 30, 60 and 90 s (Group II). Each rinsing session was followed by new plaque measurements. After rinsing plaque was finally assessed using the erythrosine mouthwash applied by means of a cotton swab.

Results: In Group I there was a difference observed between the 15 s rinsing period and those of 30 and 60 s. Explorative analysis for Group I suggested that differences in both jaws and approximal sites on both vestibular and lingual surfaces appeared to have contributed to the overall difference seen between 15 and 30 s rinsing periods. Also, pre‐molars and front teeth seem to have contributed to this observed difference. No differences were noted between rinsing sessions and cotton swab application for Group II or Groups I+II combined.

Conclusions: Rinsing for 30 s appeared to be sufficient for all plaque‐covered surfaces of the dentition to come into contact with the mouthwash.
Improving patients' compliance with the treatment of periodontitis: a controlled study of behavioural intervention
Authors: Philippot Pierre , Lenoir Nathalie , D'Hoore William , Bercy Pierre
Published: May 2005

Objectives: This clinical trial study investigates whether a behavioural educational intervention based on the autoregulation theory can improve periodontitis patients' compliance with proper dental care at a 1‐month follow‐up.

Material and Methods: Thirty patients matched for gender (20 men), age (mean age=39 years) and education were randomly assigned to a control or an experimental treatment condition. In the control condition, patients received the regular treatment based on instruction of the proper prophylactic dental care. In the experimental treatment condition, patients received information about the symptoms of periodontitis, the causes, consequences and temporal course, and the types of effective strategy and they were requested to keep daily records of the effects of applying prophylactic dental care on their periodontitis symptoms. In both groups, plaque indices (PIs) (Silness & Löe 1964) were measured prior to treatment and at a 1‐month follow‐up. A self‐report questionnaire also assessed the representation of periodontitis in all patients.

Results: A 2 (time of measurement: baseline versus follow‐up) × 3 (PI localization) × 2 (experimental group) mixed‐design anova computed on the PI reports a large effect of time, F(1, 28)=267.10, p<0.000, indicating that both groups improved from baseline (mean=1.73, SD=0.08) to the 1‐month follow‐up (mean=0.56, SD=0.06). It is important to point out that this analysis also revealed the expected Group × Time interaction, F(1, 28)=7.09, p<0.02, partial η2=0.19, indicating that smaller PI were observed in the experimental group (mean=0.24, SD=0.14) than in the control group (mean=0.88, SD=0.38) at follow‐up. Post hoc analyses showed that this pattern applies to the proximal and lingual PI but not to the vestibular PI.

Conclusions: The present data show that the behavioural education intervention is (a) more effective than a classical intervention based on information and training about prophylactic techniques and (b) that it is effective in bringing most patients to normal levels of PI. For clinical practice, it suggests that better results can be obtained if (a) patients are taught a correct representation about periodontitis and (b) patients' sense of self‐efficacy is developed through their own direct experience, by observing the effects of their behaviour on periodontitis symptoms.
A method for the validation of a new calculus detection system
Authors: Meissner Grit , Oehme Bernd , Strackeljan Jens , Kuhr Alexander , Kocher Thomas
Published: May 2005

Background: Recently, pilot studies from our laboratory have shown that dental surfaces may be discriminated by the analysis of tip oscillations of an ultrasonic instrument, which possesses computerized calculus‐detection features. For the evaluation of this smart detection system, its surface recognition qualities are of crucial importance. For in vivo studies, however, it proved to be difficult to verify the subgingival detection results. Therefore, it was necessary to develop a method, which allowed a reliable validation of surface recognition results of this new device. This evaluation method is described here.

Materials and Methods: Thirty extracted human teeth with subgingival calculus were embedded with plaster in a tray. To simulate subgingival pockets, dissected mucoperiostal porcine gingiva was sutured on the teeth. The thus‐constructed dentition was mounted into a phantom head. A CCD‐cam was attached with an intra‐oral X‐ray mount to the teeth. The dentist scanned the pockets with the ultrasonic instrument, simultaneously videotaping the scanning path of the supragingival portion of the insert. At the same time, the signals of the modified ultrasound scaler were recorded. After the tooth was removed from the phantom head, the tip of the ultrasound scaler could be repositioned using the video sequences. The actual insert location on calculus or cementum was assessed and compared with the computer signals. The whole procedure was repeated a second time and the reproducibility of the evaluation method was estimated.

Results: A κ value of 0.95 was attained for the evaluation method.

Conclusion: The present experimental design allows the in vitro repositioning of an automated dental instrument for the detection of subgingival surfaces on the tooth following an in vitro phantom‐head video recording of its intra‐oral scanning movements. This method will be used for the verification of in vivo results of a new ultrasound‐based surface detection system.
Statistical methods for testing plaque removal efficacy in clinical trials
Authors: Heynderickx I. , Engel J.
Published: May 2005

Objectives: To evaluate the ability of different statistical approaches in finding a statistically significant difference in plaque removal efficiency between brushes in clinical trials.

Materials and Methods: The approaches, which are evaluated, concern the scores after brushing only, the difference in scores before and after brushing and the relative difference scores (i.e. score before minus score after brushing divided by the score before brushing). In each case the scores before brushing may be included as a covariate. Except for the relative difference scores, the power of the test statistics of the approaches has been compared by assuming a simple statistical model. These theoretical results have been compared with the numerical results of two particular clinical trials – one with a between‐subject design and one with a within‐subject design.

Results: The numerical results of these clinical trials show that the calculated p‐values support the conclusions drawn from the statistical model, i.e. the power of the F‐test is highest when evaluating the data after brushing with the data before brushing included as a covariate. Using the differences in scores before and after brushing – again with the data before brushing as a covariate – does not add additional power to the test. Omitting the data before brushing as a covariate only gives satisfactory results when the variance over the subjects or the error variance is zero, which in general is not the case.

Conclusions: This investigation reveals that in general the approach of analysing the scores after brushing with the scores before brushing as a covariate yields the highest chance of finding a statistically significant difference between two brushes.
Periodontal conditions and subgingival microflora in Down syndrome patients
Authors: Sakellari D. , Arapostathis K. N. , Konstantinidis A.
Published: May 2005

Abstract Objectives: The periodontal conditions and the subgingival microflora of children, adolescents and young adults (8–28 years old) with Down syndrome were investigated in the present cross‐sectional study and compared with those of healthy individuals and subjects with cerebral palsy.

Material and Methods: Seventy Down syndrome patients, 121 age‐matched healthy individuals and 76 patients with cerebral palsy participated in the present study. Full‐mouth recordings of clinical parameters (probing depth, probing attachment level, bleeding on probing, hygiene index) and the community periodontal index of treatment needs were assessed and subgingival plaque samples were taken from the Ramfjord teeth and analysed for 14 species using “checkerboard” DNA–DNA hybridization.

Results: Clinical indices of periodontal inflammation and treatment needs were statistically significant higher among Down syndrome patients compared with the other two groups (anova, p=0.000). Important periodontal pathogens colonize these subjects earlier and at higher levels (chi‐squared test, p=0.000).

Discussion: Down syndrome patients display more severe periodontal destruction earlier, and heavier colonization with periodontal pathogens compared with age‐matched healthy individuals and patients with cerebral palsy.
Relationship between radiographic abnormalities of lumbar spine and incidence of low back pain in high school rugby players: a prospective study
Authors: Iwamoto J. , Abe H. , Tsukimura Y. , Wakano K.
Published: May 2005

The purpose of this study was to examine the relationship between prevalent radiographic abnormalities of the lumbar spine and the incidence of low back pain in high school rugby players. Three hundred and twenty‐seven incoming high school rugby players (15–16 years of age) were recruited between 1986 and 1994. All of them underwent athletic physical examination before participation in high school athletics. The relationship between prevalent radiographic abnormalities of the lumbar spine in the pre‐participation athletic physical examination and the incidence of low back pain during a 1‐year period after the start of participation in athletics was analyzed. Radiographic abnormalities assessed were spondylolysis, disc space narrowing, spinal instability, Schmorl's node, balloon disc, and spina bifida occulta. The frequency of respective radiographic abnormalities was 15.6%, 13.1%, 32.7%, 14.1%, 11.6%, and 30.6%. Two hundred and forty‐three players (74.3%) had at least one of these radiographic abnormalities. The incidence of low back pain was 44.0% in players with no such radiographic abnormalities and 41.2% in those with at least one radiographic abnormality. The incidence of low back pain in players with the respective radiographic abnormalities was 72.5%, 46.5%, 46.7%, 39.1%, 34.2%, and 41.0%, and only players with spondylolysis had a significantly higher incidence of low back pain than those with no radiographic abnormalities. This study shows that a radiographic abnormality, specifically spondylolysis, is a significant radiological risk factor for low back pain in high school rugby players.
Predicting dropout in male youth soccer using the theory of planned behavior
Authors: Nache Catalin M. , Bar‐Eli Michael , Perrin Claire , Laurencelle Louis
Published: May 2005

This investigation prospectively predicted dropout among young soccer players, using the theory of planned behavior (TPB). First, behavioral beliefs required to develop a TPB‐questionnaire were elicited from 53 male soccer players, aged 13–15 years. Second, at the beginning of the soccer season, 354 different male soccer players aged 13–15 years completed this questionnaire, thereby assessing direct dimensions (intention, attitude, subjective norm, perceived control) and indirect dimensions (attitudinal, normative and control beliefs) derived from TPB. Nine months later – upon termination of the soccer season – these players were classified into 323 perserverers and 31 dropouts, with TPB being applied prospectively to predict these two groups. For both direct and indirect dimensions, between‐group comparisons revealed significant differences in favor of the perseverers. Discriminant analyses revealed five measures (intention, attitude, subjective norm, a normative belief, and a control belief), which enabled a 22.1% a priori dropout prediction when used within a suitable equation. In conclusion, TPB may have a promising application to prospectively discriminate dropouts from perseverers, providing a potential predictive a priori classification model for sport participation.
Permanent disabilities in the displaced muscle from rupture of the long head tendon of the biceps
Authors: Deutch Søren R. , Gelineck John , Johannsen Hans Viggo , Sneppen Otto
Published: May 2005

Patients with a displaced muscle belly because of rupture of the long head biceps tendon were investigated for local pain and other disabilities, together with strength and endurance loss. Eleven patients (median age 59 years, minimum follow‐up 6 months) were included, and minimum follow‐up was 6 months. Magnetic resonance imaging (MRI) of both upper arms allowed investigation of muscle atrophy and evaluation of any other degenerative signs in the displaced muscle.

All patients reported pain or disability locally in the displaced muscle in certain situations, and strength and endurance were reduced by 25%. MRI revealed the displaced muscle to be unreduced in size and with no signs of degeneration.

Generally, operative reattachment of the displaced muscle is not advocated in middle‐aged or older patients. In order to elucidate this subject, we present a retrospective consecutive series of patients with considerable disabilities in the displaced muscle belly independent of shoulder disabilities.
Passive and dynamic translation in the knee is not influenced by knee exercises in healthy individuals
Authors: Tagesson Sofi , Öberg Birgitta , Kvist Joanna
Published: May 2005

No evidence exists that repeated isolated quadriceps contractions lead to increased sagittal plane tibial translation. The purpose was to analyze passive and dynamic tibial translation before, during and after a specific exercise session, including cycling and a maximum number of knee extensions and heel‐raises, in healthy individuals.

Passive and dynamic sagittal tibial translation was measured on 18 healthy individuals (nine men and nine women) before, during and after a specific exercise session with heavy load, including cycling and maximum number of knee extensions and heel‐raises. Sagittal tibial translation during the Lachman test, maximal isometric quadriceps contraction, one‐legged squat and gait was registered with the CA‐4000 electrogoniometer. The electromyographic (EMG) activity of m. vastus medialis and lateralis, m. gastrocnemius and mm. hamstrings was registered.

There was no difference in passive or dynamic sagittal tibial translation during or after the exercise session. No difference could be detected in EMG activity during squat after compared with before the exercise session.

In conclusion, the knee exercises did not influence the amount of translation in healthy individuals. The findings indicate that isolated strength training of quadriceps may be included in anterior cruciate ligament rehabilitation programs, even if further specific studies on injured individuals most be performed.