bluuebunny/crossref_metadata_2025 huggingface dataset:
Tissue regeneration principles applied to separation of fused teeth
Authors: Kohavi D. , Shapira J.
Published: December 2005

Abstract A two‐step surgical procedure for separating a central incisor fused to a supernumerary tooth with a 4‐year follow‐up is described. The fusion was between the crowns and 3/4 of the root length. The roots were connected by web‐like radio‐opaque tissue. The periodontal ligament could be followed along the lateral aspect of the roots and was continuous along the base of the web. In the first surgical phase, a full‐thickness semilunar flap was raised; a fissure bar was cut along and through the web up to the approximate location of the junctional epithelium and the flap was sutured. It was assumed that cells from the bone surrounding the web and/or connective tissue cells from the flap had migrated into contact with the web hard tissue. This resulted in replacement resorption of the web. The connective tissue replacing the web acted as a septum separating the 2 parts of the root. The distal root was extracted. Resorption continued until most of the web disappeared from the wound. At this point, the remaining layer of web tissue was thin enough to allow repopulation of the resorbed surface with periodontal cells from the buccal and palatal sides of the web. The successful clinical outcome supports the assumption that new attachment consisting of periodontal ligament and cementum was formed following the 2‐step surgical procedure. Application of the technique is limited by the width of the fusion rather than by its length.
Flow‐cytometric analysis of lymphocyte subsets in patients with advanced periodontitis
Authors: Zafiropoulos G. G. K. , Jacoby L. Flores‐de , Schoop B. , Havemann K. , Heymanns J.
Published: December 2005

Abstract Peripheral blood lymphocytes from 36 patients with advanced periodontitis and from 34 healthy subjects were examined using a panel of monoclonal antibodies and fluorescence flow cytometry. The absolute and relative counts of B‐cells, T‐cells, T‐helper (TH), T‐suppressor/cytotoxic (TS) cells, activated T‐cells and natural killer cells were assessed and the TH/S ratio was calculated. In the periodontitis patients, the TH/s ratio was 1.56 ± 0.62 and in the controls 1.35 ± 0.55. This was not statistically significant. A classification on the basis of sex also did not show significant differences in the TH/S ratio. B‐cells and activated T‐cells were slightly increased in the periodontitis group. However, all determined lymphocyte subpopulations revealed no significant differences between the groups. These results indicate that local inflammatory reactions and immunoregulatory dysfunction are limited to the periodontium in the patients with advanced periodontitis, with no significant quantitative effects on the peripheral lymphocyte subpopulations.
Evaluation of gingival suppuration and supragingival plaque following 4 modalities of periodontal therapy
Authors: Kaldahl Wayne B. , Kalkwarf Kenneth L. , Patil Kashinath D. , Molvar Michael P.
Published: December 2005

Abstract This study evaluated the effect of coronal scaling (CS), root planing (RP), modified Widman surgery (MW) and flap with osseous resectional surgery (FO) upon the presence of gingival suppuration and supragingival plaque. 75 patients completed split‐mouth therapy and 2 years of maintenance care. Data were collected prior to the initiation of therapy, following initial therapy, following surgical therapy and yearly during 2 years of maintenance care. All 4 types of therapy reduced the prevalence of suppuration with RP, MW and FO producing a greater reduction than CS in sites 5 mm. Sites were grouped according to presence of suppuration at 2 consecutive examinations. The mean changes in probing depth and probing attachment level for each time period were compared. Sites that began to suppurate between 2 exams or were suppurating at both exams had a less favorable response in mean probing depth reduction and mean probing attachment gain when compared to sites that stopped suppurating between exams or did not suppurate at either exam. The prevalence of supragingival plaque decreased during active therapy and 2 years of maintenance. There was no difference in the prevalence between the therapy groups except for FO‐treated sites showing more plaque accumulation after surgical therapy. The presence or absence of supragingival plaque at specific sites was dynamic, frequently converting to a new status between 2 examinations.
Evidence for rapid multipolar and slow unipolar production of human cellular and acellular cementum matrix with intrinsic fibers
Authors: Bosshardt Dieter , Schroeder Hubert E.
Published: December 2005

Abstract The genesis of root cementum has been studied infrequently in animal models, e.g., in mice, rats and dogs, but rarely in the human. The present study was based on 8 premolars (4 maxillary and 4 mandibular, 7 first and 1 second) selected from a large collection of freshly extracted human teeth. All teeth were free of disease and presented with roots developed to about 50–80% of their length. After decalcification in EDTA, the apical half of the roots was divided axially into mesial and distal portions. The latter were subdivided into 4 slices cut in the corono‐apical direction. These slices were Epon‐embedded and cut for examination in the light‐and transmission electron microscope. It was found that 2 basically different modes of cementum matrix production occurred at or near the advancing root edge. These 2 modes, i.e., the multipolar versus unipolar matrix production, resulted in either cellular (CIFC) or acellular intrinsic fibre cementum (AIFC). Both varieties did not contain fibres of Sharpey and were restricted to regions of the root usually covered with cellular mixed stratified cementum (CMSC). By comparison with recently published data on the rate of cementum apposition, it is suggested that the multipolar mode is a rapid form, whereas the unipolar mode is a slow‐rate form of producing intrinsic fibre cementum.
The survival of subgingival plaque bacteria in an amine fluoride‐containing gel
Authors: Bansal G. S. , Newman H. N. , Wilson M.
Published: December 2005

Abstract. Subgingival plaque samples from 20 patients with chronic inflammatory periodontal disease were exposed to a commercial gel formulation containing 2 amine fluorides. The MIC of the gel for these samples ranged from 33 to 260 μ/ml with a modal value of 260 μ/ml. In each sample, the most resistant organisms (i.e., those organisms surviving at one doubling dilution below the MIC) were identified. 33 such organisms were isolated, of which 22 (67%) were strict anaerobes, and 25 (75%) were Gram negative. The 2 most frequent isolates were Bacteroides ruminicola ss. brevis and a Selenomonas species, neither of which is a recognised periodontopathogen. The gel had a rapid effect on the viability of the bacteria in the plaque samples, the 90% kill time being 17 min or less for 90% of the samples (range <5 to 71 min).
Split‐mouth and cross‐over designs in dental research
Authors: Antczak‐Bouckoms Alexia A. , Tulloch J. F. Camilla , Berkey Catherine S.
Published: December 2005

Abstract. The presence of paired or multiple organs (arches, quadrants, teeth) and the chronic nature of many dental diseases suggest the use of split‐mouth (trials in which each subject receives ≥2 treatments, each to a separate section of the mouth) and cross‐over research designs (trials in which each subject receives ≥ 2 treatments in sequence). While these designs offer potential savings in resources, their usefulness can be negated if several strict scientific and statistical assumptions are not met. The primary prerequisites for the use of split‐mouth and crossover designs are that: (1) the disease to be investigated is relatively stable and uniformly distributed; (2) the effects of the treatments to be evaluated are short lived or reversible for cross‐over studies, or are localized for split‐mouth designs. Other important factors that influence the appropriate use of these designs include: the method of treatment sequencing and assignment, and the cross‐over rules used; blinding of patient assignment, patients and observers; assessment of order effects including period, carry‐over or spill‐over effects; the choice of statistical analysis, the sample size utilized, and the special importance of patients lost to study or of faulty data points. The objective of this study was to review 3 journals for studies using split‐mouth or cross‐over designs to determine how the assumptions underlying these research designs are considered and applied in dental research. The majority of studies used adequate methods for treatment allocation and sequencing; however, many studies failed to take advantage of the research designs in the statistical analysis of data. In addition, very few studies considered the possibility of order effects or reduced bias through blinding procedures.
The effectiveness of 3 types of dental floss for interdental plaque removal
Authors: Ong Grace
Published: December 2005

Abstract. The relative effectiveness of waxed dental floss, dental tape and Superfloss as proximal plaque removal aids were compared in 20 subjects. Each subject used each of the three interdental aids for I week. The order of use was randomly selected. Interdental plaque scores were recorded at baseline, weeks 1, 2 and 3. At the end of week 3, subjects answered a questionnaire to ascertain their subjective responses to the 3 types of dental floss they had used. The use of all 3 types of dental floss resulted in significant improvement in mterproximal plaque scores compared to baseline scores. Improvement in plaque scores, in decreasing order were: dental tape, dental floss and Superfloss. Dental tape was significantly more efficient than Superfloss (p= 0.003). There were no significant differences observed between the effectiveness of dental tape and waxed floss (p= 0.059). and waxed dental Hoss and Superfloss (p= 0.143). Regardless of the type of dental floss used, patients removed plaque more efficiently from buccal inter‐proximal areas compared to lingual/palatal interproximal areas (p < 0.001) and from anterior teeth than posterior teeth (p < 0.001). Subjective responses indi‐cated that 50% of subjects preferred dental tape. 40% waxed dental floss and only 10% preferred Superfloss.
Marginal bone loss in 16‐year‐old Swedish adolescents in 1975 and 1988
Authors: Källestål Carina , Matsson Lars
Published: December 2005

Abstract The study was designed to compare the prevalence of marginal bone loss in 2 cohorts of 16‐year‐old adolescents, born in 1959 and 1972, respectively. Bitewing radiographs from 400 adolescents in each group were evaluated and the presence of bone loss (distance between the cementoenamel junction and the alveolar crest > 2 mm), calculus, restorations and proximal dental caries were recorded. The prevalence of bone loss was 3.5% in 1975 as well as in 1988. Bone loss was found most frequently at the mesial and distal surfaces of the first maxillary molar. The prevalence of calculus was 12% in 1975 and 7% in 1988. The mean DPS for proximal surfaces was 3.1 in 1975 and 0.8 in 1988. No statistically verified dependence was found between bone loss and calculus, or bone loss and proximal caries.
Proximal attachment loss in Swedish adolescents
Authors: Källestål Carina , Matsson Lars , Persson Sten
Published: December 2005

Abstract The present study describes periodontal conditions in 22 adolescents with proximal attachment loss 2 mm (AL) and 22 matched referents without AL, all identified in a cross–sectional study of 570 16‐ and 18‐year‐olds. The cases were followed for 3 years and the referents for 1 year while they were in the care of an organized dental health system. With the exception of 1 case with Morbus Hodgkin, the case and referent groups had a similar background with respect to general health and participation in the dental health program. Bleeding on probing was found at AL sites in 12 of the cases and at corresponding sites in 4 referents. 2 cases had a history of eruption disorders at the AL sites, 1 case had experienced a defective filling and 1 had a root fissure at the AL sites. At reexaminations after 1 and 3 years, 10 out of 21 earlier identified AL cases did not meet the criterion of 1 or more sites with AL 2 mm. None of the cases showed progression 2 mm of the lesions. In 1 case, the number of AL sites increased during the period. 4 of the cases harboured Actinobacillus actinomycetemcomitans (A.a.) at AL sites in year 1 and 3 in year 3. 8 of the cases and 4 referents had antibodies specific for A.a.‐leukotoxin. The 2 most severe cases, in terms of number of sites with AL, showed bleeding at 1 or more of the AL sites, harboured A.a. at these sites and had serum titers against A.a.‐leukotoxin.
Acute necrotizing ulcerative gingivitis is associated with attachment loss
Authors: MacCarthy Denise , Claffey Noel
Published: December 2005

Abstract Acute necrotizing ulcerative gingivitis (ANUG) has been generally considered as a gingivitis. However, clinical impressions suggest that periodontal attachment loss is one of the sequelae of the disease. This study was designed to investigate the extent of probing attachment loss detectable following resolution of the acute phase of the disease. 13 patients (3 male, 10 female) aged on average 22.7 years were studied. The presence of interdental soft tissue cratering was used to determine whether a site was previously affected by ANUG. ANUG sites were compared with other sites using a paired Student t‐test (N= 13). Patient mean probing attachment level was greater for ANUG sites (2.2 ± 0.9) than for the mean of all other sites (0.8 ± 0.7). It is concluded that greater loss of probing attachment is associated with sites affected by ANUG than with other sites studied.
A new method to assess damaging effects on the gingival tissues of non‐surgical instrumentation
Authors: Walsh T. F. , Walmsley A. D.
Published: December 2005

Abstract A method of assessing the damaging effects of non‐surgical instrumentation was developed. To test the technique, the effect of cavitational activity in the water supply of an ultrasonic sealer was investigated in an in vivo situation. Using a replication technique for the scanning electron microscope, it was shown that the water supply of the ultrasonic sealer caused superficial disruption of the surface of the gingiva, distant from the area of damage caused by mechanical contact. The results indicated that further investigations of this phenomenon using the technique were required.
Autotransplantation of third molars as treatment in advanced periodontal disease
Authors: Kristerson Lars , Johansson Lars‐Åke , Kisch Jenö , Stadler Lars‐Eric
Published: December 2005

Abstract The aim of this study was to investigate the prognosis of replacing molars with advanced periodontitis by autotransplanted fully developed third molars. The patient sample consisted of 18 subjects, 24–58 years of age. The patients selected had at least 1 molar with advanced periodontal tissue destruction. After extraction of the diseased molar, autotransplantation of a third molar was immediately performed. After a splinting and healing period of 2–3 weeks, endodontic treatment was carried out. The follow‐up included recordings of the clinical parameters, probing periodontal pocket depth, probing attachment level, percussion sound, and mobility. Radiographs were taken immediately after the surgical procedure, after 6 months, 1 year, and thereafter annually. The results of this study indicate that autotransplantation may be an alternative treatment procedure for molars with advanced periodontal disease.
Multiple idiopathic root resorption
Authors: Moody G. H. , Muir K. F.
Published: December 2005

Abstract A rare case of multiple idiopathic root resorption (MIRR) involving 5 adjacent anterior and posterior teeth is presented and the pathogenesis discussed. The proposition is made that MIRR results from microbiologically‐induced osteoclast activity facilitated by prior osteoblast activation.
Effect of surgical and non‐surgical periodontal treatment on periodontal status and subgingival microbiota
Authors: Pedrazzoli V. , Kilian M. , Karring T. , Kirkegaard E.
Published: December 2005

Abstract The purpose of this study was to evaluate, on a short‐term basis, the clinical and microbiological effects of a single course of scaling and root planing as compared with those obtained by flap surgery in patients with moderate to advanced periodontitis. 11 patients participated in the study. Using a split‐mouth design, one quadrant of the mouth was treated with reverse bevel flap surgery, whereas the contralateral one was subjected to a single course of scaling and root planing. 2 approximal sites on single‐rooted teeth with a pocket depth ≥ 5 mm were monitored clinically and microbiologically for 16 weeks after active treatment. Both techniques resulted in a gain of probeable attachment levels, a reduction in bleeding on probing and a reduced mean pocket depth, although 31.2% of the sites in the scaling and root planing group still had 6–7 mm deep pockets at 8 and 16 weeks after treatment. Both techniques reduced median relative proportions and frequencies of detection of black‐pigmented Bacteroides species. A highly statistically significant increase (p < 0.01) in median proportions of oral streptococci was recorded only for surgery within the 1 st month post‐operatively. No correlation was found between residual pocket depth and any of the microbiological parameters considered in the study, suggesting that residual pocket depth does not exert a significant influence on bacterial subgingival recolonisation after therapy. The results from this study suggest that surgery can be as effective as scaling and root planing in favoring the establishment of micro‐organisms compatible with periodontal health, although this effect is limited to the 1st month after therapy.
Considerations on the contribution of ageing to loss of periodontal tissue support
Authors: Papapanou Panos N. , Lindhe Jan , Sterrett John D. , Eneroth Lennart
Published: December 2005

Abstract The present study is an attempt to assess if age‐related changes, manifested as loss of probing attachment and alveolar bone, occur in humans. 511 subjects, in ages 20–24, 30–34, 40–44, 50–54 and 60–64 years, were included in the study. All subjects had undergone a comprehensive clinical examination, including recordings of probing pocket depth and probing attachment level. A subsample of subjects was selected, whose periodontal status indicated minimal experience of destructive periodontal disease. In these particular subjects, the height of the alveolar bone was also assessed. The results showed that in the subsample, (i) attachment loss increased with age, but (ii) a high proportion of tooth surfaces remained with no attachment or alveolar bone loss in ages between 20 and 64 years. There are reasons to suggest, therefore, that age‐related alterations in the periodontium may not inevitably be manifested as loss of probing attachment or alveolar bone.
Polymorphonuclear neutrophil chemiluminescence in periodontal disease
Authors: Zafiropoulos George‐Gregory K. , Flores‐de‐Jacoby Lavinia , Plate Volker‐Michael , Eckle Llsebil , Kolb Gerald
Published: December 2005

Abstract The oxidative metabolism of polymorphonuclear leukocytes (PMNs) in rapidly progressive periodontitis (RPP, n= 19), localized juvenile periodontitis (LJP, n= 10), adults periodontitis (AP, n= 10) and healthy control subjects (HS, n= 39) was compared using the luminol chemiluminescence (CL) method. Possible influences of the isolation procedure on CL were circumvented by replacing starch with Haemaccell 35 as the sedimentation agent. In all groups, CL was significantly higher with autologous serum than with normal pooled serum (NPS) and there was a significant linear relationship between the two values. Comparisons of both pooled and autologous serum between patient groups and their matched controls were not statistically significant. There was a suggestion of serum‐induced defects in 2 patients and 1 control. The range of individual values within each group was very heterogeneous, probably because of the many factors that are able to influence both the production of CL and the basal levels of CL observed.
An in vitro investigation on the loss of root substance in scaling with various instruments
Authors: Ritz Luca , Hefti Arthur F. , Rateitschak Klaus H.
Published: December 2005

Abstract There are differing opinions as to the extent to which root cementum has to be removed during root surface instrumentation over and above that of the debridement of plaque and calculus. Similarly, the amount of tooth material removed by individual instruments is also unclear, but a trend towards less damaging methods of root surface debridement has evolved in recent years. The purpose of this in vitro study was to determine the amounts of root substance removed by 4 different methods of instrumentation, hand curette, ultrasonic sealer, airscaler and fine grit diamond bur. Measurement of tooth substance loss was carried out with a specially constructed measuring device at 360 sites on 90 mandibular incisors following 12 working strokes with a clinically appropriate force of application. Only a thin layer of root substance (11.6 μm) was removed by the ultrasonic sealer, compared to the much greater losses sustained with the airscaler (93.5 μm), the curette (108.9 μm) and the diamond bur (118.7 μm).
Ultrastructural demonstration of the importance of crystal size of bioceramic powders implanted into human periodontal lesions
Authors: Frank R. M. , Klewansky P. , Hemmerle J. , Tenenbaum H.
Published: December 2005

Abstract Stages in bone formation were studied ultrastructurally after the implantation of the following 3 bioceramic powders into human periodontal lesions: (1) ã‐tricalcium phosphate whitlockite (Synthograft®) consisting of particles with a mean length of 229± 87 μm in SEM and appearing in TEM as crystals with a mean diameter 488 ± 192 nm; (2) an hydroxyapatite (Bioapatite®) which consisted of particles with a mean length of 283 ± 87 μm in SEM and of crystals with a mean diameter of 146 ± 47 nm in TEM; and finally (3), a microsized hydroxyapatite consisting of elongated platelets with a mean length of 32 ± 4 μm in SEM, composed of small crystals with a mean diameter of 38 ± 16 nm in TEM. In a preliminary experiment in rats, it appeared that the microsized hydroxyapatite implanted into the alveolar region after first molar extraction exhibited biocompatibility. In 6‐ and 12‐month biopsies, it appeared that bone formation in association with the 3 bioceramics tested in human periodontal lesions occurred through similar mechanisms at the Ultrastructural level. After the appearance of peripheral fibroblast‐like or osteoblast‐like cells with an interposed layer reminiscent of an osteoid tissue, collagen fibrils were observed in the intercrystalline spaces. These spaces subsequently underwent mineralization, with deposition of bone apatite crystals followed by the peripheral deposition of a thin inner bone layer with a granular appearance and an outer normal bone layer of either woven bone, lamellar bone or bone with parallel calcified collagen fibrils. These bone nodules, however, formed around the bioceramic particles at highly variable time intervals. Bone formation was observed around Synthograft® and Bioapatite® implants only in 12‐month biopsies, and thicker layers of peripheral bone were observed with the latter hydroxyapatite implant. With microsized hydroxyapatite, a significant amount of peripheral bone formation had already occurred by 6 months, strongly suggesting an important effect of crystal size on bone formation.
Prevalence and severity of periodontal disease in patients with inflammatory bowel disease
Authors: Flemmig Thomas F. , Shanahan Fergus , Miyasaki Kenneth T.
Published: December 2005

Abstract Previous reports have demonstrated that oral mucosa and periodontal lesions occur in patients suffering from inflammatory bowel disease (Crohn's disease [CD] and ulcerative colitis [UC]). It is unknown whether periodontal disease is an occasional or regular finding in these patients. The purpose of this study was to assess the prevalence and severity of periodontal disease in patients with inflammatory bowel disease (IBD). The periodontal status of 107 consecutive patients seeking treatment for inflammatory bowel disease was assessed. Examination of the mid‐ and mesiobuccal aspects of one quadrant on one jaw and the contralateral quadrant of the opposite jaw revealed that 93.5% of the CD patients and 95.1% of UC patients had at least one site with probing attachment loss of 2 mm or greater, and a mean probing attachment loss of 1.4 ± 0.9 mm and 1.5 ± 1.0 mm, respectively. We found that 28.3% of CD patients and 29.5% of UC patients possessed at least 1 site with a pocket probing depth of 4 mm or greater; the mean pocket probing depth in these patients was 2.4 ± 0.2 mm and 2.3 ± 0.2 mm, respectively. Compared with the assessment of Oral Health of United States Adults, IBD patients revealed a 11.9% higher prevalence (P0.01) but 0.6 mm lower severity (P0.01) of periodontal disease. The magnitudes of these differences suggest no clinical implications for the management of periodontal disease in IBD subjects.
Immunoglobulin isotype distribution of locally produced autoantibodies to collagen type I in adult periodontitis
Authors: Jonsson R. , Pitts A. , Lue C. , Gay S. , Mestecky J.
Published: December 2005

Abstract Production of antibodies to collagen type I was analyzed by means of an enzyme‐linked immunospot (ELISPOT) assay in patients with chronic adult periodontitis (AP) before and after periodontal hygiene treatment. Anti‐collagen type I antibody‐secreting cells were found among mononuclear cells enzymatically eluted from inflamed gingiva in 9 of 15 patients with untreated AP and in 4 of 14 hygiene‐treated patients with a varied isotype distribution. A notably high prevalence of IgG and IgM isotypes was observed for the anti‐collagen antibodies in untreated patients. With wide variation, chronic AP was characterized by a high frequency of spontaneous IgG and low numbers of IgA and IgM‐producing cells. Periodontal hygiene treatment significantly reduced the number of IgA and IgM‐secreting cells. Although AP is not an autoimmune disease in the accepted sense, our results indicate that local autoimmune reactions to collagen type I are common in untreated AP, implying an interplay between periodontal infection and autoimmunity.
The effect of alignment errors on bitewing‐based bone loss measurements
Authors: Shrout Michael K. , Hildebolt Charles F. , Vannier Michael W.
Published: December 2005

Abstract Alveolar bone loss measurements made using digitized dental radiographs have been shown to be precise and accurate. We determined the influence of alignment errors introduced when exposing the radiographs on the precision and accuracy of bone loss measurements. Bitewing radiographs of 15 dry skulls were obtained using a positioning device (modified after the methods of Duckworth and associates). The sequence of radiographs was taken while the alignment of the main Roentgen beam was systematically varied within a 10° cone. Angular displacements were calculated from the digitized radiographs. Space variant digital image enhancement was performed to improve visualization of the cemento‐enamel junctions and alveolar crests. Corresponding bone loss measurements were made on dry skulls and radiographs. The criterion for truth in these measurements was established by 2 expert observers who measured the skulls with periodontal probes. Radiographic measurements were statistically compared with the criterion using validity coefficients. We found beam positioning errors of up to 10° do not substantively affect alveolar bone loss measurements of mandibular molars taken from enhanced digital images of bitewing radiographs.
Marginal alveolar bone height in an adult Swedish population
Authors: Salonen Lars W. E. , Frithiof Lars , Wouters Francis R. , Helldén Leif B.
Published: December 2005

Abstract The purpose of the present cross‐sectional epidemiologic study was to assess the interproximal alveolar bone level within the dentition of 732 randomly selected adult individuals, stratified according to gender and age. Full mouth series of periapical radiographs were used for the assessments of the relation alveolar bone height/root length (B/R). A computer/digitizer recording method was utilized for the assesments. The results were presented as (i) mean values per age group and gender, (ii) mean frequency of subjects with sites exceeding certain thresholds of bone loss and (iii) cummulative frequencies of subjects with various number and percentual proportion of sites in relation to different B/R‐ratio intervals. The results showed a reduction in mean alveolar bone/root ratio with age. The women had a significantly more favourable mean B/R‐ratio than men in the ages above 40 years; the women had, however, more missing sites above age 60 years. By older age, there was observed an increased variation between individual mean B/R‐ratios. Only a few subjects had a mean B/R‐ratio <50%. A subfraction of the subjects in the different age groups had > 20% of their sites below a B/R‐ratio of 60%. This fraction increased with age.
Altered tissue metabolism of progesterone in pregnancy gingivitis and granuloma
Authors: Ojanotko‐Harri A. O. , Harri M.‐P. , Hurttia H. M. , Sewoón L. A.
Published: December 2005

Abstract The metabolism of progesterone may play a special role in the gingival physiology. The lower the metabolism the higher its hormonal activity in the tissue. In healthy human gingiva, progesterone is metabolized only partially and is therefore in an active form. In the present study, gingival samples from pregnancy gingivitis (n = 1) and granulomas (n = 4) were studied histologically and biochemically. All samples were homogenized and then incubated with [4‐14C]‐progesterone and NADPH for 2 h at pH 7.4 and 37°C. The metabolites were separated and characterized with column, solvent and thin‐layer chromatographies as well as radioautography and quantified with liquid scintillation counting. The results showed low metabolism of progesterone, indicating active hormonal function as in healthy gingiva. It is suggested that progesterone functions as an immunosuppressant in the gingival tissues of pregnant women, preventing the rapid acute‐type of inflammatory reaction against plaque, but allowing an increased chronic‐type of tissue reaction, resulting clinically in an exaggerated appearance of inflammation.
Evaluation of stannous fluoride and chlorhexidine sprays on plaque and gingivitis in handicapped children
Authors: Chikte Usuf M. , Pochee Ebrahim , Rudolph Michael J. , Reinach Stephanus G.
Published: December 2005

Abstract The objective of this study was to evaluate the effect of twice‐daily oral sprays of 2 ml chlorhexidine (0.2%) and 2 ml stannous fluoride (0.2%) as the sole oral hygiene measure on plaque and gingivitis in handicapped children. 52 institutionalized mentally handicapped individuals (aged 10–26 years) were divided into 4 groups to participate in a 9‐week, double‐blind, randomized clinically controlled trial, which included a cross‐over. For the first 3 weeks, groups 3 and 2 had their mouths sprayed with chlorhexidine and stannous fluoride, respectively. Following a 3‐week wash‐out interval, groups 1 and 4 were sprayed with chlorhexidine and stannous fluoride, respectively. The alternate groups received a placebo, water. Plaque (PI) and gingival indices (GI) were recorded. Subgingival plaque samples were collected and counts of spirochaetes, motile rods and cocci were taken using darkfield microscopy. By the 9th week of trial, the PI and GI were reduced by 48% and 52% for the stannous fluoride group. In the chlorhexidine group, reductions of 75% (PI) and 78% (GI) were achieved. Pair‐wise comparisons of placebo, stannous fluoride and chlorhexidine using the U‐test of Mann‐Whitney revealed significant (p < 0.05) differences for both PI and GI scores in the placebo/stannous fluoride and placebo/chlorhexidine pair by the 9th week of the trial. In the stannous fluoride/chlorhexidine pair, only the PI was significantly reduced for those on chlorhexidine. Coccoid cells were more dominant at sites with low PI and GI scores (stannous fluoride and chlorhexidine groups), while spirochaetes and motile rods were more frequent at sites with high PI and GI scores (placebo group).
Closed versus open debridement of facial grade II molar furcations
Authors: Schroer Michael S. , Kirk Walter C. , Wahl Timothy M. , Jr. Hutchens L. H. , Moriarty John D. , Bergenholz Birgitta
Published: December 2005

Abstract Clinical responses of facial grade II molar furcations to closed (C) versus open (O) debridement were evaluated. 25 teeth were treated at baseline (BL) with scaling/root planing (S/RP) and evaluated at 4 months. 12 of the teeth were then treated with open flap debridement and the remaining teeth were treated with further S/RP. Clinical parameters of plaque, gingival inflammation, bleeding on probing, gingival fluid flow, pocket depth and probing attachment level were taken at BL, 4, 7, 10, 13 and 16 months. Pairwise differences were determined between visits and a Z‐test was applied to differences for C and O. For both treatment groups, the greatest changes in clinical parameters occurred from BL–4 months. Plaque and gingival inflammation showed a gradual reduction from BL throughout the study for both groups. A reduction in pocket depth from BL–16 months was noted in both groups (mid‐furcal, C= 1.5 mm, O= 1.2 mm; root prominence, C= 1.02 mm, O = 0.84 mm)! There was a gain in probing attachment level in the midfurcal area for the C group (0.6 mm) while the O group lost (−0.46 mm). There were no statistically significant differences found for any clinical parameter between closed and open debridement. The presence of plaque and bleeding at a furcal site had not significant effect on treatment response.
The effectiveness of a preventive regimen on the periodontal health of patients undergoing chemotherapy for leukemia and lymphoma
Authors: De Beule Fr. , Bercy P. , Ferrant A.
Published: December 2005

Abstract In patients with leukemia or lymphoma, the role of preventive oral hygiene in reducing infectious periodontal complications during aggressive chemotherapy is well documented. However, the effectiveness of these measures in preventing further dental or periodontal degradation remains to be demonstrated. 34 hospitalized patients with malignant heamatological diseases were observed. During chemotherapy, tooth brushing was replaced by 3 daily mouth‐rinses with 0.2% chlorhexidine digluconate. The periodontal status of these patients, appears unchanged after 12 months. This suggests that the prophylactic measures do prevent a measurable periodontal degradation, even in the presence of pre‐existing periodontal disease.
Applicability of an image analysis system in alveolar bone loss measurement
Authors: Verdonschot E. H. , Sanders A. J. , Plasschaert A. J.
Published: December 2005

Abstract Clinical and epidemiological studies in the field of periodontics and endodontics often utilize radiographs to monitor or measure the changes in bone structure and density. Periodontal bone loss or gain can be quantified on a radiograph by measurement of the distance between the bottom of the bony pocket and the apical contour of the involved tooth. The objective of this investigation was to study the accuracy of an image analysis system (IAS) to measure changes in height of the interproximal crest on radiographs. Artificial bone lesions were introduced in a dissectioned part of a human mandible. The distances between crest and apices were measured with a micrometer (MM). Radiographs were produced with horizontal and vertical deviations of 10°. The radiographs were digitized and processed by computer. The landmarks in the digital image were enhanced mathematically and by histogram‐based thresholding. The depth of the introduced defect was increased 6 times, followed by the measurement procedure. The IAS produced measurements of crown‐apex distances with an accuracy of 0.066 to 0.358 mm. Repeated crest height measurements were recorded with an accuracy of 0.112 to 0.184 mm. Both the histogram‐based binarization and the ellipse‐fitting type of contour detection could be applied precisely. Misangulation errors during radiographic exposure of 10° horizontal or vertical did not statistically significant influence the IAS‐measurements. The IAS can be applied in clinical trials and follow‐up studies.
Healing of human suprabony lesions treated with guided tissue regeneration and coronally anchored flaps Case reports*
Authors: Stahl S. S. , Froum S. J.
Published: December 2005

Abstract Teflon membranes were interposed between soft tissue flaps and roots in 4 human suprabony lesions affecting the mandibular incisor teeth in 1 volunteer patient. 4 suprabony lesions affecting the mandibular incisor teeth were used as comparisons in a 2nd patient. All roots were debrided using ultrasonic and manual instruments and the most apical positioned calculus/site on the facial surface was notched. Flaps were sutured as coronally as possible using orthodontic brackets as anchors. Tissue blocks were removed 2 to 3 months after procedures and the facial aspects of all teeth were examined histologically. New attachment in the form of new “cementum with functionally oriented fibers” was seen within the calculus notch in 3 out of 4 membrane‐treated sites and immediately apical to the notch at 1 site. The 4 comparison sites showed no evidence of new attachment within or adjacent to the notch. Rather, the gingival margins were located apical to the notch. Our observations suggest that guided tissue regeneration techniques improved coronal attachment responses in human suprabony lesions within the sample described.
3‐year observations on gingival recession in mandibular incisors in children
Authors: Andlin‐Sobocki A. , Marcusson A. , Persson M.
Published: December 2005

Abstract 28 children aged 6–13 years, with gingival recession localized to mandibular incisors, were monitored longitudinally to evaluate any changes of the labial periodontal tissues. Measurements included dental plaque, gingival inflammation, gingival recession, probing depth, probing attachment level, keratinized and attached gingiva. Following baseline examination, the incisors were observed at yearly intervals over 3 years. The results showed that a high level of oral hygiene was maintained and that gingival inflammation occurred only to a minor degree throughout the observation period. Gradual reductions in the amount of gingival recession and probing attachment levels took place in all children except for 1 of the subjects with 1 severely malpositioned tooth. Probing depths and widths of keratinized and attached gingiva remained relatively unchanged. The finding that gingival recession in mandibular incisors in young children often improves over time suggests that preventive or reparative treatment in this part of the developing dentition may not be necessary. Decisions about such treatment should be postponed until any spontaneous improvement has taken place.
Repeated measurement of crevicular fluid parameters at different sites
Authors: Smith Q. T. , Geegan S. J.
Published: December 2005

Abstract Few systematic studies have been made of amounts or of the composition of gingival crevicular fluid (GCF) from different sites or of the stability of GCF parameters over time. These data are needed to better understand the relation of GCF composition to periodontal health status. This report gives the volume and the amounts of lactate dehydrogenase (LDH), aryl sulfatase (AS) and neutrophil elastase (NE) for GCF collected from 6 samplings of 6 standard gingival sites in 11 young adult subjects over a 6–week period. Attachment loss (3 mm) was noted at only 1 of the 66 sites. The mean gingival index of the 11 subjects ranged from 0.33 to 1.67. The GCF volume and activity/sample of LDH and AS but not NE differed among subjects. However, differences among subjects were not found when the GCF enzyme activities were expressed as activity/μl GCF. GCF volume and LDH, AS and NE activity all differed among the 6 sites when the activities were expressed as either quantity/sample or μl GCF. These data show that differences among sites must be carefully considered in evaluation of GCF data. Fluid volume and LDH, AS and NE activity all varied from sampling to sampling. However, differences among sites were retained throughout the experimental period.
Influence of high glucose concentrations on glycosaminoglycan and collagen synthesis in cultured human gingival fibroblasts
Authors: Willershausen‐Zönnchen Brita , Lemmen Christa , Hamn Gerald
Published: December 2005

Abstract Human gingival fibroblasts were used to study the effects of increasing concentrations of glucose on protein, collagen and glycosaminoglycan (GAG) synthesis. GAG‐synthesis was measured as incorporation of 3H‐glucosamine into pronase‐resistant macromolecules and collagen synthesis was evaluated by 3H‐proline incorporation into collagenase‐sensitive protein. Incubation of the fibroblasts with glucose concentration ranging from 5 to 50 mM resulted in a dose‐dependent reduction of collagen synthesis; labeled collagen in the culture medium was reduced to 60% of the control incubation (5mM glucose) when incubated with 50 mM glucose for 72 h. Cell‐associated radioactivity was decreased to 80% under the same conditions. Although 3H‐glycosamine incorporation into GAGs was reduced by increasing glucose concentrations (5 to 20 mM), protein synthesis and cell number were not influenced under the same conditions, as was also the case with distribution of macromolecules in the GAG fractions. The importance of these in vitro results to the incidence of chronic inflammatory periodontal disease in diabetic patients is discussed.
Cell‐seeding of ligament fibroblasts
Authors: van Dijk L. Johan , Schakenraad Jeff M. , van der Voort H. M. , Herkströter Frank M. , Busscher Henk J.
Published: December 2005

Abstract This study was undertaken to test the hypothesis that seeded periodontal ligament cells are able to create new attachment. In one beagle dog, a premolar was removed and scrapings of the ligament were cultured. Artificial periodontal defects were made and the cultured ligament cells were seeded on the planed root surfaces and covered with muco‐periostal flaps. The opposite side served as control. After 4 months, the dog was sacrificed and histological and electron microscopical sections were prepared. The seeded root surfaces were almost completely covered with cementoblasts, whereas in controls, epithelial down‐growth could be observed. We conclude that seeding of periodontal ligament cells could be a promising technique to create new connective tissue attachment.
The width of plaque‐free zones on primary molars with attachment loss
Authors: Keszthelyi G.
Published: December 2005

Abstract The width of plaque‐free zones on stained surfaces of extracted primary molars showing attachment loss was measured. The teeth were divided into 4 groups: maxillary first and second molars, mandibular first and second molars. 30 measurements were made under a stereomicroscope on each of the 4 surfaces in every group. The plaque‐free zone had a mean width of 1.75 ± 0.49 mm and a range of 1.0–4.3 mm. The plaque‐free zone was significantly (P < 0.001) wider on the proximal surfaces (1.94 ± 0.56 mm) than on the combined buccal and lingual surfaces (1.56 ± 0.32 mm). There was no difference between the 2 proximal surfaces while the lingual surfaces gave higher values than the buccal ones. On the second and on the lower primary molars, the plaque‐free zones were wider than on the first and on the upper molars.
A 4‐quadrant comparative study of periodontal treatment using tetracycline‐containing drug delivery fibers and scaling
Authors: Heijl L. , Dahlen G. , Sundin Y. , Wenander A. , Goodson J. M.
Published: December 2005

Abstract The present study describes results on selected clinical and microbiological parameters obtained by periodontal treatment with ethylene vinyl acetate fibers containing 25% by weight tetracycline hydrochloride placed into the periodontal pocket alone or in combination with scaling. Supragingival plaque control was maintained throughout the study by weekly professional cleaning and 0.2% chlorhexidine mouthrinses. Controls included untreated sites and sites treated by conventional scaling alone in a 4‐quadrant split‐mouth design. The experiment was conducted on 95 teeth from 10 subjects with periodontal pockets ≥6 mm which initially bled on probing. All treatments resulted in changes indicative of effective therapy. Pocket depth was reduced, bleeding on probing decreased and gingival index scores decreased. Parallel to the clinical changes, all treatments reduced total bacterial numbers, % black‐pigmented Bacteroides, motile bacteria, non‐motile rods, and produced a proportionate increase in cocci. Fiber therapy with or without scaling reduced bacterial counts by approximately 2 orders of magnitude when evaluated at 62 days post‐therapy. The combination of fiber therapy with scaling was particularly effective, suggesting a possible synergy between these forms of therapy. The combined therapy eliminated bleeding on probing, and black‐pigmented Bacteroides, and produced the greatest mean reduction in pocket depth.
Periodontal conditions in Europe
Authors: Pilot Taco , Miyazaki Hideo
Published: December 2005

Abstract. The aim of the present overview is to evaluate the periodontal conditions in European populations. Study was made of a number of extensive surveys of periodontal diseases carried out in a number of European countries, primarily North West Europe. These surveys often provide considerable detail. However, international comparisons are difficult to perform because of the different methods applied. Therefore, the latest overviews of results of periodontal surveys, based on the CPITN method and stored in the WHO Global Oral Data Bank, are given for the age groups 15–19 years and 35–44 years. Based on this approach, the conclusions are as follows. Trends and prevalences in periodontal health and disease in Europe are clear, at least up to the age of 60 year. Severe periodontal destruction seems to be a limited problem, seldom leading to tooth loss before age 50 and certainly not a major cause of edentulousness before age 60. For a large majority, in most of the populations observed, the progress of periodontal destruction seems to be compatible with the retention of a natural, functioning dentition into older age. However, the periodontal problem might still be of considerable magnitude and importance as bleeding on probing is widely encountered in the younger age groups. Furthermore, 5–15% of populations affected by a serious, irreversible condition at age 40 years is high, compared with most other diseases.
Public health aspects of periodontal diseases in Europe
Authors: Sheiham Aubrey
Published: December 2005

Abstract. There is relatively little severe periodontal disease in populations in Europe. The public health significance is therefore debateable. The fact that the costs of treating the disease are high because of the organization of dental care, qualifies it as a dental public problem. In addition, the symptoms of periodontal diseases such as bleeding, halitosis, gingival recession and tooth loss have an impact on many people, and we have sufficient information to control the common forms of the disease. The goals for dental health can be expressed in terms of health, disease, health education and health promotion and training. A reasonable objective is to achieve a rate of loss of attachment compatible with maintaining at least upper and lower shortened arches for a lifetime. 4 strategies are considered: a high risk, a population, a secondary prevention strategy or a combination of the three. A combination of the 3 is needed to achieve the objective of maintaining a functional, aesthetically and socially acceptable natural dentition for the lifespan of most people. The balance of effort should be heavily weighted towards the population strategy. If the strategy is adopted, the need for treatment will be reduced and treatment will be more successful.