bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbiological and clinical effects of chlorhexidine digluconate and hydrogen peroxide mouthrinses on developing plaque and gingivitis
Authors: Gusberti Francesco A. , Sampathkumar Padmini , Siegrist Beatrice E. , Lang Niklaus P.
Published: December 2005

Abstract While the ability of chlorhexidine (CHX) to prevent plaque formation and inhibit the development of gingivitis has been well documented in the literature, the therapeutic value of hydrogen peroxide (H2O2) in preventing gingivitis is in dispute. The purpose of this study was to compare the clinical and microbiological effects of an established therapeutic agent, such as chlorhexidine with that of H2O2in the experimental gingivitis model. Following a period of stringent oral hygiene, 32 subjects were allocated to 1 of 3 treatment groups which were balanced on the basis of their pre‐experimental gingivitis scores. The subjects then refrained from any oral hygiene for 21 days. During this period, they rinsed twice a day with either a placebo, 0.12% CHX. or a 1% H2O2 mouthrinse. After 21 days, supragingival and marginal plaque was collected from each subject and assayed for total cultivable microbiota, total facultative anaerobes, facultative Streptococci, Actinomyces, Fusobacterium, Veillonella and Capnocytophaga. At the end of the experimental period, the group rinsing with 0.12% CHX showed 95% reduction in gingivitis incidence, 100% reduction in bleeding sites, and 80% reduction in plaque scores compared to the group rinsing with placebo. Conversely, the group using 1% H2O2 showed a marginal reduction In gingivitis incidence of 15% and a 28% reduction in bleeding sites compared to the placebo group, but no significant reduction in plaque scores. The microbiological results showed that 0.12% CHX was an excellent broad‐spectrum antimicrobial agent which significantly reduced the number of both facultative and obligate anaerobes in plaque. This was particularly true for facultative anaerobes, the numbers of which were reduced by 1.5–2.5 logs. Compared with 0.12% CHX, 1% H2O2 had no effect on the total cultivable microbiota or on the facultative bacterial species such as Streptococci and Actinomyces. Treatment with 1% H2O2 was also significantly less effective (0.6 log10. reduction) than 0.12% CHX (1.5 log10 reduction) in reducing the number of obligate anaerobes such as Fusobacterium and Veillonella. The clinical data obtained in this study are thus consistent with previous data documenting the superior anti‐plaque and anti‐gingivitis efficacy of CHX. They also clearly demonstrate that treatment with 1% H2O2 does not provide meaningful anti‐plaque or anti‐gingivitis benefits. The bacteriological data indicate that the superior clinical efficacy of CHX is consistent with its superior antimicrobial activity in vivo, whereas the marginal clinical efficacy of H2O2 may be due to its relatively poor antimicrobial activity in vivo towards a broad range of plaque bacteria.
Inter‐examiner reproducibility of probing pocket depths in molar furcation sites
Authors: Moriarty John D. , Scheitler Lawrence E. , Hutchens L. H. , Delong Elizabeth R.
Published: December 2005

Abstract This investigation was designed to determine the reproducibility of probing pocket depths in maxillary facial and mandibular facial and lingual grade II and III molar furcation sites. 80 untreated molar teeth with 102 furcation invasions due to periodontitis were probed with a pressure‐sensitive periodontal probe by 3 examiners. 8 sites per furcation were measured by each examiner at a single examination. The sequence of examiner probing was rotated in order to evaluate the effect of sequential probing. Tracings were made from radiographs of the inter‐root separations in order to classify the interradicular space and to determine the effect of root separation on reproducibility. Data was analyzed by regression analysis, Pearson correlations, intraclass correlations, and the Student‐Newman‐Keuls test. Analysis indicated a high reproducibility of the maxillary facial and mandibular facial and lingual furcation sites in this untreated adult sample. No effect was due to probing sequence. The mid‐root prominences, the line angles, and the internal surface sites of the furcation roots were recordable and reproducible, while the horizontal measurements were not consistently recordable The reproducibility of the facial and lingual furcation sites that were probed decreased with an increase in probing pocket depth and an increased degree of root separation.
Detectability of artificial marginal bone lesions as a function of lesion depth
Authors: Gröndahl K. , Kullendorff B. , Strid K.‐G. , Gröndahl H.‐G. , Henrikson C. O.
Published: December 2005

Abstract Subtraction of serially obtained standardized radiographs of the marginal periodontal bone offers possibilities for an increased detectability of small bony changes compared to conventional radiography. In this study, the depth of artificially induced bone lesions in the alveolar crest was assessed by means of 125I absorptiometry. The results served as reference values when a series of radiographs containing lesions of various depths was interpreted by 10 examiners. Both conventional radiographs and subtraction images made from the conventional radiographs after digitization were interpreted. The ROC‐curve technique was used to evaluate the two techniques, A close to perfect accuracy was found at a lesion depth corresponding to 0.49 mm of compact bone using the subtraction technique. A similar degree of accuracy was not reached for the conventional technique until the lesions were approximately 3 times deeper.
Assessment of bone loss in periodontitis from panoramic radiographs
Authors: Kaimenyi J. T. , Ashley F. P.
Published: December 2005

Abstract Bone loss in chronic periodontitis was assessed from panoramic radiographs by direct measurement from the cemento‐enamel junction (CEJ) and by measuring the proportion of the tooth length supported by bone. Mesial and distal bone levels of all available teeth were assessed for 50 patients aged 30–39 years referred for periodontal treatment. 85% and 74% of surfaces were measurable by the proportional and direct techniques, respectively. 27% of surfaces had no bone loss according to the proportional score, whereas 22% had a CEJ to alveolar bone distance of less than 2 mm. In addition, over half the surfaces with a proportional bone loss score of zero had a CEJ to alveolar bone distance of 2 mm or more, and for each proportional bone loss score, there was considerable overlap in the CEJ to alveolar bone distances recorded. The validity of the CEJ to alveolar bone measurements was established by comparison with direct measurements at periodontal surgery. The results support the use of direct measurement from the CEJ to alveolar bone rather than the assessment of the proportion of the tooth length within the bone when investigating bone loss from panoramic radiographs. This population of 30–40‐year‐old periodontal patients had a mean of 50% of sites with a CEJ to alveolar bone distance of 3 mm or more, and at such sites, there was a mean additional bone loss of 2.1 mm.
Partial mouth recording of plaque, gingivitis and probing depth in adolescents
Authors: Silness John , Røynstrand Torgeir
Published: December 2005

Abstract Selection of teeth representative of the whole dentition has been used in clinical and epidemiological investigations. The present study was carried out to assess the relationship between 3 different subsets of teeth and the whole dentition for the plaque index, gingival index and probing depth. The selections were: the subset described by Ramfjord (16, 21, 24, 36, 41, 44), the CPITN Alternative I subset (17, 16, 11, 26, 27, 37, 36, 31, 46, 47) and the CPITN Alternative II subset (16, 11, 26, 36, 31, 46). The comparisons were performed on data obtained for 15‐year‐old adolescents. A strong correlation was observed between the whole dentition and each of the subsets for all assessments. The distribution of scores of the Ramfjord selection and the whole dentition was not statistically different. Corresponding comparisons showed that the distribution of scores of the CPITN selections and the whole dentition was statistically different. Plaque and gingival index scores of these selections underestimated 0 scores and overestimated 2 + 3 scores. Probing depths ≤2 mm were underestimated and probing depths ≥4 mm overestimated. The bias associated with the CPITN Alt 1 was more pronounced than that of the CPTTN Alt II subset of teeth in the adolescents examined.
Aspects of the validity of buccal loss of attachment ≥ 1 mm in studies of early periodontitis
Authors: Clerehugh Valerie , Lennon Michael A. , Worthington Helen V.
Published: December 2005

Abstract The aim of this study was to consider the validity of measurements of loss of attachment on buccal surfaces in studies of early periodontitis and in particular to monitor the development of loss of attachment ≥ 1 mm on buccal surfaces over a 2‐year study period in 229 subjects initially aged 14.3 years and to relate this loss of attachment to gingival status and oral cleanliness at baseline. 3 subgroups were considered: the first comprised 83 subjects who developed no loss of attachment over the 2‐year study period; subgroup 2 comprised 56 subjects who developed loss of attachment ≥ I mm on buccal surfaces only; subgroup 3 comprised 75 subjects who developed loss of attachment ≥ 1 mm on at least 1 buccal surface and on at least 1 mesio‐buccal surface over the study period. The mean number of buccal sites with plaque, subgingival calculus, gingival colour change and gingival bleeding at baseline was lower in subgroup 2 than subgroup 3, the differences being significant for the latter three variables. The data failed to reject the null hypothesis of no differences between subgroups 2 and 1.

It was concluded that the buccal loss of attachment ≥ 1 mm found in subgroup 2 at age 16 years was associated with few oral deposits and little gingival inflammation and could probably be related to toothbrushing practices. In contrast, the buccal loss of attachment that developed in subgroup 3 was associated with oral deposits, especially subgingival calculus, and gingival inflammation, and it seemed reasonable to attribute this to early periodontitis. In view of these 2 possible different aetiologies for buccal loss of attachment, it is recommended that in studies of early periodontitis, loss of attachment measurements should be restricted to proximal surfaces.
Periodontal wound healing responses to varying oxygen concentrations and atmospheric pressures
Authors: Shannon M. D. , Hallmon W. W. , Mills M. P. , Lane J. J. , Newell D. H.
Published: December 2005

Abstract Oxygen effects on healing gingival wedge excisions were tested using Sprague‐Dawley rats. 40 operated controls were maintained at normal pressure in room air. 3 experimental groups of 40 rats each were exposed for 90 min daily to one of the following: (I) 20.8% oxygen at 2.4 atmospheres pressure, (2) 100% oxygen at 1 atmosphere, or (3) 100% oxygen at 2.4 atmospheres. 5 animals in each group were sacrificed at the following times: 30, 54, 78 h and weeks 1, 2, 3, 6 and 12. Histometric analysis was performed using light microscopy. The connective tissue healing above a reference notch on the maxillary first molar mesial root was assessed. The controls failed to show healing comparable to experimental animals until the end of 2 weeks. Enhanced connective tissue healing above the notch was most significant (p≤0.05) in the 2.4 atmospheres pressure groups at 3 and 6 weeks when compared to controls. However by 12 weeks, no significant differences could be detected. New cementum formation was rare and occasional root resorption was observed. Early connective tissue adaptation does not imply eventual attachment as epithelial downgrowth progressively displaced the connective tissue adjacent to the root in both experimental and control groups of this study.
Treatment of periodontal furcation defects
Authors: Martin Michael , Gantes Bernard , Garrett Steve , Egelberg Jan
Published: December 2005

Abstract This report provides an abbreviated review of the literature on treatment and prognosis of periodontal furcation lesions. In addition, it describes a surgical technique designed to accomplish bone regeneration in class 11 furcation defects. together with the rationale for the development of this procedure. Results of treatment of 30 defects with this technique are presented in a subsequent report.
Effect of modified Widman flap surgery and systemic tetracycline on the subgingival microbiota of periodontal lesions
Authors: Haffajee Anne D. , Dzink JoAnn L. , Socransky Sigmund S.
Published: December 2005

Abstract 33 subjects with evidence of active destructive periodontal disease were treated by modified Widman flap surgery and systemic tetracycline (1 g/day for 21 days). Subgingival plaque samples were taken from 41 sites in 12 of these subjects before and 6 months after therapy for predominant cultivable microbiota studies. Mean pocket depth and attachment levels in the 41 sampled sites were 7.1 ± 2.9 mm and 7.7 ± 3.2 mm prior to therapy and 4.8 ± 2.3 mm and 6.2 ± 3.4 mm after therapy. B. melaninogenicus and V. parvula were more frequently detected in samples taken after therapy, while S. intermedius, S. morbillorum, S. uberis and W. recta were less frequently detected after therapy. A. actinomycetemcomitans was detected in 7 sites pretherapy and 1 site post therapy. The frequency of detection of B. gingivalis and B. intermedius was virtually unchanged. The mean levels of the Aetinomyces sp., A. actinomycetemcomitans, B. gingivalis, B. intermedius, S. morbillorum. S. uberis and W. recta were decreased after therapy, while the mean levels of B. melaninogenicus, S. mitis, S. sanguis II and V. parvula were increased after therapy. V. parvula showed the greatest increase to 8.2% of the microbiota. In the second phase of the study, subgingival plaque samples from 94 sites in the 33 treated subjects were analyzed by predominant cultivable techniques. As a result of therapy, 24 sites exhibited attachment loss >2 mm, 23 sites exhibited “gain” >2 mm and the remaining 47 sites were considered to be unchanging. The microbiological findings from the treated sites were compared with the predominant cultivable microbiotas of 100 “active” sites (i.e., sites which lost >2.5 mm of attachment prior to therapy). There was an increase in the frequency of detection of S. mitis, S. sanguis I and II and V. parvula in sites which showed no change or “gain” in attachment after therapy. A. actinomycetemcomitans, B. forsythus, B. gingivalis, B. intermedius B. melaninogenicus, P. micros and IV. recta were detected less frequently in these sites. A. actinomycetemcomitans, B. forsythus, B. gingivalis, B. intermedius, B. melaninogenicus, P. micros, S. intermedius and W. recta were recovered in highest mean levels in active sites and or sites which lost attachment after therapy. The opposite pattern was observed for the Actinomyces sp., S. mitis, S. sanguis I and II and V. parvula.
The mechanism of action of chlorhexidine
Authors: Jenkins S. , Addy M. , Wade W.
Published: December 2005

Abstract Controversy exists concerning the mode of action of chlorhexidine in plaque inhibition. This study attempted to determine whether an oral reservoir of chlorhexidine was necessary for plaque inhibition. Plaque growth on enamel under the influence of topically applied or rinsed chlorhexidine was closely monitored by clinical scoring, bacterial culturing and scanning electron microscopy. Thus, 3 subjects wore removable acrylic appliances containing enamel inserts. In the first regimen, inserts on one side of the appliances were exposed to 0.2% chlorhexidine and on the other, water for 1 min twice a day for 14 days. In the second regimen, subjects rinsed with 0.2% chlorhexidine for 1 min twice a day for 14 days with the appliances in situ. Results demonstrated that plaque growth assessed by the 3 study methods was very small on chlorhexidine‐treated inserts by comparison with water‐treated specimens. Importantly, inserts treated with chlorhexidine topically or by rinsing could not be distinguished by any method of evaluation. It is concluded that chlorhexidine achieves plaque inhibition as a result of an immediate bactericidal action during the time of application and a prolonged bacteriostatic action as a result of adsorption to the pellicle coated enamel surface. Consistent with other clinical studies, it is apparent that a progressively desorbing oral reservoir of antiseptic is not the mechanism by which chlorhexidine achieves plaque inhibition on teeth.
Role of “diseased” root cementum in healing following treatment of periodontal disease
Authors: Nyman S. , Westfelt E. , Sarhed G. , Karring T.
Published: December 2005

Abstract This clinical trial was undertaken to examine whether root debridement in the treatment of periodontal disease must include the removal of the exposed cementum in order to achieve periodontal health. The study included 11 adult patients with moderate to advanced periodontal disease. In a split‐mouth design, the dentition of each patient was by random selection divided into test‐ and control quadrants comprising the incisors, canines and premolars. Following a baseline examination, all patients were given a case presentation and a detailed instruction in self‐performed oral hygiene measures. The patients were then subjected to periodontal surgery. Following reverse bevel incisions, buccal and lingual mucoperiosteal flaps were elevated and all granulation tissue was removed. In 2 jaw quadrants (control quadrants) in each patient, the denuded root surfaces were carefully scaled and planed in order to remove soft and hard deposits as well as all cementum, using hand instruments and flame‐formed diamond stones. In the contralateral quadrants (test quadrants) the roots were not scaled and planed but soft microbial deposits were removed by polishing the root surfaces with the use of rubber cups, interdental rubber tips and a polishing paste. Calculus in the test quadrants was removed by the use of a curette, but precaution was taken to avoid the removal of cementum. The flaps were repositioned to their original level and sutured. The patients were following active treatment enrolled in a supervised maintenance care program including “professional tooth cleaning” once every 2 weeks for a 3‐month period. From this time point until the final control, 24 months after treatment, the interval between the recall appointments was prolonged to 3 months. The results showed that the same degree of improvement of periodontal health was achieved following both types of treatment. A low‐frequency of gingival sites which bled on probing or had a gingival index score of 2 and 3 was obtained in all jaw quadrants as well as a high frequency of sites with shallow pockets. Between the baseline examination and the follow‐up examinations (after 6, 12 and 24 months), there was some gain of probing attachment for both treatment modalities. This gain was most pronounced in the initially deeper pockets and was similar for both treatment modalities.
Forced eruption combined with gingival fiberotomy
Authors: Kozlovsky Avital , Tal Haim , Lieberman Myron
Published: December 2005

Abstract. A new approach to clinical crown lengthening has been developed and described. The technique combines controlled eruptive tooth movement and incision of the supracrestal gingival attachment. The procedure was performed in patients with severe destruction of a tooth crown and in whom clinical crown lengthening procedures were essential before the teeth could be properly restored. Controlled eruptive forces were activated by simple orthodontic appliances. During the active phase of forced eruption, repeated intrasulcular incisions through the junctional epithelium and the supracrestal connective tissue attachment were performed. The technique prevented coronal displacement of the gingiva and the attachment apparatus during the orthodontic extrusion, thus overcoming the need for corrective osseous surgery.
Dental plaque removal by cavitational activity during ultrasonic scaling
Authors: Walmsley A. D. , Laird W. R. E. , Williams A. R.
Published: December 2005

Abstract. Photomicrographs of the surfaces of recently extracted teeth stained with erythrosin dye were obtained. The stained surfaces were treated with an ultrasonic sealer using two different types of scaling tips driven by the same instrument operated at a medium power setting. Small areas of stained plaque removal occurred when the stationary scaling tip was operated without water cooling. Additional areas of removal were observed where a water coolant was present, which were larger than those produced by the non‐water cooled tip. These additional areas were influenced by the type of scaling tip used, it's orientation to the tooth surface and it's displacement amplitude. Cavitational activity in the cooling water supply of the ultrasonic sealer is able lo remove dental plaque from tooth surfaces and may be a useful adjunct to the mechanical action of the instrument.
The effects of periodontal therapy on serum antibody (IgG) levels to plaque microorganisms*
Authors: Aukhil Ikramuddin , Lopatinct Dennis E. , Syed Salam A. , Morrison Edith C. , Kowatsk Charles J.
Published: December 2005

Abstract. The influence of periodontal therapy on serum antibody titers to selected periodontal disease‐associated microorganisms was assessed in 23 patients having chronic inflammatory periodontal disease (CIPD), The immunoglobulin G (IgG) titers were détérmined by the micro ELISA technique in serum samples obtained prior to treatment; following a hygienic phase which included scaling, root planing, and oral hygiene instruction; following surgical treatment; and one year and two years following hygienic phase (maintenance phase). Considerable individual variability existed in the magnitude of immune response to specific bacterial preparations. Significant reductions in the mean antibody titers were seen to A. viscosus. S. sanguis. F. nucleatum, S, spuligena, B. gingivalis. B. interme‐dius. B. melaninogeniem, T. vincentii, and T denticola by the end of the second year of maintenance. There was no consistent response to Capnucytophaga. When individual patient responses were examined. 6 of the 23 were found to have elevated titers to at least one of the microorganisms in the interval between pretreatment and the end of the hygienic phase; however, in all but one case, the titers at the end of the second year of maintenance were below pretreatment levels. Antibody levels to bacteria such as S. sanguis were modified during therapy. This would indicate that immune responses to microbes not generally considered to be “periodontal pathogens” may be modified by adjuvant activity associated with subgingival plaque or changes in the environment of the sulcus and that subsequent changes in titer do not necessarily reflect a role of that microorganism in the disease process.
Digital imaging in periodontal radiography
Authors: Brägger Urs
Published: December 2005

Abstract. The development and the potential impact of digital imaging techniques for the analysis of dental radiographs are reviewed with emphasis on periodontal diagnosis. The introduction of video‐based computer‐assisted image analysis systems for the evaluation of standardized dental radiographs offered increased diagnostic accuracy in the détéction of subtle density changes over Interpretation of conventional radiographs. Digital subtraction images were interprétéd qualitatively on a video monitor or Quantitatively by applying programs which measure the density differences stored in digital format. Recently, these methods, which have been extensively tested in vitro, were applied to clinical trials for the assessment of alveolar bone density changes due to progression of disease or healing following therapy. The application of digital image analysis methods offers objective, quantitative and non‐invasive ways to obtain additional diagnostic information from standardized radiographs in clinical trials.
Effect of probing depth and bleeding tendency on the reproducibility of probing depth measurements
Authors: Janssen P. T. M. , Faber J. A. J. , van Parenstein Helderman W. H.
Published: December 2005

Abstract. The aim of this study was to determine the influence of the probing depth and the bleeding tendency on the reproducibility of probing depth measurements. Duplicate probing depth and bleeding tendency measurements were performed at 717 interproximal sites in 13 subjects. Analysis indicated that the factor probing depth had a larger effect on the accuracy of probing depth measurements than the factor bleeding tendency.
Probing depth, attachment loss and gingival recession
Authors: Yoneyama T. , Okamoto H. , Lindhe J. , Socransky S. S. , Haffajee A. D.
Published: December 2005

Abstract. The present investigation describes probing pocket depth, probing attachment level and recession data from 319 randomly selected subjects, aged 20‐79 years, form Ushiku, Japan. The findings are reported as mean values, frequency distributions and percentile plots of the 3 parameters at buccal, interproximal and lingual surfaces of single rooted (incisors, cunines, premolars) and molar teeth. Inter‐as well as intra‐examiner errors for probing pocket depth and probing attachment levels were assessed and found to be small. The data reported revealed that practically all subjects studied had one or more sites in the dentition affected by destructive periodontal disease and that the severity of disease increased with age. It was further observed that in each age group, molars had suffered more attachment loss than single rooted teeth and that the interproximal surfaces as a rule had lost more periodontal tissue support than corresponding buccal and lingual surfaces. The attachment Joss difference observed between different surfaces of a given tooth or a group of teeth, however, was comparatively small. In the age groups between 20‐59 years, advanced destructive periodontal disease was found in a small subgroup of the subject sample, while after the age of 60 years, widespread destructive periodontitis was common. An attempt was made to examine the progression of destructive disease with age by comparing the frequency distributions of sites with attachment loss of 3 mm in subjects of different age groups. The data suggested that in younger subject groups, progression was confined to a subset of individuals, while in older age groups, more subjects and sites became involved, A major feature of destructive periodontal disease in older individuals was the accompaniment of attachment loss with recession at the gingival margin. Deep pockets were relatively infrequently detected, while advanced loss of attachment (with recession) occurred at many sites.
Density and localization of lymphocytes with natural‐killer (NK) cell activity in periodontal biopsy specimens from patients with severe periodontitis
Authors: Kopp Wolfgang
Published: December 2005

Abstract. Natural killer lymphocytes (NKL) in gingival biopsy specimens of 13 patients with advanced periodontitis and 6 normal control subjects have been evaluated by the monoclonal antibody NC 1. anti‐B4 and a double immunoen‐zymatic labeling technique, combining the peroxidase‐anti‐peroxidase (PAP) method with the alkaline‐phosphatase‐anti‐alkaline‐phosphatase (APAAP) technique. Mononuclear cells with NK‐activity (NKA) were mainly accumulated in the upper to middle third of the periodontal pocket. The concentration of NCI‐positive cells (CNC) of the baseline biopsy specimens was significantly increased at p = 0.05 compared to the CNC after hygiene training. The statistical difference rose to p = 0.Ol following scaling, root planing and curettage therapy. The healthy gingiva of control subjects showed an average of 1–2 NKL, and no statistical difference could be found when compared to the CNC of the biopsy specimens of patients after periodontal therapy. These data support the hypothesis that antibody‐dependent cytotoxic immunoreactive lymphocytes in chronic inflammatory periodontal disease can be reduced by scaling and root planing therapy.
The total protein concentration of gingival crevicular fluid
Authors: Curtis M. A. , Griffiths G. S. , Price S. J. , Coulthurst S. K. , Johnson N. W.
Published: December 2005

Abstract. The total protein concentration of gingival crevicular fluid (GCF), sampled repeatedly over a 10‐min period with the minimum of physical irritation to the sulcus. was evaluated in a group of 32 healthy adolescent. The mean concentration of the 1 st sample was comparable to that of normal tissue fluids and lymph, irrespective of the state of inflammation of the sample site. However, during repeated sampling, the values rose to resemble serum protein levels, except at those sites with no clinically detectable inflammation. Gel eletrophoretic analysis confirmed the increasing proportion of serum‐derived molecules in the more proteinaceous GCF samples. The results demonstrate the extreme sensitivity of the gingival vasculature to GCF sampling and consequently the need for accurate standardisation of GCF collection protocols. This will apply particularly when compositional data is to be normalised with respect to the total protein content or when the levels of a serum constituent are being examined.
Surgical treatment of severe periodontitis in a haemophilic patient with inhibitors to factor VIII
Authors: Sindet‐Pedersen Steen , Stenbjerg Stener , Ingerslev Jørgen , Karring Thorkild
Published: December 2005

Abstract. This report describes the surgical treatment of advanced periodontitis in a haemophilic patient with inhibitors to Factor VIII. The treatment was performed after substitution therapy with Factor VIII‐concentrate, supported by local and systemic antifibrinolytic treatment with tranexamic acid. No complications developed postoperatively, and after 9 months, the patient did not show recurrence of periodontal disease. Although the present case shows, that even severe periodontitis can be treated surgically in haemophilic patients with inhibitors to Factor VIII, this should not be done unless it is absolutely necessary.

The treatment of periodontal disease in such patients should be instituted as early as possible in order to prevent the need for extensive surgery or dental extractions.
Effects of 6 months use of an antiseptic mouthrinse on supragingival dental plaque microflora
Authors: Minah G. E. , DePaola L. G. , Overholser C. D. , Meiller T. R , Niehaus C. , Lamm R. A. , Ross N. M. , Dills S. S.
Published: December 2005

Abstract This study was undertaken to determine whether long‐term use (6‐months) of an antiseptic mouthrinse (Listerine Antiseptic, Warner Lambert Co., Morris Plains, NJ, USA) led to an undesirable succession of oral pathogens or the emergence of resistant microbial forms. Supragingival plaque was collected from 83 subjects before treatment and after either 3 or 6 months use of either the active antiseptic or a 5% hydroalcohol control. Subjects rinsed with their assigned mouthrinse twice daily under supervision. The plaque samples were analyzed for microbial content by darkfield microscopy, culture on a series of nonselective and selective bacterial media, and by recognition of microbial forms by recognition of distinct colony on a nonselective medium. Statistical analysis of the results revealed no significant microbial shifts including no significant increases in presumptive oral pathogens, spirochetes, black‐pigmented Bacteroides, Streptococcus mutans, or Candida albicans. Additionally, no detectable rise in either staphylococci or enteric bacteria, potential opportunistic pathogens, was observed.
Actinobacillus actinomycetemcomitans contamination of toothbrushes from patients harbouring the organism
Authors: Müller H.‐P. , Lange D. E. , Müller R. F.
Published: December 2005

Abstract The main ecological niche of Actinobacillus actinomycetemcomitans (A.a.) seems to be the periodontal pocket, but it can also be isolated from supragingival plaque, buccal and tongue mucosa, or saliva. We examined toothbrushes from 21 patients, all identified as harbouring moderate to large numbers of A.a. in subgingival plaque, for contamination with this organism. 29% of the toothbrushes presented by our patients yielded detectable numbers of A.a. Immediately after toothbrushing this figure rose to 62%, but dropped to 50% after 1 h. Numbers of isolated A.a. on toothbrushes were weakly correlated with the degree of periodontal destruction, and significantly more numbers of A.a. on toothbrushes could be detected if the organism was found on mucous membranes or in saliva. There was no association with gingival inflammation, supragingival plaque nor mean numbers of isolated subgingival A.a.
Effect of adhesive antibiotic TA on plaque and gingivitis in man
Authors: Manor A. , Eli I. , Varon M. , Judes H. , Rosenberg E.
Published: December 2005

Abstract The adhesive antibiotic TA was applied to the dento‐gingival junction of 8 human volunteers, suffering from moderate to severe gingivitis. 2 diametrically opposed quadrants of the mouth received 4 applications of 0.1 mg TA, while the other 2 quadrants were treated with a placebo and served as controls. The plaque index, gingival index and bleeding index were scored periodically for 2 weeks and in 4 patients for up to 30 days. The TA‐treated quadrants showed a rapid decrease in all 3 indices following 2 treatments. A further improvement was observed with the 3rd and 4th treatments. 30 days after the onset of the experiment and 23 days after the last application, the indices were still considerably lower than the initial values.
Prevalence of incipient radiographic periodontal lesions in relation to ethnic background and dental care provisions in young adults
Authors: Albandar Jasim M.
Published: December 2005

Abstract The prevalence of early periodontal destruction was assessed in a group of 516 14‐year‐old Iraqi schoolchildren who had not been offered public dental care programmes. Vertical bone loss adjacent to the proximal surfaces of first molars was used to indicate an incpient periodontal lesion, and the prevalence of subjects diagnosed as having one or more sites with this criterion in the Iraqi group was compared with those of 2 Scandinavian populations of the same age. These comprised 241 Norwegians who had received regular dental care and 561 Danes with or without such programmes. In the Iraqi group. 11.5% showed 1 or more sites with radiographic bone loss. However, few sites exhibited deep defects. There were significantly fewer Norwegian teenagers showing early periodontal lesions as compared to the Iraqi group (p<0.01) and the Danish subjects with no school dental programmes (p<0.01). Danish teenagers receiving regular dental care did not differ from the Norwegian group. It was concluded that the criterion used in the present study seems suitable for detecting differences in the prevalence of incipient radiographic periodontal lesions among young populations, and that the utilization of public dental care services may be an important factor in explaining such differences.
Familial gingival fibromatosis; no correlation with HLA‐antigen A family study
Authors: Katz J. , Ben‐Yehuda A. , Machtel E. , Goultschin J. , Danon Y. L.
Published: December 2005

Abstract Familial gingival fibromatosis is generally reported to be inherited as an autosomal dominant trait. We investigated 2 families with few siblings affected with gingival fibromatosis. No linkage between HLA antigen and the phenomenon was found. These results support the idea of the autosomal dominant nature of familial gingival fibromatosis.
Periodontal loser sites in untreated adult subjects
Authors: Lindhe J. , Okamoto H. , Yoneyama T. , Haffajee A. , Socransky S. S.
Published: December 2005

Abstract Subjects in age groups between 20 and 79 years were recruited for a study on the effect of different modalities of periodontal therapy. A baseline examination included assessments of plaque, gingivitis, probing pocket depth and probing attachment level. The subjects received no periodontal therapy for 2 years but were recalled for re‐examination after 1 and 2 years. The results from the baseline examination and the overall changes which occurred in the sample during the 2 years have been reported previously. The present study describes some characteristics of subjects and sites that lost probing attachment of 3 mm or more during the course of the 24 months of monitoring. 161 of the 265 subjects who returned for both re‐examinations had no change of the attachment level at any site that amounted to 3 mm or more. Of the 104 subjects that showed deterioration, at or above this level, the majority exhibited disease activity either during the 1st or the 2nd year of monitoring. Only 20 subjects showed disease activity during both year 1 and year 2. In addition, 70% of the sites that deteriorated (loser sites) occurred in 12% of the subjects. Loser sites were most frequently detected in older subjects and at molar sites. Most of the loser sites occurred at interproximal surfaces and were most numerous at surfaces with initially advanced loss of attachment.
Placement of a porous membrane underneath the mucoperiosteal flap and its effect on periodontal wound healing in dogs
Authors: Claffey Noel , Motsinger Suzanne , Ambruster Jeanne , Egelberg Jan
Published: December 2005

Abstract This study was designed to investigate the healing of surgically induced, horizontal periodontal defects in dogs following placement of a biocompatible. porous polytetrafluorethylene membrane around the roots of the treated teeth and to compare the healing to that of control teeth without membrane. Mandibular premolar teeth of 5 beagle dogs were used for experimentation. Specimen blocks were removed 3 months postoperatively for histological evaluation of contralateral experimental and control teeth. Mean apical migration of junctional epithelium among the experimental surfaces amounted to 0.1 mm as compared to 1.3 mm for the control surfaces. Accordingly, the amount of connective tissue attachment, defined by the distance from the base of the junctional epithelium to the apical termination of root planing, was greater for experimental than for control surfaces. As this increased amount of connective tissue attachment was associated with more coronal bone apposition, a periodontal ligament space was more prevalent in experimental than in control surfaces. A limited amount of ankylosis was observed for both experimental and control surfaces. Root resorption was more prevalent in control than in experimental surfaces. Conceivable reasons for the differences in healing between experimental and control teeth are discussed.
Influence of granulation tissue, dental calculus and contaminated root cementum on periodontal wound healing
Authors: Blomlöf L. , Friskopp J. , Appetgren R. , Undskog S. , Hammarström L.
Published: December 2005

Abstract The rôle of gingival granulation tissue, dental calculus and contaminated root cementum in marginal periodontal formation of new attachment was studied experimentally after chemical conditioning of the root surfaces of premolars and molars in 8 monkeys. Each treatment procedure was carried out in 4 monkeys. The other 4 monkeys served as controls. A morphometrical method was used to evaluate the results. It was concluded that a significant amount of new attachment including formation of new adhering cementum will result only on chemically‐conditioned cementum surfaces. Small amounts of calculus or granulation tissue left in situ do not seem to influence healing, provided the cementum is left intact after chemical cleansing.
Assessment of complement cleavage in gingival fluid during experimental gingivitis in man
Authors: Patters M. R. , Niekrash C. E. , Lang N. P.
Published: December 2005

Abstract The cleavage of complement may be an important immunopathologic mechanism in the development of gingival inflammation. Utilizing the experimental gingivitis model, cleavage of C3, C4 and B was assessed in gingival fluid following abstention from oral hygiene. 4 male dental students performed stringent oral hygiene measures until the gingival index approached 0, then refrained from any oral hygiene for 21 days. Gingival fluid, sampled with filter paper strips from the mesial surface of all maxillary premolars at 0, 7, 14, and 21 days, was assayed for C3, C4 and B cleavage by multilayer crossed‐immunoelectrophoresis. Clinical indices were assessed following gingivat fluid sampling. The subjects, who were plaque‐free (PI=0) at the beginning of the study, showed significant plaque accumulation at day 21 (87% of sites with PI ≥ 2). Approximately 90% of the sites were free from clinical inflammation (GI = 0) at the start, but gingivitis increased with time such that 25% of the sites had GI scores of 2 at day 21. Bleeding on probing to the base of the pocket was not observed at day 0, but was observed at 62% of sites by day 21. Statistical analyses showed that all 3 indices significantly increased with time. The %C3 cleavage increased from a mean of 24% at day 0, to 35%, 45% and then 57% at days 7, 14 and 21, respectively, and both days 14 and 21 demonstrated significantly greater C3 conversion than that seen at day 0. The Spearman rank‐order correlation coefficient for %C3 conversion versus time was p‐0.52, significant at the p < 0.0001 level. B cleavage to Bb was commonly seen, but C4 cleavage to C4c was never observed. Thus, during experimental gingivitis, %C3 cleavage significantly increased with plaque accumulation and resultant gingivitis, correlating with gingivitis at p= 0.64. These results suggest that cleavage of complement may be an important factor in the initiation of gingival inflammation.
Treatment of recurrent periodontal disease by root planing and Ornidazole (Tiberal®)
Authors: Mombelli A. , Gusberti F. A. , Lang N. P.
Published: December 2005

Abstract The purpose of this study was to evaluate the use of Ornidazole as an adjunct to root planing in the therapy of patients suffering from recurrent periodontal disease. In 10 individuals who had previously been treated with scaling, root planing and periodontal surgery and who had followed a regular maintenance program including recall visits every 3‐5 months for 1–7 years, 2 sites with recurrent periodontitis and 1 shallow site were selected. Reinfected sites had a record of losing clinical attachment of more than 3 mm since the completion of initial therapy, were bleeding upon probing and had a mean pocket probing depth of 7.85 ± 1.31 mm. They had been reinstrumented several times by a registered dental hygienist, when clinical signs of recurrence of disease had appeared and the root surfaces were judged to be smooth and free of deposits. Clinical parameters were recorded and microbial samples were collected twice prior to retreatment. Then, 500 mg Ornidazole, to be taken twice a day for 10 days, was administered, and the whole dentition was thoroughly scaled and root planed. At day 10 as well as 2, 5, 8 and 11 months thereafter, samples were again obtained. At baseline, reinfected sites showed over 20% spirochetes, over 20% motile rods and over 9% fusiform organisms in darkfield preparations of subgingival plaque samples. Culturally, over 1/10 of organisms were identified as black pigmenting Bacteroides and in 18% of all baseline samples collected, B. gingivalis was found. Immediately following therapy, total counts of bacteria were reduced to approximately 5% of the baseline counts and more than half of the bacteria were characterized as coccoid cells; Gram‐negative anaerobic rods were reduced to less than 3%. Among them, black ‐pigmenting Bacteroides, were reduced below 1%. B. gingivalis could no longer be detected. In the first weeks following therapy, most microbiological parameters showed a tendency to increase, but after some time, the microbiological situation appeared to reach a steady state and a statistically significant long‐term reduction of Gram‐negative rods, including Bacteroides ssp. persisted. These findings were paralleled by a significant decrease of pocket probing depth, no further loss of attachment and a decrease in bleeding tendency. These findings indicate that Ornidazole has an additional, beneficial clinical and microbiological effect when used as adjunct to mechanical re‐treatment of recurrent periodontitis.
Computer‐assisted densitometric image analysis (CADIA) for the assessment of alveolar bone density changes in furcations
Authors: Brägger Urs , Pasquali Lee , Weber Hanspeter , Kornman Kenneth S.
Published: December 2005

Abstract The purpose of this study was to test the applicability of computer‐assisted densitometric image analysis (CADIA) for the quantitative assessment of alveolar bone density changes in furcations of multirooted teeth. In 21 patients, standardized radiographs were obtained immediately after and at 1, 6 and 12 months after periodontal flap procedures. Digitized images were obtained by means of a video‐camera combined with an image processor that was linked to a computer. Quantitative information regarding density changes within windows covering furcation areas was obtained after superimposition and grey‐level correction of images to be compared. 1 month after flap reflection, significantly more density loss was obtained in test furcations exposed to periodontal surgery, compared to the density changes in control furcation exposed to scaling and root planing. At 12 months, however, significantly greater increase in density was measured in test furcations compared to the 1‐month results. The radiographic data were compared to the clinical parameters. In test furcations, there was a negative correlation of r=–0.52 between the GI and the loss in density at 1 month, and a negative correlation of r=–0.61 between the loss in density at 6 months and the probing attachment level at 12 months. These results indicate that CADIA may give valuable additional diagnostic information regarding alveolar bone density changes in furcations in studies on periodontal therapy.
The effect of in‐vivo‐occurring errors in the reproducibility of radiographs on the use of the subtraction technique
Authors: Janssen P. T. M. , van Palenstein Helderman W. H. , van Aken J
Published: December 2005

Abstract A device for serial radiography in maxillary and mandibular premolar and molar regions was developed. Radiographs of 9 patients were made during a period of 1 year. When testing the device, the influence of the time interval between the radiographs and the influence of the construction of the device on the reproducibility of the X‐ray images were determined. An increase of the time interval between radiographs reduced the reproducibility. The use of bilateral bite blocks improved the reproducibility of the X‐ray images in comparison with the images obtained with a device with a one‐sided bite block. Errors in the reproducibility caused differences in the image geometry of radiographs. The in‐vivo‐found differences were studied for their effect on the detection threshold of observers using photographic subtraction radiography. An increase of the differences in image geometry between the radiographs resulted in a higher detection threshold and a higher % of false positive decisions. It appeared that very small differences between clinical radiographs, corresponding with an angulation error of 0.7°, can be tolerated in order to prevent the occurrence of high numbers of type‐I errors. The % of radiographs, which met this requirement and could be used for photographic subtraction radiography, was 55%, when taken at time intervals of 1 year.