bluuebunny/crossref_metadata_2025 huggingface dataset:
Repair of periodontal furcation defects in beagle dogs following reconstructive surgery including root surface demineralization with tetracycline hydrochloride and topical fibronectin application
Authors: Wikesjö Ulf M. E. , Claffey Noel , Christersson Lars A. , Franzetti Louis C. , Genco Robert J. , Terranova Victor P. , Egelberg Jan
Published: December 2005

Abstract This study examines the effects of root surface demineralization and topical fibronectin as adjuncts to reconstructive periodontal surgery. In 14 beagle dogs, horizontal periodontal defects were surgically induced around the mandibular premolars followed by a 6‐week period without plaque control. Reconstructive surgery of the defects was subsequently carried out. The root surfaces were debrided and superficially demineralized with citric acid or tetracycline hydrochloride, with or without subsequent application of fibronectin, Muco‐periosteal flaps were raised to cover most of the crowns and sutured. The animals were sacrificed 12 weeks after surgery and block sections of the teeth and surrounding tissues were processed for histology. Analysis included incidence of furcation defects presenting with an epithelial lining, quantification of connective tissue repair relative to the furcation circumference, and regeneration of alveolar bone relative to the furcation defect height. The incidence of root resorption and ankylosis was also analyzed. Within the limitations of this study it was concluded that: (1) citric acid conditioning of the root surface frequently resulted in complete connective tissue repair of the furcation defect; (2) root resorption and ankylosis were prevalent features of the healing response: (3) citric acid and tetracycline treatment had similar potential to induce connective tissue repair and resulted in corresponding incidences of root resorption and ankylosis: (4) application of fibronectin to demineralized root surfaces did not enhance the amount of connective tissue repair and did not alter the pattern of root resorption and ankylosis.
The role of black‐pigmented Bacteroides in human oral infections
Authors: van Winkelhoff A. J. , van Steenbergen T. J. M. , de Graaff J.
Published: December 2005

Abstract Today, 10 black‐pigmented Bacteroides (BPB) species are recognized. The majority of these species can be isolated from the oral cavity. BPB species are involved in anaerobic infections of oral and non‐oral sites. In the oral cavity. BPB species are associated with gingivitis, periodontitis, endodontal infections and odontogenic abscesses. Cultural studies suggest a specific role of the various BPB species in the different types of infection. Bacteroides gingivalis is closely correlated with destructive periodontitis in adults as well as in juveniles. Bacteroides intermedius seems to be less specific since it is found in gingivitis, periodontitis, endodontal infections and odontogenic abscesses. The recently described Bacteroides endodontalis is closely associated with endodontal infections and odontogenic abscesses of endodontal origin. There are indications that these periodontopathic BPB species are only present in the oral cavity of subjects suffering from periodontal breakdown, being absent on the mucosal surfaces of subjects without periodontal breakdown. BPB species associated with healthy oral conditions are Bacteroides melaninogenicus, Bacteroides denticola and Bacteroides loescheii. There are indications that these BPB species are part of the normal indigenous oral microflora. Many studies in the past have documented the pathogenic potential and virulence of BPB species. This virulence can be explained by the large numbers of virulence factors demonstrated in this group of microorganisms. Among others, the proteolytic activity seems to be one of the most important features. Several artificial substrates as well as numerous biological proteins are degraded. These include anti‐inflammatory proteins such as alpha‐2‐macroglobulin, alpha‐1‐antitrypsin, C3 and C5 complement factors and immunoglobulins. B. gingivalis is by far the most proteolytic species, followed by B. endodontalis. Like other bacteria, the lipopolysaccharide of B. gingivalis has shown to be active in bone resorption in vitro and is capable in stimulating interleukin‐1 production in human peripheral monocytes. Based on the well documented association with periodontal disease and the possession of relevant virulence factors. BPB species must be considered as important micro‐organisms in the etiology of oral infections. B. gingivalis seems to be the most pathogenic and virulent species.
The relative effects of therapy and periodontal disease on loss of probing attachment after root debridement
Authors: Claffey Noel , Loos Bruno , Gantes Bernard , Martin Michael , Heins Paul , Egelberg Jan
Published: December 2005

Abstract This study investigated the immediate effects, and the effects during 12 months, of a single episode of root debridement in 1248 sites in 9 periodontitis patients. Single recordings for probing depths and probing attachment levels were made at baseline, and at 3, 6, 9 and 12 months. In addition, triplicate recordings of attachment levels were made for all sites by 3 independent examiners immediately prior to debridement. immediately post debridement, and at 3 and 12 months. It was found that a mean loss of probing attachment of 0.5 to 0.6 mm occurred as a result of instrumentation, irrespective of initial probing depth. Individual sites were identified as having lost probing attachment using a site‐specific standard deviation for measurement variability and a ≥1.0 mm change. 5% of all sites lost probing attachment from pre‐instrumentation to 12 months. Approximately half of these had probing attachment loss inflicted during instrumentation. 23 sites (2% of all sites) were identified as having lost probing attachment from the post‐instrumentation time point to 12 months. The majority of these sites seemed to undergo this probing attachment loss as a result of a remodelling process during the healing phase. Over the observation period used in this study, the majority of the attachment loss identified seems to be either directly attributable to instrumentation or to a remodelling process as a result of the therapy rather than to progressive periodontitis.
Correlation between electronic and visual readings of pocket depths with a newly developed constant force probe
Authors: Magnusson I. , Fuller W. W. , Heins P. J. , Rau C. F. , Gibbs C. H. , Marks R. G. , Clark W. B.
Published: December 2005

Abstract The purpose of this study was to compare probing measurements obtained using a newly developed constant force electronic probe, which eliminates errors of visual reading and variable force, to those obtained using a standard periodontal probe. The probe was connected to a digital readout through a linear variable differential transformer; the digital readout was connected to a printer and a foot switch. When the probe was in position and the foot switch depressed, the pocket depth was printed to the nearest 0.1 mm. 12 subjects with minimal to early periodontitis were selected for the study. The pocket depths of each patient were recorded electronically utilizing a constant force of 25 g, and conventionally using the same instrument in a “locked” position and visual reading. Probings were performed on each subject by 3 different examiners, on 3 separate occasions 2–3 days apart. The results showed a high correlation between manual and electronic probing. The average correlations for the 3 investigators between examinations were consistently higher for the electronic probings. In comparing the 3 examiners to each other, consistently higher correlations were found for the electronic pocket readings. Correlations for single‐rooted teeth were lower for all 3 examiners. The pocket depth measurements recorded when using the manual probe with visual readings were consistently deeper than those obtained using the electronic probe with computer readings. It was concluded that the reproducibility of measurements obtained with the electronic probe was significantly superior to that obtained with a manual probe.
The antibacterial effect of toothpastes on the salivary flora
Authors: Moran J. , Addy M. , Newcombe R.
Published: December 2005

Abstract Both past and presently available toothpastes contain potential antimicrobial agents which could have a beneficial effect in the prevention of plaque and gingivitis. If these preparations were to be effective clinically, some effect on salivary bacteria would also be expected. This cross‐over study measured salivary bacterial counts and the presence or absence of residual antibacterial activity in saliva following tooth brushing with 7 commercially available toothpastes, and moreover, compared their effect with that produced by a chlorhexidine gel. Generally, all toothpaste products produced a reduction in aerobic, anaerobic and streptococcal counts with a hexetidine containing toothpaste producing the largest and longest lasting reduction. In contrast, an enzyme containing toothpaste and an amine fluoride toothpaste, had little effect on bacterial counts. The chlorhexidine gel produced the largest reduction in salivary counts, which was evident for at least 5 h following brushing. Residual antibacterial activity in saliva was only evident immediately following brushing with the hexetidine toothpaste, but for the chlorhexidine gel, was present up to 90 min following brushing. The findings of this study have illustrated the limited antibacterial activity of presently available toothpastes on the salivary flora compared to chlorhexidine, and as such, would tend to question the relative benefit of toothpaste in preventing periodontal disease through an antimicrobial effect.
The angular bony defect in the maintenance of the periodontal patient
Authors: Pontoriero R. , Nyman S. , Lindhe J.
Published: December 2005

Abstract The present retrospective study was performed to evaluate some long‐term alterations of the alveolar bone level at periodontal sites with angular and even (“horizontal”) patterns of bone loss. The investigation included 48 patients who, following treatment for advanced periodontal disease, were placed in a maintenance care program which included recall appointments every 3‐6 months for a period of 5 to 16 years. The material of the study comprised all teeth at which angular osseous defects (test sites) could be detected in a full‐mouth series of radiographs obtained at the end of the active treatment phase. Alterations in the position of the marginal alveolar bone crest and the base of the osseous defect which took place during the maintainance period were assessed by comparing the post‐treatment radiographs with a 2nd set of radiographs obtained at the final examination. In the same patients, an equal number of contralateral or neighboring teeth at which bone loss in the radiographs had an even or “horizontal” character were included as controls. The results from the assessments demonstrated that periodontal sites which, following active therapy displayed either angular or “horizontal” patterns of alveolar bone loss underwent, during a 5‐16 year period of maintenance, only minor bone level alterations. Additional loss of supporting bone occurred equally frequently at sites with “horizontal” and angular patterns of bone loss. Thus, the findings reported failed to show up sites with angular bony defects as being particularly susceptible to recurrent destructive periodontitis.
Effects of oral hygiene measures on clinical and microbiological parameters of periodontal disease
Authors: Loos Bruno , Claffey Noel , Crigger Max
Published: December 2005

Abstract The effects of a 12‐week period of oral hygiene alone on gingival conditions and subgingival microflora in 15 patients with severe periodontitis were investigated. Clinical measurements and plaque samples from selected sites were taken at week 0 (baseline), week 6, and week 12. Plaque samples were also taken at week 13, that is, 1 week following debridement. At week 0, the patients were instructed in supragingival plaque control and at week 6, the hygiene regimen was supplemented with the subgingival use of a toothpick device. At week 12, the patients received a full mouth supra‐ and subgingival debridement under local anesthesia. In those patients who complied with oral hygiene instructions (subgroup A), the gingival condition improved moderately while no improvement was found in less compliant patients (subgroup B). No significant changes were noted in the subgingival microflora in either subgroups A or B throughout the 12‐week period of oral hygiene alone. However, significant reductions for all microbial parameters were found 1 week after debridement. Therefore, while moderate clinical improvements followed oral hygiene alone, no measurable changes in the subgingival microflora were observed concomitantly.
The relationship of the periodontal status to fluoride levels of alveolar bone and tooth roots
Authors: Reddy J. , Grobler S. R.
Published: December 2005

Abstract The periodontal status and fluoride levels of alveolar bone and tooth roots were compared for subjects from a high (2.5 ppm F) and a low (<0.05 ppm F) fluoride area. The plaque index, gingival index, probing depth and loss of attachment were measured to determine the periodontal status. The fluoride levels were determined by the use of the fluoride ion‐selective electrode. Both communities had high plaque and gingival indices. However, the mean pocket probing depths in both communities were less than 2.5 mm. No statistically significant differences could be found in the periodontal status between the 2 areas. The fluoride levels in bone and root were higher for subjects from the high fluoride area. No statistically significant difference could be demonstrated between the fluoride levels in alveolar bone and tooth roots for each area. It was found that the fluoride levels in bone and roots increased with increasing age, but to a lesser degree for subjects from the low fluoride area.
Clinical, microbiological and immunological features of subjects with destructive periodontal diseases
Authors: Haffajee A. D. , Socransky S. S. , Dzink J. L. , Taubman M. A. , Ebersole J. L. , Smith D. J.
Published: December 2005

Abstract 76 subjects with prior evidence of destructive periodontal diseases were monitored clinically and immunologically every 2 months for up to 5 years. Clinical parameters measured included bleeding on probing, gingival redness. plaque accumulation, suppuration, pocket depth and attachment level. Blood samples were taken by venipuncture and serum antibody levels to a series of 18 subgingival species determined. 33 of these subjects showed evidence of active disease during the monitoring period, based on changes in attachment level measurements assessed using the tolerance method of analysis. Mean attachment loss in these 33 subjects varied from 1.4 mm to 9.0 (median value 3.4 mm) and subjects whose mean attachment level was above the median showed a higher % of pockets > 3 mm and more suppuration. Severity of gingival inflammation related poorly to mean attachment loss. Subgingival plaque samples were taken from the active site(s) and from control sites of equal pocket depth and attachment loss in the same active disease subjects, prior to therapy, for predominant cultivable microbiota studies. 50 randomly selected isolates were identified from each sample. Predominant cultivable species in 170 pretreatment active and inactive sites combined (8500 isolates) were enumerated. The most frequently detected species were F. nucleatum (112 sites) and S. intermedius (106 sites), although the predominant species in the samples from each subject differed. The distribution of putative pathogens differed among subjects. For example. A. actinomycetemcomitans was found in 21 samples in 11 subjects and B. forsythus was found in 18 samples from 10 individuals. Antibody response patterns to the 18 subgingival species also varied among subjects. More than 81% (26/32) of the subjects demonstrated a mean elevated serum antibody level to at least 1 micro‐organism, while I subject showed an elevated response to 5 species. No pattern(s) of elevated antibody response(s) could be related to severity of attachment loss. Collectively, the data suggest that clinically, immunologically and microbiologically distinctive destructive periodontal diseases exist, and appropriate classifications could be devised.
Guided tissue regeneration in degree II furcation‐involved mandibular molars
Authors: Pontoriero R. , Lindhe J. , Nyman S. , Karring T. , Rosenberg E. , Sanavi F.
Published: December 2005

Abstract The present clinical trial was designed to evaluate the regenerative potential of the periodontal tissues in degree II furcation defects at mandibular molars using a surgical treatment technique based on the principles of guided tissue regeneration. The patient sample included 21 subjects. 22–65 years of age. The patients selected had periodontal lesions in the right and left molar regions including advanced periodontal tissue destruction within the interradicular area. After an initial examination, each patient received a series of full‐mouth scalings and root planings. 2–3 months later, they were recalled for a baseline examination including assessment of plaque, gingivitis, probing depths and probing attachment levels. The furcation involved molars were randomly assigned in each patient to either a test or a control treatment procedure. The test procedure included the elevation of mucoperiosteal flaps at the buccal and lingual aspect of the alveolar process. The inner surface of each flap was carefully curetted to remove epithelium and granulation tissue. The root surfaces were scaled and planed. A teflon membrane was adjusted to cover the entrance of the furcation area and the adjacent root surfaces as well as a portion of the alveolar bone apical to the crest. The flaps were repositioned and placed on the outer surface of the membrane and secured with interdental sutures which were removed after 10 days of healing. Following surgery, the patients were instructed to rinse the mouth twice daily with chlorhexidine gluconate. A second surgical procedure was performed after a healing period of 1–2 months to remove the teflon membrane. A procedure identical to the one used at the test teeth was performed at the control tooth regions with the exception of the placement of the teflon membrane. After 3 and 6 months of healing, the test and control sites were examined using the same parameters that were studied at baseline. The findings from the investigation demonstrated that treatment of degree II furcation defects at mandibular molars using a technique in compliance with the principles of guided tissue regeneration at most sites resulted in the disappearance of the anatomical defect. More than 90% of the sites treated with the GTR technique showed complete resolution of the furcation problem. Conventional therapy reached the same treatment goal in less than 20% of the cases treated.
Lichen planus evoked by periodontal surgery
Authors: Katz Joseph , Goultschin Joseph , Benoliel Rafael , Rotstein Ilan , Pisanty Sara
Published: December 2005

Abstract A case of Lichen Planus (LP) following periodontal surgery in a patient previously free of the disease is described. Genetic predisposition and lymphokine secretion stimulated by local trauma are suggested as a possible mechanism of the phenomenon. It is recommended that LP patients, especially those suffering from the erosive type, should be treated as conservatively as possible, minimizing the possibility of trauma to the oral tissues where local immunity may have been altered by a pathological process.
Peripheral T lymphocyte subsets in rapidly progressive periodontitis
Authors: Katz Joseph , Goultschin Josef , Benoliel Rafael , Schlesinger Michael
Published: December 2005

Abstract The peripheral blood lymphocyte subsets of 10 patients with rapidly progressive periodontitis were investigated with monoclonal antibody. In 4 patients, the T helper/T suppressor ratio was increased. 5 others had a slightly reduced T helper/T suppressor ratio as compared to control group. These findings may indicate a possible cellular immune response in the pathogenesis of rapidly progressive periodontitis.
Crevicular and salivary fibronectin before and after gingivitis treatment
Authors: Tynelius‐Bratthall Gunilla
Published: December 2005

Abstract The aims of this study were to assess crevicular fibronectin concentrations before and after conventional gingivitis treatment and to determine whether fibronectin concentration in whole saliva would be affected concomitantly. 10 subjects with generalized gingivitis were selected. Examinations were made before and after treatment and included measurements of clinical parameters as well as collection of samples of unstimulated saliva, stimulated saliva and crevicular material. The concentration of fibronectin was studied by an ELISA assay. Fibronectin was found in gingival crevices and in unstimulated as well as paraffin‐stimulated whole saliva in pre‐ and post‐treatment samples. There were no statistically significant differences between pre‐ and post‐treatment concentrations of fibronectin, whether expressed as μg fibronectin/μg protein or as μg fibronectin/ml saliva.
Morphological aspects of the gingiva in children with Down's syndrome during experimental gingivitis
Authors: Reuland‐Bosma Wimke , Liem Robert S. B. , Jansen Henk W. B. , van Dijk L. Johan , van der Weele Leo Th.
Published: December 2005

Abstract In a previous investigation, children with Down's syndrome (DS) showed an earlier, more rapid and more extensive gingival inflammation than normal healthy control children. These differences in gingival inflammation may be the result of aberrant morphology of the gingiva related to the genetic disorder in DS children. The aims of the present study were (i) to describe the structural composition of “normal” gingiva in DS compared to control children, (ii) to analyse the histological changes in the gingiva during plaque development and (iii) to investigate whether the clinical findings could be supported by morphological observations. The study was carried out in 8 DS and 8 matched control children. Their ages ranged from 5–10 years. Gingival normality was guaranteed by strict oral hygiene procedures. During a period of 21 days in which oral hygiene was abolished, gingival biopsies were taken from buccal sites of deciduous teeth following a predetermined schedule on days 0, 7, 14 and 21. Results on day 0 showed no morphological differences between the DS and control children regarding oral epithelium, junctional epithelium or connective tissue. During the experimental phase of the study, the amount of plaque accumulation in the DS children gave rise to a more extensive gingival inflammation than in the control children. The gingival inflammation in the DS group started earlier and included: (1) an acute inflammatory response, (2) an increase of the junctional epithelium area, (3) an increase of the infiltrated connective tissue area (ICT) and (4) a decrease in collagen fibre density of about 35–40% compared to day 0. The same phenomena were not seen until 7 days later in the control group. Conversely, the development of a perivascular lymphocyte infiltrate (LI) in the DS children was delayed compared to the control group. This may be caused by the impaired delayed‐type hypersensitivity response in DS children. The development of 2 separate infiltrates (ICT and LI) in this age group and the different temporal development of ICT (day 7 for the DS and day 14 for the control group) and LI (day 14 for the DS and day 7 for the control group) does suggest different immunological mechanisms for both areas and both groups.
Histiocytosis X: an oral diagnostic problem
Authors: Shaw L. , Glenwright H. D.
Published: December 2005

Abstract A case of prepubertal periodontitis in a 6½‐year‐old boy is described. Following failure to respond to conventional treatment including scaling, oral hygiene instruction and tetracycline therapy, a biopsy was performed and root planing carried out. The biopsy revealed histocytic infiltration and a diagnosis of Histiocytosis X of the Hand‐Schüller‐Christian type was made. This case emphasises the role of biopsy in establishing a diagnosis in cases of prepubertal periodontitis that do not respond to conventional therapy.
The relationship of inflammatory periodontal disease to diabetic status in insulin‐dependent diabetes mellitus patients
Authors: Rosenthal I. M. , Abrams H. , Kopczyk R. A.
Published: December 2005

Abstract This study was designed to evaluate the relationship of inflammatory periodontal disease to the diabetic status of the insulin‐dependent diabetes mellitus (IDDM) patient. 52 IDDM patients, ages 11–22 years, were evaluated. These patients were closely monitored at regular intervals in the University of Kentucky pediatric diabetic clinic. A periodontal examination was carried out for each patient. The patients were then assigned to a periodontitis or non‐periodontitis group. Moderate to advanced periodontitis was found in 5.8% of the subjects. The gingival index and sulcular bleeding index were significantly higher in the periodontitis group (P<0.05). There was no significant difference between groups for plaque index, age of diabetic onset, duration of diabetes, present age, insulin dosage/weight. or serum glucose (P>0.05). There was a greater % of ketoacidosis. retinopathy and neuropathy in the periodontitis group. IDDM patients with neurological complications or a history of chronic infections had a significantly higher gingival index score than those without the complication (P<0.05).
Methods of evaluating periodontal disease data in epidemiological research
Authors: Okamoto H. , Yoneyama T. , Lindhe J. , Haffajee A. , Socransky S.
Published: December 2005

Abstract The purpose of the present investigation was to examine the use of different methods of data analysis to examine the pattern of periodontal tissue destruction in a group of adults. A clinical examination was carried out on 319 subjects, 20–79 years of age, randomly selected from the population of the city of Ushiku. Japan. The following parameters were studied: missing teeth, plaque, gingivitis, probing pocket depth and probing attachment level. All surfaces of all teeth were examined. The data obtained were evaluated in 3 ways: (t) mean values for each of the clinical parameters were computed for each subject and age group, (ii) the frequency of subjects with one or more sites of attachment loss above certain thresholds was assessed, (iii) percentile plots were generated in such a way that for each age group the percent of sites in subjects with varying attachment levels could be determined. The results revealed that the subjects included in the study had poor oral hygiene, high frequency of gingivitis and loss of probing attachment which increased with age. The mean annual attachment loss for all tooth surfaces was calculated to be <0.1 mm. Severe periodontal tissue breakdown was not as common as might have been expected. Hence, the majority of the subjects in the 20–59 year age group had very little evidence of destructive periodontal disease. In these age groups, a comparatively small subfraction accounted for most of the disease detected. After the age of 60, periodontal disease appeared to be more widespread among the subjects examined. Each of the methods of data presentation provided some information concerning periodontal tissue destruction in the subject group. The mean values were useful in suggesting overall trends with age as well as differences in disease severity between teeth and tooth surfaces. The frequency of subjects with sites exceeding certain thresholds of attachment loss, disclosed the proportion of subjects affected, while the percentile plots provided this information and. in addition, a measure of the severity of disease within the subjects.
Relationship of subgingival microbial complexes to clinical features at the sampled sites
Authors: Socransky S. S. , Haffajee A. D. , Dzink J. L.
Published: December 2005

Abstract Subgingival plaque samples from 100 active destructive periodontal lesions and 150 inactive subgingival sites in 33 subjects were analyzed by predominant cultivable microbiota techniques, 50 isolates were characterized from each sample and where possible, the isolate was placed in 1 of 134 microbial species or groups. The sites were clustered on the basis of the proportions of all of the species detected in each sample using a minimum similarity matching coefficient and an average unweighted linkage sort. 10 clusters containing 166 sites were formed which exhibited > 35% minimum similarities. All clusters were made up of sites from multiple subjects and were formed on the basis of different combinations of micro–organisms. Certain complexes of microorganisms appeared to relate to the severity of periodontal destruction and the activity of the sampled site. The combination of F. nucleatum, B. forsyth and W. recta (cluster VII) or B. gingivalis, B. intermedius and S. intermedius (cluster VIII) distinguished clusters made up of sites which on average had the most attachment loss and the deepest pockets. These clusters contained the highest proportions of active sites and sites which lost > 3 mm of attachment after therapy. Clusters dominated by V. parvula (cluster III), the Actinomyces sp. (cluster X) or the combination of S. sanguis II, S. mitis, V. parvula and S. intermedius (cluster II) were made up of sites which exhibited less active disease and responded more favorably to therapy. Sites in other clusters exhibited moderate levels of prior destructive disease and disease activity status closer to the mean values for all 250 sites. These clusters were dominated by S. intermedius, E nucleatum and E. corrodens; F. nucleatum., S. intermedius, E. corrodens and W. recta; S. xylosusi; B. inlermedius and E. corrodens; C. oehracea, W. recta and B. intermedius. 83% of sites from refractory subjects fell into cluster groups, but only 53% of sites from subjects who responded well to therapy, suggesting a greater homogeneity of the microbiotas in subgingival sites of refractory subjects. The cluster analysis suggested complexes of micro‐organisms which might merit further investigation in human clinical studies as well as in mixed infection models.
Clinical and microbiological effects of root debridement in periodontal furcation pockets
Authors: Loos Bruno , Claffey Noel , Egelberg Jan
Published: December 2005

Abstract The aim of the present study was to investigate longitudinally over 52 weeks the clinical and microbiology effects of plaque control and root debridement at molar furcation sites. The results were compared with changes at non‐molar sites. 24 non‐molar sites and 31 grade II molar furcation sites with probing depth ≥5.0 mm were monitored in 11 patients. Clinical measurements consisted of plaque scores, probing depths, and changes in probing attachment level. Microbiological monitoring was carried out with phase‐contrast microscopy and anaerobic culturing. The debridement resulted in improvement in probing measurements and microbiological counts for both groups of sites. A slightly less favorable clinical response was noted for molar furcation sites. Higher post‐operative microbiological counts were found throughout the 52‐week, observation period for molar furcation sites. Sites with probing attachment loss showed higher microbial counts and higher proportions of spirochetes, black pigmented colony forming units (CFU), and Bacteroides gingivalis CFU than sites with probing attachment gain. Individual site analysis, however, demonstrated marked variations of the microbiological counts at the different postoperative time points. In the few available sites undergoing probing attachment loss, no apparent association between target micro‐organisms and periodontal deterioration was observed.
Remodelling of interdental alveolar bone after periodontal flap procedures assessed by means of computer‐assisted densitometric image analysis (CADIA)
Authors: Brägger Urs , Pasquali Lee , Kornman Kenneth S.
Published: December 2005

Abstract. The purposes of this study were to evaluate digitized images from standardized radiographs for quantitative changes in alveolar bone density following periodontal surgical procedures, and to correlate these changes to the changes in the clinical parameters PII. Gl, PD, AL. 14 crown‐lengthening procedures for restorative purposes were performed in 13 patients and 15 modified Widman flaps were performed in 15 patients, providing 61 surgical interdental test sites and 61 matching controls. Standardized radiographs were obtained immediately post‐operatively. and at 1 and 6 months postsurgically. Digitized images were obtained from the radiographs by means of a video camera linked to an image processor and a computer. Quantitative information regarding density changes within windows covering the interdental alveolar crest was obtained after superimposition and grey‐level correction of images to be compared. The results indicated statistically significantly more density loss 4 to 6 weeks postsurgically at test sites treated by periodontal surgical procedures compared to corresponding controls. Significant differences in the remodelling activity between the patients exposed to crown lengthening procedures for restorative purposes and the periodontitis patients in the period 1 lo 6 months postsurgically were evident. CADIA assessed differences in the tissue changes in the healing phase following periodontal surgical procedures, which were not detected by the clinical variables applied.
Accuracy of repeated single versus averages of repeated duplicates of probing depth measurements
Authors: Janssen P. T. M. , Drayer A. , Faber J. A. J. , van Palenstein Helderman W. H.
Published: December 2005

Abstract. The present study aims to determine to which extent averages or deepest recordings of repeated duplicates of probing depth measurements may increase the accuracy as compared to repeated single measurements. In total. 1247 sites were recorded in 8 patients with advanced periodontitis. The patients had received initial treatment. Each site was probed 4 times with time intervals of 100 min. The standard deviation of differences between repeated single measurements of 0.97 mm decreased with a factor to 0.69 mm for differences between averages of repeated duplicates of measurements. Differences between the averages and the deepest recordings of repeated duplicates of measurements showed a non‐Gaussian distribution. This implies that the type‐I error can not be computed on the basis of the standard deviation of the error with the use of parametric statistical analysis. The best estimate for the type‐1 error is the observed frequency of differences. The type‐I error for differences of 3 mm or more between repeated single measurements decreased from 1.5% to 0.9% and 0.2%. When deepest recordings and averages of repealed duplicates of measurements, respectively, were compared.
Dark‐field microscopy of subgingival plaque microflora in Indian and English subjects
Authors: Srivastava R. P. , Walsh T. F. , Basu M. K. , Glenwright H. D. , Rippin J.
Published: December 2005

Abstract. This present investigation reports on the microbial pattern of siibgingi‐val plaque from English and Indian subjects living in the West Midlands of England. Subgingival plaque from healthy and diseased sites was studied using darkfield microscopy, The results indicate that significant differences exist in mi‐crobial flora of clinically normal and diseased sites of English as well as Indian subjects. Coccoid cells predominated in healthy sites, with an increase of 21% in the spirochaetes in diseased sites. The ratio of non‐motiles to motiles was 1:0.6 in healthy sites, whereas in diseased sites the ratio observed was 1:1.8 in English subjects and 1:3.6 in Indian subjects. Comparison of healthy sites in Indians with healthy sites in English subjects revealed significant differences between numbers of rods (p<0.05). Comparing diseased sites of Indians with diseased sites in English subjects revealed significant difference between both cocci (p<0.05) and motile rods (p<0.01). A positive correlation between chronic inflammatory periodontal disease and spirochaete burden, and a negative one between the disease and coccal burden, was found.
The bleeding/plaque ratio in the treatment of periodontal disease
Authors: Galgut Peter N.
Published: December 2005

Abstract. The bleeding/plaque ratio has been suggested as a means of assessing susceptibility to periodontal disease, and as a prognosticator of periodontal breakdown. In this study, 100 males and 131 females were evaluated by means of the bleeding/plaque ratio to make a prognosis of the outcome of periodontal therapy. Initial plaque and gingival bleeding scores were used to calculate the bleeding/plaque of the subjects, and these ratios were compared with the resolution in the clinical parameters of plaque, gingival bleeding and severe and moderate pocketing. The subjects were divided into those showing higher bleeding incidence and lower bleeding incidence as assessed by post‐treatment gingival bleeding. The bleeding/plaque ratios for the 2 groups were not significantly different, and therefore could not be used clinically for assessment of susceptibility to, or for prognostication of periodontal breakdown. 4 subjects were randomly selected from these 2 groups, and their data used to illustrate the limitations of the bleeding/plaque ratio. The bleeding/plaque ratios bore no relationship to the response to treatment in these 8 individuals, when evaluated in terms of reduction in plaque levels, gingival bleeding or pocketing. It is therefore concluded that the bleeding/plaque ratio in its present form is not of clinical value for making a prognosis of the likely outcome of treatment, and some suggestions as to how it may be improved are made.
A clinical trial to assess the efficacy of sanguinarine‐zinc mouthrinse (Veadent) compared with chlorhexidine mouthrinse (Corsodyl)
Authors: Moran J. , Addy M. , Newcombe R.
Published: December 2005

Abstract. A single‐blind crossover study was used to compare the ability of a 0.2% chlorhexidine mouthrinse (Corsodyl) with a sanguinarine‐zinc mouthrinse (Veadent) to inhibit plaque and gingivitis. 14 volunteers starting with plaque‐free mouths and optimal gingival health, rinsed with the preparations over two 19‐day periods whilst refraining from all other oral hygiene procedures. At days 8, 15 and 19 of the trial, Corsodyl was significantly more effective at inhibiting both plaque and gingivitis. The Findings of this study would suggest that the Veadent mouthrinse would at most only have a limited rôle as an inhibitor of plaque and gingivitis.
Improvement of oral hygiene habits: a psychological approach 2‐year data
Authors: Alcouffe François
Published: December 2005

Abstract. The present communication attempts to determine the effects of individual interviews, conducted by a psychologist, on unmotivated patients' oral hygiene habits. For this investigation, 26 subjects were selected according to the following main criteria: (a) patients with good motor skills (to make sure that poor hygiene was due to poor compliance and not to poor dexterity); (b) patients suffering from periodontitis of Cl II and Cl III of the Modified Nomenclature of the American Academy of Periodontology; (c) patients, who had never been taught toothbrushing techniques prior to attending 4 routine sessions on oral hygiene, and who in spite of understanding the pathogenic relation between plaque and disease, were unable to reach a plaque index score beneath the 50% level. The 26 selected patients were divided randomly into 2 equal groups. Subjects assigned to the 1st group were submitted to interviews with a psychologist, whereas those of the 2nd group were not (control group). Throughout the investigation period, the plaque indices were scored for both groups at 3‐month intervals. Results revealed a decrease of plaque index scores in the interviewed group, from 68% to 49%. During the same period, the non‐interviewed group exhibited virtually no change.
Stereological observations on long‐term experimental gingivitis in man
Authors: Brecx M. C. , Fröhlicher I. , Gehr P. , Lang N. P.
Published: December 2005

Abstract. The purpose of the present investigation was to study stereologically the histopathologic changes in the gingiva during 6 months of abolished oral hygiene and to study the development of chronic gingivitis in man. After a thorough prophylaxis procedure, 5 dental students performed optimal oral hygiene under supervision for a period of 3 weeks. At the end of this pre‐experimental phase, they were asked to abolish all oral hygiene procedures for 4 (2 individuals) to 6 months (3 individuals). At day 21, and after 2, 3, 4, 5 and 6 months, the gingival exudate flow rate and the gingival index were assessed, and buccal gingival biopsies taken. Semi‐thin histologic sections were stained with basic fuch‐sine and methylene blue. By point counting at 2 different levels of magnification, the volume densities of epithelium, infiltrated (ICT) and non‐infiltrated connective tissue, and collagen were estimated. The %s of fibroblasts, PMN's lymphocytes, plasma cells and macrophages were estimated in a predetermined standardized area close to the apical termination of the junctional epithelium. With increasing time, the volume densities of the ICT rose concomitantly with a decrease in the volume densities of the collagen. In spite of great interindividual variations, a slow shift in the proportions of some cell populations was consistently observed. While the fraction of PMN's, lymphocytes and macrophages remained stable, a decrease of fibro‐blasts (57 to 39%) and an increase of plasma cells (0.2 to 10%) was observed. This study has, therefore, demonstrated that, in 6 months of plaque accumulation, a chronic gingivitis with a predominance of PMN's and lymphocytes develops. During this period of time, the plasma cell fraction increased continuously. However, more than 6 months of neglected oral hygiene appear to be a pre‐requisite for the development of chronic gingivitis lesions characterized by a predominance of plasma cells.
The CO2 laser in the excision of gingival hyperplasia caused by nifedipine
Authors: Barak Shlomo , Kaplan Isaac
Published: December 2005

Abstract. The CO2 laser has been shown to have decided advantages over conventional techniques in the excision of gingival hyperplasia. These advantages include accurate debulking without bleeding and simultaneous sterilization. In addition, post‐operative pain and discomfort are considerably reduced. This is particularly important in patients being treated with nifedipine for cardiac disease. A case study which demonstrates these issues is presented.
The detection of in vitro produced periodontal bone lesions by conventional radiography and photographic subtraction radiography using observers and quantitative digital subtraction radiography
Authors: Janssen P. T. M. , van Palenstein Helderman W. H. , van Aken J.
Published: December 2005

Abstract Changes in the periodontium produced by removal of bone cylinders at one interdental site of a dry human mandible, were recorded radiographically. These artificial lesions had diameters of 0.3 mm increasing to 1.4 mm in steps of 0.1 mm. Radiographs were obtained using 3 different X‐ray tube potentials and 3 different amounts of radiation. These 9 exposure variables resulted in 9 series of radiographs from the artificial lesions. Observers were asked to determine the presence or absence of these periodontal bone lesions on conventional radiographs and on photographically subtracted images. The images were also evaluated by a quantitative digital subtraction technique. This study showed that the smallest periodontal bone changes were detected with the quantitative digital subtraction technique compared to the other methods using observers. On photographically subtracted images, smaller bone changes were detected by the observers than on conventional radiographs. Only the detection threshold of the quantitative digital subtraction technique was influenced by the 2 exposure factors: kVp and mAs.
Fibronectin levels of unstimulated saliva from naval recruits with and without chronic inflammatory periodontal disease
Authors: Lamberts B. L. , Pederson E. D. , Bial J. J. , Tombasco P. K.
Published: December 2005

Abstract Past studies have suggested that gingival crevicular fluid is produced more readily in persons with severe periodontal diseases than in persons with healthy gingivae. In this study, salivary fibronectin was selected as an index of total gingival crevicular fluid flow. Our purpose was to determine whether a relationship could be found between salivary fibronectin level and periodontal disease status. Unstimulated saliva was collected from 20 healthy and 20 periodontally‐diseased naval recruits. The periodontally‐diseased subjects included 10 with localized juvenile periodontitis and 10 with moderate to severe periodontitis. Mean subject ages and salivary flow rates were similar for the 2 groups. Although 2 of the periodontally‐diseased subjects showed unusually high fibronectin levels, the mean level for the remaining 18 subjects did not differ significantly from the mean of the healthy group, and no association of periodontal disease status with salivary fibronectin content was seen. Consequently, it was not evident from salivary fibronectin levels that the content of gingival crevicular fluid in instimulated whole saliva differed significantly for persons with or without severe periodontal disease, except possibly for extreme cases of disease.
The effect of a topical non‐steroidal anti‐inflammatory drug on the development of experimental gingivitis in man
Authors: Heasman P. A. , Seymour R. A. , Boston R. F.
Published: December 2005

Abstract 24 healthy volunteers abstained from tooth‐cleaning for 17 days. Parameters of gingival health were recorded on days 1 and 17. On days 4, 6, 8, 11, 13 and 15, each volunteer randomly received, on a double‐blind basis, 100 ml of 10 mM flurbiprofen solution in buffered preservative to one upper quadrant of the mouth. The contra lateral quadrant received preservative only. Applications were made using a pulsed jet irrigating system. Gingivitis developed in all patients and there were no significant differences between the treatments for gingival index or pocket probing depths. When gingival health was re‐established, 4 volunteers had a further 3 irrigations of flurbiprofen at intervals of 2 days. Plasma levels of flurbiprofen were determined after the 1st and 3rd irrigations. Assays showed that the drug was present in the plasma of all 4 subjects (range 0.2‐0.7 μg/ml). Gingival health was re‐established in 6 further volunteers from the original study. They then abstained from toothbrushing for 17 days, during which one maxillary quadrant was irrigated with the buffered preservative solution. The irrigations were made on the same basis as in the original study. Gingivitis again developed in these quadrants, although when the results were compared to the equivalent data from the first investigation, significantly greater median values for probing pocket depths and gingival indices were found in the latter study. Therefore, it appears that systemic absorption of flurbiprofen may have reduced the severity of the developing inflammatory lesions.