bluuebunny/crossref_metadata_2025 huggingface dataset:
A 6‐month home usage trial of a 1% chlorhexidine toothpaste
Authors: Yates R. , Jenkins S. , Newcombe R. , Wade W. , Moran J. , Addy M.
Published: December 2005

Abstract Research and development has been aimed towards the development of toothpastes for oral hygiene and gingival health benefits. The most effective antiplaque agent to date, chlorhexidine. is difficult to formulate into active toothpaste products. Despite some encouraging findings for experimental chlorhexidine toothpastes, there are to date no commercially available products. Based on positive findings from an experimental gingivitis study, this investigation evaluated 2 chlorhexidine toothpastes, one with fluoride, as adjuncts to oral hygiene. The study was a double–blind controlled, parallel, balanced group design, extending over 6 months. A total of 297 volunteers commenced the study after screening for a minimum acceptance level of gingivitis. At baseline, 6, 12 and 24 weeks, stain, gingival, bleeding and plaque indices were recorded, together with a calculus index at 6, 12 and 24 weeks. After a baseline prophylaxis, volunteers used the allocated product 2 × per day, with no other oral hygiene instructions given. Plaque, gingival and bleeding scores improved in all 3 groups, but to an overall significantly greater extent in the active groups. However, staining and calculus indices were significantly increased in the active compared to the control group. If the local side‐effects of chlorhexidine are considered to be acceptable, these chlorhexidine toothpastes could be recommended for the same clinical applications as other chlorhexidine products. The apparent compatibility of fluoride with chlorhexidine in the one product may be pertinent to caries prevention.
Relationship of “bleeding on probing” and “gingival index bleeding” as clinical parameters of gingival inflammation
Authors: Chaves Eros S. , Wood Robert C. , Jones Archie A. , Newbold Dewey A. , Manwell Mary A. , Kornman Kenneth S.
Published: December 2005

Abstract Bleeding on probing (BOP) and the gingival index have been used to clinically characterize the degree of gingival inflammation. It is, however, unclear to what extent these parameters correlate to each other and to probing pocket depth (PD). The purpose of this clinical study was to evaluate the association between BOP and GI bleeding (scores of 2 and 3), as well as the relationship of these variables to PD, in a group of patients presenting with naturally‐occurring gingivitis. Based on screening examinations of 125 subjects with at least 20 teeth, no more than 4 sites with PD over 6 mm, a BOP frequency of 30% or greater, and no systemic condition that would influence the inflammatory response, were selected. 2 weeks after screening they were examined at 6 sites per tooth for plaque index, GI, PD and BOP. A standardized pressure sensitive probe (Florida Probe) with 20 g probing force was used for BOP and PD measurements. In this population, means of 40.9% (S.E.= 1.36) BOP sites and 35.3% (S.E, = 1.81) GI bleeding sites per patient were found. A total of 20,008 sites ranging in PD up to 5.9 mm were evaluated; however, the majority of sites (19,723, 98.6%) presented with <4 mm PD. When sites were evaluated, BOP demonstrated a positive correlation with PD, whereas GI bleeding correlated with PH. For sites characterized by the absence of BOP as well as the absence of GI bleeding (scores 0 and 1), the highest % of agreement between the 2 indices (77.7%) was found in shallow sites (0.1–2 mm). In contrast, when sites presenting with both BOP and GI bleeding were analyzed, the highest % of agreement (85,4%) was found for sites with PD >4.0 mm. In this gingivitis population group, it appears that BOP and GI bleeding evaluate distinct inflammatory1 conditions of the gingival tissues, and the relationship between the 2 clinical parameters may vary according to PD at the individual site examined.
Alternative methods for screening periodontal disease in adults
Authors: Machtei Eli E. , Chrisiersson Lars A. , Zambon Joseph J. , Hausmann Ernest , Grossi Sara G. , Dunford Robert , Genco Robert J.
Published: December 2005

Abstract Clinical measurements of periodontal attachment loss, while not always representing the histological changes, are used to establish the diagnosis of adult periodontitis. Such measurements are difficult to perform accurately and are labor intensive. To counter these problems, index teeth and Index sites have been employed in an attempt to estimate the severity of the periodontal condition without the need to resort to elaborate attachment measurements. Unfortunately, such indices usually tend to underestimate prevalence while often overestimating severity. The purpose of the present study was to examine the correlation of alternative clinical, radiographic and microbiological parameters, with periodontal disease using the diagnotic criteria of established periodontitis. 508 adults included in this study received thorough periodontal examination which included probing pocket depth, clinical attachment level, plaque, gingival and calculus scores, together with radiographic analysis and assays of subgingival periopathogenic microorganisms. Radiographic alveolar bone loss and probing pocket depth had the highest correlation with clinical attachment loss (φ= 0.72 and (φ= 0.75 respectively). Plaque scores (φ=0.17), like gingival scores (φ= 0.06) and calculus scores (φ= 0.42) had poor correlation with established periodontitis. Periodont‐opathogenic species demonstrated high specificity and negative predictive values; but low sensitivity and positive predictive values make for an overall low correlation of these species with established periodontitis. However, when used in a logistic regression model, the presence of P. gingivalis (odds ratio = 6.25) has shown to contribute significantly to the estimate of probability for established periodontitis. The use of these various alternative parameters for screening of periodontal disease is discussed in light of their sensitivity, specificity and predictive value.
Gingivitis in young and old dogs
Authors: Berglundh T. , Lindhe J.
Published: December 2005

Abstract The aim of the investigation was to study the development of gingivitis in young and old dogs. 10 beagle dogs were used. 5 of the dogs were 1 year old and 5 dogs were between 8 and 9 years of age. On day 0, all the teeth of all 10 dogs were scaled and polished. A 6‐week period of plaque control was initiated. On day 42, a clinical examination was performed, microbial samples from the gingival sulcus were harvested and biopsies obtained from tooth regions 3P and 4P. The tooth‐cleaning measures were abandoned following biopsy and the animals were during the subsequent 3 weeks allowed to form plaque. On day 63, i.e., day 21 of plaque formation, the clinical examination, sampling of the subgingival plaque and harvesting of biopsies were repeated in the contralateral premolar regions (P3 and P4). The histological analysis revealed that the cellular infiltrate (the lesion) of inflamed gingiva was larger and extended more apically in the old than in the young dogs. The lesion in the old dogs contained significantly more plasma cells but less macrophages, lymphocytes and PMN cells than the infiltrate in the young dogs.
The effects of Acacia arabica gum on the in vitro growth and protease activities of periodontopathic bacteria
Authors: Clark D. T. , Gazi M. I. , Cox S. W. , Eley B. M. , Tinsley G. F.
Published: December 2005

Abstract The antibacterial activity of acacia gum was assessed using fresh isolates and reference strains of Actinobacillus actinomycetemcomitans, Capnocytophaga spp., Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola. A fine aqueous suspension of gum was produced by sonication and then a soluble fraction isolated by centrifugation and membrane filtration. These preparations were incorporated into Columbia agar at doubling concentrations. Growth of P. gingivalis and P. intermedia cultures on the agar was inhibited by whole gum sonicate at concentrations of 0.5–1.0% w/v. Both species showed reduced susceptibility when horse blood was present in the agar. The gum soluble fraction did not inhibit growth of any bacterial culture. The effect of acacia on bacterial proteases was examined with cell sonicates from log phase broth cultures. Enzyme activities were determined by fluorimetric assay with various synthetic peptide substrates. Most protease activities reduced in the presence of 0.5% w/v gum sonicate, with the trypsin‐like activities of P. gingivalis and P. intermedia proving most sensitive. The gum soluble fraction was nearly always less inhibitory than the sonicate. The action of acacia gum against suspected periodontal pathogens and their enzymes suggests that it may be of clinical value.
Meta‐analysis of surgical versus non‐surgical methods of treatment for periodontal disease
Authors: Antczak‐Bouckoms Alexia , Joshipura Kaumudi , Burdick Elisabeth , Camilla Tulloch J. F.
Published: December 2005

Abstract A meta‐analysis was performed on 5 randomized controlled trials comparing surgical with non‐surgical treatment for periodontal disease. The specific procedures considered were the modified Widman flap compared with scaling and root planing or curettage with anesthesia. We chose the most consistently reported outcomes, pocket depth and attachment level, for analysis. At 1 year of follow‐up, surgical treatment reduced pocket depth more than non‐surgical for all initial levels of disease, hut by 5 years, only the deepest initial pockets (>7 mm) showed significant improvement over non‐surgically treated teeth (0.51 mm reduction, p<0.01). Attachment level showed significantly better early results for non‐surgical treatment for less diseased teeth, but by 5 years, all significant differences had disappeared. We computed quality scores following a method described by Chalmers. The mean quality score for study data analysis and presentation was 0.37±0.009 and for the study protocol, the mean quality score was 0.19±0.002. We find that this metaanalysis supports findings relating response to therapy with initial level of disease severity. We also find that the choice of outcome measure influences the choice of therapy, with surgical therapy providing greater benefit for probing depth and non‐surgical therapy providing greater benefit for attachment level. These results must be viewed, however, in light of the low quality scores of the evaluated studies and the potential for bias due to lack of blinding, the small mean treatment differences, and the observer measurement variability.
Transmission of Porphyromonas gingivalis between spouses
Authors: van Steenbergen T. J. M. , Petit M. D. A. , Scholte L. H. M. , van der Velden U. , de Graaff J.
Published: December 2005

Abstract Porphyromonas gingivalis has been associated with severe forms of periodontitis. The question can be raised about the origin of this suspected periodontal pathogen. The purpose of the present investigation was to study the possibility of transmission of P. gingivalis between spouses. 18 patients were selected with severe periodontitis and colonized with P. gingivalis. 10 of their spouses appeared to be colonized with P. gingivalis too. 8 of the patients and their spouses were investigated further clinically and microbiologically. Microbiological evaluation revealed mostly high %s of P. gingivalis in the pockets, not only of the patients (5–48% of the cultivable flora), but also in 7 of the 8 spouses (0.2–61%). Furthermore, this species was isolated often from the saliva, the tongue, the buccal mucosa and the tonsillar area from both patients and spouses. For typing purposes, bacterial DNA was isolated, treated with the restriction endonucleases Bam HI or Pst 1, after which the DNA fragments were separated by agarose gelelectrophoresis. With one exception, each individual was colonized with only one clonal type of P. gingivalis. The DNA patterns of all P. gingivalis isolates from unrelated individuals were found to be distinct. In contrast, in 6 of the 8 couples, the DNA patterns of isolates from husband and wife were indistinguishable. From these data, it can be concluded that it is most likely, that P. gingivalis can be transmitted between spouses. It remains to be investigated whether transmission of P. gingivalis is a risk factor for developing periodontal destruction.
Assessment of pain in cervical dentinal sensitivity studies
Authors: Gilam D. G. , Newman H. N.
Published: December 2005

Abstract Traditionally cervical dentinal sensitivity (CDS) has been evaluated mainly subjectively on the basis of the individual patient's subjective response, e.g., in the form of verbal rating and visual analogue scales and questionnaires. The stimuli used for evaluating this response can be grouped into 4 main categories: mechanical, chemical, electrical and thermal. This review of the literature, however, indicates that there are problems in evaluating patient subjective response to these various test stimuli used in the assessment and treatment of CDS. Opinions also vary as to the reliability of some of these methods of assessment, although recently, efforts have been made to develop controlled reproducible stimuli more suited to the evaluation of CDS. Currently no single method of eliciting and assessing CDS may be considered ideal. Further research is required to evaluate suitable methodology for the quantification of realistic test stimuli under controlled clinical conditions, whereby the subjective response may be objectively measured by the investigator.
Salivary amylase in crevicular fluid
Authors: Smith Q. T. , Camp S. J.
Published: December 2005

Abstract Extrasulcular substances such as saliva, supragingival plaque and salivary sediment may be contaminants in gingival crevicular fluid (GCF) collected with Periopaper. This report provides data obtained with salivary amylase as a marker for these substances in GCF. Amylase was a common constituent of GCF collected from sites with clinical health and with clinical signs of periodontitis. Rinsing the mouth with water reduced, but did not eliminate amylase in GCF. More frequent (p < 0.01) and greater (p < 0.001) contamination of GCF with amylase occurred in samples from periodontitis than from healthy subjects. The volume of saliva required to give the amylase in the GCF was calculated. This volume exceeded the GCF volume in 21% of samples collected without a water rinse. Thus, oral constituents other than saliva likely contribute to GCF amylase. Small quantities of plaque and salivary sediment (9.6 ± 5,9, 3.4 ± 2.0 μg protein) provided amylase from a saliva volume equal to the GCF volume in health (0.23 μl). The above and other data presented here show that extrasulcular substances likely are frequent constituents of GCF collected with Periopaper. Reporting GCF constituents as quantities/sample appears least subject to error from the contamination by extrasulcular substances.
Periodontal attachment loss assessed by linear and area measurements in vitro
Authors: Ktock Kristin Solveig , Gjerdet Nils Roar , Haugejorden Ola
Published: December 2005

Abstract The aim of the present study was to investigate the relationship between linear and area measurements of periodontal attachment loss, and to determine the root surface area on different tooth‐types. Extracted permanent teeth were collected in a national survey including a systematic random sample of 500 Norwegian dentists. The response rate was 70%. Altogether 329 teeth were received, 81 of them (excluding 3rd molars) were subjected to both linear and area measurements of attachment loss. Using a dissecting microscope (10 ×), 4 to 8 duplicate linear measurements were recorded per tooth. The areas of both lost and remaining periodontal attachment were measured by a method based on controlled release of Cu and Co metal ions from coatings applied to the root surface. Linear loss of attachment for single‐rooted teeth (n=63) was x̄=44.0% and the area loss x̄=49.2%. The corresponding measurements for multi‐rooted teeth (n=18) were x̄=30.3% and x̄=35.1%, respectively. The correlation between linear and area loss was r=0.78 for single‐rooted and r=0.75 for multi‐rooted teeth (p<0.01). The lower correlation in multi‐rooted teeth is probably due to the more complex root anatomy. It is concluded that there is a strong correlation between linear loss of attachment and area of periodontal support lost for teeth with early to moderate loss of attachment, and that linear measurements tend to underestimate the remaining periodontal attachment.
Aging and microcirculatory dynamics in human gingiva
Authors: Matheny J. L. , Johnson D. T. , Roth G. I.
Published: December 2005

Abstract There have been no published reports characterizing gingival vascular function in humans of different ages. In this study, we compared gingival vascular dynamics in 60 healthy male humans ranging in age from 18–75 years (young, 18–25 years (Y); middle, 35–45 years (M); old, 65–75 years (O), 20 subjects/group). Both videomicroscopy of individual microvessels and laser doppler flowmetry were employed to assess marginal gingival circulation. Systemic cardio‐pulmonary parameters were monitored as controls. The number of gingival vessels visible in a microscopic field was higher and the number of microvessels exhibiting active flow was lower in M and O compared to Y. There were no differences among age groups in laser doppler flow values (tissue blood flow) or in red blood cell velocity in individual vessels. Although not statistically significant with age there was a trend towards decreasing blood flow velocity in both the laser doppler and videomicroscopic measurements. Blood pressure increased slightly with age. Peripheral oxygen saturation was lower in O compared to Y and M. No differences were seen in heart rate, respiratory rate or end‐tidal carbon dioxide concentration. The changes in blood pressure and oxygen saturation were expected. The differences in numbers of visible vessels and the number of vessels with active blood flow may reflect the way the gingival microcirculation adapts with age to changing nutritional needs or to microbial and/or mechanical challenge.
Oral hygiene, periodontal conditions and carious lesions in patients treated with dental bridges
Authors: Valderhaug J. , Ellingsen J. E. , Jokstad A.
Published: December 2005

Abstract A longitudinal study, extending over a period of 15 years, was carried out in a group of 102 patients who received 108 bridges made by the senior students at the Dental Faculty, University of Oslo, in 1967/68. The study included 343 abutment teeth, and the remaining teeth in the same jaw which received the restoration. 525 in all, served as control. The oral hygiene, gingival condition, pocket depth, caries on crowned teeth, location of crown margins and changes of alveolar bone level were recorded during the study. During the First 10 years, the patients received oral hygiene prophylaxis every 6 months. The mean age of the patients at the beginning of the study was 48 years. Of the original group of 102 patients, 88 attended the clinical examination after 5 years, 71 after 10 years, and 55 after 15 years. The amount of plaque did not differ between the crowned teeth and the control teeth during the observation period, while GI score 2 and 3 was more frequent in crowned teeth than in the control teeth during this period. This was mainly observed when the crown margins were located sub‐gingivally. A slight increase in mean pocket depth was recorded in the crowned teeth while the mean pocket depth for the control teeth remained at the same level during the 15 years. Caries lesions were recorded in 3.3% of the abutment tooth surfaces at the 5th year, in 10.0% at the 10th year and in 12.0% at the 15th year examination. No statistical differences in bone loss could be detected between the control teeth and the crowned teeth.
Failure of adjunctive minocycline‐HCI to eliminate oral Actinobacillus actinomycetemcomitans
Authors: Müller Hans‐Peter , Lange Dieter E. , Müller Rüdiger F.
Published: December 2005

Abstract Considerable problems have been reported in the eradication of Actinobacillus actinomycetemcomitans from periodontal sites. The present communication describes the 2‐year results of a comprehensive combined mechanical/surgical and adjunctive rainocycline (200 mg/day for 3 and another 2 weeks) treatment regimen in 28 patients with A. actinomycetemcomitans‐associated periodontitis. Elimination of A. actinomycetemcomitans at periodontal sites was a prerequisite for gain of clinical attachment of ≥2 mm or decrease of probing depth to ≥4 mm after subgingival scaling plus minocycline (p<0.01). Whereas 2 years after active treatment A. actinomycetemcomitans could not be detected at monitored sites in 23 patients, the organism was found on buccal mucosa and in saliva in 17 and 12 cases, respectively. One or 2 years after periodontal surgery, there was a significant association between log10‐numbers of A. actinomycetemcomitans in buccal samples and numbers of residual pockets of ≥7 mm as well as gingival sites with overt gingivitis (R2= 0.687, p<0.001). Present results indicate failure of an even prolonged administration of adjunctive minocycline to eliminate oral A. actinomycetemcomitans in most cases of A. actmomycetemcomitans‐associated periodontitis.
IL‐1 in gingival crevicular fluid following closed root planing and papillary flap debridement
Authors: Reinhardt Richard A. , Masada Marvin P. , Johnson Georgia K. , DuBois Linda M. , Seymour Gregory J. , Allison Anthony C.
Published: December 2005

Abstract Interleukin (IL)‐1 alpha and beta are cytokines which can mediate inflammatory, bone resorbing. and reparative effects in the periodontium, but few longitudinal data exist exploring their role following periodontal therapy. This study examined gingival crevicular fluid (GCF) concentrations of IL‐1 alpha and TL‐1 beta at sites with shallow sulci (SS) or inflamed moderate/advanced pockets (M/AP) before and 6 months after treatment with closed scaling/root planing (SC/RP) or papillary flap debridement (PFD), all in the same subject (n=14 patients). No significant differences were noted in IL‐1 alpha or beta concentrations (determined with two‐site enzyme‐linked immunosorbent assays) between SS and M/AP sites at baseline. While both therapies improved clinical parameters of periodontal disease, IL‐1 alpha concentration increased significantly (p<0.05) in M/AP‐PFD sites 6 months after treatment, but were unchanged in other groups. IL‐1 beta concentrations were numerically lower after therapy, except for a significant increase (P<0.05) in M/AP‐PFD sites. These data suggest that surgical wound healing in an inflamed, plaque‐infected site (M/AP‐PFD) results in prolonged production of IL‐1, which may be a reflection of the extent of tissue trauma and delayed wound healing. In spite of increased IL‐1 levels, these sites demonstrated significant short‐term improvement in clinical attachment level (+ 1.8 mm, p<0.001) postoperatively.
Healing in periodontal defects treated by decalcified freeze–dried bone allografts in combination with ePTFE membranes
Authors: Guillemin M. Reina , Mellonig James T. , Brunsvold Michael A. , Steffensen Bjorn
Published: December 2005

Abstract This study quantitatively assessed radiographic changes in alveolar bone density by computer‐assisted densitometric image analysis (CADIA) in periodontal defects that were treated with decalcified freeze dried bone allograft (DFDBA) alone or in combination with interproximal expanded polytetrafluoroethylene membranes (ePTFE). The radiographic changes where then analyzed for correlation with the clinically assessed changes. The radio‐graphic changes were evaluated on standardized radiographs of treated sites treated prior to, 1 week after surgery, and 6 months post‐operatively. 15 patients with one pair of bilateral interproximal periodontal defects of similar morphology and 3:6 mm in pocket depth participated. Analysis of the changes 6 months after treatment showed that the increases in density in the defect areas that received the graft were significantly greater than the adjacent areas (p <0.001). These adjacent areas, in contrast, demonstrated significantly larger loss in radio‐graphic density than the defect area (p <0.001). The placement of DFDBA into the defects produced in itself significant increases in radiographic density, as illustrated by the results of one week which remained at six months. Utilization of ePTFE addition to DFDBA did not lead to additional radiographic gains in the defect area. While at one week the analysis suggested increased resorption by the combined treatment over grafting alone, such differences did not persist at 6 months post‐surgery. Analysis comparing CADIA derived values for change with those of the clinical assessment revealed some associations. When categorizing outcomes of density measurements as equal to 0 or numerically greater than 0, changes in density showed a non‐random correlation with clinical changes expressed by the distance from CEJ to the bottom of the defect (p <0.001) among sites treated by DFDBA. The corresponding correlation was not significant upon adjunctive treatment by ePTFE. Further analysis, however, demonstrated that the magnitudes of change by the different assessment methods were not significantly correlated. This may be an effect of the region‐of‐interest selection in this study. Further studies are needed to clarify the correlations between radiographic and clinical methods for assessing treatment effects.
Flurbiprofen in the prevention and treatment of experimental gingivitis
Authors: Heasman P. A. , Offenbacher S. , Collins J. G. , Edwards G. , Seymour R. A.
Published: December 2005

Abstract A clinical trial was undertaken to examine the effects of a potent cyclooxygenase inhibitor, flurbiprofen, on both developing and established gingivitis in humans. 21 subjects with healthy gingiva abstained from all oral hygiene procedures for 21 days. 7 subjects were prescribed flurbiprofen, 50 mg b.d. beginning from baseline and a control group (Cl. n= 14) were given placebo. Gingival redness and bleeding on probing were assessed at baseline, 7, 14 and 2J days. Crevicular fluid (GCF) samples were also taken to determine concentrations of PGE2, TxD2 and LTB4 at baseline and at 21 days. Results show that flurbiprofen significantly inhibited the development of redness and bleeding (p < 0.001) effects which were associated with a significant inhibition of TxB2 (p < 0.05). There were no apparent flurbiprofen effects on GCF‐PGE2 or GCF‐LTB4 during this 21‐day gingivitis model. To assess the effects of flurbiprofen on established experimental gingivitis, the model was extended to 28 days. On day 21, the C1 group was subdivided into 2 groups of 7 subjects. One group was prescribed flurbiprofen (50 mg b.d.) for 7 days and controls (C2) continued to take placebo. All subjects continued to abstain from tooth cleaning. Pretreatment (day 21) and post‐treatment (day 28) comparisons showed that flurbiprofen again significantly inhibited bleeding (p < 0.001), but did not affect redness. Control subjects demonstrated a significant elevation in gingival bleeding on day 28, and this was associated with significant rises in GCF‐PGE2 (p < 0.001), GCF‐TxB2 (p < 0.01) and GCF‐LTB4 (p < 0.05). Flurbiprofen suppressed the increases in these 3 mediators that occurred between 21 and 28 days. It is concluded that flurbiprofen controls gingival inflammation with both preventive and therapeutic properties in the experimental gingivitis model, an action that is associated with an inhibition in the production of both cyclooxygenase metabolites and indirectly affects GCF‐LTB4 levels.
Late onset Papillon‐Lefévre syndrome?
Authors: Bullon P. , Pascual A. , Fernandez‐Novoa M. C. , Borobio M. V. , Muniain M. A. , Camacho F.
Published: December 2005

Abstract We had the opportunity to study a family with one of the most destructive forms of periodontal disease known, the Papillon‐Lefèvre syndrome. The parents had no consanguinity and were not affected, and were therefore to be considered carriers of the disease. 2 sisters, the eldest and youngest, showed periodontal breakdown and hyperkeratotic skin lesions, but their deciduous dentition was not affected. 2 brothers had skin lesions only and another brother and sister were healthy. Furthermore, 2 babies died at birth one after a 9‐month pregnancy and the other after a 6‐month pregnancy, and the mother also suffered 3 miscarriages. For 4 years, we studied the family: in the case of both sisters, mechanical periodontal treatment and antibiotics were unable to control the disease. In the chromosomic study of the 2 sisters affected, the GTG banding technique found no trace of anomalies in the cells analyzed, whose chromosomic formation was 46, XX. Before treatment, the chemotaxis of the PMN, the phagocytosis of opsonized Staphylococcus aureus, and production of superoxide radicals by PMN was significantly impaired in both sisters. Despite scaling and root planing, the periodontal lesions still progressed, but the PMN functions evaluated were now normal in both sisters. An orally asymptomatic but dermatologically affected brother showed no significant defect in the phagocytic activity and the production of superoxide radicals.
Antimicrobial properties of human dentin impregnated with tetracycline HCI or chlorhexidine
Authors: Stabholz Ayala , Kettering James , Aprecio Raydolfo , Zimmerman Grenith , Baker Pamela J. , Wikesjö Uif ME
Published: December 2005

Abstract Substantivity of tetracycline HCI and chlorhexidine digluconate to human root dentin was assessed in vitro. 51 extracted single‐rooted teeth, their crowns removed, were assigned to 1 of 4 treatments in groups of 12. A control groups included 3 roots. Each group was divided into 3 subgroups to allow evaluation of drug exposure for 1, 3 or 5 min. The roots were immersed in tetracycline HCI (10 or 50 mg/ml) or chlorhexidine digluconate (0.12 or 0.2%) solutions following root planing. Control roots were immersed in sterile saline (0.9%). Following drug immersion, the roots were transferred to tubes containing 2 ml tris buffered saline. The tubes were incubated at room temperature for 22 days. Desorption media were replaced at 24‐h intervals. Removed media were examined for antimicrobial activity using a microtiter assay in which bacterial growth was evaluated by optical density readings. Roots immersed in tetracycline HCl 50 mg/ml released antimicrobial activity to successive desorption media for 14 days. Tetracycline HCl 10 mg/ml activity lasted 4 days. Roots subjected to chlorhexidine digluconate released antimicrobial activity for 24 h only. Within each treatment, there were no differences between the 3 exposure intervals of 1, 3 or 5 min. Our findings suggest usage of the periodontally exposed instrumented root as a depot for sustained release of tetracycline HCI, but not chlorhexidine digluconate, to the subgingival environment. The substantiveness of tetracycline HCI seems related to drug concentration rather than the exposure interval. Clinical trials are needed to confirm the clinical significance of these in vitro observations.
On the relationship between crown form and clinical features of the gingiva in adolescents
Authors: Olssoin M. , Lindhe J. , Marinello C. P.
Published: December 2005

Abstract The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary front tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. 108 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, thickness of the free gingiva, width of the keratinized gingiva and the contour of the marginal gingiva. From clinical photographs of the maxillary front tooth region, the width (at the apical third – CW) and the length (CL) of the crowns of the 6 front teeth were determined. A CW/ CL‐ratio was calculated for each tooth and averaged for each tooth region. The individual mean CW/CL‐ratio values for the central incisors were ranked. After correction for incisal attrition, the 10 subjects ranked highest and the 10 ranked lowest were selected as having either a long‐narrow (group N) or a short‐wide (group W) form of the crown of the tooth. The data for each of the examined parameters were averaged for each tooth region in each subject and mean values for subjects in groups W and N were compared using the Student t‐test. Stepwise multiple regression analysis, including data from the whole sample, was performed for each tooth region with the thickness of the free gingiva as the dependent variable. The results from the analyses demonstrated that individuals with a long‐narrow form of the central incisors displayed, compared to individuals with a short‐wide crown, form (i) a narrow zone of keratinized gingiva, (ii) shallow probing depth, and (hi) a pronounced “scalloped” contour of the gingival margin. There was no significant difference between groups N and W with respect to the thickness of the free gingiva. The CW/CL‐ratio data revealed that a certain form of the crowns in the central incisors was accompanied by a similar form in the lateral incisor and canine tooth region. The regression analyses demonstrated that the thickness of the free gingiva in central incisors was significantly related to (i) the width of the keratinized gingiva, (ii) the buccolingual width of the crown and (iii) the presence of an interproximal gingival groove. In lateral incisors, the thickness of the free gingiva was associated with the probing depth at the buccal surface. No single variable was significantly related to the thickness of the gingiva in canines.
Measures of treatment efficacy
Authors: Hujoel P. P. , Baab D. A. , DeRouen T. A.
Published: December 2005

Abstract Measures of treatment efficacy are those numbers we think about when we decide whether one treatment is “better” than another. Such measures quantify the differences between treatments and help patients and clinicians make informed choices. The usual measure of treatment efficacy in periodontal research has been the mean difference between treatments in probing level measures. This measure has frustrated clinicians and researchers alike for its failure to communicate the size of the association between treatment and clinical outcome. How‐does one interpret the clinical relevance of a small mean difference between treatments, such as 0.4 mm? This report compares the advantages and disadvantages of the different measures of treatment efficacy: the mean difference, the relative risk, significance levels (P‐values), the risk difference, and, the preventable fraction.
Successive removal of periodontal tissues
Authors: Lindskog Sven , Lengheden Annelie , Blomlöf Leif
Published: December 2005

Abstract The aim of the present study was to compare periodontal healing after successive removal of periodontal tissue components, from the alveolar bone to the dentin surface. The prevailing tissue reaction when adhering PDM was left on the exposed roots was that most of the bone tissue that had been removed from the buccal surfaces had regenerated and the integrity of the PDM between the new alveolar bone and cementum surface had been reestablished. On exposed etched cementum surfaces, 2 prevailing healing results were recorded. In half the number of the roots, the root surfaces were covered by connective tissue with fibers running parallel to the root surfaces in a capsule‐like arrangement. The other prevailing reaction was a thin epithelial cell‐lining running parallel to the root surfaces in close contact or partly penetrating the adjacent connective tissue. On exposed denuded dentin surfaces, gingival retraction was a constant finding, associated with an epithelial cell‐lining of varying thickness sometimes with rete pegs and cyst‐like formations. Gingival retraction was also a constant finding on etched dentin surfaces. This was associated with pathological pockets outlined by epithelial cell‐layers of varying thicknesses. The significance of these findings were discussed with special emphasis on dynamics of recurrent periodontitis.
Calculus removal from multirooted teeth with and without surgical access
Authors: Parashis A. O. , Anagnou‐Vareltzides A. , Demetriou N.
Published: December 2005

Abstract The purpose of this study was to evaluate the efficacy of the calculus removal from multirooted teeth after closed root planing, open root planing and use of a rotary diamond for the furcation area. The effect of pocket depth on the effectiveness of calculus removal was also examined. 30 first and second lower molars scheduled for extraction, with a calculus index 2 and a degree II or III furcation involvement, were divided into 3 groups: 10 molars were scaled and root planed using a closed approach; 10 molars were scaled and root planed using an open approach; 10 molars were scaled and root planed with an open approach and rotary diamond was used for removal of deposits in the furcation area. After extraction, the teeth were assessed in a stereomicroscope and the % of residual calculus was calculated on external and furcation surfaces. The % of residual calculus on the external surfaces was significantly higher after closed than open root planing (p=0.002). Pocket depth affected the effectiveness of scaling and root planing, with more residual calculus observed for depths 7 mm for both groups. Differences between the 3 groups in the % of residual calculus on furcation surfaces were statistically significant (p<0.0001 and p<0.0005). The most effective method was the combination of open root planing and rotary diamond. More calculus was observed in all groups for pocket depths 7 mm but the difference was significant only in the closed group (p=0.006). Closed root planing left more surfaces with residual calculus in the flute (70%) and the roof (60%) of the furcation than open root planing (35% and 50%). However, the most effective method was the use of rotary diamond, particularly for the flute area where residual calculus was detected on only 5% of the surfaces.
The effect of smoking on the response to periodontal therapy
Authors: Baumert Ah Michele K. , Johnson Georgia K. , Kaldahl Wayne B. , Patil Kashinath D. , Kalkwart Kenneth L.
Published: December 2005

Abstract This study evaluated the effect of smoking on the clinical response to non‐surgical and surgical periodontal therapy. 74 adult subjects with moderate to advanced periodontitis were treated according to a split‐mouth design involving the following treatment modalities: coronal scaling, root planing, modified Widman surgery, and flap with osseous resectional surgery. Clinical parameters assessed included probing depth, probing attachment level, horizontal attachment level in furcation sites, recession, presence of supragingival plaque and bleeding on probing. Data were collected: initially, 4 weeks following phase‐I therapy, 10 weeks following phase‐II therapy and on a yearly basis during 6 years of maintenance care. Data analysis demonstrated that smokers exhibited significantly less reduction of probing depth and less gain of probing attachment level when compared to non‐smokers immediately following active therapy and during each of the 6 years of maintenance (p< 0.05). A greater loss of horizontal attachment level was evident in smokers at each yearly exam during maintenance therapy (p < 0.05). There were no differences between groups in recession changes. In general, these findings were true for the outcomes following all 4 modalities of therapy and were most pronounced in the deepest probing depth category (≥ 7 mm). Statistical analysis showed a tendency for smokers to have slightly more supragingival plaque and bleeding on probing. In summary, smokers responded less favorably than non‐smokers to periodontal therapy which included 3‐month maintenance follow‐up.
A site‐by‐site follow‐up study on the effect of controlled versus poorly controlled insulin‐dependent diabetes mellitus
Authors: Seppälä B. , Ainamo J.
Published: December 2005

Abstract In the present site‐by‐site follow‐up study, the change in amount of approximal alveolar bone was assessed after 1 year from the baseline examination in 38 and after 2 years in 22 dentate subjects all with insulin‐dependent diabetes mellitus. The diabetics, aged 35 lo 56 years at baseline, had a history of a mean duration of 18 years of insulin‐dependent diabetes mellitus and were under medical treatment at the outpatient clinic of the III Department of Medicine, University Central Hospital of Helsinki as well as at 2 diabetic clinics of the Helsinki Health Centre. Based upon their Song‐term medical records, 26 subjects were after 1 year, and 16 subjects after 2 years from the baseline, identified as having poorly controlled insulin‐dependent diabetes (PIDD). At the 1‐year examination, 12 subjects were classified as having controlled insulin‐dependent diabetes (CIDD) as compared to 6 subjects at the 2‐year examination. After 1 and 2 years, from baseline, site‐by‐site measurements were recorded for plaque index scores, bleeding after probing, loss of attachment, and radiographic loss of alveolar bone. After 1 and 1 years from baseline, the PIDD subjects exhibited higher mean %s of sites with improved bleeding scores (p < 0.01, x3‐test) than the CIDD subjects. At the 2‐year examination, the mean % of sites with loss of approximal alveolar bone was greater in the PIDD than in the CIDD group (P < 0.05, X3‐test). The greatest differences between PIDD and CIDD subjects were found when recordings for only canines were analyzed at the 1 ‐ and 2‐year examinations (p<0.05, X2‐test). The results of our current 2–year longitudinal site‐by‐site examinations confirm earlier, results that poorly controlled insulin‐dependent diabetes mellitus is strongly related to the amount of alveolar bone loss.
Mineral status of skeleton and advanced periodontal disease
Authors: Klemetti E. , Collin H.‐L. , Forss H. , Markkanen H. , Lassila V.
Published: December 2005

Abstract Studies of the effect of general bone loss on periodontal condition and on development of periodontal pockets suggest that there is no clear correlation between periodontal health or number of teeth and the general mineral status of the skeleton. In some reports, however, deep periodontal pockets have been correlated with good mineral status in the jawbones and skeleton. The purpose of this study of 227 healthy postmenopausal women aged 48 to 56 years was to determine whether advanced alveolar bone loss, diagnosed by panoramic radiographs, and periodontal probing depths or number of remaining teeth were correlated with the bone mineral status of the skeleton and cortical bone in the mandible. The results suggest that individuals with high mineral values in the skeleton seem to retain their teeth with deep periodontal pockets more easily than those with osteoporosis. This finding may especially motivate treatment of persons suffering from advanced periodontal disease but having good mineral status.
A meta‐analysis of normal ranges for root surface areas of the permanent dentition
Authors: Hujoel P. P.
Published: December 2005

Abstract The typical values and normal ranges of the permanent dentition root surface areas were estimated based on a meta‐analysis of 4730 root surface area measurements collected from 22 published studies between 1950 and 1992. A typical dentition root surface area, excluding 3rd molars, was 75 cm2, and 95% of the dentitions had a total root surface area somewhere between 65 cm2 and 86 cm2. The prognostic significance of particular values of root surface areas for dental treatment outcomes requires further investigation.
Clinical and histological evaluation of ligature‐induced periodontitis in the domestic ferret
Authors: Fischer Ricardo Gulmarães , Klinge Björn
Published: December 2005

Abstract The aim of this study was to evaluate the clinical and histological characteristics of ligature induced periodontitis in 12 domestic ferrets. On day 0, silk ligatures were placed at the gingival margin level of selected experimental teeth. The contralateral teeth served as control teeth. On day 14, 4 animals and on day 28, 8 animals were sacrificed. Clinical measurements including gingival index (GI), probing pocket depth (PPD) and probing attachment level (PAL) were taken in 5 animals on days 0, 14 and 28. Histological sections were prepared for light microscopy. The histometric measurements performed were (1) the distance between the cemento‐enamel junction (CEJ) and the alveolar bone crest and (2) the distance between CEJ and connective tissue attachment level. The number of sections with root resorption areas was also observed. Cell counts were taken in 4 different areas. Clinical results showed, on days 14 and 28, a significant increase of the mean values of PPD and PAL at the experimental teeth when compared to the control teeth. The histometric results showed a significant loss of connective tissue attachment and bone loss in the experimental teeth on day 14. On day 28, the results were similar, although more sections with root resorption areas were observed in the experimental teeth. The predominant inflammatory cell in all the 4 experimental areas analyzed was polymorphonuclears (PMN), and they were mainly increased in areas closely related to the junctional epithelium. The results indicate that the domestic ferret may be used as an experimental animal in the ligature‐induced periodontitis model.
Clinical and histological evaluation of ligature‐induced periodontal breakdown in domestic ferrets immunosuppressed by Cyclosporin‐A
Authors: Fischer Ricardo Guimarães , Klinge Björn
Published: December 2005

Abstract The aim of this study was to evaluate, clinically and histologically, the effect of Cyclosporin‐A (CyA) on the progression of the periodontal breakdown in the domestic ferret, using the ligature induced periodontitis model. At the start of the experiment (day 0), silk ligatures were placed at the gingival margin level of experimental teeth. The contralateral teeth served as non‐ligated control teeth. Clinical measurements included gingival index, probing pocket depth (PPD), probing attachment level (PAL) and gingival overgrowth (GO) and they were performed on days 0, 14 and 28. Cyclosporin‐A, 10 mg/kg/d, was given subcutaneously from day 0 to 21, while in the last week there was a reduction of this dose to 5 mg/kg/d. Blood samples were taken on days 0, 14 and 28. On day 28 the animals were sacrificed. Histological sections were prepared for ligth microscopy. The histometric measurements performed were: (1) the distance between cemento‐enamel junction and the alveolar bone crest and (2) loss of connective tissue attachment. The number of sections with root resorption areas was observed. Cell counts were taken in 4 different areas. The results showed, on days 14 and 28, a significant increase of the mean values of PPD and PAL at experimental teeth as compared to the control teeth. GO was present on experimental teeth on days 14 and 28. On day 28, the control teeth presented a very small increase in GO, mainly at the buccal sites of P4 and M1. The histometric results showed a significant loss of attachment and bone resorption in the experimental teeth. Root resorption was found in experimental teeth only. The predominant inflammatory cell in the 4 experimental areas was polymorphonuclears. The number of plasma cells and lymphocytes was also significantly higher in experimental teeth than in control teeth. The results indicate that the T‐cell immunosystem may participate in defensive mechanisms against periodontal pathology in the domestic ferret. GO may be induced in ferrets under treatment with CyA and this result may be obtained quickly in sites where ligatures have been placed.