bluuebunny/crossref_metadata_2025 huggingface dataset:
Non‐steroidal anti‐inflammatory drugs in the reduction of human alveolar bone loss
Authors: Feldman Roy S. , Szeto Betty , Chauncey Howard H. , Goldhaber Paul
Published: December 2005

Abstract. Aspirin (ASA) and indomethacin are inhibitors of prostaglandin synthesis and reduce bone resorption in tissue culture stimulated by preparations obtained from human gingival tissue. In a retrospective study, we attempted to determine whether ASA or ASA plus indomethacin exert a bone resorption inhibiting effect on human alveolar bone. Dental radiographs of 75 patients with a history of arthritis and long‐term ingestion (>5 years) of ASA were compared with dental radiographs of 75 healthy male volunteers from the VA Dental Longitudinal Study (DLS), Proximal bone loss was measured using a Schei Ruler graded on a 10‐point scale. The data indicated that the ASA population presented with significantly fewer sites of 10%. or greater mesial and distal bone loss than the healthy control population (P<0.05). Mean percentage bone loss for the entire dentition was also lower in the ASA group, although the difference was not statistically significant. As there is no evidence to suggest that inhibition of alveolar bone loss is a natural concomitant of the arthritic process, we conclude that the inhibition of bone loss found in this study was due to the chronic ingestion of ASA or ASA and indomethacin.
Surface coatings on dental cementum incident to periodontal disease
Authors: Eide Bjørn , Lie Tryggve , Selvig Knut A.
Published: December 2005

Abstract. Root surfaces of extracted human teeth with advanced periodontal disease were studied by scanning electron microscopy. Near the bottom of the periodontal pocket in the area corresponding to the apically migrated junctional epithelium, the topography characteristic of uninvolved cementum was frequently masked by a surface coating. The thickness of the coating increased in a coronal direction where it often blended with calculus. The observations indicate that this surface coating may originate from the inflammatory exudate and corresponds to the dental cuticle. The findings also indicate that the coating may be mineralized and may contain exogenous substances. These observations illustrate a need for further study and reexamination of the rationale for removal of tooth substance during scaling and root planing.
Influence of Class II amalgam fillings on attachment loss
Authors: Keszthelyi G. , Szabo I.
Published: December 2005

Abstract 176 extracted teeth restored with Class II amalgam fillings, having identical distribution regarding tooth type, jaw and proximal surface localization, were investigated.

The loss of attachment was measured on stained teeth under a stereomicroscope fitted with an ocular micrometer. The cervical margins of restorations were examined with a probe.

Defective cervical margins were found in 85.8% of the 176 restorations. The mean loss of attachment on the restored surfaces (1.4 mm) was significantly higher (P<0.001) than on the sound unrestored surfaces of the same teeth (0.9 mm). Little difference was found between mesial and distal surfaces. The restored surfaces of the lower molars showed less loss of attachment, when compared to similar surfaces of upper molars and lower premolars (P<0.05).
Prevalence of bone loss in a group of Brazilian teenagers assessed on bite‐wing radiographs
Authors: Gjermo Per , Bellini Hamilton T. , Santos Vagner Pereira , Martins José Geraldo , Ferracyoli Jayme Reis
Published: December 2005

Abstract Bite‐wing radiographs were used to assess periodontal disease in 304 Brazilian 15‐year‐old schoolchildren from a population with a low socioeconomic status. The criterion for destructive periodontitis was a distance from the cementoenamel junction to the alveolar crest greater than 2 mm. 90 subjects were excluded, mainly due to missing first molars. Bone loss was diagnosed in 28% of the subjects. More males than females were affected. 50% of all lesions were observed adjacent to first molars. The juvenile periodontitis type of lesion was found in 8 subjects. It was concluded that in young populations bite‐wing X‐rays seem to be valuable in screening for individuals with incipient bone loss as well as for identification of subjects with juvenile periodontitis. In community programs regular use of this kind of roentgen examination is therefore recommended.
Periodontal bone loss in 15‐year‐old Norwegians
Authors: Hansen B. Frode , Gjermo Per , Bergwitz‐Larsen K. Reidar
Published: December 2005

Abstract The prevalence of marginal bone loss was determined on bite‐wing radiographs in 2,409 15‐year‐old schoolchildren living in the county of Buskerud, Norway. Radiographs were collected from all dentists in the area participating in the Public Dental Service. A distance exceeding 2 mm from the cementoenamel junction to the alveolar crest was recorded as bone loss. Bone loss around one or more teeth was found in 11.3% of the subjects. More males than females were affected, with prevalences of 13.7 and 9.0%, respectively. Most of the lesions were observed adjacent to the maxillary first molars. Overt infrabony pockets were found in only a very few cases (0.5%). A clinical examination of 31 of the subjects could not distinguish those with and those without bone loss. The present study has demonstrated that alveolar bone loss is a common finding in 15‐year‐old school children. It is concluded that bite‐wing roentgenograms may be useful in the detection of early bone lesions in young individuals.
Effect of various root surface treatments on the attachment and growth of human gingival fibroblasts: histologic and scanning electron microscopic evaluation*
Authors: Cogen Ronald B. , Al‐Joburi Wesam , Gant David G. , Denys Francis R.
Published: December 2005

Abstract Human teeth extracted because of advanced periodontal disease were obtained. The portions of the roots which had been exposed in periodontal pockets were either untreated or were treated with root planing or citric acid, or root planing followed by citric acid. Human gingival fibroblasts were then added to the roots so treated and were allowed to incubate for 72 h. The ability of cells to attach to and grow onto these roots was assessed by means of gross evaluation of staining intensity and by histologic and scanning electron microscopic observation. The results of multiple experiments in each root‐treatment category indicated that only roots which had been planed, whether or not citric acid demineralization was used, promoted cell attachment and growth. In addition, there were no discernible morphologic differences in the cells which were plated onto roots which were root planed only, compared to those which were root planed and citric‐acid treated. In both situations too, the cells displayed morphology typical of human gingival fibroblasts in culture.
“Spontaneous” repositioning of migrated teeth following periodontal surgery
Authors: Manor A. , Kaffe I. , Littner M. M.
Published: December 2005

Abstract The paper presents 2 cases of “spontaneous” repositioning of anterior teeth following periodontal surgery. In view of the reported cases, the present approach to orthodontic treatment of periodontal patients is questioned. It is suggested that the subject of “spontaneous” repositioning deserves more attention and that documentation and research are needed to elaborate on the subject in order to establish a sound approach to orthodontic intervention in periodontal cases.
Surface coatings on dental cementum incident to periodontal disease
Authors: Eide Bjørn , Lie Tryggve , Selvig Knut A.
Published: December 2005

Abstract Root surfaces, exposed by periodontal disease, were studied after treatment with sodium hypochlorite. Observations of the anorganic specimens demonstrated that substantial changes occur in root surfaces incident to periodontal disease. A mineralized surface coating was seen in all areas of the involved root surface, although local regions occurred where the coating was apparently unmineralized. These findings generally confirmed the results of a previous study where the same specimens were studied without hypochlorite treatment. It is concluded that the coating is probably identical to the dental cuticle, and stems from adsorption of components of the gingival inflammatory exudate to the root surface. The coating may also be the carrier matrix for exogenous cytotoxic substances, previously thought to be located in the cementum. The findings may have implications for the way of treating periodontitis‐involved root surfaces.
Depth of alveolar bone dehiscences in relation to gingival recessions
Authors: Löst Claus
Published: December 2005

Abstract Dehiscence depths were measured in vivo during surgical treatment of 113 teeth with gingival recession in 27 subjects. The average dehiscence depth determined was 5.43 mm with an average recession depth of 2.67 mm. Statistical evidence of a correlation between recession depth and dehiscence depth (average distance between lowest point of recession and dehiscence = 2.8 mm) leaves 16 affected teeth (n= 113) with a distance of 4 mm or more (up to a maximum of 7.5 mm) between the gingival margin and the alveolar crest (facial) unaccounted for. The significance of these deviations from mean values in the etiology and prognosis of recessions is discussed.
Marginal bone height in adolescents participating in different preventive dental care programs
Authors: Teiwik Anders , Johansson Lars‐Åke , Hamp Sven‐Erik
Published: December 2005

Abstract A radiographic evaluation was made of the marginal bone height in youth, subject to different preventive dental care regimens. A test group consisted of 14–15‐year‐olds who for 4 years had received preventive dental care based on oral hygiene education, professional tooth cleaning and topical fluorides and/or mouth rinsings every 3rd week. A comparison group had been given solely fluoride mouth rinsings every 2nd week with no particular emphasis on oral hygiene measures. The radiographic evaluation showed average differences between the investigated groups of less than 0.3 mm in the distance from the cementoenamel junction to the alveolar bone crest. In the mandibular premolar‐molar region of the comparison group, the marginal bone height differed significantly from the corresponding region in the test group. No such differences in the maxillary regions were noted. The clinical relevance of the results is discussed.
Middle zone of the root surface integument of human teeth affected by chronic periodontitis
Authors: Newman H. N. , Hardy J. H.
Published: December 2005

Abstract This study has confirmed the presence on the root surface of teeth affected by chronic periodontitis of a zoned organic integument analogous to that on enamel. Measurements showed a highly significant correlation between the levels of the bounding structures of this zone, that is, the apical plaque border and the coronal border of residual periodontal ligament, for both shallow and deep pockets. The middle zone between these two was on average 1 mm wide.
Potentials for root resorption during periodontal wound healing
Authors: Karring Thorkild , Nyman Sture , Lindhe Jan , Sirirat Mullika
Published: December 2005

Abstract The present study was undertaken to examine whether (1) the process of resorption, which invariably affects periodontitis involved reimplanted roots facing bone or gingival connective tissue during healing, is a transient phenomenon and, (2) root resorption can be prevented by permitting downgrowth of epithelium along the root surface. A total of 24 teeth in 2 monkeys (Macaca cynomolgus) was subjected to experimental periodontal tissue breakdown by the placement of elastic ligatures around the teeth. The ligatures were left in situ until about 50% of the supporting tissues had been lost. Following removal of the ligatures, the teeth were extracted and the denuded portions of the roots were scaled and planed. The crowns of the teeth were resected and the root canals filled with guttapercha. The roots were subsequently implanted into sockets prepared in the jaw bone in such a way that each root was embedded in bone except for a portion which was in contact with gingival connective tissue. 1 month prior to sacrifice of the animals, the cut surface of the coronal part of the roots was exposed by removal of the covering soft tissue. The epithelium was thereby allowed to migrate into the wound. Implantation of the roots was scheduled to provide healing periods of 1, 2, 3, 4, 8, 12, 16, 20 and 24 weeks before exposure of the roots.

The histologic examination of the implant specimens disclosed that replacement resorption was a progressive process which eventually resulted in the elimination of the transplanted roots. It was possible to prevent root resorption in this model by permitting apical downgrowth of epithelium along the root surface during the initial phase of healing. The results are discussed in relation to procedures used in periodontal therapy.
Effect of nonsurgical periodontal therapy
Authors: Badersten Anita , Nilveus Rolf , Egelberg Jan
Published: December 2005

Abstract Healing events following nonsurgical periodontal therapy in patients with periodontal pockets up to 12 mm deep were investigated. Incisors, cuspids and premolars in 16 patients were treated by plaque control and supra‐ and subgingival debridement using hand or ultrasonic instruments in a split mouth approach. The results were evaluated by recording of plaque scores, bleeding on probing, probing pocket depths and probing attachment levels. Minimal change in gingival conditions occurred during the initial 3 months of experimentation, which were utilized for plaque control measures alone. Subsequent to instrumentation and during the following 9‐month period, a gradual and marked improvement of periodontal conditions took place. During the remaining 12 months of the 24‐month experimental period no further changes of the recorded parameters were noted. No differences in results could be observed when comparing hand versus ultrasonic instrumentation, or when comparing the results of 2 different operators. Initially, a total of 305 sites demonstrated probing pocket depths 7 mm. At the 24‐month examination 43 such sites remained. The results indicate that there is no certain magnitude of initial probing pocket depth where nonsurgical periodontal therapy is no longer effective.
The effect of root planing as compared to that of surgical treatment
Authors: Isidor Flemming , Karring Thorkild , Attström Rolf
Published: December 2005

Abstract This study was undertaken in order to evaluate the effect of root planing as compared to that of surgical periodontal treatment in patients with advanced periodontal disease. 17 patients with advanced periodontal disease participated in the study. After the initial examination, the teeth were scaled and the patients were given instruction in performing proper oral hygiene. The hygienic phase for the individual patient was continued until less than 20% of the tooth surfaces demonstrated plaque at 2 succeeding appointments. After re‐assessment of the periodontal status, 1 side in both the maxilla and mandible was treated with modified Widman flap surgery. In I of the remaining quadrants, in the maxilla or mandible, reverse bevel flap surgery was used. Bone contouring was not performed in any of the surgical procedures. The last quadrant was subjected to meticulous root planing under local anesthesia. Subsequently, the patients were recalled every second week for professional tooth cleaning. The periodontal status of each patient was assessed 3 and 6 months following treatment.

Root planing resulted in considerable reduction in pocket depth, although more shallow pockets were obtained following modified Widman flap and reverse bevel flap surgery. Clinical gain of attachment was obtained following all 3 modalities, but root planing resulted in slightly more gain of attachment than the 2 surgical procedures.
Evaluation of cause‐related periodontal therapy and compliance with maintenance care recommendations
Authors: Johansson Lars‐Åke , ÖSter Britt , Hamp Sven‐Erik
Published: December 2005

Abstract An evaluation of the long‐term clinical effects of an intense period of cause‐related periodontal therapy provided by dental hygiene students, was made in patients with moderately advanced periodontitis. By the evaluation, we also intended to gain information about compliance with given recommendations for periodontal health maintenance. The results after 3 years without supervision by the specialist team showed that achieved beneficial effects on the gingival conditions were maintained despite a significant increase in plaque prevalence. Recommendations as to the daily use of a variety of additional oral hygienic measures besides toothbrushing met with a considerable lack of compliance. Maintenance visits to the referring general practitioner were mostly made once a year and included regular dental care. Despite this, no further deterioration of periodontal status was observed. The results indicate that it may be possible to maintain successful effects of periodontal therapy in this patient category with less personal and professional effort than traditionally recommended.
Relationship of ascorbic acid levels of blood and gingival tissue with response to periodontal therapy
Authors: Woolfk S. N. , Kenney E. B. , Hume W. R. , Carranza F. A.
Published: December 2005

Abstract The effect of ascorbic acid megadoses on gingival clinical parameters and vitamin content of blood and gingival tissue was studied. 10 nondeficient individuals, carefully matched according to age, periodontal status, and oral hygiene level, were divided into 2 groups: one received 250 mg q.i.d. of ascorbic acid and the other a placebo. After 1 week on the tablet all patients were scaled and root planed and received oral hygiene instructions. Blood samples and clinical parameters were obtained at baseline and 2, 6, and 7 weeks after. A gingival biopsy was taken at week 6.

Correlations between the clinical parameters and the ascorbic acid levels at the different time periods revealed no significant differences between the vitamin and the placebo groups, therefore suggesting that the use of megadoses of vitamin C in normal human subjects does not have a predictable or strong effect on the gingival response to initial therapy.
Comparison of the effect of chlorhexidine and CuSO4 on plaque formation and development of gingivitis
Authors: Waerhaug Marthe , Gjermo Per , R∅oslla Gunnar , Johansen Jan R.
Published: December 2005

Abstract Recent studies have shown that several metal ions inhibit plaque formation and reduce the acidogenicity of dental plaque. The aim of the present study was to compare the effect on plaque and gingivitis of 2.2 mM CuSO4 with an equimolar solution of chlorhexidine in a modified experimental gingivitis model. The study was performed according to a double‐blind cross‐over design. Before each experimental period the GI was recorded and the participants’ teeth were scaled and polished to remove all supragingivul deposits. All mechanical oral hygiene was suspended during the experimental periods. The mean PlI after rinsing with chlorhexidine, CuSO4 and water was 0.29, 0.79 and 1.25, respectively. The corresponding GI values were 0.57, 0.83 and 1.02. All differences were statistically significant. The results showed that CuSO4 inhibits plaque formation and development of gingivitis, but not to the same degree as chlorhexidine.
Localized juvenile periodontitis and generalized severe periodontitis: clinical findings
Authors: Burmeister J. A. , Best A. M. , Palcanis K. G. , Caine F. A. , Ranney R. R.
Published: December 2005

Abstract Medically healthy subjects (N=103), 10–32 years of age, with localized (juvenile periodontitis = JP) or generalized (severe periodontitis=SP) advanced periodontal disease were analyzed for interrelationships of sex, race, age and clinical findings. Females predominated (2:1) in both JP and SP. There were significantly more subjects of the black race in JP, but when age was included as a cofactor the race distinction became insignificant. While whole mouth Plaque and Gingival Indices were lower in JP, these values at sites with attachment loss were equally high in both groups. Extent of disease was significantly related to both plaque and age in SP, and to plaque but not to age in JP. This suggests the existence of a factor(s) in JP which interfere(s) with the age‐plaque‐disease relationships found in SP and present in adult periodontitis. Contrary to implications of some definitions of JP, periodontal attachment loss was strongly associated with plaque and gingival inflammation in both localized and generalized patterns of disease.
Effect of combined systemic antimicrobial therapy and mechanical plaque control in patients with recurrent periodontal disease
Authors: Lundströum ÅSa , Johansson Lars‐Åke , Hamp Sven‐Erik
Published: December 2005

Abstract The aim of the present study was to analyze‐the effect of systemic antimicrobial therapy and mechanical plaque control in patients with recurrent periodontal disease. 9 patients volunteered for the combined therapy. At a baseline examination they were randomly distributed into 2 groups, one given tetracycline therapy for 2 weeks and the other metronidazole therapy for 1 week. A mechanical plaque control program comprising oral hygiene training, professional cleaning of all teeth and subgingival debridement at diseased sites was carried out at the baseline examination and at all recall visits, i.e. once every month during the first 6 months and then after 9, 12, and 18 months.

The results demonstrated clinically and microbiologically that a combination of an initial antimicrobial and a continuous systematic mechanical plaque control program may be a valuable therapeutic approach in a strictly selected group of refractory patients. Recurrent periodontal lesions which still displayed severe inflammation despite renewed conventional therapy showed a marked reduction in probing depths, bleeding and suppuration from the pockets, and further, a reduced presence of spirochetes and motile rods during the trial. The results indicate that the level and longevity of success is also related to whether or not self‐performed oral hygiene measures are sufficiently carried out. No superior effect of the combined program could be observed in cooperating patients receiving tetracycline as compared with those given metronidazole.
Comparison of the clinical effectiveness of a single and a double headed toothbrush
Authors: Bastiaan Ross J.
Published: December 2005

Abstract A 3‐way, blind, cross‐over study was done to compare the plaque removing effects of a double headed toothbrush with a popular single headed flat toothbrush in 39 patients instructed in specific oral hygiene techniques. Both brushes were used with the modified Bass technique for 1 week each, whilst for an additional consecutive week, the single headed brush was used with the modified Bass and roll techniques combined.

The results of this study indicated that, lingually, the double headed brush was superior to the flat single headed brush, whilst buccally no difference was found. With single headed toothbrushes the combined toothbrushing action of the modified Bass and roll techniques was less efficient than the modified Bass technique alone in the removal of dental plaque.
The rests of Malassez and chronic marginal periodontitis
Authors: Spouge John D.
Published: December 2005

Abstract The structure of the rests of Malassez and the relationship which they bear to the junctional epithelium in the marginal region of pigs’ molars was investigated. A 3‐dimensional picture of the marginal rests and their relationship to the junctional epithelium was built up by means of standardized photomicrocraphs made from serial sections. In teeth involved in chronic marginal inflammation, the rests in this region appeared to form a continuous network and we confirmed the original suggestion of Grant & Bernick that, at frequent intervals, the junctional epithelium “…seemed to be continuous with the epithelial rests in the upper third of the root …”.

If the anatomical relationship of the rests in man resembles that seen in the pig and they form a continuous network communicating at intervals with the junctional epithelium, this relationship must inevitably lead to speculation about the effects of any potential for reactive proliferative equivalent to that which is frequently seen in the apical region. It is possible that the rests might be acting as the “thin end of the wedge”, augmenting and facilitating apical migration of the junctional epithelium during the pathogenesis of the periodontal pocket.
The relationship between attachment level loss and alveolar bone loss
Authors: Goodson J. M. , Haffajee A. D. , Socransky S. S.
Published: December 2005

Abstract Standardized radiographs and repeated periodontal probe measurements were made on 22 untreated subjects with destructive periodontal disease monitored for I year. Radiographs of selected sites were taken at 0, 6 and 12 months. Measurements of attachment level were made monthly. Radiographic measurements were made on 7× magnified projected images. Alveolar bone height from the CEJ Was Computed by multiplying the average length of the root times the measured ratio of CEJ To Alveolar bone over CEJ To Root tip. Each radiograph was measured twice by 2 investigators. Sites were excluded as having indistinct anatomical landmarks in which the standard deviation of the 4 measurements exceeded 0.16 mm, the measurement error for repeat determination of bone height on high quality radiographic images. A 3 sigma critical value for significant bone loss was selected as 0.48 mm. Changes in attachment level were computed for the intervals preceding and during the 6–12 month radiographic measurement period. Based on these critical values, 6.1% of the 231 radiographed sites showed significant bone loss. Similarly, 5.7% of the 1155 probed sites showed significant attachment loss. However, none of the sites with significant bone loss exhibited significant attachment loss over the same time period. In general, significant attachment loss preceded bone loss by 6 to 8 months. At 4 mm, attachment loss was found to predict subsequent bone loss with a true positive ratio of 60% and a false positive ratio of 5%, indicating a high degree of predictive discrimination. These observations indicate that attachment loss precedes radiographic evidence of crestal alveolar bone loss during periods of periodontal disease activity.
The effects of the inverse bevel flap procedure on gingival contour and plaque accumulation
Authors: Newman P. S.
Published: December 2005

Abstract Periodontal surgery should eliminate disease and produce a good gingival contour to allow ease of cleaning and maintenance. An important factor in the achievement of these aims may be the contour of the attached gingiva following surgery. At present, gingival contour is evaluated by one of two indices. A new disease‐related gingival contour index was designed and compared with existing indices (plaque index, periodontal index, sulcus bleeding index) following inverse bevel flap procedures. The results demonstrated that there was a statistically significant increase in the scores for gingival contour (p<0.001) a significant decrease in scores for the periodontal index (p<0.001) and sulcus bleeding index (p<0.05), but no change in the amounts of plaque accumulating (p>0.7).
Utilization of locus of control in the prediction of patients’ oral hygiene performance
Authors: ÖDman Per A. , Lange Allan L. , Bashar Bakdash M.
Published: December 2005

Abstract This study investigated the relationship between internal and external locus of control classified patients and improvement in oral hygiene skills and plaque scores. Locus of control scores, and initial and final skill and plaque scores were recorded for 22 dental patients with moderate periodontitis. Oral hygiene instruction was given over a 3‐month period to each patient. Although patient oral hygiene skill level increased significantly and plaque scores declined significantly, no relationship was detected between the locus of control personality dimension and skill or plaque scores. It was concluded that personal oral hygiene instruction reinforced by self‐instructional manual was effective in improving oral hygiene skill and reducing plaque scores; additional strategies for future studies investigating the locus of control dimension were presented.
Treatment of localized juvenile periodontitis
Authors: Lindhe Jan , Liljenberg Birgitta
Published: December 2005

Abstract The present investigation was performed to study the effect on localized juvenile periodontitis (LJP) of a treatment program which included tetracycline administration, surgical elimination of inflamed tissues, scaling and root planing, and careful plaque control during healing. Treatment of LJP lesions was carried out on 16 individuals aged 14 to 18 years (JP group). Lesions in first molars and incisors in a group of patients with adult periodontal disease (AP) were treated in an identical manner and served as controls. The presence of angular bony defects adjacent to first molars and incisors was first documented in all patients. Thereafter, a clinical examination was carried out, including assessments of oral hygiene status, gingival conditions, probing depths and attachment levels. The patients were subjected to a treatment program involving administration of tetracycline (250 mg 4 times per day for 2 weeks), removal of granulation tissue after flap elevation, and root curettage. After surgery, the patients were instructed to rinse the mouth with 0.2% chlorhexidine for 2min twice a day during the first 2 postsurgical weeks. Professional tooth cleaning was carried out once every 3 months during a 5‐year period. At 6, 12, 24 and 60 months after surgical treatment, the patients were re‐examined regarding oral hygiene, gingival conditions, probing depths and attachment levels. Treatment of LJP lesions resulted in resolution of gingival inflammation, gain of clinical attachment, and refill of bone in angular bony defects. The healing of the lesions of this patient sample was similar to healing observed in patients with AP.
Influence of variations in projection geometry on the detectability of periodontal bone lesions
Authors: Gröundahl Kerstin , Gröundahl Hans‐Göuran , Webber Richard L.
Published: December 2005

Abstract The influence of differences in imaging geometry on the detection of small periodontal bone lesions was studied when using a digital subtraction technique. The results were compared with those from conventional radiographs. Reference radiographs were obtained on human mandibular jaws before small lesions were made in the marginal alveolar bone. Subsequent radiographs were taken with the same imaging projection as well as with changes of the angulation in cither vertical, or horizontal direction, or both.

10 dentists served as observers, who compared the conventional radiographs taken before and after the lesions were made, and registered the presence or absence of lesions using a diagnostic rating scale. The conventional radiographs were digitized, and subtraction images made. These images were interpreted by the same observers. For each observer, image modality and projection, the resulting rates of true positive and false positive diagnoses were plotted on a graph. The area under the curve, obtained by connecting the paired values of true positive and false positive results associated with the different diagnostic ratings, was used as a measure of diagnostic accuracy. Statistically significant differences could be demonstrated between the results obtained from the subtraction images, whether produced from identical or non‐identical pairs of conventional radiographs, and the results from the conventional radiographs obtained under ideal conditions.
Long‐term effect of surgical/non‐surgical treatment of periodontal disease
Authors: Lindhe J. , Westfelt E. , Nyman S. , Socransky S. S. , Haffajee A. D.
Published: December 2005

Abstract The present investigation describes the effect of periodontal therapy in a group of patients who, following active treatment, were monitored over a 5‐year period. One aim of the study was to analyze the role played by the patients’ self‐performed plaque control in preventing recurrent periodontitis. In addition, probing depth and attachment level alterations were studied separately for sites with initial probing depths of 4 mm which were treated initially by either surgical or non‐surgical procedures.

Following active treatment (surgical/non‐surgical), the patients were maintained on a plaque control regimen for 6 months, which included professional tooth cleaning once every 2 weeks. During the subsequent 18 months, the interval between the recall appointments was extended to 12 weeks and included prophylaxis as well as oral hygiene instruction. Following the 24‐month examination, the interval between the recall appointments was further extended, now to 4–6 months. In addition, the maintenance program was restricted to oral hygiene instruction and professional, supragingival tooth cleaning, but further subgingival instrumentation was avoided. Clinical examinations including assessments of the oral hygiene, the gingival conditions, the probing depths and the attachment levels were performed at Baseline and after 24 and 60 months after completion of active therapy. Assessments of plaque and gingivitis were repeated annually.

The results of the examinations showed that the patients’ standard of self‐maintained oral hygiene had a decisive influence on the long‐term effect of treatment. Patients who during the 5 years of monitoring consistently had a high frequency of plaque‐free tooth surfaces showed little evidence of recurrent periodontal disease, while patients who had a low frequency of plaque‐free tooth surfaces had a high frequency of sites showing additional loss of attachment. The present findings demonstrated that sites with an initial pocket depth exceeding 3 mm responded equally well to non‐surgical and surgical treatments. This statement is based on probing depth and attachment level data from sites which were free of plaque at the 6‐, 12‐, 24‐, 36‐, 48‐ and 60‐month reexaminations. It is suggested that the critical determinant in periodontal therapy is not the technique (surgical or non‐surgical) that is used for the elimination of the subgingival infection, but the quality of the debridement of the root surface.
Phenytoin induced gingival overgrowth in institutionalized epileptics
Authors: Hassell Thomas , O'Donnell Joseph , Pearlman Joel , Tesini David , Murphy Terry , Best Henry
Published: December 2005

Abstract. In a cross‐sectional, epidemiological study of phenytoin induced gingival overgrowth in 77 institutionalized persons with epilepsy, the severity of the gum lesions was quantified by means of a precise new technique. Lesion severity was then compared statistically to other clinical and laboratory parameters. Positive correlations were detected between overgrowth severity and gingival inflammation, probing depths, calculus accumulation, plaque score and the measurement gingival margin to mucogingival junction (GM‐MGJ). No correlation was observed between lesion severity and patient age, daily drug dosage, plasma or saliva phenytoin level, or salivary concentration of the major phenytoin metabolite.
Frequency of gingival lesions after standardized brushing as related to stiffness of toothbrush and abrasiveness of dentifrice.
Authors: Niemi Maija‐Liisa , Sandholm Leena , Ainamo Jukka
Published: December 2005

Abstract. This clinical trial was primarily designed to determine to what extent the stiffness of toothbrush bristles and the abrasiveness of dentifrices influence the degree of gingival erosion. Further, the plaque removing effectiveness of the toothbrushes and dentifrices tested was evaluated. 24 dental hygienist students with clinically healthy gingivae volunteered for the study. A “soft” toothbrush with a bristle thickness of 0.15 mm, a “hard” toothbrush with a bristle thickness of 0.23 mm and 2 dentifrices of different abrasiveness were used for the experiment. The 2 brushes were also used without a dentifrice. Prior to each examination the teeth of the test subjects were brushed by the same dental hygienist. Evident signs of laceration or ulceration at any 1 of 4 gingival aspects of each tooth were recorded as brushing injuries. The teeth were then stained with basic fuchsin and the amount of remaining plaque was assessed according to the PLQ Index (Bay & Ainamo 1974).

The use of the hard brush resulted in lower plaque scores and, at the same lime, more gingival erosions than the use of the soft brush. With both brushes a significantly greater number of lesions was recorded after use of an abrasive powder than when no dentifrice was employed. The difference in the amount of erosions occurring when utilizing either brush, without a dentifrice or with a moderately abrasive toothpaste, was not, however, found to be statistically significant. When assessed separately for the 2 brushes, the slight tendency towards lower PLQ scores with increasing abrasiveness of the dentifrice was not considered statistically significant. The study showed that the modest decrease observed in mean PLQ scores with increasing stiffness of the toothbrush bristles and with increasing abrasiveness of the dentifrice is accompanied by increased damage caused to the soft gingival tissues.
Effect of non‐surgical periodontal therapy
Authors: Badersten Anita , Nilvéus Rolf , Egelberg Jan
Published: December 2005

Abstract Healing following non‐surgical periodontal therapy was studied and the results of instrumentation performed by 6 operators compared. Incisors, cuspids and premolars with periodontal pockets up to 11 mm deep in 20 patients were treated by plaque control and a single episode of supra‐ and subgingival debridemem. A split‐mouth approach was used to compare the participating therapists. The effects of the therapy were monitored using changes in plaque score, bleeding score, probing pocket depth and probing attachment level. Marked improvement, similar to that seen in previous studies evaluating non‐surgical therapy was noted during the initial 6–9 months. No further changes of the recorded parameters could be observed during the rest of the 24‐month observation period. Differences between sites treated by the various operators were negligible. Thus, it appears, that deep periodontal pockets in incisors, cuspids and premolars may be successfully treated by plaque control and 1 episode of instrumentation and that operator variability may be limited.
Chemical plaque control and extrinsic tooth discoloration
Authors: Eriksen Harald M. , Nordbø Hakon , Kantanen Heidi , Elungsen Jan Eirik
Published: December 2005

Abstract The etiology of extrinsic tooth discolorations due to chemical, plaque‐preventive agents is not fully understood. However, information from experimental investigations point to at least 3 possible mechanisms. (A) Non‐enzymatic browning reactions (Maillard reactions). (B) Formation of pigmented metal (Fe, Sn)‐sulfides. (C) Reaction products of food and beverage constituents and chemical, plaque‐preventive compounds. Available evidence indicates that browning (A) and formation of pigmented metal sulfides (B) are the most likely causes of these discolorations while dietary factors (C) may play a modifying role.
Effect of non‐surgical periodontal therapy
Authors: Badersten Anita , Nilvéus Rolf , Egelberg Jan
Published: December 2005

Abstract Incisors, cuspids and premolars in 49 patients with advanced chronic periodontitis were treated with initial, non‐surgical periodontal therapy. The results were monitored by probing attachment level measurements at 6 sites of each tooth every 3rd month during a period of 24 months. A series of 9 probing attachment level measurements for each site was subjected to linear regression analysis. The slope of the regression line, the projected probing attachment loss during the 24‐month interval (Δy) and the probability level of the slope were calculated for each site. 2 groups of sites with probing attachment loss were identified: group 1: sites with Δy > 1.5 mm and p < 0.05: group 2: sites with Δy > 1.0mm and p < 0.05. Group 1 included 120 sites (5 %) and group 2 included 265 sites (10 %) of the total of 2532 available sites. In both groups, probing attachment loss was more frequently noticed for sites with an initial probing depth ≤ 3.5 mm than for sites with initial probing depth ≥ 7.0mm. The finding that the majority of sites with probing, attachment loss was found amongst initially shallow or moderately deep lesions may indicate attachment loss due to trauma associated with therapy rather than loss as a result of a continuing, inflammatory disease process.
Effect of crown‐attached sutures on healing of experimental furcation defects in dogs
Authors: Klinge Björn , Nilvéus Rolf , Egelberg Jan
Published: December 2005

Abstract This study evaluates whether suturing of replaced flaps with crown‐attached sutures, following reconstructive surgery, counteracts postoperative recession of the gingival margins and facilitates new attachment.

Through‐and‐through furcation defects were created in the mandibular premolars of 5 beagle dogs. Bone was surgically removed from the furcation and around each root to a level 3 to 4 mm below the cemento‐enamel junction. Steel wires were placed in the furcations for 6 weeks to enhance plaque formation. After 12 weeks, reconstructive surgery that included acid conditioning of root surfaces was performed. On 1 side of the mandible, the flaps were replaced and secured by bonding the sutures to the teeth with composite resin. On the other side, the replaced Caps were sutured interdentally with single sutures. The results demonstrated that the margins of flaps secured with interdental sutures shifted apically to the fornix of the furcations after 1 week, and histologically all 10 furcations were found to be lined with epithelium. Margins of flaps secured with crown‐attached sutures remained an average of 0.5 mm coronally to the fornix, and 13 of the 14 teeth showed new attachment.

The results indicate that a suturing technique which counteracts gingival recession, favours the formation of new attachment in this beagle dog model.
Loss of attachment adjacent to class II carious lesions
Authors: Keszthelyi G. , Szabo I. , Strahan J. D.
Published: December 2005

Abstract The present study was designed to investigate the relationship between large open class II carious lesions and loss of periodontal attachment in 224 extracted teeth. Each tooth had a carious and a sound approximal surface. The teeth were divided into 4 groups: upper premolars. upper molars, lower premolars and lower molars each consisting of 56 teeth. Within each group, the carious lesions were divided equally between the mesial and distal surfaces. The teeth were stained and loss of attachment was measured under a stereomicroscope fitted with an ocularmicrometer. The difference in loss of attachment between carious (0.79±0.05 mm)and sound (0.76±0.04 mm) surfaces was not statistically significant. Loss of attachment was greater on the carious surface of 98 teeth, equal to in 40 teeth and Jess in 86 teeth than the sound surface. Mesial and distal surfaces with and without carious lesions exhibited essentially the same degree of loss of periodontal support. Upper molars and lower premolars tended towards more loss of attachment when compared with upper premolars and lower molars. The results indicate that large open class II carious lesions cannot be regarded as an important factor in the progression of attachment loss.
Subgingival spirochete and leukocyte counts as indicators of response to therapy
Authors: Claffey Noel , Magnusson Ingvar , Crigger Max , Garrett Steven , Kiger Robert D. , Egilberg Jan
Published: December 2005

Abstract The aim of this study was to determine whether changes in probing attachment levels are related to subgingival spirochete or leukocyte counts in periodontal pockets. Following initial clinical recordings and therapy consisting of oral hygiene instruction and root debridement, the probing attachment levels of proximal sites of 120 single‐rooted teeth in 7 patients were measured every 3 months for 12 months. The measurements of each site were subjected to regression analysis, which determined whether the site was deteriorating, improving, or non‐changing. Subgingival washings were taken of 19 deteriorating, 22 improving, and 127 non‐changing sites to determine the number and % of spirochetes and the number of leukocytes at each site. Improved probing attachment levels were associated with reduced numbers of spirochetes and leukocytes. However, the ranges of individual measurements of subgingival washing variables overlapped considerably between groups. Spirochete and leukocyte counts related better to the 12‐month probing depths than to changes in probing attachment levels during the preceding 12 months. These findings suggest that none of the tested subgingival washing parameters are suitable indicators of changes in attachment levels on an individual site basis.
Gram negative species associated with active destructive periodontal lesions
Authors: Dzink J. L. , Tanner A. C. R. , Haffajee A. D. , Socransky S. S.
Published: December 2005

Abstract Apical subgingival plaque samples were taken from 19 subjects exhibiting active destructive periodontal disease. The predominant cultivable Gram negative species from 50 active sites were compared to 69 inactive sites of comparable pocket depth and attachment level loss. Active disease sites were chosen which showed a significant loss of attachment within a two‐month interval.

Proportions of Gram negative rods were higher in active periodontal disease sites than in inactive sites. Species which were found to be significantly elevated only in active sites were Bacteroides intermedius, “fusiform”Bacteroides, Actinobacillus actinomycetemcomitans, and Wolinella recta. Fuso‐hacterium nucleattum, Capnocytophaga gingivalis, and Eikenella corrodens, were found in significantly increased proportions in active sites of some subjects and inactive sites of others.
The effect of rinsing with Listerine antiseptic on the properties of developing dental plaque
Authors: Fine D. H. , Letizia J. , Mandel I. D.
Published: December 2005

Abstract Plaque was collected from a group of volunteers who used either Listerine antiseptic (LA), its vehicle control (V), or a water control (C) twice daily in addition to their normal tooth brushing in a double‐blind controlled clinical experiment. Following the 9‐monlh clinical study, plaque collected from the supragingival surfaces of 20 teeth from each of 78 subjects was weighed wet, freeze dried. reweighed, resuspended, sonicated and estimated for protein. In addition, endotoxin activity was evaluated by means of the limulus lysate assay. A 52.6% reduction in wet weight was found LA versus C (p= 0.04); LA versus V showed a 55.1% reduction (p= 0.03). A 59.0% reduction in dry weight was found LA versus C (p= 0.01); LA versus V showed a 59.6% reduction (p= 0.01). A 59.7% reduction in plaque protein was seen LA versus C (p= 0.01); LA versus V showed a 59.2% decrease (p= 0.02). A 75.8% reduction in limulus lysate activity was found LA versus C (p= 0.01); LA versus V showed u decrease of 77.9% (p= 0.01). Our results demonstrate that LA has a dramatic effect on plaque toxic activity, as measured by a decrease in limulus lysate assay, as well as on its biomass.