bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of flap management and bioresorbable occlusive devices in GTR treatment of degree III furcation defects
Authors: Lindhe J. , Pontoriero R. , Berglundh T. , Araujo M.
Published: December 2005

Abstract The present experiment on guided tissue regeneration had 2 objectives namely: (i) to study if an improved anchorage of the soft tissue flaps during the initial healing period after membrane placement would reduce the tendency for soft tissue recession and allow for healing of also large furcation defects; (ii) to determine if the use of biodegradable membranes in GTR procedures may promote new attachment formation in degree III furcation defects. 2 experiments were performed which included 5 and 8 dogs each. In each animal, the 3rd pre‐molar of the left or right side of the mandible was selected as test site using the contralateral tooth as control. 2 months prior to the start of the experiment, the 2nd and 4th premolars in each side of the mandible were extracted. The extractions were performed to create a large edentulous space mesial and distal to the 3rd premolar. During GTR therapy the incisions prepared in this edentulous region were used to allow proper suture retention and flap stability during the initial phase of healing. In study 1, furcation defects (degree III) were prepared and subsequently treated according to GTR using e‐PTFE membranes in the test and no membrane in the control site. In study 2, a bioresorbable membrane (Resolut®) was installed in the test and an e‐PTFE membrane in the control sites. The non‐resorbable membranes were removed after 30 days. The animals were sacrificed 5 months after reconstructive surgery, biopsies were harvested, sectioned and analyzed histologically for new connective tissue attachment and bone. The results demonstrated that comparatively large furcation defects can be successfully regenerated by GTR therapy provided the membrane‐covering soft tissue flaps are prevented from receding apical of the furcation fornix during healing. Our findings also disclosed that a biodegradable membrane provides a barrier which is equally effective as a non‐degradable teflon membrane in a GTR procedure.
New attachment and bone formation in periodontal defects following treatment of submerged roots with guided tissue regeneration
Authors: Sander L. , Karring T.
Published: December 2005

Abstract The purpose of the present study was to examine the effect on periodontal regeneration of preventing bacterial contamination of the membrane material following the guided tissue regeneration procedure (GTR). Periodontal dehiscence defects were surgically produced in 2 monkeys. In each monkey, 8 of these defects were submerged after resection of the crowns of the teeth and a teflon (Gore‐Tex Periodontal Material®) or a polyglactin (Vicryl Mesh®) membrane was adjusted to cover the defect and the exposed root surface. 4 defects on non‐crown resected teeth were treated with either a teflon or a polyglactin membrane positioned with the coronal border approximately 2 mm below the margin of the covering tissue flap. Following 6 months of healing, the animals were sacrificed. Histological evaluation of the specimens revealed that roots which were kept completely covered during the healing period demonstrated new connective tissue attachment and bone formation corresponding to 67–100% of the length of the initial defect depth, whereas the amount of new connective tissue attachment and bone on non‐submerged roots ranged between 30–59% and 11–31%, respectively. It seems reasonable to anticipate that it is bacterial contamination of the membrane material which jeopardizes the formation of new connective tissue attachment but in particular bone formation following the GTR‐procedure.
Healing of periodontal lesions in monkeys following the guided tissue regeneration procedure A histological study
Authors: Sander L. , Karring T.
Published: December 2005

Abstract The purpose of the present investigation was to study histologically the healing of periodontal lesions in monkeys during the first 9 weeks following periodontal reconstructive surgery according to the principle of guided tissue regeneration. Horizontal interproximal lesions and through‐and‐through bifurcation defects were surgically produced in 2 adult monkeys. Following removal of granulation tissue and root planing, notches indicating the level of the reduced bone level were prepared in the root surfaces. Sterile teflon membranes were then adjusted to cover the defects, and the gingival flaps were sutured in a coronally displaced position. Sacrifice of the animals was scheduled to allow for observation periods of 1, 3, 4 and 9 weeks. Evaluation of histological specimens revealed a continuous growth of new connective tissue during a period of 4 weeks. The coronal growth of new tissue did not increase significantly between 4 and 9 weeks. New cementum had formed in the most apical part of one notch after 1 week of healing, and following 3 and 4 weeks, new cementum with inserting periodontal ligament fibers were observed in all notches and to a varying degree, also more coronally on the root surfaces of both interproximal and bifurcation defects. Limited regrowth of alveolar bone was observed in the 9‐week specimens. Judged from the course of the blood vessels within the newly formed connective tissue in the defects, the tissue in the central part of the defects had originated from the alveolar bone, whereas the tissue adjacent to the root surfaces seemed to have its origin in the residual periodontal ligament.
Variational expression of functionally different macrophage markers (27E10, 25F9, RM3/1) in normal gingiva and inflammatory periodontal disease
Authors: Gómez R. Schlegel , Langer P. , Pelka M. , von den Driesch P. , Johannessen A.C. , Simon M.
Published: December 2005

Abstract Keratinocytes and macrophages share under immunologically activated conditions several surface proteins. We investigated immunohistochemically with monoclonal antibodies and the APAAP technique the expression pattern of 27E10 antigen (inflammatory macrophages), 25F9 antigen (resident macrophages) and RM3/1 antigen (intermediate macrophages in healing tissue) in 29 specimen biopsies of different stages of gingivitis and periodontitis. Macrophages of each subtype exhibited a different localization pattern depending on the stage of inflammation. Furthermore, suprabasal oral gingival epithelia showed a constant 27E10 expression, independent of the stage of inflammation. In contrast, all layers of the sulcus and pocket epithelia in gingivitis and periodontitis were strongly 27E10‐positive, indicating immunological activation. 25F9 antigen was expressed on basal keratinocytes independent of the stage of inflammation, whereas RM3/1 was constantly negative on keratinocytes. The expression pattern of these functionally different macrophage markers on lesional macrophages and keratinocytes indicates varying differentiation and activation and suggests a participation of these cells in the local immune response in periodontal infection.
Risk factors for periodontal diseases in Ilala, Tanzania
Authors: Mumghamba Elifuraha G. S. , Markkanen Heleena A. , Honkala Eino
Published: December 2005

Abstract The purpose of this study was to evaluate associations between periodontal diseases and the common risk factors in Ilala, Tanzania. To determine behavioural and socioeconomic background, a total of 1764 subjects (827 males and 937 females) aged 3–84 years were randomly selected and interviewed. The subjects were examined clinically for the presence of plaque, calculus, gingival inflammation, periodontal probing depths and gingival recessions. Logistic regression analyses showed that the risk factors for gingivitis were male sex. presence of plaque or calculus and use of local “mswaki”; the risk factors for periodontal pockets were age of 35 years or more, presence of plaque, and rural residence. The risk factors for gingival recession were identified as age of 35 years or more, male sex, lower educational status, presence of plaque and gingival inflammation. The most significant risk factors to have periodontal diseases in this study population were age, sex, education, rural residence, plaque and calculus.
Tetracycline‐resistant micro‐organisms recovered from patients with refractory periodontal disease
Authors: Olsvik Bente , Hansen B. Frode , Tenover Fred C. , Olsen Ingar
Published: December 2005

Abstract Tetracycline in combination with scaling and root planing is frequently used to treat refractory periodontal disease. This study examined tetracycline resistance in bacteria recovered from periodontal pockets of patients with refractory periodontitis. Bacterial isolates resistant to 10 μg/ml of tetracycline were isolated from plaque samples of 17 patients, of whom 6 had received tetracycline within 8 weeks prior to sampling. Minimal inhibitory concentrations (MICs) of tetracycline and minocycline were determined by agar dilution. In the 6 patients who had received tetracycline, a mean of 22.9% (±38.2) of the total cultivable subgingival flora were resistant to tetracycline, compared with a mean of 7.2% (±8.5) in the untreated group. Although various organisms were isolated, in most patients, the tetracycline‐resistant organisms were dominated by Streptococcus spp. Overgrowth of Candida was found in one patient, and of Enterobacteriaceae in another patient, while small numbers of yeast or Staphylococcus spp. were isolated from the plaque samples of 9 others. 3 out of 4 patients who did not respond to tetracycline treatment had a variety of tetracycline‐resistant anaerobic Gram‐negative rods present. No correlation was found between increased proportions of tetracycline resistance in the whole bacterial sample and the presence of resistant periodontal pathogens.
Some suspected periodontopathogens and serum antibody response in adult long‐duration insulin‐dependent diabetics
Authors: Thorstensson H. , Dahlén G. , Hugoson A.
Published: December 2005

Abstract The subgingival microflora and serum antibody response were examined in long‐duration insulin‐dependent diabetics and age‐ and sex‐matched non‐diabetics. The material consisted of 9 diabetics aged 40–9 years and 19 aged 50–59 years, 13 non‐diabetics aged 40–49 years and 21 aged 50–59 years. The bacterial species studied (Actinobacillus actinomycetemcomitans, Campylobacter rectus, Capnocytophaga spp, Eikenella corrodens, Fusobacterium nucleatum, Por‐phyromonas gingivalis, Prevotella intermedia) were recovered in diabetics as well as in non‐diabetics. Significantly more diabetics in both age groups harboured P. gingivalis compared to non‐diabetics. Prevalence of P. gingivalis was associated with deepened periodontal pockets among non‐diabetics but not among diabetics. In diabetics and non‐diabetics, the serum antibody litres for most antigens were similar.
The effect of triclosan on mediators of gingival inflammation
Authors: Gaffar A. , Scherl D. , Afflitto J. , Coleman E.J.
Published: December 2005

Abstract Triclosan (2,4,4′,‐trichloro‐2′‐hydroxydiphenylether) is a well‐known and widely used nonionic antibacterial agent which has recently been introduced in toothpastes and mouthrinses. The efficacy of triclosan‐containing toothpaste and mouthrinse to reduce both plaque and gingivitis in long‐term clinical trials has been well documented. Until recently, it was generally assumed that triclosan's effect on gingival inflammation was due to its antimicrobial and anti‐plaque effect. It has now become apparent that triclosan may have a direct anti‐inflammatory effect on the gingival tissues. Several in vitro studies were conducted to evaluate the effect of triclosan on 4 primary enzymes of the pathways of arachidonic acid metabolism, cyclo‐oxygenase 1, cyclo–oxygenase 2, 5‐lipoxygenase and 15‐lipoxygenase. These pathways lead to the production of known mediators of inflammation such as the prostaglandins, leukotrienes and lipoxins. Triclosan inhibited both cyclooxygenase 1 and cyclo‐oxygenase 2 with IC–50 values of 43 μM and 227 μM, respectively. Triclosan also inhibited 5–lipoxygenase with an IC‐50 of 43 μM. The 15‐lipoxygenase was similarly inhibited by triclosan with an IC‐50 of 61 μM. Hence, triclosan has the ability to inhibit both the cyclo‐oxygenase and lipoxygenase pathways of arachidonic acid metabolism with similar efficacy. In cell culture experiments, it was found that triclosan inhibited IL‐1β induced prostaglandin E2 production by human gingival fibroblasts in a concentration dependent manner, and at relatively low concentrations. These data, taken together, indicate that triclosan can inhibit formation of several important mediators of gingival inflammation. The data further suggest that the necessary triclosan concentrations could probably be achieved in local tissues, such as the gingiva, from topical applications of triclosan‐containing toothpaste and mouthrinse.
Effects of triclosan on the rat phrenic nerve‐diaphragm preparation
Authors: Kjærheim V. , Röed A. , Brodin P. , Rölla G.
Published: December 2005

Abstract It has been reported that the lipid soluble, anti‐inflammatory drug triclosan, which is currently used in toothpastes and mouthrinses, may reduce pain. This may be an aspect of the anti‐inflammatory effect of triclosan, which probably reduces the production of prostaglandin PGE2. However, triclosan may also exhibit a direct analgesic effect through an effect on excitable membranes. The aim of the present study was to examine the possible effect of triclosan on the nerve action potential, on the neuromuscular transmission and on the excitation‐contraction coupling of skeletal muscle. Phrenic nerve‐hemidiaphragm preparations, as well as isolated phrenic nerves, were dissected from Wistar albino rats and mounted by standard methods in Tyrode solution. Both during indirect and direct stimulation, the preparations were irreversibly inhibited by triclosan at concentrations higher than 5.0×10−6 M. At low concentrations, the inhibition of the twitches during indirect stimulation and of the compound action potential was probably caused by a threshold increase for excitation of the phrenic nerve. At high concentrations, an additional inhibitory effect at the neuromuscular junction was disclosed. The directly stimulated preparation was also probably inhibited by an increase of the threshold for initiation of the muscle action potentials. In addition, a reduced KC1 contracture and an acceleration of the caffeine contracture indicated an interaction with the sarcolemma. These results suggest that the analgesic effect of triclosan may be due to a direct interaction with excitable membranes.
Guided tissue regeneration in the treatment of degree II furcations in maxillary molars
Authors: Pontoriero R. , Lindhe J.
Published: December 2005

Abstract The present clinical trial was designed to evaluate the clinical effect of GTR in the treatment of degree II furcation defects in maxillary molars. 28 patients, 21 to 59 years of age, referred for treatment of advanced periodontal disease were included. They presented with similar periodontal lesions in the right and the left maxillary molar regions, but had only one surface which exhibited furcation involvement. A total of 28 pairs of contralateral furcation defects of degree II including 18 interproximal pairs (10 mesial, 8 distal) and 10 buccal pairs, were available for the study. After the completion of basic therapy, the furcation involved molars in the right and left quadrants in each patient were randomly assigned to either a test or a control treatment procedure. Following flap elevation, scaling, root planing and granulation tissue removal, an e‐PTFE membrane at the test site was adjusted to cover the entrance to the furcation defect and adjacent bone and was retained in this position with sling sutures. The mucoperiostal flaps were subsequently adjusted and positioned to cover the entire surface of the membrane and were secured in this position. An identical surgical procedure was performed in the control tooth regions with the exception of the placement of a teflon membrane. No periodontal dressing was used. Starting the day before surgery and continuing for 7 days, the patients received 1 + 1 g of Amoxicillin per day; morning and evening. The sutures were removed after 10 days. At the test sites, the membranes were removed after 6 weeks of healing. The treated sites were examined and re‐entry procedures performed 6 months after reconstructive surgery. Open flap debridement at maxillary furcations of degree II resulted in some gingival recession and probing depth reduction, but no change occurred in parameters describing probing attachment or bone levels. The addition of GTR at buccal furcations enhanced the treatment result by promoting probing attachment and bone gain and reduced the amount of soft tissue recession above what was accomplished by flap debridement alone. No such benefit of membrane therapy was observed at mesial and distal furcations.
A multicenter clinical trial of PerioGardTM in distinguishing between diseased and healthy periodontal sites
Authors: RutgerPersson G. , Alves Mario E.A.F. , Chambers Donald A. , Clark William B. , Cohen Rhonna , Crawford John M. , DeRouen Timothy A. , Magnusson Ingvar , Schindler Thomas , Page Roy C.
Published: December 2005

Abstract We designed and performed a multicenter clinical trial to determine the relationship between measurements of the level of the enzyme aspartate amino‐transferase (AST) in gingival crevicular fluid (GCF) to other measures used to detect periodontal disease and monitor outcome of treatment, including pocket depth and gingival inflammation. 32 periodontitis patients were enrolled at the University of Washington, Seattle, 30 at the University of Florida, Gainesville, and 34 at the University of Illinois, Chicago. 10 periodontally normal control subjects were enrolled at each location. 8 diseased and 4 healthy sites were designated for study in each patient and 8 healthy sites designated in each control subject. Measures of disease included pocket depth, severity of gingival inflammation, and GCF volume. AST levels were measured using the PerioGardTM test kit. Clinical measurements were made and GCF samples harvested and tested 2X before and 2X after therapy consisting of scaling and root planing under local anesthetic. Specific design and other issues are discussed, including selection of patients and control subjects, sample size, selection of experimental test sites, methods for assessment of diseased and therapeutic improvement, harvesting of GCF, and selection of appropriate biostatistical methods for data analysis. Demographics of the patient populations at the 3 locations are reported. As expected, therapy induced only negligible changes in the measures of disease at healthy sites in control subjects, and relatively minor improvement in healthy sites in patients. In contrast, statistically significant improvement relative to pre‐treatment baseline status in all 3 measures of disease was observed for diseased sites at all 3 study locations with all p‐values less than 0.0002. The magnitude of improvement was comparable to that reported previously by others. The % of PerioGard‐positive sites decreased significantly between the screening baseline and both post‐treatment visits for patients at all 3 locations, with p values of 0.0001 to < 0.0008.
Subgingival temperature as a gingival inflammatory indicator
Authors: Niederman R. , Naleway C. , Lu B.‐Y. , Buyle‐Bodin Y. , Robinson P.
Published: December 2005

Abstract Elevated temperature is one of 4 cardinal inflammatory signs. Previous work indicates that Subgingival temperature assessments are accurate and reliable, and provide objective, quantitative information over a broad 10°C range, in small 0.10°C increments with a direct, immediate report on the inflammatory status at the pocket base. However, complicating the use and interpretation of Subgingival temperature assessments are its 3 forms: actual Subgingival temperature, sublingual temperature minus Subgingival temperature (temperature differential), and a temperature indicator light. We reasoned that if one could determine which of the temperature assessments reflected the periodontal condition, and which were independent variables, they would provide new and unique information about the inflammatory status of the periodontium. We also reasoned that by providing objective, quantitative data over a broad range, Subgingival temperature should reduce the sample size required to obtain significance in clinical trials. Therefore, the purpose of this study was 2‐fold: (1) to determine whether the 3 Subgingival temperature assessments could differentiate between clinically defined periodontal health and disease; (2) to determine whether the 3 assessments were dependent or independent clinical variables. The data indicated that all 3 subgingival temperature assessment methods differentiated between clinically‐defined periodontal health and disease (all p<0.02). All 3 assessments also correlated significantly (all r>0.03), but modestly (all r>0.49), with Weeding on probing. Based on scatter‐plot matrices and common factor analysis, the data indicated that only actual subgingival temperature and temperature differential were independent variables. Taken together, this data indicates that subgingival temperature and temperature differential provide unique information about the periodontal inflammatory state. Power calculations indicated that the temperature differential may significantly reduce the subject number required to achieve significance in clinical trials examining gingival inflammation. Because of the body's rapid temperature response, these assessments may also significantly reduce the time required for gingival inflammation trials.
Gingival crevicular stromelysin, collagenase and tissue inhibitor of metalloproteinases levels in healthy and diseased sites
Authors: Haerian A. , Adonogianaki E. , Mooney J. , Docherty J. P. , Kinane D. F.
Published: December 2005

Abstract. The ability of stromelysin (SL). fibroblast‐type collagenase (FIB‐CL) and tissue inhibitor of metalloproteinases (TIMP). to differentiate between healthy, gingivitis and periodontitis sites was investigated. SL and FIB‐CL are members of a family of enzymes which are capable of degrading most of the extracellular matrix macromolecules. Extracellular control of these enzymes is performed by TIMR 40 patients each provided 3 GCF samples from healthy, gingivitis and periodontitis sites. GCF samples were collected by means of sterile paper strips. GCF samples were eluted into 500 /A of assay buffer and assays for SL, FIB‐CL and TIMP were performed by a sandwich EL1SA. The mean amounts of SL and TIMP in diseased sites (gingivitis and periodontitis) were significantly higher than the mean amount of these GCF components in healthy sites (MANOVA p values were: 0.006 for SL and 0.001 for TIMP). GCF SL and TIMP differentiated healthy from diseased sites. Both SL and TIMP showed moderate correlation with clinical indices. FIB‐CL was detectable in only 20.8/o of all sites and did not correlate with disease status.
Psychosocial factors in inflammatory periodontal diseases
Authors: da Silva A.M. Monteiro , Newman H.N. , Oakley D.A.
Published: December 2005

Abstract.Reviewing the literature concerning the possible role of psychosocial factors in the aetiology of inflammatory periodontal diseases, it may be concluded that there is evidence which strongly suggests that emotional stress is one of the predisposing factors to ANUG. On the other hand, it is not clear that the scientific evidence is sufficient to substantiate the hypothesis that psychosocial factors are of aetiological importance in periodontitis. The proposed mechanisms which may mediate the putative relationship between psychosocial conditions and inflammatory periodontal diseases remain to be tested. However, psychoneuroimmunologic studies make lowered host resistance especially interesting as a possible mechanism. Although available studies do not definitively support causal relationships, they suggest that psychosocial factors may be involved in the aetiology of inflammatory periodontal diseases, which, in turn, would relate to clinical management of these conditions.
Plaque formation and gingivitis after mouthrinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 4 weeks, following an initial professional tooth cleaning
Authors: Hase J.C. , Ainamo J. , Etemadzadeh H. , Åström M.
Published: December 2005

A double‐blind, randomised. 4‐week clinical trial with parallel group design in 57 patients with gingivitis was conducted for studying the antibacterial efficacy and safety of a delmopinol HCl aqueous solution 2 mg/ml (0.2% w‐'v). which was used for unsupervised mouth‐rinsing and compared with placebo and chlorhexidine digluconate 2 mg/ml (0.2% w/v, Hibitane Dental. 1CI Pharmaceuticals, UK). The plaque index and plaque wet weight were used to measure plaque formation, and gingival fluid flow and bleeding on probing to measure gingivitis. According to the reduction from baseline, chlorhexidine showed a significantly better effect on plaque formation than the placebo after 4 weeks treatment for both plaque measurements. Delmopinol exhibited significantly lower plaque index scores than placebo. The difference between chlorhexidine and delmopinol was not statistically significant for any of the plaque measurements. For gingivitis, no statistically significant differences were obtained between the effects of delmopinol. chlorhexidine and placebo. A transient anaesthetic sensation in the oral mucosa was experienced more clearly by the patients in the delmopinol group than by those using chlorhexidine or placebo rinses. Rinsing with chlorhexidine resulted in more staining of the teeth and tongue than did delmopinol and placebo. The placebo solution lasted better than the 2 active solutions. The results showed that rinsing with either delmopinol HC1 aqueous solution 2 mg/ ml or chlorhexidine digluconate 2 mg/ml 2× daily for 60 s as a supplement to normal oral hygiene, following an initial professional tooth cleaning, leads to a lower plaque formation than rinsing with placebo. In order to obtain conclusive results beyond the initial etTect of the professional tooth cleaning and the placebo effect and lo achieve enough power in the statistical analysis of gingivitis reduction, trials of longer duration and with a larger number of patients are required. This study showed good tolerance and acceptability of mouth‐rinsing with the detmopinol HC1 aqueous solution 2 mg/ml.
A comparative clinical study: the use of human type I collagen with and without the addition of metronidazole in the GTR method of treatment of periodontal disease
Authors: Dowell P. , Al‐Arrayed F. , Adam S. , Moran J.
Published: December 2005

Abstract. This investigation was undertaken to evaluate cross‐linked human type I collagen, with and without added metronidazole, when used as a barrier membrane in the guided tissue regeneration (GTR) principle of treatment for periodontal disease. 16 patients suffering from moderate to severe periodontitis with 78 bilaterally matched periodontal defects underwent similar contralateral surgical flap procedures after preliminary scaling, polishing and oral hygiene instruction. At the experimental sites, which were selected at random, the flap was closed over metronidazole impregnated collagen as a GTR membrane, the contralateral sites receiving a plain collagen barrier as control. The plaque index (PLI), gingival index (GI), bleeding index (BI), probing pocket depth (PPD) and probing attachment level (PAL) were recorded at baseline. 6. 12 and 26 weeks post‐operatively. The bony defects were classified and furcation involvement noted. The clinical parameters were recorded by an examiner, other than the surgeon, who had been previously assessed for accurate reproducibility of measurements and was unaware of the experimental sites. PPD and PAL were measured with a constant pressure probe, localised by a soft stent. Post‐operative discomfort was evaluated by means of a questionnaire. PLI, GI and BI were significantly improved compared to baseline for both test and control sites at 6. 12 and 26 weeks post surgery (p < 0.001) but there was no significant difference between these sites (p > 0.05). There was a reduction in PPD at 6 weeks which was significant at 12 and 26 weeks post‐operatively (p < 0.001) for both test and control sites, but no difference between these sites was evident (p > 0.05). Probing attachment levels showed a significant improvement at 6. 12 and 26 weeks at both test and control sites (p < 0.001), again with no significant difference between these sites (p > 0.05). 6 patients experienced pain and an unpleasant taste after surgery, 5 at the control sites but only 1 at the test site. This study showed that all sites improved clinically and that there was less post‐operative discomfort when metronidazole was incorporated in the collagen. Nevertheless the latter did not appear to enhance periodontal regeneration beyond that of collagen alone.
Endodontic pathogens in periodontal disease augmentation
Authors: Jansson Leif , Ehnevid Helge , Blomlöf Leif , Weintraub Andrej , Lindskog Sven
Published: December 2005

Abstract. Periapical pathology indicating endodontic infection, when present in periodontitis‐affected teeth, has recently been shown to be correlated to marginal periodontal breakdown. This has been associated with patency of dentinal tubules in the tooth cervix, an area normally devoid of cementum following periodontal therapy. These studies are, however hampered by that only circumstantial evidence such as presence of periapical destruction have been applied as criteria of endodontic infection. The aim of the present investigation was to assess the effects of endodontic pathogens on marginal periodontal wound healing on root surfaces devoid of cementum but surrounded by healthy periodontal membrane. Significant differences between infected and non‐infected teeth were found with respect to pathological pocket and connective tissue: The experimental defects were covered by approximately 20% more pocket epithelium in infected teeth while defects in non‐Infected teeth showed approximately 10% more connective tissue coverage. It was concluded, that an intra‐canal infection of endodontic pathogens stimulates epitelial downgrowth along denuded dentin surfaces with marginal communication. Extrapolated to the clinical situation, endodontic infections in periodontitis‐prone patients may augment periodontitis propagation.
Improved periodontal status through self‐assessment A 2‐year longitudinal study in teenagers
Authors: Nowjack‐Raymer Ruth , Ainamo Jukka , Suomi John David , Kingman Albert , Driscoll William S. , Brown L. Jackson
Published: December 2005

Abstract. Short‐term success of the use of self‐assessment for motivating adults to improve their oral health status has been reported. The purpose of this trial was to evaluate the long‐term effectiveness of two self‐assessment strategies, one focused on gingival bleeding (group I) and another focused on plaque (group II). At baseline, 493 14‐ and 15‐year‐olds were assigned randomly to a group. Each subject was given a manual describing one of the self‐assessment, processes. Dental hygienists provided standardized classroom based instruction and two weeks later, individualized counselling. Examinations were conducted at baseline 6, 12, 18 and 24 months for gingival bleeding on probing, plaque, calculus, and probing depth; and at baseline and 24 months for recession and decayed, missing and filled surfaces (DMFS). Following the 12‐momh examination, subjects received an oral prophylaxis and individual counselling. The results revealed no statistically significant differences between groups for any clinical parameter at the final examination. However, the mean number of sites with gingival bleeding decreased steadily from baseline to 24 months with a 59% decrease and 55% decrease for groups I and II, respectively. This study suggests that self‐assessment approaches can be effective in improving the long‐term periodontal health status of teenagers.
Clinical and microbiological changes associated with the use of 4 adjunctive systemically administered agents in the treatment of periodontal infections
Authors: Haffajee A.D. , Dibart S. , Kent R.L. , Socransky S. S.
Published: December 2005

Abstract. The purpose of the present investigation was to assess the effects of periodontal surgery and 4 systemically administered agents, Augmentin, tetracycline, ibuprofen or a placebo on clinical and microbiological parameters of periodontal disease, 98 subjects were monitored at 2‐month intervals at 6 sites per tooth for clinical parameters. Subgingival plaque samples were taken from the mesial surface of each tooth at each visit and evaluated for their content of 14 subgingival species using DNA probes and a colony lift method. 40 subjects who exhibited loss of attachment >2.5 mm at 1 or more sites during longitudinal monitoring were treated using modified Widman flap surgery at sites with probing pocket depth >4 mm, subgingival scaling at all other sites and were randomly assigned 1 of the 4 agents. Treatment was completed within 30 days during which time the subject took the assigned agent. Overall, subjects exhibited a mean attachment level “gain” of 0.34±0.10 mm (SEM) and a mean pocket depth reduction of 0.62±0.09 mm 10±4 months post‐therapy. However, certain subjects in each treatment group showed a poor response. Subjects receiving antibiotics exhibited significantly more attachment level “gain” (0.57±0.15 mm, SEM) than subjects receiving either ibuprofen or a placebo (0.02±0.10). The differences between Augmentin and tetracycline groups were not significant, nor were the differences between ibuprofen and placebo, 10 months post‐therapy, there was a reduction in the number of sites colonized in any subject group by detectable levels (103) of P. gingivalis. Species showing similar reductions were B. foraythus, P. intermedia and P. micros. Subjects receiving systemically administered antibiotics had a significant increase in the proportion of sites colonized by C. ochracea coupled with a greater decrease in the number of sites colonized by P. gingivalis. B. forsythus, P. intermedia and P. micros post‐therapy than subjects not receiving antibiotics. The results of this investigation indicate that adjunctive systemic antibiotics increase periodontal attachment “gain” and decrease the levels of some suspected periodontal pathogens in subjects with evidence of current disease progression.
Temperature dependence of toothbrush bristle morphology An ultrastructural study
Authors: Franchi Marco , Checchi Luigi
Published: December 2005

Abstract. In this study, it was demonstrated that the original forms of toothbrush bristle ends undergo morphological changes during the preparatory procedures required prior to their examination by scanning electron microscopy (SEM). In particular, the distance of the specimens from the cathode of a traditional sputter‐coater and the time of gold‐palladium coating influence the temperature inside the vacuum compartment. Morover, the temperature influences the original morphology of toothbrush bristles, 2 segments of each toothbrush head with nylon or ultralon bristles were cut off the brush: one was mounted vertically and one horizontally on stubs for SEM analysis. Different temperatures were measured inside the sputter‐coater at the level of the bristle ends, during coating with gold‐palladium alloy. The temperature at the level of the bristles that were placed horizontally was about 38°C, and 59°C when they were placed vertically. SEM analysis of the specimens showed that the same toothbrush has end‐rounded bristles at about 59°C and non‐acceptable irregular bristles at about 38°C. Retraction of bristles (which appeared shortened and with increased diameters) and superficial cracks were particularly present in the vertically placed ultralon bristles.
Efficacy on supragingival plaque control of cetylpyridinium chloride in a slow‐release dosage form
Authors: Vandekerckhove Betty N. A. , Van Steenberghe Daniel , Tricio Jorge , Rosenberg David , Encarnacion Myriam
Published: December 2005

Abstract To evaluate the relative efficacy of a non‐degradable osmotic slow‐release dosage form containing 6.6 mg cetylpyridinium chloride (MOTS [Mucosal Oral Therapeutic System] CPC) to inhibit new plaque formation and gingivitis, a single‐blind, randomised, parallel group pilot study was set up. 52 healthy volunteers were assigned to receive one of the following treatments for 18 days of non‐brushing: holding 1 MOTS CPC 2× daily for 2 h intra‐orally, or rinsing 30 s with 15 ml Peridex® 2× daily, or dissolve Cepacol® (each 1.6 mg CPC) lozenges 2× daily unsupervised. Before the test period, the subejcts received a thorough tooth cleaning followed by tooth polishing 1× a week for 3 weeks to achieve clinical gingival health. After the start of therapy, the subjects were examined at day 4, 7 (±2), 14 (±2) and 18 (2±). Relative efficacy was assessed by the modified Navy plaque index, the Quigley and Hein index, the planimetric plaque index, as well as the papillary marginal gingival index. There was an increase in both plaque formation and gingivitis over the 18±2 day period of non‐brushing for all subjects in the study. Peridex® was the most effective in inhibiting plaque and gingivitis formation over that period of time. There was no difference between MOTS CPC and Cepacol® at any time point in plaque accumulation and gingivitis intensity. Peridex® was considered more convenient than MOTS CPC. Cepacol® resulted in more staining at 18 days than MOTS CPC and Peridex®.
Radiographic alveolar bone loss from posterior teeth in young adults over a 4‐year period
Authors: Bishop K. , Dummer P. M. H. , Kingdon A. , Newcombe R. G. , Addy M.
Published: December 2005

Abstract The objective of this study was to determine alveolar bone loss from premolar and molar teeth in young adults over a 4‐year period between the ages of 15‐16 years and 19‐20 years. Pairs of posterior bitewing radiographs from 382 subjects aged 15‐16 years were examined and the height of the alveolar bone adjacent to mesial and distal tooth surfaces recorded. Repeat radiographs of the same individuals taken 4 years later were then examined and the height of the alveolar bone remeasured. Change in bone height over the study period was computed for individual sites. Clinical data for the cohort were also obtained at both examinations and included plaque score, bleeding on probing and probing depth, or the 3314 sites, 16.7% exhibited bone gain, 4.5% exhibited no change whilst 78.8% demonstrated bone loss. The overall mean bone loss for all sites combined was 0.407 mm. Bone loss less than 0.5 mm was found in 36% of sites, bone loss between 0.5 and 0.99 mm in 33% of sites whilst only 0.5% of sites had bone loss greater than 2 mm. Only one site had bone loss greater than 3 mm. Bone loss was affected significantly by subject (p < 0.05) and by site (p < 0.05) but there was no significant effect for tooth type, whether the surface was mesial or distal or between quadrants. There was significantly more bone loss from around maxillary teeth than mandibular (p < 0.05). There were no significant associations between bone loss and plaque score, bleeding on probing, pocket depth, gender or social class.
Periodontal bone loss of teeth with metal posts
Authors: Eliasson Sören , Bergstrom Jan , Sanda Anton
Published: December 2005

Abstract Periodontal bone loss was compared in teeth with metal posts and contralateral teeth without metal posts by means of intraoral radiographs. 250 subjects with a high standard of dental awareness and a great number of teeth retained were included in the study. The periodontal bone loss was calculated from the ratio of the distance from bone margin to apex (bone height) and the distance from crown tip to apex (tooth length). Intra‐individual differences between experimental and control teeth were statistically analyzed with the Student paired t‐test. 96 subjects (38%) had 1 teeth with root posts. In all, 172 teeth with posts were found, i.e., on average 1.8 teeth per subject. The means ± SEM of the ratio bone height to tooth length in experimental and control teeth were 0.52 ± 0.007 and 0.56 ± 0.006, respectively. The difference was statistically highly significant (P < 0.001). Statistically significant differences were found for incisors, premolars and molars. Regression analysis indicated more severe bone loss for teeth with longer posts. The results suggest that the periodontal bone support of teeth with metal posts is inferior to that of teeth without metal posts.
Removal of hard tooth structure by ROOTSHAPE® root planing files used with a modified EVA contra‐angle
Authors: Hugo B. , Stassinakis A.
Published: December 2005

Abstract The results of numerous recent investigations indicate that root contamination with bacteria and endotoxins is limited to the root surface only. Therefore, methods on root surfaces instrumentation that preserve root substance should be focused on. Newly available instruments or treatment systems should be evaluated for their root substance‐removing potential. The devices for root planing presented here comprised specific files (Rootshape®) (with diamond‐coating on their convex working surfaces used in conjunction with a water‐spray‐cooled contra‐angle head transforming rotational movements into translatory oscillations. The substance‐removal potential of rigid and flexible files with diamond coatings of 2‐4, 15, 25 and 40 μm compared with that of regular hand curettes, was evaluated under various working forces. The results demonstrated, that depending on the grit size of the diamond coating, the Rootshape® files removed less and in no instance greater amounts of root surface substance than did hand instruments.
Clinical evaluation of natural coral and porous hydroxyapatite implants in periodontal bone lesions: results of a 1 ‐year follow‐up
Authors: Mora Francis , Ouhayoun Jean Pierre
Published: December 2005

Abstract This study examines the suitability of 2 bone graft substitutes, natural coral skeleton (NCS) and porous hydroxyapatite (PHA) for treating periodontal bone defects in human subjects, and compares them to debridement alone (DEBR). A total of 30 sites in 10 patients were treated. Measurements were made before treatment and during surgical reexamination 12 months after treatment on lesions filled with NCS (10 sites), PHA (10 sites), or DEBR (10 sites). There was no significant difference in the use of NCS or PHA for 1, 2 wall, or combined defects for the group of parameters measured in this study (clinical probing depth, clinical attachment, gingival recession, bone fill, % bone fill, and crest remodelling). Statistical analysis (Wilcoxon non‐parametric test for paired values and ANOVA for repeated measurements) revealed the beneficial effects of using each the biomaterials (57.4% for NCS, 58.1% for PHA, p < 0.86) as opposed to simple debridement (22.2%; p < 0.002; p < 0.004).
Intra‐ and inter‐examiner reproducibility in constant force probing
Authors: Wang Su‐Fang , Leknes Knut N. , Zimmerman Grenith J. , Sigurdsson Thorarinn J. , Wikesjö Ulf M. E. , Selvig Knut A.
Published: December 2005

Abstract This study evaluated intra‐ and inter‐examiner reproducibility for a conventional manual probe versus a computer‐interfaced force‐controlled periodontal probe. 2 examiners recorded probing depths (PD) and relative attachment levels (AL) at 1128 sites in 15 periodontal maintenance patients. Each site was evaluated 2x, 7 to 10 days apart by both examiners. Probing force for the electronic probe was 15 g. PD intra‐examiner reproducibility (within ± 1.0 mm) for shallow sites (PD3 mm) was 98.6% versus 91.5% for the conventional versus the electronic probe for examiner 1 and 98.5% versus 88.7% for examiner 2. Corresponding values for deeper sites (PD>3 mm) were 96.4% versus 85.9% for examiner 1 and 95.1% versus 77.0% for examiner 2. Generally, AL intra‐examiner reproducibility was 1 to 3% lower than for PD. PD inter‐examiner reproducibility (within ±1.0 mm) was 99.2% versus 90.7% for the conventional versus the electronic probe, respectively, for shallow sites and 95.4% versus 76.9% for deeper sites. AL inter‐examiner reproducibility (within ± 1.0 mm) was 1 to 5% lower than for PD. Both intra‐ and inter‐examiner reproducibility was higher for anterior than for posterior sites. Mean PD and AL were similar for both examiners. However, the electronic probe consistently recorded 0.1 to 0.2 mm higher values than the conventional probe. Standard deviations indicated a greater variability for electronic than for manual probing. The results suggest that intra‐ and inter‐examiner reproducibility may not necessarily be higher with an electronic, force‐controlled periodontal probe than with a conventional manual probe.
The comparative tea staining potential of phenolic, chlorhexidine and anti‐adhesive mouthrinses
Authors: Addy M. , Moran J. , Newcombe R. , Warren P.
Published: December 2005

Abstract Staining of teeth and mucous membranes is a well‐known side‐effect with chlorhexidine mouthrinses in which dietary chromogens play an important role. The purpose of (his study was to determine whether a co‐polymer anti‐adhesive agent would prevent staining by a low concentration chlorhexidine solution. Additionally, the possibility that an essential oil/phenolic rinse product may cause staining was investigated. The rinses studied were the anti‐adhesive alone and combined with 0.02% chlorhexidine and the essential oil/phenolic rinse. These were positioned against a positive control rinse, 0.2% chlorhexidine and a negative control rinse, water. The study was a single blind 5‐treatment randomised Latin square cross‐over design, incorporating balance for carry‐over effects. 15 volunteers participated and on Day 1 of each study period were rendered stain free by scaling and polishing of the teeth. Oral hygiene was suspended and 8x per day subjects rinsed under supervision, firstly with the allocated formulation and then with 10 ml of warm black tea. On Day 4, tooth and tongue staining was scored by area and intensity (colour). A washout period of at least 31/2 days was permitted between treatment periods when oral hygiene was resumed. Before the study and during washouts, volunteers practised tongue brushing. Tooth and tongue staining was significantly increased with 0.2% chlorhexidine compared to the essential oil/phenolic rinse which in turn was significantly increased compared to the other 3 rinses. The antiadhesive/chlorhexidine rinse produced no more staining than the anti‐adhesive or water rinse. However, the parallel plaque re‐growth study suggests this inhibition of staining resulted from the vitiation of the chlorhexidine activity by the antiadhesive. The methodology would appear a simple and quick way of assessing the propensity of mouthrinses to cause extrinsic staining.