bluuebunny/crossref_metadata_2025 huggingface dataset:
The significance of maintenance care in the treatment of periodontal disease
Authors: Axelsson P. , Lindhe J.
Published: December 2005

Abstract The present investigation was performed to assess the efficacy of a maintenance care program to prevent recurrence of disease in patients subjected to treatment of advanced periodontitis. In addition, the periodontal status was monitored of a group of patients who following the end of active treatment were referred back to genera] practitioners for maintenance care. The material consisted of 90 patients who in 1972 were referred for specialist treatment of advanced periodontal disease. The patients were first subjected to an initial examination including assessment of oral hygiene, gingivitis, probing depths and attachment levels. They were on an individual basis given case presentation, instructed how to practice proper tooth‐cleaning methods, their teeth were scaled and eventually the periodontal pockets were treated using the modified Widman technique. During the first 2 months following surgery the patients were recalled once every 2 weeks for professional tooth cleaning. Two months after the end of surgical treatment, the patients were reexamined to provide baseline data. Every third patient was thereafter referred back to the general dentist for maintenance care. Two out of three patients were maintained in a carefully designed and controlled maintenance care program at the university clinic. This program involved recalls once every 2–3 months and included instruction and practice in oral hygiene, meticulous scaling and professional tooth cleaning. The patients were reexamined 3 and 6 years after the baseline examination.

The results demonstrated that in patients suffering from destructive periodontitis, a treatment program that involved oral hygiene instruction, scaling, root planing and modified Widman flap procedures resulted in the establishment of clinically healthy gingiva and shallow pockets. Patients who were placed on a carefully designed recall program were over a 6‐year period able to maintain excellent oral hygiene standards and unaltered attachment levels. In contrast patients who subsequent to active treatment were not maintained in a supervised program showed obvious signs of recurrent periodontitis at the follow‐up examinations.
The occurrence of plaque and gingivitis and its relationship to tooth alignment within the dental arches
Authors: Behlfelt Kerstin , Ericsson Leip , Jacobson Lars , Linder‐Aronson Sten
Published: December 2005

Abstract The aim of the present investigation was to evaluate whether and to what degree discrepancies in tooth alignment can influence plaque accumulation and gingival status, An intra‐individual study was performed on 30 children with unilateral malposition of upper lateral incisors (15 children) and lower second premolars (15 children). Corresponding contralateral teeth were used as controls. The meanage was 14.4 years. The degree of malalignment in individual cases was assessed using a new malposition index (MPI). Plaque and gingival condition were assessed according to Silness & Löe (1964) and Löe & Silness (1963), respectively.

The test and control areas were compared with regard to plaque accumulation and gingival status. Correlation analysis was performed to test the connection between these two parameters and tooth malalignment. The frequency of visible plaque (P1I 2+ 3) and gingival bleeding (GI 2 + 3) was generally higher for the test areas compared with the control areas. A comparison between the test and control areas showed the difference in gingival bleeding to be significant and of similar magnitude as regards upper laterals and lower second premolars. The difference in visible plaque was less marked but still significant.

The correlation analysis did not show any connection between the degree of plaque accumulation or gingival inflammation and the degree of tooth malalignment.

The differences found between normal and malaligned teeth thus showed a difnite trend, namely:

plaque and gingivitis were more widespread around malaligned upper lateral incisors and lower second premolars than around contralateral teeth well positioned within the dental arches.

the degree of malalignment was of secondary importance.
Measurement of prostaglandin E in crevicular fluid
Authors: Offenbacher S. , Farr D. H. , Goodson J. M.
Published: December 2005

Abstract A method for the detection of prostaglandin E (PGE) in crevicular fluid has been developed which provides a sensitive, noninvasive technique for measurement of local concentrations of this mediator of inflammation. Assay sensitivity sufficient for the detection of 4 picograms of PGE2; was achieved by utilizing a high‐affinity anti‐PGE2 antibody, a solid‐state second antibody and low isotope concentrations. The method permits detection of concentrations equivalent to 108 M PGE2 in μl of crevicular fluid. Crevicular fluid PGE (CFPGE) concentrations were determined in samples from 12 patients with periodontal disease. Patients with periodontitis had significantly higher mean CFPGE concentrations than patients with gingivitis (179.5±51.4 pg/μl vs 32.1 ± 15.5 Pg/μl, mean ± SEM). Periodontitis sites were selected on the basis of clinical and radiographic evidence of periodontal destruction. Some sites displayed low CFPGE levels, while others had CFPGE concentrations which were elevated tenfold, suggesting the presence of both inactive and active periodontal lesions. CFPGE levels greater than 100 pg/μl were positively associated with gingival erythema and pain on probing.
Juvenile periodontitis‐Healing following therapy to control inflammatory and traumatic etiologic components of the disease
Authors: Evian C. I. , Amsterdam M. , Rosenberg E. S.
Published: December 2005

Abstract A case of localized juvenile periodontitis with bone loss affecting molars and premolars with advanced destruction around the lower first molars is described. These lesions were associated with areas of excess occlusal trauma. The ramifications of combined therapy aimed at the elimination and control of both the inflammatory and occlusal components of the disease are discussed relative to the successful treatment of this case. A description of the periodontal status of a sibling of the patient has been included. Extensive defects are associated with the anterior teeth and in this case the patient presented with excessive trauma in the anterior region. Considering the localities of the disease and the similarities between the inflammatory components in both cases, a link between occlusal trauma and juvenile periodontitis is discussed.
Dental prophylaxis for youths in their late teens III. Attitudes to teeth and dental health and their relation to dental health behavior
Authors: Bergendal Birgitta , Erasmie Thord , Hamp Sven‐Erik
Published: December 2005

Abstract Attitudes to teeth and dental health have been tested in ninety‐seven 19‐year‐olds. Of this number, 29 in group A and 32 in group B had for 3 years participated to varying extent in a systematic plaque control program based on professional tooth cleaning. Seventeen of the total, who after 1 year's participation in the program declined further treatment, constituted group C. The control group D consisted of 19 young people who had had only fluoride mouthrinsings each second week during the first year of the trial. Regardless of grouping, all had had fluoride mouthrinsings during the whole of their earlier schooling. Ten questions concerning their attitude to teeth and dental health were answered on a graphic rating scale, the ends of the scale marking the most positive and negative attitudes, respectively. The results showed no marked differences in attitudes among the four groups: only a few significant differences were found at the 5% level. The differences in clinical variables recorded among the groups did not correspond to significant differences in measured attitudes. Great differences, on the other hand, were found at an individual level. All subjects had consistently positive attitudes except in their views of their own future state of dental health; the large scatter (deviation) in the answers on this point reveals uncertainty of their ability to retain their present (good) state of dental health. Analysis of data showed close correlation between attitudes to their own present and future state of dental health and the number of decayed and filled tooth surfaces (DFS prevalence) at the end of the trial. There was no corresponding correlation between the opinion as to how to look after one's own teeth and the individual's gingival condition at the end of the trial.
Direct irrigation and subgingival plaque
Authors: Hardy J. H. , Newman H. N. , Strahan J. D.
Published: December 2005

Abstract The aim of this study was to compare the penetrability of periodontal pockets by two direct irrigation techniques. By use of a syringe and a blunt hypodermic needle, irrigation was performed with a disclosing solution either as the level of the gingival margin or 3 mm within the pocket. The latter, “deep” irrigation, was shown to be an effective method of reaching the apical plaque border in both shallow and deep pockets. It is suggested that deep irrigation may prove a suitable approach to the effective control of subgingival plaque.
Bacterial invasion of the periodontium in a case of juvenile periodontitis
Authors: Gillett Roy , Johnson Newell W.
Published: December 2005

Abstract A case of juvenile periodontitis is described where biopsy material taken from a lower right incisor during periodontal surgery revealed plaque‐derived bacteria present within the periodontal connective tissue. The gingival connective tissue contained an inflammatory infiltrate which exhibited a profound loss of collagen and was dominated by plasma cells, many of which had a bizarre cytoplasmic morphology. The invading bacteria were morphologically heterogeneous but mainly gram‐negative. Some were found in a patchy distribution in the apical margins of the inflammatory infiltrate and more numerous groups of organisms were in the collagenous connective tissue apical to the infiltrated area. Polymorphonuclear neutrophils (PMN) were seen in association with the bacteria and some PMN showed phagocytosis of bacteria without significant degranulation. This is the first description of bacterial penetration of the periodontium in juvenile periodontitis; it is not known how frequently this occurs but it is an interesting finding in a condition where there is known impairment of one branch of the host's defence mechanisms, namely PMN phagocytosis and degranulation.
The effect of single morning and evening rinses of chlorhexidine on the development of tooth staining and plaque accumulation
Authors: Addy M. , Moran J. , Davies R. M. , Beak A. , Lewis A.
Published: December 2005

Abstract A dietary aetiology for tooth staining associated with the use of chlorhexidine has been postulated. The time related activity of chlorhexidine would therefore suggest that evening rinsing would result in less staining than morning rinsing. This study measured tooth and tongue staining and plaque accumulation in a group of 18 volunteers, rinsing once at night or once in the morning with chlorhexidine in a blind cross‐over design. Beverage intake during two 10‐day periods was prescribed. Significantly more tooth staining, but not tongue staining, was seen with morning rinsing. Plaque accumulation showed a trend to more plaque with morning rinsing, which was not significant. The findings would be consistent with a dietary aetiology for tooth staining. However, these results emphasise the considerable duration of activity of chlorhexidine on surfaces in the oral cavity and the theory of progressive desorption of chlorhexidine from the tooth surface is questioned.
Regeneration of infrabony periodontal defects in humans after implantation of allogenic demineralized dentin
Authors: Movin Susanne , Borring‐Møller Gert
Published: December 2005

Abstract Previous studies have suggested that implants of allogenic demineralized dentin might improve bone regeneration and healing in the treatment of infrabony periodontal defects.

In order to make a clinical evaluation of this possibility, the material was inserted into 14 infrabony defects in 10 patients undergoing a new attachment operation. Twelve defects in 12 patients served as controls. In half of these cases no grafting material was used and the remaining six defects were filled with autogenous cancellous bone from the jaw. The defects were classified as two‐wall and combined three‐ and two‐wall bony defects. Probing from a fix point and periodic identical X‐rays were performed before the surgical treatment and 12 months postoperatively.

During healing no clinical signs of rejection of the dentin implants were observed, but the soft tissue healing was delayed, probably due to a slow resorption of the dentin implants. After 12 months no statistically significant difference was found between test and control groups regarding the mean coronal displacement of the bottom of the pocket.

No conclusive evidence regarding the capacity of allogenic demineralized dentin to induce new connective tissue attachment could be drawn from the present study, but the clinical results, combined with the fact that the dentin implants are time consuming to produce, indicate that this material is not suitable for the treatment of infrabony periodontal defects.
Plaque control with chlorhexidine and D‐301, a quaternary ammonium compound
Authors: Saxer U. P. , Mörmann W. , Firestone A. R. , Eltink B.
Published: December 2005

Abstract Eighteen female dental hygiene student took part in a double‐Wind, crossover clinical trial of equimolar (2.2 mmol) rinsing solutions of D‐301, a quaternary ammonium compound and chlorhexidine digluconate. Rinsings were partly supervised, test periods were 7 days (5 days without oral hygiene) with a 1‐week interval.

Plaque formation was significantly reduced by both test solutions versus the control: on not precleaned tooth surfaces plaque formation was equally inhibited by the chlorhexidine and D‐301 mouthrinses. On precleaned surfaces D‐301 significantly inhibited plaque formation compared with the control rinse, but was less effective than chlorhexidine. There was no significant change in the FBI, a measure of gingival inflammation, during any of the test periods. Staining of teeth and tongue was judged as equal after chlorhexidine and D‐301 use. Reports of taste and gastric disturbances were minimal but more frequent during the D‐301 test period.
A longitudinal study of isolated gingival recession in the mandibular central incisor region of children aged 6‐8 years
Authors: Powell R. N. , McEniery T. M.
Published: December 2005

Abstract A 2‐year longitudinal investigation of isolated gingival recession was undertaken in 42 children aged 6‐8 years at the commencement of the study. Gingival inflammation was controlled by supervised tooth brushing or professional plaque control. Mandibular anterior crowding considered to have contributed to the degree of recession was untreated in 11 subjects, while in 13 subjects serial extractions had been undertaken. No attempt was made to correct frenal involvement in those subjects (9) where it might have been considered a contributing etiologic factor. After 2 years, improvement in gingival contour was most apparent in those subjects whose gingival inflammation had been controlled. This was achieved more readily with professional plaque control than with supervised tooth brushing. Improvement in arch alignment and gingival contour was greater in untreated subjects than in those receiving serial extractions. When gingival inflammation was controlled evidence of frenal involvement declined. Control of gingival inflammation appears to be the most important factor in the treatment of isolated gingival recession in the mandibular central incisor region.
Quantitative histopathologic assessment of developing phenytoin‐induced gingival overgrowth in the cat
Authors: Hassell Thomas M. , Roebuck Steven , Page Roy C. , Wray Susan H.
Published: December 2005

Abstract Phenytoin (Dilantin®) induces gingival overgrowth characterized by an accumulation of connective tissue. The cell‐to‐matrix ratio in the mature lesion is normal, yet there must be more fibroblasts per oral cavity if there is excessive tissue mass. Using a mongrel cat model system, we studied the early, developing phenytoin‐induced lesion by quantitating fibroblasts per unit of tissue in papilla biopsies collected over a 3‐month period of daily drug administration. At 6 and 8 weeks, the number of fibroblasts per unit of tissue increased dramatically. By 3 months, as the lesions matured, the fibroblast‐to‐matrix ratio returned to normal. We suggest that the drug interacts with resident gingival fibroblasts, causes them to proliferate and thus induces a true, but transient, hypercellularity. Cell division then appears to slow or cease, and rapid production of connective tissue matrix ensues, returning the cell‐to‐matrix ratio to normal.
Anti‐bacterial effect of citric acid treatment of periodontally diseased root surfaces In vitro
Authors: Daly C. G.
Published: December 2005

Abstract This investigation examined whether citric acid may exert an anti‐bacterial effect against plaque deposits present on root surfaces in vitro. Aerobic and anaerobic blood‐agar plate cultures were prepared from plaque samples obtained from the proximal root surfaces of 20 periodontally diseased human teeth following extraction. Ten teeth were exposed to saturated citric acid (pH 1) for 3 min, followed by rinsing in sterile 0.85% saline and plaque samples were then obtained immediately adjacent to those sites sampled initially. Controls consisted of using sterile water instead of citric acid on a further five teeth. The numbers of colonies present on pre‐ and post‐treatment culture plates were counted al 24 h. The results indicated that citric acid application reduced, in all instances, the numbers of colonies grown from post‐exposure plaque samples as compared to pre‐exposure samples. No colonies were detected in 55% of aerobic and 30% of anaerobic cultures of acid‐treated root surface samples. For aerobic cultures, citric acid exposure reduced the number of colonies grown from >104 to <100 in 95% of the root surfaces sampled, while for anaerobic cultures, reduction from >104 to <100 was found in 80% of surfaces sampled. The findings indicate that citric acid exerts anti‐bacterial activity against microbial plaque deposits present on periodontally diseased root surfaces in vitro.
A probe for measuring the depth of furcal defects
Authors: Tal Haim
Published: December 2005

Abstract A probe has been devised, which permits direct measurement of the depth of furcal defects. The measurements are accurate to the nearest millimetre.

The probe is easy and convenient to use and gives consistent measurements. It can be used to measure the depth of furcal defects in dry skulls, or in living subjects, and should prove useful in biometric, anthropometric and clinical studies.
Identification of soft tissue brushing lesions
Authors: Sandholm Leena , Niemi Maija‐Liisa , Ainamo Jukka
Published: December 2005

Abstract The study was carried out in order to categorize visual signs of trauma caused to gingival tissues by standardized toothbrushing. The teeth of 12 dental hygienist students were professionally brushed after 2 days of no oral hygiene measures. A modified Bass technique was used in brushing. After visual classification the brushing lesions were replicated in order to assess the corresponding changes as seen in SEM examination. The visual evaluation comprised three types of soft tissue appearance: a positive lesion, an uncertain lesion and a non–traumatized gingival unit. Ninety out of the 101 lesions which were clinically classified as positively traumatic were found traumatized also in the SEM analysis. Of the 26 gingival lesions which were classified as clinically uncertain, 13 were determined traumatic in the SEM analysis. Clinical evaluation was thus found to correlate significantly to the SEM findings although discrepancies between the two classification systems were also observed.
The capacity of reduced periodontal tissues to support fixed bridgework
Authors: Nyman Sture , Ericsson Ingvar
Published: December 2005

Abstract The total area of periodontal ligament around the abutment teeth in 60 fixed bridges, inserted in patients treated for advanced periodontal disease, was calculated and compared with the total “periodontal ligament area” of the teeth replaced by politics. The calculations revealed that only in 8% of the bridge restorations did the periodontal ligament area of the abutment teeth equal or exceed that of the replaced teeth. In 57% of the bridge material the periodontal ligament area of the abutments was less than 50% of the anticipated normal ligament area of the pontics. Despite the fact that the periodontal support for the restorations was dramatically reduced, all bridges have functioned properly for 8‐11 years and the periodontal tissues around the abutment teeth have not suffered further loss of attachment during the period of maintenance care.
Teaching plaque control I. A five‐visit versus a two‐visit program
Authors: Söderholm Göran , Nobréus Nils , Attström Rolf , Egelberg Jan
Published: December 2005

Abstract The effects of two series of oral hygiene instruction programs were studied. One of the programs was given as a series of five consecutive 30‐min visits during 14 days. The other program contained the same basic components but was scheduled as two 60‐min visits. Sixty‐nine white‐collar employees served as subjects and were divided into three matched groups; two experimental groups (five‐visit group, two‐visit group) and one control group.

The five‐visit program as well as the two‐visit program significantly reduced the presence of plaque, gingival bleeding and periodontal pockets. No differences could be observed between the results in two experimental groups during the immediate 12‐week observation interval or throughout the subsequent 48 months of maintenance care.
Teaching plaque control II. 30‐minute versus 15‐minute appointments in a three‐visit program
Authors: Söderholm Göran , Egelberg Jan
Published: December 2005

Abstract Two plaque control programs were compared. One of the programs was given as a series of three consecutive 30‐min instruction appointments during a 14‐day period. The other program was condensed into one 15‐min instruction appointment and two subsequent 15‐min follow‐up visits. Fifty‐nine blue‐collar workers served as subjects and were divided into three matched groups: two experimental groups (30‐min and 15‐min group) and one control group.

The 30‐min program as well as the 15‐min program significantly reduced the plaque scores in the participants. No difference could be observed between the results of the two programs during the immediate 12‐week observation interval or throughout the subsequent 24 months of maintenance care. The results of the present study together with results by Söderholm et al. (1980) and Woofter et al. (1980) indicate that comprehensive plaque control programs may not be necessary and may not increase the effect of basic plaque control instruction.
Development of plaque and gingivitis following antibiotic therapy in dogs
Authors: Dahlén G. , Heijl L. , Lindhe J. , Möller Å.
Published: December 2005

Abstract Changes in the subgingival microbiota were studied during a 4‐week period of plaque accumulation in beagles which initially had clean teeth and healthy gingiva. The effect of Clindamycin, Metronidazole and Vancomycin on the microbiota and associated gingivitis was also determined. Fifteen 1‐year‐old beagle dogs were used. During two subsequent periods of plaque accumulation, one without (control) and one with (test) antibiotic therapy, the animals were allowed to accumulate plaque. Plaque and gingivitis development was assessed by clinical measurements. Plaque samples were harvested from the gingival sulcus region and the percentage distribution of different bacteria was determined following aerobic and anaerobic incubation in selected media. Following microbial sampling, biopsies of the gingiva and surrounding soft and hard tissues were removed and the size of the inflammatory cell infiltrate assessed.

The results demonstrated that beagle dogs with a normal gingiva harbored a microbiota within the gingival sulcus region dominated by gram‐positive and gram‐negative rods. After 4 weeks of undisturbed plaque accumulation, the number of sulcus bacteria had increased 100‐fold. This increase was the result of a proliferation of gram‐negative anaerobic rods. Concomitant with this change of the microflora, an inflammatory reaction developed in the gingiva. When the dogs during a similar 4‐week period were given Metronidazole, no increase of the subgingival microbiota occurred. The inflammatory response of the gingiva was minute. Treatment with Clindamycin and Vancomycin did not entirely prevent the proliferation of the subgingival bacteria. The number of microorganisms harbored after 4 weeks of Clindamycin and Vancomycin treatment was, however, only 50% of that of the control period. Even if the number of colony forming units was similar at the end of Vancomycin and Clindamycin treatment the quality of the two subgingival microbiotas was different. Vancomycin treatment resulted in a plaque dominated by gram‐negative bacteria while Clindamycin allowed gram‐positive bacteria to increase in number. Gingival inflammation resulting in the Vancomycin group was more pronounced than the gingivitis response in the Clindamycin group.
A new In vivo replica technique for scanning electron microscope study of dental plaque morphology
Authors: Lambrechts Paul , van Steenberghe Daniel , Vanherle Guido
Published: December 2005

Abstract For the micro‐morphological investigation of soft oral tissues and deposits on the teeth in vivo. the use of an accurate replica technique is essential if the object under study cannot be examined directly. The conventional replica techniques based on resin or elastomer positive dies, have so me limitations due to the instability of the sample die in the scanning electron microscope (S.E.M.) conditions and artifacts induced at higher magnifications. Therefore, a new replica technique has been developed using a low viscosity impression material that is subsequently copperplated and poured with synthetic plaster. 11 s offers a stable metal positive die suitable for direct examination in the S.E.M. without prior gold evaporation. Higher magnifications (>7500) are easily obtained without the danger of artifacts. Reproduction of details is of a high order, and the reproduction ability depends only on the accuracy of the first impression. This technique offers new possibilities of discerning fine changes in surface detail n longitudinal clinical investigations.
The regenerative potential of the periodontal ligament
Authors: Nyman Sture , Gottlow Jan , Karring Thorkild , Lindhe Jan
Published: December 2005

Abstract The aim of the present study was to examine if new cementum and new attachment may form during healing of a wound prepared in such a way that preference is given to periodontal ligament ceils to repopulate the wound area adjacent to a root which has been surgically deprived of its periodontal ligament and cementum layer. The maxillary lateral incisors and mandibular canines in three monkeys were used for experimentation. Following elevation of a mucoperiosteal flap, the buccal and approximal alveolar bone was removed within an area extending from the mid‐root level to a level 2 mm apical to the marginal bone crest. Following bone removal, the root surfaces were curetted in order to remove the cementum layer. Notches were prepared in the roots to demarcate the denuded root portion. Prior to repositioning of the tissue flap a millipore filter was placed over the treated area in order to prevent the gingival connective tissue from coming into contact with the root surface during healing. The animals were sacrificed 6 months after surgery. The jaws were removed and histological sections of the experimental teeth and surrounding periodontal tissues were produced.

New cementum with inserting collagen fibers was observed on the curetted root surfaces. However, this result of healing did not consistently occur along the entire length of the curetted root portion. In the coronal part of the wound, healing was frequently characterized by connective tissue adhesion to the root surface without signs of cementum formation and fibrous attachment.

The results of the experiment suggest that the periodontal ligament cells possess the ability to reestablish connective tissue attachment.
Gingival bleeding after Chlorhexidine mouthrinses
Authors: Ainamo J. , Asikainen S. , Paloheimo L.
Published: December 2005

Abstract During a clinical trial for evaluating the antiplaque effect of two flavoured chlorhexidine rinses, the observation was made that bleeding after gentle massage of the gingival margin occurred more often after chemical than after mechanical oral hygiene measures. In order to ascertain the validity of this unexpected observation, the same dental students participated in a repetition of the trial 18 months later. The results of the two trials indicate that gingival bleeding after gentle massage of the margin with the side of a periodontal probe actually occurs more frequently after rinsing twice daily with a 0.2% aqueous Chlorhexidine solution for 1 week than after meticulous mechanical oral hygiene measures during an equally long time period. The average frequency of bleeding, in per cent of all examined gingival units, ranged from. 1.3% after mechanical cleaning of the teeth to 5.4% after rinsing with Chlorhexidine for 1 week. Neither the frequency of bleeding nor the difference between mechanical and chemical plaque control were considered to be of clinical significance. Further microbiological and histological studies are being conducted in an attempt to clarify the reason for the observed bleeding tendency.
Effects of sugared and sugar‐free chewing gum on the accumulation of plaque and debris on the teeth
Authors: Addy M. , Perriam E. , Sterry A.
Published: December 2005

Abstract The aim of this study was to determine the effects of sugar‐free and sugar‐containing gums on plaque formation, established plaque and salivary debris. Plaque accumulating during three 5‐day periods was recorded in a group of 10 students who, in the absence of normal oral hygiene methods, chewed sugar‐free or sugar‐containing chewing gum or did not chew gum. In a second group of 10 students the effect of chewing the two types of gum on 3‐day accumulations of plaque was recorded. Finally, the wet weight of liquorice debris present in saliva with and without gum chewing, was recorded. During the no chewing periods distinct and significant differences in the amounts of plaque accumulating at different sites were apparent. Both types of chewing gum significantly and comparably reduced plaque accumulation during the 5‐day period. The chewing gums also significantly reduced established plaque on many tooth surfaces. Salivary debris was significantly reduced by 50% after chewing gum. It was noted that plaque removal occurred primarily from sites remote from the gingival margin and interdental areas and therefore it was concluded that the observed effects of chewing gum on plaque would not be reflected in a reduction in gingival inflammation.
Effect of root surface alterations on periodontal healing. I. Surgical denudation
Authors: Proye M. P. , Polson A. M.
Published: December 2005

Abstract The present study was undertaken to evaluate the effect of root surface denudation on periodontal healing. Twelve teeth, distributed in four squirrel monkeys, were extracted and reimplanted after surgically denuding the coronal root surface of connective tissue fibers and cementum by root planing. The reimplantation schedule provided three teeth for histologic analysis at 1, 3, 7 and 21 days after reimplantation. One day after reimplantation a zone of fibrin enmeshing erythrocytes and inflammatory cells was interposed between the root surface and the remaining periodontal fibers attached to the alveolar bone. Epithelium migrated rapidly along the denuded root, had reached the alveolar crest at 3 days, and was within the ligament space at 7 days. At 21 days, the epithelium was at the apical limit of root instrumentation, which corresponded to the level of attached connective tissue fibers on the root surface. No evidence of new connective tissue attachment was observed on the denuded root surface. It was concluded that the absence of fibers on the root surface resulted in apical migration of the epithelium, and precluded formation of new connective tissue attachment.
Regeneration of the interdental soft tissues following denudation procedures
Authors: van der Velden U.
Published: December 2005

Abstract The present study investigated the location of the gingival margin, following denudation of the interdental alveolar bone. In seven patients apically positioned flap procedures were performed in such a way that complete interdental denudation was achieved. Teeth showing interdental osseous craters were excluded from the study. Three years post‐treatment a mean pocket depth of 2.17 mm was found. No differences in attachment level prior to and 3 years after treatment could be assessed.

Results showed a mean distance of 4.33 mm between the location of the gingival margin 3 years post‐treatment and the bone level during surgery. This finding is discussed in relation to the question of how much alveolar bone should be removed if, in case of extensive carious lesion or crown fracture, the cervical outline of the restoration is located near the bone level.
An approach to the definition of periodontal disease syndromes by cluster analysis
Authors: Socransky S. S. , Tanner A. C. R. , Goodson J. M. , Haffajee A. D. , Walker C. B. , Ebersole J. L. , Sornberger G. C.
Published: December 2005

Abstract Clinical syndromes of 22 untreated patients with advanced destructive periodontal disease were analyzed using cluster analysis. Clinical characteristics coded for each patient included age, sex, measures of gingival inflammation, plaque, suppuration, pocket depth, attachment level, extent and pattern of bone loss, rate of change in pocket depth, and correlation coefficients between certain clinical measurements. Microbiologic features included darkfield enumeration of 10 morphologically distinct forms of organisms which were removed from the three sites showing the most advanced destruction in each patient, as well as viable counts of specific microbial groups from the same teeth using elective and selective media. Serum antibody levels were determined by the ELISA technique to 13 species of subgingival microorganisms. The Gower coefficient was used to estimate similarity between patients and clusters were formed using an average unweighted linkage sort. Three distinct patient clusters were observed with greater than 70 % average intra‐cluster similarity. One subject did not fall into any of the patient clusters. The features which defined and differentiated the clusters were found to include age of subject, extent and patterns of bone loss, percent of sites showing change in pocket depth and attachment level, percent of small motile rods, intermediate spirochetes and fusiforms and serum IgG levels against Bacteroides gingivalis, Selenomonas sputigena and a Wolinella strain.
Effect of tetracycline on gingival inflammation and alveolar bone resorption n beagles: An individual tooth by tooth analysis
Authors: Jeffcoat M. K. , Williams R. C. , Goldhaber P.
Published: December 2005

Abstract The effect of systemic tetracycline on gingival inflammation and alveolar bone resorption was studied in beagle dogs. Seventeen dogs were divided into three groups receiving either no treatment, 250 mg tetracycline HO, or 500 mg tetracycline HC1 daily. The severity of gingival inflammation and activity of alveolar bone resorption during a 6‐month pretreatment period was compared to a 24‐month treatment period for each individual tooth studied. In the first 12 months of treatment there was a significant decrease in the severity of gingival inflammation and the activity of alveolar bone loss in the tetracycline treated dogs. By 24 months of treatment increased gingival inflammation and rate of bone loss was evident in the treated dogs. In the untreated control dogs there was a statistically significant association between the severity of gingival inflammation and activity of alveolar bone resorption about the teeth studied. In the tetracycline treated dogs, no such association existed.
Effect of longstanding jiggling on experimental marginal periodontitis in the beagle dog
Authors: Ericsson Ingvar , Lindhe Jan
Published: December 2005

Abstract The aim of the present experiment was to study the effect of a prolonged period of jiggling force application on the rate of progression of ligature‐induced, plaque‐associated marginal periodontitis in the beagle dog.

The experiment was performed on eight dogs fed a diet which permitted dental plaque accumulation. On Day 0 a phase of periodontal tissue breakdown was initiated around the mandibular fourth premolars (4P; P4) by the placing of plaque retention ligatures around the neck of the teeth. The ligatures were exchanged once a month throughout the entire study. On Day 60 trauma from occlusion of the jiggling type was produced in the P4 region and maintained for 300 days. The animals were sacrificed on Day 360. Following sacrifice tissue sections comprising 1M, 4P, 4P and P3, P4, M1 were produced and subjected to microscopic analysis.

The experiment revealed that in the dog jiggling forces applied to teeth which are also subjected to ligature‐induced and plaque‐associated marginal periodontitis, may enhance the rate of destruction of the periodontium.
Use of chlorhexidine as a plaque control measure following surgical treatment of periodontal disease
Authors: Westfelt Elisabeth , Nyman Sture , Lindhe Jan , Socransky Sigmund
Published: December 2005

Abstract Chlorhexidine mouth rinsing was compared with regularly performed professional tooth cleaning as a plaque control measure during healing following periodontal surgery. 14 patients were selected for the study. A Baseline examination included assessment of oral hygiene status, gingival condition, probing depth and attachment level. In each patient, scaling and root planing was earned out in conjunction with the modified Widman flap procedure including reacontouring of alveolar bone irregularities in 2 jaw quadrants. The same procedures without osseous surgery were performed in contralateral jaw quadrants.

7 patients rinsed their mouth with a solution of 0.2% chlorhexidine digluconate twice a day, 2 min each time, for the first 6 months after therapy (healing phase). During the same period the remaining 7 patients were recalled every 2 weeks for professional tooth cleaning ad modum Axelsson & Lindhe (1974). Following reexamination after 6 months, all 14 patients were placed on a maintenance care program which included mechanical prophylaxis once every 3 months for 18 months (maintenance phase). Reexaminations were performed 6, 12 and 24 months after completion of initial therapy.

The results revealed that professional tooth cleaning was somewhat more effective as a plaque control measure during healing following surgery than chlorhexidine mouth rinsing. At the end of the healing phase (1) there was a higher frequency of sites with pockets deeper than 4 mm in the patients who rinsed with chlorhexidine, (2) less gain of attachment occurred following chlorhexidine rinsing in pockets with an initial probing depth of >4 mm, and (3) attachment Joss in initially shallow pockets was somewhat more pronounced in the patients who rinsed with chlorhexidine, The differences in the effect of the 2 methods of plaque control, however, were small and in most respects diminished in the course of the maintenance phase. It was concluded that mouth rinsing with chlorhexidine is a proper alternative to plaque control during healing following periodontal surgery.
Use of metronidazole as a probe in the study of human periodontal disease
Authors: Lindhe J. , Liljenberg B. , Adielson B. , Börjesson I.
Published: December 2005

Abstract The present investigation was performed to test the hypothesis that the persistence of inflammatory periodontal disease in human subjects is incompatible with the elimination of the anaerobic segments of the subgingival microbiota.

16 human subjects participated in the trial. They were selected on the basis of advanced periodontal disease which had produced at least 4 pairs of contra lateral teeth with advanced disease. At the Baseline examination the diseased sites were characterized by assessment of plaque, gingivitis, probing depth and attachment level. In addition, the composition of the subgingival microbiota was determined. One pair of sites was subjected to biopsy. In the tissue samples the size of the inflammatory cell infiltrate was assessed.

Following the Baseline examination the patients were randomly distributed into 2 treatment groups, test and control. The patients of the test group received metronidazole for 3 periods of 2 weeks each, separated by intervals of 8 weeks. In addition, all patients received detailed oral hygiene instruction and a series of subgingival scalings involving 2 quadrants of the dentition, either the right or the left jaw quadrants, Reexaminations were performed 2, 10, 20, 30 and 50 weeks after the Baseline examination. Biopsies from the predetermined sites were obtained at the reexaminations performed 2,20 and 50 weeks after the initiation of the therapy.

The results demonstrated that the elimination of metronidazole sensitive bacteria from the subgingival microbiota resulted in the disappearance of clinical and histopathological signs of periodontal disease. Metronidazole has a unique bactericidal range against anaerobic bacteria. The present findings, therefore, emphasize the central role played by the anaerobic segments of the subgingival plaque for the maintenance of the inflammatory component of periodontal disease.
Comparison of different data analyses for detecting changes in attachment level
Authors: Haffajee A. D. , Socransky S. S. , Goodson J. M.
Published: December 2005

Abstract The purpose of the present investigation was to evaluate methods to detect periods of destructive periodontal disease activity in individual sites using pairs of repeated attachment level measurements. Attachment level measurements were made at 6 sites on every tooth in 22 individuals with radiographie evidence of periodontal destruction, and were repeated within 7 days. A total of 3414 sites were monitored at 2‐month intervals for approximately 1 year. 3 analytical procedures were used to test for significant changes in attachment level. For regression analysis, a linear least squares fit function of time in days vs attachment level was computed for each site and the slope tested for difference from 0. Running medians of 3 were used to smooth attachment level measurements and changes > 2 mm in the smoothed curves were considered significant. By the tolerance method diferences between pairs of attachment level measurements were used to compare the mean change and the site specific variability of that change. The proportion of specific agreement (Ps) for breaking down sites was highest between the tolerance and running median methods (Ps = 0.63). Overall agreement (kappa), which included sites which showed “loss”, “gain”, and no change was 0.56. By regression analysis (P < 0.01). 175 sites were identified as having significant attachment loss and 79 sites were identified as improving. By running medians these figures were 90 and 50. and by tolerance 94 and 40, respectively.

Each of the 3 methods had certain advantages. Regression analysis was particularly sensitive to gradual changes in slope whereas the running median method detecting abrupt changes in attachment level. The tolerance method was well suited to detecting changes over a short period of time. The tolerance and running median methods detected more breaking down sites on the molars and tower incisors and on interproximal surfaces: whereas regression analysis did not show these differences.
A long junctional epithelium ‐ A locus minoris resistentiae in plaque infection?
Authors: Magnusson Ingvae , Runstad Lilian , Nyman Sture , Lindhe Jan
Published: December 2005

Abstract The present experiment was undertaken to examine whether a gingival unit with a long junctional epithelium provides a. less efficient seal against plaque infection than a unit with a junctional epithelium of normal length. Periodontal tissue breakdown was produced around 8 teeth (test teeth) in each of 4 monkeys by placing elastic ligatures around the neck of the teeth. When the periodontal pockets at the approximal tooth surfaces were 4–5 mm deep and angular bony defects had been produced, the ligatures were removed. The periodontal tissues of the test teeth were subjected to flap surgery. The exposed root surfaces were scaled and planed but no osseous surgery was carried out. Following surgery, plaque control comprising all teeth of the dentition was instituted and maintained for 4 months. Healing following this type of surgical treatment involved the establishment of a long junctional epithelium. During the final 6 months of experimentation, oral hygiene measures were abandoned and plaque was allowed to accumulate. In each animal, 4 test teeth and 3 normal control teeth were selected to study gingival inflammation resulting from undisturbed plaque accumulation. In order to enhance subgingival plaque formation, in each animal cotton floss ligatures were placed in the entrance of the gingival sulci of the remaining 4 test teeth and in 3 controls. The animals were sacrificed 10 months after surgery. The jaws were removed and histological sections of the teeth including surrounding periodontal tissues were produced.

The histological analysis revealed that the inflammatory lesion in the gingival connective tissue (the ICT area) resulting from plaque infection did not extend deeper into the periodontal tissues in sites with a long junctional epithelium than in gingival units of normal height. The results were interpreted to indicate that the barrier function of a long junctional epithelium against plaque infection is not inferior to that provided by a dentogingival epithelium of normal length.
Dentine hypersensitivity ‐ A review
Authors: Dowell P. , Addy M.
Published: December 2005

Abstract The exposure of cervical dentine has a multifactorial aetiology and pain may frequently be elicited by a number of stimuli. Management of the condition, dentine hypersensitivity, tends to be empirical because of the lack of knowledge concerning the mechanism of pain transmission through dentine. The pulpal changes associated with the condition and any modulating effect on symptoms are by no means clearly established. Evidence suggests that exposed dentine which is sensitive exhibits patent tubules. The question of how pain is initiated across the dentine has received considerable attention but still remains somewhat debatable. The literature reviewed indicates that, at most, nerve fibres only penetrate a limited distance along some dentinal tubules. The theories that either the odontoblasts and their processes act as dentinal receptors or the nerves in the pulp are the pain receptors, are discussed. Evidence for the stimulation of pulp nerve fibres by a hydrodynamic mechanism would appear the most likely mechanism. Nevertheless, whichever theory proves to be correct, occlusion of dentinal tubules would appear an essential prerequisite for an effective desensitising agent.