bluuebunny/crossref_metadata_2025 huggingface dataset:
Indicators of periodontal disease activity: an evaluation
Authors: Fine Daniel H. , Mandel Irwin D.
Published: December 2005

Abstract It is becoming increasingly apparent that the traditional clinical criteria are inadequate for: (a) determining active disease sites in periodontitis, (b) monitoring quantitatively the response to therapy or (c) measuring the degree of susceptibility to future breakdown. In an attempt to develop objective measures, a wide varity of studies have been undertaken using saliva, blood, plaque and gingival crevicular fluid (GCF) as the specimen source. Examination has included: (a) specific bacteria and their products; (b) host cells and their products (enzymatic and antibacterial, both immunologic and non‐immunologic); (c) products of tissue injury derived from local epithelial and connective tissues and bone. Although most of the work to date has failed to provide reliable aids to the clinician, refinements in techniques for sampling and the availability of more sophisticated analytic techniques give cause for optimism.

Methods proposed for detection of disease‐associated bacteria in subgingival plaque vary in their sensitivity and specificity. Dark field microscopy shows some correlation with existing disease; however, the limited specificity of this method imposes severe restrictions on its usefulness. Highly specific polyclonal and monoclonal antisera to suspected pathogens Bacteroides gingivalis and Actinobacillus actinomycetemcomitans have been developed and improved methods of identification of these microbes in plaque by ELISA immunofluorescence and flow cytometry are under development.

With respect to the host response, a strong correlation between antibody patterns to specific bacteria and periodontal disease categories appears to be emerging. Although most studies have focused on serum antibody derived from peripheral blood, a shift to detection of local antibody response appears to be likely. Techniques of measurement that are exquisitely sensitive have been developed for detection of major immune recognition proteins such as antibody and complement in crevicular fluid. Research efforts attempting to correlate local antibody response to local disease activity are underway.

Measurement of GCF flow rate, endotoxin, H2S, butyrate and a variety of enzymes (e. g., collagenase, arylsulfatase, B‐glucuronidase) show good correlation with levels of gingivitis. In periodontitis, the most promising markers of tissue breakdown are prostaglandins of the E series, the enzymes collagenase and aspartate aminotransferase, sulfated glycosaminoglycans, osteoclastic activating factor and bone resorptive capacity of crevicular cells. Assay of the migration of crevicular leucocytes in vivo can serve as an indicator of a defect in host resistance. Experimental study in animal models with histological correlates and prospective studies on humans with standardized clinical correlates are needed to validate these objective measurements.
Calculus revisited
Authors: Mandel Irwin D. , Gaffar Abdul
Published: December 2005

Abstract. Although there is no doubt that gingivitis can develop in the absence of supragingival calculus, it is not clear to what extent the presence of mineralized deposit enhances gingival inflammation. Partial inhibition of plaque mineralization can be accomplished by chemical agents, but there has been no demonstration in humans of a reduction in gingivitis. It remains to be established what level of inhibition (if any) is required to have more than a cosmetic effect.

Since the accepted scenario is that apical growth of supragingival plaque precedes the formation of subgingival calculus, there is no longer an issue of whether subgingival calculus is the cause or the result of periodontal disease. Subgingival mineralization results from the interaction of subgingival plaque with the influx of mineral salts that is part of the serum transudate and inflammatory exudate. This chronology, however, should not be the basis for relegating calculus to the ash heap. Morphologic and analytical studies point to the porosity of calculus and retention of bacterial antigens and the presence of readily available toxic stimulators of bone resorption. When coupled with the increased build up of plaque on the surface of the calculus, the combination has the potential for extending (beyond that of plaque alone) the radius of destruction and the rate of displacement of the adjacent junctional epithelium. The centrality of thorough scaling and root planing in the successful maintenance of periodontal health supports the view that subgingival calculus contributes significantly to the chronicity and progression of the disease, even if it can no longer be considered as responsible for initiation.
The osteoclast and periodontitis
Authors: Sterrett John D.
Published: December 2005

Abstract. The osteoclast may play an important rô le in the variable rate of osseous destruction seen in periodontitis. Current understanding of various aspects of the osteoclast may help explain this fact. This review paper will first look at two theories of cell origin of the osteoclast: the multipotential osteoprogenitor cell theory and the hemopoietic stem cell theory. Next, ultrastructural features characteristic to the cell such as the ruffled border, clear zone, and lysosomal system, will be discussed. Thirdly, current and proposed theories on the actual mechanism of bone degradation are considered. This includes the one‐cell theory and the two‐cell theory. Finally, elements which activate the osteoclast are enumerated and their delicate interplay is outlined. In the context of this information, pathways found in the periodontal lesion (microbial agents, inflammatory cells and their products) which attract and activate elements of the osteoclastic system are discussed.
The nature of the inflammatory infiltrates in childhood gingivitis, juvenile periodontitis and adult periodontitis: immunocytochemical studies using a monoclonal antibody to HLA Dr
Authors: Gillett Roy , Cruchley Alan , Johnson Newell W.
Published: December 2005

Abstract. Routinely fixed and processed gingival biopsies from childhood gingivitis, juvenile periodontitis and chronic adult periodontitis patients have been stained immunocytochemically with a monoclonal anti HLADr antibody to aid in the identification and quantification of cell types in the inflammatory infiltrates. Using immunoperoxidase staining and morphological criteria, 9 cell types were quantified in 30 patients.

Lesions in the 3 groups were found to differ widely both in size and composition. In the small childhood gingivitis lesions, most cells were small lymphocytes, over half of which were HLADr positive, whereas in juvenile periodontitis biopsies, well over half the infiltrate was plasma cells. The chronic adult periodontitis samples showed greater variability in composition between these 2 extremes, perhaps reflecting differences in disease activity. These results suggest that, when disease is quiescent, the volume of inflamed gingival connective tissue is small and is dominated by B‐small lymphocytes, whilst on activation, the lesion increases in size and much of the B‐lymphocyte population is transformed to plasma cells.

This view corroborates the results of other workers with regard to juvenile periodontitis, but suggests a different interpretation of the quiescent lesion of childhood gingivitis from that current in the literature.
Experimental gingivitis around deciduous teeth in children with Down's syndrome
Authors: Reuland‐Bosma Wimke , van Dijk Johan , van der Weele Leo
Published: December 2005

Abstract. Epidemiological studies have shown that there is a high prevalence and rapid progression of periodontal disease in children with Down's Syndrome (DS). In this respect, DS children exhibit a markedly different response compared with healthy children. In order to understand the reasons for this difference, a controlled study was set up to determine the extent and the quality of the differences in the early periodontal tissue response towards dental plaque in the deciduous dentition of DS children and matched control children.

In a preliminary investigation, the gingival health was estimated by determining the bleeding tendency. 9 healthy children were selected from a group of 14 and matched with 9 DS children with respect to plaque development, sulcus depth and age. The DS children had a higher bleeding tendency than the matched controls. In the DS children, moreover, a correlation was found between bleeding tendency and age. No such correlation was found in the controls.

After a period of intensive oral hygiene, all cleaning of teeth was discontinued for 21 days. The amount of plaque according to the plaque index, the gingival health according to the gingival index, and the amount of crevicular leucocytes and gingival exudate were assessed at days 0, 7, 14 and 21.

During the experimental phase of the study, the amount of plaque increased at a similar rate in both groups. In the DS children, the development of gingival inflammation started earlier and was more extensive. It increased after day 14, whereas in the control children, the gingival inflammation seemed to stabilize at this time. The results of the present experimental study thus confirm earlier results from epidemiological studies. The amount of gingival exudate was very low in both groups, but in the DS group it increased after day 14. In contrast to the DS children, the amount of crevicular leukocytes increased significantly in the control children from day 0 to day 21, the highest score being found on day 14. On day 7, a significantly larger amount of crevicular leucocytes was found in the DS children than in the controls. The findings of this study suggest that DS children have a different leucocyte response together with a more extensive gingival inflammation than normal children.
The effect of non‐surgical treatment on periodontal pockets in smokers and non‐smokers
Authors: Preber Hans , Bergström Jan
Published: December 2005

Abstract. Changes in probing pocket depth following non‐surgical periodontal treatment were investigated in 75 patients, 40 of whom were heavy smokers. Pockets with an initial probing depth of 4–6 mm were studied. The treatment consisted of patient instruction and motivation and debridement of plaque and calculus by hand instrumentation. The treatment was completed within 5 months and probing depth was recorded prior to and 1 month following the completion of therapy. Plaque index was reduced to a minimum in both smokers (P1I = 0.2) and non‐smokers (P1I = 0.1) following treatment. An average reduction in probing pocket depth of 1.1 mm in smokers and 1.2 mm in non‐smokers was observed. The reduction attained was less in smokers than in non‐smokers for all regions of the dentition investigated. The greatest difference between groups was observed for the maxillary anterior region.
Cell populations associated with interdental gingival bleeding*
Authors: Thilo B. E. , Caton J. G. , Poison A. M. , Espeland M. A.
Published: December 2005

Abstract. The purpose of this study was to characterize the cell populations of the mid‐interproximal gingival tissue related to the presence or absence of bleeding. 15 bleeding and 15 non‐bleeding interproximal gingival biopsies were obtained from 30 patients and processed for light microscopic evaluation. Morphometric analysis of tissue components revealed that bleeding was associated with an inflammatory lesion located in the mid‐interproximal connective tissue. The inflammatory infiltrate was dominated by mononuclear cells of the lymphocyte/macrophage/monocyte group, and the proportions of plasma cells and polymor‐phonuclear leukocytes were relatively small. The results of this study indicated that interproximal bleeding can be associated with an inflammatory infiltrate not dominated by plasma cells. The rôle of gingival bleeding in the diagnosis of periodontal disease activity is discussed.
Blastogenetic responsiveness of peripheral blood lymphocytes from patients with adult periodontitis, evaluated by a reverse hemolytic plaque assay
Authors: Kopp W. , Marggraf E.
Published: December 2005

Abstract. Peripheral blood lymphocytes were obtained from 10 patients with advanced periodontitis and from 5 normal control subjects. The lymphocytes were cultured with dental plaque, supernatant of homologous fibroblast cytoplasm and Pokeweed‐mitogen (PWM). The number of immunoglobulin‐ secreting cells (ISC) was assessed after 7 days using a reverse hemolytic plaque assay (RHPA). The stimulation levels of lymphocytes from periodontitis patients and control subjects stimulated with dental plaque and PWM were not statistically different (p>0.05). In contrast, the number of ISC produced after stimulation with fibroblast cytoplasm was increased significantly in the patients group (p<0.05). These data support the hypothesis that autologous substances play an important rôole in the cellular immune responses of patients with severe chronic inflammatory periodontal disease (CIPD).
Clinical alterations in relation to the morphological composition of the subgingival microflora following scaling and root planing
Authors: Müller Hans‐Peter , Hartmann Jürgen , Flores‐de‐Jacoby Lavinia
Published: December 2005

Abstract. The aim of the present study was to relate shifts in the composition of subgingival plaque in periodontal pockets to alterations of the clinical periodontal conditions following a single course of subgingival scaling and root planing during a period of professional supragingival plaque control. For this purpose, 36 pairs of contralateral periodontal pockets in 10 subjects with moderately advanced periodontitis were assessed for the degree of gingival inflammation, probing pocket depths, bleeding on probing, attachment levels and the amount of supragingival plaque. In addition, samples of subgingival plaque were analyzed morphologically by dark‐field microscopy. All patients received detailed information about proper oral hygiene and every 1–2 weeks, professional removal of supragingivally located deposits. When the oral hygiene standard had been sufficiently improved, 1 course of subgingival scaling on 1 side of each jaw only (test side) was carried out. Clinical and microbiological examinations were repeated after the scaling as well as after 2 and 6 months, while patients were recalled for supragingival prophylaxis every 2nd to 4th week.

Our data showed that a single course of subgingival scaling and root planing resulted in reduced probing depths, a gain in clinical attachment and a shift in the composition of the subgingival microflora to a composition found in relatively healthy periodontal conditions. In relatively shallow pockets, however, a possible influence of repeated sampling on the subgingival microflora could not be ruled out. Bleeding on gentle probing was a reliable parameter for predicting a subgingival microflora where motile bacteria hold an increased portion. The differences in the subgingival microflora between sites exhibiting gain in clinical attachment after 6 months and non‐responding sites, could not be confirmed statistically.
Influence of plasma components on luminol‐enhanced chemiluminescence from peripheral granulocytes in juvenile periodontitis
Authors: Åsman Björn , Bergström Kurt , Wijkander Peter , Lockowandt Birgitta
Published: December 2005

Abstract. The generation rate of free oxygen radicals as measured by maximal light intensity of luminol‐enhanced chemiluminescenee from peripheral blood granulocytes (PMN) stimulated with differently opsonized Staphylococcus aureus was studied in 13 patients with juvenile periodontitis (JP) and pair‐matched, healthy controls. Plasma proteins related to inflammation were also assayed. When stimulated with bacteria opsonized with autologous serum, the PMN from the JP patients showed a more intensive chemiluminescenee than did their pair‐matched controls (p<0.0005). The difference was consistent but slightly reduced when using, heat‐treated serum (p<0.006) or heterologous gammaglobulin (p<0.19) for opsonization. When testing freeze preserved sera from 11 of the compaired pairs, the sera from JP patients induced a slightly higher chemiluminescence in PMN from a healthy donor (p<0.031).

Protein analysis of the patient sera revealed a slightly higher concentration of complement 4 (p<0.032) and IgM (p<0.030) when compared with their respective pair‐matched healthy controls.

The influence of other blood components contaminating our assay system was checked on healthy PMN cells. Lymphocytes, platelets, relevant amounts of ADP and serum had no effect on the chemiluminescence.

In conclusion, the increased chemiluminescence of peripheral blood granulocytes from patients with juvenile periodontitis seems to be related mainly to the cells. The association with free oxygen radicals and their tissue‐damagemg potency might be a contributing factor in the pathogenesis of periodontal disease.
Effect of citric acid conditioning on fibroblast cell density in periodontal wounds
Authors: Aukhil I. , Pettersson E.
Published: December 2005

Abstract The present experiment was undertaken to study the repopulation of curetted root surfaces by fibroblast‐like cells in experimental periodontal wounds. 6 beagle dogs were used. After reflecting mucoperiosteal flaps, fenestration wounds were made through the buccal cortical plate exposing roots of maxillary canines in 6 beagle dogs. Exposed root surfaces were curetted to remove cementum and periodontal ligament. On 1 side, the exposed root surface was conditioned with citric acid (pH 1) for 3 min while the contralateral root was treated with distilled water. Millipore filters were placed over the wounds to prevent flap connective tissues from contacting the exposed root surface. Histometric analysis was made 10 days after wounding. Fibroblast‐like cells were seen migrating into the fenestration space and were primarily aligned along the root surface. Cell densities measured at the borders and central part of the wound showed significantly lower values (p < 0.01 and p < 0.05) in acid‐conditioned wounds compared to controls. No significant difference in cell density was noted between the borders and central part of the wound in the acid‐conditioned group. In the controls, the cell density at the borders was significantly greater than at the center, suggesting active cell migration from the borders. The present findings suggest that citric acid conditioning of root dentin may result in a low cell density during the early stages of healing in experimental periodontal wounds.
Prepubertal periodontitis
Authors: Çelenligil Haviye , Kansu Emin , Eratalay Kenan , Yavuzyilmaz Ezel
Published: December 2005

Abstract An 11‐year‐old boy with clinical and radiological features of prepubertal periodontitis is presented. He had a history of recurrent upper respiratory tract infections and otitis media. Neutrophil chemotaxis was significantly reduced compared to normal. Total T‐ and B‐lymphocyte numbers were not altered. T‐lymphocyte subsets studied with monoclonal antibodies revealed that both T‐helper and T‐suppressor cell populations were reduced with a normal TH/Ts ratio of 1.8. No significant changes were observed in the serum IgG, IgA and IgM values. Serum C3c and C4 levels were found to be elevated. These findings may contribute to the pathogenesis of prepubertal periodontitis.
Distribution of morphologically different micro‐organisms associated with active periodontal lesions
Authors: Müller Hans‐Peter , de Jacoby Lavinia Flores
Published: December 2005

Abstract The morphological composition of the subgingival plaque associated with active periodontitis lesions and comparable inactive control lesions were determined in a 36‐year‐old patient with advanced periodontal disease. Monthly measurements of the clinical attachment level were subjected to linear regression analysis as a function of time. Attachment loss was recorded during the monitoring period at 10 sites, with loss of 2 mm or more at 6 sites. Plaque samples taken from these 6 sites and from 6 control sites with similar clinical conditions were not of uniform composition. Active lesions harboured on average 46% more cocci and twice as many large spirochetes as inactive control lesions. A linear regression analysis of the proportions of different morphotypes in the subgingival plaque versus the calculated monthly attachment loss rate at the time of sampling provided only very weak correlations, if at all. The observations made in the patient under investigation suggest that there is no great probability of suspected differences in the floras of active and inactive lesions being detected by dark‐field analysis alone. The role of motile rods and spirochetes may have been overrated hitherto.
Clinical management of prepubertal periodontitis in 2 siblings with Papillon‐Lefèvre syndrome
Authors: Preus Hans , Gjermo Per
Published: December 2005

Abstract The development of prepubertal periodontitis in Papillon‐Lefevre syndrome (PLS) has been studied in 2 siblings. 12 and 8 years of age, since they were 5 and 3 years of age, respectively. Results of the treatment which comprised mechanical and chemical plaque control as well as systemic tetracycline medication, are reported. Extraction of temporary teeth, resulting in edentulousness prior to eruption of permanent teeth in the youngest child seemed to prevent destructive periodontitis from developing in the permanent dentition. After institution of continuous tetracycline medication in the oldest child at the age of 10 years, periodontitis with attachment loss did not occur in new sites. The possible role of specific micro‐organisms in the progression of PLS‐periodontitis is discussed.
Lack of association between width of attached gingiva and development of soft tissue recession
Authors: Wennström Jan L.
Published: December 2005

Abstract The purpose of this study was to longitudinally monitor changes in the position of the soft tissue margin at 26 buccal sites surgically deprived of all gingival tissue. A baseline examination carried out 6 months after treatment revealed that the sites to be monitored were lacking or had only a minimal zone (< 1 mm) of regenerated attached gingiva. 12 control sites with an “adequate” width of attached gingiva (> 1 mm) were also examined. Assessments of oral hygiene and gingival conditions, probing pocket depths, probing attachment levels, position of the soft tissue margin, and gingival width were carried out at baseline and after 5 years. The results revealed that in the test sites, a slight increase of the width of the gingiva occurred during the observation period. 7 out of the 26 areas showed a coronal regrowth of the soft tissue margin, while 2 sites showed a further apical displacement of the soft tissue margin. In the control areas, 3 sites developed recession accompanied by a reduction in the width of the gingiva. Hence, it appears that in patients maintaining a proper plaque control, the lack of an “adequate” zone of attached gingiva does not result in an increased incidence of soft tissue recessions.
The effect of different types of composite resin fillings on marginal gingiva
Authors: Van Dijken Jan W. V. , Sjöström Staffan , Wing Kenneth
Published: December 2005

Abstract Earlier studies of plaque accumulation on and gingival response around conventional composite resin fillings have produced conflicting results. No studies have been found in which the gingival reaction around newer types of resin fillings had been recorded. The aim of this study was to measure plaque retention and gingival conditions around in vivo, aged, subgingivally located, composite fillings of conventional, hybrid and microfiller types. This study was performed in 2 groups of patients. In the 1st group, there were 108 1‐year‐old class‐III restorations of the 3 composite types and in the 2nd group, 228 3‐ or 4‐year‐old class‐III or class‐IV fillings. Plaque and gingival index scores and the amount of crevicular fluid were recorded. In the group with 1‐year‐old fillings, the composite resins did not adversely affect the health of the gingival tissues. The amount of plaque on and the degree of gingivitis around the composite fillings were not significantly higher than those for the enamel surfaces. Significant differences in the amount of crevicular fluid were found between both the conventional and hybrid composites and the enamel In the groups with 3–4 year‐old fillings, the indices for each material were significantly higher than those for the enamel surfaces and the fillings showed greater amounts of plaque and a higher degree of gingivitis than the I‐year‐old fillings. Differences among the 3 types of composite resins were minimal in both groups and not statistically significant.
Microbial and clinical measurements of periodontal pockets during sequential periods of non‐treatment, mechanical debridement and metronidazole therapy
Authors: van Oosten M. A. C. , Mikx F. H. M. , Renggli H. H.
Published: December 2005

Abstract Microbial and clinical parameters were studied in 11 subjects with chronic inflammatory periodontitis. 2 periodontal pockets per subject were studied longitudinally. The microbial parameters included counts of different subgingival micro‐organisms by dark field microscopy, counts of the total colony forming units (c.f.u.) on anaerobic blood agar. the facultative anaerobic counts and counts of black‐pigmented Bacteroides, Fusobacleriurn and E. corrodens. The clinical parameters were probing pocket depth, bleeding after probing and crevicular fluid production. Clinical and microbial observations were compared during 3 consecutive periods of non–treatment, debridement and metronidazole therapy. The experimental sites were debrided by deep scaling while no debridement was carried out at the control sites. The effect of this treatment was studied over a period of 3 months. Then, at the experimental sites, a 2nd session of debridement was followed by administration of metronidazole. The effect of metronidazole alone and combined with mechanical debridement was studied during a subsequent 3‐month period. The disease activity did not correlate with the microbial parameters and was evident in the presence as well as in the absence of black‐pigmented Bacteroides. A single session of subgingival debridement resulted in significant reductions in probing depth, spirochetes, motile organisms, black‐pigmented Bacteroides and E. corrodens. Repopulation of the subgingival sites was observed. However, the composition of the subgingival microbiota remained significantly changed during the 3 months after debridement. The re‐isolation of the same Bacteroides‐species and the same B. gingivalis type after treatment indicated an outgrowth of micro‐organisms remaining at these sites. The 2nd session of debridement and metronidazole therapy resulted in a further probeable pocket depth reduction and changes in the subgingival microbiota. At the non‐debrided control sites, metronidazole therapy had a significant effect on the composition of the subgingival microbiota and at 5 of the 11 control sites, a reduction in pocket depth was observed. However, at one site, an increase in pocket depth took place in spite of reductions in black–pigmented Bacteroides, Fusobacteria, E. corrodens, spirochetes and motiles. It was concluded that metronidazole exerts an antimicrobial effect on the subgingival microbiota similar to that of mechanical debridement.
Effect of an air‐powder abrasive system on root surfaces in periodontal surgery
Authors: Horning Gregory M. , Cobb Charles M. , Killoy William J.
Published: December 2005

Abstract The purpose of this study was to compare the effectiveness of an air‐powder abrasive technique to conventional root planing during periodontal surgery. 7 patients scheduled for multiple extractions of periodontally‐involved teeth were selected. Full thickness mucoperiosteal flaps were reflected, and proximal surfaces of 32 teeth were either ultrasonically scaled and exposed to the air‐powder abrasive, or ultrasonically scaled and then manually root planed. Following extraction, teeth were stained for residual plaque and photographed, or prepared for scanning electron microscopy. The air‐powder abrasive technique used for surgical root preparation was found to produce a root surface favorably comparable to manual root planing with regard to removal of plaque, calculus, and exposed cementum. A mean of 80 μm of cementum was abraded away after 40 s of exposure to the air‐powder spray. The air‐powder abrasive spray demonstrated an advantageous ability to remove plaque and cementum from areas of difficult access, such as furcations and root flutings.
Bleeding on probing and probing depth as indicators of the response to plaque control and root debridement
Authors: Vanooteghem Rik , Hutchens L. H. , Garrett Steve , Kiger Robert , Egelberg Jan
Published: December 2005

Abstract 19 adult periodontitis patients were treated with plaque control and a single episode of root debridement. Results of this treatment were monitored in non‐molar sites, molar flat surface sites, and molar furcation sites by probing attachment level measurements every 3rd month for 24 months. After 24 months, sites with probing attachment loss were identified using linear regression analysis. Clinical scores for supragingival plaque, bleeding on probing, suppuration on probing, and probing depth, obtained from these sites during the 24‐month study, were analyzed to determine if they could be used diagnostically as indicators of probing attachment loss. The results demonstrated that the diagnostic accuracy for these clinical indicators was generally low at all 3 anatomical site locations. A possible explanation for this limited diagnostic accuracy may be that some areas of probing attachment loss following basic periodontal therapy are caused by factors other than the progression of an inflammatory periodontal disease of microbial etiology.
The effect of plaque control and root debridement in molar teeth
Authors: Nordland Peter , Garrett Steven , Kiger Robert , Vanooteghem Rik , Hutchens L. H. , Egelberg Jan
Published: December 2005

Abstract The healing response of non‐molar sites, molar flat surface sites, and molar furcation sites was investigated in 19 adult periodontitis patients following a periodontal therapy of plaque control and root debridement. A total of 2472 sites were monitored by recordings of dental plaque, bleeding on probing, probing depth, and probing attachment levels every 3rd month for 24 months. The results demonstrated that in sites with initial probing depth of 4.0 mm or greater, molar furcation sites responded less favorably to the therapy as compared to molar flat surface sites or non‐molar sites. This was demonstrated by higher mean scores for bleeding on probing, less reduction in probing depth, and a mean loss of probing attachment of 0.5 mm over 24 months. Site analyses using linear regression showed a higher % of deeper sites with probing attachment loss for the molar furcations than either molar flat surface or non‐molar sites. Among sites initially 7.0 mm or deeper, 21% of molar furcations were identified as showing probing attachment loss as compared to 7% of the molar flat surface sites and 11 % of the non‐molar sites.
The relationship of sanguinaria extract concentration and zinc ion to plaque and gingivitis
Authors: Southard G. L. , Parsons L. G. , Thomas L. G. , Boulware R. T. , Woodall I. R. , Jones B. J. B.
Published: December 2005

Abstract The effects of sanguinaria extract and zinc chloride on plaque growth and gingivitis inhibition were assessed on subjects with initially plaque‐free tooth surfaces using a series of oral rinses in a single‐blind, crossover, no‐oral‐hygiene study lasting 2 weeks. A placebo oral rinse containing no sanguinaria or zinc chloride (A), and test rinses containing 150 μg/ml sanguinaria and 0.2% zinc chloride (B), 300 μg/ml sanguinaria and no zinc chloride (C), and 300 μg/ml sanguinaria and 0.2% zinc chloride (D) were evaluated. Subjects using the higher concentration rinses C and D had significantly lower plaque scores than rinse A at 7 and 14 days (p<0.05 for C, p<0.01 for D). However, groups C and D were not significantly different from each other. Group D had significantly lower plaque (p<0.05) and gingivitis (p<0.01) scores than group B. Subjects who used rinse B and placebo rinse A had the highest plaque and gingivitis scores and comparison of these two groups revealed no significant difference. At the end of 14 days, the % distribution of 0 plaque and gingivitis scores was greatest among subjects using rinses C and D. Subjects in these 2 groups also had the lowest incidence of plaque and gingivitis scores of 2+.

It is concluded that the effects of sanguinaria rinses on developing plaque and gingivitis are influenced more by sanguinaria concentrations than the presence or absence of zinc ion, but that zinc ion may provide a mild enhancement of sanguinaria effectiveness against gingivitis.
Cell surface hydrophobicity of Actinobacillus actinomycetemcomitans Y4
Authors: Kozlovsky A. , Metzger Z. , Eli I.
Published: December 2005

Abstract Oral bacteria colonize the dento‐gingival tissues in a selective manner. Hydrophobic reactions have been suggested as one of the major mechanisms of adhesion. Hydrophobicity of Actinobacillus actinomycetemcomitans Y4 (Aa) cells was studied in vitro using adherence to the liquid hydrocarbon, octane. Adherence of Aa cells to octane varied from 60–90%, depending on the medium in which they were grown, age of the culture and the buffer in which the assay was carried out. These data suggest that Aa is a hydrophobic bacterium, the hydrophobicity of which is expressed to a varying degree, and may have a role in its adherence to oral tissues.
Experimental gingivitis in relation to age in individuals not susceptible to periodontal destruction
Authors: Winkel E. G. , Abbas F. , Van der Velden U. , Vroom Th. M. , Scholte G. , Hart A. A. M.
Published: December 2005

Abstract The purpose of the present investigation was to study the effect of age on the rate of development of gingival inflammation in individuals not susceptible to periodontal destruction. 7 younger (mean age 37 years) and 7 older (mean age 58 years) individuals were selected on the basis of the presence of at least 18 teeth, no evidence of extraction due to periodontal destruction, no loss of attachment, shallow pockets, gross amounts of plaque and a history of no interdental cleaning. All individuals were subjected to a carefully controlled oral hygiene program and experimental gingivitis was induced in 1 quadrant of the mouth during a period of 33 days. The amount of plaque, redness and swelling of the gingivitis, and bleeding on probing were assessed before, during and after the experiment. Al day 33, supra‐gingival plaque samples were taken for bacteriological examination and gingival biopsies were taken for histopathological and immunohistochemical investigation. Results showed no differences between the 2 age groups with regard to the amount of plaque accumulation and the rate of development of gingival inflammation. Furthermore phase‐contrast microscopy of plaque samples showed no differences between the 2 age groups. Neither his to‐logical nor immunohistochemical investigation showed any differences between the 2 age groups. All biopsies diffusely showed presence of IgG, whereas in most biopsies, IgA plasma cells and in one biopsy IgM plasma cells were found. Neither IgD, IgE nor complement deposits were found. It was concluded that age is of minor importance in the development of experimentally‐induced gingivitis in individuals not susceptible to periodontal destruction.
Apical migration of oral epithelium in experimental dehiscence wounds
Authors: Iglhaut J. , Suggs C. , Borjesson B. , Aukhil I.
Published: December 2005

Abstract The purpose of the present investigation was to determine if the placement of free mucosal grafts would delay the apical migration of oral epithelium into surgically created dehiscence wounds.

Dehiscence wounds, measuring 8 × 6 mm, were surgically created on the mandibular canines of 5 beagle dogs. The exposed root surface was then curetted and horizontal grooves were made, one at a point just below the gingival sulcus and the other at the apical border of the dehiscence. Experimental teeth received free alveolar mucosal grafts while the contralateral teeth served as controls. The grafts were placed with the epithelial side against the tooth surface to bridge the dehiscence at the level of the coronal notch and were sutured in place. The flaps were then repositioned (over the mucosal grafts) and sutured. Apical migration of the oral epithelium, after 10 days, was assessed histologically using the coronal and apical grooves as points of reference.

The oral epithelium was detected in the coronal one half of the dehiscence, in both the control and experimental teeth. There were no significant differences observed between the two. suggesting that the placement of a mucosal graft, as described here, provides little benefit in delaying apical migration of oral epithelium. The fact that the epithelium failed to reach the apical half of the dehiscence may indicate that features of this wound model may help our understanding of epithelial cellular kinetics operative in periodontal wound healing.
Densitometric analysis of lower molar interradicular areas in superposable radiographs
Authors: Payot P. , Haroutunian B. , Pochon Y. , Herr P. , Bickel M. , Cimasoni G.
Published: December 2005

Abstract Superposable radiographs of lower molar areas were obtained by means of a specially designed film holder and a gnathostat maintained in a constant position with respect to long‐cone radiological equipment. A quantitative evaluation of the bone mass in the interradicular area was obtained by scanning the area under a photodensitometer. A photodensitometric scan of the image of an aluminium wedge adapted to each radiograph was also performed. This allowed the transformation, with the aid of a computer, of the photodensitometric recording of bone into a tracing of mm of aluminium equivalents. The reproducibility and precision of the method were verified by comparing magnifications of repeated radiographs, by photodensitometric readings of radiographs developed in different batches and by repeated quantitative readings of the same film. The method allowed one, for instance, to follow quantitatively the healing of a radiographically visible periapical lesion. It was also used to evaluate quantitatively, in the interradicular area, bone changes which could not be seen with the naked eye.
Longitudinal quantitative radiodensitometric study of treated and untreated lower molar furcation involvements
Authors: Payot P. , Bickel M. , Cimasoni G.
Published: December 2005

Abstract 38 first or second lower molars from 16 patients showing furcation involvements of degrees 1 and 2 were treated after motivation and hygiene instruction, either by subgingival curettage, or by the modified Widman surgical procedure or by furcation plasty. The plaque index, the gingival index of inflammation and the depth of interproximal and interradicular pockets were recorded before and up to 1 year after the 3 therapeutical procedures. The above clinical indices were also followed for 1 years in 15 lower molars from 7 untreated patients. A quantitative radiographical analysis of the interradicular bone was performed in all patients, by using superposable identical radiographs and a computer‐assisted photodensitometric technique.

In the 3 groups of treated patients, the clinical scores were, in general, improved by the 3 therapeutic modalities. In the furcation areas, the plaque index was always higher on the lingual side, whereas the depth of “horizontal” pockets was always greater on the buccal side. Except for the lesions treated by furcation plasty, no change could be noticed clinically in the depths of vertical or horizontal penetration of a periodontal probe in the furcation areas. The quantitative radio‐graphic analysis, however, clearly showed a loss in the first 2 mm of superficial bone during the 2 months following the 3 therapeutical procedures: this loss was followed by a statistically significant recovery and, for the group treated by curettage, even by a net gain during the 6 to 12 months following therapy. The radiographical density of the deeper layer of bone did not change in the group treated by curettage only. It showed a loss in the first 2 months following the 2 surgical procedures but a statistically significant recovery in the months thereafter.

As for the group of untreated patients, at the examinations performed initially, 6 months, 1 and 2 years later, the number of plaque‐free and non‐bleeding sites in the furcation areas was lower on the lingual as compared to the buccal side, whereas the frequency distribution of furcation involvements was similar on both aspects. No significant changes were found in the various clinical parameters throughout the 2 years of the study. On the contrary, a significant loss of average density of the superficial layer of interradicular bone was already measured on the superposable radiographs 6 months after the initial examination and was found to increase thereafter. No changes of radiodensity could be measured for the deeper layer of bone. The statistical analysis on the relationship between probing scores and radiographical measurements failed to show any predictability between clinical probing measurements and bone loss in the furcation areas.
The effect of toothbrush grip on gingival abrasion and plaque removal during toothbrushing
Authors: Niemi Maija‐Liisa , Ainamo Jukka , Etemadzadeh Hossein
Published: December 2005

Abstract The aim of the present study was to determine whether the type of toothbrush grip affects gingival injury during brushing. The cleanness of the teeth achieved by use of 2 different brush grips was also evaluated. The teeth of 13 dental nurse students were brushed by a dental hygienist. Using the split mouth technique, one side of the mouth was brushed for 2 min holding the toothbrush with a pen grip and the other side for another 2 min using the palm grip. The procedure was repeated 11 days later with reversed brush grips on the 2 sides of the jaws. More gingival injuries were found when the toothbrush was held with the palm grip than with the pen grip. This difference was statistically significant (P<0.01). No statistically significant difference were observed between corresponding plaque scores as measured according to the PLQ‐index, irrespective of whether the plaque scores were presented as plaque remaining after experimental brushing or as the difference between the PLQ scores before and after brushing.
Bacterial penetration of pocket soft tissues in chronic adult and juvenile periodontitis cases
Authors: Liakoni H. , Barber P. , Newman H. N.
Published: December 2005

Abstract This study investigates bacterial invasion of the soft tissue walls of deep pockets from cases with adult (AP) and juvenile periodontitis (JP). Transmission electron microscopy was used to examine pocket soft tissue walls removed from extracted teeth from 5 patients with AP and 2 patients with JP. Bacteria were sparse throughout the epithelium and connective tissue, regardless of the level of tissue breakdown. However many inflammatory cells were seen, and these did appear to be located in regions of marked collagen loss. Accumulations of large numbers of bacteria were extremely rare and found only on the epithelial surface or in artefactual spaces within the deeper tissues. The findings indicate that the tissue destruction associated with periodontitis is not directly related to bacterial invasion. The sparse organisms within the pocket tissues probably result from passive entry rather than an invasive action. Under these circumstances, it would seem reasonable to suggest that bacterial metabolic products rather than the micro‐organisms themselves penetrate the tissues in periodontitis.
An evaluation of basic periodontal therapy using sonic and ultrasonic sealers
Authors: Loos Bruno , Kiger Robert , Egelberg Jan
Published: December 2005

Abstract 10 adult patients with periodontitis were treated with oral hygiene instruction and a single episode of supra‐ and subgingival debridement using either a sonic or an ultrasonic instrument in a split‐mouth design. The clinical response was evaluated by measurements of dental plaque, bleeding on probing, probing depths, and probing attachment levels taken at baseline and every 3rd month for 12 months. An improvement of periodontal conditions was observed during the initial 3–6 month period followed by a stabilization of parameters. No difference in clinical response could be observed between sites treated with the sonic or ultrasonic instruments.
Antimicrobial properties of 2 aliphatic amines and chlorhexidine in vitro and in saliva
Authors: Salem A. M. , Adams D. , Newman H. N. , Rawle L. W.
Published: December 2005

Abstract The surfactants tetradecylamine, hexadecylamine and chlorhexidine have been compared with regard to their ability to inhibit microbial growth. Antibacterial activity was assessed by tube dilution methods. Tetradecylamine and chlorhexidine were similar in antibacterial activity, being effective at low concentrations against most organisms tested. Hexadecylamine also inhibited growth but at higher concentrations. Viable counts of salivary organisms were monitored in volunteers over 48 h after one rinse with the agents. The initial reduction in numbers of total viable salivary bacteria and streptococci by tetradecylamine and of streptococci by hexadecylamine had disappeared 3 h after a single mouth rinse, but the reduction in numbers of all salivary bacteria by chlorhexidine was more prolonged.
A papillary – verrucous lesion in the gingiva, developing into squamous cell carcinoma
Authors: Helldén Leif , Jonsson Roland
Published: December 2005

Abstract This report will focus attention on the diagnostic and therapeutic difficulties involved in a patient who presented with a gingival papillary‐verrucous lesion, which subsequently developed into a squamous cell carcinoma.
Difficulties encountered in the search for the etiologic agents of destructive periodontal diseases
Authors: Socransky S. S. , Haffajee A. D. , Smith G. L. F. , Dzink J. L.
Published: December 2005

Abstract The present paper outlines some of the difficulties encountered in the search for the etiologic agents of destructive periodontal diseases. These include technical problems such as acquiring an appropriate microbial sample, as well as difficulties in the dispersion, cultivation and identification of isolates in that sample. Many of these difficulties are currently being successfully addressed. A second set of problems is more conceptual in nature. These include difficulties in distinguishing between periodontal diseases and determining the state of activity of periodontal lesions. In addition, complexes of organisms and/or sequences of species may be involved in the progress of lesions. A further problem is encountered in attempting to distinguish overgrowths of opportunistic species from increases in proportions of true pathogens. Finally, it appears likely that different infections occur at the same time in a single oral cavity. The technical and conceptual difficulties eventually filter down to the data analytical step and present numerous problems to the analyst. With all of these difficulties in mind it is not surprising that the etiologic agents of destructive periodontal diseases are not clearly defined. However, improvement in technological assessments of the microbiota and clinical evaluation of the disease should permit reasoned approaches to be taken. The delineation of the etiologic agents of destructive periodontal diseases will be, of necessity, a multistage iterative process. Etiologic agents will be suggested by predominant cultivable studies and hypotheses concerning subsets of these agents tested using more specific procedures such as selective media, immunofluorescent techniques or DNA probes. Etiologic agents will be verified or discarded by such procedures. When new lesions are found without recognized pathogens, the process will iterate back to the predominant cultivable methodology again.