bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of a chlorhexidine toothpaste on the development of plaque, gingivitis and tooth staining
Authors: Jenkins S. , Addy M. , Newcombe R.
Published: December 2005

Abstract Chlorhexidine has found many uses in clinical dentistry as an antiplaque agent. To date, effective chlorhexidine‐containing toothpastes have not been made available. This study was the first phase in the evaluation of a 1% chlorhexidine toothpaste, formulated to ensure a high availability of the contained antiseptic. The study was a 19‐day, randomised double‐blind placebo‐controlled, crossover experimental gingivitis clinical trial employing 14 healthy human volunteers. From a zero plaque and low gingivitis baseline, the development of plaque, gingivitis and dental staining was measured on days 12 and 19 of the 2 study periods. The toothpaste was used 2 × a day as a slurry rinse with no other form of oral hygiene. The washout period was 21 days. The development of plaque and gingivitis was statistically and clinically highly significantly reduced during the use of the active compared to the placebo product. Conversely, dental staining was statistically and clinically significantly increased. The product deserves further evaluation for potential clinical use.
Inhibition of plaque formation by local application of a degradable controlled release system containing cetylpyridinium chloride
Authors: Kozlovsky Avital , Sintov Amnon , Moldovan Meir , Tal Haim
Published: December 2005

Abstract The effect of a degradable controlled release system containing cetylpyridinium chloride (CPC) on plaque accumulation and gingivitis was evaluated when applied on the anterior teeth of volunteers (16–17 years) over 4 weeks. At baseline, plaque index (PI) and gingival index (GI) of the Ramfjord teeth were measured in the experimental and placebo groups, including 23 and 21 participants respectively. Following scaling and root planning, the participants were instructed to brush, using one brush stroke, the film‐forming solution on the buccal surface of the maxillary and maudibular incisors, 1 × a day before bedtime. The applied active solution contained 9 mg of CPC (approximately 80 mg of 11% CPC solution), while the placebo solution was identical in formation, but without, the active agent. After 4 weeks, in the CPC‐applied group, the recorded PI scores were 0.52 (±0.56) in the anterior area and 1.31 (±0.80) in the posterior area, whereas the corresponding areas in the placebo group reached 1.25 (±0.74) and 1.51 (±1.00), respectively. The P)=0 frequency in the buccal anterior surfaces after 4 weeks was 54.6% (±38.7%) in the experimental group as compared with 21.9% (±29.0%) in the placebo group (p = 0.005). In contrast to the anterior teeth, there was no significant difference between groups with respect to the PI scores in the non‐applied posterior teeth. It may be postulated that the impressive 58% inhibition of plaque accumulation at the site of application is the result of an increase of the substantivity of the CPC due to its incorporation in the film–forming degradable controlled release system.
Effects of the Nd:YAG laser and combined treatments on in vitro fibroblast attachment to root surfaces
Authors: Thomas Daniel , Rapley John , Cobb Charles , Spencer Paulette , Killoy William
Published: December 2005

Abstract The purpose of this in vitro study was to evaluate the effects of the Nd:YAG laser either alone or in combination with root planning or air‐powder abrasive treatment on fibroblast attachment to non‐diseased root surfaces. 28. 4x4 mm root specimens and four disc‐shaped root specimens 6 mm in diameter were obtained from unreputed 3rd molars. The root segments were randomly assigned to 4 treatment groups: (1) control: (2) laser‐only treated: (3) laser treated followed by root planning; (4) laser treated followed by air‐powder abrasive treatment. Laser‐treated root specimens were exposed for 1 min with the Nd:YAG laser calibrated at an energy setting of 75 mJ at 20 pulses/s using a 320 μm contact fiber. The contact fiber was held parallel to the root segments and the root segments were kept moist with distilled water. Following the prescribed treatments, the root specimens were incubated with fibroblast cultures and then prepared for SEM examination. Results of cell counts of fibroblasts attached to specimens within each treatment group yielded the following means and standard deviations: control groups. 181.64 ± 44.74; lased only, 78.57 ± 21.35; lased and root planed 125.35 ± 26.13: and lased followed by an air‐powder abrasive, 177.28 ± 55.71. Application of ANOVA followed by the Dunn Multiple Comparison test revealed significant differences (p<0.01) in the number of attached cells between the control and laser‐only treated groups: and between the laser‐only and laser/air‐powder abrasive treated groups. The decreased fibroblast attachment observed in the laser‐only treated group suggests a laser‐induced bio in compatibility of the root surface. Several surface alterations including ablation of cementum with exposure of dentinal tubules and crater formation were observed. Increased numbers of fibroblasts were seen attached to the lased root segments after root planning or after exposure to an air‐powder abrasive, indicating that the laser‐induced bioincompatibility is reversible and most likely a surface phenomena. A pilot study using pholoacoustic Fourier transform infrared spectroscopy revealed reductions in the intensity of the Amide II band between 1500–1550 cm‐1, suggesting the laser exposure denatures surface protein which, in turn, may contribute to inhibition of fibroblast attachment.
The prevalence and distribution of gingival recession in subjects with a high standard of oral hygiene
Authors: Serino Giovanni , Wennström Jan L. , Lindhe Jan , Eneroth Lennart
Published: December 2005

Abstract The aim of this study was to evaluate the prevalence and the development/progression of attachment loss and gingival recession at buccal tooth surfaces in a population sample with a high standard of oral hygiene. An additional aim was to study the relationship between attachment loss and gingival recession. The subject sample examined comprised 225 regular denial care attendants at 12 community dental clinics in Sweden. Ail subjects were subjected to a baseline examination in 1977–78 and were re‐examined after 5 years and 12 years. The clinical examinations involved assessment of plaque, gingivitis, probing depth, probing attachment loss and gingival recession. A full‐mouth set of intra‐oral radiographs was obtained at each examination and used for determination of the height of periodontal bone support. The results of the cross‐sectional and longitudinal analyses performed showed that in subjects with a high standard of oral hygiene (i) buccal gingival recession was a frequent finding, (ii) the proportion of subjects with recession increased with age. (iii) the prevalence as well as the incidence of recessions within the dentition showed different patterns depending on age, (iv) sites with recession showed susceptibility for additional apical displacement of the gingival margin and (v) loss of approximal periodontal support was associated with gingival recession at the buccal surface.
Prevalence of periodontitis and suspected periodontal pathogens in families of adult periodontitis patients
Authors: Petit M. D. A. , van Steenbergen T. J. M. , Timmerman M. F. , de Graaff J. , van der Velden U.
Published: December 2005

Abstract The aim of the present study was to investigate the prevalence of periodontopathic microorganisms and periodontal destruction in the spouses and children of adult periodontitis patients. For this study, 24 families were selected on the basis of one parent with severe periodontal breakdown and the presence of Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis and/or more than 30%Prevotella intermedia subgingivally. The clinical examination of both parents and children included pocket depth and clinical attachment loss (CAL) measurements. Samples for bacterial examination were obtained from the mucous membranes, the saliva and pockets. Pocket selection was based on the most advanced periodontitis situation found in a subject. The samples were cultured for the detection of A. actinomycetemcomitans, P. gingivalis and P. intermedia. By phase‐contrast microscopy, the % of spirochetes and motile microorganisms was assessed. The number of children within each family varied between 1 and 3. In total 49 children were investigated with a range in age of 3 months to 15 years. Results showed that under the age of 5 years, none of the children had CAL. whereas in the age group of 5–15 years, 26.5% had 1–5 sites in the primary and/or permanent dentition with 1–3 mm CAL. 3 of the spouses had no interproximal CAL. 16 of the 24 spouses had a light to moderate form of periodontitis, with at least one site with 1 to 4 mm CAL and 5 spouses had severe periodontal breakdown with sites showing at least 8 mm CAL. Spirochetes, motile microorganisms and P. intermedia were frequently present in all family members. 18 out of the 24 probands were positive for P. gingivalis. This organism was found once only in a 5‐year‐old boy and in 11 of the spouses. A. actinomycetemcomitans was detected in 13 probands; 5 children and 5 of the spouses were also positive for this bacterium. If a child harboured one of the periodontopathogens, at least 1 of the parents was also positive for that bacterium. This phenomenon may be due to transmission of microorganisms between family members. Comparison of the clinical data reported in the present study with similar clinical parameters from epidemiological studies of the Dutch population suggest that the spouses and children of adult periodontitis patients might be at relatively high risk of developing periodontal breakdown.
Experiences with guided tissue regeneration in the treatment of advanced periodontal disease
Authors: Flores‐de‐Jacoby Lavinia , Zimmermann Axel , Tsalikis Lasaros
Published: December 2005

Abstract The aim of this study was to evaluate the predictability of guided tissue regeneration (GTR), using ePTFE‐membranes (Gore‐Tex®) in the treatment of advanced periodontal disease. The study presents long‐term results for 88 teeth in 23 patients at least 9 months after membrane surgery. The periodontal lesions included severe horizontal and/or vertical bone loss. The bone level (BL and BL) and the tissue level (TL), a new parameter between cemento‐enamel junction and coronal margin of the tissue in the defect, were recorded during surgery: immediately before application of the membrane (BL), after membrane removal (TL) and during a re‐entry procedure (BL') 9 to 12 months later. The average tissue gain in the periodontal defect (BL‐Tl) at membrane removal was 65.7% (p < 0.001) and the average gain in mineralized tissue at re‐entry (BL‐BL'), 30.4%, meaning more than 46% of the gained tissue at removal was mineralized at reentry. The decreased amount of mineralized tissue at re‐entry in relation to the tissue gain at membrane removal might be due to formation of a so‐called long connective tissue attachment or to mineralization‐induced shrinkage of the new tissue and some surgical difficulties in coverage of the newly formed tissue. Nevertheless, an absolute gain of 31% mineralized tissue after GTR can provide a marked improvement in the prognosis of a periodontally severely damaged tooth.
The long‐term effect of an oscillating/rotating electric toothbrush on gingivitis An 8‐month clinical study
Authors: van der Weijden G. A. , Timmerman M. R , Reijerse E. , Danser M. M. , Mantel M. S. , Nijboer A. , van der Velden U.
Published: December 2005

Abstract The purpose of this study was to evaluate the safety and efficacy of the Braun Plak Control® for the removal of supragingival plaque and improving gingival health in a long‐term clinical trial, and to compare it to a regular manual toothbrush. Assessed were plaque accumulation, amount of gingival inflammation, gingival bleeding on probing, and calculus. In total, 77 young individuals were selected on the basis of having moderate gingivitis'. They were monitored over 8 months and divided among 2 groups; a control group that used a manual toothbrush and a test group that used the Braun Plak Control. The clinical assessments were repeated after 1, 2, 5, and 8 months. At baseline, subjects were handed their assigned toothbrushes together with written oral hygiene instructions. They were instructed to brush for at least 2 min. 1 month after baseline examinations, all subjects received a professional prophylaxis and oral hygiene instruction from an experienced dental hygienist. Plaque removal was reinforced at the 2‐ and 5‐month examination. In conclusion, results indicate that the Braun Plak Control is a safe and efficient home care device. At the end of this trial, this electric toothbrush proved to be more effective than a regular manual tooth brush.
The effect of systemically‐administered flurbiprofen as an adjunct to toothbrushing on the resolution of experimental gingivitis
Authors: Heasman P. A. , Seymour R. A. , Kelly P. J.
Published: December 2005

Abstract Non‐steroidal anti‐inflammatory drugs (NSAIDs) have been widely researched in an attempt to control periodontal diseases. This double‐blind parallel group study investigated the effect of a systemic flurbiprofen preparation (100 rag daily), when combined with toothbrushing on the resolution of experimental gingivitis in human volunteers. 47 volunteers abstained from tooth cleaning for 21 days. On day 21, 23 subjects were prescribed 100 mg of flurbiprofen daily whereas 24 subjects were prescribed placebo. In both groups, toothbrushing was re‐introduced and all subjects used the Bass technique for 2 min each day. Both treatment regimens were continued for 7 days. Plaque indices, gingival indices and gingival crevicular fluid flow were assessed at baseline (day 0) and on days 21 and 27. There were no significant differences at p= 0.05 between the groups for plaque indices or gingival crevicular fluid flow. The flurbiprofen group, however, demonstrated greater resolution of gingival inflammation by day 27 when compared to the placebo controls (p= 0.04). The plasma levels of flurbiprofen in the test group showed mean concentrations of flurbiprofen of 4.7 (±2.1) μg/ml at 1 h after dosing. After 6 h, this had fallen to 4.4 (±1.6) μg/ml. It is concluded that these serum concentrations of flurbiprofen are sufficient to produce significant anti‐inflammatory effects in the gingival tissues.
Comparative reproducibility of proximal probing depth using electronic pressure‐controlled and hand probing
Authors: Mullally Brian H. , Linden Gerard J.
Published: December 2005

Abstract This investigation assessed the effect of an electronic pressure‐sensitive probe on the reproducibility of probing‐depth measurement. Clinical measurements were made at the mesial and distal aspects of all teeth from the buccal and palatal or lingual aspects. Probing was carried out either in a conventional manner using gentle pressure referred to as hand probing or using an electronic pressure‐sensitive probe set at 25 g and referred to as pressure‐controlled probing. Probing‐depth recordings were repeated for one randomly selected quadrant in each subject with random application of the 4 different combinations of pressure‐controlled and hand probing. A total of 2584 replicate pairs of probing depth measurements were recorded on 4 proximal surfaces in 646 teeth in 100 adult subjects. The majority (98%) of all repeated measurements were within 1 mm of the initial values. The highest levels of agreement resulted when the same probing method was used at both examinations with electronic pressure‐controlled probing being superior to hand probing regardless of tooth position or site. Duplicate measurements recorded with combinations of hand and pressure‐controlled probing showed significant systematic bias towards shallower pocket depths with electronic pressure‐controlled probing.
Comparison of 2 chlorhexidine mouthwashes on plaque regrowth in vivo and dietary staining in vitro
Authors: Mendieta C. , Vallcorba N. , Binney A. , Addy M.
Published: December 2005

Abstract Until recently, the few available chlorhexidine mouthrinse products have been 0.2% formulations. However, concentrations of 0.12% chlorhexidine appear as effective as 0.2%, if the volume of the rinse is increased to 15 ml. Since the mere incorporation of chlorhexidine in a formulation does not guarentee availability of the antiseptic, it would seem reasonable to evaluate or compare all products. This is particularly the case when other ingredients, such as fluoride are added. The 1st study compared the effect of a 0.12% chlorhexidine rinse with a 0.12% chlorhexidine/0.022% sodium fluoride rinse for effects on plaque re‐growth. The study was a 7‐day, blind, randomised, 2‐cell cross‐over design with a baseline control run in period, in which 18 subjects participated. Both chlorhexidine products significantly reduced plaque compared to control but the chlorhexidine fluoride rinse was less effective than the chlorhexidine only rinse. The 2nd study assessed the propensity of the chlorhexidine rinses to induce dietary staining in vitro. For the chlorhexidine fluoride rinse, this was less than the other 0.12% rinse and a commonly used 0.2% product. The data in vivo and in vitro suggest reduced chlorhexidine availability from the chlorhexidine fluoride product which appears to cause some loss of efficacy.
The topography of the furcation entrance in Chinese molars
Authors: Hou Guey‐Lin , Chen Si‐Feng , Wu Yih‐Min , Tsai Chi‐Cheng
Published: December 2005

Abstract The purpose of the present study was to document the furcation entrance dimensions (FEDs) of the maxillary and mandibular 1st and 2nd molars and relate them to the choice of periodontal therapy. Study samples consisted of 89 maxillary molars (49 1st and 40 2nd molars) and 93 mandibular molars (50 1st and 43 2nd molars). All the FEDs of the molars were examined and measured under a stereomicroscope at 2.5 × equipped with a Bioscan OPTIMAS Image Analyzer (BOIA). The results may be summarized as follows. (1) The mean FEDs in the buccal, distal and mesial furcations of maxillary 1 st and 2nd molars were 0.74 mm, 0.99 mm and 1.04 mm in the 1st molars, and 0.63 mm, 0.67 mm, 0.90 mm in the 2nd molars, respectively. In the buccal and lingual furcations of mandibular 1st and 2nd molars, they measured 0.88 mm and 0.81 mm, and 0.73 mm and 0.71 mm, respectively. (2) The %s of FEDs of 0.56 mm or less (the tip width of a Cavitron tip being 0.56 mm) in the buccal, distal and mesial furcations of maxillary 1st and 2nd molars, accounted for 32%, 8% and 6% of 1st molars, and 40%, 40% and 18% of 2nd molars. In the buccal and lingual areas of mandibular 1st and 2nd molars, they accounted for 16% and 26%, and 35% and 33% of the furcations, respectively. (3) The %s of FEDs of 0.75 mm or less (the width of curettes being 0.75–1.0 mm) in the buccal, mesial and distal furcations of maxillary 1st and 2nd molars accounted for 57%, 18% and 43% of 1st molar furcations, and 83%, 43% and 65% of 2nd molar furcations, respectively. In the buccal and lingual areas of mandibular 1st and 2nd molars, they accounted for 36% and 52%, and 63% and 61% of the furcations, respectively. (4) The majority of mean FEDs in 2nd molars were less than the blade width of new Gracey curettes, whereas in 1st molars they were similar to the blade width of unused Gracey curettes. (5) Most mean FEDs in 1st and 2nd molars were greater than the width of unused Cavitron tips. (6) To achieve complete debridement of root surfaces within furcations, an appropriate selection and combination of Cavitron tips and periodontal curettes should be considered.
Repair processes in the periodontium following dentoalveolar ankylosis: the effect of masticatory function
Authors: Wesselink P. R. , Beertsen W.
Published: December 2005

Abstract It has recently been shown that administration of the drug 1‐hydroxy‐ethylidene‐1,1‐bisphosphonate (HEBP) perturbs the homeostasis in the periodontal ligament resulting in an osteoid‐mediated ankylosis between the alveolar wall and the root surface. In the present study, the events after discontinuing HEBP administration were investigated and the effect of function on repair of the periodontal ligament was evaluated. In mice, the maxillary left molars were extracted. They then received a daily subcutaneous injection of HEBP (10 mg P/kg b.w.) for a period of 50 days, were killed 24 h, 14, 28, 56 and 112 days after the last injection and their mandibles processed for light microscopy. HEBP administration caused a significant decrease of the width of the periodontal ligament space with localized ankylosis. In the period after discontinuing HEBP treatment, the newly‐formed bone did first mineralize and was then partly resorbed resulting in the disappearance of the ankylotic areas. Furthermore, root resorption was seen. Finally, the periodontal ligament regained its normal architecture and width and a new layer of cementum was formed. Functional teeth showed more root resorption than hypofunctional ones and a more rapid repair of the periodontal ligament. It is concluded that in the period after HEBP treatment the periodontal ligament regains its normal width by a repair process including extensive root resorption, that seems to accelerate this process.
Short‐term effect of full‐mouth extraction on periodontal pathogens colonizing the oral mucous membranes
Authors: Danser M. M. , van Winkelhoff A. J. , de Graaff J. , Loos B. G. , van der Velden U.
Published: December 2005

Abstract In this study, we investigate the prevalence of selected periodontal pathogens on the oral mucous membranes before and after full‐mouth tooth extractions in patients with severe periodontitis. 8 patients were microbiologically examined 2 × before and 2 × after extraction; several locations on the oral mucous membranes, saliva, supra‐ and subgingival plaque, were sampled. Besides their presence in subgingival plaque, we detected before extraction on the mucous membranes Actinobacillus actinomycetemcomitans in 2 patients (mean 0.03%), Porphyromonas gingivalis in 6 patients (mean 9%), and Prevotella intermedia (mean 2%) and other Prevotella species (mean 7%) in all patients. At 1 and 3 months after extraction, A. actinomycetemcomitans and P. gingivalis could not be detected in any of these patients on the oral mucous membranes and in saliva, while from all patients still P. intermedia (mean 3%) and the other blackpigmented Prevotella species (mean 4%) could be isolated. These results indicate that the preferable habitat for A. actinomycetemcomitans and P. gingivalis is dental plaque in subgingival lesions. P. intermedia and the other blackpigmented Prevotella species can colonize the oral mucous membranes of edentulous patients irrespective of the presence of a subgingival microflora. We speculate that in periodontal patients the colonization of mucous membranes with P. gingivalis and A. actinomycetemcomitans is transient in nature and most likely the result of dissemination from the subgingival microflora. Thus it seems unlikely that edentulous patients constitute a reservoir of infection of P. gingivalis A. actinomycetemcomitans.
The effects of a 0.3% triclosan‐containing dentifrice on the microbial composition of supragingival plaque
Authors: Walker Clay , Borden Loretta C. , Zambon Joseph J. , Bonta C. Yolanda , DeVizio William , Volpe Anthony R.
Published: December 2005

Abstract. 144 subjects completed a 6‐month, double‐blind study which examined the effects of a 0.3% triclosan/2% copolymer/0.243% sodium fluoride dentifrice on the microflora of supragingival dental plaque. The subjects were randomly assigned to use, in an oral hygiene program, either the triclosan/copolymer/fluoride test dentifrice or a control dentifrice. The latter had the same formulation as the test dentifrice except it did not contain triclosan. Supragingival plaque was collected from the buccal and lingual surfaces of 4 teeth at baseline, 3 months, and 6 months, and microbiological examined by darkfield microscopy, gram stain morphology', immunofluorescence, and selective and non‐selective media. Antimicrobial susceptibilities were determined by agar dilution and whole plaque susceptibility methodologies on plaque samples from 136 subjects at each of the above sample periods and at 6‐week intervals for an additional 6 months post‐therapy. Both dentifrices resulted in highly statistically significant reductions in the total cultivable flora obtained at both the 3 and 6‐month samples relative to baseline as well as at 6 months relative to the 3‐month sample. The relative decrease in total anaerobic counts and in strict anaerobes, while not statistically significant, was more pronounced at both the 3‐ and 6‐month sample periods in subjects receiving the triclosan dentifrice than for the controls. Neither dentifrice resulted in detrimental shifts in the microbial composition of the normal flora nor led to the emergence of periodontal or opportunistic pathogens. There was no difference in the relative proportions of the microflora resistance to triclosan or in the number of subjects harboring triclosan‐resistant micro‐organisms regardless of whether the subjects received the triclosan dentifrice or the control. The proportion of the cultivable flora resistant to triclosan was higher at baseline than at any other sample period. This study demonstrates that the extended use of the 03% triclosan/2% copolymer/fluoride dentifrice does not disrupt the normal microflora associated with supragingival plaque, favor the growth or colonization of periodontal or opportunistic pathogens, or promote the acquisition of microbial resistance.
Evaluation of a new toothbrush concept with regard to bacterial elimination
Authors: Apiou J. , Gueguen M. M. , Doleux S. , Bonnaure‐Mallet M.
Published: December 2005

Abstract. The efficacy of a new toothbrush filament layout concept (Topix, Peridental, France) was compared to that of a standard vertical‐tuft toothbrush. Bacterial and exogenous deposit elimination were used as parameters of efficacy. 30 dental surgery students look part in the study. Plaque index scores were calculated according to a pre‐defined protocol. Imprints of the 6 anterior teeth were taken before and after brushing with the 2 types of brushes, without toothpaste or rinsing, Imprints were examined by scanning electron microscopy (SEM). 12 h after brushing, imprint examination revealed bacterial flora polymorphism and the amount of dental plaque accumulated at the cervical third zone of teeth. Automated quantification in this zone of exogenous bodies showed that after brushing with vertical‐tuft and cross‐tuft brushes, there remained 1.26 mm2 and 0.83 mm2 of dental plaque, squamae, and blood residues, respectively. The plaque index values correlated to scanning electron microscopic observations. There was no significant difference in terms of efficacy between the cross‐tuft and vertical‐tuft toothbrushes.
The correlated binomial model in the analysis of clinical diagnostic test parameters for recurrence of periodontitis
Authors: Müller Hans‐Peter , Heinecke Achim , Lange Dieter E.
Published: December 2005

Abstract. In the present study, recall data of 29 patients with advanced periodontitis were utilized to calculate diagnostic test parameters for bleeding scores or increased residual probing depth on increase of periodontal probing depth of ≥ 2 mm after 2 years, comparing the simple binomial and correlated binomial model. 5.6% of sites were identified, where the periodontal probing depth increased 2 mm or more during 2 years of maintenance. Within‐patient correlation coefficient of sites were found to be small, in general (P > 0.02), with the exceptions for predictive value of a positive test for frequent (≥3/4 times) bleeding on probing and residual probing depth of ≥4 mm (P= 0.137 and P=0.086, respectively), and specificity for no bleeding (P= 0.151). Point estimates of test parameters generally did not differ between simple binomial and correlated binomial model. The respective standard deviations were either over‐ or underestimated in the simple binomial model. It was concluded that the suggestion of a limited diagnostic value of bleeding scores or increased residual postoperative probing depth to predict recurrence of periodontitis cannot be rejected after application of a correlated binomial model.
Prevalence of periodontal pathogens with varying metabolic control of diabetes mellitus
Authors: Tervonen Tellervo , Oliver Richard C. , Wolff Larry F. , Bereuter Jana , Anderson LuAnn , Aeppli Dorothy M.
Published: December 2005

Abstract. The purpose of this study was to determine the prevalence of 5 periodontal pathogens in individuals with diabetes mellitus. Subjects (n= 107) 20–70 years of age with type 1 (n= 60) or 2 (n= 47) diabetes mellitus were studied for the occurrence of the periodontal pathogens A. actinomycetemcomitans, F. nude‐alum, E. corrodens, P. gingivalis and P. intermedia. Subgingival plaque was sampled in each subject from a single site exhibiting the greatest inflammation. The evaluation of selected periodontal bacterial pathogens was based on an immunoassay utilizing bacterial specific monoclonal antibodies. 35% of the sites harbored P. gingivalis, 28%F. nucleatum and 21%E. corrodens. A. actinomycetemcomitans and P. intermedia were found in less than 10% of the sites. Subjects for whom the probing depth at the sampled site was 4 mm were more often found to have detectable pathogens than those with a probing depth 3 mm. Diabetic factors such as duration, type and metabolic control of the disease had no statistically significant effect on the prevalence of these bacteria.
Impaired early bone formation in periodontal fenestration defects in dogs following application of insulin‐like growth factor (II). Basic fibroblast growth factor and transforming growth factor beta 1
Authors: Selvig Knut A. , Wikesjö Ulf M. E. , Bogle Gary C. , Finkelman Richard D.
Published: December 2005

Abstract. Effects of a topically applied growth factor combination on fibroblast migration, collagen fiber formation and bone regeneration were studied in standardized periodontal defects in 4 beagle dogs. Following elevation of facial mucoperiosteal flaps, fenestration defects, 3 mm in diameter, were made through the cortical bone and into the dentin of maxillary and mandibular teeth. Collagen sponges, impregnated with 200 ng insulin‐like growth factor II, 20 ng basic fibroblast growth factor and 6 ng transforming growth factor beta 1 were fitted to defects randomly in right or left quadrants and the flaps repositioned and sutured. Contralateral control defects received the collagen with vehicle only. Experimental procedures were staggered to allow observations of healing 3, 7, 10, and 14 days after surgery. Histometric analysis showed no differences in fibroblast and collagen density between control and growth factor defects. Bone regeneration was significantly greater in control than in growth factor defects 10 and 14 days after surgery. The rate of healing generally appeared more affected by intra‐dog variations or procedural variations than by the growth factor combination.
Site‐specific alkaline phosphatase levels in gingival crevicular fluid in health and gingivitis: cross‐sectional studies
Authors: Chapple I. L. C. , Glenwright H. D. , Matthews J. B. , Thorpe G. H. G. , Lumley P. J.
Published: December 2005

Abstract. Using a recently developed chemiluminescent assay enabling alkaline phosphatase (ALP) quantification in nanolitre volumes of gingival crevicular fluid (GCF), we have investigated GCF ALP levels in health and in the presence of gingivitis. In gingival health, there was a site‐specific pattern of ALP concentration with higher enzyme concentrations around the upper and lower anterior teeth. Furthermore, clinically normal sites that had been subjected to different levels of plaque control produced significantly different ALP levels, (p < 0.03). This indicates that biochemical components of GCF may be used to measure sub‐clinical inflammatory status. The ratio of GCF to serum ALP varied from 6:1 to 11:1, suggesting that a major source of the enzyme is through local production. The main cross‐sectional study of 30 patients with gingivitis (276 sites) demonstrated that total GCF ALP levels, collected over a 30‐s sampling time were higher for a gingival index of 1 than of 0 (p < 0.014). There was no significant relationship between total GCF ALP and plaque levels of the enzyme, and analysis of plaque within the study group demonstrated very low levels of ALP, indicating that the enzyme is likely to be largely derived from the periodontal tissues. The ratio of GCF ALP levels to those of saliva within individuals was 530:1, thereby eliminating saliva contamination as a risk, when total GCF ALP is being measured.
The effect of a dentifrice containing chlorhexidine and zinc on plaque, gingivitis, calculus and tooth staining
Authors: Sanz Mariano , Vallcorba Nuria , Fabregues Sebastian , Müller Irmtraud , Herkströter Frank
Published: December 2005

Abstract. In this 6 months randomized, stratified double‐blind parallel study, plaque, gingivitis, calculus formation and tooth staining were assessed in 208 participants. The participants either used a 0.12% chlorhexidine rinse and a gum care dentifrice (positive control) or a placebo rinse and the gum care dentifrice (control) or the placebo rinse and an experimental dentifrice containing 0.4% chlorhexidine and 0.34% Zn2+ (experimental group). After 6 months product use, all groups had less plaque, less gingivitis and all developed calculus and tooth staining. For the positive control group and for the experimental group, significant reductions in plaque and gingivitis (gingival index and number of bleeding sites) were seen compared with the control group. Significantly more calculus developed in the positive control group, while the experimental group was not different from the control group. Finally, tooth staining was significantly higher for the groups using chlorhexidine containing products compared with the control group. The experimental dentifrice users however did develop significantly less staining compared with the positive control. It is concluded that the experimental dentifrice will contribute to a significant improvement in oral hygiene with less staining compared with using a 0.12% chlorhexidine rinse.
Kinetics of spiramycin/metronidazole (Rodogyl®) in human gingival crevicular fluid, saliva and blood
Authors: Rotzetter P.‐A. , Le Liboux A. , Pichard E. , Cimasoni G.
Published: December 2005

Abstract. The peripheral distribution of spiramycin and metronidazole, which are combined in the proprietary drug “Rodogyl®”, has been studied in gingival fluid, saliva and blood after a single administration to 12 healthy volunteers and after repeated administration to 4 patients with recurring severe periodontitis. Analysis of the 2 antibiotics have been performed at regular intervals during the 24‐h period immediately following the administration to the volunteers and after the 1st and the 15th days of repeated administration to the patients. The results show that gingival fluid contains concentrations of spiramycin and metronidazole higher than those needed to inhibit the growth of periodontopathic bacteria. Spiramycin was found at higher concentrations in GCF than in blood, although this feature was not found for metronidazole, which was administered simoultaneously and showed similar concentrations in both fluid and serum. Such high concentrations persist for a long time, and suggest the potential of this compound in the treatment of severe cases of periodontitis.
Cellular and molecular effects of malnutrition and their relevance to periodontal diseases
Authors: Enwonwu C.O.
Published: December 2005

Abstract In response to periodontal pathogens, the leukocytes (PMN) elaborate destructive oxidants, proteinases, and other factors. The balance between these factors, the antioxidants and endogenously synthesized antiproteinases determine the extent of periodontal damage. Malnutrition (PEM) is characterized by marked tissue depletion of the key antioxidant nutrients, including GSH (γ‐glutamyl‐cysteinyl‐glycine), and impaired acute‐phase protein response (APR) to infections. The latter results in diminished production of the acute‐phase proteins (APP). The APR plays a key rôle in promoting healing, and its deficit in PEM is due to impairment in the production and cellular action of the cytokines. Other features of malnutrition include inverted helper – suppressor T‐cell ratio, hista‐minemia, hormonal imbalance with increased blood and saliva levels of free cortisol, and defective mucosal integrity. Malnutrition, particularly of the PEM type which usually involves concomitant deficiencies of several essential macro‐ and micronutrients, therefore has the potential to adversely influence the prognosis of periodontal infections.
Clinical characteristics of periodontal sites with probing attachment loss following initial periodontal treatment
Authors: Claffey Noel , Egelberg Jan
Published: December 2005

Abstract Periodontal sites which had undergone probing attachment loss were identified in 16 advanced periodontitis patients subjected to initial periodontal treatment and monitored every 3rd month for 42 months. Many sites with probing attachment loss showed no increase in probing depth and bled on probing at a few of the examinations during maintenance. Others showed increase in depth, frequent bleeding and suppuration. An arbitrary classification of ‘questionable periodontitis’ sites was used and included sites with the following characteristics: probing depth at 42 months 3.5 mm + bleeding on probing at no more than 5 of the 14 examinations 3‐42 months + no suppuration on probing 3‐42 months. The % sites in this category ranged from 21‐35%, depending upon method used to determine probing attachment loss. Widely varying characteristics of sites identified with probing attachment loss were evident for all surface locations and all subgroups of initial probing depth. From a traditional viewpoint, a significant proportion of the losing sites might not have been afflicted with periodontitis. On the other hand, deterioration does not necessarily have to be coupled with obvious inflammation, particularly following therapy.
Periodontal manifestation of hypophosphatasia. A family case report
Authors: Plagmann Hans‐Christian , Kocher Thomas , Kuhrau Norbert , Caliebe Almuth
Published: December 2005

Abstract Hypophosphatasia is a rare inherited disease, the 1st clinical sign of which is often a premature loss of deciduous teeth. We describe clinical, histological and SEM findings of 2 cases of hypophosphatasia from a single family and discuss the pathological mechanisms with reference to the literature.
Triclosan protects the skin against dermatitis caused by sodium lauryl sulphate exposure
Authors: Barkvoll P. , Rølla G.
Published: December 2005

Abstract It has recently been suggested that the lipid‐soluble, antibacterial agent triclosan possesses an anti‐inflammatory effect in the oral cavity. The aim of the present study was to examine whether triclosan can protect the skin from the irritation or inflammation that may be caused by exposure to sodium lauryl sulphate (SLS). Finn Chamber patch tests on the forearms of 10 volunteers showed that a mixture of SLS and triclosan caused no inflammation, whereas SLS alone caused reactions in all the subjects. Pre‐treatment with triclosan before SLS exposure had a slight effect whereas treatment after exposure showed a significant effect. It is suspected that the reported anti‐gingivitis effect of triclosan may at least in part be explained by an anti‐inflammatory effect.
Some microbiological, histopathological and immunohistochemical characteristics of progressive periodontal disease
Authors: Liljenberg B. , Lindhe J. , Berglundh T. , Dahlén G , Jonsson R.
Published: December 2005

Abstract The aim of the present investigation was to study the local nature of human periodontal disease by assessing the microbiota and the composition of the tissue lesions at sites with progressive attachment loss in periodontitis susceptible subjects. 300 subjects with periodontal disease were monitored for 2 years without treatment. 8 subjects lost >2 mm of attachment at 3 sites during both the first and the second 12 month interval. These 8 subjects (progressive disease group; PD)were recalled for a microbiological and histopathological examination. A group of age‐ and sex‐matched subjects were identified who during the 2 years of monitoring exhibited gingivitis and deep pockets, but no further attachment loss. This group of 11 subjects (non‐progressive disease group; NPD) served as controls. From the 8 active disease subjects, 1 interproximal site which had displayed disease activity (progressive disease active; PDA) and 1 contralateral site without disease progression (progressive disease inactive; PDI) were sampled. From the 11 control subjects, 1 site/subject was sampled (NPD). The total number of viable micro‐organisms (TVC) in the subgingival microbiota was estimated and a series of bacterial species were identified and enumerated. The gingival tissue of the sampling site was excised and the soft tissue prepared for morphometrical and immunohistochemical analyses. No differences were observed in the subgingival microbiota of the sample sites in the subjects who exhibited disease progression (PD) when compared with the subjects with periodontally diseased but stable conditions (NPD). Furthermore, no marked difference could be noted between progressive (PDA) and non‐progressive (PDI) sites in the PD group of subjects. The results from the morphometric determinations revealed that the lesions from the PD and NPD subjects on the average were of similar size, but the PD lesions were comprised of a larger relative volume of plasma cells, a higher % number of plasma cells and monocytes/macrophages and a lower numerical density of lymphocytes than the corresponding sites in the NPD group. Both T cell markers (CDS and CD4) and B cell markers (CD22) examined were significantly elevated in the PDA compared to the PDI lesions. The CD4/CD8 ratios calculated from assessments made in the PD and NPD tissue samples were 2.4 and 2, while the corresponding ratios for PDA and PDI lesions were 3 and 2.1 (p<0.05) respectively. The present data indicate that differences exist between disease active and inactive subjects and sites and it is suggested that the human model described may be used to study disease progression using shorter time intervals between examinations and additional parameters.
The effect of electronic dental analgesia during sonic scaling
Authors: Jacobs Reinhilde , van Steenberghe Daniel
Published: December 2005

Abstract The aim of the present study was to investigate the effects of electronic dental analgesia (EDA) during sonic scaling. The clinical trial included 30 healthy adult subjects and was conducted as a randomised single‐blind split‐mouth design. The applied procedure consisted of periodontal scaling by means of a sonic sealer, while using the EDA device either in an active or placebo state. Rather similar results were obtained for the subjective pain rating in both the active and the placebo trials. When patients rated their discomfort on a scale 0‐4 from no pain to very severe pain, the mean (s.d.) score for both the EDA and the placebo was 1.2 (0.6). The subjective pain estimate was positively correlated to the electrical current intensity provided. This implied that with a stronger pain experience, patients tried to administer more anaesthesia by turning the dial of the control box to an increased intensity of the electrical current. This remained insufficient to eliminate pain sensation. It was concluded that application of electronic dental anaesthesia in periodontal treatment remains questionable.
An evaluation of a pre‐scaling gel (SofScale™) on the ease of supragingival calculus removal
Authors: Smith S. R. , Foyle D. M. , Daniels J.
Published: December 2005

Abstract SofScale™ is a pre‐scaling gel, containing disodium EDTA and sodium lauryl sulphate, which is claimed to soften calculus and therefore facilitate its removal. 31 subjects were treated in a double blind randomised placebo controlled split mouth study to evaluate this product. Test or placebo gels were applied to the lingual surfaces of the mandibular teeth for 4 min and the time taken to complete the removal of supragingival calculus recorded. The operator recorded on which side the calculus was considered easier to remove and the patient indicated how comfortable the scaling had been. The mean calculus index was 1.99 for the SofScale™ group and 1.97 for the placebo. The mean time taken to complete scaling was 5.31 min for both groups. Using the Student Mest, there were no statistically significant differences (p>0.7) between either the calculus index or time taken to complete the scaling between the groups. The operator did not consider SofScale™ to facilitate calculus removal and patients did not find calculus removal more comfortable when SofScale™ had been used. There was no increased sensitivity in the SofScale™ group following scaling. The results of this study do not support the use of SofScale™ as an adjunct to scaling.
Calcium and other salivary factors in periodontitis‐affected subjects prior to treatment
Authors: Sewón L. A. , Karjalainen S. M. , Sainio M. , Seppä O.
Published: December 2005

Abstract Salivary calcium was shown to be higher in treated periodontitis‐affected subjects (P+) than in periodontitis‐free patients (P−). Here the aim was to study whether differences in calcium or other salivary factors exist prior to treatment. The test group consisted of 20 (15 men, 5 women) periodontitis‐affected subjects and the control group 15 subjects (10 men, 5 women) free from periodontitis. Paraffin‐stimulated whole saliva was collected to determine the flow‐rate, calcium and phosphate concentrations, pH, buffering capacity, numbers of mutans streptococci, lactobacilli and yeasts. The results showed a higher calcium concentration (p < 0.05) in the P+ group (x̄: 1.68 mmol/l; SE: 0.06 in men and x̄: 1.49 mmol/l; SE: 0.10 in women) than in the P‐group (x̄: 1.48 mmol/l; SE: 0.09 in men and x̄: 1.18 mmol/l; SE: 0.10 in women). The P+ group had more intact teeth (x̄±SE: 9.9±0.8 in men and 11.2±2.0 in women) than the P‐group (x̄± SE: 8.3±0.7 in men and 8.2±2.4 in women). The present findings may indicate that an elevated level of salivary Ca is characteristic of P+ patients both before and after periodontal treatment.