bluuebunny/crossref_metadata_2025 huggingface dataset:
Cellular aspects of and effects on the gingiva in children with Down's syndrome during experimental gingivitis
Authors: Reuland‐Bosma Wimke , Liem Robert S. B. , Jansen Henk W. B. , van Dijk L. Johan , van der Weele Leo Th.
Published: December 2005

Abstract In a previous experimental gingivitis study, it was shown that in children with Down's syndrome (DS), gingival inflammation started earlier, was more extensive and developed faster, than in normal healthy control children. In both groups, the start of the process was accompanied by an acute inflammatory response and an increase of the infiltrated connective tissue area (ICT). The purpose of the present study was to investigate how these facts were reflected at a cytological level. The study was carried out in 8 DS and 8 matched control children. Their ages ranged from 5–10 years. A “normal” healthy gingiva was attained after strict oral hygiene procedures. During a period of 21 days in which oral hygiene was abolished, gingival biopsies were taken on days 0, 7, 14, and 21. In both groups, junctional epithelium (JE) and ICT contained low numbers of polymorphonuclear leucocytes (PMNs). The start of the inflammation (day 7 for the DS and day 14 for the control children) was marked by a significant positive correlation between the numbers of PMNs in the JE and the ICT, and a significant increase of the numbers of PMNs in ICT. In ICT, a concomitant decrease in collagen fibre density was observed. In the control group, the decrease correlated with the numbers of PMNs in ICT, which suggests that this collagen breakdown is caused by PMN products. After the initial decrease, the collagen fibre density remained fairly constant in this group throughout the study. In the DS group, there was a tendency to a further decrease in the ICT3 area, correlated with the numbers of PMNs in ICT, Whereas the PMN response reflected the start of the clinically assessed inflammation, the lymphocytes did not follow this pattern. The DS children showed an impaired lymphocyte migration; in the control children, the numbers of lymphocytes increased significantly. On days 7 and 21. the numbers of lymphocytes found in the DS were significantly lower than in the control children. The early PMN response and the impaired lymphocyte migration may be the result of impaired lymphocyte and/or PMN function in DS children. These factors constitute the more likely explanation for the specific character of the gingival inflammation in DS children.
The predominant cultivable microbiota of active and inactive lesions of destructive periodontal diseases
Authors: Dzink J. L. , Socransky S. S. , Haffajee A. D.
Published: December 2005

Abstract Subgingival plaque samples were taken from active and inactive lesions in 33 subjects exhibiting active destructive periodontal diseases. Active diseased sites were those which showed a significant loss of attachment within a 2‐month interval as computed by the “tolerance method”. The predominant cultivable species from 100 active sites were compared with those found in 150 inactive sites of comparable pocket depth and attachment level loss. Among the 33 subjects, W. recta, B. intermedius, F. nucleatum, B. gingivalis and B. forsythus were elevated more often in active sites; whereas, S. mitis, C. ochracea, S. sanguis II, V. parvula and an unnamed Actinomyees sp. were elevated in inactive sites. The likelihood of a site being active was increased if B. forsythus, B. gingivalis, P. micros, A. actinomycetemcomitans, W. recta, or B. intermedius were detected in that site, and decreased if S. sanguis II, the Actinomyces sp., or C. ochracea were detected.
Longitudinal study of untreated periodontitis
Authors: Jenkins W. M. M. , MacFarlane T. W. , Gilmour W. H.
Published: December 2005

Abstract The principal aim of this study was to investigate the use of certain clinical and microbiological criteria to predict periodontal breakdown during a 1‐year period. A further aim was to establish whether the act of collecting subgingival plaque samples periodically throughout the observation period would have any effect on the clinical or microbiological variables. Only the clinical data is presented in this paper. The study population comprised 11 volunteers (aged 32–51 years) with persistent advanced periodontitis and inadequate plaque control in spite of a previous intensive course of hygiene therapy. From the left jaw quadrants, 89 teeth were selected, yielding 148 bleeding pockets of 4 mm depth or more. From the right jaw quadrants, 74 teeth were selected, yielding 117 bleeding pockets of 4 mm depth or more. All subjects were examined on 7 occasions at 2–monthly intervals when plaque index scores, dichotomous measurements of gingival redness, pocket depths and attachment levels were recorded. Bacteriological sampling was carried out at each visit for each site only in the left jaw quadrants while the right jaw quadrants were sampled only at the first and last visits. During the study, no subgingival instrumentation was performed, except at 3 sites which exhibited loss of attachment of 3 mm. These teeth were withdrawn from the study for ethical reasons. At the completion of the study, the sequential changes in probing attachment level at each site were subjected to regression analysis to determine the direction and extent of attachment change which had taken place at each site. Further analysis revealed that neither the plaque index scores, the presence of gingival redness nor the pocket depth measurements could be used in a predictive capacity with respect to attachment loss. Comparison of right and left jaw quadrants showed that the act of sampling at 2‐monthly intervals had no effect on any of the variables studied.
Longitudinal study of untreated periodontitis
Authors: MacFarlane T. W. , Jenkins W. M. M. , Gilmour W. H. , McCourtie J. , McKenzie D.
Published: December 2005

Abstract 11 volunteer subjects with advanced chronic periodontitis participated in a 1‐year longitudinal clinical and microbiological study. Subgingival plaque was collected at each of 7 visits from 148 pre‐selected sites in the left jaw quadrants (test sites) and on the first and last visits, only from 117 sites in the right jaw quadrants (control sites). All sites were examined clinically at each of the 7 visits, and the microbiological markers investigated were the % spirochaetes and % black pigmented Bacteroides species in subgingival plaque. At the completion of the study, the sequential changes in probing attachment level at each site were subjected to regression analysis to determine the direction and extent of attachment change. Possible correlations between attachment change and % spirochaetes or % black‐pigmented bacteroides were investigated using both individual sites and individual subjects. No significant differences were observed in either of the microbial variables between test and control sites. Possible correlations between the microbiological markers and attachment changes were investigated at baseline, at the 12‐month visit and using the microbial data accumulated over all 7 visits. Significant differences were observed only at the 12‐month visit when the % spirochaetes of both test and control sites were significantly lower in subjects showing the greatest improvement in attachment level. Overall, these results indicate that quantification of either spirochaetes or black‐pigmented Bacteroides species cannot be used reliably to identify or predict disease‐active sites.
Detection of high‐risk groups and individuals for periodontal diseases
Authors: Griffiths G. S. , Wilton J. M. A. , Curtis M. A. , Maiden M. F. J. , Gillett I. R. , Wilson D. T. , Sterne J. A. C. , Johnson N. W.
Published: December 2005

Abstract The fundamental concepts of measuring periodontal diseases and the interpretation of such information as an historical record of disease, rather than disease activity, emphasises the need for improved diagnostic and prognostic tests. Criteria for an indicator of disease activity were suggested and an index fulfilling these should allow sites to be categorised as “active”, quiescent or healing, and enable one to predict the risk of future disease activity. The ability of current measurements and indices, routinely used during clinical assessments of periodontal diseases, to fulfill the suggested criteria was considered and rejected in all cases. It is concluded that clinical parameters are only capable of identifying disease retrospectively, indicating the need for longitudinal, rather than cross‐sectional studies in the search for clinical and laboratory markers of disease activity and susceptibility.
A re‐examination of within‐mouth correlations of attachment level and of change in attachment level
Authors: Fleiss Joseph L. , Wallenstein Sylvan , Chillton Neal W. , Goodson J. Max
Published: December 2005

Abstract Using a data set from the Forsyth Dental Center consisting of repeated measurements of periodontal attachment level on 22 patients over 1 year, we performed correlation analyses at 4 time points (baseline, 1 month, 6 months and 9 months) for 3 units of measurement (sites, teeth and quadrants). Values of the intraclass correlation coefficient were obtained for the cross‐sectional measurements and for changes from baseline. The values were positive and often of appreciable magnitude, indicating that measurements of attachment level and of change in attachment level within the same mouth are positively correlated. Taking sites rather than patients as the units of statistical analysis in comparative clinical trials in periodontology will therefore tend to produce underestimated standard errors and overstated statistical significance.
Periodontal diseases in adult Kenyans
Authors: Baelum V. , Fejerskov O. , Manji F.
Published: December 2005

Abstract This study comprised 1131 persons who constitute a stratified random sample of the entire population aged 15–65 years in Machakos District, Kenya. Each person was examined for tooth mobility, plaque, calculus, gingival bleeding, loss of attachment and pocket depth on the mesial, buccal, distal and lingual surface of each tooth. The oral hygiene was poor with plaque on 75–95% and calculus on 10–85% of the surfaces depending on age. Irrespective of age, pockets ≥4 mm was seen on less than 20% of the surfaces, whereas 10–85% of the surfaces had loss of attachment ≥1 mm. The proportion of surfaces per individual with loss of attachment ≥4 mm or ≥7 mm, and pocket depths ≥4 mm or ≥7 mm, respectively, showed a pronounced skewed distribution, indicating that in each age group, a subfraction of individuals is responsible for a substantial proportion of the total periodontal breakdown. The individual teeth within the dentition also showed a marked variation in the severity of periodontal breakdown. Our findings provide additional evidence that destructive periodontal disease should not be perceived as an inevitable consequence of gingivitis which ultimately leads to considerable tooth loss, A more specific characterization of the features of periodontal breakdown in those individuals who seem particularly susceptible is therefore warranted.
Periodontal status in relation to age and tooth type
Authors: Papapanou Panos N. , Wennström Jan L. , Gröndahl Kerstin
Published: December 2005

Abstract The purpose of the present study was to assess by radiographic means the pattern of destructive periodontal disease within the dentition of individuals of different ages. Full‐mouth series of intra‐oral radiographs from 531 dentate individuals aged 25–75 years were examined with respect to number and type of remaining teeth, location of the alveolar bone in relation to the cemento‐enamel junction and presence of angular bony defects. The assessments of alveolar bone levels and angular bony defects were performed at the approximal surfaces of all teeth present. The results showed that although most individuals had experienced a reduction in alveolar bone height with age, only a small number of subjects had developed advanced breakdown of the periodontium. Hence, pronounced bone loss was observed in only 11% of the subjects and was non‐existent in ages below 35 years. 23yo of the individuals accounted for 3/4 of the total number of sites with bone level values (bone loss) of ≥6 mm. Out of the total number of tooth sites examined, 28% showed no bone loss., while 13% demonstrated pronounced periodontal tissue breakdown. Angular bony defects were found at 8% of all teeth examined and were most frequent at the maxillary first premolars. Teeth in the incisor regions consistently showed the highest frequency of advanced alveolar bone loss and the lowest frequency of normal tissue support, while corresponding figures for teeth in the molar regions were found to be the opposite. However, molars were the most frequently missing teeth.
Periodontal health at first permanent molars adjacent to primary molar stainless steel crowns
Authors: Guealmann Marcio , Matsson Lars , Bimstein Enrique
Published: December 2005

Abstract. The present investigation was designed to study the effect of stainless steel crowns (SSC), placed on second primary molars, on the periodontal tissues of neighbouring first permanent molars. 36 children (9‐12 years old) with an SSC on a second primary molar on one side of the mouth only, were selected for the study. A clinical and radiographic examination was performed at the mesial surface of the first permanent molar, adjacent to the SSC, and at the corresponding area on the contralateral side of the mouth. The clinical examination included gingival and plaque index scores and probing depth measurements. In the radiographic examination, the marginal bone level was assessed. No statistically significant differences in plaque index scores, gingival index scores and probing pocket depth were noted between the mesial surface of first permanent molars and the contralateral control area. Nor were any significant differences in bone level seen. The present findings suggest that the presence of a well‐adapted SSC on a second permanent molar does not affect the periodontal health of the neighbouring first permanent molar.
Gingivitis in the human deciduous dentition
Authors: Bimstein E. , Soskolne W. A. , Lustmann J. , Gazit D. , Bab I.
Published: December 2005

Abstract. This study examined the relationship between clinical and histomorphometric parameters in the human deciduous dentition. Clinical parameters including plaque index, gingival swelling, gingival color, tooth mobility and degree of root resorption were determined prior to the extraction of teeth. The teeth were extracted with their surrounding gingiva in order to preserve the in situ relationship between the hard and soft tissues. Histomorphometric analysis was carried out on 55 sites, using block surface light microscopy (BSLM). Apical migration of the junctional epithelium was found at 53% (29) of the sites. The gingival sulcus was shallow (0.3 ± 0.19 mm) and coronal to the cementoenamel junction at 84% (46) of the sites. Junctional epithelium with retepegs was present at 89% (49) of the sites, whilst an inflammatory cell infiltrate (ICI) was present at all sites examined. The ICI was located opposite to the junctional epithelium and cementum at 80% (44) of the sites. The extent of ICI correlated positively with the patients' age and was significantly increased when clinical evidence of gingival swelling or redness was present.
Treatment of rapidly destructive periodontitis in Papillon‐Lefèvre syndrome
Authors: Preus Hans R.
Published: December 2005

Abstract. This paper reports the successful treatment of the pcriodontal component of the Papillon‐Lefèvre syndrome in 2 siblings. Treatment consisted of extractions of periodontally‐involved teeth under antibiotic therapy. The exogenous source of the suspected pathogenic A. actinomycetemcomitans in this family, identified as a pet dog, was also treated with antibiotics. Assessments of monocyte function and levels of serum antibodies against A. actinomycetemcomitans were performed prior to an immediately after treatment. Microbiological screening of subgingival dental plaque of the PLS patients as well as the rest of the household members, including the dog, was performed every month during the study period. Remission of the rapidly destructive periodontitis, as well as an earlier‐described monocyte dysfunction in these two PLS patients occurred concommitantly with the eradication of A. actinomycetemcomitans from the family. 15 months after this treatment, the children still had no signs of periodontitis or of A. actinomycetemcomitans infection. The legitimacy with which PLS is defined as a disease entity is discussed and questioned.
Studies on the effect of toothpaste rinses on plaque regrowth
Authors: Addy Martin , Jenkins Susan , Newcombe Robert
Published: December 2005

Abstract A number of compounds have been added to toothpastes to inhibit plaque regrowth. The inclusion of cationic antiseptics, such as chlorhexidine, poses formulation difficulties because of interactions with other ingredients particularly aniontc detergents. More recently. Triclosan/zinc citrate formulations have been shown effective plaque inhibitors. The aim of this study was to compare a commercially available 0.2% Triclosan/0.5% zinc citrate toothpaste with a number of experimental 0.5% chlorhexidine/detergent toothpastes for effects on plaque regrowth over 4 days. Subjects rendered plaque free at each baseline rinsed twice a day with toothpaste slurries and disclosed plaque was scored at the end of each period. All toothpastes significantly reduced plaque by comparison with a control toothpaste, but were significantly less effective than a 0.2% chlorhexidine rinse. Some significant differences in favour of one chlorhexidine toothpaste were noted but these were small in magnitude. Whether the plaque inhibition obtained with Triclosan/zinc citrate toothpaste was greater than would be expected from other commercially available preparations cannot be determined from this study and is the subject of a further investigation.
Studies on the effect of toothpaste rinses on plaque regrowth
Authors: Jenkins Susan , Addy Martin , Newcombe Robert
Published: December 2005

Abstract Encouraging findings have been reported for the effects of Triclosan/zinc citrate toothpastes on plaque regrowth and in some studies gingival health. To date, commercially‐available toothpastes contain 0.2% Triclosan with or without 0.5% zinc citrate. The aim of this study was to evaluate the effects on 4‐day plaque regrowth, of a number of 0.2% Triclosan toothpastes with or without zinc citrate. All of the toothpastes contained varying levels of anionic detergent sodium lauryl sulphate and were compared with a commercially available toothpaste without Triclosan or zinc citrate and a 0.2% chlorhexidine mouthrinse. The toothpastes were used as slurry twice a day and plaque regrowth scored by area and the criteria of the debris index. Plaque inhibition was significantly greater with the chlorhexidine mouthrinse than with all of the toothpastes. There were no significant differences in plaque scores between any of the toothpastes. It would appear that at the concentration of 0.2% Triclosan with or without 0.5% zinc citrate provides little if any additional benefit to plaque inhibition to that produced by a conventional toothpaste containing sodium lauryl sulphate.
Tumoral calcinosis associated with early onset periodontitis
Authors: Katz J. , Ben‐Yehuda A. , Machtei E. E. , Danon Y. L. , Metzker A.
Published: December 2005

Abstract A rare case of tumoral calcinosis (TC) with oral manifestations is presented in a 5‐year‐old child. The possible correlation between prepubertal periodontitis and TC is suggested and discussed.
Detection of high‐risk groups and individuals for periodontal diseases:
Authors: Curtis M. A. , Gillett I. R. , Griffiths G. S. , Maiden M. F. J. , Sterne J. A. C. , Wilson D. T. , Wilton J. M. A. , Johnson N. W.
Published: December 2005

Abstract Gingival crevicular fluid is regarded as a promising medium for the detection of markers of periodontal diseases activity. The collection protocols are straight forward and non‐invasive and can be performed at specific sites of interest in the periodontium. Because the fluid accumulates at the gingival margin, it will contain potential markers derived not only from the host tissues and serum but also the subgingival microbial plaque, and thus an extremely broad range of candidate molecules may be investigated. However, the ability to successfully describe indicators of current disease activity and predictors of future disease is dependent not only upon the choice of the biochemical marker but also on the accurate description of the health status of the sample sites using currently available clinical and radiographic methods. Areas of study which currently show the most promise involve the analysis of host enzyme activities directed against components of the extracellular matrix, the nature of the glycosaminoglycans released into the sulcus and the concentration in gingival crevicular fluid of certain mediators of the inflammatory process, most notably prostaglandin E2.
A 1‐year study on the maintenance of gingival health by a dentifrice containing a zinc salt and non‐anionic antimicrobial agent
Authors: Svatun B. , Saxton C. A. , Rolla G. , van der Ouderaa F.
Published: December 2005

Abstract An experimental dentifrice containing zinc citrate and Triclosan was used by student nurses for 12 months without supervision, while a corresponding group used a control dentifrice. Dental flossing was not permitted during the first 6 months. Gingival health achieved in a pre‐experimental period, during which oral hygiene instruction was given, was maintained by users of the experimental dentifrice for 12 months but not by users of the control dentifrice. About 1/3 of the control group used floss daily during the 2nd 6 months and significantly improved their gingival health to a level comparable to that of the experimental group. Flossing brought no extra benefit for the latter group. In the control group, approximal regions were less healthy than buccal or lingual sites. The gingival health of these sites improved significantly with daily flossing. The experimental dentifrice maintained gingival health in all sites irrespective of the use of floss. The study has confirmed that oral health can be maintained by the use of the experimental dentifrice for at least 12 months in a habitual tooth brushing regime, and that the dentifrice would be as effective and simpler than relying on the combination of brushing and regular flossing.
Comparative longitudinal study of 2 methods of scheduling maintenance visits: 4‐year data
Authors: Listgarten M. A. , Sullivan P. , George C. , Nitkin L. , Rosenberg E. S. , Chilian N. W. , Kramer A. A.
Published: December 2005

Abstract 116 subjects were recruited from a population of patients previously treated for adult periodontitis and maintained in periodontal health by means of periodic prophylaxes every 3–6 months. The subjects were divided into a control (C) and a test (T) group. A total of 33 patients in the T group and 47 in the C group completed the 4‐year study. The C subjects were examined every 6 months and given a prophylaxis every 3 months. The patients in the T group were examined at similar intervals, but prophylaxes were administered according to the individualized scheme of Listgarten and Shiffter, on the basis of a differential microscopic count of subgingival bacterial morphotypes. Recurrent periodontitis was defined as an increase in probing depth of 3 mm or more from baseline measurements. Teeth so affected were sampled microbiologically when the diagnosis of recurrent disease was made and “exited” from the study for treatment. A control microbial sample was taken at the same time from a previously‐defined pooled sample of non‐affected surfaces with comparatively high, but stable probing depths. During a 4‐year period, more than half of the subjects developed at least one recurrence of disease, and one‐third of the subjects had 2 or more recurrences of periodontitis. Disease recurred on approximal surfaces 81% and on oro‐vestibular surfaces 19% of the time. There were no significant differences in the rate of disease recurrence between the C and the T group, even though recall intervals in the T group at the 4‐year examination averaged 19.4 months and an average of 30.6 months had elapsed since the previous prophylaxis. Both groups exhibited similar plaque index and gingival index scores, similar probing depth and attachment level measurements, and similar proportions of different bacterial morphotypes during the 4‐year study. However, differences were noted between examinations for both groups with respect to most of these criteria. This study provides 4‐year longitudinal data on the clinical and certain microbiological characteristics of a population of adult patients previously treated for moderate to advanced periodontitis, and subsequently placed on periodontal maintenance. The results indicate that some of these patients may remain in good periodontal health despite the lack of regular tri‐monthly recall visits, and that microscopic monitoring of the subgingival microbiota may be of value in identifying these individuals. Our findings also indicate that microscopic monitoring of the subgingival microbiota may not provide sufficient benefits to justify the additional time and labor required to incorporate this technique into a standard regimen of periodontal preventive maintenance.
The impact of regression towards the mean on probing changes in studies on the effect of periodontal therapy
Authors: Egelberg Jan
Published: December 2005

Abstract The purpose of this report was to evaluate the magnitude of the regression towards the mean (RTM) relative to the observed changes in probing measurements following periodontal therapy in 2 groups of patients. Regression lines were calculated for observed changes in probing depths and probing attachment levels related to the initial probing depths of the individual sites. Regression lines, adjusted for the RTM effect, were also calculated. For the extreme subgroups of recorded shallow and deep sites, the RTM effect (mm) was found to amount to a maximum of 0.6 mm. It appears unlikely that erroneous conclusions have been made in previous clinical studies evaluating probing depth changes in deep sites, since the RTM accounts for a limited portion of the observed changes. For probing depth changes in shallow sites and for probing attachment level changes in both shallow and deep sites, the RTM accounts for a larger proportion of the observed mm changes. It therefore seems prudent to be careful about interpretation of these changes in clinical studies, where the RTM effect has not been adjusted for. Whenever possible, duplicate initial recordings should be taken to allow determination of and subsequent adjustment for the RTM effect.
Metronidazole plus amoxycillin in the treatment of Actinobacillus associated periodontitis
Authors: van Winkelhoff A. J. , Rodenburg J. P. , Goené R. J. , Abbas F. , Winkel E. G. , de Graaff J.
Published: December 2005

Abstract The potential use of an adjunctive therapy of metronidazole plus cillin for the subgingival elimination of Actinobacillus actinomycetemcomitans in periodontitis patients was investigated. 22 patients participated in this study, 11 with localized juvenile periodontitis (LJP) and 11 with rapidly progressive periodontitis (RPP). 14 patients had received periodontal treatment in the past. All patients were subgingivally infected with A. actinomycetemcomitans. After mechanical subgingival debridement in combination with the antibiotic treatment, elimination of A. actinomycetemcomitans was achieved in all patients but one. With this one exception, clinical improvements were observed in all patients, resulting in reduced pocket probing depths as well as in a significant reduction in bleeding on probing. Re‐examination of 16 patients after 9–11 months revealed that A. actinomycetemcomitans was still undetectable and further clinical improvement was observed. It was concluded that the combination of metronidazole plus amoxycillin is a valuable adjunct to mechanical therapy in A. actinomycetemcomitans associated periodontal infections.
The effect of ultrasonic cleaning and air polishing on the marginal integrity of radicular amalgam and composite resin restorations
Authors: Gorfil Colin , Nordenberg Daniel , Llberman Reuven , Ben‐Amar Ariel
Published: December 2005

Abstract This study attempts to put at ease some uncertainty of a possible damaging effect of ultrasonic scaling and air polishing procedures on dental restorations (amalgam and composite resin). Under optimal in vitro conditions, the margins of 120 restorations were subject to thorough ultrasonic and air polishing instrumentation in order to mimic those extensively used in periodontal treatments. Light‐cure composite resin and Dispersalloy amalgam alloy were used to restore class V cavities at the CEJ. After being exposed to ultrasonic scaling and air polishing, cleaning, and thermocycling, clinical evaluation of the cavity margins and microleakage examination showed no detrimental effects of these procedures.
Inter‐and intra‐examiner variability using standard and constant force periodontal probes
Authors: Walsh T. F. , Saxby M. S.
Published: December 2005

Abstract Current methods of measuring periodontal probing depths at specified sites by clinical means are subject to wide variation both within and between examiners. This paper reports an investigation into the influence of a constant‐force periodontal probe on intra‐and inter‐examiner variability when measuring probing depths. 30 sites in 10 patients with untreated chronic adult type periodontitis were examined by 2 operators, firstly using a standard periodontal pocket probe then with a constant force probe. Neither examiner was aware of the others readings and were thus blind in relation to one another. Comparison of the recordings of the 2 operators using the standard probes showed significant differences between the operators (p<0.01) but this difference became insignificant when the constant force probe was used. One operator had a significant variation between his standard and constant force measurements (p<0.01), but the other did not. Overall there was a maximum variation of ± 1 mm in 79.9% of recordings using the standard probe and this agreement was increased to 100% with the use of the constant pressure probe.
Prevalence of interproximal periodontal intrabony defects in an adult population in Sweden
Authors: Wouters Francis R. , Satonen Lars E. , Helldën Leif B. , Frithiof Lars
Published: December 2005

Abstract The aim of this study was to determine the prevalence and localization of interproximal periodontal intrabony defects (IPIDs) in the total adult population of a Swedish county. On each interproximal tooth surface (third molars excluded) in 733 randomly selected dentate individuals aged 20 years and over, one examiner recorded from x 5‐magnified periapical radiographs, the presence or absence of IPID with a width and depth of at least 5 and 10 mm, respectively, representing 1 and 2 mm unmagnified. Intra‐examiner reproducibility determined from double recordings was substantial (k = 0.66). Recordings of IPID were compared with those performed by 24 specialist periodontists using their own diagnostic criteria. IPIDs were recorded in 32% of the 733 examined individuals; the number of defects per individual ranged from 1 to 15. The prevalence of IPID increased with increasing age and IPID occurred more frequently in men than in women. IPID was observed more frequently on mesial than on distal tooth surfaces, whereas there was no difference between maxillary and mandibular tooth surfaces. Symmetrical localizations of IPID in relation to the sagittal plane were observed.
The use of repeated measures analysis of variance for plaque and gingival indices
Authors: Gunsolley J. C. , Chinchilli V. M. , Koerlge T. E. , Palcanls K. G. , Sarbin A. G. , Brooks C. N.
Published: December 2005

Abstract Clinical trials for anti‐gingivitis and anti‐plaque agents commonly use the mean of Silness and Löe plaque indices and Löe and Silness gingival indices as response variables. The aim of this report is to determine if data from anti‐plaque and anti‐gingivitis clinical trials using Silness and Löe plaque indices and Löe and Silness gingival indices satisfy conditions necessary for the use of the univariate or multivariate approach to repeated measures. These conditions are multivariate normality, homogeneity of variance‐covariance matrices, and for the univariate approach, a type‐H variance‐covariance matrix. Data from 5 separate clinical trials representing a wide range in sample size, pretreatment mean gingival and plaque indices and treatment effects were used to test these conditions. Either the univariate or multivariate approach to repeated measures was found to be appropriate for both responses of the 5 clinical trials. Thus, means of Silness & Löe and Löe and Silness gingival indices meet the necessary conditions for use of either the univariate and/or multivariate approach to repeated measures. However, significant time‐treatment interactions are a common occurrence in these types of clinical trials and must be evaluated carefully. The analyses in this study were carried out using SAS. Other mainframe statistical software packages and many micro‐computer statistical software packages have routines to analyze repeated measures experiments with analysis of variance methods. However, some of the packages may omit the multivariate approach to repeated measures or may not include interactions between within‐subject and between‐subject effects. These packages should be used with caution.
Relationship of subgingival plaque flora to lysosomal and cytoplasmic enzyme activity in gingival crevicular fluid
Authors: Harper D. Scott , Lamster Ira B. , Celenti Romanita
Published: December 2005

Abstract Examining the relationships among indicators of the acute inflammatory response in gingival crevicular fluid (GCF) and specific bacterial species in subgingival plaque may provide indications of which bacterial species or groups of species may be associated with potentially destructive host‐derived processes. Here we report on the relationship of the subgingival plaque flora to the activity of mammalian forms of the enzymes β‐glucuronidase (βG). lactate dehydrogen‐ase (LDH), and arylsulfatase (AS) in GCF from a total of 54 4‐6 mm periodontal sites from 13 periodontitis patients. Sites were scored for probing depth (PD) and bleeding on probing, and GCF was collected using filter paper strips inserted into the sulcus for 30 s, eluted in buffer and assayed for enzyme activity. 1 week later, the patients were again evaluated for PD and bleeding, and subgingival plaque was removed with a curette oriented toward the pocket epithelium. Plaque samples were examined by darkfield microscopy and cultured anaerobically on selective and non‐selective media. Various groups of bacteria, including species of black pigmenting Bacteroides (BPB), Fusobacterium sp., Capnocytophaga sp, Streptococcus sanguis, and total facultative organisms were enumerated. Relationships among the enzymes and bacterial groups expressed as colony‐forming unit (CPU) counts or as a % of the total cultivable flora were assessed by Spearman correlation analysis. βG levels were significantly correlated with populations of spirochetes, B. inrermedius, B. gingivaiis, and total lactose negative BPB's, Correlation between βG and E nucleatum sp. or Capnocytophaga sp. approached but did not reach statistically significant levels. In contrast, LDH activity showed a significantal positive correlation with levels of B. gingivaiis and total lactose negative BPBs. AS levels were significantly correlated only with B. gingivaiis. fid and LDH showed a significant negative correlation with levels of coccoid forms. Thus, βG, an acid hydrolase which can serve as a marker for primary granule release from polymorphonuclear leukocytes, was most closely correlated with the micro‐organisms found in other studies to be associated with chronic adult periodontitis.
Periodontal conditions in insulin‐dependent diabetics
Authors: Hugoson A. , Thorstensson H. , Faltt H. , Kuylenstierna J.
Published: December 2005

Abstract The aim of this study was to compare the prevalence and severity of periodontal disease in age and sex matched adult long and short duration insulin‐dependent diabetics and non‐diabetics. The study involved 82 subejcts with long‐ and 72 with short‐duration diabetes and 77 non‐diabetics, all aged 20‐70 years. The clinical and radiographic examination comprised recordings of the number of existing teeth, absence or presence of plaque and supra‐ and subgingival calculus, gingival conditions, probing pocket depth and alveolar bone level. There were no significant differences in the number of existing teeth or presence of plaque and supra‐ and subgingival calculus between long‐ and short‐duration diabetics and non‐diabetics. Diabetics, irrespective of the duration of the disease, had a higher prevalence of sites with gingivitis than non‐diabetics. Overall, there were no significant differences between the groups regarding the prevalence of tooth surfaces with probing pocket depths of 4 and 5 mm. However, on comparison between age subgroups, long‐duration diabetics younger than 45 years had significantly more 4 and 5 mm pockets than non‐diabetics. Long‐duration diabetics altogether had significantly more tooth surfaces with probing depth ≥ 6 mm than non‐diabetics. The radiographs of alveolar bone height exhibited significantly more extensive alveolar bone loss in long‐duration diabetics aged 40–49 years than in short‐duration diabetics and non‐diabetics. This, together with the increased number of subjects belonging to classification groups with severe peridontal disease experience among long‐duration diabetics, indicates more periodontal disease in these diabetics.
Scanning electron microscopic examination of pocket wall epithelium and associated plaque in localized juvenile periodontitis
Authors: Verderame Richard A. , Cobb Charles M. , Killoy William J. , Drisko Connie L.
Published: December 2005

Abstract The purpose of this investigation was to describe the morphologic characteristics of epithelial‐associated plaque in periodontal pockets of patients with localized juvenile periodontitis (LJP). 25 tissue specimens obtained from 10 adolescent patients were examined by scanning electron microscopy. Specimens were evaluated to determine the following specific features: (1) distribution of microbial colonies on the epithelial surface; (2) topographic features of pocket epithelium associated with microbial colonies; and (3) the predominante microbial morphologic types comprising the colonies. Observations made during this investigation revealed the following. (1) The surface epithelium in the coronal one‐third of the pocket wall was essentially healthy in appearance and exhibited no distinct microbial colonies or unusual topographic features. (2) The surface epithelium in the middle one‐third area featured randomly‐dispersed microbial colonies consisting of 3 major morphotypes: cocci, bacilli and coccobacilli. Also in this zone, there was morphologic evidence of microbial penetration of the epithelial barrier along intercellular spaces. (4) The apical one‐third zone was characterized by lymphocytic infiltration, epithelial cavitation and ulcerations, and singular organisms entrapped in fibrin meshworks. There were no distinct microbial colonies in this zone, although individual spirochetes, fusiforms, filamentous organisms, and short and longe rods were observed.
Early plaque colonization on human cementum
Authors: Carrassi A. , Santarelll G. , Abati S.
Published: December 2005

Abstract We have described the morphology of developing plaque on cementum in an in vivo human model. Slabs of cementum obtained from sound teeth, rendered anorganic with 5% sodium hypochlorite, were glued to orthodontic brackets and positioned on the upper canines, premolars and molars in 8 volunteers, The brackets were removed after 2, 4, 8, 24 h and processed for scanning electron microscopy (SEM). Within 2 h, a thin pellicle covered the cementum surface, with few micro‐organisms detectable. At 4 and 8 h, coccoid plaques were present. Filaments inserted perpendicularly to the plaque surface were seen at 24 h. The results indicate that early bacterial colonization of human cementum is a selective process, mediated by an organic pellicle and mainly involves cocci.
Criteria for assessment of interproximal bone loss on bite‐wing radiographs in adolescents
Authors: Källestål Carina , Matsson Lars
Published: December 2005

Abstract The present study was performed to determine radiographically the normal distance between the cemento‐enamel junction (CEJ) and the alveolar bone crest (AC) as a background for diagnostic decision on bone loss in adolescents. For this purpose, the normal appearance of the alveolar crest was studied in 30, 18‐year‐olds reported to have had a clinically healthy gingiva at the age of 16 years. A clinical examination was performed and 4 posterior bite‐wing radiographs were taken. Sites with bleeding on probing, loss of probing attachment, defective fillings and calculus were excluded from the analysis. At the remaining 737 sites, the distance CEJ‐AC was measured on radiographs. Also, the appearance of the marginal bone (normal, sclerotic, notched and/or irregular image, widening of the periodontal ligament space) was recorded. The mean distances CEJ‐AC for the separately‐recorded maxillary surfaces amounted to 0.9 or 1.0 mm. In the mandible, the distances amounted to 0.7 or 0.8 mm except for the mesial surface of the mandibular first premolar, where a mean distance of 0.5 mm was noted. At maxillary surfaces, 84‐90% of the sites showed a distance of I mm or less and 94‐100% a distance of 1.5 mm or less. At mandibular surfaces, 93‐100% of the sites showed a distance of 1.0 mm or less and 100% a distance of 1.5 mm or less. At 4 sites, located at the mesial surface of the first and second premolars in the maxilla, the CEJ‐AC distance was recorded as 2 mm. One site was classified as not having a normal appearance. In this site, the marginal bone had an irregular image. Based on the finding that all measurements were within the range 0–2 mm, it is suggested that > 2 mm would be the criterion of choice in epidemiological studies of bone loss in adolescents. However, depending on the purpose of the survey, a shorter CEJ‐AC distance may be appropriate.
Comparison of manual and power toothbrushing, with and without adjunctive oral irrigation, for controlling plaque and gingivitis
Authors: Walsh M. , Heckman B. , Leggott P. , Armitage G. , Robertson P. B.
Published: December 2005

Abstract We compared the effects of four oral hygiene methods (manual tooth‐brushing, power toothbrushing. manual toothbrushing plus irrigation, and power toothbrushing plus irrigation) on plaque and periodontal disease. These methods were tested both when used alone and when used in conjunction with professional mechanical oral hygiene. 108 subjects were clinically assessed for plaque, stain, gingival inflammation, bleeding to probing, probing depth and attachment loss, and randomly assigned to one of the 4 oral hygiene groups. Subjects were carefully instructed in the use of their assigned method and asked to discontinue all other forms of oral hygiene. After 3‐months, subjects returned for re‐examination and full‐month professional mechanical oral hygiene care. 3 months later, subjects returned for a final oral examination. All subjects kept a diary of use of their assigned method and were called every 2 weeks to monitor discomfort, provide reinforcement and answer questions. Results showed that all the oral hygiene methods were equally effective in reducing plaque and stain accumulation, gingival bleeding, bleeding to probing ratio and the % of pockets 4 mm or deeper. None of the oral hygiene methods was associated with injury to soft or hard tissues.
Reproducibility of microscopic and cultural data in repeated subgingival plaque samples
Authors: Mombelli A. , Minder Ch. E. , Gusberti F. A. , Lang N. P.
Published: December 2005

Abstract In association studies, micro‐organisms can only be recognized as suspects for playing a major rôle in the development of a pathological environment, if their destructive action goes along with a marked proportional increase of their numbers or if their first detection can be related to the clinical onset of the disease. Limitations in the reproducibility of repeated samples have lo be taken into account, when changes of the microbial composition of subgingival environments are to be studied, and when local clinical changes are to be related to shifts in the composition of the pertaining microbiological compartment. To study reproducibility, a total of 109 sites was sampled repeatedly with sterile paperpoints at an interval of 7 to 10 days in 24 patients suffering from periodontal disease and 12 edentulous patients wearing successful and failing osseointegrated titanium implants. Using continuous anaerobic techniques, the samples were cultured on nonselective and selective media and were studied by darkfield microscopy. Both the intertest‐agreements of frequencies of detection (x‐statistics) as well as the discrepancies of proportions of bacterial groups and selected bacterial species were determined. The standard deviation of proportional differences between first and second samples ranged between 6.4% (fusiform organisms) and 17.2% (coccoid cells) for darkfield parameters, between 4.3% (B. melaninogenicus on ETSA/Kana.) and 14.0% (B. gingivalis on ETSA/Kana.) for selected bacterial species and between 6.9% (gram‐negative anaerobic cocci) and 24.0% (gram‐positive facultative cocci) for bacterial groups classified according to gram stain characteristics and atmospheric growth conditions. As the magnitude of deviation depended upon the mean value, coefficients of variation (cv) were also determined. The lowest cv values (0.25) were found for the proportions of spirochetes in the darkfield microscope, for the proportions of the gram‐positive facultative rods (0.29) for gross bacterial groups and for Fusobacterium spp. (0.60) for selected bacterial species. The intertest‐agreement of the frequencies of detection were best for spirochetes in the microscope and for B. intermedius with selected cultivated species. The results did not indicate a general bias of the results of second samples due to the previous sampling (McNemar's x2). Methodological proposals for estimation and comparison of proportions of bacteria are made and discussed in an appendix.
Prevalence of chronic periodontal disease using probing depth as a diagnostic test
Authors: Bergström J. , Eliasson S.
Published: December 2005

Abstract. The prevalence of chronic periodontal disease was investigated using the occurrence of diseased pocket sites as the diagnostic criterion. The study group comprised 250 dentally aware subjects aged 21–60 years, with a high number of teeth remaining in all age groups. The % of sites with a probing depth of 4 mm was 16% for the total sample. Most diseased sites (69%) were in the 4‐tnm class, with only 4% at depths 7 mm. 82% on the subjects had 1 or more sites 4 mm. With probing depth as the sole criterion for diagnosis of chronic periodontal disease, prevalence in a sample is heavily dependent on the critical levels selected for probing depth and cut‐off point. With critical levels of 4 mm for probing depth and 1 diseased site for the cutoff point, prevalence was 49% in the 21–30 year age group and 95% in the 51–60 year age group. A shift in cutoff point to 40 diseased sites gave a prevalence of 2% and 41%. respectively, in the 2 age groups. For a critical depth of 7 mm and a cutoff point of 1 diseased site, the prevalence was 2% and 43% for the 2 age groups, respectively. Aspects of importance for the decision‐making process on disease are discussed.