bluuebunny/crossref_metadata_2025 huggingface dataset:
Microscopic evaluation of clinical measurements of connective tissue attachment levels
Authors: Armitage Gary C. , Svanberc Gunnar K. , Löe Harald
Published: December 2005

Abstract. The purpose of this study was to determine how accurately periodontal probes measure connective tissue attachment levels in beagle dogs with (1) clinically healthy gin‐givae, (2) experimental gingivitis, and (3) periodontitis. In the healthy and experimental gingivitis specimens die probes were inserted with a standardized force of 25 ponds. In periodontitis specimens the probes were inserted with a gentle, but non standardized force After insertion, 120 plastic periodontal probes (40 in each group) were held in place by fusing them to the teeth. Blocks of periodontal tissue with the probes in situ were subsequently processed and serially sectioned. Histometric measurements were made from the sections in order to compare the level of connective tissue attachment to the level of probe penetration. In healthy specimens the probes consistently failed to reach the apical termination of the junctional epithelium (x =−0.39 mm). In the experimental gingivitis group most probes came closer to the apical termination of the junctional epithelium, but on the average stilt fell short by x =−0.10 mm. In periodontitis specimens the probes consistently went past the most apical cells of the junctional epithelium (x =+0.24 mm). A significant relationship between the degree of inflammation and level of probe penetration was found. No relationship was observed between histological and clinical sulcus depths. It is concluded that in beagle dogs (1) periodontal probes do not precisely measure connective tissue attachment levels, (2) inflammation has a significant influence on the degree of probe penetration, and (3) histological and clinical sulcus depths differ significantly.
Demonstration of lipids in the pathologic granules in cementum and dentin in periodontal disease
Authors: Bigarre Claude , Yardin Michael
Published: December 2005

Abstract. Granules can be demonstrated in dental cementum which has been exposed to the oral environment as a result of gingival retraction. In the present study frozen sections of decalcified, periodontally diseased teeth were stained by the Sudan black and Schultz‐Hershberger methods, which indicated that the granules contained cholesterol or steroids. The lipid content of cementum suggests that the outer layer of cementum has been penetrated by exogeneous substances of bacterial or salivary origin.
Some considerations on the role of cementum in periodontal disease
Authors: Emslie R. D.
Published: December 2005

Abstract The protective role of cementum against root resorption is discussed in relation to buried teeth, orthodontic treatment, replantation and periodontal disease. The essential feature seems to be a layer of partially calcified precementum or vital cementoblasts. Root resorption close to the epithelial attachment, although not common, is probably the result of death of cementoblasts caused by irritants from bacterial plaque, and the presence of severe or prolonged inflammation. Cementum exposed in the pocket can be affected in different ways by these irritants, and rendered unacceptable for re‐attachment to periodontal tissue. Successful re‐attachment procedures involve either the removal of the affected cementum or its treatment with agents partially to decalcify such as acids, or detoxify by phenol for example. Examples of treatment embodying some of these principles arc illustrated by two case histories of localised gingival recession and one of intra‐bony pocketing associated with an acute lateral periodontal abscess. In this case a follow‐up radiograph taken 16 years later is presented as evidence of the permanence of repair which can he achieved. Root resorption which often follows the use of fresh autogenous bone from the ilium is then discussed and the conclusion reached that the vital cells in the transplant discourage the migration of cementoblasts from the adjacent periodontium. The cementum and dentine thus remain unprotected and susceptible to resorption.
Development of gingivitis in pre‐school children and young adults
Authors: Matsson Lars
Published: December 2005

Abstract Earlier studies suggest that children and adults differ in the propensity to develop gingivitis when oral hygiene is abandoned. To confirm the existence of such a difference, a comparative study of pre‐school children and young adults was made with objective registration methods. The author performed all registrations

After a period of intensive oral hygiene, all cleaning of teeth was discontinued for 21 days. The amount of bacterial plaque, the amount of gingival exudate and crevicular leukocytes and the bleeding tendency were registered on days 0, 7, 14 and 21.

During the experiment the amount of bacterial plaque increased continously in both groups. The amount of gingival exudate and the tendency to gingival bleeding increased to high values in the adults, while only a small rise was seen in the children. The amount of crevicular leukocytes increased in both groups, but the increment was greater in the adults.

A comparison concerning differences in gingival exudate and bleeding tendency between pre‐school children and adults was undertaken for gingival units that showed a similar plaque development. Under these statistically acceptable prerequisites, it was shown that there is a real difference in the tendency to develop gingivitis between pre‐school children and adults.
Effect on plaque growth of xylitol and sucrose‐containing chewing gums
Authors: Plüss Edith M.
Published: December 2005

Abstract Two experiments tested the effects of xylitol or sucrose‐containing chewing gums on plaque formation. In the first experiment the 18 subjects maintained their normal dietary habits, and in the second they received a sucrose‐free diet during the 3‐day experimental periods. Plaque formation was assessed gravimetrically and/or planimetrically. When the dietary habits were not altered, neither the sucrose nor the xylitol‐containing chewing gums had significant effects on the plaque scores. When sucrose was almost eliminated from the diet, plaque formation was significantly higher in the sucrose than in the xylitol and the placebo groups. Although plaque formation was lower in the xylitol group than in the placebo group, the differences were not statistically significant.
A comparison of the scalloped and linear incisions as used in the reverse bevel technique
Authors: Cattermole Andrew E. , Wade A. Bryan
Published: December 2005

Abstract Using a split‐mouth technique in 20 patients, a comparison was made of the linear and scalloped incisions an used in the reverse bevel technique. Forty full thickness periodontal flap procedures were evaluated. The PII and GI were recorded and gingival fluid collected at operation and at weeks 1, 2, 3, 4 and 12 after operation. Pocket depths and attachment levels were noted and gingival contour assessed, using the Contour Index, pre‐operatively and 12 weeks after operation. Pain experience during the first week after operation was evaluated. No significant changes in PII occurred throughout the study. The GI and gingival fluid flow showed comparable trends. More inflammation was present after the linear incision during the first 2 weeks after operation. Clinically, satisfactory results were achieved for both scalloped and linear incision procedures as shown by the improvement in gingival contour, reduction in pocket depth, slight gain in attachment, lack of gingivitis and low plaque scores.
Gingivo‐periodontal manifestations in chronic benign neutropenia
Authors: Reichart Peter A. , Dornow Hartmut
Published: December 2005

Abstract A case of chronic benign neutropenia in a 7‐year‐old Caucasian male is reported. The predominant clinical symptoms were persistent gingivitis and periodontitis. The clinical, hematological, oral radiographical, histological, and therapeutical features of this uncommon disease are discussed.
Estimating the time and personnel required to treat periodontal disease
Authors: Ekanayaka A. N. I. , Sheiham A.
Published: December 2005

Abstract A study was undertaken to estimate the time taken to carry out the common periodontal treatments. Patients attending a university dental hospital were followed up until the end of their periodontal treatment. The average patient reqtuired 3.1 hours of treatment spread over 9.3 ± 3.9 visits. The largest proportion of the time was for doing scaling (39.3 %) ‐ that took 72.8 ± 41.0 minutes per patient. Patient education took 30.2 % of the time ‐ 55.9 ± 21.8 min per patient, examination 18.5 % (26.2 ± 17.3 min) and surgery 11.6 % (21.4 ± 46.3 min per patient). As the number of patients requiring surgery was small, timings of surgery were done on additional groups of patients. The 75 surgical procedures took 51.9 ± 29.7 min each ‐ an average of 14.3 ± 12 min per tooth. Most of the periodontal treatment was done by auxiliaries; they carried out 68.5 % of treatment (education, scahng and charting), whilst the dentists carried out the examinations and the surgery. The treatment of 60 patients at an industrial clinic was timed. Education took 8.0 ± 4,7 min and scaling and polish, 26.7 ± 16.1 min per patient. The examination time increased with increased severity of disease; patient education increased with increases in debris scores and periodontal scores; the scale and polish time increased with increasing debris, calculus and periodontal scores. The number of visits increased with increases in debris, calculus and periodontal scores. The results indicate that commonly used periodontal indices can be used to estimate treatment times and types of personnel required.
Use of transformed data in clinical trials
Authors: Powell R. N. , Highfield J. E. , Murkell J. F.
Published: December 2005

Abstract The conduct of clinical trials requires that satisfactory indices are available for the objective measurement of clinical signs and symptoms. While no ideal index exists, it is nevertheless possible to use existing indices, despite their ordinal nature, in such a manner that more sophisticated and complex null hypotheses may be tested. In particular the Analysis of Variance (ANOVA) permits significance tests of interactions between two or more variables.

In the case of dental trials, tested differences between groups using one‐way statistical analyses imply that such differences arise from the effects of one variable only. If two variables are manipulated together, their effects are confounded.

The capacity of ANOVA to attribute data variability to main effects and interactions is its great power. To enable plaque and gingival inflammation scores to be analysed in this manner it is suggested that a derived frequency score, the G‐ratio, should be employed. Where there are four possible scores (0,1,2,3), there are three possible G‐ratios – G(0), G(O,1) or G(0,2). The G‐ratio which gives an overall mean closest to 0.50 is chosen for any particular investigation in order to avoid skew data distribution.

In order to meet ANOVA assumptions, the G‐ratio should be formed on groups of not less than 10 surfaces. Since the distribution of any measure based on a proportion is unlikely to be normal, the data should also be transformed so that X'= are sin x which is to say that the transformed score is equal to the angle whose sine is the square root of the raw score.

A clinical study of the effects of lectures and individual instruction in oral hygiene was subjected to analysis by a five‐way ANOVA. Location and jaw effects were markedly qualified by interactions. Such considerations point to the need for care in the design of trials where subject variability, repeated measurements, trial manipulations and interactions occur.
Extrinsic discoloration of teeth
Authors: Eriksen Harald M. , Nordbø Hakon
Published: December 2005

Abstract The majority of tooth discolorations are extrinsic in nature and appear as brown integuments. Various clinical indices and photometric techniques have been used for the evaluation of extrinsic discolorations. Smoking, tea or coffee consumption and increasing age are promoting factors and such discolorations are frequently seen in connection with oral use of antibacterial plaque‐inhibiting mouthrinses. Chemical alteration of the acquired pellicle appears to be the major reason for these brown integuments.
Screening for periodontal disease
Authors: Sheiham Aubrey
Published: December 2005

Abstract The prime objective of screening is to detect disease at an earlier stage than would normally occur with people presenting with the disease, on the assumption that earlier treatment would alter the natural history of the disease in a significant proportion. However, before a screening survey is done a number of conditions should be fulfilled. The disease should be an important health problem; there should be effective and acceptable treatments available for those with the disease; the natural history of the disease should be adequately understood and there should be an agreed policy on whom to treat.

Periodontal disease does not fulfil many of the requirements for a disease suitable for population screening. There is no reliable evidence that earlier detection alters the natural history of the disease or the survival and function of the teeth. Neither is there sufficient information on the importance of clinical signs of periodontal disease. We do not know whether screening tests are able to detect periodontal diesease which is likely to have an important impact on periodontal health. For example, is bleeding an important sign of destructive periodontal disease? Does gingivitis evidenced as redness progress to alveolar bone destruction? The lack of answers to these questions casts serious doubts on the accuracy of estimates of periodontal treatment needs which include all persons with a positive gingivitis score as needing treatment.

A number of other gaps in our knowledge relating to periodontal disease are outlined. Because of these, it was concluded that screening for periodontal disease is not justified at present. Instead, research should be directed at answering questions about the natural history of periodontal diseases, the effectiveness of prevention and treatment, the significance of clinical signs of periodontal disease and the validity, sensitivity and specificity of the signs.
General anaesthesia for periodontal surgery
Authors: Manson J. D. , Midlar‐Danks S.
Published: December 2005

Abstract. A technique is described in which full‐mouth periodontal surgery is carried out under general anaesthesia. The use of an endotracheal tube with inflatable cuff allows good visibility and access to all parts of the mouth unhampered by a throat pack; access is further improved by sloping the operating table foot‐down.

A system of haemorrhage control is used involving a combination of procedures: smooth anaesthetic induction and controlled carbon dioxide levels; intravenous injection of a fibrinolytic inhibitor (epsilon amino‐caproic acid); foot‐down tilt to the operating table and infiltration with local analgesic solution.

The advantages and disadvantages of the technique are discussed.
Gingival inflammation and bone loss in periodontal disease
Authors: Kardacihi B. , Wolffe G. N. , Manson J. D.
Published: December 2005

Abstract Fifty subjects between 27 and 43 years of age were studied to determine the relationship between the severity of gingival inflammation, the amount of bone loss and the plaque score in interproximal sites.

The results indicate moderately good correlations between Gingival Index or Plaque Index and percentage bone loss. However a low correlation was found between the amount of crevicular fluid and percentage bone loss. Gingival Index and Plaque Index were well correlated. It was also found that when patients were divided into two age groups, younger and older than 35 years, the older individuals studied had more bone loss interproximally compared with the younger despite comparable amounts of plaque or gingival inflammation. The data suggest that both severity and longevity of the inflammation may play a role in determining the rate of alveolar bone resorption.
Histologic characteristics of experimental gingivitis in the juvenile and adult beagle dog
Authors: Matsson Lars , Attström Rolf
Published: December 2005

Abstract An earlier study (Matsson & Attström 1979) revealed an unexplained difference between juvenile and adult dogs in the propensity to develop clinical signs of gingivitis. The aims of the present investigation were to depict the structural composition of clinically normal gingiva and to analyze the histologic changes in the gingiva during plaque development in juvenile and adult dogs.

Six beagle dogs were used. Two periods of discontinued oral hygiene were studied, the first at 3 and the second at 12 months of age. Biopsies were sampled on days 0, 4, 7, 14, 21 and 28 of each period. Sections from the biopsies were analyzed at two levels of magnification.

Compared to adult dog gingiva, juvenile gingiva seemed to display: 1) a thicker keratinized layer of the oral epithelium, 2) a junctional epithelium that structurally resembles the oral epithelium, 3) a cuticular structure at the surface of the junctional epithelium, 4) a limited mononuclear inflammatory cell response during experimental gingivitis, and 5) a delayed establishment of an infiltrated connective tissue portion during experimental gingivitis.

In addition, during experimental gingivitis, subgingival plaque formed along the tooth surfaces to a lesser extent in the juvenile stage compared to adult dogs.
Recession: A 4‐year longitudinal study after free gingival grafts
Authors: Raterrschak Klaus H. , Egli Ueli , Fringeli Guido
Published: December 2005

Abstract. Free gingival grafts were performed on recession areas around 42 teeth in 12 patients, with postoperative evaluation of recurrent recession after 1, 6, 12, 24 and 48 months. No changes in degree of recession were observed during the 4‐year period. The vestibuloplasties, which were always wider than the transplants, exhibited recurrence up to the transplant margin 6 months after surgery, while the transplants themselves exhibited an average shrinkage of 25%. In addition, 25% of the increase in vestibular depth achieved by the surgery was lost 1 month postoperatively, but there was a tendency toward increasing vestibulum depth during the ensuing 47 months. Gingival sulcus depth was not affected by the surgery.
Clinical improvement of gingival conditions following ultrasonic versus hand instrumentation of periodontal pockets
Authors: Torfason Thoevaldur , Kiger Rokert , Selvig Knut A. , Egelberg Jan
Published: December 2005

Abstract. A study utilizing a split‐mouth design in 18 subjects and with four operators was performed in order to compare the effect of hand and ultrasonic instrumentation of periodontal pockets. Contralateral pairs of teeth with pockets of comparable depth were treated by either hand or ultrasonic instruments. Instrumentation was repeated after 4 weeks. Pocket depth, bleeding on probing and gingival fluid measurements were used for evaluation. A gradual reduction of pocket depth and number of bleeding points took place throughout the 8‐week experimental period. Clinically significant differences were not observed comparing the effect of hand instruments to ultrasonics for any of the operators. The amounts of gingival fluid were similar for both methods of instrumentation at the final examination. Thus, the present study failed to demonstrate any significant differences between the effect of ultrasonic root debridement and hand instrumentation in the treatment of 4–6 mm deep periodontal pockets.
Oral hygiene levels and behaviour in pre‐clinical and final‐year dental students
Authors: Howat A. , Trabelsi I. , Bradnock G.
Published: December 2005

Abstract. The oral hygiene levels and behaviour in pre‐clinical and final‐year dental students attending Birmingham University 1977 were investigated. Gingival inflammation, bacterial plaque and calculus accumulations were clinically recorded. Tooth cleaning habits were assessed by a questionnaire. Oral hygiene habits differed between the two groups and an improvement in oral hygiene levels was evident in the final‐year students. Statistically significant differences (P < 0.05) were found between the plaque index scores of the pre‐clinical and final‐year students, and for the gingival and calculus index scores of the male students. Thus in this investigation it was possible to show that improvement in oral hygiene does occur between the pre‐clinical and final year of the undergraduate course.
Development of experimental gingivitis in the juvenile and adult beagle dog
Authors: Matsson Lars , Attström Rolf
Published: December 2005

Abstract. In a previous paper a lower tendency to develop gingivitis was reported among preschool children compared to adults. The aim of the present study was to clarify if the same age‐dependent difference exists in dogs.

Six beagle dogs from the same litter were used. two periods of discontinued oral hygiene were studied, one period when the dogs were 3 months old and the other at 12 months. Prior to and between the experimental periods the animals were subjected to meticulous toothcleaning. During the experimental periods the Gingival and Plaque Index scores as well as the amounts of gingival exudate and crevicular leukocytes were determined on days 0, 4, 7, 14, 21 and 28.

During the juvenile period the development of dental plaque was lower compared with the adult period. The frequency of gingival units with high Gingival Index scores was lower at every registration interval during the juvenile period. The amounts of gingival exudate and crevicular leukocytes increased to high values during the adult stage but only small increments were found in the juvenile stage. An intraindividual comparison of the increase in the amount of gingival exudate from day 0 to day 28 in areas with the same amount of dental plaque accumulation showed a lower increase in gingival exudate during the juvenile stage in all dogs.
Periodontal dressing materials
Authors: Watts Trevor L. P. , Combe Edward C.
Published: December 2005

Abstract. A detailed review of periodontal dressings is presented, covering physical, chemical and biological aspects. Areas requiring further research are outlined, particularly in the physico‐chemical sphere; and some contra‐indications to particular substances are described. It is concluded that there is a definite place for dressings, but that more knowledge is required before optimal properties can be developed.
Effects of a 1% chlorhexidine gel during the healing phase after inverse bevel mucogingival flap surgery
Authors: Bakaéen G. S. , Strahan J. D.
Published: December 2005

Abstract A split‐mouth double‐blind trial was designed to compare the effects of chlorhexidine and placebo gels during the healing phase following mucogingival flap surgery.

Fifteen patients were treated with 30 inverse bevel flap procedures, one on each side of the maxilla, with an interval of 4 weeks between each procedure. Gel was applied to the gums using a toothbrush once daily.

Comparison of results revealed no significant differences in Plaque Index, Gingival Index, crevicular fluid or depth of pockets. More pain and swelling were recorded on the side treated with placebo gel, and more patients indicated that they preferred the chlorhexidine gel. The results were comparable to previous investigations using penicillin and suggest that, because of the reduced pain and swelling, chlorhexidine gel may be a suitable alternative to penicillin after periodontal flap surgery.
Histological evaluation of probing depth following periodontal treatment
Authors: Magnusson I. , Listgarten M. A.
Published: December 2005

Abstract The aim of this study was to compare the periodontal probing depth in teeth exposed to pariodontal treatment with teeth having received no treatment. In pockets deeper than 4 mm, a significant difference was found between the two groups. In the non‐treated teeth, metal strips used for probing penetrated an average of 0.29 mm into the connective tissue apical to the junctional epithelium. The average probing depth for teeth exposed to scaling, root planing, curettage and chlorhexidine rinses for 1 month was 0.31 mm coronal of the connective tissue attachment within the junctional epithelium. The results indicate that care should be taken when evaluating changes in periodental probing measurements during longitudinal studies.
Cigarette smoking, oral hygiene and periodontal health in Swedish army conscripts
Authors: Preber Hans , Kant Theo , Bergström Jan
Published: December 2005

Abstract Possible dissimilarities between smokers and nonsmokers regarding oral hygiene, gingivitis, periodontal pocketing and alveolar bone loss were studied in a sample of 134 army conscripts. Compared to nonsmokers, smokers had a higher plaque index and greater severity of gingivitis, while no differences were found concerning pocket depth and bone loss.

It could be demonstrated that the difference regarding gingivitis disappeared when a check was made for plaque values. It still remains to be explained why plaque deposition is more pronounced in smokers.
Influence of periodontal health on probing depth and bleeding tendency
Authors: van der Velden U.
Published: December 2005

Abstract This study investigates the effect of initial treatment on 1) probing force related to probing depth, 2) the attachment level, 3) the position of the gingival margin and 4) the clinical signs of color and change of contour of the gingiva in relation to the bleeding tendency of a pocket. It also addresses the question of whether, in deep inflamed periodontal pockets, the tip of the probe is located at the attachment level when a probing force of 0.75N is used, as has already been shown in pockets related to noninflamed gingival margins. Four different probing forces are used: 0.15N, 0.25N, 0.50N and 0.75N and results show an increasing probing depth with an increasing probing force, both before and after treatment. Initial treatment results in a decrease of mean probing depth but the change is dependent on the applied probing force. The mean probing depth reduction decreased from 1.71 mm (assessed with 0.15N) to 1.24 mm (assessed with 0.75N). Since results from this and a previous study indicate that both before and after treatment the tip of the probe is located at the attachment level when a probing force of 0.75N is used, it may be postulated that the reduction of mean probe‐tip level measurements (= probing depth measurement from a fixed point) reflects a degree of connective tissue reattachment. Patients in the initial treatment study were selected on the basis of obvious redness and swelling of the gingiva. After treatment, both of these symptoms almost disappear, whereas the Periodontal Pocket Bleeding Index (P. P. B. I.) decreases only from 0.87 before treatment, to 0.45 after treatment.
Interproximal periodontal intrabony defects
Authors: Nielsen I. M. , Glavind L. , Karhing T.
Published: December 2005

Abstract The purpose of the present investigation was to study the distribution of interproximal periodontal intrabony defects as related to age, sex and localization, and to examine the relationship between some possible etiological factors and the occurrence of intrabony defects.

A total of 209 adult patients presenting for dental treatment at the Royal Dental College in Arhus participated in this study. The patients were subjected to a questionnaire and were examined clinically and radiographically. All osseous defects in the radiographs were recorded but only those with a depth and width of at least 2 mm were considered periodontal intrabony defects. Only 18 % of the participants had one or more periodontal intrabony defects but the prevalence was higher in older than in younger age groups. While periodontal intrabony defects occurred with the same frequency on the various tooth types, more defects were found on distal than on mesial surfaces. The presence of periodontal intrabony defects correlated with loss of attachment, increased tooth mobility, a wide interproximal space and open mesio‐distal contact relationships between the teeth.
Histometric evaluation of periodontal surgery II. Connective tissue attachment levels after four regenerative procedures
Authors: Caton Jack , Nyman Sture , Zander Helmut
Published: December 2005

Abstract The present study was undertaken to determine the effect of four periodontal regenerative procedures on the connective tissue attachment level. The procedures tested were: 1) the modified Widman flap procedure, 2) the modified Widman flap procedure combined with transplantation of previously frozen autogenous red marrow and cancellous bone, 3) the modified Widman flap procedure in combination with implantation of beta tricalcium phosphate, and 4) periodic root planing and soft tissue curettage. Eight adult Rhesus monkeys, divided into four equal groups, were used. Periodontal pockets were produced around contralateral teeth in a standardized manner. In each group of animals, the pockets on one side of the jaws were subjected to one of the above‐mentioned surgical treatments, while the contralateral pockets remained as unoperated controls. Three weeks before surgery, a carefully designed plaque control program was instituted and continued until the animals were sacrificed 12 months after surgery. In histologic sections, linear measurements along the root surfaces were made from the cemento‐enamel junction (CEJ) to the most apical cells of the junctional epithelium (JE). These measurements from operated and unoperated sites were then compared.

The data revealed that healing following the four different regenerative procedures resulted in the reformation of an epithelial lining (long junctional epithelium) along the treated root surfaces, with no new connective tissue attachment.
Longitudinal evaluation of free autogenous gingival grafts
Authors: Dorfman Howard S. , Kennedy James E. , Bird William C.
Published: December 2005

Abstract This study was designed to determine the necessity for and effectiveness of the free autogenous gingival graft in maintaining the periodontal attachment to teeth. Ninety‐two patients with bilateral facial surfaces of inadequate keratinized gingiva had a free autogenous gingival graft placed on one of the facial surfaces (experimental side) while the contralateral side served as the control. Measurements were recorded from the CEJ to the 1) free gingival margin, 2) base of the gingival sulcus, and 3) mucogingival junction on the mid‐facial of selected teeth. The Gingival Index and Plaque Index (Löe 1967) were also evaluated. A total of 107 grafts were performed and followed from 6 months to 2 years post grafting. Patients were recalled (scaling, root planing, plaque control instruction) and clinical parameters such as pocket depth, recession and attachment level were measured at 3‐ and 6‐month intervals. Both experimental (grafted) and control (unoperated) sides showed marked reduction in the Gingival Index and Plaque Index. Neither side demonstrated further attachment loss. It would appear that minimizing inflammation is sufficient to maintain attachment levels despite the width of keratinized attached gingiva.
Probing force in relation to probe penetration into the periodontal tissues in dogs A microscopic evaluation
Authors: van der Velden U. , Jansen J.
Published: December 2005

Abstract In four beagle dogs, periodontal tissue breakdown was experimentally induced around the upper left premolars (P1, P2 and P3). Wooden probes were inserted mesially and distally to each premolar. Six different probing forces were used in each dog. Microscopic examination showed:

) the presence of an intact layer of epithelium between the probe tip and the connective tissue in 21 of 23 specimens.

) an increasing compression of the connective tissue with increasing probing force, without penetration of the probe tip into the connective tissue.
Interrelationship of inflammation and tooth mobility (trauma) in pathogenesis of periodontal disease
Authors: Polson Alan M.
Published: December 2005

Abstract A series of studies has investigated interactions between periodontal trauma and marginal periodontitis in relation to the initiation, progression and treatment of periodontal disease. Lesions of trauma in the periodontal ligament consequent to either single or jiggling displacing forces result in morphologic alterations in the ligament and alveolar bone. These changes do not initiate the loss of connective tissue attachment characteristic of marginal periodontitis. Studies conducted in squirrel monkeys and beagle dogs in which jiggling forces have been produced subjacent to an established marginal periodontitis reported increased loss of alveolar bone, but the accelerated loss of attachment which occurred in the dog model did not occur in the monkey model. To clarify the relative importance of inflammation and tooth mobility in the treatment of advanced periodontal disease, periodontal response was evaluated after removing traumatic and/or inflammatory components. Elimination of trauma in the presence of existing marginal inflammation did not reduce tooth mobility or increase bone volume. Osseous regeneration and decreased tooth mobility occurred after resolving both components, however, similar findings occurred after resolving inflammation in the presence of continued tooth mobility. Resolution of marginal inflammation is of prime importance in the management of periodontal disease. After resolution of inflammation, bone regeneration may occur around mobile teeth and, furthermore, any residual tooth mobility does not result in increased loss of connective tissue attachment.
Chemical inhibition of Plaque
Authors: Hull P. S.
Published: December 2005

Abstract. Attempts to control plaque by chemical means using enzymes, antibiotics and antiseptics are reviewed. Enzymes such as mucinase, dehydrated pancreas, enzymes at fungal origin, dextranase and mutanase showed limited clinical success despite promising in vitro and animal studies. Side effects from the use of enzymes were observed.

Many antibiotics have been used in attempts to control plaque and several have been successful. However, problems exist from the long‐term use of such drugs which precludes their routine use as agents for controlling plaque.

The biguanide chlorhexidine is the most widely used and investigated method of chemical plaque control. Many studies have demonstrated that it will successfully control plaque. No toxic side effects have been reported from its long‐term use but local side effects such as staining of the teeth do occur. The quaternary ammonium compounds have at present no advantages over the biguanides and require more frequent usage to achieve the same degree of plaque control as chlorhexidine.
Effect of selective antimicrobial therapy on plaque and gingivitis in the dog
Authors: Heijl Lars , Lindhe Jan
Published: December 2005

Abstract. The present investigation was performed to assess the effect of selective antibiotic therapy on developing plaque and gingivitis in dogs, which at the start of the study had normal gingiva. Fifteen beagle dogs were used. Throughout the entire observation period the animals were fed a diet which favored plaque accumulation. A baseline examination involved assessments of plaque, gingivitis and gingival exudate. The subgingival bacterial flora was assessed by dark‐field microscopy. Subsequently the teeth of the right jaws were allowed to accumulate plaque. A careful tooth‐cleaning program was maintained in the left jaws. Plaque and gingivitis assessments were repeated and subgingival plaque sampled in the right jaws after 14 and 28 days. On experimental day 28 the second part of the study was initiated. The dogs were randomly distributed into three groups of five animals each. A new baseline examination was performed in the left jaws, after which all tooth cleanings were terminated. During the subsequent 28 days each group of dogs was treated with one of three antimicrobial compounds (vancomycin, metronidazole or clindamycin). Examinations were repeated after 14 and 28 days.

The results demonstrated that systemic administration of antimicrobial substances can reduce the rate of plaque formation, change the composition of the developing subgingival microbiota and prevent (or retard) the onset of gingivitis. A comparison of the ability of the three compounds to prevent the formation of a “gingivitis‐inducing” plaque revealed that metronidazole and clindamycin were markedly more effective than vancomycin. In fact, in dogs receiving metronidazole and clindamycin treatment, the initiation of gingivitis was almost entirely prevented during the 28 days of treatment.
Assessment of tooth mobility using small loads
Authors: Persson Rutger
Published: December 2005

Abstract. Tooth mobility at loads between 20 p and 80 p was studied in maxillary incisors and canines in eight subjects with moderate periodontal disease. The periodontal conditions of the investigated teeth exhibited clinical criteria of gingival inflammation and a moderate loss of attachment. None of the subjects showed subjective or clinical signs of occlusal disturbances. In all, 35 teeth were investigated over the 12‐week period following periodontal hygiene treatment, including oral hygiene instructions and removal of supra‐ and subgingival plaque and calculus.

During the course of the investigation, a gradual decrease of tooth mobility was observed amounting to a tooth mobility decrease of 65 % (using the corrective formula described by Mühlemann 1960) at 50 p load.

Tooth mobility curves within the 20–80 p loading area were transformed to lines of regression (Persson & Svensson 1980). Analyses of the lines showed significantly lower tooth mobility values 12 weeks after start of treatment.
Healing after treatment of periodontal intraosseous defects I. Comparative study of clinical methods
Authors: Renvert Stefan , Badersten Anita , Nilvéus Rolf , Egelberg Jan
Published: December 2005

Abstract Four clinical methods to evaluate healing after reconstructive therapy of intraosseous periodontal defects were compared: 1. probing attachment level, 2. probing bone level, 3. entry/re‐entry bone height measurements, 4, radiographic bone height determinations. Thirteen patients with a total of 33 defects volunteered for the study.

It was found that the depth of the lesions recorded by the various methods showed differences which seem to relate to the varying nature of the methods, On the average, the periodontal probe penetrated 0.8 mm deeper during probing for bone level than during probing for attachment level and another O.3mm deeper after denudation of the lesions during entry/re‐entry. The average‐ gain of periodontal support following treatment was approximately 1.4mm as recorded by probing attachment level, probing bone level and entry/re‐entry bone height determinations, respectively. A high degree of correlation was found between all three probing methods when the changes following therapy for the individual sites were compared (r = 0.8 5, 0.75 and 0.81, respectively), Radiographic bone height showed lower degrees of correlation with all three probing parameters (r = 0.45, 0.46 and 0,47, respectively).
Clinical and radiographic long‐term study of teeth with periodontal destruction treated by a modified flap operation
Authors: Raeste Anna‐Maija , Kilpinen Eero
Published: December 2005

Abstract Forty‐three patients with severe periodontal destruction were treated by a modified flap operation and their periodontal condition reassessed about 4 years later. The aim of the study was to see what would happen to the periodontium when the responsibility for oral hygiene was left to the patients themselves. Before the operation the importance of plaque in the etiology of periodontal disease was explained to the patients. They were requested to return for reexamination every 6 months, but no recall system was used.

A highly significant reduction in the depth of the gingival pockets was achieved and the average loss of bony support during the observation time was only 0.3 mm.

However, an increased bleeding index, loss of marginal bone and deepening of the gingival pockets were found around teeth provided with artificial crowns, especially when the crowns had ill‐fitting margins extending into the gingival pocket.
Chronology of an interdental periodontal lesion
Authors: Moskow Bernard S.
Published: December 2005

Abstract A case in which intermittent and spontaneous periodontal breakdown and repair has occurred on two different occasions in the same interproximal site over a period of 18 years is described. The possible etiology of the lesions is discussed in terms of current concepts of localized bacterial selectivity. Also reviewed is the potential for repair in two‐walled infrabony defects.
Relationship between periodontal disease and cirrhosis of the liver in humans
Authors: Movin Susanne
Published: December 2005

Abstract The periodontal condition of a well‐described group of cirrhotic patients was compared with that of a control group, matched forage, sex ratio and socio‐economic background, expressed as years of education. The test group comprised 30 cirrhotic patients, 35–64 years of age. The diagnosis cirrhosis of the liver was confirmed histologically, and no other systemic diseases were present. The material was grouped according to age, 35–44, 45–54 and 55–64 years of age. The examination included determination of tooth loss, a plaque index, a gingival index, retentive calculus, retentive decay and fillings, and loss of attachment. The amount of plaque was equal in test and control groups, whereas the cirrhotics had a higher degree of severity of gingival inflammation as well as a greater amount of subgingival calculus than the controls. Test and control groups exhibited no significant difference as regards loss of attachment and tooth loss, and similar correlations between loss of‐attachment and age were demonstrated in the two groups. Patients suffering from cirrhosis for more than 3 years showed significantly greater loss, of attachment, as well as more plaque and calculus compared with those with a disease duration of less than 3 years. It is suggested that this aggravation of the periodontal condition is related to increasing neglect of the teeth, as the cirrhotic condition aggravates.
Radiographic measurement of alveolar bone loss: A perspective in vitro
Authors: Greenfield David S. , Williams Ray C. , Goldhaber Paul
Published: December 2005

Abstract In the present study, radiographs of a model simulating several degrees of alveolar bone height were taken at different vertical projection angles. Bone height was measured by three examiners utilizing a projection technique similar to that originally employed by Björn et al. (1966, 1969). Correlation coefficients of inter‐ and intra‐examiner readings were found to be statistically significant. The 95% confidence interval of the mean deviation between the observed bone height and the true bone height was less than 5.5 %. Further investigations are planned to determine whether this method of quantitating the information on radiographs exposed under various conditions is applicable in clinical practice.
Alveolar bone fenestrations and dehiscences in dry Bedouin jaws
Authors: Edel Alan
Published: December 2005

Abstract The incidence and distribution of alveolar fenestrations and dehiscences and their association with root prominence and occtusal faceting were investigated in 87 dry Bedouin jaws derived from the region of the southern Negev. Fenestrations were most frequently found in maxillary molars and canines and mandibular canines and lateral incisors. Dehiscences were most consistently observed in mandibular canines and first premolars. Maxillary fenestrations were consistently found in the apical half of the root length as were 60% of mandibular fenestrations.
Comparative antibody titers to Actinobacillus actinomycetemcomitans in juvenile periodontitis, chronic periodontitis and periodontally healthy subjects
Authors: Listgarten M. A. , Lai C.‐H. , Evian C. I.
Published: December 2005

Abstract Circulating antibody levels to four strains of Actinobacillus actinomycetemcomitans (Aa) were determined by means of an indirect immunofluorescent technique in three groups of 21 subjects each, including one with juvenile periodontitis (JP), one with chronic periodontitis (CP) and one free of periodontal disease (N). Mean levels of antibody to Aa were significantly elevated in the JP group as compared to the CP and N groups with respect to strains Y4, 29522 and 29524, but not strain 29523. Since strains Y4, 29522 and 29524 contain a leukotoxin that is missing from strain 29523, the results suggest that the leukotoxin could account for the difference in the immune response among the three groups of subjects. Varying the end‐point considered to represent positive fluorescence did not significantly affect the results, although discrimination among the three groups appeared to be somewhat better at lower intensities of fluorescence. Because of wide variations in antibody titers recorded in individual subjects, elevated levels of antibody to certain strains of Aa may not be useful as a primary diagnostic test for JP, but may be of value in confirming an otherwise uncertain clinical diagnosis.
Optimal dosage of chlorhexidine digluconate in chemical plaque control when applied by the oral irrigator
Authors: Lang Niklaus P. , Ramseier‐Grossmann Katharina
Published: December 2005

Abstract Chlorhexidine digluconate for chemical plaque control was tested in different concentrations using a fractionated jet oral irrigator. The inhibition of plaque formation and the prevention of gingival inflammation were evaluated in a double‐blind study. During a 10‐day period of abstinence from any mechanical oral hygiene procedures, the pattern of plaque formation and gingivitis development under the influence of chemical plaque control was analyzed. As a positive control, one group rinsed twice daily with 30 ml of a 0.2% chlorhexidine solution while a group applying 600 ml of a placebo solution served as a negative control.

Forty dental students and assistants with plaque‐free dentitions and healthy gingival tissues were divided into four groups. After a 10‐day period of no oral hygiene, a recovery period of 11 days with perfect oral hygiene was again instituted. This experiment was repealed three times so that a total of 10 concentrations in the irrigator, the control rinsing and the placebo control could be evaluated. Daily application of 600 ml of a 0.001%(6 mg), 0.0033% (20 mg), 0.005% (30mg), 0.01% (60 mg), 0.02% (120 mg), 0.05% (300 mg) and 0.1% (600 mg) and 400 ml of a 0.015 % (60 mg), twice 400 ml of a 0.015% (120 mg) and 400 ml of a 0.02% (SO mg) solution of chlorhexidine was tested. At the start of each experimental period (day 0), after 3, 7 and 10 days and 11 days following reassuming oral hygiene procedures, the plaque accumulations were determined using the Plaque Index System (Silness & Löe 1964) and the development of gingivitis was evaluated according to the criteria of the Gingival Index System (Löe & Silness 1963).

The results suggested that one daily irrigator application of 400 ml of a 0.02 % chlorhexidine solution was the optimal and lowest concentration and dose to be used for complete inhibition of dental plaque.