bluuebunny/crossref_metadata_2025 huggingface dataset:
Microcirculatory dynamics in experimental human gingivitis
Authors: Matheny J. L. , Abrams H. , Johnson D. T. , Roth G. I.
Published: December 2005

Abstract The purpose of this study was to determine the changes that occur in the gingival microcirculation during the development of experimental gingivitis in humans. There have been no studies published to date combining videomicroscopy and laser Doppler flowmetry to study vascular dynamics in experimental gingivitis. Alterations occurring in the microcirculation of the marginal gingiva in 10 (18–30‐year‐old), healthy male humans when they suspended oral hygiene procedures in a proscribed area for 12–16 days were monitored. A partial mouth, experimental gingivitis model was employed. Gingival health was evaluated before and after the experimental period by assessing gingival and plaque indices and gingival crevicular fluid volume. Gingival vascular monitoring included measurement of red blood cell velocity in individual gingival microvessels via video‐microscopy and measurement of regional gingival blood flow using laser doppler flowmetry. The number of vessels visible in a given microscopic field in a given subject and the number of vessels exhibiting flow were also determined from the videotapes. Systemic cardiovascular and respiratory parameters were monitored to ensure that gingival vascular changes were not secondary to systemic changes. Gingivitis developed in all subjects; significant increases (Student t‐test, P < 0.05) were seen in plaque index, gingival index, bleeding on probing and crevicular fluid volume. No change in superficial capillary blood velocity and a significant decrease in gingival regional blood flow were seen with gingivitis. A significant increase in the number of vessels visible in microscopic fields and a decrease in the % of vessels exhibiting flow were observed. Gingival microcirculation exhibited a dramatic, dynamic change in response to the development and progression of gingivitis.
Mechanical stimulation by toothbrushing increases oxygen sufficiency in human gingivae
Authors: Hanioka Takashi , Nagata Hideki , Murakami Yukitaka , Tamagawa Hiroo , Shizukuishi Satoshi
Published: December 2005

Abstract We studied the immediate effect of mechanical stimulation with a toothbrush on oxygen sufficiency in human gingivae. Teeth were brushed with a modified Bass technique at various forces (100, 200, and 300 g) for various times (5. 10, and 30 s). Hemoglobin (Hb) oxygen saturation was measured before and intermittently for 60 min after brushing, by non‐invasive tissue reflectance speetrophotometry. Hb oxygen saturation increased within a few min after brushing and then slowly returned to the initial level. Toothbrushing at 200 g for 10 s caused the longest‐lived increase in Hb oxygen saturation; saturation remained about 6% above the baseline level for more than 25 min. Before brushing, Hb oxygen saturation was significantly lower in inflamed gingivae than in healthy gingivae (P<0.05). After brushing of inflamed gingivae. the Hb oxygen saturation almost reached the level measured in healthy gingivae before brushing. These findings suggest that stimulation with a toothbrush increases oxygen sufficiency in both healthy and inflamed gingivae.
A dose‐response study of triclosan mouthrinses on plaque regrowth
Authors: Jenkins S. , Addy M. , Newcombe R. J.
Published: December 2005

Abstract Triciosan is used in toothpastes and mouthrinses as a plaque inhibitory agent. The concentrations used and therefore the dose of triclosan varies between products and there is, as with most plaque inhibitory agents, little information on the dose response of this agent. The purpose of this investigation was to measure the plaque inhibitory properties of triclosan in a simple mouthrinse formulation over a range of concentrations and therefore doses. The study was a 5 treatment, double‐blind, Latin‐square randomised, minus‐active controlled design balanced for residual effects. The formulations were 0.01%, 0.05%, 0.1% and 0.2% triclosan in 0.5% sodium carbonate and 5% alcohol aqueous solutions, used as 10 ml, 1‐min rinses 2 x daily, without tooth‐brushing. 2 groups each of 15 healthy volunteers rinsed during alternate 4‐day treatment, 1‐week washout periods with the allocated rinses. From a zero‐plaque baseline on Day 1, plaque was scored by index and area on Day 5. A dose response pattern of decreasing plaque indices and particularly areas, with increasing triclosan dose was observed. However, by far the largest sequential drop in plaque scores occurred between 0.1% and 0.2% triclosan treatments. Extending the dose‐response study to higher concentrations is considered impractical if not unjustifiable, because of potential harmful local side‐effects and compliance difficulties. Dose–response studies to assess the agents thought to potentiate triclosan would seem warranted.
Periodontal disease and dental caries in relation to primary IgG subclass and other humoral immunodeficiencies
Authors: Dahlén G. , Björkander J. , Gahnberg L. , Slots J. , Hanson L.‐Å.
Published: December 2005

Abstract 22 females and 3 males with primary hypogammaglobulinaemia (n=6) or IgG subclass deficiencies with (n=3) or without (n=16) concomitant IgA deficiency were examined for periodontal disease and dental caries. Only 1 patient showed more tooth loss than that found in the normal Swedish population. 1 patient demonstrated advanced periodontal disease. No patient exhibited more severe dental caries than that of comparable normal Swedes. Microbiological samples from periodontal pockets and saliva showed recovery of potential periodontopathic and cariogenic bacteria within normal ranges. This study could not support the notion that immunodeficient subjects exhibit an increased risk of developing periodontal disease or dental caries.
Evaluation of a mouthrinse containing chlorhexidine and fluoride as an adjunct to oral hygiene
Authors: Jenkins S. , Addy M. , Newcombe R.
Published: December 2005

Abstract Chlorhexidine and fluoride have valuable preventive roles in dental and oral diseases. There is also evidence that in caries prevention, together, they provide additive benefits. However, combined chlorhexidine/fluoride formulations have rarely been evaluated. The aim of this study was to determine whehter a 0.12% chlorhexidine, 100 ppm F‐ mouthrinse provided adjunctive oral hygiene benefits compared to a minus active control rinse. The study was a randomised double‐blind parallel design involving 102 subjects of whom 99 completed the 6 week experimental period. Subjects rinsed 2 × per day for 1 min with 15 ml of the allocated rinse. Normal toothbrushing procedures were maintained throughout the study. At 6 weeks, plaque and gingivitis scores were significantly lower and the incremental reduction significantly larger in the active rinse group. However, as expected, tooths mining was significantly increased with the active rinse. It is apparent that this chlorhexidine/fluoride rinse could be used in those regimens recommended for other chlorhexidine formulations. The value of the formulation in caries prevention would seem worthy of further investigation.
Lactoferrin in the gingival crevice as a marker of polymorphonuclear leucocytes in periodontal diseases
Authors: Adonogianaki E. , Moughal N. A. , Kinane D. R
Published: December 2005

Abstract This study examined lactoferrin (LF) levels in gingival crevicular fluid (GCF) and set out to test the hypothesis that LF could act as a marker of crevicular polymorphonuclear leucocytes (PMN), Therefore, 2 experiments were conducted: (a) to quantify total LF (ng/30 s sample) in GCF; (b) to correlate LF levels (ng/μl) and PMN numbers (PMNs/μl) in gingival crevicular washings (GCW). GCF was collected from 71 sites in a total of 22 patients. These sites were classified on the basis of clinical indices of gingivitis (GI) and pocket depth (PD) into three clinical groups:‘healthy’, ‘gingivitis’ and ‘periodontitis’. GCWs were obtained from an additional 63 sites in 21 patients. LF in GCF and GCWs was assayed by a sandwich ELISA. Total leucocyte and differential counts were performed on the GCWs. GCF LF (ng/30 s) correlated positively with GI (r=0.418, p<0.001), PD (r=0.415, p<0.001) and GCF volume (r=0.624, p<0.001). Gingivitis (n=21) and periodontitis sites (n=24) demonstrated significantly higher (p<0.05) total GCF LF than healthy (n=26) sites. In GCWs LF (ng/μl) showed stronger correlations with clinical indices (GI: r=0.452, PD: r=0.513, p<0.001) than did PMN numbers (PMNs/μl) (GI: r=0.279, PD: r=0.388, p<0.05). LF correlated strongly with PMNs in GCWs (r=0.531, p<0.001) and provides a simple and effective marker of crevicular PMN numbers.
Relationship between periodontal probing velocity and gingival inflammation in human subjects
Authors: Tessier J.‐F. , Ellen R. P. , Birek P. , Kulkarni G. V. , McCulloch C. A. G.
Published: December 2005

Abstract Little is known about the biophysical characteristics of the dentogingival junction in response to the development or resolution of inflammation. The Toronto Automated Periodontal Probe (TAPP) provides an estimate of the integrity of the dentogingival junction by measuring intrapocket probing velocity. The aim of this study was to measure changes of probing velocity in inflamed human periodontium before and after subgingival debridement. 32 subjects exhibiting gingival inflammation were selected; 29 completed the study. Gingival index (GI), plaque index (PLI), bleeding index (BI) and the rate of gingival crevicular fluid flow (CFF) were measured as concomitant variables. The experimental group (N= 16) received scaling, root planing and oral hygiene instruction at baseline. The control group (N=13) received no treatment until after 28 days. Subjects were seen at baseline, day 14, 21 and 28 for measurement of probing velocity and concomitant variables on 6 index teeth. At day 28, the control group was treated and then reassessed 28 days later. The experimental group showed a reduction of 51.6% for mean crevicular fluid flow (p<0.0001), 79.7% for mean plaque index (p<0.0001), 58.0% for mean gingival index (p<0.0001), and 72.0% for mean bleeding index (p<0.002) at day 28, confirming that inflammation was reduced compared with baseline. No significant changes were observed in the control group until after treatment. The velocity of probing and the formation of a plateau in the velocity profile were recorded. The experimental group demonstrated a significant increase (p<0.002) in the frequency of plateau formation and a decrease in mean slope between baseline and day 28 (p<0.02). No significant change was observed in the control until day 56, 28 days after treatment. These data indicate a direct relationship between improved clinical health and increased resistance to probe penetration near the base of the pocket, as reflected by the increased frequency of plateau formation and decreased slope for the terminal segment of the velocity profile curve.
The validity of the CPITN scoring and presentation method for measuring periodontal conditions
Authors: Lewis Jenny M. , Morgan Michael V. , Clive Wright F. A.
Published: December 2005

Abstract The CPITN is used widely in estimating periodontal treatment needs and, in many cases also to make generalizations about periodontal disease. It is therefore imperative that the heirarchical scoring method used to allocate CPITN scores is validated, and that the presentation of CPITN data reflect the true distribution of periodontal conditions. Data from one study carried out in Melbourne, Australia and one in Jakarta, Indonesia were used to compare CPITN scores on a mouth, sextant and tooth basis. Clinical periodontal components were compared with CPITN scores to establish the validity of the CPITN hierarchical scoring method. The distributions of CPITN scores varied widely on a mouth, sextant and tooth basis, and CPITN scores frequently differed from those indicated by the periodontal components. It was concluded that CPITN data should be presented not only as the % of subjects with each score, but also as the % of sextants, and. if possible, the % of tooth sites with each CPITN score. It was also concluded that there is an advantage in measuring components (calculus and bleeding) as well as CPITN in order to limit the overestimation of treatment needs, particularly for anterior teeth.
The effect of using a pre‐brushing mouthwash (Plax®) on removal of tooth stain in vivo and in vitro
Authors: Mills D. C. S. , Smith S. R. , Chung L.
Published: December 2005

Abstract The aim of this study was to determine whether the use of a pre‐brushing mouthwash Plax ‐ reduced extrinsic tooth staining in vivo and in vitro. Firstly, in a double‐blind placebo controlled cross‐over study, 20 subjects with tooth staining used Plax® or a placebo for 14‐day periods separated by a 1‐month wash‐out period. The area of stain was assessed before and after each mouthwash had been used from clinical photographs. Secondly, extracted 3rd molar teeth were stained with tea and chlorhexidine. After exposure to either Plax® or placebo, the teeth were brushed in a standardized manner. The area and intensity of stain were assessed before and after rinsing and brushing. Results of the study in vivo showed that the mean % stained area for any of the surfaces studied changed very little throughout the study. No statistically significant changes were detected (Student t‐test, p > 0.05). Results of the study in vitro showed that the mean area of stain fell by 19% after exposure to Plax® and by 17% after exposure to placebo. No statistically significant changes were detected (Student t‐test, p > 0.05). There were also no significant changes in intensity (Wilcoxon signed rank sum test p > 0.1).
Reduction of collagen degradation in experimental granulation tissue by vitamin E and selenium
Authors: Åsman B. , Wijkander P. , Hjerpe A.
Published: December 2005

Abstract The importance of antioxidants in inflammatory tissues has been studied in vivo. Degradation of homologous 3H‐collagen powder by experimental granulation tissue induced by cellulose sponges in the rat was monitored as the radioactivity excreted in urine. By administering pharmacological doses of both vitamin E and selenium subcutaneously and by injection into sponges implanted subcutaneously, this breakdown of collagen was reduced. Injections in the sponges also arrested the maturation of the granulation tissue. Vitamin E and selenium are potential inhibitors of the free oxygen radicals from phagocytic inflammatory cells. It is therefore suggested that these radicals may play a role in the collagen destruction by granulation tissues, as in periodontitis.
Repeated subgingival oxygen irrigations in untreated periodontal patients
Authors: Schlagenhauf U. , Horlacher V. , Netuschil L. , Brecx M.
Published: December 2005

Abstract The aim of this study was to assess the effect of repeated subgingival oxygen irrigations in previously untreated deep periodontal pockets. 112 pockets ≥4 mm were selected in 14 subjects. Probing attachment level and bleeding on probing were recorded, as well as the presence of disease‐associated microorganisms within the pocket. Subsequently, the pockets were irrigated with gaseous oxygen 1 × a week during a continuous 8‐week period. Irrigations with nitrogen served as control. The re‐evaluation of all clinical and microbiological parameters at the end of study revealed that repeated oxygen insufflations resulted in a significant clinical improvement of the periodontal baseline conditions superior to the one found in the control.
Differential prediction of dental health behaviour by self‐esteem and health locus of control in young adolescents
Authors: Regis D. , Macgregor I. D. M. , Balding J. W.
Published: December 2005

Abstract A survey of 7770 schoolchildren, aged 14–15 years, from 131 secondary schools in England, was made in 1990 to obtain information about toothbrushing frequency, motivation for mouth care, frequency of dental visits, self‐esteem and health locus of control (HLOC). The aim of the study was to compare self‐esteem and HLOC as predictors of dental health behaviour. Subjects completed a questionnaire, anonymously, in class during normal school hours. The results showed significant associations (Z2 test) between the 3 dental variables and self‐esteem, in both sexes. Toothbrushing frequency and the proportions of subjects brushing to make their teeth feel clean increased with increasing self‐esteem; recent and distant visits to the dentist were associated with low self‐esteem. Only toothbrushing frequency showed any significant variation with HLOC. In males, this association showed more frequent toothbrushing with more internal HLOC, but in females, no consistent pattern emerged. HLOC scores showed markedly less correlation (Spearman) with frequencies of toothbrushing and dental visits compared with self‐esteem scores. Significant positive correlations were observed between toothbrushing frequency and self‐esteem in both sexes, and frequency of dental vigils in males, but not in females. HLOC showed a significant positive correlation only with toothbrushing frequency in males. The correlation between toothbrushing frequency and self‐esteem was significantly greater than that between brushing frequency and HLOC, in both sexes. The results suggest that self‐esteem, which is a general construct, may have more potential for predicting dental health behaviour than the more specific health‐related measure HLOC.
Subgingival distribution of A. actinomycetemcomitans in periodontitis
Authors: Ebersole J. L. , Cappelli D. , Sandoval M.‐N.
Published: December 2005

Abstract This investigation developed an experimental design that (1) detailed the distribution of A. actinomycetemcomitans in Subgingival plaque related to the level of serum antibody to this pathogen; (2) used broad based subgingival plaque sampling to allow a definition of the distribution of A. actinomycetemcomitans infection in periodontitis patients; (3) described the distribution of A. actinomycetemcomitans serotypes in patients and within sites; and, (4) assessed how this infection impacted upon local clinical symptoms of disease. We noted a significant positive relationship between the level of IgG anti‐A. actinomycetemcomitans antibody and the frequency of teeth infected until nearly 13 teeth demonstrated an infection. Furthermore, the results showed a generally negative relationship between the antibody level and the burden of A. actinomycetemcomitans in the infected sites. Interproximal sites associated with first molar teeth were the predominant sites for subgingival colonization; incisors were also frequently infected in this population. The first molar teeth also exhibited the greatest level of A. actinomycetemcomitans while the incisors demonstrated a high level of A. actinomycetemcomitans in individual sites. The results clearly indicated the majority of the sites sampled were colonized by a single serotype of A. actinomycetemcomitans. We detected A. actinomycetemcomitans nearly 2 × times more frequently and a significant increase in the proportion of A. actinomycetemcomitans was found in samples obtained from teeth with bleeding on probing. The results also showed a significant trend for both pocket depth and attachment levels to be related to the presence and proportion of A. actinomycetemcomitans in the subgingival plaque. These findings detail the microbiological, immunological and clinical characteristics of a unique subset of periodontitis patients that appear to exhibit disease associated (caused?) with A. actinomycetemcomitans infection irrespective of clinical categorization. The results support a unique distribution of this microorganism in the subgingival ecology that is related to active host immune responses and clinical presentation of the tooth.
Comparison of a manual and a new electric toothbrush for controlling plaque and gingivitis
Authors: Stoltze Kaj , Bay Lena
Published: December 2005

Abstract In the present clinical trial, the effect on existing plaque and gingivitis of a new electric toothbrush (ET) was compared to that of a manual toothbrush (MT). 40 medical students, age 18–30 years, participated. Plaque index (PlI) and gingival index (GI) were recorded at 6 sites at all teeth. At baseline, a PlI and GI > 1 were required. The participants were at random allocated to a group using either ET or MT and were instructed only to use the assigned toothbrush, brushing each morning and evening for 2 min. No oral hygiene instruction was given. Reexamination was done after 1, 2 and 6 weeks. In the MT group, a minor decrease in mean PlI was found after 6 weeks (all sites: from 1.2 to 1.1, approximal sites: from 1.4 to 1.2). The corresponding figures in the ET group were: 1.2 to 0.6 and 1.4 to 0.8. After 6 weeks, the % of sites with visible plaque with MT was: 24% (all sites) and 30% (approximal sites) and with ET 8% and 9%, respectively. With MT, mean GI was unchanged after 6 weeks compared to baseline, whereas with ET, the changes were from 1.1 to 0.9 (all sites) and from 1.1 to 1.0 (approximal sites). The % of sites with GI score 2 had not changed after 6 weeks with MT (all sites: 11%, approximal sites: 13%). With ET, these results were 3% and 4%, respectively.
Microbial identification and antibiotic sensitivity testing, an aid for patients refractory to periodontal therapy
Authors: Fine Daniel H.
Published: December 2005

Abstract The importance of microbial surveillance is illustrated in 3 clinical cases. Each case demonstrated a continued lack of response to conventional periodontal treatment. Repeated bouts of periodontal abscess formation and bone Joss occurred over a 3‐ to 4‐ year period, despite numerous surgeries supplemented with antibiotics. As a result, patients were termed refractory to treatment and extensive microbiological analysis and sensitivity testing was performed. Following institution of the appropriate antibiotic and conservative therapy consisting of several sessions of scaling and root planing, each of these cases demonstrated a dramatic remission of disease progression. No further breakdown has been seen for a minimum of 21/2, years. While anecdotal in nature, these cases support the usefulness of microbial identification coupled with antibiotic sensitivity as an adjunct to conventional conservative periodontal therapy.
Topical metronidazole as an adjunct to subgingival debridement in the treatment of chronic periodontitis
Authors: Hitzig C. , Charbit Y. , Bitton C. , Fosse T. , Teboul M. , Hannoun L. , Varonne R.
Published: December 2005

Abstract The purpose of this study was to evaluate the clinical effects of a single application of a 5% metronidazole collagen device in periodontal pockets deeper than 5 mm, in association with debridement and without reinforcement of home care and hygiene as practiced by the patient at any time. Pocket depth, attachment level, bleeding on probing, gingival index and plaque index were assessed at baseline, and on days 15, 30 and 90. Analysis of data from 28 patients indicated the both debridement and metronidazole therapy decreased pocket depth, bleeding on probing and gingival index, but results were significantly better with metronidazole. These results indicate that topical metronidazole provides an effective adjunctive treatment of advanced periodontitis.
Relationship between clinical periodontal condition and the radiological appearance at 1st molar sites in adolescents
Authors: Waite I. M , Furniss J. s. , Wong W. M.
Published: December 2005

Abstract There has been considerable controversy about the incidence of periodontal disease in adolescents. It is noteworthy that there is disagreement between workers as to be radiological features that should be used to detect the earliest signs of periodontitis, and variation in the choice of criteria may have influenced the results of previous studies. The present project represents a 3–year longitudinal assessment into the periodontal condition, assessed clinically and radiologically, of a group of adolescents. The radiographic investigations were carried out using vertical bitewing radiographs and, to reduce potential error caused by variation in film placement and tube alignment, individual impressions were used so that the film could be positioned accurately at repeat assessments. It was found that several of the radiographic features, such as the width of the periodontal ligament space and the angle of the interproximal bone crest relative to the tooth, similar to those previously attributed to the commencement of destructive periodontal changes, were found to be correlated with the maturation changes associated with the eruption of the adjoining permanent teeth. In spite of the use of impressions, some of the series of radiographs showed variation in tube alignment, and several of the above radiological features were also found to correlate with errors in radiographic technique. It was concluded that the various eruptive and maturation changes taking place during this stage in the adolescent dentition must be allowed for when looking for the earliest signs of periodontal destruction.
Relationship between salivary blood group antigens, microbial flora and periodontal condition in young adults
Authors: Lie M. A. , van der Weijden G. A. , Timmerman M. F. , Abbas F. , de Graaff J. , Henskens Y. M. C. , van der Velden U.
Published: December 2005

Abstract To investigate a possible role for salivary blood‐group antigens in the relative frequencies of selected periodontal pathogens and commensal oral micro‐organisms, we studied the clinical and microbiological condition in young adults with or without blood group reactive substances in saliva (secretors or non‐secretors respectively). Clinical measurements were recorded at the Ramfjord teeth in 81 1st‐year dental students. In addition, presence of interproximal loss of attachment (LA) was assessed at sites with a pocket depth of ≥4 mm. Microbiological samples were taken from one of the Ramfjord teeth (site without inteproximal LA), from interproximal sites of ≥4 mm in conjunction with LA, and from the saliva. The samples were analyzed for the presence of Actinomyces naesiundii, Actinomyces viscosus, Campylobacter rectus, Fusobacterium nucleatum, Peptostreptococcus micros, Prevotella intermedia. Porphyromonas gingivalis and Actinobacillius actinomycetemcomitans. Clinically, no statistically significant differences were found in the periodontal status between secretors (78% of our population) and n on‐secretors. Furthermore, the occurrence of the monitored micro‐organisms was not correlated to the secretor status. It is concluded that bacterial colonization with the micro‐organisms tested in this study, apparently occurred independent of secretor status. Among the periodontal pathogens, only P. intermedia was more frequently recovered from the saliva of subjects with interproximal LA (49%) than in those without (33%; p=0.03). This finding was irrespective of the secretor status. Therefore, P. intermedia may be an important micro‐organism in relation to the onset of periodontal destruction in young adults.
Quantitative aspects of the subgingival distribution of Actinobacillus actinomycetemcomitans in a patient with localized juvenile periodontitis
Authors: van Winkelhoff A. J. , de Groot P. , Abbas F. , de Graaff J.
Published: December 2005

Abstract The subgingival microflora in a patient with localized juvenile periodontitis was studied. Of the 97 sites investigated, 28 (29%) showed attachment loss. A correlation was found between the number of Actinobacillus actinomycetemcomitans cells and the clinical attachment level and probing pocket depth. Of the 97 test sites, 70 (73%) were positive for A. actinomycetemcomitans. Of the total number of A. actinomycetemcomitans cells isolated from this patient, more than 99% were found at sites with attachment loss, <1 % being present at sites without attachment loss. The mean percentage of A. actinomycetemcomitans was 21.2% at sites with attachment loss and 0.45% at sites without attachment loss. The distribution of Porphyromonas gingilis showed a symmetrical pattern, being present at the 1st molar and 2nd premolar sites in all quadrants and at the lower incisor sites. This species was absent at multiple sites showing overt attachment loss.
Clinical assessment of gingival hyperplasia in patients treated with nifedipine
Authors: Bullon P. , Machuca G. , Martinez‐Sahuquillo A. , Rios J. V. , Rojas J. , Lacalle J. R.
Published: December 2005

Abstract Gingival hyperplasia caused by the use of nifedipine has been extensively reported. In this paper, the gingiva of 18 patients suffering from cardiopathy and treated with nifedipine were compared with those of 10 patients with cardiac disorders who had not been treated with calcium antagonists and with a no‐treatment group of 12 patients. Nifedipine produced gingival hyperplasia although patients who had not been treated with calcium antagonists also had mild hyperplasia. Hyperplasia first appeared in the interproximal areas, an observation which may be important for early detection. There was a direct correlation between the degree of hyperplasia and the bacterial plaque score. When we studied the influence of administration time and dose of nifedipine with the degree of hyperplasia, no statistically significant differences were found.
The morphology of root fusion in Chinese adults (I). Grades, types, location and distribution
Authors: Hou Guey‐Lin , Tsai Chi‐Cheng
Published: December 2005

Abstract The purpose of the present study was to investigate the morphology, extent, and distribution of root fusions in 1st and 2nd permanent molars in a Chinese population. The sample consisted of 158 maxillary and 151 mandibular extracted 1st and 2nd molars. Root fusion in molars was assessed by direct viewing and measuring the length of the root and root trunk with stereoscopic microscopy. Root fusion was graded by the extent effusion and the number of affected surfaces. The main results were as follows: (1) the majority of root fusions affected upper and lower 2nd molars (39.7% and 28.1%, respectively); (2) the prevalence of maxillary roots with 1, 2 and 3 fusions was 55.2%, 31.3% and 13.4% respectively, and most of the root fusions affected the maxillary 2nd molars (65.7%); (3) the majority of mandibular root fusions affected the 2nd molars (89.2%). and were of grade III (48.7%): (4) in order of decreased prevalence, the grades of root fusion in 2nd molars were grades III, II and I; whereas in 1st molars they were grades I. II and III; (5) there were 44 (4).5%) and 19 (51.4%) complete root fusions (grade III) among 106 fused roots in maxillary molars and 37 fused roots in mandibular molars, respectively.
Periodontal diseases in HIV‐infected patients
Authors: Holmstrup Palle , Westergaard Jytte
Published: December 2005

Abstract Periodontal diseases may be the first clinical sign of human immunodeficiency virus (HIV)‐infection. Since the immunosuppression and subsequent susceptibility may alter the responses of the oral tissues as well as the microflora, both periodontal treatment and result of therapy may be modified. The periodontal diseases in HIV‐seropositive patients include common as well as less conventional forms of gingivitis and periodontitis, and bacteria, mycotic and viral infections are seen. Neoplasias may also involve the periodontium; most common are Kaposi's sarcoma and non‐Hodgkin's lymphoma. Recent studies of unselected groups of patients indicate that periodontal health in at least some groups of HIV‐seropositive patients is better than previously reported.
Plaque and gingivitis in the deciduous and permanent dentition
Authors: Ramberg P. W. , Lindhe J. , Gaffar A.
Published: December 2005

Abstract The aim of the present investigation was to monitor de novo plaque formation and associated alterations of the gingival conditions in the deciduous, mixed and permanent dentition in man. 31 volunteers, divided into 3 study groups participated in the trial. Group 1 was made up of 11 subjects, 4–6 years of age (deciduous dentition), group 2 comprised of 10 subjects, 8–9 years of age (mixed dentition) and group 3 included 10 subjects, 14–16 years of age (permanent dentition). After a screening examination, each participant received detailed instruction in a proper oral hygiene technique and was subjected to professional tooth cleaning. The professional debridement and the oral hygiene instruction were repeated after 1 week. After another week, a given day was termed Day 0 and a baseline examination was performed. This examination included assessments of plaque and gingivitis. Each subject received an additional, comprehensive professional tooth cleaning and was asked to abstain from all mechanical oral hygiene measures. Re‐examinations were performed after 3 and 7 days. The findings demonstrated that: (i) during a 7‐day period of no active oral hygiene, subjects with a mixed or a permanent dentition formed visible amounts of plaque and developed modest signs of gingivitis; (ii) during the 7 days of the trial, young subjects with a fully erupted deciduous dentition formed less plaque than the older subjects, and failed to respond to de novo plaque formation with enhanced signs of gingivitis; (iii) in subjects with a mixed dentition, the amount of plaque formed during the 7 days of experiment and the matching gingivitis development were similar in the deciduous and permanent tooth segments of the dentition.
Influence of a single application of subgingival chlorhexidine gel or tetracycline paste on the clinical parameters of adult periodontitis patients
Authors: Unsal E. , Akkaya M. , Walsh T. F.
Published: December 2005

Abstract. The clinical effects of subgingivally placed 1% chlorhexidine gel (w/w) and 40% tetracycline (w/w) paste in periodontal pockets of 22 adult periodontitis patients were studied. The 2 agents were applied following scaling and root planing in pockets exceeding 4 mm. The patients were randomly divided into 3 groups: (a) scaling and root planing (SCRP) only, the control group; (b) corsodyl gel + SCRP; (c) Tetracycline paste + SCRP. Gel or paste were gently applied using a syringe with a blunt needle until the selected pocket was overfilled. Evaluations were made of clinical parameters including the plaque index (PI), gingival index (GI), bleeding index (GI‐S), probing pocket depths, probing attachment levels and position of the gingival margin. The results suggested that all the treatment modalities were effective in producing statistically significant improvements in clinical parameters. It was concluded that the conventional treatment modalities were essential in the treatment of periodontal diseases, but in view of the structure of the periodontal pocket and adjacent complex root surface, subgingival drug application in certain cases, might also provide adjunctive improvement.
Effectiveness of a calculus scaling gel
Authors: Maynor Gayle Bunger , Wilder Rebecca Scruggs , Mitchell Shannon C. , Moriarty John D.
Published: December 2005

Abstract. This study evaluated the effect of a calculus scaling gel (SofScale TM) on time and ease of the scaling procedure in a double‐blind, split‐mouth clinical study of 32 subjects. The Volpe‐Manhold calculus index was used to quantify the distribution and amount of calculus deposition on the lingual aspect of the man‐dibular 6 anterior teeth at baseline. The gel was applied directly to the calculus and subgingivally to the area to be scaled. Pre‐ and post‐treatment gingival and stain indices were taken. Operator and subject questionnaires were completed immediately after treatment to determine ease of the scaling procedure. Results were analyzed with paired t‐tests. The time difference in scaling between the product and placebo side was not significant. This study found that SofScaleTM is safe to gingival tissues and does not promote tooth sensitivity. However, this study did not find significant differences in scaling time between product and placebo when using a 2‐minute gel contact time.
Bleeding on probing. A parameter for monitoring periodontal conditions in clinical practice
Authors: Joss Andreas , Adler Rolf , Lang Niklaus P.
Published: December 2005

Abstract. The present study is a follow‐up report on the use of bleeding on probing (BOP) as a clinical indicator for disease progression or periodontal stability, respectively. Following active periodontal therapy, 39 patients were incorporated in a program of supportive periodontal therapy for a period of 53 months with recall intervals varying between 2–8 months. The patients received supportive therapy 7 to 14 ×. At the beginning of each maintenance visit, the tissues were evaluated using BOP. Reinstrumentation was only performed at sites which bled on probing. However, supragingival plaque and calculus were always removed. Probing depth and probing attachment levels were determined after active treatment and at the conclusion of the study. Progression of periodontal disease was defined by a measured loss of probing attachment of 2 mm or more. During the observation period, 4.2% of all the sites lost attachment. Approximately 50% of these losses were due to periodontal disease progression, while the other half was the result of attachment loss in conjunction with recession of the gingiva. 2/3 of all the sites which lost attachment were found in a group of patients which presented a mean BOP 30%. In a group of patients‐with a mean BOP of 20%, only 1/5 of the loser sites were found. This clearly indicated, that patients with a mean BOP of 20% have a significantly lower risk for further loss of probing attachment at single sites.
Effect of chlorhexidine (0.12%) rinses on periodontal tissue healing after tooth extraction
Authors: Lang N. P. , Schild U. , Brägger U.
Published: December 2005

Abstract. The aim of the present study was to evaluate the effects of a 1 ‐month period of chlorhexidine (CHX) rinses on the periodontal conditions of teeth adjacent to extraction sockets. 40 patients signed consent forms for this double blind trial and were randomly assigned to either the test group rinsing 2 × daily with 15 ml of a 0.12% CHX solution (Peridex®) starting 2 days after tooth extraction or the control group rinsing with a placebo solution for 30 days. Clinical periodontal parameters were obtained from test sites located adjacent to as well as matched controls distant to the extraction sites. The measurements were performed at baseline before the extraction and 1, 2, 3 and 6 months thereafter. During the observation period, the patients were exposed to initial periodontal therapy. The test sites of the group rinsing with CHX demonstrated significantly reduced (p < 0.05) plaque indices, gingival indices and lower %s of sites bleeding on probing one month following the extraction. The test sites of the control group rinsing with the placebo demonstrated a tendency for loss of clinical attachment between 1 and 2 months after the tooth extraction. The mean pocket probing depth (PPD) at test sites of the CHX rinsing group was smaller than in the placebo rinsing group at the one month examination. Also, the mean PPD of the test sites in the CHX group was significantly smaller than at the control sites at 1 month. This difference was not observed in the control group rinsing with placebo. Due to the effect of initial periodontal therapy, the differences in the clinical parameters were no longer statistically significant at six months. It is concluded that the administration of 0.12% CHX rinses following tooth extraction results in a significant improvement of the periodontal conditions adjacent to extraction sockets and hence, should be recommended routinely.
Effect of chlorhexidine (0.12%) rinses on periodontal tissue healing after tooth extraction
Authors: Brägger U. , Schild U. , Lang N. P.
Published: December 2005

Abstract. The aim of the present study was to assess the influence of a 1‐month period of chlorhexidine digluconate (CHX) rinses on the remodelling activity of periodontal tissues adjacent to an extraction wound. From 12 patients assigned to the test group rinsing 2 × daily with 15 ml of 0.12% CHX solution (Peridex®) starting 2 days after tooth extraction and from 11 patients assigned to the control group rinsing with a placebo solution, standardized radiographs were available taken immediately after tooth extraction and 1, 2, 3 and 6 months thereafter. Computer assisted densitometric image analysis (CADIA) was applied in order to quantify changes in density during the healing phase after tooth extraction. Regions of interest (ROI) were chosen for CADIA covering supracrestal periodontal soft tissue adjacent to the extraction wound. ROIs were also defined on crestal alveolar bone adjacent to the extraction wound. In the active group, 15/20 sites demonstrated an increase in alveolar bone density between months 1 and 6 (mean CADIA value 6.7 ± 10.0), whereas in the control group 11/21 sites demonstrated a loss in density (mean CADIA values ‐1.4 ± 10.5). Similar observations were made when the ROIs covering supracrestal periodontal tissues were analyzed (mean CADIA values 7.8 ± 8.4 for the experimental group and –0.3 ± 10.5 for the control group). These differences were statistically significant (p < 0.04). The digitized series of standardized radiographs were also evaluated for changes in bone height. The distances from the alveolar bone crest to reference points were measured in mm within the baseline: the 1, 2, 3 and 6 month radiographs. Whereas the control group rinsing with a placebo solution lost almost 1 mm of bone height over 6 months after tooth extraction, it was obvious that in the patients rinsing with the CHX solution, the crestal alveolar bone level was maintained. It was concluded that the administration of 0.12% chlorhexidine rinses for 1 month following tooth extraction resulted in a beneficial healing effect on the periodontal conditions of teeth adjacent to the extraction site.
Proximal restorations and periodontal status
Authors: Jansson Leif , Ehnevid Helge , Lindskog Sven , Blomlöf Leif
Published: December 2005

Abstract. The purpose of the present investigation was to evaluate the influence of overhanging marginal restorations on periodontal status and whether any such influence is modified by the patient's oral hygiene level and degree of radiographic attachment loss. The investigation was conducted as a retrospective study on a consecutive referral population. Periodontal pockets at proximal sites with marginal overhangs were significantly deeper (0.42 mm) compared to sites with metal restorations without overhangs. This difference was larger (0.62 mm) for sites with radiographic attachment loss 6 mm, while no significant difference was found for sites with radiographic attachment loss 〈6 mm. In patients with a mean radiographic attachment loss 5 mm, an overhanging restoration margin was associated with a significantly increased loss of radiographic attachment (0.66 mm). It was concluded that the influence of a marginal overhang on pocket depth and radiographic attachment decreases with increasing loss of periodontal attachment in periodontitis‐prone patients. The effect on pocket depth of a marginal overhang may act synergistically, potentiating the effect of poor oral hygiene.
The prevalence of A. actinomycetemcomitans, P. gingivalis and P. intermedia in selected subjects with periodontitis
Authors: Van der Weijden G. A. , Timmerman M. F. , Reijerse E. , Wolffe G. N. , Van Winkelhoff A. J. , Van der Velden U.
Published: December 2005

Abstract. The present study was carried out in a private periodontal practice. 8 clinical criteria were chosen to select patients for microbiological examination. These criteria characterize prominent features of disease which at the start, during, or in the maintenance phase of treatment suggest difficulties in the progress of the periodontal therapy. Based on these clinical characteristics, an inventory was made of the prevalence of the 3 putative periodontal pathogens: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia. Out of 320 referred patients 91 patients did meet 1 of the clinical criteria and consequently were selected for microbiological examination. Results showed that young patients (19–30 years) with periodontitis demonstrated the presence of A. actinomycetemcomitans more often (69%: p(0.005) compared to older age cohorts. A. actinomycetemcomitans was found more often when localized breakdown (in particular in the 1 st molar and incisor region) was observed and in patient who responded poorly to scaling and rootplaning. P. gingivalis and P. intermedia were most frequently recovered in patients showing primarily a bone loss pattern of angular defects of 5 mm. Retrospectively, these patients were further categorized, based on full mouth radiographs, in (1) patients with primarily horizontal bone loss and (2) patients with primarily angular bony defects. Results showed that A. actinomycetemcomitans occurred less frequently in patients showing horizontal bone loss (p(0.05).
The reliability of furcation measurements
Authors: Eickholz Peter , Staehle Hans Jörg
Published: December 2005

Abstract. The furcation involvement of 100 molars in 25 patients suffering from moderate to advanced periodontitis was investigated. Presurgically, the horizontal probing attachment level (PAL‐H) within the furcations was assessed 2 × within 14 days. To determine the measurement error of PAL‐H, the standard deviation of single measurements was calculated. The measurements were repeated intrasurgically and compared with presurgical assessments of furcation degrees. The overall standard deviation of single measurements was 0.739 mm. For buccal, lingual, mesiolingual and distolingual furcations, the standard deviations were 0.602 mm, 0.559 mm, 0.759 mm, 1.099 mm, respectively; measurement error was less in buccal and lingual furcations than in distolingual furcations (p<0.001). The agreement of replicate measurements of furcation degrees was excellent for buccal, lingual and mesiolingual furcations (weighted κ– coefficients between 0.776 and 0.944), but only moderate for distolingual furcations (κw= 0.706). Multiple linear regression analysis revealed significant influence of furcation depth, width and furcation location on differences of PAL‐H (p<0.05). There was no significant difference between furcation degree as assessed presurgically and intra‐surgically.
Diagnosis of periodontal disease activity by detection of key microbial antigens
Authors: Smith G. L. F.
Published: December 2005

Abstract. This paper reviews the development of various rapid microbial identification techniques and their potential role in the diagnosis of active periodontal tissue destruction. It also explores the concerns expressed by some, that although these techniques offer enormous promise as research tools, validation and translation of test results to clinical diagnosis, prognosis and treatment planning are still problematic. It may be premature to recommend these tests to clinicians in practice. Further longitudinal studies are required to establish the best use of these techniques in a clinical setting.