bluuebunny/crossref_metadata_2025 huggingface dataset:
Does root surface conditioning with citric acid delay healing?
Authors: Selvig Knut A. , Bogle Gary C. , Sigurdsson Thorarim J. , Wikesjö Ulf M. E.
Published: December 2005

Abstract Effects of topical citric acid application on tissue maturation was studied in standardized periodontal defects in 6 beagle dogs. Following elevation of facial mucoperiosteal flaps, fenestration defects, 3 mm in diameter, were made through the cortical bone and recessed 0.5 mm into the dentin of maxillary canines. 1 defect in each dog was conditioned with a saturated solution of citric acid for 3 min and then rinsed with saline. Control defects in contralateral teeth were treated with saline only for the same length of time. The defects were covered with an expanded polytetrafluoroethylene membrane and the flaps re‐positioned and sutured. 14 days postsurgery, healing appeared more advanced along the defect walls and floor than in the center of the defect in all instances. Histometrically, citric acid‐conditioned defects exhibited a higher density of collagen fibers along the defect walls and floor and adjacent to the barrier membrane as well as more advanced resolution of the residual blood clot than the surgical controls. Differences in fibroblast density within specimen pairs were non‐significant. All control defects but none of the acid‐conditioned defects showed an artifactual split between the dentin walls and the granulation tissue. This study failed to support the contention that topical application of citric acid to root surfaces may delay healing following periodontal surgery.
Periodontal reasons for tooth loss in an Asian population
Authors: Ong G.
Published: December 2005

Abstract This study analysed data on periodontal reasons for tooth extractions, obtained from 52 dentists practising general dentistry in Singapore. The results revealed that, out of 2172 teeth extracted from 1276 patients. 35.8% were lost due to periodontal disease and 35.4% due to caries. Extraction due to periodontal problems increased with age. were more conspicuous in the Indian ethnic group and were frequently associated with pocketing and tooth mobility.
0.1%/0.2% commercial chlorhexidine solutions as subgingival irrigants in chronic periodontitis
Authors: Asari A. Mohd , Newman H. N. , Wilson M. , Bulman J. S.
Published: December 2005

Abstract This study compared 2 proprietary chlorhexidine (CH) products, Corsodyl (CO ‐ 0.2% CH. then ICI. U.K.) and Eludril (EL ‐ 0.1% CH. Pierre Fabre. France) as subgingival irrigants adjunctive to Simplified Oral Hygiene. 19 subjects. 8M, HE aged 30‐57 years, mean 44 years, took part. Probing pocket depth (PPD) ranged from 5‐10 mm, mean 6.5 mm (CO and EL), with 60 CO and 65 EL sites. After oral hygiene instruction, without stress on interdental cleaning, patients received one visit supra‐ and subgingival debridement. and instruction in subgingival irrigation using the Max‐I‐Probe system (Smith & Nephew MPL, USA). For baseline, days 28 (end of irrigation). 56 and 84. data were respectively: GI (medians): 1.7. 1.2. 1.2. 1.0 (CO). 1.9. 1.5, 1.3. 1.0 EL): BOP (medians): 1.2, 0.4. 0.7. 0.4 (CO), 1.5. 0.6. 0.6, 0.25 (EL): PPD (mm) (means): 6.3. 4.8, 4.2, 4.5 (CO). 6.8, 5.2, 5.3. 4.7 (EL); PAL (mm) (means‐change relative to day 0): 0.6, 0.5. 0.8 (CO), 0.8. 0.8. 1.5 (EL). By Wilcoxon for non‐parametric and /‐tests for parametric data, both groups showed significant improvement for all variables at all times relative to baseline, with only one significant difference between the groups, in favour of EL, for PAL at day 84 (p<0.05). This pilot study indicates that both simplified oral hygiene regimes are effective in periodontitis. but that there was no difference between the 2 commercial irrigants as adjunctives.
The effect of age on the development of gingivitis
Authors: Fransson C. , Berglundh T. , Lindhe J.
Published: December 2005

Abstract In the present “experimental gingivitis” study, the response of the marginal gingiva to plaque formation was studied in one group of young subjects, 20‐25 years of age, and in one group of older subjects, aged 65‐80 years. During a 4‐week period, all subjects received a series of professional tooth cleaning to establish healthy gingival conditions. A baseline examination (Day 0) included assessments of plaque and gingivitis. Sites that were examined (the experimental sites) included the mesiopalatal, palatal, and dislopalatal surfaces of all teeth present in the 15. 25 tooth region. Among the experimental sites, microbial sampling and gingival fluid assessment were performed and one gingival biopsy harvested from each subject. Following the baseline examination, the participants abolished mechanical tooth cleaning measures in the palatal and approximal surfaces of 15, 25. The clinical examination and the gingival fluid measurement were repeated on days 7, 14 and 21 of no oral hygiene. The microbiological sampling and the biopsy procedure were repeated on days 7 and 21. The data collected demonstrated that old subjects, during a 3‐week period of oral hygiene abstention, formed similar amounts of plaque as the young subjects, but developed more gingivitis than young subjects. Thus, the clinical gingivitis assessments, the gingival fluid measurements and morphometric determinations made in the biopsy samples documented that the gingival lesion which formed in the old individuals was more pronounced and contained more inflammatory cells than the corresponding lesion in the young subject sample.
The effect of interleukin‐1 (IL‐1) on androgen metabolism in human gingival tissue (HGT) and periodontal ligament (PDL)
Authors: Kasasa S.C. , Soory M.
Published: December 2005

Abstract Due to the potent anabolic effects of the androgenic metabolite 5α‐dihydrotestosterone (DHT) on matrix synthesis by connective tissue and bone, it was pertinent to investigate the effects of interleukin‐1 (IL‐1) on androgen metabolism by chronically inflamed human gingival tissue (HGT) and periodontal ligament (PDL). Duplicate incubations of HGT and PDL derived from 6 subjects (age‐ and sex‐matched) were performed in Eagle's MEM+FCS with 14C‐testosterone to study baseline conversion to DHT and 4‐androstenedione. Similarly further incubations were performed for 24 h in a 5% CO2 in air incubator, with HGT and PDL from 4 comparable patients to study the effect of IL‐1 on this conversion. The medium was extracted radioactive metabolites separated by thin‐layer chromatography and quantified. When baseline metabolism of HGT was compared with that of PDL. both tissues metabolised 14C‐testosterone to DHT and 4‐androstenedione. There was a 2.4‐fold increase in DHT synthesis by PDL over that of HGT (n=6; p<0.005) and a 2.5‐fold increase in 4‐androstene‐dione formation by PDL compared with HGT (n=6; p<0.01). In response to IL‐1, HGT demonstrated a 2‐fold increase in DHT synthesis (n=4; p<0.005) and a 3.5‐fold increase in 4‐androstenedione formation (p<0.01) over control gingival tissue; PDL showed a 9‐fold increase in DHT synthesis in response to IL‐1 (n=4; p<0.005) and a 6‐fold increase in 4‐androstenedione formation (p<0.005) over control ligament tissue. The increased androgen metabolic capacity of PDL over HGT, both at baseline and in response to IL‐1 is in keeping with protein studies and may be relevant to repair processes during inflammatory periodontal disease.
Inhibitory effects of acid water prepared by an electrolysis apparatus on early plaque formation on specimens of dentine
Authors: Ito Koichi , Nishida Tetsuya , Murai Seidai
Published: December 2005

Abstract The aim of this study was to compare the effects of acid water prepared by an electrolysis apparatus with placebo treatment on the infrastructure of early plaque formed on dentine specimens attached to retainers in the oral cavity. Dentine specimens were taken from 12 healthy extracted human 3rd molars. 4 dentine specimens were placed in both the right and left buccal flanges of retainers fabricated from self‐setting acrylic resin. The retainers were placed on both maxillary buccal sites in 6 subjects. The test solution was acid water (AW) prepared by an electrolysis apparatus with a pH of 2.7 and an oxidation‐reduction potential of more than 1100 mV. As a positive control, 0.2% chlorhexidine digluconate (CHX) solution was used and normal saline solution as a negative control. 4 specimens placed in the right and left retainers were randomly allocated to 4 treatments as follows: treatment A. washing with AW; treatment B. washing with CHX solution: treatment C, washing with normal saline; treatment D, no washing. Washing was carried out in a plastic beaker containing 30 ml of each solution for 30 s 2× daily over a 7‐day period. The specimens were then carefully removed from the retainers, the morphology and thickness of the plaque formed examined by SEM, and the developmental condition of the plaque analyzed statistically. The plaque on the specimens in treatments A and B consisted mainly of coccoid forms. Mature plaque formation with complex flora was seen on the specimens in treatments C and D. The mean thickness of the plaque deposits on the dentin specimens as measured on SEM photographs magnified 2000 times was 8.80 mm for treatment. A. while in treatment B it was 3.90 mm. Plaque thickness for treatment C was 24.97 mm, and for treatment D 25.67 mm. The thickness of plaque formed on the sectioned specimens was significantly less for treatments A and B than for treatments C and D. However, there was no statistically significant difference between treatments A and B, and between treatments C and D (p<0.0001). The results of this short‐term study indicate that AW washing has almost the same potential for inhibition of plaque formation as CHX washing, and is more effective for inhibiting plaque formation than washing with sterile saline. It is therefore concluded that AW may be useful as an anti‐plaque agent.
Scientific data‐exchange in periodontology via Internet
Authors: Spallek Heiko , Gougousoudis Alexandras , Johnson William W.
Published: December 2005

Abstract The aim of the present paper was to study the current state of electronic scientific data‐exchange in the field of dentistry and particularly in the specialty of periodontology. The use of electronic communication is unquestionably growing in all areas of life and has established itself in almost all areas of sciences and research. The potential use of Internet resources in the area of periodontology is the main topic of this paper. An overview explains the Internet system, its history, its structure, and the necessary hardware and software to use it. Text‐orientated software and graphic interfaces like the World Wide Web will be described. Examples will be included to describing the basic services of Internet. The pros and cons of Internet use will be discussed and a preview of possible future developments in the field of communication for scientifically‐oriented information will be included. This paper indicates that modern periodontal therapy and research may be enhanced by the use of Internet resources.
A comparative study of a surgical method and scaling and root planing using the Odontoson®
Authors: Forabosco Andrea , Galetti Riccardo , Spinato Sergio , Colao Paola , Casolari Chiara
Published: December 2005

Abstract This investigation compared a traditional periodontal surgical method with a non‐surgical treatment of scaling and root planing by an ultrasonic device (Odontoson M®) using irrigation with an iodised solution. 8 adult patients with periodontal disease were each treated at 2 randomly chosen quadrants by a Widman flap type surgical technique, and the remaining non‐surgically. The patients then attended bi‐monthly oral hygiene sessions over a period of 1 year. At that stage, clinical evaluation revealed that the Odontoson M® plus an ionised irrigant solution achieved a statistically comparable outcome to that of surgical treatment, even in the pockets initially up to 7 mm in depth.
Tooth thickness at the furcation entrance of lower molars
Authors: Sterrett John D. , Pelletier Hughes , Russell Carl M.
Published: December 2005

Abstract Better understanding of the furcation anatomy may serve to decrease the risk of pulpal injury during rotary odontoplasty, a procedure often used in conjunction with guided tissue regeneration. The purpose of this study was to determine (i) the tooth thickness about the furcation entrance of lower molars, and (ii) whether there is a relationship between tooth thickness and patient age. 40 mandibular 1st molars (M1) (mean age = 36.2; range 10–65 years) and 40 mundibular 2nd molars (M2) (mean age=37.9; range 14–70 years) were collected. Age, gender and furcation involvement (if any) were noted for each tooth at the time of extraction. Teeth were sectioned in half, buccal‐lingual. at the furcation entrance with a rotary diamond blade. A standardized linear reference scale was placed on each experimental section and an 8×10 in. photograph generated. The distance from the floor of the pulp chamber to 5 predetermined sites on the root surface was calculated. The data were expressed as (a) the mean of each site and (b) the mean of each tooth (the average of the 5 points of each tooth). Analysis of covariance failed to show a relationship between thickness measurements and gender or furcation involvement. Thus, the data was subjected to simple regression analysis to determine the relationship of age with tooth and cementum thickness. This study revealed that by site, the mean measurements ranged from 2.7–3.0 mm for both M1 and M2. The single least/greatest measurements of the 5 sites were for M1: 1.6/4.7 mm and for M2: 1.8/4.2 mm. By tooth, the average distance from the pulp to the root surface was 2.83 mm (±0.49) for Ml and 2.88 mm (±0.44) for M2. Regression analysis of tooth thickness with age was significant for M1 only. The maximum slope of the 5 sites was approximately 0.3 mm/10 years. No relationship was found between cementum thickness and age for either tooth group. The results of this study indicate that the majority of times the pulp is 1.6–4.2 mm from the root surface in the vicinity of the furcation entrance of lower 1st and 2nd molars. Although tooth thickness in this area may increase with age, the amount is not enough to forego judicious odontoplasty on older patients.
Proof of efficacy of different modified sonic sealer inserts used for debridement in furcations – a dummy head trial
Authors: Kocher Thomas , Rühling Andreas , Herweg Mark , Plagman Hans‐Christian
Published: December 2005

Abstract The purpose of this study was to determine the suitability of different scaling instruments for surgical removal of hard and soft bacterial deposits and for the removal of soft accretions only for maintenance treatment within furcations. 12 upper and 12 lower plastic replicated molars, with through‐and‐through furcations, were instrumented 3× with 4 different types of instruments: (1) hand instruments: (2) a conventional sonic sealer insert: (3) a set of 3 modified sonic sealer inserts with budded tips and different angulated shafts; (4) a set of 3 sonic sealer inserts with a plastic‐ coating and different angulated shafts. The plastic replicas were fixed in a dummy head without any replicated soft tissues. In the furcation area, an easily removable surface coating material was applied to the teeth to represent the “plaque” and a second, more stubborn lacquer layer representing “calculus/cementum”. Following instrumentation, the following parameters were recorded to assess efficacy: time required for instrumentation, loss of weight, depth of substance removal at the furcation entrance, % of furcation area instrumented, whereby removal of these 2 layers was judged separately. Only minor differences were observed between hand instruments, conventional and budded sonic sealer inserts as to loss of weight, depth of substance loss and area instrumented. The plastic‐coated sonic sealer inserts were just as effective in surface layer removal representing “plaque” as the 3 other instruments, but resulted in less loss of weight and less depth of substance removal. In conclusion, the more aggressive hand instruments, the conventional and budded sonic sealer insert, are preferably used for the surgical phase to increased ease of entry into the furcation dome. An effective debridement of the furcation roof seems only possible with an odontoplastic, for which a furcation is fitted to the instrument by means of an intensive instrumentation, thus leading to weight loss and pronounced substance removal. The plastic‐coated sonic sealer inserts seems to be a reasonable choice for maintenance treatment within furcation, since this treatment phase is usually restricted to removal of soft bacterial deposits.
A 2‐year longitudinal study of elastase in human gingival crevicular fluid and periodontal attachment loss
Authors: Eley B.M. , Cox S. W
Published: December 2005

Abstract The purpose of this study is to determine whether gingival crevicular fluid (GCF) elastase total activity (TA) and concentration (EC) correlate with and predict progressive attachment loss (AL). 75 previously untreated patients with moderate periodontitis were recruited. GCF was collected from 16 molar and pre‐molar mesiobuccal sites and probing attachment loss (PAL), probing depth (PPD), gingival index (GI), gingival bleeding index (GBI) and plaque index (PLI) were measured, PAL and PPD were measured with an electronic, constant pressure probe. Patients were given basic periodontal treatment prior to baseline when the above procedures were repeated. In addition, carefully localised radiographs were taken of the test teeth and repeated annually. Patients were seen at 3 months intervals to 2 years and the procedures were repeated. 119 AL sites were detected and 89 of these were rapid AL sites (RAL) and 30 were gradual AL sites (GAL). Elastase levels (TA & EC) at RAL sites were significantly higher (p≤0.0001) than paired control sites in the same patient at both the attachment loss time (ALT) and the prediction time (PT). The mean levels (TA & EC) over the study period at GAL sites were significantly higher (p≤0.0001) than paired control sites in the same patient. Using a critical value (CV) of 125 μU/30 s (TA) and 400 μU/μL (EC) in 2×2 contingency tables showed a sensitivity of 100% and specificity of 99.95% (TA) and a sensitivity of 100% and specificity of 99.91% (EC) at the PT with very similar values at the ALT. Patient level comparisons showed that the mean elastase levels (TA & EC) were significantly higher (p≤0.0001) at RAL and GAL sites than non‐attachment loss (NAD sites in AL patients and that the mean levels were significantly higher (p≤0.0001) in AL patients than NAL patients. All these results indicate that these CVs for GCF elastase activity may serve as a predictors of future attachment loss.
Comparison of modes of oral hygiene instruction in improving gingival health
Authors: Lim L. P. , Davies W. I. R. , Yuen K. W. , Ma M. H.
Published: December 2005

Abstract 195 Hong Kong Chinese employees from a single company participated in a 10‐month longitudinal study on the effects of various modes of delivery of oral hygiene messages on their gingival health. Subjects were allocated to one of the following modes of oral hygiene education: (1) personal instruction; (2) self‐education manual; (3) video; (4) a combination of 2 or more of these modes of instruction. Scaling or any other form of periodontal treatment was not given throughout the study period. Full mouth clinical examinations were carried out using a Williams Periodontal probe to examine for the presence or absence of plaque and bleeding on probing from the gingival sulcus. At 2 weeks, 4 months and 10 months, results showed significant reductions in the mean % of plaque and bleeding when compared with baseline. No significant differences were found between the groups given the various modes of oral hygiene education. The study does confirm the effectiveness of oral hygiene alone in improving gingival health, but the lack of difference in the outcome of various oral hygiene education approaches indicates that the mode of instruction is not crucially important to the end result. However, it has to be acknowledged that improvement in oral hygiene may be related to factors other than the oral hygiene programme itself. The findings have significant implications in oral health promotion programmes to improve the periodontal status of the local community.
Toothbrushing force in relation to plaque removal
Authors: van der Weijden G. A. , Timmerman M. F. , Reijerse E. , Snoek C. M. , van der Velden U.
Published: December 2005

Abstract This was a 2‐part study. The purpose of the 1st part was to examine the relationship between brushing force and plaque removal efficacy comparing a regular manual toothbrush (M) with an electric toothbrush the Braun Oral‐B Plak Control* (B). The study consisted of a single oral prophylaxis followed by 5 experiments which differed solely in respect to toothbrushing force. At baseline (after 24‐h plaque accumulation), the amount of dental plaque was evaluated and subsequently, the subject's mouth was brushed by a dental hygienist. Brushing was carried out in a random split‐mouth order. Either the 1st and 3rd quadrants or the 2nd and 4th quadrants were brushed with 1 toothbrush and the 2 remaining quadrants with the other. The available time for the brushing procedure was 2 min. After brushing, the amount of remaining dental plaque was assessed. The force used in experiment 1 through 5 was 100, 150, 200, 250, 300 g, respectively. The results show that when brushing force is increased, more plaque is removed with either of the two brushes. Except for the high brushing force (300 g), the electric toothbrush removed more plaque than the manual brush. The purpose of the 2nd part was to evaluate the habitual brushing force which individuals use with various toothbrushes. Besides a manual toothbrush (M), 3 electric toothbrushes were examined, the Rotadent® (R). Interplak® (I) and Braun® (B). 20 subjects were selected on the basis of being ‘good brushers” (plaque score at screening <25%). At baseline, each subject randomly received 1 of the 4 brushes. They were allowed a training period of 3 weeks at the end of which they were asked to abstain from brushing for at least 24 h. The plaque (Turesky modification of the Quigley & Hein) was scored, after which the subjects brushed their teeth (2 min) with the assigned toothbrush equipped with a strain gauge. A computer set–up measured (100 Hz) and calculated the mean brushing force. After brushing, the amount of remaining plaque was assessed. The design of the study was a 4‐way cross‐over. The results show that with a manual brush, considerably more force is used than with the electric brushes (R=96. 1 = 119. B= 146, M=273). No significant relation between brushing force and plaque removal was demonstrated for any of the brushes.
A clinical survey of periodontal conditions in Greece
Authors: Anagnou‐Vareltzides A. , Diamanti‐Kipioti A. , Afentoulidis N. , Moraitaki‐Tsami A. , Lindhe J. , Mitsis F. , Papapanou P. N.
Published: December 2005

Abstract The present study used full‐mouth clinical assessments of plaque, calculus, bleeding on probing, probing pocket depth and probing attachment level to evaluate the periodontal conditions in a rural (A) and an urban (B) sample of 25–64 year old Greek adults, comprising 190 and 373 subjects, respectively. 13% of the subjects in sample (A) and 8% in sample (B) were edentulous, while mean values of teeth present in the four age cohorts ranged between 19.8—12.6 and 23.3—18.3. respectively. A poor level of oral hygiene was recorded in both samples with high plaque, calculus and bleeding scores. Deep pocketing was more pronounced in the rural than in the urban sample: between 1.7 and 8.0% of all sites probed showed a PPD of ≥6 mm and between 20 and 51.2% of the subjects in each age cohort had at least one deep pocket. Corresponding figures for the urban sample was 0.6‐4.7% and 15.1‐49.2%. However, the prevalence of severe attachment loss was of comparable magnitude in both samples: between 2.8–25.7% of the sites in sample (A) and 2.8–20.6% in sample (B) displayed a PAL of ≥6 mm, while 32.5‐72.1% and 31.8‐73.8% of the subjects, respectively, had at least one severely affected site. It was further found that the distribution of advanced disease in the samples was skewed; 14.4% of the subjects in sample (A) and 9.5% in sample (B) accounted for 75%, of all deep pockets, while 21.8 and 19.4% of the subjects, respectively, accounted for 75% of all sites with PAL of ≥6 mm. Multiple regression revealed that male sex and high plaque and bleeding scores had a significant, positive influence to the amount of attachment loss on a subject level.
Increased gingival dimensions. A significant factor for successful outcome of root coverage procedures?
Authors: Wennström Jan L. , Zucchelli Giovanni
Published: December 2005

Abstract The aim of this study was to evaluate whether an increased thickness of the gingiva through the use of a free connective tissue graft, in conjunction with a coronally advanced flap procedure, may positively influence the treatment outcome with respect to (i) root coverage and (ii) long‐term stability of the position of the soft tissue margin following treatment of recession type defects. 67 consecutive patients having a total of 103 buccally located recession type defects of at least 3 mm were included in the study. After an initial phase of prophylaxis including instructions in a tooth brushing technique giving minimal apically directed forces to the gingival margin, the recession sites were surgically covered with a coronally advanced flap alone (control sites), or coronally advanced flap combined with a free connective tissue graft taken from the palate (test sites). Clinical examinations, including assessments of oral hygiene, gingival conditions, recession depth, gingival height, probing pocket depth and probing attachment loss, were performed before and 6. 12 and 24 months after surgical treatment. The mean initial recession depth for both treatment groups was about 4.0 mm (SD 1.0) with a gingival height apical to the recession of 1.0 mm (0.5). At the re‐examination performed 6 months after surgical treatment, the mean recession depth had decreased to 0.2 mm in both the test and control groups. Complete root coverage was observed at 72% of the test sites and 74% of the control teeth. At teeth treated with the combined surgical procedure, the mean gain in probing attachment amounted to 3.7 mm and the mean gingival height had increased to 3.5 mm (0.6). The corresponding figures for control teeth were 3.6 mm and 1.5 mm (0.5), respectively. At the 24‐month follow‐up examination, the mean root coverage amounted to 98.9% (test) and 97.1% (control). 88% of the teeth in the test group showed complete root coverage compared to 80% for teeth in the control group. It was concluded that the 2 surgical procedures resulted in similar degree of root coverage and that changes of tooth brushing habits may be of greater importance than increased gingival thickness for long‐term maintenance of the surgically established position of the soft tissue margin.
Psychosocial factors and adult onset rapidly progressive periodontitis
Authors: Monteiro da Silva A. M. , Oakley D. A. , Newman H. N. , Nohl F. S. , Lloyd H. M.
Published: December 2005

AbstractOn the basis of clinical observations, some periodontologists have suggested an association between psychosocial factors such as depression, stress and anxiety, and adult onset rapidly progressive periodontitis (RPP). This study investigated more formally possible associations between a number of relevant psychosocial factors and RPP The significance of the psychosocial variables was assessed by comparing 3 groups: 50 patients with RPP, 50 patients with routine chronic adult periodontitis (RCAP). and 50 patients without significant periodontal destruction (controls). It was anticipated that the RPP group would show higher levels of psychosocial maladjustment than the RCAP and control groups. A between‐subjects multivariate analysis of covariance indicated that the combined psychosocial variables were significantly related to the periodontal diagnosis. 2 psychosocial factors, depression and loneliness, were significant in distinguishing between groups. The RPP group presented significantly increased depression and loneliness compared to the RCAP and control groups. Future research is indicated to further clarify the significance of these psychosocial differences in relation to the onset and progression of RPP.
The effect of tetracycline fiber therapy on β‐glucuronidase and interleukin‐1β in crevicular fluid
Authors: Lamster Ira B. , Pullman John R. , Celenti Romanita S. , Grbic John T.
Published: December 2005

Abstract Treatment with the tetracycline HCL‐containing (Actisite®) fiber has been shown to improve clinical measures of periodontitis, as well as reduce the number of sites infected with putative periodontal pathogens. In this study, we examined the effect of the tetracycline fiber on biochemical mediators of the host's inflammatory response in gingival crevicular fluid (GCF). The total amount of the lysosomal enzyme β‐glucuronidase (βG), considered a marker of primary granule release from polymorphonuclear leukocytes and interleukin‐1β, a cytokine with important proinflammatory effects, were examined in GCF. Patients with localized recurrent periodontitis were followed over a 16 week period. Treated teeth (Tx), teeth adjacent to treated teeth (ADJ) and control teeth (Cx) were studied. Following fiber therapy, the Tx teeth displayed statistically significant reductions in mean probing depth, depth of the deepest site and bleeding on probing over the 16 weeks of the trial. Significant reduction in the depth of the deepest site was also seen for the ADJ teeth over 16 weeks. Total βG in GCF was reduced for the Tx teeth comparing baseline to 16 weeks, but no significant changes were observed for the ADJ or Cx teeth. Prior to treatment, total βG for the Tx teeth was 211±49 U (mean±standard error), versus 146±174 U for the ADJ teeth and 121±33 U for the Cx teeth. 16 weeks treatment, the mean values for these 3 categories of teeth were comparable (Tx=95±20 U. ADJ = 93±42 U and Cx=103±29 U). For the Tx teeth, the maximum reduction in total βG following therapy occurred at 6 weeks (65%). Total IL‐1β was significantly reduced for the Tx teeth at 3 and 6 weeks, but rebounded at 16 weeks. In contrast to what was seen for βG, the maximum reduction in total IL‐1β for the Tx teeth was observed at 3 weeks (68%). These data suggest that host mediators associated with increased risk for active disease are reduced following tetracycline fiber therapy. Future studies will determine the relative importance of a reduced microbial challenge versus a tetracycline‐mediated direct modification of the host response to account for the reduction in the host inflammatory response in GCF following tetracycline fiber therapy.
Peripheral blood leukocyte populations in the elderly with and without periodontal disease
Authors: McArthur William P. , Bloom K. , Taylor M. , Wheeler T. , Smith J. , Magnusson N. Ingvar
Published: December 2005

Abstract Periodontal disease in the elderly has not been characterized. Initial reports suggest that the disease is common and severe. Deficiencies in the immune response have also been reported to occur in the elderly. Consequently it was hypothesized that aging‐related changes in the immune response may contribute to the severity and occurrence of periodontal disease in the elderly. To test that hypothesis, the % and number of leukocytes and leukocyte subsets in the peripheral blood of elderly (65–75 years) subjects were tested and used as indicators of the immune potential of those individuals. Age and gender effects on several of the parameters tested were identified. With the exception of increased number of leukocytes in the elderly group with severe periodontal disease, no other alteration in the leukocyte parameters tested were identified. These results suggest that periodontal disease in the elderly was not associated with obvious changes in the leukocyte and leukocyte subsets in the peripheral blood due to aging.
Bone density of class II furcation lesions treated by guided tissue regeneration
Authors: Dubrez B. , Duioux P. , Cimasoni G.
Published: December 2005

Abstract 12 buccal or lingual class II furcation lesions were selected in the lower molars of 7 patients after treatment by routine scaling. In each of the 7 patients. I lesion was treated by guided tissue regeneration (GTR) with expanded polyte‐trafluoroethylene membranes, while 5 neighbouring molars underwent conventional flap operations. The index of gingival inflammation, the plaque index, the depths of the pockets, the horizontal and vertical attachment levels were measured before and 6 months. 1 year and 2 years after surgery. Standardized reproducible radiographs were taken before treatment, post‐operatively (at the time of membrane removal for the GTR treated sites), at 6 months, 1 year and 2 years after treatment. The density of bone was quantified in several areas by using high‐resolution digital analysis. With the exception of the higher gain in horizontal attachment observed in the GTR treated furcations, the improvement of clinical parameters was similar in all sites during the 2 years of follow‐up. The radiographical analysis showed no statistically significant changes neither in the GTR nor in the conventionnally treated lesions over this period of time, even when they were compared to untreated bone control areas. However, in this study limited to 7 patients, the interdental bone next to the GTR treated furcations showed significant signs of remodeling.
The onset of diabetes and poor metabolic control increases gingival bleeding in children and adolescents with insulin‐dependent diabetes mellitus
Authors: Karjalainen Kaisa M. , Knuuttila Matti L. E.
Published: December 2005

Abstract Gingival health (bleeding on probing) and oral hygiene (plaque percent) were assessed in 2 groups of children and adolescents with insulin‐dependent diabetes mellitus (IDDM). 1st study group included 12 newly diagnosed diabetic children and adolescents (age range 6.3‐14.0 years, 5 boys and 7 girls). They were examined on the 3rd day after initial hospital admission and at 2 weeks and 6 weeks after initiation of insulin treatment. Gingival bleeding decreased after 2 weeks of insulin treatment (37.8% versus 19.0%. p < 0.001. paired t‐test). and remained at the same level when examined 1 month later while glucose balance was excellent. Another group (n=80) of insulin‐dependent diabetic children and adolescents (age range 11.7 ‐ 18.4 years, 44 boys and 36 girls) with a mean duration of diabetes 6.0 years (range 0.3‐15.0 years) were examined 2× at 3‐month intervals. Subjects with poor blood glucose control (glycosylated haemoglobin, HbA1, values over 13%) had more gingival bleeding (46.3% on examination 1, 41.7% on examination 2) than subjects with HbA1 values less than 10% (mean gingival bleeding 35.2% and 26.9%, respectively) or subjects with HbA1 values between 10 to 13% (mean gingival bleeding 35.6% and 33.4%, respectively). Differences were significant on both examinations (p < 0.05, Anova). and remained significant after controlling the groups for differences in age, age at the onset of diabetes, duration of diabetes and pubertal stage (Ancova). Results were not related to differences or changes in dental plaque status, supporting the concept that imbalance of glucose metabolism associated with diabetes predisposes to gingival inflammation. An increase in gingival bleeding in association with hyperglycaemia suggests that hyperglycaemia‐associated biological alterations, which lower host resistance toward plaque, have apparently taken place. Consequently, although not all gingivitis proceeds into a destructive periodontal disease, prevention of plaque‐induced gingival inflammation should be emphasised, particularly in children and adolescents with poorly controlled diabetes.
The effect of hexetidine spray on dental plaque following periodontal surgery
Authors: Bokor Marija
Published: December 2005

Abstract The aim of the present study was to determine the effects of a 0.2% bexetidine spray, used as a supplement to regular oral hygiene measures, on dental plaque and gingival condition following periodontal surgery. This study was carried out on 38 patients who required 2 episodes of periodontal surgery. Examinations regarding dental plaque were performed at 0. 7. 14. 21 and 28 days, while the condition of the gingival were examined at 0 and 28 days. Dental plaque was assessed by the Turesky modification of Quigley‐Hein index; the gingival condition was evaluated using the gingival index of Löe‐Silness and the papilla bleeding index. In a double‐blind cross‐over study of 28 days duration, significant reduction in plaque accumulation and an improvement m wound healing were demonstrated for the test spray compared to the placebo.
In vitro and in vivo studies on salifluor/PVM/MA copolymer/NaF combination as an antiplaque agent
Authors: Nabi Nuran , Kashuba Bonnie , Lucchesi Shirley , Affiitto John , Furuichi Yasushi , Gaffar Abdul
Published: December 2005

Abstract Salifluor (5‐n‐octanoyl‐3′‐trifluoromethyl‐salicylanilide), a broad spectrum antimicrobial agent, was investigated for its ability to inhibit dental plaque formation. A combination of salifluor with PVM/MA copolymer and NaF was optimized for its antiplaque effect in mouthrinse and dentifrice formulations based on a series of both laboratory and clinical studies. It was found that salifluor, a highly hydrophobic compound, could not be adequately solubilized with the conventional amount of sodium lauryl sulfate (SLS), the most commonly used anionic surfactant in oral hygiene products. However, it was possible to prepare stable mouthrinse formulations using a mixed surfactant system containing both anionic and nonionic surfactants. The most suitable mixture was found to be a combination of SLS, Pluronic and Tauranol m a proportion of 1:1:1, This combination provided adequate stability and high antimicrobial activity as determined by in vitro microbiological tests. Addition of a PVM/MA copolymer to the formulation improved the adsorption and retention of salifluor on simulated tooth surfaces in vitro (saliva coated hydroxyapatite disks) by almost two‐fold and also increased the antiplaque efficacy in both laboratory and human clinical studies, it was also found that a non fluoride dentifrice containing a combination of salifluor and PVM/MA copolymer with a dicalcium phosphate dihydrate abrasive, was highly effective in reducing smooth surface and fissure caries in rats. The results of the present studies demonstrated that salifluor is an effective antiplaque agent in mouthrinse and dentifrice when carefully formulated to maximize its delivery and bioavailability on oral surfaces. They also illustrated the difficulties encountered in exploiting the antimicrobial efficacy of highly hydrophobic, nonionic antimicrobial agents such as salifluor in commonly used oral hygiene vehicles.
Extraoral apical elongation of deeply damaged roots with titanium posts
Authors: Bühler Hans
Published: December 2005

Abstract 42 very deeply fractured or otherwise damaged single roots which could not be saved by intra‐alveolar transplantation only were replanted to a supragingival level after extraoral transapical elongation by either an ordinary titanium root screw (method 1) or a specially designed titanium post (TransApex, Dentatus) (method 2). After observation periods of x=73 months (method 1) and x= 34 months (method 2), 61% and 85% of the cases‐respectively, were considered successful, fulfilling all 5 predefined success criteria. No other resorptions than slight surface resorptions were seen and all teeth showed very shallow pocket depths and physiological mobility, indicating that the long extraoral treatment had not caused lasting traumatic injury to the PDL cells. The most frequent complication in method 1 was periapical osteitis, indicating that the elongation system had become insufficient. On the other hand, the method showed the capacity to heal many of the pre‐existing osteitis cases. Both root elongation techniques described in this report are comparatively inexpensive and safe, since the apical elongation is never extended beyond the lamina dura structure of the alveolus. Method 2 is to be preferred, however, as the specially designed through‐and‐through post‐system which simultaneously provides apical closure, transapical elongation and coronal retention, allows treatment of even very short roots and seems to give better results.
Matrix metalloproteinases and their inhibitors in gingival crevicular fluid and saliva of periodontitis patients
Authors: Ingman Tuula , Tervahartiala Taina , Ding Yanli , Tschesche Harald , Haerian Ahmad , Kinane Denis F. , Konttinen Yrjö T. , Sorsa Timo
Published: December 2005

Abstract Matrix metalloproteinases (MMPs) and serine proteinases seem to be related to tissue destruction in periodontitis. The presence of MMPs in gingival crevicular fluid (GCF) and saliva, however, has not been studied comprehensively with the enzyme‐linked immunosorbent assay (ELISA)‐technique, We therefore examined the levels of MMP‐1,‐3.‐8 and ‐9, and their endogenous inhibitor, tissue inhibitor of matrix metalloproteinases (TIMP‐1). in GCF and saliva of patients with adult periodontitiss (AP) and localized juvenile periodontitis (LJP). Elevated levels of MMP‐1 were detected in LJP GCF compared to AP and control GCF. Elevated levels of TIMP‐1 were also detected in LJP GCF in comparison to AP and control GCF Higher MMP‐8 levels were detected in AP GCF compared to LJP and control GCF. The relative low levels of MMP‐3 were present in all studied GCF samples. Elevated levels of MMP‐8 were further detected in saliva of AP compared to LJP and the controls. Both MMP‐1 and TIMP‐1 were detected in all studied saliva samples, but not significant differences were detected between the studied groups. Our ELISA‐results confirm that (i) PMN MMP‐8 and MMP‐9 are the main collagenase and gelatinase in AP GCF, whereas GCF collagenase in LJP seems to be of the MMP‐1‐type; (ii) only low levels of TIMP‐1. endogenous MMP‐inhibitor. are present in AP GCF. which emphasises the importance of doxycycline as a possible adjunctive drug in the treatment of AP patients; (iii) tests based on specific antibodies against PMN MMPs. especially MMP‐8, might serve as a reliable method of measuring and monitoring enzyme levels in GCF from different periodontitis patients.
Effects of cyclosporine A on plasma cells in experimental gingivitis in dogs
Authors: Berglundh T. , Lindhe J. , Tarkowski A.
Published: December 2005

Abstract The aim of the present investigation was to evaluate the effect of Cyclosporine A (CsA) on the inflammatory lesion formed in the gingival tissues during de novo plaque formation. 5 beagle dogs were used. On day 0, all teeth of the 5 dogs were scaled and polished. A 6‐week period of plaque control including daily tooth cleaning with toothbrush and dentifrice was initiated. A clinical examination regarding plaque and gingivitis was performed, and the plaque control measures were abandoned on the right side of mandible. 3 weeks later, the clinical examination was repeated, samples of subgingival plaque harvested and biopsies obtained from the 3rd and 4th right mandibular premolar regions. The tooth cleaning measures on the left side of the mandible were terminated at this interval. During the following 3 weeks, the animals formed plaque in the lower left premolar regions, and received, 1 × daily, a subcutaneous injection of CsA. At the end of this 2nd plaque formation period (test), the clinical examination was repeated, subgingival plaque was sampled and biopsies from the 3rd and 4th left mandibular premolar regions harvested. The biopsies were prepared for histometric and morphometric analyses. The clinical and histological examinations demonstrated that plaque formation resulted in a gingival lesion (ICT) which, in the 2 periods, had similar size and apical extension. The ICT formed during the CsA administration period, however, harbored an increased number of plasma cells and a reduced macrophage density than the control lesion. It is suggested that CsA administration may result in a Th‐2 (T‐helper 2‐cell) dependent activation of B‐lymphocytes.
Effect of local application of delmopinol hydrochloride on developing and early established supragingival plaque in humans
Authors: Klinge B. , Matsson L. , Attström R. , Edwardsson S. , Sjödin T.
Published: December 2005

Abstract The aim of the study was to investigate the effect of delmopinol hydro‐chloride on the development of dental plaque and on newly established plaque. In addition, the influence of this compound on the composition of the microbiota colonizing the gingival mucous membrane was studied. 14 healthy male volunteers took part. After a 3 week pre‐experimental period of intense oral hygiene, the participants refrained from all oral hygiene for 14 days. The buccal surfaces of cuspids and bicuspids on one side of the jaws were treated with a 1% aqueous solution of delmopinol hydrochloride (applied with a paint brush) 2 × a day for 7 days, while the contralateral side received placebo solution. On day 7, the application procedures were changed m that the test compound was applied on the teeth previously treated with placebo and vice versa. Plaque development was assessed clinically and by photo‐based planimetric determination. The clinical recordings revealed that 89.3% of the placebo‐treated surfaces displayed visible plaque on day 7, compared to 6.0% of the delmopinol hydrochloride treated surfaces. Delmopinol hydrochloride treatment of the previously placebo‐treated surfaces resulted in a decrease in the number of surfaces with visible plaque from 89.3% on day 7 to 6% on day 14. These results were confirmed by the planimetric data. No significant change in the composition of the mucosal flora was observed during the experimental period. The present results indicate that delmopinol hydrochloride markedly reduces the formation of dental plaque on a clean tooth surface exposed to conditions which favour bacterial colonization. Furthermore, the substance appears to possess plaque‐dissolving properties.
Suitability of gingival indices for use in therapeutic trials
Authors: Barnett Michael L.
Published: December 2005

Abstract A number of gingival indices have been described which include visual and invasive components, either separately or in combination. In selecting indices for use in gingivitis therapeutic trials, some investigators maintain that only invasive indices should be used, since indices that include a bleeding‐on‐provocation component are deemed to be the most objective. Other investigators, however, maintain that non‐invasive indices are the more appropriate insofar as invasive procedures will not only disrupt the plaque at the gingival margin, but could also mildly traumatize the tissue and present an impediment to assessing examiner standardization and reproducibility. This paper discusses these aspects of gingivitis evaluation. The data indicate that all validated indices, whether invasive or non‐invasive, have some degree of both objectivity and subjectivity. Therefore, the selection of an appropriate index will depend upon the ability of a given index to achieve the objectives of the clinical trial in which it is to be utilized.