bluuebunny/crossref_metadata_2025 huggingface dataset:
Gingivitis*
Authors: Page Roy C.
Published: December 2005

Abstract Gingivitis is caused by substances derived from microbial plaque accumulating at or near the gingival sulcus; all other suspected local and systemic etiologic factors either enhance plaque accumulation or retention, or enhance the susceptibility of the gingival tissue to microbial attack. Microbial species specifically associated with gingival health include Streptococcus sanguis1, 5. D‐7, and Fusobacterium naviforme. Bacteria involved in the etiology of gingivitis include specific species of Streptoccous, Fusobacterium, Aclinomyces, VeiUonella, and Treponema and possibly Bacteroides, Capnocytophaga, and Eikenella. Microbial colonization and participation is sequential, with the complexity of the associated flora increasing with time. The pathogenesis has been separated into the initial, early, and established stages, each with characteristic features. The initial lesion is an acute inflammation which can be induced experimentally by application of extracts of plaque bacteria to normal gingiva. The early lesion is characterized by a lymphoid cell infiltrate predominated by T lymphocytes, characteristic of lesions seen at sites of cell‐mediated hypersensitivity reactions. The early lesion can be induced by application of purified contact antigens to the gingival tissues of previously sensitized animals. As the clinical condition worsens, the established lesion appears, predominated by B lymphocytes and plasma cells. Established lesions may remain stable for indefinite periods of time, they may revert, or they may progress. Periodontal destruction does not result from the conversion of a predominantly T cell to a predominantly B cell lesion as has been suggested, but rather from episodes of acute inflammation. Clinical manifestations of gingivitis are episodic phenomena characterized by discontinuous bursts of acute inflammation. Most lesions are transient or persistent but not progressive. Attachment loss may precede alveolar bone loss and may occur without the manifestations of a concurrent or a precursor gingivitis. On the other hand, the evidence indicates that a portion of gingivitis lesions can and does progress to periodontitis. Gingivitis and the periodontal microflora differ in children and adults. Clinical signs of gingivitis either do not appear as plaque accumulates, or they are greatly delayed in children, and the inflammatory infiltrate consists mostly of T lymphocytes. The conversion to a B cell lesion does not appear to occur. The evidence supports the conclusion that gingivitis is a disease, and that control and prevention is a worthwhile goal and a health benefit. Efforts to achieve this goal should be continued and intensified, since we are as yet unable to distinguish between gingivitis lesions which will progress and those which will not.
Natural history of periodontal disease in man
Authors: Löe H. , Anerud A. , Boysen H. , Morrison E.
Published: December 2005

Abstract This paper describes the initiation, rate of progress of periodontal disease and consequent tooth loss in a population never exposed to any programs or incidents relative to prevention and treatment of dental diseases. The group consisted of 480 male laborers at two tea plantations in Sri Lanka. The study design and baseline data have been published. At the initial examination in 1970, the age of the participants ranged between 14 and 31 years. Subsequent examinations occurred in 1971, 1973, 1977, 1982 and 1985. Thus, the study covers the age range 14–46 years. Throughout the study, the clinical indices were scored by the same two examiners, both well‐trained and experienced periodontitis. Intra‐examiner reproducibility for each index was tested at baseline and repeated periodically during the study. The data for each examination were computerized and updated on an ongoing basis. At the last examination in 1985, there were 161 individuals who had participated in the first survey. This population did not perform any conventional oral hygiene measures and consequently displayed quite uniformly large aggregates of plaque, calculus and stain on their teeth. Virtually all gingival units exhibited inflammation. Based on interproximal loss of attachment and tooth mortality rates, three subpopulations were identified: (1) individuals (∼8%) with rapid progression of periodontal disease (RP), those (∼81%) with moderate progression (MP), and a group (∼11 %) who exhibited no progression (NP) of periodontal disease beyond gingivitis. At 35 years of age, the mean loss of attachment in the RP group was ∼9 mm, the MP group had ∼4 mm and the NP group had less than 1 mm loss of attachment. At the age of 45 years, the mean loss of attachment in the RP group was ∼13 mm and the MP group ∼7 mm. The annual rate of destruction in the RP group varied between 0.1 and 1.0 mm, in the MP group between 0.05 and 0.5 mm, and in the NP group between 0.05 and 0.09 mm. Since this population was virtually caries free, essentially all missing teeth were lost due to periodontal disease. In the RP group, tooth loss already occurred at 20 years of age and increased throughout the next 25 years. At 35 years of age, 12 teeth had been lost, at 40 years of age 20 teeth were missing and at 45 all teeth were lost. In the MP groups, tooth mortality started after 30 years of age and increased throughout the decade. At 45 years of age, the mean loss of teeth in this group was 7 teeth. The NP group essentially showed no tooth loss.
Considerations in the statistical analysis of clinical trials in periodontitis
Authors: Imrey Peter B.
Published: December 2005

Abstract Adult periodontitis has been described as a chronic infectious process exhibiting sporadic, acute exacerbations which cause quantal, localized losses of dental attachment. Many analytic problems of periodontal trials are similar to those of other chronic diseases. However, the episodic, localized, infrequent, and relatively unpredictable behavior of exacerbations, coupled with measurement error difficulties, cause some specific problems. Considerable controversy exists as to the proper selection and treatment of multiple site data from the same patient for group comparisons for epidemiologic or therapeutic evaluative purposes. This paper comments, with varying degrees of emphasis, on several issues pertinent to the analysis of periodontal trials. Considerable attention is given to the ways in which measurement variability may distort analytic results. Statistical treatments of multiple site data for descriptive summaries are distinguished from treatments for formal statistical inference to validate therapeutic effects. Evidence suggesting that sites behave independently is contested. For inferential analyses directed at therapeutic or preventive effects, analytic models based on site independence are deemed unsatisfactory. Methods of summarization that may yield more powerful analyses than all‐site mean scores, while retaining appropriate treatment of inter‐site associations, are suggested. Brief comments and opinions on an assortment of other issues in clinical trial analysis are preferred.
A clinical study of the width of the attached gingiva in the deciduous, transitional and permanent dentitions
Authors: Tenenbaum Henri , Tenenbaum Monique
Published: December 2005

Abstract. This study involved 331 individuals who were without clinical evidence of gingival inflammation. The width of the keratinized gingiva and the depth of the gingival sulcus were measured on the mid‐facial aspect of all teeth in each patient, using a calibrated, flat periodontal probe. The mean width of the attached gingiva did not show an increase from the deciduous to the permanent dentition. However, the width of the attached gingiva in the case of newly erupted permanent teeth was narrower than in the corresponding primary teeth. The widest zone of attached gingiva was found over the central and lateral incisors. The width of the attached gingiva decreased over the canine and the first premolar (and first primary molar). It then increased over the second pre‐molar (and second primary molar) and the first molar. These variations were approximately the same in both the maxilla and the mandible, although there was a greater over‐all width of attached gingiva in the maxilla than in the mandible. The tendancy, in the permanent dentition, for the attached gingiva to increase in width with age was related to a concomitant decrease in sulcus depth.
A new periodontal probe with automated cemento‐enamel junction detection
Authors: Jeffcoat M. K. , Jeffcoat R. L. , Jens S. C. , Captain K.
Published: December 2005

Abstract. A new automated periodontal probe has been developed which measures attachment level relative to the cemento‐enamel junction in a single measurement. The probe tip automatically enters the periodontal pocket and retracts under controlled force. As the probe tip transverses the cemento‐enamel junction, the electronics detect an alteration in the acceleration of the probe tip. Thus, the location of the cemento‐enamel junction is determined automatically. The repeatability and accuracy of the probe was assessed in vitro. Measurements of attachment level were repeatable to 0.03 mm, and the probe had a net accuracy of 0.04 mm.
The prevalence of spirochetes in the subgingival microbiota of Tanzanian and Dutch children
Authors: Mikx F. H. M. , Matee M. I. , Schaeken M. J. M.
Published: December 2005

Abstract. The subgingival microflora of 71 Tanzanian and 77 Dutch prepurberty children was analyzed by dark‐field microscopy.

Spirochetes were observed in almost every Tanzanian child and in 66% of the Dutch children. The predominant spirochetes were small and medium sized; large spirochetes were infrequently observed in the rural Tanzanian children and. at the bleeding sites of the Dutch children. Further differences in the %s of cocci, rods and fusiforms indicated that the subgingival microflora of Tanzania children is different from that of Dutch children. Generally, spirochetes occurre at higher %s and frequency at bleeding sites than at non‐bleeding sites in both populations. However, the non‐bleeding sites in the Tanzanian children had a higher prevalence of spirochetes than the bleeding sites in Dutch children. It is concluded that spirochetes are members of the normal flora of prepuberty children, that in children gingivitis is associated with increased proportions of spirochetes and that the presence of spirochetes in the gingival crevice is not dependent upon gingival inflammation.
A clinical evaluation of fixed‐bridge restorations supported by the combination of teeth and osseointegrated titanium implants
Authors: Ericsson Ingvar , Lekholm Ulf , Brånemark Per‐Ingvar , Lindhe Jan , Glantz Per‐Olof , Nyman Sture
Published: December 2005

Abstract. The present paper reports on the result of the use of osseointegrated titanium fixtures and teeth as combined abutments for fixed‐bridge restorations in 10 partially dentate patients. In these patients, the remaining teeth were too few or too unfavourably distributed in the jaws to serve as sole abutments for fixed bridgework. Titanium fixtures ad modum Brånemark were therefore implanted in suitable positions and used as abutments in combination with the remaining teeth. Evaluations at periods of 6 to 30 months postoperatively revealed good clinical results. Some tissue reactions, however, were also observed, indicating the presence of certain clinically significant differences in the functional behaviour of tooth abutments and titanium fixture abutments. These reactions and differences are discussed.
Longitudinal evaluation of a self‐inspection plaque index in periodontal recall patients
Authors: Baab David , Weinstein Philip
Published: December 2005

Abstract. This paper presents a controlled clinical trial to compare the effects of 2 programs for maintenance of oral hygiene after periodontal treatment. Oral hygiene instruction using a self‐inspection plaque index was compared to traditional instruction using professional monitoring of disclosed plaque. 31 periodontal recall patients were randomly assigned to 2 groups. 15 patients in the self‐inspection group were provided a manual that taught scoring of disclosed plaque on 6 teeth, a lighted dental mirror, and disclosing wafers. 16 patients in the traditional group were shown disclosed plaque in their own mouths, and were given feedback regarding oral hygiene skills. Instruction was given initially, at 2 weeks, at 1.5 months and at 3 months. The teeth were scaled at the start and at 3 months. Disclosed dentogingival plaque (before and after brushing), gingival bleeding on probing, and oral hygiene skills were assessed at 0, 1.5, 3 and 6 months. Initial mean plaque scores for only the self‐inspection group decreased significantly at 1.5 months and were maintained throughout the study; however differences between groups were not observed at any time except at baseline. Gingival bleeding scores were low throughout the study for both groups. Results provide some evidence for the effectiveness of self‐evaluation of disclosed plaque as a means for improving oral hygiene behavior in already‐motivated patients.
Dynamics of infection by leukotoxic strains of actinobacillus actinomycetemcomitans in juvenile periodontitis
Authors: Tsai Chi‐Cheng , Taichman Norton S.
Published: December 2005

Abstract. Juvenile periodontitis is associated with a high incidence of infection by Actinobacillus aclinomycetemcomilans (Aa). The data presented indicate that the ability of Aa to destroy human PMNs is altered during the course of infection. Leukotoxic strains of Aa are characteristically found in isolates obtained from younger patients (6–12 years of age) but not in older subjects (13–25 years old). This suggests that the leukotoxin may be more important during early as opposed to more advanced phases of juvenile periodontitis.
Radiographic quantification of alveolar bone level changes
Authors: Albandar Jasim M. , Abbas Dhia K.
Published: December 2005

Abstract. Radiographic bone level changes over 2 years were assessed by 1 absolute and 2 relative techniques in a group of 180 subjects (age 18–68 years, mean 46.7). The absolute tehnique measured the CEJ‐AC distance (mm). The Schei and Björn techniques employed rulers which expressed the alveolar bone level as a % of the root and tooth length, respectively. The applicability and readability of the 3 techniques were compared and their interrelationship evaluated. The absolute technique showed significantly better readability than did both the relative methods (p<0.0005). while the Schei technique exhibited the highest ability in detecting the radiographic change in bone level. The correlation between the measurements of bone level change made by the absolute and Schei techniques (r= 0.87) was far better than that between the other techniques (r= 0.56, 0.59).
Alpha 2‐macroglobulin in gingival fluid: correlation with alveolar bone loss in periodontal disease
Authors: Skalerič Uroš , Zajšek Peter , Cvetko Erika , Lah Tamara , Babnik Joža
Published: December 2005

Abstract. The concertration of total, free and bound (complexed forms) of alpha 2‐ macroglobulin was measured by crossimmunoelectrophoresis in patients with different degrees of periodontal disease as indicated by the gingival index (GI) and the proportion of alveolar bone loss (ABL). The concentration of toral a2‐ M (bound and free forms) is lower in gingival fluid taken from sites with more inflamed gingivae. Its concentration decreases with an increase in the pocket depth and the alveolar bone loss at the sites of fluid collection. The concentration of a2‐M bound form, i.e., the presence of a2‐M: protease complexes, in gingival fluid is low or absent at the sites with more pronounced bone loss (above 15%). Our results support the hypothesis that unbalanced protease activity damages the periodontal tissue. Not only the proteolytic but also inhibitory activities are altered and correspond to the severity of the disease.
Concentration of doxycycline in human gingival fluid
Authors: Pascale Dorothy , Gordon Jeffrey , Lamster Ira , Mann Philip , Seiger Mia , Arndt Wayne
Published: December 2005

Abstract. Doxycycline is a synthetic tetracycline compound whose main advantages over tetracycline hydrochloride are increased oral absorption, prolonged serum half‐life and decreased gastrointestinal side‐effects. The purpose of this study was to measure the concentration of doxycycline in gingival fluid and blood after oral administration. 4 volunteers were given doses of 100 mg doxycycline every 12 h on the first day of antibiotic administration followed by a maintenance dose of 100 mg per day for an additional 4 days. 3 of these volunteers were also given tetracycline hydrochloride every 6 h for 5 days either 1 month before or after doxycycline administration to compare gingival fluid levels of these 2 tetracycline compounds. Gingival fluid was sampled from 4 gingival sites in each volunteer at hourly intervals from hours 0 to 6, 9, 24, 27, 48 to 54, 57. 72, 75, 96 to 102 and 105. Blood was sampled by finger puncture at hours 0, 3, 6, 24, 48, 54, 72, 96 and 102. Antibiotic levels in gingival fluid and blood were measured using an agar diffusion assay method.

The results demonstrated that doxycycline achieved much higher levels in the gingival fluid than in blood and yielded comparable gingival fluid levels to those achieved by tetracycline hydrochloride. Doxycycline levels in gingival fluid ranged between 1.2 μg/ml and 8.1 μg/ml in the first 24 h and generally achieved 3–10 μg/ml after 48 h. Blood levels after 48 h ranged between 2.1 μg/ml and 2.9,μg/ml. Tetracycline hydrochloride in gingival fluid after 48 h was generally in the range of 4 μg/ml–10 μg/ml with blood levels between 2.2 μg/ml and 3.4 μg/ml. Due to certain advantages of doxycydine over tetracycline hydrochloride, this synthetic tetracycline compound may be favorably considered as an alternative to tetracycline hydrochloride in periodontal therapy.
The effect of a plaque control program on the development of phenytoin‐induced gingival overgrowth
Authors: Dahllöt Göran , Modéer Thomas
Published: December 2005

Abstract. The effect of a plaque control program on the development of phenytoin(PHT)‐induced gingival overgrowth was studied in 16 epileptic children, 8–16 years of age during a 2‐year longitudinal study. The parameters studied were: visible plaque index (VPI), gingival bleeding index (GBI), probing depth and gingival overgrowth. A preventive program was instituted before the start of the PHT‐medication and included oral hygiene instruction and frequent professional tooth cleaning during the observation period. When gingival overgrowth was evaluated on the basis of probing depth, no patients on PHT therapy for 2 years developed pseudopockets (≥4 mm). During the 2‐year observation period, there was a statistically significant increase (p<0.01) in the thickness of the marginal gingiva bucco‐lingually in all patients. This gingival enlargement was already evident (p<0.01) after 1 month. The degree of gingival enlargement in this patient group did not increase significantly after the 1st year of PHT‐medication and was not significantly correlated to the plasma concentration of PHT. The results of this study show that the development of PHT‐induced gingival overgrowth could not be prevented by this specific plaque control program.
Healing following surgical and non‐surgical treatment of juvenile periodontitis
Authors: Wennström A. , Wennström J. , Lindhe J.
Published: December 2005

Abstract. The patient sample used in the present study comprised 16 young individuals who were referred for treatment of advanced periodontal disease. Based upon the age of the patients and the location of the diseased sites, the patients were divided into 2 groups; a juvenile periodontitis group (JP) and a post‐juvenile periodontitis group (post‐JP). The patients in the JP group had periodontal lesions only at first molars and incisors. All 16 subjects were in excellent general health and none had been treated with antibiotics during a period of at least 12 months prior to the 1st examination. At a baseline examination and 6, 24 and 60 months after active therapy, the diseased sites were examined regarding plaque, gingivitis, probing pocket depths, probing attachment level, recession of the gingival margin and marginal alveolar bone level.

Following a case presentation and instruction in proper oral hygiene measures, the 16 subjects were subjected to periodontal treatment, utilizing a split mouth design. By random selection, the diseased sites in one side of the jaws were treated by scaling and root planing in conjunction with a “modified Widman flap” procedure, while in the contralateral jaw quadrants treatment was restricted to scaling and root planing. During the 1st 6 months following active therapy, the patients were subjected to professional tooth cleaning once every 4 weeks. Subsequently, the interval between the recall appointments was 3 months, 2 years after treatment, this maintenance care program was terminated. A final examination was performed 5 years after therapy. None of the patients involved in the trial received antibiotic treatment during the 5 years of observation. The findings of the present study revealed that the response of the periodontal tissues to therapy, both in the JP and the post‐JP group of patients, was almost identical to that found for similar types of treatment in patients with adult periodontitis. The re‐examinations performed after 6, 24 and 60 months following active therapy of JP and post‐JP lesions revealed that excision of the granulation tissue in conjunction with flap elevation did not enhance the degree of probing pocket depth reduction, probing attachment gain and bone fill that occurred following meticulous root surface instrumentation.
Alveolar bone levels in a geriatric Swedish population
Authors: Palmqvist Sigvard , Sjödin Bengt
Published: December 2005

Abstract A random sample of non‐institutionalized elderly people in Örebro County, Sweden, has been examined. The present report studies marginal bone levels in this population. Measurements were made on intra‐oral radiographs. The marginal bone levels of the teeth were measured in fifths between the apex and a point 1 mm apical to the cemento‐enamel junction. More than 87% of the teeth received a bone score 1 or 1. which indicates that more than 60% of the original bone level was remaining. About half of the teeth were given the bone score of 1, i.e., having more than 80% of the original bone level intact. For those subjects receiving regular dental treatment, the average bone level index (mean bone score for the subject) was lower than for the others. The general bone level of a subject is described by a classification which takes into consideration only the best 70% of the teeth. Using these bone level classes, people aged 65‐74 years positively differ from older groups. The % of subjects belonging to the better bone level classes increases with increasing number of remaining teeth. In a multiple stepwise regression analysis, the number of teeth is the only predictor having significant correlation to bone level index. A variable such as regular treatment in itself seems to have little influence.
Some periodontal tissue reactions to orthodontic tooth movement in monkeys
Authors: Wennström Jan L. , Lindhe Jan , Sinclair Flemming , Thilander Birgit
Published: December 2005

Abstract The purpose of the experiment reported was to study soft tissue changes at teeth which were orthondontically moved into areas with varying thickness and quality of periodontal tissues. The maxillary central incisors and first premolars in 5 adult monkeys were used as experimental teeth. 6 months prior to the start of the orthodontic treatment phase, the maxillary second premolars were extracted. By surgical means, areas with varying width of the keratinized gingiva were established in the incisor and premolar region. Following a clinical baseline examination which involved assessments of gingival width, location of the gingival margin in relation to cemento‐enamel junction and probing attachment level, fixed orthodontic appliances were inserted in order to bodily move (1) the two contral incisors in labial direction through the alveolar bone envelope and (2) the first premolars in distal direction into contact with the first molars. Orthodontic forces were applied for a period of 3‐4 months. The lateral incisors and first molars were selected as non‐moved control teeth. After the experimental teeth had been retained in their new positions for 1 month, the clinical examination was repeated. Tissue blocks containing test and control specimens were subsequently dissected and prepared for microscopic analysis. The analysis included histometric assessments of loss of connective tissue attachment and height of alveolar bone.

The results showed that at every second labially moved incisor, the gingival margin had become displaced in apical direction. The degree of displacement, however, was small and only at 2 teeth accompanied by loss of connective tissue attachment. Throughout the study, these particular teeth also showed obvious signs of gingival inflammation. In the incisor tooth regions, no relationship was found between the initial width of the keratinized gingiva and the degree of apical displacement of the gingival margin during orthodontic therapy. Furthermore, there was no statistically significant difference in terms of loss of connective tissue attachment between premolars which had been bodily moved into areas of the jaw bone lined by alveolar mucosa or keratinized gingiva. These observations suggest that plaque‐induced inflammation and the thickness (volume) of the marginal soft tissue, rather than the apico‐coronal width of the keratinized and attached gingiva, are determining factors for the development of gingival recession and attachment loss during orthodontic tooth movement.
New attachment in monkeys with experimental periodontitis with and without removal of the cementum
Authors: Blomlöf Leif , Lindskog Sven , Appelgren Rolf , Jonsson Björn , Weinlraub Andrej , Hammarström Lars
Published: December 2005

Abstract Experimental periodontitis was induced in monkeys by means of elastic orthodontic ligatures. The periodontally‐involved teeth were then treated with different methods. At the end of the treatment period, the monkeys were sacrificed. The premolar‐molar areas were dissected out and embedded in a low‐viscosity embedding medium (Spurr). The results of the treatment procedures were analyzed on ground sections. Formation of new cementum and new bone was determined by means of tetracycline labeling. Root planing with an ultrasonic device or with hand instruments almost completely removed the cementum and a portion of the peripheral dentin. The root surface was more uneven after treatment with the ultrasonic device than after using hand instruments. No new attachment could be found after root planing. Cleaning of the periodontally‐involved root surfaces with two detergents (cetylpyrimidinium chloride and sodium‐N‐lauroyl sarcosine) without root planing resulted in a significant amount of new attachment.
The effects of a dentifrice containing a zinc salt and a non‐cationic antimicrobial agent on plaque and gingivitis
Authors: Saxton C. A. , Lane R. M. , van der Ouderaa F.
Published: December 2005

Abstract The antiplaque potential of metal salts in mouthwashes or dentifrices has been previously demonstrated. The purpose of the present investigation was to establish the effects on plaque and gingival health of a dentifrice which contained a combination of the metal salt, zinc citrate, and the anti‐microbial agent, Triclosan. Plaque growth was reduced by a dentifrice which contained either zinc citrate or triclosan, but greater inhibition was achieved with dentifrices which contained both agents. A 4‐day non‐brushing study in which slurries of the dentifrice were used, confirmed that the test dentifrice which contained 1% zinc citrate and 0.5% Triclosan reduced the accumulation of plaque by 50%. In a double‐blind crossover study of 28 days duration, a significant reduction in plaque accumulation and an improvement in gingival health was demonstrated for the test dentifrice compared to the placebo. Further analysis of the data indicated that the dentifrice was most efficacious for participants who brushed ineffectively. Also, the greatest benefit was obtained by subjects that used the largest amount of dentifrice.
The effect of supragingival plaque control on the composition of the subgingival microflora in human periodontitis
Authors: Beltrami M. , Bickel M. , Baehni P. C.
Published: December 2005

Abstract The aim of this study was to evaluate the effect of supragingival plaque control on the composition of the subgingival microflora. 8 subjects with moderate to severe periodontitis were chosen for the study. Sites with periodontal destruction (GI > 2; probing depth > 6.5 mm; vertical alveolar bone loss on radiographs) were submitted to professional plaque control 3 × a week for 3 weeks. Contralateral sites received no prophylaxis and served as controls. Patients maintained usual oral hygiene during the observation period: it consisted exclusively of tooth brushing once or twice a day with no use of interdental cleaning aids. Clinical examination and bacterial sampling were performed every week. At the end of the study. PII scores for the experimental sites showed a marked diminution compared with the control sites. No variations were observed in GI or probing depth in test or control sites during the study. The composition of subgingival plaque in both groups showed no significant variations during that period.
The relationship between the multidimensional health locus of control and the performance of subjects on a preventive periodontal programme
Authors: Galgut P. N. , Waite I. M. , Todd‐Pokropek A. , Barnby G. J.
Published: December 2005

Abstract Criteria have been defined to quantify a personality characteristic‐termed locus of control. The criterion at one extreme of this range was referred to as external, indicating a belief that health was determined by a variety of other factors such as powerful other individuals or by chance. The criterion at the other extreme was termed internal, indicating a belief that health might be modified by the behaviour pattern of the individual. Locus of control scales have been used to relate psychological factors to physical disease, and the response of patients to disease. The aim of the present study was to investigate whether locus of control could be used to anticipate the response of subjects to a plaque control programme.

A study was carried out on 14 males and 46 females to investigate the relationship between the multidimensional health locus of control (MHLC) and the response of a group of office workers to a plaque control programme. It was found that there was significant correlation between the external MHLC dimension of powerful others and improvement in some of the clinical criteria; a similar result was found for the internal dimension of the MHLC. In contrast, there was minimal correlation between the external dimension of the MHLC termed chance and the clinical results. It was concluded that subjects who perceive their susceptibility to disease being influenced by powerful external factors or who believe that susceptibility can be controlled by their own actions, respond more positively to a plaque control regime than those subjects who consider that susceptibility to disease is an event of chance.
Lacking anti‐plaque efficacy of 2 sanguinarine mouth rinses
Authors: Etemadzadeh Hossein , Ainamo Jukka
Published: December 2005

Abstract The aim of the study was to compare the anti‐plaque effect of sanguinaria extract to that of a known effective agent, chlorhexidine gluconate. and to that of a known ineffective agent, tap water. The study was conducted as a 3 times crossed‐over and blindly evaluated 3 week clinical trial. 12 dental students rinsed in an individually randomized sequence twice daily for 4 days (Monday to Friday) with Viadent® containing 0.03% sanguinaria extract (0.01% sanguinarine chloride) and a 1000 ppm concentration of zinc ions (ZnCl2), 2 × 30 s × 10 ml; with Hibitane Dental containing 0.2% chlorhexidine giuconate. 1 min × 10 ml; and with tap water. 1 min × 10 ml. Mechanical oral hygiene was allowed only during the 3 days between test periods. When measured according to the plaque index or in terms of plaque wet weight, only the chlorhexidine rinse further reduced the low Monday scores. No significant difference was observed between Friday scores after rinses with Viadent® and water. The variation in effect of the 3 rinses was less marked when assessed by means of area of plaque on the tooth surfaces. Subjectively, both the taste and effect of Viadent® was reported to be poor. In a second controlled clinical trial using the same design, no significant difference in anti‐plaque effect was found between the commercially available Viadent® rinse and an experimental rinse with a tripled concentration of sanguinarine chloride but the same content of zinc.
Correlation of histometric, microbial, and clinical indicators of periodontal disease status before and after root planing
Authors: Harper D. S. , Robinson P. J.
Published: December 2005

Abstract Effective diagnosis and treatment of periodontal disease requires accurate evaluation of disease status before and after treatment. This study evaluated relationships among multiple parameters that have been used for periodontal disease evaluation. A total of 61 initially deep (≥6 mm) interproximal pockets from 16 patients examined before and after a 3‐week course of root planing therapy were evaluated for probing depth, bleeding on probing, darkfield and cultural characterization of subgingival plaque, and histometric indices of infiltrated connective tissue (ICT) and mature plasma cell infiltrate. 36 sites were evaluated before treatment, and 25 after treatment. A comparison of mean scores for pre‐treatment sites versus post‐treatment sites indicated that there was an average improvement in most disease‐related parameters. However, patterns of significant correlations among the parameters differed markedly. Motile bacteria enumerated by darkfield microscopy were significantly correlated with ICT and plasma‐cell populations before, but not after treatment. In contrast, probing depth and populations of black pigmented Bacteroides (BPB's). principally B. gingivalis, were significantly correlated with ICT after, but not before, treatment. Bleeding on probing was not significantly correlated with ICT levels before or after treatment. This suggests that different sets of parameters should be used for evaluating periodontal disease status before or after treatment. Our data further suggest that B. gingivalis populations may be related to delayed healing of deep periodontal lesions after instrumentation.
Efficacy of mouthrinses in inhibiting dental plaque and gingivitis in man
Authors: Axelsson Per , Lindhe Jan
Published: December 2005

Abstract The aim of the present trial was to determine the effect of different mouthwash preparations used as supplements to regular oral hygiene measures on dental plaque and gingivitis in humans. 96 volunteers were recruited for the study. Following a baseline examination, each subject was given a careful prophylaxis, following which the mouthrinse regimens were initiated. During the 6 weeks of trial, the subjects continued to exercise their regular non‐supervised, self‐performed plaque control measures. The 96 volunteers were assigned either to 1 or 3 different treatment groups or to a control group according to a randomized code. The members of the control group and the listerine group rinsed with 20 ml of the mouthrinse for 30 s, twice daily, while the members of the chlorhexidine groups (using either a 0.2% or a 0.1% solution) rinsed with 10 ml of the antiseptic solution for 60 s twice daily. Examinations regarding extrinsic stain and plaque were performed at baseline and after 3 and 6 weeks, while the conditions of the gingiva were examined at baseline and after 6 weeks. Extrinsic stain was evaluated using the Lobene index, plaque was assessed by the Turesky modification of Quigley‐Hein index and the gingival condition was examined using the gingival index system of Loe & Silness. The results of the trial demonstrated that the 3 active mouthwash preparations used as supplements to regular tooth cleaning measures markedly improved both the oral hygiene status and the gingival conditions of the participating human volunteers, compared to the control rinse. The findings thus agree with data previously reported on the effects of chlorhexidine digluconate and listerine antiseptic both in terms of plaque inhibition and resolution of gingivitis.
Monitoring untreated periodontal disease
Authors: Harley Alison , Floyd Peter , Watts Trevor
Published: December 2005

Abstract The purpose of this study was to monitor clinical attachment levels, using a constant force probe, in patients with untreated periodontal disease, and to use darkfield microscopy to monitor changes in subgingival plaque. 10 patients with untreated disease were studied over 12 weeks. The parameters measured at baseline and every 4 weeks were probing depth, attachment level and bleeding. The subgingival microflora of the deepest site in each quadrant was examined by darkfield microscopy, using a Hellber counting chamber, at baseline and 12 weeks. The subgingival plaque from any site which lost more than 2 mm clinical attachment was also sampled and the microflora examined. Analysis of the results shows that 91 % of probing depths and attachment levels remained the same or within ± 1 mm. 3.5% of probing depths and 3.7% of attachment levels became deeper by 2 mm. 6.9% of probing depths and 4.5% of attachment levels became shallower by 2 mm. Only 6 sites out of 1029 showed loss of clinical attachment > 2 mm.

Darkfield microscopy showed no differences in the proportion of microorganisms at the 6 sites which lost more than 2 mm of clinical attachment, compared with the baseline value. A surprising result was the tendency for probing depths and attachment levels to decrease, especially in deeper pockets.

This study showed that none of the parameters monitored, i.e., probing depth. attachment level, bleeding or subgingival microflora. indicated which sites would lose attachment over a 12‐week period.
Association between bacteriophage‐infected Actinobacillus action‐mycetemcomitans and rapid periodontal destruction
Authors: Preus Hans R. , Olsen Ingar , Namork Ellen
Published: December 2005

Abstract Actinobacillus actinomycetemcomitans was isolated from periodontal pockets in a patient suffering from prepubertal periodontitis. Electron microscopy revealed 3 different groups of bacteriophages in Filtrates of subgingival plaque from all the active periodontal lesions. Phage infected A. actinomycetemcomitans in this patient was restricted to periodontal pockets which, according to standardized roentgenograms, had shown bone destruction during the past 12 months. A follow‐up study of 7 months revealed that a “burned out” site which harbored noninfected A. actinomycetemcomitans, turned into an active site at the same time as the A. actinomycetemcomitans of that site became infected with the phages. These findings indicate a relationship between rapid prepubertal periodontal destruction and phage‐infected A. actinomycetemcomitans.
Two‐dimensional gel electrophoresis of dog crevicular fluid proteins
Authors: Mukherjee Sabyasachi , Novack Nancy , Blaustein David , Chambers Donald A.
Published: December 2005

Abstract The ligature‐induced periodontitis model was used in beagle dogs to compare and contrast profiles of crevicular fluid (CF) proteins collected from gingivitis and periodontitis sites. The protein profiles of CF and serum were determined by 2‐dimensional gel electrophoresis (2‐D PAGE) using a silver stain. 2‐D PAGE showed that CF contained proteins with molecular weight 16 K or less and many proteins with molecular weights between 64 K and 16 K in the isoelectric pH between approximately 5.8 and 6.8. The number of such proteins was greater in samples collected from the ligated (periodontitis) side compared to the non‐ligated (gingivitis) side. Thus, analysis by 2‐D PAGE revealed differences between CF samples from gingivitis and ligature‐induced periodontitis sites. This study suggests that analysis of human CF by 2‐D PAGE may be useful in diagnosis and investigation of the pathogenesis of periodontitis.
The relationship between periodontal conditions and perceptions of periodontal health among Pakistani immigrants in Norway
Authors: Selikowitz Harry‐Sam
Published: December 2005

Abstract The purpose of the present study was to assess the periodontal status of Pakistani immigrants in Norway, a Third World population in an industrialized country. The findings were related to treatment needs, socio‐demographic variables and cultural beliefs about periodontal health. The mean number of remaining teeth ranged from 27.7 in the 20–24‐year‐old age group to 25.1 in the group of 35‐year‐olds and older. Very few of the study population had no plaque or no subgingival calculus. Only 7.5% of the participants exhibited no bleeding at any index teeth. Age and residence in Pakistan were the strongest predictors of subgingival calculus and pocket depth. Those from the rural areas of Pakistan had deeper pockets than those from the cities. The data showed a population with high prevalences of teeth with plaque, subgingival calculus and frequent gingival bleeding, but few sites with deep pockets. A periodontal treatment need index would indicate a substantial amount of treatment time. The present study suggests that also the perceived periodontal conditions, should be taken into account when periodontal services and health education strategies are planned. The concept of periodontal illness is introduced, defined as a person's perceptions and interpretations of periodontal symptoms.
Non‐Gaussian distribution of differences between duplicate probing depth measurements
Authors: Janssen P. T. M. , Faber J. A. J. , van Palenstein Helderman W. H.
Published: December 2005

Abstract The present study aims to determine the accuracy and the distribution of the error of probing depth measurements. Duplicate measurements were performed at 1069 sites in 13 subjects. Measurements in shallow pockets (≤3 mm) were significantly (p<0.001) more reproducible than measurements in deep pockets (>3 mm). The overall standard deviation of the measurements was 0.74 mm. Differences between duplicate measurements were not normally distributed. Differences of 2 mm or more were recorded more frequently than one would expect on basis of the standard deviation and a hypothetical normal distribution. The observed frequency of large differences (≥3 mm) is much higher than the theoretical change as suggested in the literature that such differences may occur as a result of the inaccurate probing measurements. This finding implies consequences for the chance of making false claims that true changes in probing depth and attachment level have occurred over time, if the claims are based on the standard deviation and the wrong assumption that the error of the measurement is normally distributed.
Cell and fiber attachment to demoralized dentin A comparison between normal and periodontitis‐affected root surfaces
Authors: Polson A. M. , Hanes P. J.
Published: December 2005

Abstract The purpose of the present study was to compare and contrast cellular, connective tissue, and epithelial responses to dentin specimens derived from the roots of either normal or periodontitis‐affected human teeth after surface demin‐eralization. Rectangular dentin specimens, with opposite faces of root and pulpal dentin. were derived from beneath root surfaces covered by periodontal ligament (normal) or calculus‐covered areas of periodontitis‐affected teeth. In each of the groups, the specimens were treated with citric acid (pH 1 for 3 min), whereupon they were implanted transcutaneously into incisional wounds on the dorsal surface of rats with one end of the implant protruding through the skin. 4 specimens were available in each group at 10 days after implanation. Histologic and histometric analyses of the root surfaces of the implants included counts of adhering cells, evaluation of connective tissue fiber relationships, and assessment of epithelial migration. New connective tissue attachment with inhibition of epithelial migration occurred in both groups. Cement urn formation was not present. Comparisons between the groups showed no significant differences regarding length of implant surface adjacent to connective tissue, number of attached cells, or density and diameter of attached fibers. The fiber attachment system which had developed on these demineralized surfaces seemed intrinsic to the connective tissue location, and differed morphologically from corresponding fibers attaching the root surface in a normal periodontium. It was concluded that there were no observable differences between the new connective tissue attachment systems which developed on demineralized dentin from either normal or periodontitis‐affected root surfaces.
Peripheral ameloblastoma‐a clinical dilemma in gingival lesions
Authors: Horowitz Isack , Hirshberg Abraham , Dayan Dan
Published: December 2005

Abstract A case of peripheral ameloblastoma on the gingiva of a 50‐year‐old male is presented. The clinical and histological picture of the lesion is described. The etiology and the dilemma in the differential diagnosis of this peripheral odontogenic tumor is discussed.
Immunologic dysfunction in the pathogenesis of periodontal diseases*
Authors: Shenker Bruce J.
Published: December 2005

Abstract Despite significant progress in our understanding of the pathogenesis and etiology of periodontal diseases, the nature and contribution of the immune system to this disorder remains unclear. Several studies provide evidence for either a protective or destructive rôle. These conflicting findings are difficult to reconcile, since most interpretations tend to argue for a static contributory rôle (i.e., either protective or destructive) of the immune system. Current theories on the role of the immune response do not address these conflicting findings as well as the contradictory observation of a delectable immune response in the face of persistent infection in these patients. In this article, we present a model, based on available data, for the contribution of the immune system to the pathogenesis of periodontal disease. This model ascribes a dynamic role for the immune response. As documented in other infectious diseases, it is entirely possible, for example, that a state of immunologic dysfunction may occur in the earliest stages of periodontal disease progression; this may then be followed by a period of active immune reactivity (humoral and/or cellular) that would represent either a delayed or depressed response. This model is discussed in conjunction with recent findings that several suspected periodontal pathogens are capable of producing immuno‐suppressive agents. Many of the apparently contradictory clinical observations concerning the host immune response to oral pathogens and its correlation (or lack of) with both the progression and severity of periodontal disease may be accounted for in this model.