bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of nonsurgical periodontal therapy
Authors: Badersten Anita , Nilvéus Rolf , Egelberg Jan
Published: December 2005

Abstract Incisors, cuspids and premolars in 49 patients with advanced chronic periodontitis were treated with initial, nonsurgical periodontal therapy. The results were monitored by probing attachment level measurements for 6 sites of each tooth every 3rd month during a period of 24 months. Amongst sites with initial probing depth ≥ 4.0 mm, sites with probing attachment loss were identified using regression analysis. Scores for plaque, bleeding, suppuration on probing and probing depth, obtained for these sites during the 24‐month study, were analyzed to determine whether any of the scores could be used diagnostically as an indicator of probing attachment loss. Diagnostic sensitivity and predictability were calculated for different levels of each of the scores. The results showed that sites with probing attachment loss were more frequent for sites with high scores for plaque, bleeding, residual probing depth and suppuration than in sites with low scores. However, the diagnostic sensitivity and predictability of these clinical indicators was generally low. Thus, records of plaque, bleeding, suppuration and probing depth do not obviate the need for probing attachment level measurements for identification of sites with probing attachment loss following initial, nonsurgical periodontal therapy.
Healing after treatment of periodontal intraosseous defects
Authors: Renvert Stefan , Garrett Steven , Shallhorn Robert G. , Egelberg Jan
Published: December 2005

Abstract The present study was performed to determine whether the healing of periodontal intraosseous defects could be improved through the combined use of citric acid conditioning of the root surfaces and grafting of autogenous intraoral cancellous bone. 28 proximal defects in 19 patients were treated surgically including acid conditioning of the root surfaces. Another 25 defects in these patients were treated with acid conditioning combined with osseous grafts using the maxillary tuberosity areas as donor sites.

Both therapies, e.g., citric acid conditioning alone and acid conditioning combined with osseous grafting resulted in approximately 1 mm gains of probing attachment and probing bone levels. Within the parameters of this study, osseous grafting did not enhance the effect of citric acid conditioning alone. Limited improvement of the treated defects of the present study was obtained in spite of the use of supplementary regenerative techniques.
Bone regeneration pattern and ankylosis in experimental furcation defects in dogs
Authors: Klinge Björn , Nilvéus Rolf , Egelberg Jan
Published: December 2005

Abstract This study reports on the pattern of interradicular bone formation and the frequency and localization of ankylosis following regenerative surgery of experimentally‐induced furcation defects in 12 beagle dogs. Observations were made in 39 specimens showing healing with connective tissue attachment in the full circumference of the furcation. The findings indicate that bone regeneration first occurs adjacent to the root surfaces, followed by a subsequent fill of the central portion of the interradicular area. Ankylosis, observed in 24 of the 39 specimens, was more frequent in large defects than in small defects. The incidence of ankylosis increased with increased distance from the base of the original wound. These findings suggest that coronal bone apposition may require or be facilitated by the presence of a root surface, and that undisturbed coronal regeneration may be dependant upon cellular or sonic other activity from the intact periodontal ligament.
Microbiological and clinical effects of surgical treatment of localized juvenile periodontitis
Authors: Christersson Lars A. , Slots Jørgen , Rosling Bengt G. , Genco Robert J.
Published: December 2005

Abstract Since Actinobacillus actinomycetemcomitans appears to be a key etiologic agent in localized juvenile periodontitis, this study determined the effectiveness of different treatment modalities in suppressing A. actinomycetemcomitans in localized juvenile periodontitis lesions. A total of 25 deep. periodontal lesions from 7 patients with localized juvenile periodontitis were included in the study. The test periodontal lesions either received scaling and root planing alone, scaling and root planing together with soft tissue curettage, or modified Widman (lap surgery. Subgingival A. actinomycetemcomitans were enumerated using selective culturing. Clinical measurements included changes in probing periodontal attachment level, probing periodontal pocket depth, gingival index, plaque index, and digital subtraction of standardized serial radiographs. The microbiological and clinical effects of treatment were monitored over a period of 16 weeks.

All periodontal lesions studied demonstrated high numbers of A. actinomycetemcomitans prior to treatment. Scaling and root planing alone did not markedly change the subgingival A. actinomycetemcomitans counts, nor any of the clinical parameters studied. In contrast, soft tissue curettage as well as modified Widman flap surgery suppressed A. actinomycetemcomitans to undetectable levels immediately after therapy in more than 80% of the lesions studied. A total of 5 periodontal lesions exhibited gain of probing periodontal attachment after subgingival curettage or Widman flap treatment; 3 of these sites revealed no detectable A. actinomycetemcomitans, and the remaining 2 sites harbored only low levels of A. actinomycetemcomitans. 5 periodontal lesions which lost probing attachment after treatment all demonstrated high numbers of subgingival A. actinomycetemcomitans. Changes in alveolar bone, assessed by digital subtraction of serial radiographs, correlated with changes in probing periodontal attachment level, confirming the clinical results.

The present study revealed a close relationship between post‐treatment A. actinomycetemcomitans levels and the clinical response to treatment, which supports the concept that A. actinomycetemcomitans is an important organism in the etiology of localized juvenile periodontitis. This study also showed that a substantial suppression of subgingival A. actinomycetemcomitans cannot be achieved by periodontal scaling and root planing alone, but can be accomplished by surgical removal of periodontal tissues. However, the predictability of surgical procedures in suppressing subgingival A. actinomycetemcomitans was poorer than that obtained in a previous study in which systemic tetracycline was used without concomitant periodontal surgery.
The thermodynamic behaviour of labial gingiva in patients with destructive periodontal disease
Authors: Mörmann W. H. , Bösigur P. , Grau P. , Scaroni F.
Published: December 2005

Abstract The temperature changes of the labial gingiva and mucosa of the maxillary incisor regions were investigated using computer‐assisted thermography. 9 patients with destructive periodontal disease (7 female and 2 male, aged between 12 and 33 years, undergoing periodontal treatment for periods varying from 6 months to 12 years) and 10 volunteers with clinically normal periodontia (6 female and 4 male, aged between 19 and 26 years) took part in this study. The gingivae and mucosae were initially cooled using a homogenous flow of air (15 1/min at 15deg;C) for 3 min. 20 s after the cooling phase, temperature increases of these soft tissues were sequentially recorded using 48 thermograms per person. This procedure was repeated 4 times for each person examined. The weighted mean of the time constants of the tissue re‐warming curves was significantly higher (p < 0.025) for the periodontitis group (152 ± 6 s) compared to the clinically healthy group (110 ±9 s). The different thermodynamic behaviour between the 2 groups studied indicated differences in the blood‐flow and/ or its regulation.
Relationship between some subgingival bacteria and periodontal pocket depth and gain or loss of periodontal attachment after treatment of adult periodontitis
Authors: Slots Jørgen , Emrich Lawrence J. , Genco Robert J. , Rosling Bengt G.
Published: December 2005

Abstract We studied the association between post‐treatment periodontal disease activity and subgingival Bacteroides gingivalis. Bacteroides intermedius, spirochetes and motile rods. 20 adults. 22–62 years, with moderate‐to‐severe periodontitis participated in a split‐mouth treatment study. All individual quadrants received supragingival cleaning and in addition, subgingival scaling and a NaHCO3–NaCl‐H2O2 slurry, subgingival scaling alone, slurry alone, or no subgingival treatment. Post‐treatment periodontal disease status was determined over a period of 12 months by changes in probing periodontal pocket depth and probing periodontal attachment level. Subgingival specimens obtained by paper point‐sampling were evaluated for B. gingivalis and B. intermedius using indirect immunofluorescence and for spirochetes and motile rods using bright light phase contrast microscopy. A total of 142 periodontitis lesions representing all 4 quadrants of the 20 subjects were studied. The relationship between clinical data and bacteria was analyzed using logistic regression.

The probability of the study organisms being present in subgingival sites at 3 to 6 months after treatment increased with increased residual pocket depth. The presence of B. gingivalis showed a strong positive association (p<0.004) with loss of periodontal attachment. A significant association was also found for spirochetes (p<0.008) but not for motile rods (p>0.35) or B. intermedius (p>0.13). Similar results were obtained at 12 months after therapy, except that the presence of motile rods was significantly associated with loss of periodontal attachment (p<0.03).

Caution must be exercised when using B. gingivalis or spirochetes to evaluate treatment efficacy. If the presence of these organisms was utilized to indicate progressing periodontitis many active lesions could be identified, and only 1 to 17% and 13 to 43% of sites in remission at 3–6 months after therapy would be expected to harbor B. gingivalis and spirochetes respectively. The consequences of treating periodontal sites in remission would mainly be limited to cost and inconvenience. However, since several active periodontitis lesions did not reveal the organisms, treatment decisions based solely on the absence of the organisms may result in the omission of needed therapy. As a practical consideration, periodontal treatment should be continued as long as B. gingivalis and maybe spirochetes are detectable in the subgingival microflora. In the absence of these organisms, and until additional periodontal pathogens have become known, the decision to continue or conclude periodontal therapy must be based on clinical grounds.
Survival analysis of periodontal sites before and after periodontal therapy
Authors: Haffajee Anne D. , Socransky Sigmund S. , Ebersole Jeffrey L.
Published: December 2005

Abstract Periodontal diseases appear to progress with bursts of destructive activity at individual sites. One effect of treatment might be to diminish the frequency of such bursts. Survival analysis was employed to seek such effects on the periodontal sites of 16 individuals with prior evidence of destructive periodontal disease. The subjects were monitored at bi‐monthly intervals and actively breaking down sites were detected using attachment level measurements and the tolerance method of analysis. When active sites were detected, control sites of equal pocket depth and attachment loss were selected and microbiological and immunological samples were taken. The subjects were treated by modified Widman flap surgery and systemically administered tetracycline. On completion of therapy, bi‐monthly monitoring was reinstituted. Life tables were constructed for periodontal sites in each of the 16 subjects prior to and after therapy. A site losing more than 3 mm of attachment at any time interval was considered to have relapsed or “died”. Survivor functions were calculated for each time period indicating the % of sites which survived at any time. The subjects were divided into 3 categories on the basis of post‐therapy survivor functions. The annual hazard rate in 9 good treatment response subjects (group I) was reduced from 0.10/year to 0.01/year. The hazard rate of 5 intermediate treatment response subjects (group 2A) was reduced from 0.16/year 10 0.04/year and that of 2 poor treatment response subjects (group 2B) from 0J5/year to 0.07/year.

Group 2A and 2B individuals were combined and differences were sought in clinical, microbiological and immunological parameters between the good and poor treatment response groups, 5 out of 7 of the poor responding individuals showed elevated humoral antibody responses to 3 or more gram‐negative subgnigival species tested. Many of the elevated responses in this group were to organisms which are widely distributed and return quickly after therapy such as Fusobacterium nucleatum, Eikenella corrodens, Bacterodes intermedius and Capnocytophaga sputigena. The predominant cultivable microbiota in subgingival samples taken prior to therapy from the good responding group had significantly greater proportions of Actinobacillus actinomycetemcomitans, C. ochracca and B. intermedius than the poor responding group. The latter group showed significantly elevated proportions of F. nucleatum Peptostreptococcus micros and Streptococcus intermedius.
Antimicrobial irrigation of deep pockets to supplement oral hygiene instruction and root debridement
Authors: MacAlpine Robert , Magnusson Ingyar , Kiger Robert , Crigger Max , Garrett Steven , Egelberg Jan
Published: December 2005

Abstract 64 sites with probing pocket depth 6 mm from 11 patients were treated with plaque control instruction and one episode of root planing. Subsequently, selected sites in each patient were irrigated with either chlorhexidine, tetracycline, saline or served as non‐irrigated control sites. Irrigation immediately followed instrumentation, and was repealed every 2 weeks for 24 weeks. Healing was monitored at 8, 16, and 24 weeks clinically and at 7, 15, and 23 weeks with subgingival washings for determination of % as well as total number of spirochetes.

The following changes were apparent from comparing pooled site means al 24 weeks with pre‐treatment data: (1) bleeding sites decreased from 62 of 64 sites initially to 22 of 64 at 24 weeks; (2) spirochetes decreased from 34% to 2%; (3) probing pocket depths decreased from 7.6 to 4.7 mm; (4) probing attachment levels showed a gain of 1.2 mm. The improvement of the chlorhexidine and tetracycline irrigated sites was similar to that of the saltne irrigated and non‐irrigated control sites.

Thus, biweekly chlorhexidine, tetracycline or saline irrigation of deep pockets did not appear to augment the effects of non‐surgical periodontal therapy.
Statistical transformations of indices of gingivitis measured non‐invasively
Authors: Fleiss Joseph L. , Park Molly H. , Bollmer Bernard W. , Lehnhoff Robert W. , Chilton Neal W.
Published: December 2005

Abstract An index (PMGI) that combines the Massler‐Schour (PMA) and Löe‐Silness (GI) indices for non‐invasive scoring of gingivitis was applied in 2 independent comparative clinical studies. 4 statistical transformations of the scores of individual papillary and marginal units were analyzed: the whole‐mouth mean, its square root, the proportion of units judged to be inflamed, and its arc sin transformation. According to the criteria of how closely the transformations produced approximately normal distributions, and of how successful they were in detecting treatment differences, the square root transformation performed the best.
Effect of age on healing following periodontal therapy
Authors: Lindhe Jan , Socransky Sigmund , Nyman Sture , Westfelt Elisabeth , Haffajee Anne
Published: December 2005

Abstract The present investigation was performed in order to analyze the effect of age on healing of the periodontal tissues following treatment. The patients included in the present analysis consisted of 2 different samples. One group of 62 patients (sample A) was examined and treated between 1980 and 1982. 13 of these subjects were <40 years of age, 26 subjects were 40–49 years of age and 23 subjects were >49 years old. The patients were subjected to periodontal surgery using the modified Widman flap procedure. During the active phase of treatment and for the subsequent 6 months of healing, all 62 patients were subjected to professional tooth cleaning. Instruction in proper oral hygiene measures was repeated and scaling was carried out when indicated. Sample B consisted of 21 subjects treated for advanced periodontal disease in 1969. Six of these patients were between 26 and 29 years of age at the start of treatment and 15 were at least 60 years old. The criterion for acceptance for the study in 1969 was that the patient should have lost 50% or more of his/her periodontal tissues. Following an initial examination, all patients were subjected to scaling and root planing and surgical elimination of pathologically deepened pockets. After the termination of active treatment, the patients were placed in a maintenance care program which included recall appointments every 3–6 months. Once a year after the completion of active treatment, all patients in this sample were examined regarding probing depths and clinical attachment levels.

The findings from the present retrospective analyses failed to demonstrate that the age of patients with moderately advanced or advanced forms of periodontal tissue breakdown had an influence on the results of periodontal therapy. If anything, the younger patients appeared to heal with a higher frequency of shallow pockets and more gain of probing attachment than older patients.
A comparative study of effectiveness in plaque removal by Super Floss® and waxed dental floss
Authors: Wong C. H. , Wade A. Bryan
Published: December 2005

Abstract The effectiveness of Super Floss® and waxed dental floss as proximal surface cleansing agents was compared in 34 subjects. Each subject used I agent twice daily for 2 weeks followed by the other agent used with the same frequency and for the same period. The order in which the agents were used was selected at random. Plaque was stained by erythrosin, and a plaque index of Wolffe used. Super Floss® was found to be superior to waxed dental floss in removing proximal plaque, but neither was 100% effective. Some plaque was present in 49.9% of the proximal surfaces when Super Floss® had been used and on 54.7% when the waxed dental floss had been used. Both agents cleaned distal surfaces better than mesial surfaces, proximal surfaces of anterior teeth more effectively than those of posterior teeth, the coronal half of the proximal surfaces better than the apical half and the facial half more efficiently than the lingua] half. No differences were found between maxillary teeth and mandibular teeth. Subjects used more lengths of Super Floss® than of waxed dental floss, indicating its relative ‘brittleness’. However, the majority of subjects preferred Super Floss®, mainly because it was thicker and felt more abrasive.
Effect of nonsurgical periodontal therapy
Authors: Badersten Anita , Nilvéus Rolf , Egelberg Jan
Published: December 2005

Abstract. Incisors, cuspids and premolars in 33 patients with advanced chronic periodontitis were treated by plaque control and 1 single episode of supra‐ and subgingival debridement. The results were monitored by probing attachment level measurements for 6 sites of each tooth every 3rd month during a period of 24 months, A total of 1368 sites were observed. From these were selected 280 “non‐responding” sites showing 1.0 mm or more loss of probing attachment at 24 months compared to baseline. Scatter diagrams of the sequence of 9 probing attachment recordings obtained during the 24‐month study were produced for each of these 280 sites. Study of these scatter diagrams resulted in identification of 7 different patterns of probing attachment change over time. A linear pattern of gradual Joss of probing attachment throughout the 24‐month observation period was found for 73% of the non‐responding sites. Of the less frequently seen patterns, 3 approximated a linear course and 3 were non‐linear. Linear analysis of regression as a statistical method to determine attachment loss for individual sites seems to be suitable for sites with linear patterns and for sites approximating a linear pattern. The insensitivity of regression analysis in non‐linear patterns may be acceptable if a cautious analysis is warranted.
Healing following reimplantation of teeth subjected to root planing and citric acid treatment
Authors: Nyman Sture , Houston Frank , Sarhed Gun , Lindhe Jan , Karring Thorkild
Published: December 2005

Abstract. The aim of the present study was to examine the effect of citric acid treatment on periodontal healing around teeth which were extracted, root planed and then reimplanted. Maxillary incisors and mandibular incisors, premolars and molars of 5 monkeys were used. The teeth were divided into 3 experimental groups. In 1 group, the teeth were extracted and immediately reimplanted into their own sockets. In a 2nd group, the teeth were extracted, root planed to a level corresponding to 50–75% of the root length and then reimplanted. In the 3rd group, periodontal breakdown extending to 50‐75% of the root length was first induced by placing orthodontic elastic ligatures around the teeth. They were then extracted and root planed and transplanted into the sockets of the contralateral, periodontally healthy teeth which had just been extracted. Half the number of the teeth of groups 2 and 3 were treated with citric acid before reimplantation or transplantation. The animals were sacrificed after 6 months of healing. The jaws were removed and histological specimens prepared for microscopic examination.

With the exception of a limited coronal regrowth of new cementum in the apical part of the planed portion of a few roots, connective tissue attachment failed to reform on most root surfaces deprived of their periodontal ligament tissue. Healing was most frequently characterized by root resorption and ankylosis. These were the most predominant features of healing both on root surfaces which had been deprived of the ligament tissue by mechanical means or during a course of experimentally‐induced periodontal disease, and occurred in citric acid as well as non‐citric acid treated roots. The findings imply that the result of healing following tooth reimplantation or transplantation is determined by the type of cells that repopulate the wound area adjacent to the denuded root surface.
Significance of probing force for evaluation of healing following periodontal therapy
Authors: Chamberlain A. Durwin H. , Renvert Stefan , Garrett Steven , Nilveus Rolf , Egelberg Jan
Published: December 2005

Abstract. The present report compares pre‐ and postoperative probing pocket depths and probing attachment levels in deep pockets treated non‐surgically as well as surgically using probing forces at 0.25 N.0.50 N and 0.75 N. The results demonstrated that the recorded mean pre‐and postoperative probing depths were deeper with increasing probing force. In deep preoperative pockets, the difference amounted to as much as 2.0 mm comparing measurements at 0,25 N and 0.75 N. The use of 0.25 N for evaluation of therapy showed less mean pocket reduction and probing attachment gain than the use of 0.50 Nor 0.75 N. Selection of a higher probing force before therapy (i.e. 0.75 N land a lower force after therapy (i.e. 0.25 N) resulted in increased values for pocket reduction and probing attachment gain compared to use of the same probing force for both pre‐ and postoperative recordings. The bindings emphasize the significance of using a known and standardized probing force for evaluation of results following periodontal therapy.
Relationship between alignment conditions of teeth in anterior segments and dental health
Authors: Silness John , Roynstrand Torgeir
Published: December 2005

Abstract. The purpose of the study was to examine the association between alignment conditions of anterior teeth and dental health in 15–year‐old adolescents. The study group consisted of 74 females and 70 males with 6 anterior teeth in both jaws. The following parameters were assessed: plaque index (PII), gingival index (GI), probing depth (PD), space index (SpI), filled surfaces (FS), and the NONAS ‐ i.e., the number of non‐aligned proximal tooth surfaces in each jaw counted on model casts. Statistical examination of the data was performed using x2 tests of association and homogeneity and correlation coefficient analyses. In both sexes and both jaws, anterior tooth segments with none or few non‐aligned teeth had a more favourable periodontal state than segments with an increased number of non‐aligned teeth. Likewise, tooth segments with none or few non‐aligned teeth had a reduced frequency of proximal fillings compared to segments with an increased number of non‐aligned teeth. In males, the distribution of restorations in the anterior segment of the lower jaw was relatively homogeneous in the 3 groups.
Effect of implants on healing of experimental furcation defects in dogs
Authors: Klinge Björn , Nilveus Rolf , Bogle Gary , Badersten Anita , Egelberg Jan
Published: December 2005

Abstract. The present study was performed to find out whether implants placed around periodontally involved teeth during reconstructive surgery would support replaced flaps and prolong gingival coverage of the treated root surfaces facilitating new attachment.

Through‐and‐through furcation defects were made in the mandibular second, third, and fourth premolars of 10 beagle dogs. Bone was surgically removed from the furcation and from the circumference of each tooth to a level 3 to 4 mm apical to the cementoenamel junction. Steel wires were passed through the furcations and ligated to enhance plaque formation. At 6 weeks, the wires were removed. At 12 weeks, during reconstructive surgery, 4 dogs received implants of autogenous intraoral cancellous bone, 2 of autogenous iliac cancellous bone and marrow, 2 of Proplast®, and 2 of Avitene®. The results demonstrated that none of 12 teeth implanted with Avitene® or Proplast® showed new attachment. Only 2 of 6 teeth implanted with autogenous iliac bone showed new attachment, combined with extensive root resorption and ankylosis. Of 12 teeth implanted with autogenous intraroral bone, 6 showed new attachment. Our findings suggest that flap support by intraoral cancellous bone implants may facilitate new attachment. A more predictable technique, however, needs to be developed.
Experimental gingivitis in relation to susceptibility to periodontal disease II. Phase‐contrast microbiological features and some host‐response observations
Authors: Abbas F. , van der Velden U. , Moorer W. R. , Everts V. , Vroom Th. M. , Scholte G.
Published: December 2005

Abstract In the present investigation, a number of histological and immunohistochemical characteristics of periodontal tissues as well as the phase‐contrast microscopy of dental plaque were studied after experimentally‐induced gingival inflammation in relation to susceptibility to periodontal disease. The study included a younger (mean age 34.1 years) and an older age group (mean age 48 years) with a reduced but healthy periodontium. Both age groups had the same amount of loss of attachment which may suggest that they had different degrees of susceptibility to periodontal disease. At the start of the experiment, each patient was instructed to abstain from oral hygiene in one quadrant of the mouth for a period of 18 days. At the end of the 18‐day period, supra‐gingival plaque and gingival tissue samples were taken. As determined by phase‐contrast microscopy, the plaque samples of both age groups contained relatively high proportions of spirochetes. This may indicate that the patients are at risk for recurrence of periodontal breakdown. The general histopathologic picture of the gingival tissue samples of both age groups was similar to the so‐called ‘early lesion’. However, IgA‐producing plasma cells were found in most tissue samples of both age groups. The first part of this study showed that the younger, in comparison to the older, patients developed inflammation in terms of bleeding on probing more rapidly. These clinical results cannot be explained by the host‐parasite parameters investigated in the present study.
Human gingival attachment responses to subgingival crown placement Marginal remodelling
Authors: Tarnow D. , Stahl S. S. , Magner A. , Zamzok J.
Published: December 2005

Abstract 13 teeth in block were extracted from 2 patients. Their facial periodontal condition was essentially within normal clinical limits. Temporary crowns covering the bevel were placed below the base of the crevice 1 to 8 weeks prior to extraction. At time of extraction, all blocks were decalcified, the temporary crown dissolved, and the blocks prepared for histologic examinations using bucco‐lingual cut, step serial sections.

Histologic data revealed reformation of a new supracrestal attachment unit within 1 week following crown placement. The reformation of the gingival unit consisted of marginal recession with apical and lateral migration of the junctional epithelium to the level of remaining cementum inserted fibers. With gingival recession and migration of junctional epithelium, resorption of crestal portions of the facial plate occurred. However, periodontal fibers anchored into cementum opposite the resorbed bone were not lysed. Rather, the attached fibrillar ends appeared to interdigitate with fibers from the corium of the facial gingiva at this site, thereby forming a more apically located crestal attachment. This response may be one mechanism of reformation of the gingival attachment unit taking place following mechanical and/or surgical injury to this site and is completed often, within 2 weeks after injury.
Bleeding on probing. A predictor for the progression of periodontal disease?
Authors: Lang Niklaus P. , Joss Andreas , Orsanic Thomas , Gusberti Francesco A. , Siegrist Beatrice E.
Published: December 2005

Abstract Bleeding on probing (BOP) is a widely used criterion to diagnose gingival inflammation. The purpose of the present retrospective study was to evaluate its prognostic value in identifying sites at risk for periodontal breakdown during the maintenance phase of periodontal therapy. 55 patients who had been treated for advanced periodontitis participated in a recall system for at least 4 years, at regular intervals of 3–5 months. At the start of every appointment, BOP to the bottom of the pocket was registered at 4 sites of every tooth. A random selection of 1054 pockets was made and subdivided into 5 categories according to the incidence of BOP during the last 4 recall appointments. All pockets with a BOP incidence of 4/4 and 3/4 were selected, while only interproximal sites with a BOP incidence of 2/4, 1/4 and 0/4 were chosen. Subsequently, these categories were grouped according to whether or not the attachment level had been maintained from the time prior to the last 4 recall visits. 2 mm was defined as loss of clinical attachment. The results indicated that pockets with a probing depth of 5 mm had a significantly higher incidence of BOP. Patients with 16% or more BOP sites had a higher chance of loosing attachment. Pockets with an incidence of BOP of 4/4 had a 30% chance of loosing attachment. This chance decreased to 14% with BOP of 3/4, 6% with BOP of 2/4, 3% with BOP of 1/4 and 1.5% with BOP of 0/4. Sensitivity and predictability calculations revealed that BOP is a limited but yet useful prognostic indicator in clinical diagnosis for patients in periodontal maintenance phase.
New attachment formation in the human periodontium by guided tissue regeneration Case reports
Authors: Gottlow Jan , Nyman Sture , Lindhe Jan , Karring Thorkiid , Wennström Jan
Published: December 2005

Abstract The aim of the present study was to evaluate whether a regenerative surgical procedure, based on guided tissue regeneration, could predictably result in the formation of a new attachment in human teeth. The material included 12 teeth in 10 patients with advanced periodontal disease. Following flap elevation, scaling, root planing and removal of granulation tissue, a teflon membrane was placed over the denuded root surface in such a way that the epithelium and the gingival connective tissue were prevented from reaching contact with the root during healing. The flap was replaced on the outer surface of the membrane and secured with interdental sutures. This design of wound preparation gives preference to the cells originating from the periodontal ligment (PDL‐cells) to repopulate the wound area adjacent to the root. Histologic analysis of the result of treatment was made in 5 of the 12 teeth scheduled for extraction. In the remaining 7 teeth, the result was evaluated using clinical measurements. The result of healing disclosed that in all teeth treated, substantial amounts of new attachment had formed. This suggests that predictable restitution of the attachment apparatus can be accomplished by using a method of treatment which is based on the principle of guided tissue regeneration.
Frequency distributions of periodontal attachment loss
Authors: Socransky S. S. , Haffajee A. D.
Published: December 2005

Abstract 3 patterns of attachment loss were described based on curve fitting the frequency distributions of baseline attachment level measurements of 61 subjects with destructive periodontal diseases. The frequency distributions of attachment level measurements of 30 group I individuals were satisfactorily fit by tachment level measurements of 30 group I individuals were saticfactorily fit by the sum of 2 normal curves, while those of 14 group II individuals were fit by the sum of 3 normal curves. Frequency distributions of 17 group III subjects were fit by a single normal curve. A computer algorithm was used to simulate attachment level loss frequency distributions by varying the “burst size” at active lesions and by imposing “immunity” for varying periods of time on sites which had been attacked.

Frequency distributions of group I subjects could be simulated using burst sizes between 0.3 and 3.4 mm. These subjects could be divided into 2 groups: 14 subjects with localized minimal attachment loss required an average burst size of < 1 mm, while 16 subjects with more destruction at diseased sites required an average burst size of > 1 mm to simulate their frequency distributions. Frequency distributions of 16 of 17 group III subjects could be simulated using an average burst size of < 1 mm. However, the frequency distributions could also be simulated using larger burst sizes with the imposition of “immunity” for substantial periods of time at the attacked sites.

The frequency distributions of group II subjects were more difficult to simulate. A better simulation could be obtained using a large average burst size (> 1 mm) than a small burst size. However, the most satisfactory fit was obtained by the superimposition of a large burst pattern of attack on a distribution created using small bursts. The optimal average sizes of the small and large bursts varied from subject to subject as did the mean attachment level at which the burst size was changed. The simulations suggest that the different frequency distributions result from different modes of progression of attachment loss with burst size and possibly local “immunity” playing major rôles.
The autologous mixed lymphocyte reaction (AMLR) as a possible indicator of immunoregulation in chronic inflammatory periodontal disease
Authors: Seymour J. , Boyatzis S. , Powell R. N.
Published: December 2005

Abstract Immunoregulatory control at both a local and systemic level is likely to be an important factor in the control of chronic inflammatory periodontal disease, explaining, at least in part, the individual variations between patients as well as the cyclical nature of the disease process. The autologous mixed lymphocyte reaction (AMLR), which is due to the stimulation of T cells by autologous HLA‐DR positive non‐T cells in the absence of specific antigen, is thought to be an in vitro correlate of immunoregulation. It is possible therefore, that the AMLR may detect systemic immunoregulatory phenomena in chronic inflammatory periodontal disease and that aberrations in the AMLR may be a manifestation of the disease and in turn reflect disease activity. Recent evidence does in fact suggest that the peripheral blood AMLR may identify particular disease groups, provided age and time of peak responsiveness are taken into account and hence may have an epidemiological application. It remains to be determined, however, that when used in a longitudinal fashion, the AMLR does reflect individual disease activity. These results are reviewed and areas of future research discussed.
Serum antibody levels to 4 periodontal pathogens remain unaltered after mechanical therapy of juvenile periodontitis
Authors: Sandholm Leena , Tolo Kare
Published: December 2005

Abstract Serum antibody titers to Actinobacillus actinomycetemcomitans (A.a.) Y4, Bacteroides gingivalis, Capnocytophaga ochracea and Eubacterium saburreum were determined with an enzyme immunoassay in 12 patients with juvenile periodontitis (JP) at the beginning of treatment and 16 to 32 months later after clinically successful mechanical therapy without antibiotics. The values were compared to corresponding data obtained from 26 age‐ and sex‐matched individuals with a healthy periodontium. 6 JP patients had significantly increased levels of IgG and IgA antibodies to A.a. and 2 patients had increased IgG and IgA antibodies to C.ochracea. About 75% of the JP patients had a level of IgG antibody to B.gingivalis and E.saburreum which was more than one SD lower than the mean of the healthy controls, and in the IgA class 80–100% had such decreased levels of antibodies to these bacteria. In the IgM class, the JP patients by and large had normal levels of antibodies to the 4 bacteria. After treatment, antibodies to A.a. had decreased in only 3 patients, but the levels were still significantly higher than in healthy controls. Minimal alterations were observed in the levels of antibodies to B.gingivalis, C.ochracea and E.saburreum after treatment.
Relationship of gingival thickness and bleeding to loss of probing attachment in shallow sites following nonsurgical periodontal therapy
Authors: Claffey Noel , Shanley Derry
Published: December 2005

Abstract Periodontal sites of shallow initial probing depth often seem to lose probing attachment following various types of periodontal therapy, including non‐surgical therapy. The susceptibility to this treatment‐associated probing attachment loss may conceivably be related to gingival architecture as well as to the inflammatory status of the tissues. This study was designed to study the relationship of buccolingual gingival thickness and bleeding on probing in shallow buccal sites ( 3.5 mm probing depth) to loss of probing attachment following nonsurgical therapy. 3 months following treatment consisting of oral hygiene instruction and supra‐ and subgingival debridement, thin ( 1.5 mm), initially non‐bleeding sites displayed a mean loss of probing attachment of 0.3 mm. Thick ( 2.0 mm), non‐bleeding sites displayed a less noticable mean loss of probing attachment, whereas bleeding sites of both categories of gingival thickness showed a tendency towards gains in probing attachment levels. It may be concluded that the mean loss in probing attachment levels, commonly seen for shallow sites post‐therapy, may be primarily due to the changes in shallow, thin healthy areas.
Clinical effects on chronic periodontitis of a simplified system of oral hygiene including subgingival pulsated jet irrigation with chlorhexidine
Authors: Watts E. A. , Newman H. N.
Published: December 2005

Abstract The aim of this study was to investigate the effects of a simplified system of oral hygiene, comprising Bass brushing, scaling, root planing and subgingival irrigation using a pulsated monojet oral irrigator, in patients with chronic periodontitis.

After initial assessment, patients received scaling, root planing and instruction in Bass brushing and in use of a pulsated jet oral irrigator (Water Pik + Imax attachment) to irrigate subgingivally. 11 patients with 262 approximal periodontal pockets used 0.02% chlorhexidine (CH), or a placebo as the irrigating solution once daily for 28 days. Plaque index (P1I), sulcus bleeding index (SBI), and probing pocket depth (PPD) were assessed on days 0, 28, 56 and 84. Within procedure comparisons for all groups showed that the regime was highly effective in reducing P1I, SBI and PPD, improvements being maintained at least until day 84. Between procedure comparisons showed that benefits were improved only marginally by the use of 0.02% CH as the irrigation fluid. The patients found the procedure pleasant and neither injuries nor staining were noted during the study.

It was concluded that this simplified oral hygiene system was effective in reducing periodontal inflammation and pocket depth, although no significant added benefit with 0.02% CH was apparent. The technique may be useful in patients who cannot achieve high levels of routine mechanical oral hygiene, particularly interdentally. The effects of using higher concentrations of chlorhexidine should be investigated.
Effects of folate mouthwash on experimental gingivitis in man
Authors: Pack Angela R. C.
Published: December 2005

Abstract Although the experimental gingivitis model has been used extensively since 1965, some doubts exist concerning the nature of the tissue response in this model. Accordingly, the present study was designed to determine whether or not experimental gingivitis responded to 0.1% folate mouthwash (MW) in a similar manner to that already reported for established gingivitis. 20 male dental students took part in a double blind cross‐over study which involved two 3‐week experimental periods with random allocation to folate or placebo MW. The experimental site was the lower anterior area and 24 points of gingival examination were made at baseline and weeks 1, 2 and 3. Inflammation was assessed by presence or absence of colour change, and bleeding being slight, profuse or absent when gingivae were stroked with a blunt probe. A plaque sample was evaluated using dark field microscopy, and dry weight of accumulated plaque was measured at the end of each experimental period. Folate MW did not appear to have any statistically significant effects on accumulated plaque, or clinical signs of experimental gingivitis in this study. The different response of experimental gingivitis to folate MW, compared with the response of established gingivitis already reported, further suggests that experimental gingivitis may not represent an authentic replica of the cellular and immunological responses occurring in established gingivitis.
Detection and serotyping of Actinobacillus actinomycetemcomitans isolates on nitrocellulose paper blots with monoclonal antibodies
Authors: McArthur William P. , Stroup Suzanne , Wilson Lisa
Published: December 2005

Abstract A combination of blotting of bacterial colonies on nitrocellulose paper discs and immunoenzymatic detection of bound antigens with specific monoclonal antibodies was used to detect and serotype Actinobacillus actinomycetemcomitans directly off the initial agar culture dish. The A. actinomycetemcomitans antigens, representative of specific colonies, were identified immunoenzymatically using monoclonal antibody specific for a species‐specific antigen. The serotype of the bacteria in colonies was identified by dividing the blotting paper into sections and immunoenzymatically identifying the serotype antigens with serotype‐specific monoclonal antibodies. This procedure provides for simple, rapid, sensitive and accurate identification and characterization of A. actinomycetemcomitans isolates from the initial isolation agar plates.
Gingival abrasion and plaque removal with manual versus electric toothbrushing
Authors: Niemi Maija‐Liisa , Ainamo Jukka , Etemadzadeh Hossein
Published: December 2005

Abstract A clinical trial was designed to test the relative numbers of gingival lesions caused during standardized brushing of the teeth of 22 volunteer dental nurse students with a manual soft multitufted, a manual soft V‐shaped, and an electric toothbrush. First, the left or the right side of the jaws of each subject was brushed by a dental hygienist using the manual V‐shaped or the electric brush, and the other side using the manual multitufted brush. At the 2nd brushing 1 week later, the same hygienist used the multitufted brush for brushing the side contralateral to the one in which it was used the 1st week and the V‐shaped manual brush instead of the electric and vice versa. After each brushing, the number of new gingival lesions was recorded and the cleansing effect evaluated by assessment of the amount of remaining plaque. This examiner was unaware of the type of brush used. The V‐shaped manual toothbrush was found to have caused more gingival abrasion than the electric toothbrush (P < 0.005) and a similar difference was found between the multitufted manual and the electric toothbrush (P < 0.05). There was no clinically significant difference between the plaque removing effects of the 3 brushes tested.
Initial attachment of fibroblast‐like cells to periodontally‐diseased root surfaces in vitro
Authors: Fardal Oystein , Aubin Jane E. , Lowenberg Beate F. , Freeman Eric
Published: December 2005

Abstract The precise factors mediating both initial cell attachment and longer term connective tissue reattachment after tissue destruction due to periodontal disease are not known. An in vitro model was used to assess initial attachment of fibroblast‐like cells to periodontally‐diseased root surfaces. Root fragments were obtained from freshly extracted teeth from 6 different patients. Individual roots were prepared such that a comparison could be made of initial attachment to non‐instrumented diseased root surface, curetted diseased root surface and the non‐diseased, non‐instrumented portion of the same root. The amount of hard tissue removed by instrumentation was quantitated and kept constant between 0.9–1.0 mm. The unsterilized fragments were incubated with human gingival fibro‐blasts (HGF) for 1 h at 37°, after which the roots were first washed to remove non‐adherent cells and then photographed. The number of attached cells per unit area was quantitated from the photographs using a grid system. No significant differences could be detected between the numbers of cells attached to the 3 types of root surfaces studied on the individual roots or between any of the roots studied. Thus, initial attachment of HGF to diseased root surfaces is not inhibited by the presence of plaque or endotoxins.
Serum IgA and IgG antibodies to Treponema vincentii and Treponema denticola in adult periodontitis, juvenile periodontitis and periodontally healthy subjects
Authors: Lai C.‐H. , Listgarten M. A. , Evian C. I. , Dougherty P.
Published: December 2005

Abstract 13 patients with untreated adult periodontitis (AP) were compared to 8 subjects free of periodontal disease (H) with respect to plaque index (P1I), gingival index (GI), probing depth (PD) and differential counts of subgingival bacterial morphotypes from a pooled sample of 6 surfaces with the greatest probing depth. Serum antibody levels to T. vincentii and T. denticola strains were also determined in these subjects as well as in the sera from 5 subjects with localized juvenile periodontitis (UP). Subjects with AP had significantly elevated proportions of spirochetes and motile rods and lower proportions of coccoid cells than H subjects. They also exhibited significantly higher P1I and GI scores and greater probing depths. Antibody levels were normalized against a standard serum and expressed as ELISA units (EU). IgA and IgG antibody levels to all tested spirochete strains were significantly elevated in AP subjects as compared to subjects in group H or subjects with LJP. No significant differences in antibody liters were detectable between the H and LJP groups with respect to any of the tested strains. No significant correlation could be demonstrated between serum antibody titers to any of the oral spirochete strains tested and the proportions of oral spirochetes determined microscopically.