bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental transient bacteraemias in human subjects with clinically healthy gingivae
Authors: Silver John G. , Martin Alexis W. , McBride Barry C.
Published: December 2005

Abstract. Thirty‐six subjects with no evidence of clinical gingival inflammation underwent a standardized toothbrushing procedure. Blood specimens, obtained from a vein in the antecubital fossa during the last 30 seconds of brushing, were cultured under aerobic and stringent anaerobic conditions. Three subjects exhibited detectable bacteraemias, Propionibacterium sp. being isolated from two of the subjects, while Aclinomyces sp, Streptococcus sanguis and Streptococcus mitis were isolated from the third. The implications of these results are discussed.
Comparison of results following three modalities of periodontal therapy related to tooth type and initial pocket depth
Authors: Knowles J. , Burgett F. , Morison E. , Nisle R. , Ramfjord S.
Published: December 2005

Abstract Results following three modalities of periodontal therapy (subgingival curettage, modified Widman flap surgery, and pocket elimination or reduction surgery) in 78 patients over 8 years were compared for variations in pocket depth and clinical attachment level related to tooth types (maxillary molars, mandibular molars, maxillary biscupids, mandibular biscupids, maxillary anterior teeth, mandibular anterior teeth). The analysis was based on a classification of three severity groups according to initial crevice or pocket depth (Class I, 1–3 mm; Class II, 4–6 mm; and Class III, 7–12 mm) and with patient's means of measurements being the experimental units for the statistical analysis.

Reduction in pocket depth and gain of clinical attachment for pockets 4 mm or deeper occurred following all three methods of treatment, and was well sustained over 8 years. No one modality of treatment was consistently superior to any of the other two with regards to sustained reduction of pocket depth and gain of clinical attachment.

Surgical pocket elimination or reduction did not enhance the prognosis for maintenance of periodontal support in either moderate or advanced periodontal lesions anywhere in the mouth compared with more conservative modalities of treatment.

In spite of prophylaxis and instruction in home care every 3 months, there was a slight progressive loss of attachment over time in areas of shallow crevices (1–3 mm).
Adhesion of periodontal dressings to enamel in vitro
Authors: Watts Trevor L. P. , Combe Edward C.
Published: December 2005

Abstract Adhesion to enamel is an important aspect of periodontal dressing retention. Details of tensile and shear bond strengths are presented for three dressing materials and a positive polycarboxylate control, and the data are discussed with regard to optimum levels of retention. A level of 2 MN/m2 is suggested for shear bond strength, and 1 MN/m2 for tensile bond strength, under the test conditions employed.
Healing following implantation of periodontitis affected roots into bone tissue
Authors: Karring Thorkild , Nyman Store , Lindhe Jan
Published: December 2005

Abstract The aim of the present experiment was to study whether new connective tissue attachment can occur to root surfaces which have been exposed to the oral environment and subsequently implanted into bone tissue. Twelve teeth in three beagle dogs were subjected to progressive periodontal breakdown to half the root length by placing cotton floss ligatures around the neck of the teeth. Following crown resection and root hemisection, the teeth were root filled and the roots thoroughly scaled and planed. Each root was extracted and implanted into bone cavities prepared in edentolous areas of the jaws in such a way that epithelial migration into the wound and bacterial infection were prevented during healing. Root implantation and sacrifice of the animals were scheduled to allow for observation periods of 1, 2 and 3 months. The results demonstrated that new connective tissue attachment did not occur to root surfaces which had been exposed to the oral environment, but healing was characterized by repair phenomena, i. e. mainly root resorption and ankylosis. In those areas of the roots where periodontal ligament tissue was preserved following tooth extraction, a functionally oriented attachment apparatus was reformed. The results indicate that in addition to apical migration of junctional epithelium and regrowth of subgingival plaque, the type of cells which repopulate the wound area may jeopardize new connective tissue attachment.
Influence of overhanging posterior tooth restorations on alveolar bone height in adults
Authors: Hakkarainen Kristiina , Ainamo Jukka
Published: December 2005

Abstract The aim of this radiographic investigation was to compare the approximal bone height adjacent to class II amalgam restorations with and without overhangs to the bone height adjacent to homologue intact tooth surfaces, and to determine the possible effect of age and sex on the relative amount of such bone resorption. The x‐rays of 43 persons aged 27–45 years and 42 persons aged 46–64 years were examined. In the total material the average amount of bone loss increased with age and was 0.34 mm greater in men than in women. About 50 % of all posterior tooth restorations had an overhang. A comparison between the mean heights of approximal bone adjacent to sufaces with an overhang and homologue intact surfaces showed a statistically significant difference. When equal comparisons were made separately in the younger and the older age groups, only the older group showed a similar difference at a statistically almost significant level. The effect of overhanging restorations thus seemed to be accentuated with age. When men and women were studied separately, only men showed statistically significant differences between the age groups. The investigation confirms earlier results that overhanging posterior restorations are associated with excessive marginal approximal bone loss.
Plaque removal by various triangular toothpicks
Authors: Bergenholtz Axel , Bjorne Assar , Glantz Per‐Olof , Vikström Bert
Published: December 2005

Abstract Two intraindividual studies were performed on 35 persons treated for periodontal disease to investigate the plaque preventing effect of five different types of triangular toothpicks: Stim‐U‐Dent® (Balsa), Jordan® (Birch), Te‐Pe® (Lime), Sanodent® (Birch) and Alfa® (a polymeric one) and four toothpicks of which three were wooden of the same shape and one was polymeric with a similar shape: Birch, Lime, Limba (Jordan A/S), and polymer (Fixident). Only teeth in contact with neighboring ones and with open interdental spaces were included in the study. The plaque‐removing ability of the toothpicks was registered by estimating the amount of plaque accumulation at the end of each experimental period (2 weeks) according to a Plaque Index (Silness & Löe 1964) modified for plaque registration on 10 surfaces around each tooth.

In a laboratory study, relevant properties of the toothpick material (modulous of elasticity, surface roughness, water absorbing capacity, surface hardness) were investigated and compared to the plaque preventing effect of the different triangular toothpicks.

Using a questionnaire, the test person's opinions on the surfaces, sizes, forms and rigidities of the toothpicks also were examined.

Minor differences were observed between the plaque‐removing ability of the different triangular toothpicks. No clear relations were observed between any of the properties of the toothpick materials, however, the surface hardness as well as the strength values of the toothpick materials seemed to be of importance.

The conclusions of the present studies are that the plaque‐removing ability of a toothpick seems to be more dependent on the shape of the toothpick than on existing minor differences among the materials used for their manufacturing. Low surface hardness and high strength values seem to be of importance for interdental cleaning.
The role of visual feedback by a disclosing agent in plaque control
Authors: Tan A. E. S. , Wade A. Bryan
Published: December 2005

Abstract The common prescription of disclosing agents for home use assumes a relationship between visual feedback from stained plaque and subsequent oral hygiene behaviour. A study of double crossover design showed that there was no significant difference in the improvement in plaque control between the group which received only individual oral hygiene education and another group which had the same oral hygiene education supplemented by the home use of a disclosing agent for 2 weeks. On receiving oral hygiene reinforcement and discontinuing use of the disclosing agent, there was a further significant improvement in plaque control after another 2 weeks. This again suggests that visual feedback from the disclosing agent did not play a critical role in patient motivation. It appears that oral hygiene education is still fundamental to the whole concept of prevention. The prescription of a disclosing agent for home use should not be considered mandatory. Thorough and repeated oral hygiene education seems to be the most important feature in patient motivation.
Bruxism and trauma from occlusion
Authors: Budtz‐Jørgensen Ejvind
Published: December 2005

Abstract The present study describes an experimental approach for inducing bruxism and trauma from occlusion in animals. Gold occlusal cap splints overlaying the maxillary pre‐molar and molar teeth were inserted in eight Macaca irus monkeys. The cap splints were designed to raise the vertical dimension of occlusion by 3–4 mm and were adjusted to a balanced occlusion with the mandible in an unstrained retruded position. The splint on the right side (test side) was given a tight occlusion with the opposing mandibular teeth, whereas the splint on the left side (reference side) had only small occlusal contact areas. Before insertion of the splints, the monkeys had slight gingivitis but no alveolar bone loss. The cap splints were in situ for 4 weeks. During this period the monkeys showed distinct signs of bruxism. The mandibular teeth on the test side showed increased mobility and there was radiographic evidence of breakdown of marginal and interradicular alveolar bone. Mean GI increased significantly on the test side and in two animals gingival abscesses developed. Deep intrabony pockets persisted adjacent to these teeth. Only slight gingival and radio‐graphic changes were seen adjacent to the teeth on the control side. From the present experimental study there was no overall clinical or histological evidence that bruxism had caused a progression of gingivitis to destructive, chronic marginal periodontitis.
Periodontal probing: What does it mean?
Authors: Listgarten M. A.
Published: December 2005

Abstract The periodontal probe has been and continues to be used as an important diagnostic instrument by the dental profession. The measurements recorded with the probe have generally been considered to represent a reasonably accurate estimate of sulcus or pocket depth. Recent reports on the histopathology of the periodontal lesion and the histological features of a healing lesion, together with histological studies on the relationship of the probe to periodontal tissues, have shed some new light on periodontal probing.

It is now apparent that probing depth measured from the gingival margin seldom corresponds to sulcus or pocket depth. The discrepancy is least in the absence of inflammatory changes and increases with increasing degrees of inflammation. In the presence of periodontitis the probe tip passes through the inflamed tissues to stop at the level of the most coronal intact dento‐gingival fibers, approximately 0.3–0.5 mm apical to the apical termination of the junctional epithelium. Decreased probing depth measurements following periodontal therapy may be due in part to decreased penetrability of the gingival tissues by the probe. Following treatment aimed at obtaining new attachment in periodontal defects, wider variations may occur between the location of the probe tip and the most coronal dento‐gingival fibers than in the case of untreated sites. This is due in part to the formation of a so‐called “long” junctional epithelium. In the absence of inflammation this epithelium may not be penetrable during ordinary probing, but could account for a rapid increase in probing depth measurements when inflammatory changes allow the probe to traverse the epithelium and/or the adjacent infiltrated connective tissue.

In view of the difficulty inherent in relating periodontal probing measurements to actual sulcus or pocket depth, the interpretation of periodontal probing in the practice of periodontics may need reappraisal.
Short‐term effects of initial, nonsurgical periodontal treatment (hygienic phase)
Authors: Morrison E. C. , Ramfjord S. P. , Hill R. W.
Published: December 2005

Abstract Longitudinal studies have reported the effect of various modalities of periodontal surgery on pocket depth and attachment levels related to pretreatment measurements. However, possible changes in these measurements as a result of scaling, oral hygiene improvements and occlusal adjustment during the hygienic phase were not considered. The purpose of the present study was to examine the short‐term effect of treatment of the hygienic phase in 90 patients with some pockets extending 4 mm or more apically to the CEJ. Pretreatment pocket depths and attachment levels related to the CEJ were measured by a thin probe in five sites at all 2,355 teeth in the sample. Scaling, root planing, instruction in oral hygiene and occlusal adjustment were completed during four to six sessions for each patient.

Four weeks after completion of the hygienic phase, all variables were recorded. Mean measurements for pocket depths 1–3 mm, 4–6 mm. and ≥ 7 mm prior to treatment were compared to their posttreatment scores. Pocket depth decreased significantly for pockets extending 4 mm or more apically to the FGM. For pockets 4–6 mm there was a mean difference in pocket depth of 0.%± 0.47 mm (P < .0001) between pretreatment and post‐treatment observations. For pockets 7 mm or greater the mean difference was 2.22 ± 1.35 mm (P < .0001). Reduction in depth of pocket and improvement in attachment levels were related to the initial level of severity. Pocket reduction was in part due to the improvement in attachment levels. This study has demonstrated that the clinical severity of periodontitis is reduced significantly 1 month following the hygienic phase of periodontal therapy, and that need for surgical pocket treatment cannot be assessed properly until completion of the hygienic phase of treatment.
Histometric evaluation of periodontal surgery I. The modified Widman flap procedure
Authors: Caton Jack , Nyman Sture
Published: December 2005

Abstract The present investigation was performed in the Rhesus monkey to determine the effect of the modified Widman flap procedure on the level of the connective tissue attachment and supporting alveolar bone. Two adult male Rhesus monkeys were used. Eighteen contralateral pairs of periodontal pockets were produced in a standardized manner. Surgical treatment of the pockets was performed around experimental teeth and the contra‐lateral teeth were used as the unoperated controls. Twelve months following treatment the animals were sacrificed and histological sections obtained. Using the cemento‐enamel junction (CEJ) as a fixed reference point, linear measurements along the. root surface were made to the most apical cells of the junctional epithelium (JE), to the crest of the inter‐proximal alveolar bone (CR), and to the apical extent of angular bony defects (AAD). These measurements from operated and unoperated pockets were then compared.

The data revealed that treatment of periodontal pockets using the modified Widman flap procedure produced no gain in connective tissue attachment and no increase in crestal bone height. In angular bony defects a certain degree “bone fill” was noted. This bone repair was never accompanied by new connective tissue attachment.
Update on plaque and periodontal disease*
Authors: Newman Hubert N.
Published: December 2005

Abstract The relationship between plaque and inflammatory periodontal disease is complex, and requires extensive and often abstruse research. One unfortunate consequence is that much relevant information concerning this relationship is not readily available to those most concerned with the prevention and treatment of inflammatory periodontal disease. The present review is concerned with some relevant developments in recent plaque research.
Access to subgingival plaque by disclosing agents using mouthrinsing and direct irrigation
Authors: Pitcher G. R. , Newman H. N. , Strahan J. D.
Published: December 2005

Abstract Teeth destined for extraction and exhibiting periodontal pockets had reference grooves cut on the proximal surfaces at the level of the gingival margin. A disclosing agent was then applied either as a mouthrinse or by direct irrigation at the entrance of the pocket. After extraction, the extent of apical penetration of the solution was measured from the reference point. Subsequently, the tooth was stained enabling similar measurements from the reference point to the level of the apical plaque border and the coronal level of the residual periodontal ligament.

Analysis of these measurements indicated that neither mouthrinsing nor direct irrigation routinely achieved penetration of the solution to the apical plaque border. While mouthrinsing failed to achieve any significant penetration of pockets, the direct irrigation technique was partially effective.

It was concluded that direct irrigation offers promise as a mode of application of chemical agents to subgingival plaque.
Effects of a zinc citrate mouthwash on dental plaque and salivary bacteria
Authors: Addy M. , Richards J. , Williams G.
Published: December 2005

Abstract A double‐blind crossover trial was carried out to assess the effect of zinc citrate on plaque accumulation in vivo and to measure total salivary aerobes and anaerobes both during the trial and throughout the day following a single rinse. When compared to the placebo, zinc citrate significantly reduced the plaque accumulation in the subjects. However, the mean reduction was small and of qestionable clinical importance. A progressive increase in plaque was observed throughout both active and placebo 7–day rinsing periods. There was no significant reduction in salivary bacterial counts either during the crossover study or during the day following a single rinse with zinc citrate.
Influence of eating frequency upon plaque formation and periodontal bone loss
Authors: Savoff K. , Rateitschak K. H.
Published: December 2005

Abstract The normal oral flora of weanling Osborne‐Mendel rats was suppressed with penicillin, then bone resorption was induced in the test group by inoculation with Actinomyces viscosus Ny 1. In the control group the oral flora was suppressed with erythromycin. A programmable feeding machine forced the rats into extremely varied eating frequencies.

Rats which ate less frequently than normal exhibited significantly less bone loss. Frequent eating was correlated with elevated plaque accumulation.

AVIS‐inoculated animals exhibited significantly (P < 0.001) more plaque than antibiotic‐treated rats. Both inoculated as well as non‐inoculated animals exhibited significantly more plaque (P < 0.001) when fed 28 times per day, in comparison to all other feeding schedules.

AVIS‐inoculated animals exhibited significantly (P < 0.001) more bone loss than the antibiotic‐treated rats. Inoculated animals which were fed only seven times per day exhibited significantly (P < 0.05) less bone loss than similarly inoculated animals fed more frequently. Bone loss in the antibiotic‐treated animals was independent of feeding frequency. Among the other feeding frequencies (14 and 28 x/day, and ad libitum), there were no significant differences either in AVIS‐inoculated or in antibiotic‐treated animals.
Influence of free gingival grafts on the health of the marginal gingiva
Authors: de Trey Eric , Bernimoulin Jean‐Pierre
Published: December 2005

Abstract In order to evaluate the effect of increasing the width of inadequate attached gingiva on the health of the marginal gingiva, 12 free gingival grafts were performed on 12 patients with less than 1.0 mm of attached gingiva on homologous contralateral pairs of mandibular teeth.

A baseline examination, which included measurements of plaque, gingival exudate, sulcus bleeding, sulcus probing depth and width of attached gingiva, was done before surgery. One week after surgery, plaque was eliminated mechanically on the test and control sides. All measurements were repeated 7 and 14 weeks after surgery. During the week following the first postsurgical examination, individual oral hygiene instruction was given until the patient could show plaque‐free test and control sites.

The width of the attached gingiva increased significantly on the side where the grafting was performed (test side). The only other significant changes observed during the experiment were a decrease of the mid‐buccal plaque index on the test side during the first 7 weeks following surgery and a decrease of the buccoproximal plaque index on the test and control sides during the total experimental period (14 weeks). None of the other clinical parameters measured showed significant differences when test and control sites were compared or when the same sites were compared longitudinally.
Effects of topical and systemic folic acid supplementation on gingivitis in pregnancy
Authors: Pack Angela R. C. , Thomson Maria E.
Published: December 2005

Abstract A double‐blind study evaluated the effects of systemic and topical folate on gingival inflammation during the fourth and eighth months of pregnancy. Thirty women were randomly divided into three groups. Group A received placebo mouthwash and tablets; Group B: placebo mouthwash and 5 mg folate tablets; Group C: folate mouthwash and placebo tablets. Supplementation lasted for 14 days during months 4 and 8. Subjects took one tablet daily and rinsed twice daily for 1 min with the mouthwash. At the start and finish of each 14‐day period, fasting serum and red cell folate levels were estimated and oral status assessed by a plaque index (PII), a gingival index (GI), and gingival exudate flow meter (GEF). Subjects completed 1‐week diet sheets which were analysed for dietary folate. All groups were similar in each parameter at the start. Correlation was demonstrated between GI and P1I, and between GI and GEF. GI tended to increase throughout pregnancy in all groups except Group C, when in the eighth month there was a highly significant improvement (0.001 < P < 0.01) despite no significant change in PH. Although dietary intake of folate was significantly higher during the eighth month in Group C as compared with Groups A and B, (0.001 < P < 0.01), the folate mouthwash produced highly significant improvement in gingival health in pregnancy.
The influence of probing force on the reproducibility of pocket depth measurements
Authors: van der Velden U. , de Vries J. H.
Published: December 2005

Abstract Seven patients were selected on the basis of having about 50% loss of alveolar bone support in some part of the mouth. All patients received initial treatment consisting of plaque control and removal of subgingival deposits. In these patients, 102 interproximal pockets were measured by three different examiners, both with the pressure probe and a Merritt – B probe (Hu – Friedy®). No specific instructions were given as to how the interproximal regions should be probed. Results indicate that a standardized probing force of 0.75 N does not lead to more reproducible pocket depth measurements.
Influence of probing force on the reproducibility of bleeding tendency measurements
Authors: van der Velden U.
Published: December 2005

Abstract Three groups of seven patients were selected on the basis of about 50 % loss of alveolar bone support in some part of the mouth. All patients received initial treatment consisting of plaque control and removal of subgingival deposits. In the first group of patients 95 interproximal pockets were measured three times by one examiner using the pressure probe employing a constant probing force of 0.75 N. Bleeding or lack of bleeding from a pocket was sought for up to 30 seconds after probing. Results show that a time interval of 15 minutes between reexamination procedures is enough to prevent an increased bleeding index caused by repeated probing. In the second group of patients, 98 interproximal pockets were measured three times with a Merritt‐B probe (Hu‐Friedy®), each time by a different examiner. In the third group of patients, 102 interproximal pockets were measured three times with a pressure probe, each time by a different examiner. The same three examiners were involved. In both groups presence or absence of bleeding from a pocket was recorded. Results show a proportion of inter‐examiner agreement among three examiners of 0.40 with the Merritt‐B probe and 0.71 with the pressure probe. It is concluded that a constant probing force of 0.75 N does contribute to more reproducible bleeding tendency measurements.
Influence of chlorhexidine rinsing on the healing of oral mucosa and osseous lesions
Authors: Bassetti C. , Kallenberger A.
Published: December 2005

Abstract. The influence of chlorhexidine rinsing on wound healing was studied using standardized, open mucosal‐osseous wounds in the left side of the palate in Wistar rats. In five test groups, each containing 10 rats, rinsing was performed twice daily for 30 sec with 0.1, 0.2 and 0.5 % chlorhexidine solution, chlorhexidine solution vehicle, and Ringer solution. A sixth test group (control) was not rinsed at all. Seven days postoperatively, wound healing was evaluated clinically (size of the defect) and histomorphometrically (percent composition of mature connective tissue, immature connective tissue, granulation tissue, fibrin with granulocytic infiltrate). Clinically it was clear that wound healing was best in those animals that rinsed with Ringer solution, and worst in those that rinsed with 0.5 % chlorhexidine solution. Increasing concentration of chlorhexidine caused a delay in wound healing, which in the following cases resulted in significant differences: rinsing with Ringer solution and vehicle versus all concentrations of chlorhexidine, no rinsing versus 0.5 % chlorhexidine. Intensive rinsing with high concentrations of chlorhexidine may, after oral surgical operations, especially surgery in which bone is. exposed, result in delay and disturbance of wound healing in humans.
Effect on gingival health of removing overhanging margins of interproximal subgingival amalgam restorations
Authors: Rodriguez‐Ferrer H. J. , Strahan J. D. , Newman H. N.
Published: December 2005

Abstract. This study was designed to clarify the relationship between amalgam restorations with subgingival overhanging margins and gingival health. This required the presence of such a restoration defect as the sole variable parameter. This was achieved by pairing 26 defective premolar and molar amalgams with similarly defective restorations in the same mouths, test and control being allocated randomly. Test amalgams were contoured to remove overhangs. All other procedures, namely, scaling, polishing and oral hygiene instruction were applied with equal emphasis. Plaque accumulation, gingival inflammation and pocket depths were recorded at 0, 4, 8 and 12 weeks. At the baseline (week 0) there were no significant differences between test and control sides for any of the parameters. Significant differences between test and control sides for all parameters were apparent at all other times.

The greatest change took place during the first 4 weeks of the study. It was concluded that the presence of a subgingival overhanging defective margin may be the only important clinically significant feature of an amalgam restoration related to the pathogenesis of chronic inflammatory periodontal disease. It was also demonstrated that correction of defective restorations should be effected during the initial phase of periodontal therapy.
Histological determination of probe tip penetration into gingival sulcus of humans using an electronic pressure‐sensitive probe
Authors: Polson A. M. , Caton J. G. , Yeaple R. N. , Zander H. A.
Published: December 2005

Abstract. The purpose of this investigation was to determine histologically the depth of probe tip penetration into the clinically healthy gingival sulcus of humans using a controlled insertion pressure of 25 g. The midfacial gingival units of 22 maxillary and mandibular incisor, canine and premolar teeth, displaying no visual signs of inflammation, were used for probing determinations. An electronic pressure‐sensitive probe, with a terminal probe tip diameter of 0.35 mm, was used to standardize insertion pressures. After insertion of the probe into the sulcus, it was then aligned on the facial surface of the gingiva with the tip corresponding to the depth and location of probe insertion. A horizontal reference incision was made on the facial gingival surface which corresponded to the depth of the sulcus probed. This incision served as a histologic landmark of probe tip penetration. Gingival biopsies were taken, and step‐serial sections analyzed histologically and histometrically. Probe tip penetration was coronal to the apical end of the junctional epithelium in all cases (mean = 0.25 mm). In addition, probe tip penetration was always apical to the coronal end of the junctional epithelium (mean = 0.70 mm).
Tooth mobility and periodontal therapy
Authors: Fleszar Thomas J. , Knowles James W. , Morrison Edith C. , Burgett Frederick G. , Nissle Robert R. , Ramfjord Sigurd P.
Published: December 2005

Abstract. Data collected as part of an 8–year longitudinal study on periodontal therapy involving 82 patients and 1974 teeth were analyzed to determine if tooth mobility influenced the results of treatment.

For each patient, pocket depth, attachment level and tooth mobility were scored clinically at the initial appointment, and once a year for 8 years following periodontal therapy. The treatment consisted of scaling, oral hygiene instruction, occlusal adjustment, periodontal surgery (curettage, modified Widman or pocket elimination), followed by recall prophylaxes every 3 months. Tooth mobility data on a scale of 0–3 were related to changes in attachment levels for three grades of severity of periodontal disease, based on initial pocket depth (1–3 mm, 4–6 mm, and 7+ mm). Mean patient attachment changes were calculated from teeth in the same severity category for each patient. The data were analyzed by one‐way analysis of variance and Scheffe's multiple comparison procedure to test the hypothesis of equal effects of tooth mobility on the results of the treatment for the three severity groups over 8 years.

The results indicate that there is a statistically significant relationship between original tooth mobility and the change in level of attachment following treatment. Pockets of clinically mobile teeth do not respond as well to periodontal treatment as do those of firm teeth exhibiting the same initial disease severity.
Alterations of the position of the marginal soft tissue following periodontal surgery
Authors: Lindhe Jan , Nyman Sture
Published: December 2005

Abstract. The present study was performed to examine the alterations of the position of the marginal soft tissue (“gingival margin”) on the buccal surface of teeth in patients who following periodontal surgery were enrolled in a supervised maintenance care program for 10–11 years. The material consisted of 43 patients with severe destruction of the periodontal tissues. Following initial treatment comprising scaling, root planing and instructions in plaque control measures, deepened periodontal pockets were eliminated by the use of an apically repositioned flap procedure including osseous surgery to eliminate bony defects. After treatment, the patients were recalled once every 3–6 months for maintenance care. In all patients, the distance between the cementoenamel junction and the gingival margin on the buccal surfaces of all treated teeth was assessed (1) prior to surgery, (2) after initial healing, and (3) at a reexamination 10–11 years after treatment. In addition, the presence or absence of keratinized gingiva was determine (The results showed that (1) during active periodontal treatment the position of the gingival margin was shifted in an apical direction, (2) this displacement was to some extent compensated for by a coronal regrowth during the postoperative maintenance care period, (3) the alterations of the position of the gingival margin followed a. similar pattern in areas with and without a zone of keratinized gingiva, (4) the number of gingival units devoid of keratinized gingiva decreased during the maintenance care period.)
A combined endodontic‐peripdontic lesion Its management and resolution
Authors: Rosenberg Edwin S. , Garber David A. , Rossman Louis E. , Evian Cyril I.
Published: December 2005

Abstract A case report of a combined endodontic and periodontic lesion is described. Emphasis has been placed on the difficulty in diagnosing this type of case. Solutions to this problem including sequence of therapy have been discussed.
Tooth mobility measurements following two methods of eliminating nonworking side occlusal interferences
Authors: Moozeh M. B. , Suit S. R. , Bissada N. F.
Published: December 2005

Abstract The objective of this study was to compare tooth mobility following two methods of eliminating nonworking side interference (NWSI). The first method involved the complete elimination of any tooth contact on the NWS. The second method involved the reduction of the NWSI to a level which was harmonious with the occlusion on the working side.

Thirty‐three clinically healthy individuals having nonworking side interferences and no pathological signs of occlusal trauma, participated in the study. After 1 month of intensive training in oral hygiene, the volunteers were divided into three groups of 11 each. The first two groups were experimental and the third group received no occlusal adjustment to serve as a control.

In the first group tooth mobility measurements and periapical x‐ray films of teeth with nonworking interferences were taken. Occlusal interferences were then totally eliminated by selective tooth grinding. Two months later mobility and x‐ray recordings of same teeth were repeated. In the second group the same procedure was performed, but nonworking side interferences were adjusted to harmonious contacts with occlusion on the working side. Tooth mobility was measured in hundredths of a millimeter, using the microperiodontometer designed by Mühlemann (1954). Data were subjected to statistical analysis and the following conclusions were drawn:

Tooth mobility was significantly (P < 0.001) reduced after complete elimination of nonworking side interferences, as well as after adjusting the nonworking side interferences to harmonious contacts with occlusion on the working side (P < 0.01).

The reduction in mobility was significantly (P < 0.001) greater when occlusal interferences were completely eliminated than when harmonious contacts were achieved.

There were no detectable radiographic changes, either in the interproximal alveolar bone level or periodontal ligament spaces, 2 months following occlusal adjustment.
Healing after treatment of periodontal intraosseous defects
Authors: Renvert S. , Egelberg J.
Published: December 2005

Abstract Citric acid conditioning of the root surface as a supplement to replaced flap surgery of intraosseous periodontal defects was evaluated, Thirteen patients and a total of 45 proximal defects with residual probing pocket depth ≥ 6 mm after initial preparation were used. The effect of treatment was studied in matched subsamples of the total material including one acid‐treated and one nonacid‐treated defect from each subject, The results demonstrated that an average gain of probing attachment level amounting to 2.0 mm was obtained following acid treatment as compared to 1.l–1.2 mm for the nonacid‐treated controls. Corresponding figures for gain of probing bone level were 1.2–1.3 mm for acid treatment and 0.8–0.9 mm for controls. The clinical significance of these findings was discussed.
Assessment of tooth mobility using small loads
Authors: Persson Rutger
Published: December 2005

Abstract The effect on tooth mobility of periodontal treatment utilizing a gingivectomy procedure was studied during a period of 26 weeks in 25 maxillary anterior teeth of six subjects with moderate to advanced periodontal disease. The gingival conditions were evaluated by gingival fluid measurement and the loss of marginal bone as seen on radiographs. Tooth mobility was measured in a bucco‐lingual direction using forces between 20 p and 80 p.

The results show a decrease of gingival fluid throughout the study. Tooth mobility was already reduced in the majority of teeth 2 weeks after surgery. An average reduction of tooth mobility amounting to 43.7 % (using the corrective formula of Mühlemann 1960) was observed after 4 weeks. No additional reduction took place during the remaining experimental period.
Clinical study to compare the effect of stannous fluoride and chlorhexidine mouthrinses on plaque formation
Authors: Helldén Leif , Camosci David , Hock Janet , Tinanoff Norman
Published: December 2005

Abstract A clinical study was conducted on four adults to compare the relative efficacy of 0.2% chlorhexidine digluconate and 0.1 % stannous fluoride (SnF2). Using a crossover experimental design, subjects rinsed twice daily for 5 days with SnF2 and then, after a 2‐day interim recovery period, for 5 days with chlorhexidine. Statistically significant differences (P < 0.05) in the relative efficacy of the two agents were found. Chlorhexidine was more effective in reducing Gingival and Plaque Indices, plaque wet weight and bacterial Colony Forming Units, calculated both per subject and per group.
The effect of locally released oxygen on the development of plaque and gingivitis in man
Authors: Hirsch Robert S. , Clarke and Nigel G. , Townsend Grant C.
Published: December 2005

Abstract An experimental gingivitis study was designed to test the effect of a 5‐min twice daily oxygen application on the development of plaque and onset of gingivitis A method for the local application of medical grade oxygen to the upper anterior teeth was developed, with the lower anterior teeth used as controls. Fourteen periodontally healthy dental students of average age 21.9 years participated in the study.

There was no significant effect of oxygen on plaque formation, crevicular fluid flow, or the number of gingival bleeding sites. Experimental and control gingival segments exhibited bleeding on probing at an average of 6.6 days after cessation of mechanical plaque control, much earlier than reported in other experimental gingivitis studies.
The predominant cultivable dental plaque flora of beagle dogs with periodontitis
Authors: Syed S. A. , Svanberg M. , Svanberg G.
Published: December 2005

Abstract The predominant cultivable dental plaque flora was studied in 10 adult female beagle dogs with advanced periodontitis. Supragingival and subgingival plaque from a maxillary third premolar (P3) was removed and cultured anaerobically on various growth media and all colonies were subcultured and partially characterized. Histopathological specimens of the plaque sampling sites showed significant loss of connective tissue attachment. Spirochetes were found in ail samples. Anaerobic gram‐negative organisms were predominant in both types of plaque accounting for about 55 % of the cultivable organisms in the supragingival plaque and almost 75% in the subgingival plaque. Bacteroides asaccharolyticus was the most prominant organism in the supragingival plaque, whereas Fusobacterium nucleatum predominated in the subgingival flora. Streptococcal and actinomycotic species were common in the supragingival plaque, but their proportions, especially those of the actmomycetes, were decreased in the subgingival flora. In many respects the bacterial profile associated with disease resembled that reported in human periodontal disease.
Effect of nonsurgical periodontal therapy
Authors: Badersten Anita , Nilvéus Rolf , Egelberg Jan
Published: December 2005

Abstract Healing events after nonsurgical periodontal therapy in patients with periodontal pockets 4–7 mm deep were investigated. Incisors, cuspids and premolars in 15 patients were treated by plaque control and supra‐ and subgingival debridement using hand or ultrasonic instruments in a split mouth approach. The results were evaluated by recordings of plaque scores, bleeding on probing, probing pocket depths and probing attachment levels. All these parameters were improved during the initial 4–5 months after start of therapy. Little change occurred during the rest of the 13‐month observation period. No difference of results could be observed comparing hand and ultrasonic instrumentation or comparing the results of two different operators. Initially a total of 106 sites demonstrated probing pocket depths ≥ 6 mm. At 13 months only 13 such sites were observed. The apparently successful results of conservative treatment of patients with 4–7 mm deep pockets in the present study raise the question to what extent nonsurgical therapy is feasible also in patients with severely advanced lesions.
Oral hygiene instruction of adults by means of a self‐instructional manual
Authors: Glavind Leif , Zeuner Ella , Attström Rolf
Published: December 2005

Abstract The need for improved oral cleanliness in adults presents a large scale resource requirement for professional manpower if oral hygiene instruction is to be accomplished conventionally on an individual basis at the chairside. Therefore a self‐instructional manual in oral hygiene measures, to be used by the patients at home, has been designed. The effect on oral hygiene of periodontal patients following instruction by means of this manual has been compared with the effect of one instruction carried out by a dental hygienist as well as with the effect of minimal instruction by the aid of a short brochure. Thirty‐seven patients (25–64 years of age) were allocated to three groups matched with regard to baseline scares of dento‐gingival plaque, age and sex. Presence of disclosed dento‐gingival plaque (Plak‐lite®) and gingival bleeding on probing were recorded at the start, 1,2 and 6 weeks, 3 and 6 months. Toothbrushing performance of the patients was evaluated at each visit by a “brushing test”. The treatment of all the patients consisted of scaling and polishing of the teeth at the start and after 3 months as well as the patients being supplied with the necessary oral hygiene aids including a lighted mouth mirror, a toothbrush, toothpicks and disclosing tablets. The baseline mean plaque and bleeding scores of 64 and 40% decreased during the first 6 weeks to a level of 20 and 14%. This improvement was maintained during the 6‐month study period. Among the three groups no significant differences were observed in oral hygiene and gingival health. The results indicate that an oral hygiene instructional mode relatively independent of professional manpower may be equally effective as one single personal instruction. Furthermore the results suggest that factors other than the instruction per sc are important for obtaining improvements in oral home care.
Use of oral irrigators as vehicle for the application of antimicrobial agents in chemical plaque control
Authors: Lang N. P. , Räber K.
Published: December 2005

Abstract The purpose of the present investigation was to study the topographical distribution of plaque formation using chlorhexidine digluconate (CH) as a mouthrinse and in oral irrigators during experimental gingivitis.

Forty dental students (aged 22–26) with clean teeth and healthy gingivae abolished oral hygiene oral period of 3 weeks (Löe et al. 1965). During this period the participants were randomly assigned to one of five groups, Group A rinsed daily with 30 ml of a placebo and Group B with 30 ml 0.1% chlorhexidine digluconate. In Groups C and E a fractionated jet irrigator was used for the daily application of 600 ml placebo (C) or O.05% CH (E); 600 ml of 0.05% CH was also used in a monojet irrigator (Group D). At the start, after 1, 2 and 3 weeks of no oral hygiene and 1 week following reinstituted oral hygiene, plaque was assessed using the Plaque Index (Silness &. Löe 1964) and gingival health was scored according to the criteria of the Gingival Index (Löe & Silness 1963). The discoloration of the teeth was determined using a set of color photos.

During the experiment all groups reached plaque levels that were significantly different from each other. The highest PII were seen in the placebo rinsing group (A) followed by placebo irrigation (C). Plaque was significantly reduced in the CH groups. However, rinsing (B) formed significantly more plaque than using the oral irrigator (D, E). Group E showed the least amount of plaque. In addition, the interproximal PII were equally low as the buccal and lingual. With CH (B, D, E), gingivitis did not develop except for some interproximals in Group B. A fractionated jet irrigator was more effective for the application of CH than rinsing.
Healing following surgical treatment and root demineralization in monkeys with periodontal disease
Authors: Nyman Sture , Lindhe Jan , Karring Thorkild
Published: December 2005

Abstract The aim of the present investigation was to study the potential for new attachment to root surfaces which 1) had become devoid of attachment either by mechanical removal or in conjunction with experimental periodontal tissue breakdown and 2) subsequently had been conditioned with citric acid. Three adult monkeys (Macaca cynomolgus) were used. Periodontal pockets were produced during a 2–6‐month period around the maxillary central incisors and first and second premolars and around the mandibular central incisors by the placement of orthodontic elastics. Surgical treatment of the pockets was carried out with the use of a flap procedure. During surgery, the roots of the premolars on the right side of the jaws were first scaled and planed and subsequently treated with citric acid. Citric acid conditioning was not performed on the premolars of the left side. In the front tooth regions the surgical treatment included citric acid conditioning of the mandibular central incisors in two animals and of the maxillary central incisors in one animal.

Surgical procedures were also carried out around the mandibular second premolars and first molars which had not been exposed to periodontal tissue breakdown. Folio wing flap elevation, the buccal bone plate was mechanically removed within an area corresponding to that of bone loss produced by the experimental periodontitis model in the maxillary premolars. The cementum layer of the surgically denuded portion of the roots was removed by root planing.

In all treated teeth, a notch was prepared in the buccal root surfaces at the level of the alveolar bone crest. Six months following treatment the animals were sacrificed and histologic sections prepared. Linear measurements were made along the root surface from the apical border of the prepared notch to the apical termination of the junctional epithelium and to the crest of the alveolar bone.

The results demonstrated that cementum formation and new connective tissue attachment did not occur on root surfaces previously exposed to periodontal pockets and subsequently subjected to scaling and root planing or on root surfaces surgically deprived of their supporting bone and previously “non‐exposed” cementum layer. Cementum formation and new connective tissue attachment also failed to occur following citric acid conditioning of root dentin surfaces. In all sections representing all three treatment groups, the attachment between the gingiva and the root was established by epithelium.