bluuebunny/crossref_metadata_2025 huggingface dataset:
Neutrophil elastase in crevicular fluid: comparison of a middle‐aged general population with healthy and periodontitis groups
Authors: Smith Q. T. , Harriman L. , Au G. S. , Stoltenberg J. L , Osborn J. B. , Aeppli D. M. , Fischer G.
Published: December 2005

Abstract Neutrophil elastase (NE) was measured in crevicular fluid (GCF) collected from 3 subject groups. GCF was harvested at a single visit of subjects with periodontal health (n=21) and with periodontitis (n=28). Samples were obtained from 132 middle‐aged, middle‐class health conscious patients of a health maintenance organization (HMO) at baseline and 1 year later. GCF NE was higher in periodontitis than in health. Mean GCF NE of HMO subjects was much closer to health than to periodontitis. Few members of the HMO population had enzyme levels typical of periodontitis. Subjects and sites of the HMO population were segregated into 3 categories based on enzyme levels of the healthy and periodontitis subjects. Most HMO subjects and sites were in the activity category corresponding to healthy subjects. Only a small portion were in the activity category common in periodontitis. Enzyme levels in the highest activity category at both samplings were infrequent. High enzyme levels in the HMO population were not associated with attachment loss. Thus, assay of GCF NB provided little evidence of disease in a middle‐aged, middle‐class health conscious general population. This finding confirms an analysis of epidemiological surveys which concluded that a population such as studied here would not benefit from periodontal diagnostic testing.
Periodontal healing and periopathogenic microflora in smokers and non‐smokers
Authors: Preber Hans , Linder Lars , Bergström Jan
Published: December 2005

Abstract The aim of the present study was to monitor the clinical and microbiological effects of non‐surgical therapy in smokers and non‐smokers. The subject material included 32 patients (age range 32–61 years), 11 men and 21 women with moderate to severe periodontitis. 17 patients were smokers ( l5 cigarettes/day) and 15 non‐smokers. All patients were subjected to non‐surgical periodontal therapy performed by a dental hygienist. Periodontal variables (plaque index, gingival index and probing depth) were registered and bacterial samples were collected before and 2 months alter treatment. The treatment resulted in significant reductions towards very low plaque and gingival indices in smokers and non‐smokers alike (p<0.05). Although probing depth was reduced in both smokers and non‐smokers, the probing pocket depth reduction was significantly smaller in smokers than non‐smokers (p<0.05). Microbiologically, the same therapeutical efficacy was attained in both smoking groups, indicating an almost total eradication of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Concerning Prevotella intermedia, out of 14 smokers and 10 non‐smokers positive at baseline, 9 and 5, respectively, remained positive after treatment. The results suggest a less favourable clinical outcome of non‐surgical therapy in smokers than non‐smokers in spite of the fact that the therapy was equally effective with regard to reducing the alleged periopathogens A. actinomycetemcomitans, P. gingivalis and P. intermedia.
The effects of antimicrobial mouthrinses on de novo plaque formation at sites with healthy and inflamed gingivae
Authors: Ramberg P. , Furuichi Y. , Volpe A.R. , Gaffar A. , Lindhe J.
Published: December 2005

Abstract The objective of the present investigation was to evaluate to what extent mouthrinses containing triclosan and chlorhexidine may modify the amount of de novo plaque that forms on tooth surfaces adjacent to healthy and inflamed gingival units. 10 volunteers were recruited. On day 0, gingival crevicular fluid (GCF) was obtained at predetermined sites and gingivitis (GI) was assessed. A careful oral profylaxis was given to each of the volunteers who subsequently abstained from all mechanical plaque control measures for the following 18 days. During the first 4 days (rinse phase I), they rinsed with either 0.12% chlorhexidine. 0.06% triclosan or placebo solution. Clinical examinations (GCF, GI) were repeated and the amount of plaque formed determined on days 4, 7 and 14. On day 14, the participants received a new professional tooth cleaning after which rinse phase II was initiated. During this 2nd phase, the participants rinsed for 4 days with the same mouthwash preparation and in the same manner as during rinse phase I. The examinations were repeated on day 18. Each participant received a comprehensive oral prophylaxisis and was instructed to perform meticulous mechanical plaque control during the following 4 weeks. A 2nd experimental period was then initiated. A total of 3 experimental periods were repeated until all subjects had rinsed with the 3 different mouthwash preparations. The results demonstrated (i) that significantly more plaque formed at sites with gingivitis than at surfaces adjacent to healthy gingival units and (ii) pre‐existing gingivitis significantly increased the amount of de novo plaque that formed in subjects who rinsed with mouthwash preparations containing chlorhexidine and triclosan.
Effect of toothbrush wear on plaque control
Authors: Daly C. G. , Chapple C. C. , Cameron A. C.
Published: December 2005

Abstract The purpose of this study was to investigate the effect of progressive toothbrush wear on plaque control. At baseline (week 0). each of 20 subjects was given a new toothbrush which they used for the 9‐week period of the study. At weeks 0, 3 and 6, all plaque was professionally removed. The amount of plaque which accumulated in each of the 3 successive 3‐week experimental periods was assessed at weeks 3, 6 and 9. Toothbrush wear was evaluated by measuring the increase in the brushing surface area of toothbrushes at weeks 3, 6 and 9 as compared with week 0. The brushing surface area was measured by computer analysis of tracings of the brushing surface outlines obtained from standardized photographs. Despite progressive toothbrush wear, the amount of plaque which accumulated in each successive 3‐week period decreased. The decrease in plaque scores between weeks 3 and 6 and between weeks 3 and 9 were found to be highly significant (p<0.001). Toothbrush wear varied widely amongst the subjects. When plaque scores were evaluated for the 10 subjects with highest toothbrush wear and the 10 with lowest wear, no significant differences were found between the 2 subgroups. Under the experimental conditions of this study, progressive toothbrush wear did not lead lo a decrease in plaque control. The improvement in plaque scores may have been due lo motivational effects resulting from study participation and anticipation of oral examinations. It was concluded that the wear status of a toothbrush may not be critical in ensuring optimal plaque control.
Adjunctive controlled topical application of tetracycline HCl in the treatment of localized persistent or recurrent periodontitis
Authors: Flemmig T.F. , Weinacht S. , Rüdiger S. , Rumetsch M. , Jung A. , Klaiber B.
Published: December 2005

Abstract 35 patients receiving regular supportive periodontal therapy (SPT) and showing signs of localized persistent or recurrent periodontitis were enrolled in the study. Within 1 week after SPT, each patient had a tetracycline HCl loaded ethylene vinyl acetate co‐polymer fiber placed into the periodontal pocket of 1 randomly selected tooth with persistent or recurrent periodontitis (test); the fiber was removed after 9.5±2.0 days. A non‐adjacent tooth with persistent or recurrent periodontitis in a separate quadrant, which received no further treatment, served as a control. A total of 28 patients completed the 6‐month study. Compared to control teeth, in test teeth at 6 months significantly (p < 0.01) lower scores were found for gingival index, pocket probing depths, and PMN elastase‐α1‐proteinase inhibitor concentrations in gingival crevicular fluid. With the exception of plaque index scores, test teeth demonstrated significant reductions from baseline to 6 months in all parameters (p < 0.05). Conversely, all parameter measurements in control teeth, except bleeding on probing, showed no significant difference between baseline and 6‐month values. The results suggest that the use of controlled topical application of tetracycline HCl may improve periodontal health and reduce the risk of disease progression in localized persistent or recurrent periodontitis. Moreover, the effects of this application appear to be sustained for at least 6 months.
Squamous odontogenic tumor (SOT): a benign neoplasm of the periodontium
Authors: Philipsen Hans P. , Reichart Peter A.
Published: December 2005

Abstract True neoplasms are rarely localised to the periodontium. However, early recognition and diagnosis of neoplastic lesions resides within the realm of responsibility of the dentist. In recent years, a number of odontogenic tumors has been described characterized by an occurrence on the gingiva or in the intrabony part of the periodontium. One such neoplasm, the squamous odontogenic tumor (SOT) originally described 20 years ago is now a well‐recognized entity localized to the periodontium, be it in the periodontal ligament or in the gingivae. A review of 36 acceptable cases of this tumor published sofar, forms the basis of the present paper.
Triclosan reduces prostaglandin biosynthesis in human gingival fibroblasts challenged with interleukin‐1 in vitro
Authors: Modéer T. , Bengisson A. , Rölla G.
Published: December 2005

Abstract The effect of the toothpaste ingredient triclosan (2,4,4′‐trichloro‐2′‐hydroxyldiphenyl ether) on the prostaglandins biosynthesis in human gingival fibroblasts challenged with interleukin‐1β (IL‐1β) or tumor necrosis factor α (TNFα) was studied in vitro. When gingival fibroblasts were treated simultaneously with triciosan and IL‐1β, the stimulatory effect of IL‐1β on prostaglandin E2 (PGE2) and PGI2 formation was reduced in a dose‐dependent manner by triclosan. Triclosan also reduced the PGE: formation induced by TNFα. Furthermore, the capacity of IL‐1β to induce release of [3H] arachidonic acid from prelabelled gingival fibroblasts was reduced in the presence of triclosan. Addition of exogenous unlabelled arachidonic acid (AA) to the cells resulted in enhanced PGE2 formation which was reduced by triclosan. The upregulation of the metabolism of AA to PGE2 induced by IL‐lβ, was markedly reduced in the presence of triclosan. The study indicates that the stimulatory effect of IL‐1β on prostanoid formation (PGE2, PGI2) in human gingival fibroblasts was diminished in the presence of triciosan partly at the level of phospholipase A2 and partly at the level of cyclooxygenase. The present data that triclosan. in vitro, inhibits the production of inflammatory mediators such as prostaglandins suggests that this can be an aspect of its clinical effect on gingivitis, in addition to its antibacterial effect.
Combined treatment approach to gingival overgrowth due to drug therapy
Authors: Darbar Ulpee R. , Hopper Colin , Speight Paul M. , Newman Hubert N.
Published: December 2005

Abstract A case of severe gingival overgrowth associated with combined drug therapy of cyclosporin A and nifedipine is reported. The frequently increased vas‐cularity of the gingival tissues in such cases often causes problems with bleeding both during and after surgery. Acrylic suckdown splints have been used postoperatively to assist haemostasis, however, these can interfere with function and cause discomfort. This report describes a combined treatment approach using conventional gingivectomy and carbon dioxide laser for the removal of the hypertrophic soft tissue. The benefits of such combined treatment include reduced bleeding during surgery with consequent reduced operating time and rapid post‐operative haemostasis, thus eliminating the need for a splint.
Microbiological and immunohistological findings in a patient with Papillon‐Lefére syndrome
Authors: Kleinfelder J.W. , Topoll H.H. , Preus H.R. , Muller R.F. , Lange D.E. , Böcker W.
Published: December 2005

Abstract The following communication is a case history of an 11 year‐old female patient suffering from Papillon‐Lefére syndrome. Since a massive occurence of A actinomycetemcomilans had been found in the subgingival microflora of the periodomal pockets, the patient was treated with repeated subgingival scaling, with an adjunct Amoxicillin and Metronidazol treatment. A bacteriological examination of the girl's family proved that several brothers and sisters as well as one parent also carried A. actinomycetemcomitans. showing 3 different strains of this bacterium within the family. An immunohistological examination of the gingival tissue showed a massive inflammatory infiltrate which was dominated by plasma cells. The histological investigation of the first molars did not show morphological abnormalities of the root cementum. Posttreatment clinical and radiographical improvement of the periodontal conditions is reported despite the recurrent finding of A. actinomycetemcomitans.
Bacterial colonization of barrier material and periodontal regeneration
Authors: De Sanctis M. , Zucchelli G. , Clauser C.
Published: December 2005

Abstract The objective of this study was to evaluate the relationship between the presence of bacteria on the tooth‐facing surface of ePTFE barriers and the clinical outcome of membrane supported reconstructive periodontal surgery. 20 systemically healthy subjects affected by chronic periodontitis were enrolled. One tooth site per patient, associated with an angular bony defect and a probing attachment loss of >4 mm. was selected to be treated by means of a guided tissue regeneration procedure using an ePTFE barrier membrane. Antibiotics (Augmentin 1 g/day) for 2 weeks were prescribed. In addition to the use of chlorhexidine for post‐surgical plaque control, all patients were recalled once a week for professional tooth cleaning. The barrier material was harvested for SEM analysis after 4–6 weeks. Professional tooth cleaning and reinforcement of selperformed oral hygiene measures were given at 1 month intervals after membrane removal. For each treated site, the difference in probing attachment loss between baseline examination and a follow‐up examination after 6 months of healing was calculated. The results of the SEM‐analysis revealed that bacterial colonization was evident in the collar area of all the retrieved membranes. In the mid part of the membranes 30 out of 60 microscopic fields (50%) demonstrated microbial colonization, and in the most apical part 9 out of 60 fiels (15%). Regression analysis indicated that gain in probing attachment level was positively‐correlated to initial attachment loss and negatively correlated to microbial colonization of the mid part of the membranes. It was concluded that bacterial colonization in the mid part of the ePTFE membrane reduced the potential gain in probing attachment following GTR–therapy with almost 50%.
Cathepsin G in gingival tissue and crevicular fluid in adult periodontitis
Authors: Tervahartiala T. , Konttinen Y.T. , Ingman T. , Häyrinen‐Immonen R. , Ding Y , Sorsa T.
Published: December 2005

Abstract The presence, localization and activities of cathepsin G in gingival tissue specimens and crevicular fluid (GCF) from 9 adult periodontitis patients and 6 controls with clinically healthy periodontium were studied by use of avidin‐biotin‐peroxidase complex method. Western and dot blotting, and spectrophotometric activity assay. In contrast to healthy gingival tissue specimens, gingival tissue specimens collected from adult periodontitis patients contained inflammatory cells in lamina propria, beneath the oral sulcular epithelium, 10–50% of which were cathepsin G positive polymorphonuclear neutrophilic leukocytes (PMNs) and monocyte/macrophage‐like cells. Cathepsin G activities were increased in adult periodontitis GCF when compared to periodontally healthy controls' GCF (p>0.05). In adult periodontitis GCF, Western blotting disclosed free cathepsin G but also clear complexes of cathepsin G with its predominant endogenous inhibitor α1antichymotrypsin (α1‐ACT). The present results demonstrate that part of the cathepsin G, despite the presence of increased concentrations of α1‐ACT, was in an uncomplexed, free and functionally active form. Our results suggest that GCF cathepsin G reflects the disease process in adjacent inflamed gingiva and also increased host response to microbiota and/or dental plaque in the periodontitis lesions. Cathepsin G may contribute to periodontal tissue destruction directly and indirectly, via proteolytic activation of latent neutrophil procollagenase (promatrix metalloproteinase‐8 [proMMP‐8]).
The effect of periodontal therapy in diabetics
Authors: Westfelt E. , Rylander H. , Biohmé G. , Jonasson P. , Lindhe J.
Published: December 2005

Abstract The present investigation was performed to study the frequency of recurrence of periodontitis in diabetic subjects, who, prior to the initiation of a 5‐year period of monitoring, were treated for moderate to advanced periodontal disease. 20 patients with diabetes, type 1 (LDDM) or type 2 (N1DDM) and 20, sex and age matched, controls with similar amounts of periodontal tissue destruction, were selected for the study. Following a screening examination, all patients were subjected to non‐surgical periodontal therapy (oral hygiene instruction, supra‐and subgingival scaling). 3 months later, the baseline examination for the study was performed. This included assessments of several parameters such as: number of teeth, plaque, gingivitis, probing pocket depth and probing attachment level. 6 months after the baseline examination, all 40 subjects were recalled for a 2nd examination. Sites which at this 6‐month examination exhibited bleeding on probing, and had probing depth >5 mm, were scheduled for additional surgical therapy (modified Widman flap). Following this selective additional therapy, the main period of monitoring was initiated. During this period, a plaque control program was repeated every 3 months. Re‐examinations regarding plaque, gingivitis, probing depth and probing attachment level were performed 12, 24 and 60 months after the baseline examination. The findings from the examinations disclosed that diabetics and non‐diabetics alike, treated for moderately to advanced forms of adult periodontitis, during a subsequent 5‐year period, were able to maintain healthy periodontal conditions. Thus, the frequency of sites which exibited signs of recurrent disease was similar in the 2 study groups.
Occurrence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in juvenile periodontitis
Authors: López Néstor J. , Mellado Juan C. , Leighton Gloria X.
Published: December 2005

Abstract The occurrence of Actinobacillus actinomycetemcomitans, Porphyromanas gingivalis and Prevotella intermedia in subgingival plaque in 24 juvenile periodontitis patients was determined using DNA probe. 36 samples of subgingival plaque from 36 pockets having ≥6 mm depth, ≥3 mm of loss of attachment, and Weeding on probing anchor suppuration were taken from 18 patients with localized juvenile periodontitis (LJP, age range 12‐24 years); and 12 samples from‐6 patients with generalized juvenile periodontitis (GJP, age range 23–26 years). As control, an equal numbers of samples from health sites in the same patients were studied. P. gingivalis was found in 17 of 18 LJP patients, and in 31 of 36 diseased sites in those patients. P. intermedia was found in 15 out of the 18 LJP patients and in 28 of the 36 diseased sites. A, actinomycetemcomitans was present in 7 of the 18 LJP patients, and in 9 of the 36 diseased sites, and was not found in any GJP patients. All GJP patients had P. gingivalis 1 out of 12 diseased sites) and P. intermedia (all of the diseased sites). None of the three bacterial species was detected in healthy sites of GJP patients, and were found in healthy sites in only 2 of 18 LJP patients. The high prevalence and high levels of P. gingivalis and P. intermedia found in the LJP and GJP patients studied, suggest that there are populations affected by juvenile periodontitis in which this type of periodontitis is more associated with these species than with A. actinomycetemcomitans.
Long‐term stability of clinical attachment following guided tissue regeneration and conventional therapy
Authors: Cortellini Pierpaolo , Prato Giovan Paolo Pini , Tonetti Maurizio S.
Published: December 2005

Abstract 44 patients (34% smokers) presenting with severe periodontitis were treated with full mouth root planing (RPL). In each patient, 1 intrabony defect was treated with guided tissue regeneration (GTR). After 1 year of monthly prophylaxis, full mouth plaque (FMPS) and bleeding (FMBS) scores were 8.3±4.1% and 5.6±3.S%. At 1 year, the GTR treated sites were matched, in each patient, with 1 RPL site, in terms of probing attachment level (PAL 6.8±2.4 mm GTR, and 6.5±2.3 mm RPL). At this point, 24 patients took part in a supportive periodontal care program. 20 patients did not participate, and received only sporadic care by general dentists. At 5 years, all patients were re‐examined. FMPS was 10.5±6.8% and FMBS 7.7±6.4%. A significant PAL loss was observed in both sites (L2± 1.4 mm GTR, 1.3± 1.3 mm RPL, p<0.0001) between f and 5 years. Differences in PAL loss between GTR and RPL sites were not statistically significant. Only a minority of sites (34%), however, lost PAL. while 66% remained stable. 75% of the matched sites (GTR and RPL) within the same patients were concordant in terms of PAL stability. The 23 patients in which both sites remained stable, had good oral hygiene, complied with the recall system, and did not smoke. The 10 patients in which both sites lost PAL showed deteriorating oral hygiene, did not comply with the recall system, and smoked. PAL loss in the GTR and/or RPL sites was consistently observed in patients (losers) showing PAL loss in other teeth. Losers had, in general, negative subjects characteristics, and showed a higher prevalence of tooth loss. In conclusion; (i) GTR and RPL sites showed comparable susceptibility to periodontal breakdown; (ii) stability of outcomes was consistently associated with good oral hygiene, compliance with a supportive periodontal care program, and no cigarette smoking.
Effect of pretreatment with ketorolac tromethamine on post‐operative pain following periodontal surgery
Authors: Trombelli Leonardo , Schincaglia Gian Pietro , Zangari Francesca , Scapoli Chiara , Calura Giorgio
Published: December 2005

Abstract A double‐blind, randomized, single‐dose clinical trial to evaluate the analgesic efficacy of preoperative ketorolac tromethamine administration on periodontal postoperative pain was designed. One group received 20 mg ketorolac immediately before periodontal flap surgery, and the other group received placebo. Naproxen sodium was allowed post operatively as rescue medication. The visual analog scale was used to estimate pain. Postoperative pain was assessed hourly for the first 10 h on the day of surgery, and 4× daily on the 1st and 2nd postsurgical days. Timing and dose of rescue analgesic remedication were also recorded. Results indicated that preoperative treatment with ketorolac significantly reduced initial pain intensity and delayed the onset of postoperative pain as compared to placebo. Incidence and amount of naproxen consumption was similarly small in both ketorolac‐ and placebo‐treated groups. No adverse reactions related to preoperative medication were observed.
Clinical evaluation of tine shape of 3 periodontal probes using 2 probing forces
Authors: Barendregt Dick S. , Van der Velden Ubele , Reiker Jurgen , Loos Bruno G.
Published: December 2005

Abstract The objective of this study was to evaluate the effect of the tine shape of different periodontal probes. One tapered, one parallel‐sided and one WHO‐probe line, each with a diameter of 0.5 mm at the tip. were mounted in hinged handles exerting a constant probing force (Brodontic®). The handles were adjusted to either 0.25 N (127 N/cm) or 0.5 N (255 N/cm). 12 patients with moderate to severe periodontitis were measured after supra‐ and subgmgival debridement. using all 6 possible tine force combinations in 3 sessions. In each session one tine/force combination was used in the 1 si and 3rd quadrants, and another tine/force combination in the 2nd and 4th quadrant. The measurements in the same quadrants could therefore be used for comparisons within the same site. The selection for the 2 quadrants in which a given tine/force combination was to be used, was randomised. Calculations of differences (mean per patient) between probing measurements show, that the WHO tine yields deeper recordings than the parallel sided and tapered tines, both at 127 N/cm2 and 255 N/cm2. We conclude that in addition to probing force, the tine shape of a periodontal probe is of significant importance for the recorded probing depth.
Methodological considerations in GCF sampling with paper strips: poor recovery of uncomplexed elastase
Authors: Gustafsson A.
Published: December 2005

Abstract The purpose of this study was to assess the recovery of certain proteins from paper strips used for sampling of gingival crevicular fluid (GCF). During a period of 60 mm. proteins were eluted in isotonic phosphate‐buffered saline. pH 7.4. without detergent. This eluent did not lyse neutrophils applied to the strips, which might otherwise contribute intracellular substances‐, e.g., elastase‐to the GCF samples. The proteins applied (MW 12‐725 kD) were satisfactorily recovered (about 90%). However, free neutrophil elastase, unlike elastase complexed with α‐2‐macroglobulin, could not be recovered from the paper strips. Strips made of polyvinylidene difluoride (Durapore) were also tested and 31% of the applied pure elastase was recovered from them. A comparison of measurements made with a Periotron 6000 on Periopaper and Durapore strips, showed that the values obtained with Durapore were too low for accurate measurements of small volumes of fluid. On the whole, when the elution was made in isotonic buffers al neutral pH and without detergents, the recovery of most proteins was satisfactory and reproducible, and independent of MW in the tested range. However, the study also showed poor recovery of uncomplexed elastase.
Periodontal status of a subject sample of Yemen
Authors: Mengel Reiner , Eigenbrodt Matthias , Schünemann Thomas , Florès‐de‐Jacoby Lavin
Published: December 2005

Abstract From August to October 1991, the periodontal status of 1001 Yemenis representing the age groups 12‐14, 15‐19, 20‐24 and 35‐44 years was recorded and evaluated with preference to the CPITN, the calculus index and clinical attachment levels. The impact of chewing khat, the leaves of a cultivated, alkaloid shrub, and of using the traditional miswak chewing stick for oral hygiene purposes were investigated. The results show that 6.9% of the juvenile probands (15‐19 years) had healthy periodontal tissue (CPITN 0). whereas bleeding on probing and calculus (CPITN 1+2) were registered in 86.2%. In the 35‐44 year age group. 1.7% were periodontally healthy, whereas 84.5% displayed plaque retention or shallow pocketing (CPITN 2‐3) and 12.5% deep pocketing (CPITN 4). The treatment needs in all age groups are confined primarily to calculus removal and instruction in oral hygiene. The clinical attachment level and the calculus index revealed age‐related attachment loss and calculus formation, primarily among male probands. The higher khat consumption among the male population is reflected in its detrimental effect on the periodontal tissue, especially among younger probands. Oral hygiene aids have also an influence on periodontal status, with a toothbrush proving more efficient than the miswak. WHO efforts directed towards prophylactic programs need to be intensified but can be staffed by dental hygienists.
Biostimulation of wound healing by low‐energy laser irradiation A review
Authors: Conlan Michael J. , Rapley John W. , Cobb Charles M.
Published: December 2005

Abstract This paper reviews studies on the basic principles of biostimulation of wound healing by various low‐energy lasers. It looks at the mechanism of action of biostimulation as well as the lasers effect on cell proliferation, collagen synthesis, and would healing.
Determinants of gingival overgrowth severity in organ transplant patients
Authors: Thomason J. Mark , Seymour Robin A. , Ellis Janice S. , Kelly Peter J. , Parry Gareth , Dark John , Wilkinson Robert , Ilde Jeffrey R.
Published: December 2005

AbstractThe role of HLA phenotype as a risk factor for drug‐induced gingival overgrowth was investigated in a cohort of 172 transplant recipients. Clinically significant overgrowth warranting surgical correction was observed in 72 patients (42%). Using stepwise regression modelling. 6 clinical parameters were identified as significant risk factors for the severity of gingival overgrowth. These were; age. sex. creatinine plasma level, duration of therapy, papilla bleeding index and concomitant medication with a calcium channel blocking drug. 3 HLA alleles were also identified as risk factors when adjusted for other clinically significant risk factors (HLA ‐DR2, A24, B37). However, when the p‐values for the HLA variables were corrected to compensate for the use of multiple significance testing, only HLA‐B37 remained statistically significant at the 5% level. Organ transplant patients are at risk of developing gingival overgrowth, with approximately 25% medicated with cyclosporin alone requiring corrective gingival surgery. This figure more than doubles in patients concomitantly medicated with a calcium blocking drug. The data at present available would suggest that the severity of gingival overgrowth is also significantly associated with the HLA‐B37 phenotype.
Evaluation of gingival and periodontal conditions following causal periodontal treatment in patients treated with nifedipine and diltiazem*
Authors: Bullon P. , Machuca G. , Martinez‐Sahuquillo A. , Rios J.V. , Velasco E. , Rojas J. , Lacalle J. R.
Published: December 2005

Abstract It is established that phenytoin, cyclosporin and some calcium antagonists produce gingival overgrowth, but it is not known how this condition may respond to causal periodontal treatment. In order to find out, a longitudinal study was carried out, over a year, comparing a group of patients who were given nifedipine (NG, n= 18) and another group who were given diltiazem (DG. n= 13) with 2 others: one comprised cardiopathic patients who took no calcium antagonists (CG, n= 12) and the other contained patients who were medically healthy. with moderate periodontitis (HG, n= 12). On their basal visit, they were examined and instructed in oral hygiene, and then given causal periodontal treatment, being seen again at 4 and 8 months, when hygiene instructions were reinforced. They were seen for the last time at 12 months, when they were again examined. Groups NG and DG, on their basal visit, showed larger gum size than groups HG and CG. which was statistically significant; on their final visit, these differences remained only at the interproximal level. The number of patients with gingival overgrowth‐taking the average of group HG as a minimal value‐was much higher in groups CG (92%). DG (100%) and NG (89%) on the basal visit; on the final visit, the differences remained only in groups DG (85%) and NG (83%). The probing pocket depth reduction was much greater in groups HG and CG than in DG and NG. basically due to a greater gaining on clinical attachment level. The % of sites in which the pocket depth improved by more than 2 mm was 39.8% in HG, 54.5% in CG, 23.7% in DG and 28.7% in NG. The % of sites where the attachment gain by more than 2 mm was 46.2% in HG, 55.5% in CG, 22.8% in DG and 21.4% in NG. The amount of plaque and bleeding on probing, which was similar in all groups on the basal visit, decreased throughout the study, especially between the basal and 2nd visit in groups HG and CG. We have demonstrated that patients that take nifedipine and diltiazem show a larger gum size and their response to causal periodontal treatment is poorer than in the healthy and the cardiac groups.
Molar furcation involvement associated with cigarette smoking in periodontal referrals
Authors: Mullally Brian H. , Linden Gerard J.
Published: December 2005

Abstract The aim of this study was to investigate the relationship between cigarette smoking and furcation involvement in molar teeth. A consecutive group of 50 smokers were recruited from referrals to a periodontal clinic and age and gender matched with never smokers. Smokers consumed an average of 18.0 (SD 6.7) cigarettes per day and had smoked for 20.7 (SD 6.5) years. Radiographs of all molar teeth were assessed 2 × by an examiner blinded to the smoking status. Smokers had slightly fewer molar teeth 6.7 (SD 2.6) than the never smokers. 7.3 (SD 2.3), t= 1.2, P=0.22. More smokers (72%) had evidence of furcation involvement than never smokers (36%), χ2=13.0, P=0.0003. The odds ratio for a smoker having 1 molar with furcation involvement was 4.6 (c.i. 2 – 10.6). Smokers had more molars with furcation involvement 1.94 (SD 1.7) compared with never smokers, 0.94 (SD 1.4), t= 3.1. P= 0.003. It is concluded that cigarette smoking is associated with a greater expression of molar furcation involvement in periodontitis affected subjects.
A double‐blind trial of tetracycline in the management of early onset periodontitis
Authors: Palmer R.M. , Watts T. L. P. , Wilson R.F.
Published: December 2005

Abstract The aim of the study was to evaluate the adjunctive effect of systemic tetracycline (250 mg qds for 14 days) in sequential root planing and surgical phases of treatment in a randomised, double‐blind controlled trial. 38 patients who were under 26 years of age. in good general health and with localised (15 test/15 control) or generalised (4 test/4 control) early onset periodontitis completed the non‐surgical phase. Data were analysed by ANOVA using baseline covariates and transformations where appropriate. Improvements in probing depth, probing attachment level and bleeding on probing were significantly better in the group treated with adjunctive tetracycline. at 3 months post‐treatment. 26 patients (13 test/13 control) subsequently completed the surgical phase (modified Widman flap surgery with adjunctive tetracycline or placebo as before) and were re‐examined at 6 months and 12 months. In the test group, 58% of the originally affected teeth required surgery compared to 75% in the control group. Surgery produced further reductions in mean probing depths but no further gains in probing attachment. There were no further statistically significant differences between test and control groups for any of the clinical measures, although the tetracycline group appeared to maintain an advantage. In conclusion, systemically administered tetracycline is a useful adjunct in the management of early onset periodontitis. particularly in non‐surgical treatment.
Partial expression of the Papillon‐Lefèvre syndrome in 2 unrelated families
Authors: Soskolne W. Aubrey , Stabholz Ayala , van Dyke Thomas E. , Hart Thomas C. , Meyle Joerg
Published: December 2005

Abstract The Papillon‐Lefèvre syndrome (PLS) is a rare, autosomal recessive trait that is characterized by palmar plantar keratosis (PPK) and severe, early onset periodontitis. affecting both deciduous and permanent dentitions. The clinical presentation of PLS is variable: the disease occurs so infrequently as to limit clinical cases for study. The exception is a few families with extensive consanguinity in which numerous cases occur. Of particular interest to mapping the genetic origin of the syndrome is the co‐expression of the major traits of hyperkeratosis and periodontitis, and their severity. In this paper, we report 2 families with multiple affected individuals from geographically remote areas. A large extended family, from the Cochin region of India, currently residing in Israel, in which there is documented consanguinity and a family from the southwest region of Germany. In each family, 1 individual presents with hyperkeratotic lesions with the complete absence of periodontal lesions. Further, the difference in severity of the hyperkeratotic lesions between families is marked, and one sibling in the German family expressed rapid, early onset periodontitis in the absence of PPK. The genetic nature and penetrance of the genetic defect are discussed.
2 multi‐center trials assessing the clinical efficacy of 5% sanguinarine in a biodegradable drug delivery system
Authors: Poison Alan M. , Stoller Norman H. , Hanes Philip J. , Bandt Carl L. , Garrett Steven , Lee Southard G.
Published: December 2005

Abstract A biodegradable drug delivery system containing 5% sanguinarium (Sa) was compared to vehicle control (VC), scaling and root planing (SRP). and supragingival plaque control (SPC) in the treatment of adult periodontitis in 2 well‐controlled clinical trials. Studies were 4‐quadrant (split mouth) designs at 2 centers each, having 94 (Study A) and 107 (Study B) patients. All patients had at least 3 pockets between 5 and 9 mm that bled on probing, in each quadrant. Probing pocket depth (PD), clinical attachment level (AL), bleeding on probing (BOP), and plaque index were recorded at baseline, 14, 30, 60, and 90 days. All treatments gave statistically significant reductions from baseline for PD and BOP. and significant gains for AL. For PD reduction. SRP was superior to all test groups at all time points in both studies (p < 0.001). Sa was superior to VC in Study A at 14 and 30 days and to SPC at all time points. For AL gain at 90 days, in both studies. SRP gave gains of 0.42 and 0.78 mm respectively with superiority seen over the SPC group at 90 days (p<0.001) in study A only. For BOP reduction, in Study A SRP was superior to Sa. VC. and SPC at 60 and 90 days (p<0.005) and in Study B superiority to Sa and VC was at 90 days and to SPC at 60 days (p<0.05). Sa was superior to VC for pocket depth in deep pockets only. Sa failed to demonstrate superiority over VC on a consistent basis. Analysis of residual Sa indicates that Sa potency was insufficient to show an advantage beyond clinical effects inherent in treatments with VC and SPC.
Measurement of patient‐derived utility values for periodontal health using a multi‐attribute scale
Authors: Bellamy C. A. , Brickley M. R. , McAndrew R.
Published: December 2005

Abstract Periodontal health states are difficult to quantify and no formal scale quantifying patients' utilities for periodontal health states exits. Multi‐attribute utility (MAD) techniques were used to develop such a scale. The MAU scale maybe used to quantify patients' assessment of their current periodontal health and that of possible treatment outcomes. Such data, combined with probability values in formal decision analysis techniques would result in improved rationality of treatment planning for periodontal disease. 20 patients attending for routine undergraduate care were interviewed. Data from these interviews were sorted into groups of common interest (domains). Intra‐domain health statements were complied from the interview content. 21 patients ranked the intra‐domain statements on a scale of 0–100. This same group of patients also performed an inter‐domain weighting. Mean results showed that patients were 2× as concerned with how they felt and with the prognosis of possible outcomes, than with how they looked and what facts they knew about their oral health. However, the real value of utilities research lies in application of individual results to treatment planning, as there is a wide range of opinion regarding outcome health states.
A longitudinal study of various crevicular fluid components as markers of periodontal disease activity
Authors: Nakashima Koichi , Giannopoulou Catherine , Andersen Elene , Roehrich Nicolas , Brochut Patrick , Dubrez Bertrand , Cimasoni Giorgio
Published: December 2005

Abstract In order to examine the relationship of possible crevicular biochemical parameters to attachment loss (ALOSS), 330 sites from & untreated adult patients were monitored longitudinally at 3‐month intervals, for up to 1 year. Attachment levels were measured with a force‐sensing probe and an acrylic stent in duplicates at each study point. Crevicular samples were collected and used for the determination of the following 11 markers: number of polymorphonuclear leukocytes (PMNs), prostaglandin E2 (PGE2), osteocalcin (OC), alkaline phosphatase (ALP), collagenase (COL), β‐glucuromdase (BG), antigenic and functional elastase (AEL and FEL), α‐1 antitrypsin (alAT), α‐2 macroglobulin (a2M) and aspartate aminotransferase (AST). 10 sites with ALOSS of 1.5 mm per 3 months (active sites) and 43 sites with negligible changes (inactive sites) were identified. Total amounts of ALP, BG and COL were found to be significantly higher in active as compared to inactive sites, prior to significant ALOSS, without any significant differences in crevicular fluid volume and clinical indices. When biochemical parameters were expressed as ratios to the number of PMNs, PGE2/PMNs was significantly elevated in active sites. The capacity of such individual parameters to distinguish between active and inactive sites was limited. However, linear discriminant analysis using total amounts of PGE2, COL, ALP, a2M, OC and AEL showed more significant diagnostic values (sensitivity: 80%. specificity: 91%). These findings suggest that the combination of several biochemical parameters in crevicular fluid could give more information to predict future clinical ALOSS.
The effect of cyclosporin‐A on the oral microflora at gingival sulcus of the ferret
Authors: Fischer Ricardo Guimaraes , Edwardsson Stig , Klinge Björn , Attström Rolf
Published: December 2005

Abstract The effect of cyclosporin‐A (CyA) on the dentogingival flora of ferrets with healthy and experimentally induced periodontal breakdown was studied. Five animals were given 10 mg/kg/d CyA. At the start of the experiments (day 0). ligatures were placed around 4 teeth in the right upper and lower jaws: corresponding contralateral teeth on the left side served as control. On days 0 and 28 (end of the experiment), microbiological samples were collected from the gingival sulcus of the experimental and the control teeth and from closely located gingival mucosa membrane. The samples were subjected to viable counts and to darkfield microscopic analyses. On day 0. facultative anaerobic rods, mainly Pasteurella spp, Alcaligenes spp. Corynebacterium spp. and Rothia spp dominated in the viable counts. No anaerobic bacteria were detected in the viable counts. On day 28 spirochetes increased in the experimental gingival sulcus samples and anaerobic bacteria appeared in most of the samples and constituted 40–60% of the total cultivable flora: Fusobaclerium necrophorum and Eubacterium spp. predominated in the samples from the experimental sites. The results of the present study were compared with those of our previous investigation of ferrets not medicated with cyclosporin but also subject to experimental ligature penodontitis. Eubacterium spp. were absent in the animals not treated with cyclosporin, while this species was frequently present in the immunosuppressed ferrets. The results indicate that the presence of the large numbers of gram negative rods and of anaerobic bacteria may have enhanced the inflammatory process and further provoked the gingival overgrowth observed.
Salivary peroxidase activity in whole saliva of patients with insulin‐dependent (type‐1) diabetes mellitus
Authors: Güven Y. , Satman I. , Dinççaǧ N. , Alptekin S.
Published: December 2005

Abstract In this study, salivary peroxidase activity was measured in a group of 10 patients with insulin‐dependent (type I) diabetes mellitus (IDDM) who had a tendency towards periodontitis. In healthy subjects (N: 10), mean salivary peroxidase activity was 0.0025±0.001 IU/ml, while in this group of type I diabetic patients it was 0.051±0.015 IU/ml, a significantly higher level (p <0.001). Approximal plaque index (API), modified sulcus bleeding index (mod SBI) and pocket depths were assessed clinically. The values for mod SBI and API were 60% and 68% respectively for the diabetic patients while for the control group mod SBI was measured 0.0% and the value for API was 10.67% (p < 0.001). The administration of this simple and practical test may provide an early marker of a tendency towards periodontitis in IDDM patients.
Resorption rates of 2 commercially available bioresorbable membranes
Authors: Miller Neal , Penaud Jacques , Foliguet Bernard , Membre Hervé , Ambrosini Pascal , Plombas Marc
Published: December 2005

Abstract The respective resorption rates of recently commercialized collagen versus polylactic acid‐citric acid ester membranes were compared. 16 rabbits were implanted with 2 mmx4 mm pieces of membrane of both types in the alveolar mucosa just apically to the incisors on either side of the mouth. 1 animal was sacrificed on day 0, just after the operation. The others were sacrificed at 1. 2, 3, 5, 7, 9 and 12 weeks. The specimens were prepared for histologic examination. Observations showed that the cross‐linked collagen membranes induced severe inflammation and were resorbed within 2 weeks. The polylactic acid‐citric acid ester polymer barriers produced a much more moderate infiltrate and were still not totally resorbed at 12 weeks. Although resorption rates in the rabbit may not be similar to those observed in humans, it seems that the durability of the polymer barrier is more adequate for guided tissue regeneration than the cross‐linked collagen.
Periodontal healing following reconstructive surgery: effect of guided tissue regeneration
Authors: Nygaard‐østby Per , Tellefsen Georg , Sigurdsson Thorarinn J. , Zimmerman Grenith J. , Wikesjö Ulf M. E.
Published: December 2005

Abstract Clinical healing following guided tissue regeneration (GTR) in deep intrabaony pockets was compared to healing following gingival flap surgery alone (GFS). 15 patients received the GTR treatment including an expanded polytetrafluoroethylene membrane. 13 other patients received the control treatment GFS. A postsurgery protocol emphasizing wound stability and infection control was used. Treatment effects were evaluated 6 months postsurgery. Mean pre‐surgery probing depth for the GTR and control treatments was 7.5±1.0 and 7.7±1.5 mm. respectively. Significant probing depth reduction (3.8±1.2 and 2.9±1.1 mm), attachment level improvement (2.4±2.1 and 2.2±1.2 mm) and bone fill (2.0±2.0 and 2.4±0.9 mm) followed the GTR and control protocols, respectively (p < 0.01) Significant differences between GTR and control treatments were observed in probing depth reduction (p < 0.01) and in gingival recession increase (1.7±1.5 and O.7±0.9 mm. respectively; (p < 0.05). The results suggest that GTR procedures compared to GFS have similar clinical potential in intrabony pockets, under the present protocol.