bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of splinting on tooth mobility. I. During initial therapy
Authors: Kegel Wally , Selipsky Herbert , Phillips Ceib
Published: December 2005

Abstract. The purpose of this study was to assess whether fixed splinting aided in the reduction of posterior tooth mobility during initial therapy. A “split‐mouth” approach was used in order to compare splinted segments with similar unsplinted segments. Seven patients were selected, all of whom demonstrated chronic destructive periodontitis and mobile teeth. Initial therapy, consisting of oral hygiene instruction, root curettage and occlusal adjustment, was performed over a 2‐week period. At the time of initial therapy, teeth in contralateral segments were splinted with an intracoronal wire‐and‐acrylic splint. Tooth mobility and gingival inflammation were recorded in all four segments every 3 weeks for a 15‐week monitoring period following initial therapy. The splints were removed before each data recording session and then replaced and the occlusion refined. Prophylaxis and oral hygiene instruction were repeated every second week throughout the monitoring period. The reduction in the mobility of teeth splinted during the entire therapy period did not differ from the reduction observed in the unsplinted segments. The reduction in tooth mobility observed in both the splinted and unsplinted segments over the 17‐week period can be attributed to the improved occlusal relationships and reduction in inflammation.
Juvenile periodontitis
Authors: Liljenberg B. , Lindhe J.
Published: December 2005

Abstract The microflora of periodontal pockets and some histopathological characteristics of adjacent tissues from individuals with clinical signs of juvenile periodontitis were studied. Adult individuals with ordinary, rapidly advancing periodontitis served as controls. All of the patients had been referred for specialist treatment. Using criteria defined by Baer (1971), the patients were assigned to one juvenile periodontitis (eight patients), one post‐juvenile periodontitis (seven patients) and one adult periodontitis group (seven patients). Only lesions around the first molars and central incisors were studied. Bacterial samples were obtained from each site and were examined by darkfield microscopy and different morphological forms identified. The soft tissue of the diseased sites was excised. The biopsies were placed in a fixative, cut in 1‐mm‐thick blocks and embedded in Epon. In semithin sections the infiltrated connective tissue (ICT) was identified and the ICT portion further processed for electron microscopy. The numeric and volumetric densities of different cells and structures of the ICT were determined using a morphometric point‐counting procedure.

The results showed that juvenile periodontitis lesions are associated with a subgingival microflora, the composition of which is different from that of adult periodontitis. Thus, in patients belonging to the adult periodontitis and post‐juvenile periodontitis groups, motile microorganisms dominated the subgingival plaque samples, whereas deep pockets in juvenile periodontitis lesions contained a flora dominated by coccoid cells and straight non‐motile rods.

The most pronounced difference in the composition of ICT between the juvenile on one hand and the post‐juvenile and adult periodontitis lesions on the other, was related to the amount of extracellular structures. Thus, in post‐juvenile and adult periodontitis lesions, collagen and residual tissue made up around 50% of the infiltrate. In the juvenile periodontitis lesions, however, extracellular structures occupied only around 20% of the volume. In the ICT of the juvenile periodontitis sites, around 70 % of the volume was occupied by plasma cells and blast cells. The corresponding figures for the post‐juvenile and adult periodontits sites were 50 and 30%.
The furcation problem
Authors: Wærhaug Jens
Published: December 2005

Abstract The furcation problem was studied in a dental autopsy material, i.e. extracted teeth were examined under the stereomicroscope. The folowing conclusions were reached: extraction. Plaque and Gingival Indices, degree of mobility, and other pertinent clinical data were recorded. A landmark was made on the tooth surface at the gingival margin so as to localize the margin during the examination of the extracted tooth. Immediately following the extraction, loosely attached soft tissue between the roots and in the area of the junctional epithelium were removed; any blood was washed away. The tooth was kept in a 1 % solution of Water Blue for 10 min, rinsed in running water, and air‐dried. The teeth were examined under the stereomicroscope. The following conclusions were reached:

Subgingival plaque is common, even in the absence of supragingival plaque, among patients who have started efficient supragingival plaque control but after subgingival plaque has been formed.

Efficient supragingival plaque control may remove subgingival plaque as far as 2.5 mm below the gingival margin.

Subgingival plaque, in the absence of supragingival plaque, is only occasionally associated with a marginal gingivitis. Subgingival plaque, in the absence of supragingival plaque, causes a clinically undetectable submarginal gingivitis which leads to destruction of the attachment apparatus and eventually to furcation involvement. Loss of attachment, whether it takes place on the outer surfaces or in the furcations, is strongly correlated with subgingival plaque and submarginal gingivitis. There is no correlation between visible supragingival plaque and loss of attachment in the furcations, nor is there any association between subingival plaque in the furcations and marginal gingivitis. The conventional Plaque and Gingival Indices do not reflect the actual conditions in advanced destructive periodontal disease, including furcation involvement. Subgingival plaque control is likely to be incomplete on the outer surfaces and is a total failure in the furcations. In established furcation involvement more attachment is likely to be lost between the roots than on the outer surfaces.

An early diagnosis is essential for successful management of the furcation problem. But it is extremely difficult to make a correct diagnosis because so many of the clinical criteria are misleading and because pain often precludes the probing which is necessary to establish the extent of the lesion.

Root resection can be given a logical place in the overall plaque control rationale; but the indication for this treatment is strongly dependent on the anatomy of the tooth, the age of the patient and his predisposition to destructive periodontal disease.

The prognosis of root resection depends on successful endodontic treatment as well as total plaque control.

Increased mobility is a very late symptom in the development of the furcation involvement and is not involved in its etiology.
Prevalence of juvenile periodontitis in Finland
Authors: Saxén Leena
Published: December 2005

Abstract The prevalence of juvenile periodontitis was studied in Finland, in an ethnic group representing a uniform Caucasoid population. The study population consisted of the 16–year‐old subjects in the county of Uusimaa, population approximately 1,000,000. The screening study was based on the well‐organized national dental care service which provides free dental care for all, up to the age of 17. Bitewing radiographs taken of all subjects at the age of 16 were used as the basic material for screening for juvenile periodontitis. Altogether 8,096 pairs of bitewing radiographs were available from the 16–year‐old subjects born in 1960–61, representing 56 % of the total age group. The radiographs were examined by the author and 28 cases were singled out for thorough clinical and radiographic examination. The following criteria were set for juvenile periodontitis:

The patient must be in good general health

Radiographically detectable bone loss more than 2 mm must be demonstrated around more than one tooth

Local irritants must not be commensurate with the bone loss.

Eight cases among the 8,096 subjects fulfilled these criteria giving a prevalence of 0.1 %. With 95 % confidence this gives an estimate between 0.06 and 0.26 %.
Effect of stannous fluoride mouthrinse on dental plaque formation
Authors: Tinanoff N. , Hock J. , Camosci D. , Helldén L.
Published: December 2005

Abstract A double‐blind, crossover design study was performed on 29 young adults to test the effectiveness of 0.1 % SnF2 mouthrinse (250 ppmF−) on plaque formation using clinical and microbiological criteria.

Participants were assigned to either a placebo or SnF2 rinse which was used twice daily for 5 days. After an interim recovery period of 2 days, the participants used the alternate rinse in a similar manner for another 5 days. Clinical data collected at the end of each experimental period included Gingival Index (GI), and plaque scores. Supragingival plaque removed from each subject at the end of the experimental periods was weighed and then microbial enumeration was performed.

Results showed that after SnF2 rinses, there were statistically significant reductions (P < 0.01) in plaque wet weight, number of bacteria per milligram plaque (CFU/mg). and total number of bacteria per sample (Total CFU). Visual plaque scores (PS) showed a significant (P < 0.05) but small reduction as a result of SnF2 rinse. No significant difference in gingival inflammation was noted.

It is apparent from this study that, besides the well‐documented ability of SnF2 to increase the resistance of teeth to demineralization, this agent is capable of reducing plaque formation. Long‐term studies are indicated to examine usefulness of SnF2 in the control of early periodontal disease.
Clinical standardization of horizontal tooth mobility*
Authors: Stoller Norman H. , Laudenbach Kenneth W.
Published: December 2005

Abstract The clinical measurement of horizontal tooth mobility is discussed on the background of the current theories regarding the pathogenesis of periodontal disease. The common indices which have been designed to measure horizontal tooth mobility are discussed and critiqued. These indices are not sensitive in that they do not discriminate well between small increments in mobility. In addition, many of the indices cannot be utilized for individual teeth on a longitudinally reproducible basis.

The preliminary testing of an in vitro model with mobile teeth which was designed to aid the clinician in assessing tooth mobility is described. Results indicate that the clinician may be capable of discriminating between mobilities that are in the 0.1 mm range, with the aid of the model.
Assessment of tooth mobility using small loads
Authors: Persson Rutoer , Svensson Alvar
Published: December 2005

Abstract An apparatus for recording tooth mobility of maxillary anterior teeth using loads below 100 p in a bucco‐lingual direction is described. Strain gauges and a differential transformer are used as sensors of force and displacement. The displacement is recorded at the same location on the tooth surface and in the same direction as the loading force. Compressed air is used as the source of force. Documentation of signals is obtained by means of a two‐channel potentiometric recorder.

Tooth mobility was studied in six subjects with healthy periodontal conditions and in six subjects with moderate periodontal disease. Repeated measurements under standardized conditions demonstrated a satisfactory reproducibility of the measuring method. Tooth mobility curves within the 20–80 p loading range were transformed to lines of regression. Analysis of such lines seems to provide further information of tooth mobility qualities as compared to previous methods of tooth mobility measurements.
Heredity of juvenile periodontitis
Authors: Saxén Leena
Published: December 2005

Abstract A family study was carried out, based on the hypothesis that juvenile periodontitis is inherited in an autosomal recessive mode. Propositi were selected according to standardized criteria. Thirty‐one cases with a female/male ratio of 20 to 11 were obtained. Their first‐degree relatives were examined radiographically, mostly by orthopantomography. Sixty parents. 64 siblings (out of 66) and three children aged 13–16 were traced and examined. Neither parents nor the children showed findings suggestive of juvenile periodontitis, whereas 11 of the 64 siblings were affected.

The genetic ratio was first calculated by using an a priori method assuming complete ascertainment. The result, 0.256 ± 0.061, is close to the theoretical assumption of 0.25. Since the calculation was based on the assumption that juvenile periodontitis is inherited as an autosomal recessive trait, the results were also exposed to an a posteriori analysis assuming a truncate, complete ascertainment. The result. 0.268 ± 0.062, is again close to the expected ratio for autosomal recessive inheritance. A third method assuming a single, very incomplete ascertainment gave a much lower ratio. It is concluded that the results of the family study are compatible with the hypothesis that juvenile periodontitis is inherited in an autosomal recessive mode.
An analysis of factors affecting compliance with tooth‐cleaning recommendations
Authors: Rayant Garry A. , Sheiham Aubrey
Published: December 2005

Abstract A study was undertaken on a group of patients who have had periodontal treatment in an attempt to test some of the predictions of the “Health Belief Model” (Rosen‐stock et al. 1966). This present study set out to test whether (1) persons who knew they had periodontal disease (hence considered themselves susceptible) (2) thought the condition serious and (3) had a knowledge of how to prevent the disease (4) were effectively complying with a previously prescribed oral hygiene regimen.

The study was conducted at a school of dental hygiene, providing a source of patients attending specifically for periodontal care and where the format of hygiene instruction and treatment is largely standardized.

A questionnaire was designed to assess (1) attitudes and beliefs (2) knowledge of the disease (3) reported behavior. Gingival health was measured using Gingival Index (Löe & Silness 1963) and patients actual behavior was measured using the Plaque Index (Silness & Löe 1964).

The majority of the highly motivated patients in the study were concerned with their susceptibility to, the seriousness of, and the benefits of treatment for periodontal disease. They were stimulated to take action by a cue. bleeding gums. These findings confirm the predictions made in the Health Belief Model.

However, none of the factors in the Health Belief Model were significantly associated with the gingival health status of the patients, indicating that other factors were important for patients to clean their teeth effectively. It was also shown that information is not necessary followed by a change in behavior.
Influence of optimal and excluded oral hygiene on early formation of dental plaque on plastic films
Authors: Brecx Michel , Theilade Jørgen , Attström Rolf
Published: December 2005

Abstract The influence of oral hygiene on early plaque formation has been studied. The amount and structure of dental deposits formed on plastic films were determined at two occasions with or without a preceding period of effective oral hygiene. Six human subjects developed plaque during 4 hours on plastic films applied to the buccal surfaces of premolars and cuspids. The plastic films with adhering deposits were processed for electron microscopy. In presence of healthy gingiva, the plastic films were covered by a surface coating of acellular material in or on which bacteria, epithelial cells and leukocytes were observed. The microorganisms were almost exclusively Gram‐positive cocci. When plaque formation was preceded by a week of excluded oral hygiene, the deposits collected on the same teeth exhibited a threefold increase in the number of bacteria. The relative composition of the flora was altered, as evidenced by a higher number of Gram‐negative cells as well as the occurrence of rods and filamentous organisms. The results indicate that neglect of oral hygiene favors an earlier establishment of a complex bacterial flora at the dento‐gingival region of the buccal surfaces of premolars and cuspids.
Healing following implantation of periodontitis‐affected roots into gingival connective tissue
Authors: Nyman Sture , Karring Thorkild , Lindhe Jan , Plantén Staffan
Published: December 2005

Abstract The aim of the present investigation was to examine if a new connective tissue attachment can be established on a previously periodontitis involved root surface, located in contact with gingival connective tissue during healing. A total of 28 teeth in one dog (beagle) and two monkeys (Macaca cynomolgus) were subjected to experimental periodontal tissue breakdown by placing cotton floss ligatures or orthodontic elastics around the teeth. The ligatures were left in situ until about 50% of the supporting tissues had been lost. Following resection of the crowns, the teeth were root filled and the exposed parts of the roots thoroughly scaled and planed. Each root was extracted and implanted into grooves prepared in edentulous areas of the jaws in such a way that the root was embedded to half its circumference in bone, leaving the remaining part to be covered by the gingival connective tissue of the repositioned flap of the recipient site. Root implantation and sacrifice of the animals were scheduled to allow for observation periods of 2 and 3 months of healing. An analysis of histologic specimens, obtained from biopsies of the recipient site tissues, disclosed that a new fibrous attachment failed to form on a previously “exposed” root surface located in contact with gingival connective tissue. In areas of the roots where the periodontal ligament tissue was preserved prior to transplantation, a fibrous reattachment occurred between the root and the adjacent gingival tissue. The results indicate that gingival connective tissue does not possess the ability to establish conditions which enable the formation of a new connective tissue attachment.
Antimicrobial effect of fluorides on Bacteroides melaninogenicus subspecies and Bacteroides asaccharolyticus
Authors: Yoon Nancy A. , Newman Michael G.
Published: December 2005

Abstract. This study was undertaken to determine whether the suspected periodontopathogens Bacteroides melaninogenicus ss melaninogenicus and intermedius and Bacteroides asaccharolyticus are killed by clinically used topical fluorides. The viability of each organism was examined after exposure to three fluoride compounds, stannous (SnF2), acidulated phosphate (APF), and neutral sodium (NaF), for 1 and 8 h. Stannous fluoride was found to be effective at lowest fluoride concentrations with APF next in effectiveness. NaF required the highest concentrations of fluoride to kill test organisms. Longer exposure times were found to be more effective at lower concentrations. Data obtained in this study with gram‐negative organisms support and extend previous information regarding the antibacterial effect of fluorides against gram‐positive periodontopathogens.
Plaque removal by dental floss or toothpicks
Authors: Bergenholtz Axel , Brithon Jan
Published: December 2005

Abstract. The amount of plaque accumulation was assessed in an intraindividual study comprising 10 individuals. During different 2‐week periods, the test subjects used nylon floss (unwaxed, waxed and specially treated), silk floss (unwaxed and waxed), Superfloss®, or triangular toothpicks for interdental tooth cleaning. Only teeth in contact with neighboring ones and with open interdental spaces were included in the study. The plaque removal of the interdental aids used was registered by estimating the amount of plaque present at the end of each experimental period according to a Plaque Index (Silness & Löe 1964) modified for plaque registration on 10 surface units around each tooth. In general, dental floss had a higher plaque removing potential than triangular toothpicks, especially on lingual axial surfaces.
Therapeutic considerations in the management of a periodontal abscess with an intrabony defect
Authors: Kareha Michael J. , Rosenberg Edwin S. , Dehaven Harold
Published: December 2005

Abstract A case report of the clinically successful management of an intrabony pocket associated with a periodontal abscess of a lone‐standing, functioning mandibular canine utilizing an autogenous, intraoral site cortical and cancellous bone graft concurrently with a lateral pedicle soft tissue graft is presented. The rationale for the diagnostic, prognostic and therapeutic considerations is discussed in light of the experimental and observational knowledge gained from the literature to date.
Prediction of root surface caries in patients treated for advanced periodontal disease
Authors: Ravald Nils , Hamp Sven‐Erik
Published: December 2005

Abstract The present investigation was undertaken (1) to analyze the prevalence of root surface caries prior to and after periodontal treatment and (2) to determine the feasibility of using simple clinical criteria for predicting a patient's risk of developing root surface canes following periodontal therapy.

Thirty‐one patients were given advanced periodontal treatment including periodontal surgery. At baseline they were examined for oral hygiene status, periodontal status, root surface canes experience and number of lactobacilli per ml saliva as evaluated by the Dentocult® dip‐slide method. Follow‐up examinations 1, 2 and 4 years after baseline showed that a majority of the patients were treated successfully and maintained in periodontal health. Root surface caries developed in approximately two‐thirds of the patients during the 4–year observation period. However, the total increment of root lesions during these years was mostly extremely low. i.e. less than 5% of exposed root surfaces.

In higher risk patients developing new root surface caries, significant correlations were demonstrated with initial pretreatment scorings for (1) their previous root surface caries experience, (2) high lactobacillus counts and (3) advancing age. In addition, root surface caries incidence and low saliva secretion rates were found to correlate significantly during the course of the study.
Retrospective longitudinal study of the rate of alveolar bone loss in humans using bite‐wing radiographs
Authors: Selikowitz Harry‐Sam , Sheiham Aubrey , Albert Douglas , Williams Gordon M.
Published: December 2005

Abstract This study investigates the possible use of unstandardized bite‐wing radiographs to determine the rate of alveolar bone loss over long periods of lime. A total of 100 pairs of bite‐wing radiographs obtained from patients of two general dental practitioners were read on a 3M Reader, normally used for reading microfilm. For the purpose of measurement, two reference points were selected on the teeth; the highest point on the occlusal surface of the crown, the mesial and distal points of the cemento‐enamel junction. Both vertical and horizontal bone loss was measured. Initially bone levels on 20 full mouth bite‐wing radiographs on all posterior teeth were measured, then in the next 80 cases, an abbreviated index was used. The bone heights were first examined at the beginning and then at the end of a 10–year time span. The percentages of measurable distances were 28% and 57%. From the Occlusal measurement point and the C E J measurement points, reasons for unreadability were also recorded. The annual rate of horizontal boneless was 0.06 mm and 0.04 mm from the Occlusal reference point and the CEJ reference point. The rates for the vertical bone loss were 0.05 and 0.03 mm. In order to study whether there was a constant loss over a period of time, bone levels were measured for 10 successive years. The findings suggest that the bone loss rate per year fluctuated. The study suggests that the bite‐wing radiographs can be used in longitudinal studies of periodontal disease and can provide important information on the natural history of the disease.
Effects of malalignment of teeth in the anterior segments on plaque accumulation
Authors: Griffiths G.S. , Addy M.
Published: December 2005

Abstract The importance of malposition of teeth and plaque accumulation is still not established. The purpose of this study was. to measure plaque accumulation on individual malpositioned teeth for comparison with contralateral nonmalpositioned teeth. Furthermore, the distribution of plaque in the anterior segments was measured and compared between aligned and nonaligned segments and the total mouth plaque score. Plaque scores and contact point indices were recorded from a total of 87 subjects of which 20 were drawn from dental and ancillary students and 67 from randomly chosen patients. For anterior teeth, in both groups significantly more plaque accumulated on malpositioned teeth compared with contralateral nonmalpositioned teeth. For the right‐handed subjects (83), mean plaque scores for malpositioned teeth were greater than for nonmalpositioned teeth whether the malpositioned tooth was on the right or left of the anterior segment. This difference was significant in the patient group. The contact point index of the anterior segments correlated only with plaque accumulation in those subjects with a plaque index of less than 1. Upper and lower anterior segment plaque scores correlated with total mouth scores in both groups. However, the upper anterior segment scores had significantly less plaque than the total mouth score irrespective of the presence or absence of tooth malalignment, whereas the lower anterior segment always had significantly higher plaque scores than the total mouth score, irrespective of the presence or absence of malalignment. Finally, lower segments, whether aligned or malaligned, had significantly more plaque than upper anterior segments which were aligned or malaligned.
Studies on immunologic and inflammatory factors in saliva in patients with asthma and in patients with periodontitis
Authors: Hyyppå Tuula
Published: December 2005

Abstract To study the salivary response in asthma and periodontitis, calcium and phosphorus concentrations were determined from parotid and whole saliva. The IgE and histamine concentrations and the activities of lysozyme and arginine aminopeptidases were assayed from whole saliva. The values were compared with those obtained from matched healthy controls (n = 20 in each group).

In whole saliva the phosphorus concentrations were elevated in the asthma group and the calcium concentrations in the periodontitis group. Regarding parotid saliva no significant differences between the group? were observed.

The results indicate that in patients with asthma the IgE concentrations in whole saliva were elevated, while in patients with periodontitis and in healthy controls no detectable values were obtained.

Both histamine and lysozyme concentrations seemed to increase in the asthma and periodontitis groups. A slight increase was also observed in the arginine aminopeptidase activities in the saliva of patients with asthma and patients with periodontitis.
An estimation of the strength of attachment of subgingival calculus to extracted teeth
Authors: Watts Trevor L. P. , Combe Edward C.
Published: December 2005

Abstract The approximate shear bond strength of subgingival calculus was measured on freshly extracted teeth. The experimental method was validated on polycarboxylate controls. The object was to specify a suitable upper limit for periodontal dressing adhesion, and a level of 4.0MN/m2 is suggested by these results
The temperature of the periodontal pockets
Authors: Mukherjee Sabyasaci
Published: December 2005

Abstract The temperature of 104 periodontal pockets of various depths was measured before institution of any preventive or curative therapy. A tendency to a rise in pocket temperature due to increased pocket depth was noted. However, statistically no linear correlation was observed between the temperature and the depth of the periodontal pockets. The possibility of using temperature measurements as a diagnostic and prognostic aid in periodontal disease has been discussed.
Treatment of periodontal infections due to anaerobic bacteria with short‐term treatment with metronidazole
Authors: Loesche W. J. , Syed S. A. , Morrison E. C. , Laughon B. , Grossman N. S.
Published: December 2005

Abstract In the present report, five selected periodontal patients were treated for 1 week with metronidazole. Two of the patients had their teeth scaled and root‐planed the week they received metronidazole. Prior to treatment, B. asaccharolyticus accounted for 41 % of the cultivable isolates and the spirochetes averaged 29 % of the microscopic count in plaque removed from each of four pockets per patient. The presence of these elevated proportions of periodontopathic bacteria combined with the presence of periodontal pockets and attachment loss suggested that the patients were in a state of an active infectious process involving primarily anaerobic bacteria. If this be the case, then antimicrobial therapy directed against these anaerobes with metronidazole was indicated. The 1‐week treatment with metronidazole significantly reduced the proportions of these organisms for up to 6 months after treatment. Coincident with these findings was an improvement in the clinical parameters, especially in those sites that initially had greater than 5 mm pocket or attachment loss. These sites showed a 2 mm or more reduction in pocket depth and an almost 2 mm gain in apparent attachment that was evident 6 months after treatment. The results obtained were in only five patients. However, the magnitude of improvement suggests that antimicrobial therapy directed against anaerobic organisms may be a valuable adjunct to periodontal therapy.
Effect of controlled oral hygiene procedures on caries and periodontal disease in adults
Authors: Axelsson P. , Lindhe J.
Published: December 2005

Abstract The present report describes the result of a clinical trial in which a group of adults have been maintained on a proper oral hygiene standard over a 6‐year period. In 1971–72, 375 individuals were recruited to a test group and 180 to a control group. During the 6 years of trial, 65 persons from the test group and 34 controls were lost. The patients were divided into three age groups; I <35 years, II 36–50 years, III >50 years. The members of the test and control groups were first subjected to a Baseline examination which included assessments of oral hygiene, gingivitis, periodontal disease and caries. Following this examination all caries lesions were treated and ill‐fitting dental restorations adjusted. Each patient was also given a detailed case presentation and a dental prophylaxis. The control group patients were not involved in any further dental health programs during the subsequent 6‐year period. Once a year, however, they were recalled to a public dental health clinic for examination and received symptomatic dental treatment. The test group participants, on the other hand, were given a preventive treatment, repeated once every 2–3 months which included (1) instruction and practice in oral hygiene techniques and (2) meticulous prophylaxis.

The patients were re‐examined 3 and 6 years after the baseline examination. At the Follow‐up examinations the parameters studied at the Baseline examination were recorded again. The findings demonstrated that a preventive program which stimulates individuals to adopt proper oral hygiene habits may resolve gingivitis and prevent progression of periodontal disease and caries. Traditional dental care, on the other hand, did not prevent the progression of caries and periodontitis in adults.
Microbial etiology of periodontal disease
Authors: van Palenstien Helderman Wim H
Published: December 2005

Abstract Longitudinal studies with humans indicate that gingivitis is associated with an increased dental plaque mass. Also, prior to the onset of gingivitis, changes in the microflora towards a more complex bacterial composition frequently occur. On the other hand, recent cross sectional cultural studies generally do not reveal clear‐cut differences between the composition of the subgingival microflora associated with healthy or inflamed gingivae. Also, some studies have demonstrated an enhanced cell‐mediated immune response during the course of gingivitis to a variety of subgingival plaque bacteria. It has also been observed that plaques allowed to form on cleaned teeth for 2 or 3 days do not differ substantially in their microbial composition. However, long‐term thorough oral hygiene performed at intervals of 48 h permits maintenance of gingival health, whereas that instituted at intervals of 72 h will lead eventually to gingivitis. Collectively, this evidence supports the concept that the etiology of gingivitis is bacteriologically nonspecific. Thus a large increase in the accumulation of bacteria on the tooth surface per se may have a greater pathogenic effect on the periodontal tissues than the relatively minor and inconsistent shifts in the microbial composition.

The transition from gingivitis into periodontitis may be induced by changes in the pathogenic potential of subgingival plaque. Gram‐negative rods appear to be specifically associated with periodontitis. A growing body of evidence implicates especially Bacteriodes asaccharolyticus as one of the responsible pathogens.

Juvenile periodontitis (periodontosis) seems to be a distinct disease entity. Recent findings suggest abnormalities in peripheral blood polymorphonuclear leucocytes (PMNL) of patients with juvenile periodontitis. The subgingival microflora is different from that associated with periodontitis and the findings so far implicate Actinobacillus actinomycetemcomitans as an important pathogen.

The bacterial etiology of acute necrotizing ulcerative gingivitis (ANUG) is still unclear. Satisfactory cultural studies have yet to be performed. The presence of spirochetes in the ulcerative lesions of the junctional epithelium does not necessarily imply that they play an important role in this disease entity.

Future research on the bacteriology of periodontal disease should concentrate on longitudinal studies; particular attention should be paid to the change of gingivitis into periodontitis whereby animals as well as humans can be used. Improvements of sampling methods as well as precise and simple identification techniques of microorganisms are required.
Comparison of the in vivo and in vitro antibacterial properties of antiseptic mouthrinses containing chlorhexidine, alexidine, cetyl pyridinium chloride and hexetidine
Authors: Roberts W. R. , Addy M.
Published: December 2005

Abstract A study was carried out to compare the antibacterial properties of four cationic antiseptics, three of which are available as commercial mouthrinse preparations. Minimum inhibitory concentrations for alexidine, cetyl pyridinium chloride, chlorhexidine gluconate and hexetidine against a range of standard test organisms, were determined by tube dilution, Similar values for Oxford staphylococcus were then obtained in Dubos medium to which protein as yeast, or food extract, or serum was added in doubling dilutions to 16%. Salivary bacterial counts after a single rinse with the antiseptics 01 water throughout the day were measured in 10 subjects together with the duration of any residual antiseptic activity in the saliva. All antiseptics were effective at low concentrations against the organisms tested but the minimum inhibitory concentration values for hexetidine were the highest. Food extract and serum markedly increased the minimum inhibitory concentration values of all antiseptics, although alexidine and hexetidine were the least affected in percentage terms. The activity of a 1% povidone iodine preparation, used for comparison, was almost completely vitiated. An immediate significant fall in salivary bacterial counts was produced by the cationic antiseptics. Return to pre‐rinse levels was seen for hexetidine after 90 min, cetyl pyridinium chloride after 3 hours, alexidine after 5 hours and chlorhexidine gluconate after 7 hours. Residual salivary antibacterial activity remained to 90 min for cetyl pyridinium chloride, to 3 hours for alexidine and alexidine and to 5 hours for chlorhexidine gluconate. The antibacterial properties measured, in particular the duration of effect in vivo, may be relevant to the anti‐plaque activity of cationic antiseptics.
Role of keratinized gingiva for gingival health
Authors: Wennström J. , Lindhe J. , Nyman S.
Published: December 2005

Abstract The present study was carried out in the Beagle dog in order to determine if variations of the width of the zone of keratinized gingiva occur in the canine dentition, if the width alters during the development of destructive periodontitis and if, subsequent to surgical excision of the periodontal lesion, the regenerated gingival margin differs from that of a normal, noninflamed gingiva. Five dogs were used. A baseline examination comprised assessments of dental plaque, gingival conditions and width of the zone of keratinized gingiva. Cotton floss ligatures were placed around the teeth on the right side of the jaws and plaque was allowed to accumulate in order to induce periodontal tissue breakdown. After 150 days the inflamed periodontal tissues around the experimental teeth were removed surgically using a “gingivectomy” or a flap procedure. In the “gingivectomy” procedure the entire zone of the keratinized gingiva was excised whereas the main part of the keratinized tissue was maintained with the flap procedure. During a healing period of 120 days plaque control was carried out daily. On the left side of the jaws (control side) a careful toothcleaning program was performed during the entire observation period of 270 days. Clinical examinations of all control and experimental tooth units were repeated on days 150 and 270. Biopsies were sampled from both sides of the jaws on day 270. In histological sections the free gingival tissue was subjected to histometric assessments and a stereologic analysis based on a standardized morphometric point‐counting procedure. In addition, the number of leukocytes residing within the junctional epithelium was determined.

The results showed that in Beagle dogs the width of the keratinized gingiva (WKG), on the facial aspect of premolars and molars, varies between 2 and 6 mm. During a period of 270 days of careful plaque control, the WKG was maintained unaltered. In comparison, a phase of experimental periodontitis resulted in a substantial decrease of the WKG. Subsequent to the excision of the inflamed periodontal tissues, which in some cases included the entire zone of the keratinized gingiva, a new free gingival unit developed. In most respects the structural composition of this regenerated gingival unit was similar to that of a normal control unit. Furthermore, in the absence of plaque, the regenerated soft tissue was free from signs of inflammation independent of presence or absence or width of the keratinized zone.
Serum neutralizing activity against Actinobacillus actinomycetemcomitans leukotoxin in juvenile periodontitis
Authors: Tsai Chi‐Cheng , McArtkur William P. , Baehni Pierre C. , Evian Cyril , Genco Robert J. , Taichman Norton S.
Published: December 2005

Abstract A relatively high incidence of infection by Actinobacillus actinomycetemcomitans can be shown in subgingival plaque samples obtained from patients with juvenile periodontitis. These organisms possess a potent leukotoxin(s) which rapidly destroys isolated human polymorphonuclear leukocytes (PMNs) and monocytes. If such leukotoxins operate in vivo, they could deprive the gingival crevice area of an essential antibacterial defense mechanism. We have found that sera from juvenile periodontitis patients consistently (>90%) contain antibodies which neutralize Actinobacillus actinomycetemcomitans leukotoxin(s). On the other hand, sera from normal individuals or patients with other types of periodontal disease usually amplified rather than inhibited the leukotoxic reaction. Many patients with juvenile periodontitis have demonstrable defects in PMN or monocyte chemotaxis and this may place them at risk to gingival infection by Actinobacillus actinomycetemcomitans. The immune response against these organisms could be a crucial determinant in the course of juvenile periodontitis. While this disease is relatively rare, it does cause immeasurable emotional, physical and economic hardship for patients and their families. The identification of Actinobacillus actinomycetemcomitans as a potential pathogen in this disorder may eventually lead to specific forms of therapy to prevent and eliminate infection by this organism in these patients.
Studies of a periodontal tissue lesion in the rat, untreated or treated with chlorhexidine digluconate
Authors: Kenworthy R. , Baverel M.
Published: December 2005

Abstract The studies currently reported farmed part of an enquiry whose overall objective was to identify a suitable animal model upon which initial screening of compounds and formulations with prophylactic and/or therapeutic potential in periodontitis could be carried out, An earlier study (Rovin et al. 1966) reported that periodontal inflammation could be produced in the conventional laboratory rat by application of a ligature to the molar teeth. The present paper describes the pathological and histopathological changes in the periodontium following application of ligatures to the molar teeth of young rats, and the tissue responses observed after topical application of chlorhexidine digluconate. Plaque formed rapidly and an acute periodontitis was induced; application of increasing concentrations of chlorhexidine digluconate gave a progressive diminution in the severity of the lesions. The major bacterial components of the plaque were actinomycetes and streptococci.
Dental prophylaxis for youths in their late teens I. Clinical effect of different preventive regimes on oral hygiene, gingivitis and dental caries
Authors: Hamp Sven‐Erik , Johansson Lars‐Åke
Published: December 2005

Abstract The effect of a dental prophylactic program based on systematic plaque control has been tested during a 3‐year period on youths aged 16–19 years. During their last year at comprehensive school they received professional tooth cleaning every third week by specially trained dental hygiene nurses. At the end of this first experimental year the subjects were offered continued prophylaxis of the same type against caries and gingivitis during 2 more years. Interested subjects were divided equally at random into test groups A and B. In the second year group A received professional tooth cleaning once a month and in the third year once each 6 months. Group B was offered, both in the second and third years, only two prophylactic sessions each year according to this model. Test group C comprised the subjects who expressed no interest in continued professional tooth cleaning. A control group, group D, consisted of pupils of the same ages from a neighboring school area. These received in the first experimental year a prophylactic program based on mouthrinsing each second week with 0.2% sodium fluoride solution. After this first year neither test group C nor the control group D participated in any organized dental health care program.

After the first year there were significant differences among the groups, the plaque and gingival indices in the control group D being significantly higher than in test groups A, B and C. At the end of the third year significant improvements in these indices had taken place in groups A and B. The corresponding values in groups C and D did not differ significantly at the three recordings. Significant correlations existed between the plaque and gingivitis scores at the end of the experimental period within the respective groups.

Significantly more dental caries (new DPS) developed in the control group D than in test groups A and B during the period of the experiment: on average 3.3 versus 1.0 and 1.2 new DFS, respectively. The figure for caries increment in group C was 2.0. Regardless of grouping, individuals with caries increment during the experimental period had a significantly higher number of risk factors, here defined as the total of upper or lower quartile values for lactobacillus counts, secretion rate and buffering capacity of the saliva, than individuals without caries increment.
Experimental use of a slow release device employing chlorhexidine gluconate in areas of acute periodontal inflammation
Authors: Coventry J. , Newman H. N.
Published: December 2005

Abstract Eleven patients suffering acute exacerbations of chronic periodontitis were treated by the insertion into affected periodontal pockets of dialysis tubing containing 20% chlorhexidine gluconate. After 7 days, 9 of the 11 patients exhibited greatly reduced crevicular fluid flow, relief of discomfort and the cessation of bleeding on probing.
Scanning electron microscopy of unused and used manual toothbrushes
Authors: Massassati A. , Frank R. M.
Published: December 2005

Abstract A scanning electron microscopic study of the brushing surface of 17 different types of commercial toothbrushes with natural and nylon bristles was conducted on new unused brushes as well as on 65 brushes used from 1 month up to 1 year, once, twice or three times a day, with various brushing techniques. Natural swine or wild boar toothbrushes, even when new, had filaments of irregular length and diameter with deficient and irregular ends. These defective surface conditions became worse with use. Unused soft and hard nylon toothbrushes were made of tufts with bristles of the same length and diameter with cut or rounded ends. The surface of the bristle ends was generally flat but various surface defects were observed. The contours of the bristle ends of both types of nylon toothbrushes improved with use, becoming smooth and rounded. Deteriorations of the brushing surfaces of both soft and hard nylon brushes were observed at time intervals varying from one subject to another, but hard nylon bristles wore best. Soft nylon brushes wore out more rapidly.
Histologic probe position in treated and untreated human periodontal tissues
Authors: Fowler Clifford , Garrett Steve , Crigger Max , Egelberg Jan
Published: December 2005

Abstract This study was designed to histologically determine the relationship of the periodontal probe tip to the periodontal tissues during probing of untreated periodontal pockets and periodontal pockets treated with oral hygiene and root planing. Human, condemned, single rooted teeth with buccal probing pocket depth at least 6 mm were used. Two groups of specimens were included: 12 untreated teeth from six patients and 15 treated teeth from 10 patients.

In the treated group, the effects of therapy were monitored clinically every 2 weeks until maximum improvement had taken place. A periodontal probe tip was then inserted on the buccal aspect of the tooth using 0.50 N pressure, and block section biopsies were taken. The histologic examination of the untreated teeth showed that the probe tip penetrated beyond the apical termination of the functional epithelium and into the subjacent connective tissue by a mean of 0.45 ±0.34 mm, whereas in the treated specimens the probe stopped coronally to this landmark by a mean of 0.73±0.80 mm.

This study demonstrated that the probe tip most often does not reach the base of the junctional epithelium in pockets treated by plaque control and root planing, and that clinical measurements of attachment levels are not reliable in determining the true histologic level of connective tissue attachment.