bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of severe atrophy of the maxilla with the prefabricated free vascularized fibula flap
Authors: Rohner Dennis , Bucher Peter , Kunz Christoph , Hammer Beat , Prein Joachim , Schenk Robert K.
Published: March 2003

Abstract: Treatment of severe maxillary atrophy despite complex major surgery often ends up with an unsatisfactory result. This paper presents the augmentation of the maxilla with a prefabricated free vascularized fibula flap in combination with ITI® implants (Straumann AG, Waldenburg, Switzerland) in 4 patients. The technique of prefabrication for the reconstruction of maxillofacial defects is described based on the experience with 17 patients. The key points of this treatment are i) preoperative planning and fabrication of the drilling template; ii) prefabrication of the fibula with ITI® implants and performing of a “vestibuloplasty” using a skin graft; iii) technical construction and fabrication of the suprastructure and the denture; iv) reconstruction of the maxilla using the prefabricated fibula as free vascularized flap. The reconstructions with the fibula flaps were successful and the 18 ITI® implants that have been inserted showed good osseointegration without loss of attachment in all 4 patients after a mean observation period of 12 months.
Long‐term follow‐up of osseointegrated titanium implants using clinical, radiographic and microbiological parameters
Authors: Leonhardt Åsa , Gröndahl Kerstin , Bergström Christina , Lekholm Ulf
Published: March 2003

Abstract: The aim of this study was to longitudinally follow up osseointegrated titanium implants in partially dentate patients by clinical, radiographic and microbiological parameters in order to evaluate possible changes in the peri‐implant health over time. Fifteen individuals treated with titanium implants, ad modum Brånemark, and followed for ten years were included in the study. Before implant placement ten years previously, the individuals had been treated for advanced periodontal disease and thereafter been included in a maintenance care program. The survival rate of the implants after ten years was 94.7%. The bone loss was 1.7 mm when using the abutment‐fixture junction as a reference point. Of the individuals, 50% were positive for plaque at the implants. Bleeding on sulcus probing was present at 61% of the implant surfaces. Ten years previously, the individuals had been carriers of putative periodontal pathogens, such as Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, Capnocytophaga spp. and Campylobacter rectus, and were also carriers of these species at the current examination. The results of the present study suggest that the presence of these putative periodontal pathogens at implants may not be associated with an impaired implant treatment. These species are most likely part of the normal resident microbiota of most individuals and may therefore be found at random at both stable and progressing peri‐implant sites.
Two‐stage IMZ implants and ITI implants inserted in a single‐stage procedure
Authors: Heydenrijk Kees , Raghoebar Gerry M. , Meijer Henny J. A. , Van Der Reijden Willy A. , Van Winkelhoff Arie Jan , Stegenga Boudewijn
Published: March 2003

Abstract: The aim of this study was to evaluate the feasibility of using a two‐stage implant system in a single‐stage procedure and to study the impact of the microgap at crestal level and to monitor the microflora in the peri‐implant area. Forty edentulous patients (Cawood & Howell class V–VI) participated in this study. After randomisation, 20 patients received two IMZ implants inserted in a single‐stage procedure and 20 patients received two ITI implants. After 3 months, overdentures were fabricated, supported by a bar and clip attachment. A standardised clinical and radiographic evaluation was performed immediately after denture insertion and 6 and 12 months later. Twelve months after loading, peri‐implant samples were collected with sterile paper points and analysed for the presence of putative periodontal pathogens using culture techniques. One IMZ implant was lost due to insufficient osseointegration. With regard to the clinical parameters at the 12 months evaluation, significant differences for plaque score and probing pocket depth (IMZ: mean 3.3 mm, ITI: mean 2.9 mm) were found between the two groups. The mean bone loss in the first year of functioning was 0.6 mm for both groups. Prevotella intermedia was detected more often in the ITI group (12 implants) than in the IMZ group (three implants). Porphyromonas gingivalis was found in three patients. In one of these patients an implant showed bone loss of 1.6 mm between T0 and T12. Some associations were found between clinical parameters and the target microorganisms in the ITI group. These associations were not present in the IMZ group. The short‐term results indicate that two‐stage implants inserted in a single‐stage procedure may be as predictable as one‐stage implants. The microgap at crestal level in nonsubmerged IMZ implants seems to have no adverse influence on the peri‐implant microbiological colonisation and of crestal bone loss in the first year of functioning. The peri‐implant sulcus can and does harbour potential periodontal pathogens without signs of peri‐implantitis during the evaluation period of 1 year.
Freeze‐dried bone for maxillary sinus augmentation in sheep
Authors: Haas Robert , Haidvogl Daniela , Dörtbudak Orhun , Mailath Georg
Published: March 2003

Abstract: This study examines the biomechanical loading capacity of dental implants placed in the posterior maxilla in conjunction with subantral augmentation with either homogeneous demineralized freeze‐dried bone from sheep (s‐DFDB) or heterogeneous demineralized freeze‐dried human bone (h‐DFDB) as grafting material in sheep. In 36 adult female mountain sheep, the Schneiderian membrane was elevated extraorally in both maxillary sinuses, and two titanium plasma‐flame‐sprayed cylindrical implants were inserted in each lateral antral wall. Three groups of 18 maxillary sinuses each were augmented with s‐DFDB, h‐DFDB and autogenous bone from the illiac crest, respectively. In the remaining 18 sinuses, the subantral hollow space was left empty. Pull‐out tests were carried out after intervals of 12, 16 and 26 weeks. The mean pull‐out force needed, irrespective of time, was 259.3 N in the empty control group, 356.7 N in the group augmented with autogenous bone, 278.1 N in the test group augmented with h‐DFDB and 365.2 N in the group augmented with s‐DFDB, revealing no significant difference between the individual groups (P > 0.05). The implants of the group augmented with autogenous bone showed an increase in the mean pull‐out force from 223.8 N after 12 weeks to 523.7 N after 26 weeks. The nonaugmented control group yielded values of 248 N after 12 weeks, which rose to 269.8 N at the last test, while the values of the h‐DFDB group increased from 275.4 N to 325.4 N. The highest initial pull‐out values were obtained in the s‐DFDB group. They amounted to 310.5 N after 12 weeks and rose to 481.4 N after 26 weeks. Time thus proved to have a significant influence on the pull‐out forces (P = 0.014) with a statistically proven linear trend (P = 0.007). The findings of this experimental study indicate that the use of homogeneous DFDB in one‐stage sinus lift procedures results in a mechanical loading capacity of implants comparable to that achieved by autogenous cancellous bone from the iliac crest. In contrast, the use of heterogenous‐DFDB resulted in only slightly higher pull‐out forces than those observed in the nonaugmented control group after 26 weeks.
Local administration of growth hormone enhances periimplant bone reaction in an osteoporotic rabbit model
Authors: Tresguerres Isabel F. , Clemente Celia , Donado Manuel , Gómez‐Pellico Luis , Blanco Luis , Alobera Miguel Angel , Tresguerres Jesús A. F.
Published: March 2003

Abstract:  Objective: The purpose of this study was to determine whether rhGH administered locally during the surgical placement of an implant, in the tibia of an osteoporotic rabbit model, would induce qualitative and quantitative differences in peri‐implant bone reaction.

Material and methods: Eight New Zealand rabbits were ovariectomized and fed with a low‐calcium diet (with 0.07% of calcium) to induce osteoporosis. After 6 weeks, an experimental titanium sheet was inserted into the rabbit tibiae. The rabbits were randomly divided into two groups. The experimental group was treated with 4 IU of rhGH added locally into the ostectomy as a lyophilized powder and the control group was left without any treatment. After 2 weeks, animals were sacrificed, tibial sections were prepared and bone–titanium interface was examined at light microscopy, using Masson, hematoxylin‐eosin and Pichrosirius stains. Light microscopic morphometry and densitometry were used to comparatively quantitate bone reaction.

Results/Conclusion: Local administration of rhGH during the surgical placement of titanium sheets on the tibiae of an osteoporotic rabbit model enhances periosteal and transcortical reaction and mineralization of osteoid 14 days later around titanium sheets, without increasing bone resorption.
Production of transforming growth factor β1 and prostaglandin E2 by osteoblast‐like cells cultured on titanium surfaces blasted with TiO2 particles
Authors: Mustafa Kamal , Rubinstein Joanna , Lopez Blanca Silva , Arvidson Kristina
Published: March 2003

Abstract: The surface roughness of an implant to which osteoblasts attach may influence endogenous expression of growth factor and cytokines at the implant–tissue interface, modulating the healing process and affecting the quality of bone formation. The present study, using cells derived from human mandibular bone, investigated the effect of varying roughness of titanium surfaces on production of transforming growth factor β1 (TGF‐β1) and prostaglandin E2 (PGE2). The titanium surfaces were turned (control) and then roughened by blasting with 63–90 µm, 106–180 µm or 180–300 µm TiO2 particles. The cells were cultured onto the surfaces till confluence was achieved. Fresh media were added in the presence or absence of 1,25‐dihydroxyvitamin D3[1,25‐(OH)2D3], the stimulator of osteogenic differentiation, and aliquots of conditioned cell media were used for assay 24 h later. Cellular morphology was determined by scanning electron microscopy. Cellular production of TGF‐β1 and PGE2 on each surface was assessed by enzyme‐linked immunosorbent assay (ELISA) and radioimmunoassay (RIA), respectively, using commercially available kits. All blasted surfaces showed significantly higher production of TGF‐β1 than the turned surfaces (P < 0.05). In response to stimulation by 1,25‐(OH)2D3 cellular production of TGF‐β1, was also significantly greater (P < 0.05) on the blasted surfaces than on the turned one. The total amount of PGE2 in the conditioned media was higher than on the turned surfaces in the presence or absence of 1,25‐(OH)2D3. There were no significant differences among the three blasted surfaces with respect to production of the local factors. However, we could not show a synergistic effect of surface roughness and vitamin D on the production of both TGF‐β1 and PGE2 using primary cell culture model.
Periodontal flap surgery with 25% metronidazole gel
Authors: Needleman Ian G. , Moles David R. , Collins Angela M.
Published: March 2003

Objectives:

The aim of this study was to examine the effect of periodontal surgery on PGE2 levels in patients treated for advanced adult periodontitis, with and without application of a 25% metronidazole gel over 12 months follow‐up.

Material and methods:

The trial employed a randomised controlled, single‐blind, parallel arm design on 43 patients with at least 1 pocket probing 6 mm with bleeding on probing (BOP).

Results: The results showed that GCF PGE2 levels showed no significant change following surgical therapy despite marked improvements in clinical periodontal health (p=0.653). No significant differences in the reaction of sites to treatment were detected between test and control groups throughout the study (p=0.709). However, PGE2 levels in GCF were significantly higher in experimental sites compared with healthy untreated sites (negative controls) in both surgery only (p=0.001) and surgery+gel (p=0.023) groups throughout the study.

Conclusion: Whilst clear differences were observed between healthy control sites and sites with periodontal breakdown, no effect of treatment on PGE2 levels was discernible in this study.
Diamond‐coated sonic tips are more efficient for open debridement of molar furcations
Authors: Auplish Gita , Needleman Ian G. , Moles David R. , Newman Hubert N.
Published: March 2003

Background/aims: The aim of this study was to compare the efficacy of open debridement of class II and III furcations by a new diamond‐coated sonic instrument tip (Sonicparo) with a conventional sonic insert (Sonicrecall) and hand instruments (Gracey curettes).

Method: Open debridement was simulated using a manikin head and standardised plastic teeth. The efficacy of debridement was examined by 3 parameters: residual root surface marker, ‘tooth’ weight loss and time taken for debridement. The teeth used were 1st and 2nd upper and lower molars. Upper left and lower right molars were chosen to represent class II furcation involvements and upper right and lower left molars class III furcation involvements. Each tooth was debrided 4 times with each instrument for both class of furcations.

Results: The results of this study showed significantly less residual marker area comparing Sonicparo with Gracey curettes (mean difference 2.52 mm2, p<0.001). However, no significant differences in marker removal were observed between Sonicrecall inserts and the other instruments. Sonicparo inserts also took significantly less time to debride the furcation than Gracey curettes (mean difference 98.3 s, p<0.001) or Sonicrecall instruments (mean difference 74.3 s, p<0.001). However no significant differences were found between instruments concerning weight loss of the plastic teeth.

Conclusions: It was concluded from this in‐vitro study that the Sonicparo insert was a more efficient instrument for open molar furcation debridement than Sonicrecall and hand instruments (Gracey curettes) when considering both marker removal and debridement time.
Relationships between radiographic alveolar bone height and probing attachment level: data from healthy post‐menopausal women
Authors: Pilgram Thomas K. , Hildebolt Charles F. , Yokoyama‐Crothers Naoko , Dotson Mary , Cohen Sheldon C. , Hauser Jay F. , Kardaris Eugenia
Published: March 2003

Objective: To determine the cross‐sectional and longitudinal relationships between radiographic alveolar bone height and probing attachment level in a population of healthy postmenopausal women.

Materials and Methods:

The 81 patients in this report were part of a prospective estrogen replacement interventional study. All patients were in good oral health at entry and received annual oral prophylaxis as part of the study. Standard probing measurements were made with a pressure sensitive probe at 6 sites on each tooth. Vertical bitewing radiographs were digitized, and 6 linear measurements corresponding to probing‐site measurements were made from the cementoenamel junction to the alveolar crest. These procedures were performed at baseline and at annual intervals for three years. Data were analyzed both by site and by patient.

Results: Moderately strong correlations were found between cross‐sectional measurements of probing attachment height and radiographic bone height. Correlations were stronger for patient data (r=0.44–0.61) than for site data (r=0.19–0.36). No relationships were found between longitudinal changes in alveolar bone height and attachment level in either the site data (r=−0.10–0.04), or the patient data (r=−0.005–0.10).

Conclusion: Healthy patients may experience sporadic, temporary changes in attachment level or alveolar bone height which are resolved without one affecting the other.
Diffuse but unilateral gingival enlargement associated with von Recklinghausen neurofibromatosis
Authors: Bekisz Oleg , Darimont Frédérique , Rompen Eric H.
Published: March 2003

Background: An 8‐year old girl was referred for diagnosis and treatment to the Department of Periodontology – Oral Surgery of the University Hospital of Liège with an unusual clinical situation: a major, non‐inflammatory, diffuse but unilateral enlargement of the interproximal, marginal and attached gingiva around all teeth of the right side of both the upper maxilla and mandible, whereas the alveolar process of the left side of upper and lower arches appeared strictly normal.

Method: The clinical examination showed delayed eruption of some permanent teeth in the 1st and 4th quadrants. Except for its asymmetric occurrence, this gingival enlargement strongly resembled phenytoin‐induced enlargement or gingival fibromatosis. This unilateral expression was evocative of a vascular or neurologic pathology. Several large “café‐au‐lait” spots were found disseminated on the body. Several selective surgical removals of thick gingival caps impairing the eruption of some permanent teeth were performed, and the removed tissues were histologically analyzed.

Results: Because of the presence of the large “café‐au‐lait” spots, a clinical diagnosis of Von Recklinghausen's disease was given and later confirmed several times by the histological analysis of the gingival biopsies. Now, 6 years later, this gingival enlargement due to the development of intra‐gingival neurofibromas is stable and all permanent teeth have had a normal eruption, but alveolar bone growth has been partly impaired by the presence of the tumor.

Conclusions: The present case of unilateral diffuse hyperplasia is a unique clinical expression of neurofibromatosis type I, a slowly evolving neurodermic dysplasia.
The periodontal abscess (I). Clinical and microbiological findings
Authors: Herrera David , Roldán Silvia , González Iciar , Sanz Mariano
Published: March 2003

Background/aims: Little information is available regarding the diagnosis and microbiology of periodontal abscesses. The aim of this descriptive clinical and microbiological study was to provide more information in order to help in the characterisation of the periodontal abscess associated to periodontitis.

Method: 29 consecutive patients with a periodontal abscess were studied by the assessment of clinical variables, including both subjective (pain, edema, redness and swelling) and objective (bleeding on probing, suppuration, probing pocket depth, tooth mobility and cervical lymphadenopathy) parameters. Microbiological samples were taken for anaerobic microbiology and processed by means of culture. Systemic involvement was also studied through the analysis of blood and urine samples using conventional laboratory standards.

Results: 62% of the abscesses affected untreated periodontitis patients, and 69% were associated with a molar tooth. More than 75% of the abscesses had moderate‐severe scores related to edema, redness and swelling, and 90% of the patients reported pain. Bleeding occurred in all abscesses, while suppuration on sampling was detected in 66%. Mean associated pocket depth was 7.28 mm, and 79% of teeth presented some degree of mobility. Cervical lymphadenopathy was seen in 10% of patients, while elevated leucocyte counts were observed in 31.6%. The absolute number of neutrophils was elevated in 42% of the patients. High prevalences of putative periodontal pathogens were found, including Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Bacteroides forsythus.

Conclusions: The periodontal abscess has clear clinical characteristics and is usually associated with severe periodontal destruction. This condition may cause systemic involvement and the lesion generally has a large bacterial mass with a high prevalence of well‐recognised periodontal pathogens.
Alveolar bone loss in type 1 diabetic subjects
Authors: Tervonen Tellervo , Karjalainen Kaisa , Knuuttila Matti , Huumonen Sisko
Published: March 2003

Aim, background:

The aim of this study was to assess the degree of marginal alveolar bone loss in a group of young subjects with type 1 diabetes mellitus (DM) (n=35, age range 24–36 years) and age‐matched non‐diabetic control subjects (n=10).

Method: The diabetic group was divided into 3 subgroups (D1, D2, D3) according to the severity of the diabetic state. The level of alveolar bone was measured on panoramic radiographs of maxillary and mandibular molars as the % of the distance between the cemento‐enamel junction (CEJ) and the bone crest along the total length of the root. All mesial and distal sites with a distance of >15% (BL>15%) were picked, and calculations were performed using the individual %s of sites with BL>15%.

Results: Based on the present findings, we conclude that type 1 DM has a modifying effect on marginal loss of alveolar bone. A clear trend towards increased marginal bone loss was seen in the subjects with complicated DM (D3). The subjects with good metabolic control and no complications of DM (D1) are no more susceptible to marginal bone loss than non‐diabetic controls of the same age.

Conclusions: The present findings confirm our previous results on increased loss of periodontal support in subjects with complicated DM already at an early age.
A prospective longitudinal study on periodontal bone height changes in a Swedish population
Authors: Hugoson Anders , Laurell Lars
Published: March 2003

Background, aims: This investigation was performed to assess longitudinal changes in periodontal bone height in an adult population over a period of 17 years.

Methods: In 1973, a random sample of 1000 individuals aged 3–70 years in the city of Jönköping, Sweden, was examined clinically and radiographically to assess dental status and treatment needs. Out of the 574 dentate individuals 15–60 years, 433 accepted the invitation and were re‐examined in 1989–91, 4 were edentulous and the study therefore finally included 429 dentate individuals. The examination included full mouth plaque and gingivitis scores and bone height measurements on full mouth intra‐oral radiographs. All age groups except the youngest had very good oral hygiene with 50% or more having plaque and gingivitis scores below 20%.

Results: From the age of 20, there was a general pattern of bone height reduction over time corresponding to an annual loss of around 0.1 mm. From the age of 30 years, about 80% of the population had one or more sites with bone loss of 10% or more. Very few individuals, about 5%, exhibited an individual mean bone loss of 2 mm or more. 17% had 6 such sites indicating destructive periodontal disease. These individuals and sites could not be identified in advance based only on previous disease experience.
Effects of hormonal contraceptives on the periodontium, in a population of rural Sri‐Lankan women
Authors: Tilakaratne A. , Soory M. , Ranasinghe A. W. , Corea S. M. X. , Ekanayake S. L. , De Silva M.
Published: March 2003

Aims: Women using hormonal contraceptives can be considered to be a ‘risk group’ for periodontal disease, due to prolonged, sustained serum levels of oestrogens and progesterone. This investigation aims to study the effects of hormonal contraceptives on periodontal tissues.

Methods: 32 women using hormonal contraceptives for less than 2 years, 17 for 2–4 years and a matched control group of 39 non‐users were selected for the study. They were clinically examined for plaque levels (plaque index: PLI), gingival condition (gingival index: GI) and loss of periodontal attachment (LA).

Results: Contraceptive users of less than 2 years and 2–4 years duration (n=32, n=17 repectively) and non‐users (n=39) had similar oral hygiene levels; yet the contraceptive users had a significantly higher level of gingival inflammation, compared to the non‐users (p<0.001; 1‐way ANOVA). Usage of hormonal contraceptives for 2–4 years (n=17) caused a significantly higher LA (p<0.001) compared to that of controls (n=39).

Conclusions: Usage of contraceptive preparations containing oestrogen and progesterone resulted in hormonal changes similar to those seen in pregnancy, associated with increased prevalence of gingivitis. There was significantly higher LA with prolonged usage of hormonal contraceptives, compared with controls.
Periodontal disease status during pregnancy and 3 months post‐partum, in a rural population of Sri‐Lankan women
Authors: Tilakaratne A. , Soory M. , Ranasinghe A. W. , Corea S. M. X. , Ekanayake S. L. , De Silva M.
Published: March 2003

Objectives:

The aim of this investigation was to study the effects of pregnancy on the periodontium, in a rural population of Sri‐Lankan women.

Methods: The study group consisted of 47 pregnant women and 47 non‐pregnant women who served as matched controls. All subjects were examined for plaque (plaque index: PLI), gingival condition (gingival index: GI) and loss of periodontal attachment (LA) levels, 4 × during the study, at 3‐monthly intervals.

Results: Despite similar scores for plaque levels in both pregnant and non‐pregnant women, the GI of pregnant women was significantly increased, during the 1st and 2nd trimesters compared to the controls (p<0.01, 2‐way ANOVA). During the 3rd trimester, GI was further increased (p<0.001), but dropped at 3 months post‐partum. Values for LA did not show significant differences from that of controls, during any of the stages of pregnancy.

Conclusions: The results of this study show that pregnancy had an effect only on the gingivae and not on periodontal attachment levels. The effects of oestrogen and progesterone could give rise to a more florid response to the irritant effects of plaque, resulting in severe gingivitis.
Microbiology of destructive periodontal disease in adolescent patients with congenital neutropenia
Authors: Van Winkelhoff A. J. , Schouten‐van Meeteren A. Y. N. , Baart J. A. , Vandenbroucke‐Grauls C. M. J. E.
Published: March 2003

Background, aims: Congenital neutropenia is one condition that may predispose for destructive periodontal disease at a young age. In this report, we describe the microbiology of 3 adolescent patients with congenital neutropenia two of whom suffered from severe periodontitis.

Method: Microbiological testing of the parents was also performed in 1 case. DNA fingerprinting was used to study transmission of putative periodontal pathogens in this case. From 1 patient with periodontitis, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were isolated; a 2nd periodontitis patient was infected with P. gingivalis. A 3rd patient had gingivitis only and no A. actinomycetemcomitans or P. gingivalis were found.

Results: Using the amplified fragment length polymorphism DNA fingerprinting technique, bacterial transmission between the father and a patient was shown for A. actinomycetemcomitans but not for P. gingivalis.
Alcohol‐free mouthrinse solutions to reduce supragingival plaque regrowth and vitality
Authors: Arweiler N. B. , Netuschil L. , Reich E.
Published: March 2003

Background: The aim of this study was to evaluate the clinical and antibacterial properties of alcohol‐free mouthrinses, an amine fluoride/stannous fluoride mouthrinse (ASF) and two triclosan solutions in comparison with a chlorhexidine and a placebo rinse.

Material and methods: In a double‐blind, randomised 5‐cell cross‐over 4‐day plaque regrowth study, 19 volunteers rinsed 2 × a day with 15 ml of each of the distributed solutions. Each test cycle was followed by a 10 days wash‐out period. On day 0 of each test week, volunteers received a dental prophylaxis. Thereafter they refrained from all mechanical oral hygiene procedures for the next four days. Plaque regrowth was assessed daily by the plaque index and on day 4 by calculating the plaque area with a computer program after disclosure and photography of the front teeth. The vitality of the plaque was examined on days 1 to 4 by the vital fluorescence technique.

Results: 19 participants completed the study. Compared to the placebo the ASF solution showed 15.7% (p>0.5), 30.6% (p<0.001), 40.5% (p<0.001) and 44.7% (p<0.001) reductions on the consecutive days 1–4 in plaque index and a reduction of 61.9% in plaque area. The decrease of vitality of supragingival plaque was highly significant compared to placebo on every test day ranging between 30.9% and 36.6%. A reduction in plaque index from 19.4% (p<0.01) on day 2, 34.9% (p<0.001) on day 3 and 40.4% (p<0.001) on day 4 concommitant with a reduction in plaque area of 48.9% (p<0.001) was noted for alcohol‐free chlorhexidine. Concerning the vitality chlorhexidine reduced the percentage of vital bacteria significantly on every day (16.0% to 24.9%). The reductions in mean plaque index for the 0.15% triclosan solution during the test period were 6.3%, 22.4%, 24.6% and 36% and in plaque area 41.8%. Vitality was significantly reduced at every day compared to placebo. Plaque Index reduction with the 0.02% triclosan increased from 15.3% (day 2) to 31.0% (day 4) and a reduction of 23.6% was seen in plaque area. A significant effect concerning the vitality of the plaque was only found at the first and the last day of the test cycle.

Conclusion: Alcohol‐free mouthrinse solutions were shown to be effective in reducing both plaque accumulation and plaque biofilm vitality compared to a placebo solution.
The effect of working tip angulation on root substance removal using Er:YAG laser radiation: an in vitro study
Authors: Folwaczny Matthias , Thiele Lidka , Mehl Albert , Hickel Reinhard
Published: March 2003

Objectives: The present investigation attempted to determine the amount of cementum and/or dentin removal with Er:YAG laser radiation, dependent on the angulation of a specially‐developed application tip.

Material and methods: Subject of the study were 150 extracted incisors, canines, premolars, and molars. Source of laser radiation was an Er:YAG laser device emitting pulsed infrared radiation at a wavelength of 2.94 μm with a pulse duration of 250 μs and a pulse repetition rate of 10 pps. The samples of the 3 study groups were irradiated with 380 laser pulses at radiation energies of 60 mJ (group A), 100 mJ (group B), or 180 mJ (group C). In each group, 10 samples were treated at working tip angulations of 15°, 30°, 45°, 60°, and 90°. The substance removal was determined 3‐dimensionally using a newly developed laser scanning system (100,000 surface points per sample, accuracy 5 μm) and a special image‐analysing software (Match 3D). Statistical analysis was completed with ANOVA followed by multiple comparisons using the Scheffé‐test and with linear regression analysis according to Pearson‐Bravais (p<0.05).

Results: Strong dependance of substance removal, both determined as maximum depth of the defects (0.5% quantil) as well as defect volume, on the angulation of the working tip was shown. At 60 mJ, the depth of the defects was 41.39 (±32.55) μm at an angulation of 15° and that at 90° was 181.39 (±74.42) μm (R2=0.921). For the radiation energy at 100 mJ, the depth of the defects ranged from 51.96 (±26.86) μm at 15° to 306.64 (±62.44) μm at 90° (R2=0.983). Choosing radiation energies at 180 mJ, the depth of the defects ranged from 64.73 (±27.73) μm at 15° to 639.89 (±47.28) μm at 90°, on average (R2=0.853).

Conclusions: The results of the present study provide clear evidence that besides the physical radiation parameters, also the parameters of clinical handling, in particular the angulation of the application tip, has a strong influence on the amount of root substance removal using Er:YAG laser radiation.
Retrospective comparison of clinical variables between compliant and non‐compliant patients
Authors: König Jörgen , Plagmann Hans‐Christian , Langenfeld Norbert , Kocher Thomas
Published: March 2003

Background: The aim of this retrospective study was to evaluate if patients with moderate to advanced periodontitis had comparable periodontal conditions at baseline and during supportive periodontal therapy (SPT) whether they were compliant or not.

Method: Patient‐related variables were compared: age, tooth mobility, furcation involvement, number of teeth, pocket probing depth, plaque index. Compliant patients (n=142) received complete periodontal treatment and were followed over at least 10 years (group A). Non‐compliant patients either discontinued supportive periodontal therapy (n=42, group B) or dropped out before or during periodontal surgery (n=44, group C).

Results: At baseline, there were no significant differences between the 3 groups except for mobility. During SPT, mean pocket probing depth and plaque index differed significantly.

Conclusion: These results indicate that non‐compliant patients compared to compliant patients had similar periodontal conditions at baseline, but responded less favourably to periodontal surgery and maintenance.
Detection rate of Actinobacillus actinomycetemcomitans on the permanent 1st molars of primary school children in Taiwan by polymerase chain reaction
Authors: Yuan Kuo , Hsu Ping‐Chi , Tseng Chuen‐Chyi , Kiang David , Wang Jen‐Ren
Published: March 2003

Abstract Background, aims: Actinobacillus actinomycetemcomitans (Aa) has been implicated as the putative micro‐organism for localized juvenile periodontitis (LJP). The most distinct clinical features of LJP include severe angular bony defects of the mesial sides of permanent first molars and the onset of disease during puberty. Currently, no large‐scale studies have been performed which address the change in detection rates of Aa on the mesial sides of permanent 1st molars following eruption and up to puberty.

Method: In this study, subgingival plaque samples were taken from the mesial pockets of 2 randomly selected permanent 1st molars from 328 primary school children and 50 adult staff, and analyzed by polymerase chain reaction (PCR) to detect Aa.

Results: The results showed a 5.5% prevalence rate of Aa which increased after the eruption of 1st molars and peaked near puberty. There were no significant differences in the detection rates of Aa among different groups in terms of gender, plaque index (PlI), and gingival index (GI); however, the higher detection rates of Aa were significantly associated with increased probing depths at p<0.05.

Conclusion: PCR analysis of the subgingival plaques demonstrated a prevalence of Aa which peaked near puberty, suggesting that Aa may be important for LJP in Taiwan.
Interleukin‐1 gene polymorphism and periodontal status
Authors: Papapanou Panos N. , Neiderud Anne‐Marie , Sandros Jens , Dahlén Gunnar
Published: March 2003

Objectives: This case‐control study examined polymorphisms at the interleukin‐1 gene in relation to periodontal status, subgingival bacteria and systemic antibodies to periodontal microbiota.

Methods: 132 periodontitis patients were age‐ and gender‐matched with 73 periodontally intact controls. Full‐mouth clinical assessments of the periodontal tissues were performed. Subgingival plaque samples (2440 in total) were analyzed by genomic DNA probes, and serum IgG antibodies to periodontal microbiota were assessed by an immunoassay. Polymorphisms in the IL‐1A gene at position +4845 and the IL‐1B gene at position +3953 were studied by PCR. A composite positive genotype was defined as at least one rare (#2) allele present at each locus.

Results: No skewed distribution of the composite genotype was observed between cases and controls (45.2% vs 41.7%). In cases, both the composite genotype and the number of #2 alleles were positively correlated with the severity of attachment loss. No relationship between genotype and subgingival microbial profiles was observed. Genotype positive patients revealed both overall lower serum antibody levels and specific titers against selected bacteria.

Conclusions: The composite genotype failed to distinguish between periodontitis patients and controls but correlated in patients with the severity of the disease and the antibody responses to periodontal microbiota.
Assessment of newly developed tongue sulfide probe for detecting oral malodor
Authors: Morita Manabu , Musinski Donald L. , Wang Hom‐Lay
Published: March 2003

Aim: The present study examined the relationship between sulfide levels on tongue dorsum surfaces (pS levels) and oral malodor.

Method: The pS levels of 20 systemically healthy volunteers were evaluated using an industrial device equipped with a newly‐developed tongue sulfide probe. The pS levels on 3 parts of the tongue – anterior, middle and posterior along the median groove of the tongue dorsum – were determined for each subject.

Results: The device reported the pS level in a digital score ranging from 0.0 (<10−7 M of sulfide) to 5.0 (10−2 M of sulfide) in increments of 0.5. Oral malodor was assessed by measuring the level of volatile sulfur compounds in mouth air, as well as by the organoleptic method. The pS levels were 0.03±0.11, 0.20±0.41 and 0.88±0.76 for the anterior, middle and posterior parts, respectively. This difference was significant (p<0.001). Both oral malodor measurements showed significant correlation (p<0.05) with the pS levels of middle and posterior parts of tongue.

Conclusion: It was concluded that the tongue sulfide probe might be useful in management of subjects with oral malodor.
Bone mineral content and bone metabolism in young adults with severe periodontitis
Authors: Von Wowern Nina , Westergaard Jytte , Kollerup Gina
Published: March 2003

Objectives: To clarify in young adults with severe periodontitis (1) whether the bone mineral content (BMC) or density (BMD) in the mandible/other skeletal sites and the systemic bone metabolism differed from normal and (2) whether mandibular/forearm BMC did change during the 5 to 10‐year follow‐up.

Material and Methods: 24 young otherwise normal patients with verified severe periodontitis were included, of which 20 attended the follow‐up visit. Mandibular/forearm BMC was measured at both visits by dual‐photon absorptiometry, supplemented with femoral neck/lumbar spine BMD measurements at follow‐up visit by dual‐energy X‐ray absorptiometry. Serum alkaline phosphatase/ionized calcium, urinary excretion of pyridinoline/deoxy‐pyridinoline were analysed at the follow‐up visit. A conventional periodontal examination was performed at both visits.

Results: Mandibular BMC was significantly below normal mean BMC at both visits. The mandibular Z‐scores were −2.00 in 33.3% (8/24). BMC/BMD in the remaining sites and the values for bone markers did not differ from normal. Mandibular/forearm BMC was stable while a significant aggravation of alveolar bone loss occurred during the trial without change of probing depth.

Conclusions: Severe periodontitis in young adults seems to be a local disorder associated with relatively low BMC in the jaws without systemic alterations of BMC/BMD and bone metabolism.
Capnocytophaga granulosa and Capnocytophaga haemolytica: novel species in subgingival plaque
Authors: Ciantar M. , Spratt D. A. , Newman H. N. , Wilson M.
Published: March 2003

Background: The oral cavity accommodates one of the most diverse microfloras in the human body. Knowledge of this microflora, and of the periodontal microflora in particular, proves crucial towards an understanding of the bacterial‐host interactions which lead to the development of infectious inflammatory periodontal diseases. Capnocytophaga species have been implicated as putative periodontal pathogens. To date, only 3 members of this genus (C. gingivalis, C. ochracea and C. sputigena) have been isolated from subgingival plaque.

Aim: This communication reports the isolation of 2 recently‐speciated strains, namely C. granulosa and C. haemolytica, from subgingival plaque collected from adult periodontitis patients.

Material and Methods: Subgingival plaque was collected from 29 patients with chronic adult periodontitis. Plaque samples were inoculated onto fastidious anaerobe agar and incubated anaerobically for 5 days. Routine identification of clinical isolates was performed by 16S rRNA PCR‐RFLP analysis, using Cfo I as restriction enzyme and corroborated by 16S rRNA gene sequencing.

Results: 16 of 29 patients (55%) tested positive for either C. granulosa and or C. haemolytica. A total of 70 isolates (63 C. granulosa and 7 C. haemolytica) were cultivated from subgingival plaque. 15 (51%) patients tested positive for C. granulosa, and 3 (10%) patients tested positive for C. haemolytica.

Conclusion: This is the 1st report which recounts the presence of C. granulosa and C. haemolytica in subgingival plaque. Further research is required to establish the relative proportions of these species subgingivally in health and disease.
Pre‐treatment conceptions of periodontal disease and treatment in periodontal referrals
Authors: Fardal Øystein , Johannessen Anne C. , Linden Gerard J.
Published: March 2003

Background: Patients preconceptions of periodontal therapy have not been extensively studied and are poorly understood.

Aims: To register specific anxieties and preconceptions held by patients referred for specialist periodontal treatment and to investigate the risks such patients were prepared to take of progressive periodontal problems before deciding that periodontal treatment was necessary.

Materials and methods:

79 patients referred for specialist treatment completed a structured questionnaire. Participants completed visual analogue scales to quantify the risks which they were prepared to take of various symptoms of periodontal disease before they believed treatment was essential.

Results: The majority (71%) had anxieties about pending treatment with the main concern being pain. Those who had sought information prior to treatment mainly did so from close relatives.

The majority of patients opted to take no or a very low (<20%) risk of any periodontal problems and, therefore, were supportive of treatment. The loss of many teeth due to periodontal disease was the least acceptable outcome followed by tooth mobility. Patients were prepared to accept a significantly higher risk of bleeding on brushing (p<0.0001) than any of the other outcomes investigated. Females recorded substantially lower risk scores than males particularly in relation to developing recession or tooth mobility in the absence of treatment. Patients who were worried about experiencing pain during treatment recorded lower risk scores than those who had no anxiety regarding pain.

Conclusion: It is concluded that the Norwegian periodontal referrals studied were prepared to take very low risks of further periodontal symptoms despite high levels of anxiety and evidence of a lack of knowledge regarding periodontal treatment.
The effect of a polyhexamethylene biguanide mouthrinse compared to an essential oil rinse and a chlorhexidine rinse on bacterial counts and 4‐day plaque regrowth
Authors: Rosin M. , Welk A. , Kocher T. , Majic‐Todt A. , Kramer A. , Pitten F. A.
Published: March 2003

Objectives: For various clinical applications, polyhexamethylene biguanide hydrochloride (PHMB) has been used for many years as an antiseptic in medicine. Recently, a 0.04% PHMB mouthwash was shown to inhibit plaque regrowth and to reduce oral bacterial counts. In this study, a 0.12% PHMB mouthrinse (A) was compared with a negative control placebo rinse (10% ethanol, flavour) (B), a positive control 0.12% chlorhexidine rinse (C), and a commercially available mouthrinse containing essential oils (Listerine®) (D).

Materials and Methods: The study was a double‐blind, randomised 4‐replicate 4×4 Latin square cross‐over design in which plaque regrowth was measured. The in vivo antibacterial effect was assessed by taking bacterial counts from the tooth surface and mucosa 4 h after the first rinse with the preparations on day 1 and prior to the clinical examination on day 5. 16 volunteers participated and, on day 1 of each study period, were rendered plaque‐free, ceased toothcleaning, and rinsed 2×daily with the allocated mouthrinse. On day 5, plaque was scored and smears were collected according to the protocol. Washout periods were 9 days. Data were analysed using ANOVA with Bonferroni HSD adjustment for multiple comparisons (significance level α=0.05).

Results: The 0.12% PHMB mouthrinse (A) was significantly more effective in inhibiting plaque than the placebo (B) but no significant differences could be observed between A and 0.12% chlorhexidine (C), or between A and Listerine® (D). Bacterial count reductions on the tooth surface with PHMB (A) were significantly greater compared to the placebo (B) after 4 h and significantly greater compared to B and D after 5 days. Chlorhexidine (C) was more effective than A after 5 days. On the mucosa, chlorhexidine (C) was significantly more effective in reducing bacterial counts than the other 3 treatments at both time points investigated. PHMB (A) was significantly more effective in reducing bacterial counts than the placebo (B) after 4 h and after 5 days, and than D after 4 h.

Conclusion: Consistent with a previous study, a PHMB mouthrinse was shown to inhibit plaque recolonisation and to reduce oral bacterial counts, indicating that PHMB may find applications in the prevention of plaque‐associated diseases.
Treatment of dentin hypersensitivity by Nd:YAG laser
Authors: Lier B. B. , Rösing C. K. , Aass A. M. , Gjermo P.
Published: March 2003

Background, aims: Promising results using Nd:YAG laser against dentin hypersensitivity have been reported. The aim of this double‐blind, controlled, split‐mouth designed clinical trial was to assess the effect of a single Nd:YAG laser application on alleviating hypersensitivity.

Methods/Results: Seventeen subjects participated in the study. Each of them had two teeth treated; one with the laser activated and one with nonactivated (placebo), for 2 min The assessment of pain was performed by a VAS, after an air blast at baseline immediately after treatment, at 1 week, 4 weeks and 16 weeks. Mean values of VAS for test and control teeth were compared by paired t‐test (α = 0.05). The results showed mean baseline VAS values of 6.59 (± 1.65) and 6.14(± 1.95) for test and control teeth, respectively. Immediately after treatment, these values decreased to 4.09(± 2.28) and 3.89(± 2.11), respectively. After 1 week, 4 weeks and 16 weeks the mean values for test and control teeth were 3.85 ± 2.36, 4.03 ± 1.95, 3.60 ± 2.66, and 4.44 ± 2.56, 3.41 ± 2.30, 3.42 ± 2.30, respectively. There were no statistically significant differences between test and control at any time. However, both groups improved significantly (P < 0.05) from baseline to immediately after application, and at 1 week, 4 weeks and 16 weeks, respectively. The changes that occurred between immediately after application and 1 week, 4 weeks and 16 weeks, respectively, were not statistically significant.

Conclusion: It is concluded that the effect of treatment of hypersensitive teeth with Nd:YAG laser is not different from placebo. The observed effects seem to last for at least 16 weeks.