bluuebunny/crossref_metadata_2025 huggingface dataset:
The finding of antiplaque features in Acacia Arabica type of chewing gum
Authors: Gazi Mohamed I.
Published: December 2005

Abstract The gum of Acacia Arabica is described in the British pharmacopoeia as a source of useful medicaments. It is believed to be of value for treating gingivitis and for reducing plaque. 2 blind crossover trials were carried out to evaluate the antiplaque potential of Acacia gum compared with sugar free gum. In trial 1, the mean gingival and plaque scores were lower after 7 days of using Acacia compared with sugar‐free gum but the differences were insignificant. In trial 2, daily photographic assessment of erythrocine‐stained plaque showed lower scores after Acacia gum compared with sugar‐free gum. The total difference in scores for each day from each individual between the 2 treatments was highly significant (p<0.05), This implies the presence of substances in Acacia gum which, compared with ordinary gum, primarily inhibit the early deposition of plaque.
Periodontal characteristics in individuals with varying form of the upper central incisors
Authors: Olsson Michael , Lindhe Jan
Published: December 2005

Abstract It has been suggested that the variation in the morphology of the human periodontium may be related to the shape and form of the teeth. Furthermore, the severity of symptoms of periodontal disease have been proposed to differ among these various morphologic entities or “biotypes”. The aim of the present study was (i) to identify individuals with markedly different crown forms and (ii) to determine probing pocket depth, probing attachment level and amount of gingival recession that had occurred at different teeth and tooth surfaces in such individuals. Clinical photographs of the maxillary incisor tooth region of 113 subjects who had been recruited for a long‐term study on periodontal disease were available. The length (CL) and width (CW) of the crowns were determined and the CW/CL ratio was calculated for each tooth. 10% in each tail, 11 subjects in each group, were arbitrarily chosen as having either a long‐narrow (N) or a short‐wide (W) form of the central incisors. The probing pocket depth, probing attachment level and gingival recession data available from all subjects and subjects in groups W and N were compared and analyzed using the Student t‐test and multiple regression analysis. The result from the analyses demonstrated that: (1) subjects with a long‐narrow form of the upper central incisors had experienced more recession of the gingival margin at buccal surfaces than subjects who had a short‐wide tooth form; (2) there was a significant influence of the CW/CL‐ratio on the probing attachment level (p<0.05) and the amount of gingival recession (p<0.01) on buccal tooth surfaces. The observations reported tend to confirm the hypothesis that subjects with long, narrow teeth have a comparatively thin periodontium, and may be more susceptible to gingival recession than subjects who belong to a thick periodontal “biotype”.
On the prevention of caries and periodontal disease
Authors: Axelsson P. , Lindhe J. , Nyström B.
Published: December 2005

Abstract In 1971–72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planing and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2–3 months. After the 6–year follow‐up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9–year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3–6 times per year for oral hygiene control and preventive therapy. The re‐examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15‐year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease.
The effect of glass ionomer cement and composite resin fillings on marginal gingiva
Authors: van Dijken J. W. V. , Sjöström S.
Published: December 2005

Abstract Glass ionomer cement and composite resin are the most popular restorative materials in operative dentistry today. Earlier studies have shown more crevicular exudate around different types of composite resins than around intact enamel surfaces. The aim of this study was (1) to investigate plaque, retention on and the condition of the gingiva around, 1‐year‐old, subgingivally located, glass ionomer cement and composite resin fillings, and (2) to compare the initiation of gingival inflammation around these materials with that around enamel during a 14‐day period of experimental gingivitis. Plaque index, gingival index, bleeding on probing and crevicular fluid were recorded and compared intra‐individually. The amount of plaque and the degree of gingivitis adjacent to the composite fillings were not significantly higher than those for the glass ionomer cement and enamel surfaces in both the cross sectional and the experimental gingivitis study. Composite resin surfaces showed significantly higher crevicular fluid levels than did enamel at all days in the experimental gingivitis study. Glass ionomer cement showed significantly higher values at day‐0 and day‐7.
Postoperative pain experience after gingivectomies using different combinations of local anaesthetic agents and periodontal dressings
Authors: Skoglund L. A. , Jorkjend L.
Published: December 2005

Abstract The present study examines postoperative pain experience following 243 gingivectomies in Norwegian patients using possible combinations of 3 local anaesthetics (lidocaine‐adrenalin, prilocaine‐felypressin or mepivacaine) and 3 periodontal dressings (Coepak, Wondrpak or Nobetec). When Coepak was used, the mean pain score was higher (P<0.05) in the group treated with lidocaine‐adrenalin 4 to 6 h after gingivectomy than the groups treated with prilocaine‐felypressin or mepivacaine. There was no significant difference between the groups treated with prilocaine‐felypressin or mepivacaine. When Wondrpak or Nobetec were used, there was no significant difference between any of the local anaesthetics used. The present finding shows that the local anaesthetic combination of lidocaine‐adrenalin (1:80,000) gives rise to a higher mean postoperative pain experience after gingivectomy than prilocaine‐felypressin or mepivacaine. However, the relative difference in pain experience seen after gingivectomy when using the present local anaesthetic agents is masked when using an eugenolcontaining periodontal dressing. Thus, the higher pain experience reported after lidocaine‐adrenalin may only be clinically important when using periodontal dressings without local anaesthetic components such as eugenol.
Effect of folic acid on recurrence of phenytoin‐induced gingival overgrowth following gingivectomy
Authors: Poppell Timothy D. , Keeling Stephen D. , Collins J. Frank , Hassell Thomas M.
Published: December 2005

Abstract This study examined the effect of folic acid supplementation on the recurrence of phenytoin‐induced gingival overgrowth following gingivectomy. 8 residents of an institution for the developmentally disabled were randomly assigned to a treatment (N= 4) or control (N= 4) group. Subjects in the treatment group received an oral supplementation of 5 mg of folic acid daily during the study; those in the control group did not. A gingivectomy with an external beveled incision made to the crest of the alveolus was completed by quadrants. The following data were obtained prior to gingivectomy, 2 weeks following the last quadrant of surgery, and at 3 and 6 months post‐surgery: plaque and gingival index scores, red blood cell folic acid levels, free phenytoin blood levels, photographs, and impressions. % change in overgrowth was determined from cross‐sectional area measurements made on dies obtained from bucco‐lingual cuts on stone models. Differences across time between and within groups were tested by a two‐factor repeated measure analysis of variance. The groups did not differ in plaque and gingival index scores or free phenytoin blood levels. The treatment group had significantly higher red blood cell folic acid levels (p≤ 0.0001). Reduction in gingival overgrowth as a result of surgery was similar in both groups. Although the treatment group had significantly less recurrence of gingival overgrowth (p≤ 0.05), the mean differences amounted to only 6–7% at 3 and 6 months.
Periodontal diagnosis in the 1990s
Authors: Lang Niklaus P. , Brägger Urs
Published: December 2005

Abstract. Clinicians are usually inclined to reduce data obtained from diagnosis to a simpler form such as “yes or no” answers in order to obtain useful parameters for daily practice. It should be realized, however, that the diagnostic process very rarely exhibits “black and white” situations. Rather the evaluation of numerous “grey levels” is imperative. The diagnostic process, therefore, remains always incomplete and inaccurate, and it represents an evaluation of probabilities rather than certainties. For this reason, the diagnostician should realize and understand the mathematical relations between the information provided by diagnostic tests and the clinical situation actually present at the time of the test. This will allow one to convert diagnostic results into therapeutic procedures with a high degree of confidence. Since results from diagnostic tests are quite often used to decide on treatment, complex data are reduced to simple dichotomy, such as presence or absence of disease, normal or abnormal conditions, etc. In order to react to diagnostic tests in an ordinal, dichotomous manner, the clinician has to choose a particular level of a test at which he initiates treatment without having the assurance that this level represents the one and only standard at which treatment has to be initiated.
The use of genomic DMA fingerprinting in studies of the epidemiology of bacteria in periodontitis
Authors: Genco Robert J. , Loos Bruno G.
Published: December 2005

Abstract. Recent studies of microbial epidemiology emphasizing the genetic organization and distribution of organisms associated with orofacial infections have led to new insights into the possible origins of pathogenicity. Studies into genetic heterogeneity, acquisition and transmission of these organisms have been markedly advanced by the utilization of the powerful technique of genomic DNA fingerprinting. Characteristic fingerprints for each bacterial isolate can be produced by cleavage of high molecular weight genomic DNA by restriction endonucleases. It is assumed that each DNA fingerprint represents a clonal type. In this report, we review and analyze studies of the epidemiology of bacteria associated with orofacial infections with an emphasis on periodontal disease. Studies of nontypable (NT) Haemophilus influenzae associated with recurrent otitis media illustrate the utility of this technique. DNA fingerprinting clearly demonstrates genetic heterogeneity of NT H. influenzae isolates, and clonality of infection of any individual. Furthermore, DNA fingerprinting has shown that the same clonal type is seen in siblings concurrently suffering from otitis media, suggesting horizontal transmission within the family. Studies of mutans Streptococci also show extensive genetic heterogeneity and show vertical transmission of a predominant clonal type only from mother to infant, but not from father to infant. Studies of Actinobacillus actinomycetemcomitans show considerable genetic heterogeneity among monkey isolates. Thus far, three clonal types have been reported with DNA fingerprinting among isolates from periodontal patients, but additional genetic heterogeneity can be found using specific DNA fragments as probes in hybridization experiments. Intrafamilial transmission of A. actinomycetemcomitans has been demonstrated. Porphyromonas (Bacteroides) gingivalis shows extensive genetic heterogeneity and case reports suggest clonal infection of any one individual. In contrast, results with DNA fingerprinting of Eikenella corrodens, Fusobacterium nucleatum, and Bacteroides intermedius show that individuals may be infected with 2 or more clonal types. These studies point to the great potential of DNA fingerprinting for investigating the epidemiology of putative orofacial pathogens. Such studies with periodontal microorganisms will likely reveal steps in the acquisition, intraoral and person‐to‐person transmission, which then could possibly be inhibited or interfered with to prevent periodontal disease or its recurrence.
Microbiology in the management of destructive periodontal diseasea
Authors: van Winkelhoff A. J. , de Graaff J.
Published: December 2005

Abstract. This paper summarizes the rationale for the application of microbiology in the management of destructive periodontal diseases. The subgingival microbiota in patients with severe periodontitis is complex and contains high numbers of obligate anaerobic bacteria as well as facultative micro–organisms. It has become clear that major differences exist in the composition of the subgingival microflora. These differences are not only quantitative but also qualitative. Difference in plaque composition is the basis for the application of clinical microbiology in the management of periodontal disease. Several bacterial species have emerged as useful indicators for progressive periodontitis. In this respect, the importance of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and Bacteroides intermedius has been shown in a number of studies. It has become clear that A. actinomycetemcomitans is not specifically associated with the local form of juvenile periodontitis, but this micro–organism is probably also of importance in severe periodontitis in adult patients. Selection of individuals with an A. actinomycetemcomitans associated periodontitis is essential since successful treatment in these patients needs an adjunctive antibiotic therapy. Microbiological testing can be useful in patients showing a poor response to periodontal treatment (refractory periodontitis). Factors which may be responsible include poor oral hygiene, poor subgingival debridement, the patient's susceptibility and a subgingival microflora resistant to therapy. In this patient category, microbiological testing is capable of diverting continuing periodontal treatment. Furthermore, microbiology can be useful in evaluating periodontal treatment. Successful elimination of specific periodontopathic microorganisms can be used to determine recall intervals.
New views on periodontal microbiota in special patient categories
Authors: Slots Jorgen , Rams Thomas E.
Published: December 2005

Abstract. The microorganisms in periodontitis of special patient categories have been only partially elucidated. The periodontitis microbiota of HIV–infected individuals, cancer patients on myelosuppressive therapy, and persons with other medical disorders includes common suspected periodontal pathogens as well as enteric rods, pseudomonads, staphylococci and yeasts. Failing implants also may be associated with classical periodontal pathogens as well as primarily nonoral potential pathogens. Refractory periodontitis in systemically healthy adults can show a great variety of oral and nonoral organisms. The frequent occurrence of unusual periodontal organisms in special patient categories may be due to a weakened host response and/or usage of various chemotherapeutic regimens. The unusual organisms may contribute to progressive periodontitis and in leukemia patients may even give rise to life–threatening systemic manifestations. The primary therapeutic goal in special periodontitis patients is control of pathogens and amid the wide range of pathogenic microfloras, an effective treatment strategy should include a comprehensive microbiological analysis, especially if systemic antimicrobial therapy is contemplated.
Periodontal diesease mechanisms in immunocompromised patients
Authors: Tolo Kåre
Published: December 2005

Abstract. Deficiency in the number and function of phagocytes is associated with gingival inflammation and periodontitis. A hereditary deficiency in membrane glycoproteins involved in granulocyte adherence causes impaired chemo‐taxis, reduced phagocytosis and periodontal problems. Virus infections of antigen‐presenting cells interfere with immune responses and lead to seriously increased susceptibility to infections with bacteria which cause no problems in normal patients. Increased levels of IgG antibodies may limit penetration of antigens in the tissues, but at the cost of local inflammation and tissue injury. Mucosal inflammatory disease with increased local formation of IgG is more frequent in IgA deficient patients. The immunological homeostasis depends on a balance between the respective classes and subclasses of antibodies. Deficiencies in the IgA system may contribute to a disturbed balance of the humoral immune response to critical antigens from oral bacteria. A disproportional increase in IgGl and IgG3 antibodies may persistently activate complement, stimulate the inflammatory activity and cause tissue injury.
Non‐plaque related periodontal lesions
Authors: van der Waal I.
Published: December 2005

Abstract. An overview is presented of some common and uncommon non‐plaque‐related lesions and conditions of the periodontal tissues. Erosive lesions of the gingiva, such as lichen planus, may clinically be misdiagnosed as being the result of inflammation. Likewise, local and generalized gingival swelling may be based on non‐plaque‐related lesions and conditions. True leukoplakia of the gingiva is rare, but should be looked upon with suspicion. The reasons for pigmentation of the gingiva are many‐fold. Especially in the maxilla, the clinician should be alert for an early malignant melanoma. A large variety of lesions may affect the periodontal bone structures, ranging from the common periapical granuloma to the rare, sometimes sclerosing, osteosarcoma. Irregular widening of the periodontal ligament and loss of the lamina dura are ominous radiographic signs.
Predictive power of various models for longitudinal attachment level change
Authors: Yang Mark C. K. , Marks Ronald G. , Clark William B. , Magnusson Ingvar
Published: December 2005

Abstract Several statistical models that have been suggested in the periodontal literature for describing longitudinal attachment level changes, such as the gradual loss, single‐burst, multiple‐burst, and random walk models as well as other models introduced in this paper are compared by their power to predict future attachment loss. The data used in this analysis is from 1061 sites of 8 subjects, with moderate to severe periodontal disease, monitored monthly for about a year. This study found that none of the suggested models could significantly outperform the naive mean predictor, which predicts the future attachment level from the past mean. It was also found that no single model, such as the burst, gradual, or random walk, together with measurement error can fully explain the variation in the data. These results indicate that in the course of one year, the attachment level change may not follow the same model. Consequently, a model that fits well to past data cannot be accurately extended to the future.
Cellular source and tetracycline‐inhibition of gingival crevicular fluid collagenase of patients with labile diabetes mellitus
Authors: Sorsa Time , Ingman Tuula , Suomalainen Kimmo , Halinen Sirkka , Saari Herkko , Konttinen Yrjö T. , Uitto Veli‐Jukka , Golub Lome M.
Published: December 2005

Abstract Accelerated periodontal tissue destruction in patients with labile insulin‐dependent diabetes mellitus (DM) and localized juvenile periodontitis (LJP) has been suggested to be related to functional abnormalities of neutrophils. We have recently found that collagenase in gingival crevicular fluid (GCF) of adult periodontitis patients is primarily derived from neutrophils and that neutrophil collagenase activity is more sensitive to inhibition by tetracyclines than collagenase produced by fibroblasts. This study is to characterize the cellular sources, activation and inhibition of collagenase in GCF of DM patients and to compare it with collagenase in LJP GCF. We found differences which may have therapeutic implications. Specific doxycycline inhibition tests revealed that GCF collagenase in DM is derived from neutrophils, whereas the enzyme in LJP originates primarily from fibroblasts. Oxidant, sodium hypochlorite activated efficiently GCF collagenase of DM but not LJP patients. In contrast, plasmin activated LJP GCF collagenase but not that of DM patients. In GCF of DM patients 50–60% of collagenase existed in an active form, whereas in LJP GCF, the enzyme was almost completely in a latent form. The results suggest that collagenase in GCF of periodontitis patients with labile DM is primarily derived from neutrophils and that tetracycline therapy may be an effective adjunct in treatment aimed at controlling the periodontal breakdown in these patients. On the other hand, in LJP the anti‐collagenase property of tetracyclines may be less important for control of periodontal tissue destruction because of the tetracycline‐resistance of fibroblast collagenase.
Use of multiple sensitivity measurements and log it statistical analysis to assess the effectiveness of a potassium‐citrate‐containing dentifrice in reducing dentinal hypersensitivity
Authors: Chesters R. , Kaufman H. W. , Wolff M. S. , Hunungton E. , Kleinberg I.
Published: December 2005

Abstract A potassium citrate‐SMFP containing dentifrice was tested in double‐blind 8‐week clinical trial on subjects with a history of dentinal hypersensitivity. A dentifrice containing SMFP but no potassium salt was used as the control and a 2nd test dentifrice containing potassium nitrate‐SMFP was assessed at the same time. The sensitivity of the subjects was evaluated at 0, 3 and 8 weeks using electrical and tactile methods plus a 1‐s air blast. The sensitivity scores for each subject at each examination were summarised as a proportion of the examined teeth deemed sensitive. Assessment of any effects of the dentifrices was via an analysis of covariance of the logit transformation of these proportions with the baseline value as the covariate. The use of this novel method of analysis had the advantage of taking into account changes in sensitivity of alt of the teeth, both sensitive and non‐sensitive, since electrical measurements indicated effects on both. Of the original 120 subjects. 111 completed the trial and the 3 dentifrice groups remained well balanced for age, sex and sensitivity. All 3 dentifrice groups showed statistically significant reductions in sensitivity over the 8 weeks. However, the potassium citrate‐SMFP dentifrice was significantly more effective than either the control SMFP dentifrice, or the potassium nitrate‐SMFP dentifrice, at reducing sensitivity after 3 weeks, and this difference plus further sensitivity reduction with all 3 dentifrices was observed after 8 weeks.
A rare case of a multicentric peripheral ameloblastoma of the gingival
Authors: Hernandez G. , Sanchez G. , Caballero T. , Moskow B. S.
Published: December 2005

Absstarct

A rare case of a multicentric peripheral ameloblastoma of the gingiva in a 54‐year‐old male patient is described along with a light and electron microscopic study of the excised tumors. The peripheral ameloblastoma is considered to be the gingival counterpart of the more common intraosseous ameloblastoma. Although both tumors have similar histomorphologic characteristics, their clinical appearance and behavior are completely different. The peripheral ameloblastoma is slow growing and non‐invasive, and recurrence is uncommon following excision. The more common central ameloblasloma, is locally invasive and can destroy large segments of the jaw. The histogenesis of the peripheral ameloblastoma and several other odontogenic tumors of the gingiva serves to illustrate the proliferative potential of the basal cell layer of gingival epithelium.
A follow‐up case report of Actinobacillus actinomycetemcomitans in human periodontal disease
Authors: Skaar D. D. , Wolff L. R , Aeppli D. M. , Bloomquist C. G. , Liljemark W. F.
Published: December 2005

Abstract The purpose of this investigation was to compare clinical and microbial parameters in a follow‐up case report of adult subjects harboring Actinobacillus actinmycetemcomitans (Aa) with clinically matched subjects who did not have detectable Aa, 16 subjects with Aa and 16 subjects without Aa at the baseline examination were re‐examined at an average of 46 months following collection of baseline data. Clinical measurements were recorded and subgingival plaque sampled and evaluated for microbtal flora from each maxillary first molar. In 16 subjects with Aa at baseline, 4 sites in 3 subjects had detectable actinobacilli at the follow‐up appointment. 26 sites in 13 individuals with Aa at baseline had a significantly increased gingival index at the follow‐up visit (p 0.05), but there was no significant increase in probing depth or attachment loss. 32 sites in the 16 subjects without Aa at baseline still did not have detectable levels of this microorganism at the follow‐up examination nor was there any significant difference between baseline and the follow‐up appointment for the gingival index, probing depth and attachment level measurements. In subjects with Aa at baseline. 1 of 12 teelh without Aa and 5 of 20 teeth with Aa had been extracted prior to the follow‐up visit. In this population group, having sites where Aa was detected, 6 of 9 teeth which had a probing depth 5 mm were lost before the follow‐up data collection appointment. In the control group, which did not have detectable Aa at baseline, 9 teeth with probing depths 5 mm were not lost. These observations, although not proving, suggest in this population group, that deeper probing depths taken together with the presence of Aa may have placed an individual at greater risk of tooth loss.
Determination of lymphocyte populations and subpopulations extracted from chronically inflamed human periodontal tissues
Authors: Malberg K. , Mölle A. , Streuer D. , Gängler P.
Published: December 2005

Abstract The lymphocyte populations and subpopulations extracted from inflamed periodontal tissues of patients with adult periodontitis were determined. 34 patients were grouped according to the gingival index score (GI) of 1, 2 and 3. Gingival tissue from 2 involved teeth was excised, treated with collagenase, and infiltrating cells were isolated and identified using monoclonal antibodies for lymphocyte sets and subsets. The % of CD3+ cells was about 54.5% in all 3 patient groups, but the percentage of CD22+ cells increased from 28.9 ± 3.3% in the group with GI = 1 to 33 ± 1.2% in the group with GI = 3. %s of CD4+ cells and activated CD4+ cells increased from 30.2 + 2,1% and 4.1 ±1.1% in the group with GI= 1 to 38.4±1.2% and 16.0 ± 3.4% in the group with GI = 3, respectively, while in the same groups, the % of CD8+ cells decreased from 24.9 ± 2.0% to 17.7 ± 1.6%. These data indicate a possible importance of activated CD4+ cells in pathogenetic mechanisms of periodontitis.
Guided tissue regeneration in surgically‐produced furcation defects
Authors: Pontoriero R. , Nyman S. , Ericsson I. , Lindhe J.
Published: December 2005

Abstract The aim of the investigation was to evaluate the potential for new attachment formation at various degree III furcation involvements in the beagle dog. 3 differently shaped furcation defects were prepared; one small and one large key‐hole defect, and one furcation defect which was part of “circumferential” loss of attachment and bone. 15 beagle dogs were used in the experiments. The furcation defects were surgically created at mandibular premolars in the right and left side of the jaw. Test teeth were subsequently treated according to the GTR principle, while control teeth were treated without the application of membranes. The result from the histological examination of biopsy specimens revealed that GTR treatment may result in complete new attachment at surgically produced “through and through” furcation involvements in dogs. The study, however, also revealed that the size of the furcation defect as well as the shape of the surrounding alveolar bone were factors that determined the outcome of this kind of treatment. The treatment failures were consistently associated with flap recession during healing which resulted in the exposure of the furcation defect.
Efficacy of Listerine®, Meridol® and chlorhexidine mouthrinses as supplements to regular tooth‐cleaning measures
Authors: Brecx M. , Brownsfone E. , MacDonald L. , Gelskey S. , Cheang M.
Published: December 2005

Abstract The anti‐plaque, anti‐gingivitis and anti‐microbial efficacies of a phenolic compound (Listerine®) and 2 different amine/stannous fluoride mouthwashes (Meridol1® I, II) were compared when these solutions were used in addition to usual toothcleaning. A placebo preparation was utilized as a negative control and a chlorhexidine solution as a positive control in this double‐blind study. After professional toothcleaning, 49 volunteers continued their habitual, self‐performed and non‐supervised oral hygiene for a period of 2 weeks, in order to have a more standard baseline. At day 0, they began to rinse twice daily with 1 of the 5 mouthwashes. After 3 weeks of rinsing, plaque indices remained the lowest in the chlorhexidine and the Meridol® 1 groups, while subjects using Listerine® or Merido® II demonstrated similar indices significantly lower than that of individuals rinsing with the placebo solution. Through this period, the gingival index scores were similar in the Meridol®, Listerine® and chlorhexidine groups. At day 21, the mean GI scores in the chlorhexidine group were significantly lower than the scores in the placebo group. The plaque vitality scores showed a bacteria] effect in vivo of chlorhexidine and, to a lesser extent, of the Meridol® solutions. No substantial evidence of an antibacterial effect in vivo was found for Listerine®. This study has demonstrated that when mouthrinses are used to supplement habitual mechanical oral hygiene, chlorhexidine remains the most powerful solution. Furthermore, it was also shown that a combination of habitual self‐performed and non‐supervised oral hygiene with Meridol® or Listerine® is more beneficial for plaque control than the use of mechanical oral hygiene alone.
Digital subtraction radiography in assessing bone changes in periodontal defects following guided tissue regeneration
Authors: Wenzel Ann , Warrer Kirsten , Karring Thorkild
Published: December 2005

Abstract 19 patients with a total of 23 periodontal lesions were selected for the study. Following flap‐elevation, an occlusive membrane (Gore Tex®) adjusted to the size and shape of the lesion was applied. The membrane was removed 4–6 weeks later by a 2nd operation. Clinical attachment levels were measured and intraoral radiographs taken prior to surgery, and 6 and 12 months postoperatively. The root length and marginal bozie level were measured on paper drawings of the teeth magnified (15 ×) from the conventional radiographs. The radiographs were digitized for analysis of the subtraction images between the preoperative and the 6‐ and 12‐month postoperative images. Clinical attachment gain was seen in 78% of the teeth after 6 months and 70% after 12 months. Bone gain was recorded in 56% and 22% after 6 months and in 44% and 66% after 12 months by conventional and digital subtraction radiography, respectively, The bone level measurements on conventional radiographs differed significantly (p= 0.001) between the preoperative and 6‐month postoperative, but not between the 6‐ and 12‐month, (p=0.29) conventional radiographs. There was no significant relationship between the clinical measurements and the assessments of bone changes on conventional radiographs (r= 0.28, p= 0.25), while a stronger relationship was observed between assessment of clinical attachment gain and assessment of bone changes on the subtraction images (r= 0.58, p= 0.01).
The incidence and severity of nifedipine‐induced gingival overgrowth
Authors: Barclay S. , Thomason J. M. , Idle J. R. , Seymour R. A.
Published: December 2005

Abstract The gingival health of 19 patients with cardiovascular problems who were medicated with nifedipine was compared with a similar cohort treated with atenolol and a control group of healthy patients. In the nifedipine and atenolol groups, patients had been taking their respective medication for a minimum period of 6 months. Plaque scores were similar for all three groups. However, patients medicated with nifedipine had a significantly higher gingival index (P < 0.005), gingival overgrowth scores (P <0.02) and probing sites >3 mm (P < 0.005) when compared with the atenolol and control groups. 4 patients in the nifedipine group experienced clinically significant gingival overgrowth which required surgical excision. Gingival changes in the nifedipine patients were not related to drug dosage or plaque scores. It is concluded that nifedipine therapy results in significant gingival changes, an effect which may be mediated by the drug's action on calcium transport.
Healing of experimental wounds in sialadenectomized rat
Authors: Bodner Lipa , Dayan Dan , Oberman Mordechai , Hirshberg Abraham , Tal Haim
Published: December 2005

Abstract The present study evaluates the healing of an experimental standardized full thickness excisional wound in the palate of a sialadenectomized rat model. Experimental rats underwent sialadenectomy of the submandibular and sub‐lingual glands and ligation of the parotid ducts. A full thickness circular wound, 3 mm in diameter, was produced in the palate. Wound diameter was measured clinically and the area of inflammation and area of new connective tissue formation were determined histologically at 3, 7, 14, 21 and 28 days post‐surgery. Wound diameter was similar in both the experimental and the control groups. The area of inflammation, however, was larger (p<0.05) in experimental rats at days 3, 7 and 14. New connective tissue formation was less (p<0.05) in sialadenectomized rats at days 14 and 21. The present results indicate that palatal wound healing is altered and delayed in sialadenectomized rats.
Guided tissue regeneration combined with osseous grafting in suprabony periodontal lesions
Authors: Warrer Kirsten , Karring Thorkild
Published: December 2005

Abstract The purpose of the present investigation was to evaluate the use of bone grafts in combination with the GTR‐procedure in reinstituting periodontal support around teeth with horizontal bone loss. Orthodontic elastic bands were placed around mandibular and maxillary premolars in 3 dogs in order to induce breakdown of the periodontal tissues. When the destruction had reached a level corresponding to approximately half the root length, the elastic bands were removed and the teeth were scaled. After a period with plaque control, mucoperio‐steal flaps were elevated on the buccal and lingual aspects of the experimental teeth. The exposed root surfaces were curetted, and a notch was made at the level of the reduced bone crest. In randomly selected test quadrants, Kielbone® mixed with fibrin sealant (Tisseel®) was placed in the interproximal space and in the bifurcations. Both the buccal and lingual aspect of the test teeth were then covered by a teflon membrane (Zitex®) and the raised tissue flaps sutured in a coronally displaced position. The contralateral teeth (controls) were treated the same way, except that fibrin sealant without Kielbone was applied in the bifurcations and the interproximal space prior to the placement of the membranes. The membranes were removed by a 2nd operation after 35 days. Clinically, various complications were observed during healing. The buccal and lingual flap margins consistently failed to join in the interproximal area, and increasing recession of the flap margins and exposure of the membranes, resulting in accumulation of bacterial deposits and food debris, occurred during the period the membranes were maintained. The histological analysis after 3–4 months of healing failed to demonstrate any consistency in periodontal regeneration in both test and control specimens, and no appreciable differences were observed between the 2 groups. On 10% of the bifurcation surfaces in the test teeth and on 18% of those in the controls, the gain of attachment exceeded 2 mm. The treatment had mainly resulted in bone loss but also regrowth of bone had occurred. The results suggest that the application of the large membranes have resulted in poor wound closure, thereby facilitating contamination of the treated area, which may have disturbed healing and led to exfoliation of the grafted materials.
A randomized trial of occlusal adjustment in the treatment of periodontitis patients
Authors: Burgett F. G. , Ramfjord S. P. , Nissle R. R. , Morrison E. C. , Charbeneau T. D. , Caffesse R. G.
Published: December 2005

Abstract The purpose of the randomized clinical trial was to test; (1) the influence of occlusal adjustment (OA) in association with periodontal therapy on attachment levels, pocket depth, and tooth mobility, (2) whether OA was of greater significance in non‐surgically treated periodontal defects, and (3) whether initial tooth mobility or disease severity had an affect on post‐treatment attachment levels following OA. After hygienic‐phase therapy, 50 patients received OA/No OA according to random assignment; 22 patients received an OA and 28 were not adjusted. 2 months after OA, either modified Widman flap surgery or scaling and root planing by a periodontist were done according to random assignment within each patient in a split‐mouth design. Following active treatment patients were maintained with prophylaxis done every 3 months and scored annually. For the analysis of this two‐year data, a repeated measures analysis of variance was performed using attachment level change and pocket depths as outcome indicators. There was significantly greater gain of clinical periodontal attachment in patients who received an OA compared to those who did not. Both the surgically and non‐surgically treated sides of the mouth responded similarly to OA. There was no affect of OA on the response in pocket depth, nor did initial tooth mobility or initial periodontal disease severity influence the response to OA.
Use of toothpicks for chlorhexidine S‐M staining*
Authors: Tilliss Terri S. I. , Stach Donna J. , Cross‐Poline Gail N.
Published: December 2005

Abstract The purpose of this study was to determine if the extrinsic dental staining associated with the use of chlorhexidine gluconate (CHX) mouthrinse could be prevented or controlled by the patient with the use of toothpicks. 25 subjects received a prophylaxis to establish a stain‐free baseline and were then randomly assigned a control and experimental side of the mouth. The rinsing regimen was 1/2 oz of 0.12% CHX mouthrinse 2 x a day for 3 months. Subjects self‐examined daily for the appearance of stain. Where stain was visible, a toothpick was used to ‘rub it away’ on the distolabial, labial and mesiolabial surfaces of the experimental side only. The rubbing action was similar to the use of an eraser to remove a pencil mark from paper. The amount and intensity of stain was photographed and graded by a blinded examiner after 2 weeks, 1, 2 and 3 months. Subjects kept calendars to encourage and document compliance. When analyzed across time, teeth and surfaces, there was a statistically significant difference in stain between the control and experimental sides for stain amount, intensity, and for a composite of amount/in tensity. Clinical differences were slight. The study indicates that the use of a simple toothpicking technique can affect chlorhexidine stain.
Subgingival temperature (I). Relation to baseline clinical parameters
Authors: Haffajee A. D. , Socransky S. S. , Goodson J. M.
Published: December 2005

Abstract 44 subjects ranging in age from 14–71 years were measured at 6 sites per tooth for gingival redness, plaque accumulation, suppuration, bleeding on probing, pocket depth and attachment level. Subgingival temperatures were measured at the same 6 sites per tooth using a periodontal temperature probe (Perio‐tempTM, AbiodentSM, Danvers, MA). This instrument was also used to measure each subject's sublingual temperature in order to compute the differences between sublingual and Subgingival temperature. Relationships were sought between the baseline clinical parameters and the temperature variables in subjects and at sites. The mean and standard deviation of the sublingual temperatures for the 44 subjects was 36.6±0.4°C (range 35.8–37.6°C). The mean of each subject's mean whole mouth subgingival temperature was 1.9°C lower, 34.8±0.6°C (range 33.4–36.1°C). The differences of the mean subgingival temperature from sub‐lingual ranged from ‐0.8 to ‐3.2°C (average ‐1.9 + 0.5°C). Mean temperature difference for a subject correlated with % of sites with plaque (rs= 0.45), redness (rs= 0.33), bleeding on probing (rs= 0.44), % of sites with attachment level > 3 mm (rs= 0.44), mean pocket depth (rs= 0.44) and mean attachment level (rs= 0.39). There were higher mean temperatures at sites exhibiting or not exhibiting plaque (35.0, 34.5°C), redness (34.9, 34.6), bleeding on probing (35.1, 34.7) and suppuration (35.4, 34.8). Sites with pockets <4, 4–6 and >6 mm had mean temperatures of 34.6, 35.2, 35.8°C, respectively. Site temperature showed a similar relationship with attachment level. The data indicated that subjects differed in their mean subgingival temperature and that some of the differences were indicative of the extent of prior periodontitis and current levels of gingival inflammation. Similarly, temperature at a site related to location of the site in the mouth, pocket depth, attachment level and inflammatory status.
Sub gingival temperature (II). Relation to future periodontal attachment loss
Authors: Haffajee A. D. , Socransky S. S. , Goodson J. M.
Published: December 2005

Abstract The purpose of the present investigation was to determine whether sub gingival temperature was a risk indicator of periodontal attachment loss (detected in the following 2 months) in a subject or at a site. 29 subjects were measured at 6 sites per tooth for clinical parameters as well as sub gingival temperature using a periodontal temperature probe (PeriotempTM, ABIO‐DENTSM, Danvers, MA). The same instrument was used to measure sublingual temperature in order to compute differences between sub gingival and sublingual temperature. Clinical and temperature parameters were measured at 2‐month intervals. A total of 49 subject visits which had both baseline temperature and subsequent attachment level change measurements were available for analysis. Attachment level loss >2.5 mm occurred at 1 or more sites at 16 of 49 subject visits. Elevated mean sub gingival temperature was related to subsequent attachment loss particularly in individuals who exhibited more than 1 progressing site. The odds ratios of a subject exhibiting new attachment loss at 1 or more sites or at 2 or more sites were 14.5 and 64.0 if the subject's mean sub gingival temperature exceeded 35.5°C. Subjects with high mean sub gingival temperatures and widespread periodontal destruction appeared to be at greatest risk for new attachment loss. Discriminant analysis using % of sites with suppuration, redness and attachment level > 3 mm and mean site temperature correctly “predicted” disease activity with a sensitivity, specificity and overall agreement of 0.75, 0.76 and 0.82 respectively. Of 7243 sites, 43 (0.59%) and 160 (2.2%) showed attachment loss of either 2.5 mm or more or 2 mm or more respectively. Unchanging sites exhibited lower mean site temperature and higher deviations from sublingual than sites which lost or “gained” attachment. % of sites showing new attachment loss increased with increasing site temperature, decreasing site temperature deviation and a change in the indicator value from green to yellow to red. For example, % of sites exhibiting loss of attachment of 2.5 mm or more was 0.23 at <34°C, 0.36 at 34–35°C, 0.82 at 35–36°C and 1.04 at >36°C. This pattern was observed for subsets of sites with pocket depths < 4 mm and 4–6 mm, but was weaker for pockets > 6 mm. Most striking was the high risk (8.9% of sites) of new attachment loss at sites with shallow pockets (<4 mm), which bled on probing and had red temperature indicator values compared with the lower risk (1.4%) at shallow, non‐bleeding sites with green indicator values. The findings of the present investigation suggest that knowledge of the sub gingival temperature will be useful in identifying subjects and sites at risk for new attachment loss.
Clinical evaluation of a light energy conversion toothbrush
Authors: Hoover Jay N. , Singer David L. , Pahwa Punam , Komiyama Kunio
Published: December 2005

Abstract A blind, two‐way crossover clinical trial was carried out to compare the effectiveness of plaque removal between a new, light energy conversion toothbrush incorporated with a semiconductor of TiO2 (test) and a similar toothbrush without the semiconductor (control). The study was completed by 73 school children aged 13–15 years. Each toothbrush was used for a period of 3 weeks. The mean differences between baseline plaque scores and after subjects used the test and control brushes were analyzed by the paired f‐test. The Soladey 2 toothbrush showed significantly more reduction of plaque on the buccal surfaces of all teeth than the control brush. There was no significant difference in the plaque removing ability of the two brushes on the lingual aspects of the mandible and on the lingual surfaces of the maxillary posterior sextant. As the buccal surfaces are more likely to allow light to reach the semiconductor during brushing than the lingual areas, it is possible that the reported photocatalytic property of the semiconductor may be involved in some way in the observed reduction of plaque.
Peripheral inflammatory root resorption
Authors: Gold Steven I. , Hasselgren Gunnar
Published: December 2005

Abstract External resorptions associated with inflammation in marginal tissues are many times misdiagnosed and confused with caries and internal resorptions. A lack of uniformity in nomenclature has added to the confusion. This paper reviews the literature and presents cases to illustrate a rational approach to diagnosis and treatment. A new name is suggested to better reflect the features of this type of root resorption: peripheral inflammatory root resorption.
Granulocyte elastase in gingival crevicular fluid
Authors: Gustafsson A. , Åsman B. , Bergström K. , Söder P‐Ö
Published: December 2005

Abstract The granulocyte elastase activity and the immuno‐reactive (antigenic) granulocyte elastase of gingival crevicular fluid (GCF) were studied in 16 periodontitis patients and in 10 gingivitis patients. The elastase activity was measured with a low molecular weight substrate specific for granulocyte elastase. The antigenic elastase was determined with specific antibodies against granulocyte elastase. Intracrevicular sampling of GCF with paper strips for 30 s seemed to provide representative values of elastase. The elastase activity correlated with probing depth and attachment loss and appeared to be a measure of the degree of tissue destruction. Antigenic elastase represents the number of granulocytes in GCF and should thus be related to the degree of inflammation. The periodontitis patients and the gingivitis patients both had a similar degree of inflammation as measured by antigenic elastase per μ1 GCF and gingival index. The elastase activity per μ1 GCF. however, was higher in the periodontitis group. Elevated granulocyte elastase activity in GCF seems to be independent of inflammation and could thus be an indicator of patients at risk for periodontitis.