bluuebunny/crossref_metadata_2025 huggingface dataset:
Supracrestal soft tissue preservation with enamel matrix proteins in treatment of deep intrabony defects
Authors: Trombelli Leonardo , Bottega Sabrina , Zucchelli Giovanni
Published: March 2003

Background/aims: The purpose of the present study was to investigate the effectiveness of a regenerative procedure based on supracrestal soft tissue preservation in association with enamel matrix proteins (EMP) in the treatment of deep intrabony defects.

Methods: The subjects included 35 consecutively treated patients, 23 females and 12 males, aged 28–61 years, 11 of whom were smokers. Patients presented with at least one intrabony defect with probing pocket depth ≥ 6 mm and a radiographic depth of the defect ≥ 4 mm at the initial visit. Immediately before surgery and 9–12 months after surgery, Local Plaque Score (LPS), Local Bleeding Score (LBS), probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (REC), and radiographic depth of the defect (DEPTH) were recorded.

Results: Thirty‐one (88.6%) defects were LPS‐negative presurgery, while 29 (82.9%) defects presented with no plaque postsurgery. The prevalence of LBS‐positive defects shifted from 94.3% presurgery to 8.4% postsurgery (p < 0.0000). PPD was 8.9 mm before surgery, and decreased to 3.5 mm postsurgery (p < 0.0000). CAL varied from 10.1 mm presurgery to 5.4 mm postsurgery (p < 0.0000), with an average improvement (gain) of 4.7 ± 1.7 mm. Twenty‐six (74.3%) defects presented a gain of least 4 mm. Regression analysis showed a positive correlation between CAL gain as a dependent variable, and presurgery PPD and amount of supracrestal soft tissues as predictors. DEPTH improvement (gain) was 3.9 ± 1.8 mm, which represented 65% of defect fill. Twenty (57.1%) defects presented a DEPTH gain of at least 4 mm. DEPTH gain was significantly correlated to presurgery PPD (p < 0.000). No significant differences were found between smokers and non‐smokers in terms of CAL and DEPTH gain.

Conclusions: Results from the present study indicated that the regenerative procedure based on supracrestal soft tissue preservation and EMP application leads to clinically and statistically significant improvement of hard and soft tissue conditions of deep intrabony defects.
A method to compare four mouthrinses:
Authors: Yates R. , Shearer B. H. , Huntington E. , Addy M.
Published: March 2003

Background and Aim: The experimental gingivitis model is a well‐established method in comparing the chemical antiplaque activity of agents and products. The aim of the present study was to use time in order to achieve an exit level of bleeding on probing (BOP) as the primary outcome variable.

Methods: The study was a single blind, randomised four treatment parallel group design employing 76 healthy volunteers. The cohort was accepted into the study proper if they achieved a level of ≤ 25% BOP after a 5‐week pre‐study oral hygiene phase. At baseline, 1, 2, 3, 4, 5 weeks BOP, modified gingival index (MGI) and plaque index scores were obtained from each subject. After baseline, oral hygiene was suspended and subjects rinsed twice daily with one of the test rinses, namely:

1 0.05% cetylpyridinium chloride

2 Control fluoride

3 0.2% chlorhexidine

4 0.3% triclosan

Subjects were removed from the study when they achieved ≥ 50% BOP. Using the baseline and exit BOP, MGI and plaque, a deterioration rate for each parameter was derived and used as the unit of analysis.

Results: There were highly significant treatment differences for all three parameters. Paired analyses revealed chlorhexidine was highly significantly more effective than the other rinses for all three parameters. CPC and triclosan were not different from the control for BOP, but CPC was significantly different from the control for MGI and plaque, and triclosan was different from the control for plaque. There were no differences between the CPC and triclosan rinses.

Conclusions: The method achieved the expected result of differentiating between the chlorhexidine and the other rinses. Some modification of the method, primarily to group sizes, should improve specificity. The method has the considerable volunteer appeal of early exit, particularly when allocated to control or low activity treatments for plaque.
PMN responses in chronic periodontal disease: evaluation by gingival crevicular fluid enzymes and elastase‐alpha‐1‐proteinase inhibitor complex
Authors: Buchmann Rainer , Hasilik Andrej , Nunn Martha E. , Van Dyke Thomas E. , Lange Dieter E.
Published: March 2003

Objectives: In the present trial, the hypothesis was examined that the local PMN responses in untreated and treated chronic periodontitis can be differentiated by gingival crevicular fluid lysosomal enzyme activities and elastase‐alpha‐1‐proteinase inhibitor complex.

Methods: In nine subjects (average age 49.2 ± 7.1 years) with chronic periodontitis, clinical parameters and markers of the PMN‐derived inflammatory tissue response in gingival crevicular fluid (GCF) were assessed before and 6 months after surgical periodontal therapy. Myeloperoxidase (MPO), beta‐N‐acetyl‐hexosaminidase (beta‐NAH) and cathepsin D (CD) were analyzed as indicators of the PMN‐associated host tissue destruction, and elastase‐alpha‐1‐proteinase inhibitor complex (alpha‐1‐EPI) as the major serum protein inactivating PMN elastase. The total activities of the lysosomal enzymes MPO and beta‐NAH were evaluated spectrophotometrically, the CD levels by liquid scintillation counting with [14C] hemoglobin as substrate, and the total alpha‐1‐proteinase inhibitor complex using a sandwich‐immunoassay.

Results: The clinical parameters revealed a statistical significant decrease at the 6‐month reexamination. PD levels dropped from 5.40 to 2.88 mm (change 2.52 ± 1.04 mm), the CAL scores from 6.67 to 4.43 mm (change 2.24 ± 0.77 mm). The 30 s GCF volumes dropped from 129.8 to 68.6, displaying a change of 61.1 ± 18.6, p ≤ 0.05. The decrease in total MPO, beta‐NAH and CD levels (medians: 1.7/0.6 µU MPO, 0.035/0.020 µU beta‐NAH, 1.3/0.5 ng CD) following therapy was associated with a significant drop in total GCF amounts of alpha‐1‐EPI from 76.3 ng at baseline to 52.4 ng after 6 months.

Conclusion: The clinical healing in chronic periodontal disease is associated with a downregulation of the local PMN responses following periodontal therapy. The reorganization of periodontal tissues is characterized by a decrease of lysosomal enzyme activities and the alpha‐1‐proteinase inhibitor complex in gingival crevicular fluid.
HLA‐A, B, Cw, DRB1, DRB3/4/5, DQB1 in German patients suffering from rapidly progressive periodontitis (RPP) and adult periodontitis (AP)
Authors: Machulla H. K. G. , Stein J. , Gautsch A. , Langner J. , Schaller H.‐G. , Reichert S.
Published: March 2003

Background/Aim:  There is growing indication that differences in host response determine susceptibility and resistance to periodontal disease. Particularly, the effect of histocompatibility antigens (HLA) on early onset periodontitis (EOP) has been studied. As most of the results are not conclusive and to date no report has been done on German patients, the aim of this study was to investigate the distribution of HLA alleles in a group of 50 German RPP patients and 102 German AP patients and to compare them to 102 control probands without periodontitis.

Methods:  Diagnosis was established according to standardised clinical criteria. HLA typing was performed using serologic and molecular biologic (PCR‐SSP) techniques.

Results: Compared to the controls, RPP patients had a significantly higher frequency of HLA‐DRB1*13 and a significantly lower frequency of HLA‐DRBblank*(non‐DRB3/4/5). AP patients showed a significantly increased occurrence of HLA‐B*14 and ‐Cw*08 as well as a significantly decreased frequency of HLA‐A*03. In both patient groups HLA‐A*11 and ‐A*29 had an increased frequency and HLA‐A*31 and ‐A*30/31 were decreased. These differences were statistical significant in the whole patient group (RPP + AP).

Conclusions:  Based on modern DNA techniques the present study shows an association of HLA to both RPP and AP. Certain HLA alleles seem to be associated with susceptibility or resistance to periodontitis in general. However, before this knowledge can be used for differential diagnosis or prognosis, further investigations are necessary.
Risk factors for periodontal disease progression among elderly people
Authors: Ogawa Hiroshi , Yoshihara Akihiro , Hirotomi Toshinobu , Ando Yuichi , Miyazaki Hideo
Published: March 2003

The aim of this study was to identify the risk factors for periodontal disease progression by individual characteristics at baseline among elderly people over a 2‐year period. Subjects were selected from 4542 people aged 70 years residing in Niigata who were in good general health and who did not require special care for their daily activities. Gender, smoking and alcohol drinking habits were obtained using a questionnaire, while serum levels of disease markers were investigated and attachment levels were clinically recorded. For the assessment of periodontal disease progression, additional attachment loss was used if one or more sites had a 3‐mm or more increase in probing attachment level over a 2‐year period. In all, 394 subjects (208 males and 186 females) were surveyed. Approximately 75% of subjects exhibited additional attachment loss over a 2‐year period. Significant associations were found between additional attachment loss and smoking, and attachment level of 6 mm or more at baseline, with odds ratios of 3.75 and 2.29, respectively. Smoking habit and baseline attachment level of 6 mm or more may be considered risk factors for further attachment loss among healthy elderly people.
Substantivity of toothpaste slurries and their effect on reestablishment of the dental biofilm
Authors: Arweiler Nicole B. , Auschill Thorsten M. , Reich Elmar , Netuschil Lutz
Published: March 2003

Objectives: Toothpastes are good vehicles for antibacterial substances to exert a prolonged effect. This effect depends on the substantivity and ability to interfere with plaque metabolism and/or vitality. It was the purpose of this clinical, randomized 2 × 4 cell crossover study to evaluate and to compare the antibacterial effects of two toothpastes (Colgate Total®, COL and Parodontax®, PAR) applied as slurries on established plaque over 24 h (Part I) and their effect on 4‐day plaque regrowth (Part II). Chlorhexamed® (0.1%; CHX) and water served as positive and negative controls.

Material and methods: After professional toothcleaning eight students were asked to refrain from all mechanical hygiene measures for the next 72 h. After 48 h plaque was sampled and vitality of the plaque flora examined (baseline, VF0%). The subjects then rinsed for 1 min with 15 mL of one of the test or control solutions. Every second hour up to 14 h and 24 h after rinsing, plaque sampling and staining was performed to assess plaque vitality (VF2‐24, Part I). In Part II, the classical 4‐day plaque regrowth design was used with two rinses (1 min) a day as the only oral hygiene measure. Vitality values were assessed on day 1 and day 4 (VF1, VF2). At day 4, teeth were stained to assess the whole mouth plaque index (PlI) and to evaluate the percentage of plaque area (PA) of the anterior teeth.

Results: Compared to placebo, all active rinses reduced plaque vitality significantly over a period of 24 h (Part I). PAR, COL and CHX revealed reductions of 18–31%, 28–50% and 19–50%, respectively. In Part II, similar reductions of all parameters were found for all active rinses (PAR 12–30%, COL 34–51%, CHX 40–64%).

Conclusions: Colgate Total has shown a significant action on plaque regrowth and a high substantivity during 24 h, while Parodontax revealed a more moderate but still significant effect.
Effect of a controlled‐release chlorhexidine chip on clinical and microbiological parameters of periodontal syndrome
Authors: Grisi Daniela C. , Salvador Sérgio L. , Figueiredo Luciene C. , Souza Sérgio L. S. , Novaes Arthur B. , Grisi Márcio F. M.
Published: March 2003

Aim: The aim of this study was to evaluate the effectiveness of a controlled‐released chlorhexidine chip (CHX) as adjunctive therapy to scaling and root planing (SRP) in the treatment of chronic periodontitis.

Material and methods: Twenty patients with at least four sites with probing depth ≥ 5 mm and bleeding on probing were selected. This randomized single‐blind study was carried out in parallel design. The control group received SRP alone, while the test group received SRP plus CHX chip. The clinical parameters, Plaque Index (PlI), Papillary Bleeding Score (PBS), Bleeding on Probing (BOP), Gingival Recession (GR), Probing Depth (PD) and Relative Attachment Level (RAL), and the microbiological parameter BANA test were recorded at baseline and after 3, 6 and 9 months.

Results: Both groups presented significant improvements in all parameters analyzed over the study period. There were no statistically significant differences between the two groups for any parameter analyzed after 9 months, except for BOP, which was significantly reduced in the control group. The mean reductions on PD and RAL were 2.4 mm and 1.0 mm for the control group and 2.2 mm and 0.6 mm for the test group, respectively.

Conclusion: The CHX chip did not provide any clinical or microbiological benefit beyond that achieved with conventional scaling and root planning, after a 9‐month period.
Phenytoin‐mediated androgen metabolism in gingival fibroblasts
Authors: Soory M. , Suchak A.
Published: March 2003

Objectives: This investigation attempts to identify the role of the alkaline phosphatase inhibitor levamisole (L) and the antiandrogen finasteride (F) on 5α‐reductase activity in gingival fibroblasts, to elucidate mechanisms for phenytoin‐induced gingival overgrowth.

Material and methods: Human gingival fibroblasts were incubated with Eagle's MEM and 14C‐testosterone/14C‐4‐androstenedione as substrates; effective concentrations of phenytoin (Ph), levamisole (L) and finasteride (F), alone and in combinations of (Ph + F) (Ph + L) were added to the incubate. After 24 h, the medium was analysed for steroid metabolites and quantified using a radioisotope scanner.

Results: The metabolites isolated were 5α‐dihydrotestosterone (DHT), 4‐androstenedione (4‐A) or testosterone (T) from each substrate. With 14C‐T as substrate, Ph stimulated DHT synthesis by 1.7‐fold, while F and L inhibited this activity by 1.8‐fold and 34%, respectively (n = 6; P < 0.001). The combination of Ph + F reduced yields by 2.7‐fold compared with Ph alone and Ph + L reduced DHT synthesis by 2.4‐fold compared with Ph alone (n = 6; P < 0.001). When 14C‐4‐androstenedione was used as substrate, similar trends were identified.

Conclusion: These results suggest that the alkaline phosphatase inhibitor levamisole and the 5α‐reductase inhibitor finasteride can substantially decrease the yields of DHT in fibroblasts, stimulated by phenytoin. This could be a potential target for reducing the gingival overgrowth caused by phenytoin.
A comparison of the plaque‐inhibitory properties of stannous fluoride and low‐concentration chlorhexidine mouthrinses
Authors: Claydon N. , Smith S. , Stiller S. , Newcombe R. G. , Addy M.
Published: March 2003

Background: Plaque inhibition by chlorhexidine (CHX) rinses is dose related with a relatively flat dose–response curve above 5–6 mg twice daily. Low dose regimens could therefore reduce local side effects but maintain reasonable efficacy.

Aims:  To compare the plaque inhibitory properties of two low‐dose CHX rinse products with more conventional levels delivered from proprietary rinses. A secondary outcome was a comparison with a stannous fluoride/amine fluoride (SFAF) rinse product.

Methods:  The study was a five‐treatments, negative controlled, randomised, single blind crossover design balanced for residual effects, involving 20 healthy subjects in a 24‐h plaque re‐growth model. On day 1 of each study period, subjects were rendered plaque free, suspended tooth cleaning and followed the appropriate rinse regimen. On day 2, subjects were scored for plaque by index and area. The rinse codes and rinsing regimens were: (A) 15 mg CHX 2 × daily for 30 s (0.1% CHX), (B) 9 mg CHX 2 × daily for 60 s (0.06% CHX), (C) 10 ml SFAF rinse 1 × daily for 30 s, (D) 15 ml placebo 2 × daily for 60 s, and (E) 6 mg CHX 2 × daily for 30 s (0.06% CHX).

Results:  Average mouth plaque indices and areas were highly significantly different between rinsing regimens. All test rinses were significantly more effective than the placebo rinse. There was a mean dose–response pattern for the CHX rinses, but there were no statistically significant differences between any of the test rinses.

Conclusions:  Lower doses of chlorhexidine in rinses can be used to exert plaque inhibition comparable with products used at higher doses and equivalent to benchmark products such as the SFAF rinse. However, the availability of chlorhexidine from formulations has to be considered as in part explaining the results.
Lateral ridge augmentation by the use of grafts comprised of autologous bone or a biomaterial. An experiment in the dog
Authors: Araújo M. G. , Sonohara M. , Hayacibara R. , Cardaropoli G. , Lindhe J.
Published: March 2003

Objective: The present investigation was performed to determine if a block of Bio‐Oss® used as an onlay graft can be used as a scaffold for new bone formation.

Material and methods: Five mongrel dogs were used. The mandibular premolars were extracted. On both sides of the mandible, the buccal bone plate was resected and defects, about 25 mm long, 8 mm high and 5 mm wide, were produced After 3 months of healing, a second surgical procedure was performed. In the left side, a block of Bio‐Oss® was adjusted to the buccal bone wall. The graft had the shape of a cylinder and was retained with a miniscrew and covered with a collagen membrane. In the contra‐lateral side of the mandible, a block biopsy was first obtained from the ascending ramus. This bone graft had the shape of a cylinder that was 8 mm in diameter and 3 mm thick. The graft was transferred to the experimental site, adjusted to the buccal wall, retained with a miniscrew, and covered with a membrane. The flaps were repositioned and closed with sutures to ensure a complete coverage of the experimental sites.

After 6 months of healing, the dogs were sacrificed and the experimental sites dissected. The biopsies were processed for ground sectioning. The sections were stained in toluidine blue, examined in the microscope, and a number of histo‐ and morphometric assessments made.

Results: The study demonstrated that cortical bone used as an onlay graft in the lateral aspect of the alveolar ridge, during a 6‐month period of healing integrated with the host bone but underwent marked peripheral resorption. Thus, close to 30% of the height and 50% of the length of the graft was replaced with connective tissue. It was further observed that while the dimensions of a graft which contained a scaffold of cancellous bovine bone mineral remained unchanged, only moderate amounts of new bone formed at the base of this graft.

Conclusion: Grafts of autologous cortical bone, placed on the surface of a one‐wall defect, may undergo marked resorption during healing. A similar graft of Bio‐Oss® may retain its dimension, and limited amounts of new bone will form within the biomaterial.
In vitro validity of the Dundee Selectable Threshold Method for caries diagnosis (DSTM)
Authors: Fyffe Hazel E. , Deery Chris , Nugent Zoann J. , Nuttall Nigel M. , Pitts Nigel B.
Published: March 2003

Abstract – Objectives: It is not generally possible to assess diagnostic accuracy in dental surveys as no histological ‘gold standards’ are available, therefore examiner agreement tends to be used as a proxy for accuracy. The aim of this study was to investigate, using extracted teeth in arch models, the in vitro validity of a diagnostic system to assess caries at the D1 (enamel and dentine) and D3 (dentine) diagnostic thresholds, for epidemiological purposes. Method: Two groups of 10 dental examiners trained in the use of the Dundee Selectable Threshold Method for caries diagnosis (DSTM) each examined (on two occasions) 160 extracted permanent molar and premolar teeth set in arch models in phantom heads according to the codes and criteria of the DSTM. The teeth were subsequently radiographed and sectioned to provide validation of the diagnoses. Results: Intra‐examiner agreement according to the kappa statistic was substantial. In general terms the results of the in vitro validation exercise demonstrated significantly higher sensitivity values at the D1 diagnostic threshold than were found at the D3 diagnostic threshold with a consequent loss of specificity. Conclusions: The results of this in vitro validation exercise demonstrate that at the D1 diagnostic threshold the sensitivity of the DSTM was greater than at the D3 threshold indicating no loss of diagnostic accuracy at the D1 threshold.
Impact of analytic conventions on outcome measures in two longitudinal studies of dental caries
Authors: Slade Gary D. , Caplan Daniel J.
Published: March 2003

Abstract – Caries increment is the primary outcome measure used in most longitudinal studies of caries. Its computation requires the adoption of specific analytic conventions for handling examiner misclassification (“reversals”), teeth lost due to caries, and multiple events such as caries initiation and progression. However, little is known about the impact of these analytic conventions on cumulative incidence and incidence density – two additional outcome measures used in longitudinal studies. Objective: We evaluated the impact of analytic conventions on caries outcome measures in two longitudinal caries studies. Methods: A secondary analysis was undertaken using data from two studies: a 2‐year observational cohort study of 683 older adults and a 3‐year clinical trial of 1754 children. Crude, net and adjusted increments were compared, effects of inclusion and exclusion of teeth lost due to caries were contrasted and measures of caries initiation and progression were assessed among subgroups in each study. Results: Cumulative incidence indicated a high risk of caries (50% or more) in both studies but was not sensitive to subgroup differences. Increment and incidence density measures consistently revealed between‐subgroup differences when subgroups had comparable numbers of teeth. For all three outcome measures, crude DFS values were larger than net DFS values. The adjusted DFS was similar to crude DFS in older adults, but similar to net DFS in children. Measurement of caries initiation and progression increased disease estimates for all three outcome measures. Conclusions: In the populations studied, analytic conventions for handling examiner misclassification, teeth lost due to caries and multiple events had a greater impact on inferences than the choice of outcome measure.
ART restorations and sealants placed in Chinese school children – results after three years
Authors: Holmgren Christopher J. , Lo Edward C.M. , Hu Deyu , Wan Huchun
Published: March 2003

Abstract – Objectives: These were to assess whether ART restorations and sealants could be provided to children in a school environment in China, to assess patient acceptability of the ART approach, and to evaluate on a longitudinal basis the treatments performed. Methods: This study was conducted in Deyang, Sichuan Province, in western China. A total of 294 ART restorations were placed in 197 children and 191 fissure sealants were placed in 140 children by five middle‐level dentists in four secondary schools. Standard instruments and procedures for ART were used. The restorative material used was a high‐strength glass‐ionomer (Ketac‐Molar, ESPE). The treatments were evaluated annually after placement by the same examiner who had not been involved in the placement of the restorations nor sealants using explorers and mouth‐mirrors. At the 3‐year examination an independent external examiner evaluated the restorations using USPHS criteria. Results: Most of the children did not report discomfort during treatment and 92% were willing to receive ART restorations again. The cumulative 1‐year and 3‐year survival rates of small Class I restorations were 99% and 92% respectively. The corresponding figures for large Class I restorations were 90% and 77%. After 3 years, 72% of the sealants were either partially or completely retained. Only 2% of the sealed teeth developed fissure caries and these involved teeth where the sealants had been lost. Similar success rates were found using USPHS criteria. Conclusions: The ART approach for preventing and treating tooth decay in Chinese school children was shown to be appropriate, effective and acceptable. The 3‐year survival rates of the restorations were high but were related to the size and type of the restoration.
Salt fluoridation and dental caries in Jamaica
Authors: Estupiñán‐Day Saskia R. , Baez Ramón , Horowitz Herschel , Warpeha Rosalie , Sutherland Bernard , Thamer Mae
Published: March 2003

Abstract – Purpose: In 1987, Jamaica initiated a comprehensive island‐wide salt fluoridation program. A survey was conducted in 1995 to monitor the impact of salt fluoridation among children in Jamaica. Methods: Dental examinations of 1120 children aged 6–8, 12, and 15 years were conducted according to World Health Organization criteria to assess dental caries, fluorosis, the presence of and need for dental sealants, and Community Periodontal Treatment Needs (CPI). Results: Age specific DMFT means observed in 1995 were 0.2 at age 7, 0.4 at age 8, 1.1 at age 12 and 3.0 at age 15. The mean DMFT scores in children 6, 12 and 15 years of age were dramatically lower than the corresponding scores of 1.7, 6.7 and 9.6 obtained at the baseline examination in 1984 for children of the same age groups, respectively (baseline data for 7‐ and 8‐year‐olds were not collected). The mean percentage of sound permanent teeth for all age groups was 90% in 1995. The percentage of children caries‐free at baseline was 27.6% for 6 years, 2.8% for 12 years and 0.3% for 15 years of age. In 1995, the percentage of caries‐free children (permanent teeth) was 61%. In 1984, 23 children were scored as having very mild or mild fluorosis. In 1995, five children were scored in the same categories of fluorosis, using Dean’s criteria; thus, fluorosis remained at negligible levels in 1995. Conclusions: The oral health survey conducted in Jamaica in 1995 indicated a significant decline in dental caries compared with findings in 1984. The major change in Jamaica during the interval was the introduction of salt fluoridation in 1987. Dental fluorosis was low in the 1995 survey.
On the retention and effectiveness of fissure sealant in permanent molars after 15–20 years: a cohort study
Authors: Wendt Lill‐Kari , Koch Göran , Birkhed Dowen
Published: March 2003

Abstract – The aim of the present study was to clinically evaluate fissure sealants on the occlusal fissures and buccal pits of permanent first and second molars after 20 and 15 years, respectively. The population consisted of 72 children, each of whom had had their four first molars sealed between 1977 and 1980. At the annual examinations, all caries‐free, newly erupted second molars were sealed. When sealant was applied to the second molars, the first molars were checked and sealant was reapplied to those that had deficient sealants. At the follow‐up, when the subjects were 26–27 years of age, 27 in the original group had moved from the community. Thus, the present result is based on 45 subjects. One hundred and fifty‐three sealed first molars and 161 sealed second molars were available for inspection. At the follow‐up examination of the first molars 20 years after sealant had been applied, 65% showed complete retention, 22% partial retention without caries, and 13% caries or restoration in the occlusal fissures or buccal pits. At the 15‐year follow‐up of the second molars, the corresponding figures were 65%, 30%, and 5%, respectively. Of the restored or carious molars, significantly more were found in the mandible than in the maxilla (P<0.001). This longitudinal study showed that pit and fissure sealants – applied during childhood – have a long‐lasting, caries‐preventive effect.
The relationship between problem behaviour and traumatic dental injury amongst children aged 7–15 years old
Authors: Odoi Rebecca , Croucher Ray , Wong Ferranti , Marcenes Wagner
Published: March 2003

–

Aim: The aim of this study was to test whether dental injuries are related to problem behaviour. In addition, it aimed to confirm the relationship between dental injuries and size of overjet and type of lip coverage.

Methods: A hospital‐based matched (age and sex) case‐control design was adopted. Data were collected through clinical examinations and interviews. The informant‐rated version of the Strengths and Difficulties Questionnaire (SDQ) was used to identify problem behaviour. One parent of the child, most often the mother, was interviewed. Hierarchical modelling using conditional logistic regression was used to test the relationship between the five problem behaviours and traumatic dental injuries.

Results: The Odds ratio of having a dental injury increased 3.14 times if children have peer relationship problems (P = 0.032), whilst a prosocial behaviour showed a tendency to have a protective effect (OR = 0.25; P = 0.064). Emotional symptoms, conduct disorder and hyperactivity behaviours were not related to dental injury (P > 0.75). Results were adjusted by father's level of education, size of overjet and type of lip coverage, and these variables were significantly related to dental injury (P < 0.05).

Conclusion: Problem behaviour may play an important role in the occurrence of traumatic dental injury.
Private dental visits per dentist in Spain from 1987 to 1997
Authors: Bravo Manuel
Published: March 2003

Objectives: In view of the sharp increase in the number of dentists in Spain, the aim of the present study was to analyse changes in the private dentist workload in Spain over the period 1987–97.

Methods: Data were taken from censuses of the population and of dental practitioners, and from the Spanish National Health Interview Surveys. The percentage of people that had visited the dentist in the 3 months prior to the survey was calculated, and of these, the percentage whose last visit was private. The total number of visits made by those people was taken as the estimate of total private visits in Spain during 3 months. Total private activity in 1 year was derived by multiplying this estimate by four. Annual private activity was then divided by the number of dentists.

Results: From 1987 to 1997, the Spanish population grew 2.5% (from 38.7 to 39.7 million) and the number of dentists increased by 136.1% (from 6373 to 15 044). The total annual number of private dental visits (±SE) was 35.7 ± 1.0 million in 1987, and 48.9 ± 2.0 million in 1997 – a 36.8% increase. Thus, the mean number of private dental visits per dentist decreased 42.0% (from 5610 ± 152 to 3251 ± 133).

Conclusion: A significant reduction in private dental visits per dentist is taking place in Spain.
Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia
Authors: Al‐Malik Manal I. , Holt Ruth D. , Bedi Raman
Published: March 2003

Objectives:The objective of this study was to determine the prevalence of dental erosion in preschool children in Jeddah, Saudi Arabia, and to relate this to caries and rampant caries in the same children.Methods:A sample of 987 children (2–5 years) was drawn from 17 kindergartens. Clinical examinations were carried out under standardised conditions by a trained and calibrated examiner (M.Al‐M.). Measurement of erosion was confined to primary maxillary incisors and used a scoring system and criteria based on those used in the UK National Survey of Child Dental Health. Caries was diagnosed using BASCD criteria. Rampant caries was defined as caries affecting the smooth surfaces of two or more maxillary incisors.Results:Of the 987 children, 309 (31%) had evidence of erosion. For 186 children this was confined to enamel but for 123 it involved dentine and/or pulp. Caries were diagnosed in 720 (73%) of the children and rampant caries in 336 (34%). The mean dmft for the 987 children was 4.80 (±4.87). Of the 384 children who had caries but not rampant caries, 141 (37%) had erosion, a significantly higher proportion than the 72 (27%) out of 267 who were clinically caries free (SND=2.61,P<0.01). Of the 336 with rampant caries, 96 (29%) also had evidence of erosion.Conclusions:The level of erosion was similar to that seen in children of an equivalent age in the UK. Caries was a risk factor for erosion in this group of children.
Socio‐economic effect on caries. Incidence data among Swedish 12–14‐year‐olds
Authors: Källestål Carina , Wall Stig
Published: March 2003

Objective: To assess whether socioeconomic factors are associated with the progression of caries, independently of a previous history of caries. Subjects and methods: In 1995, as part of a longitudinal study of preventive measures, 3373 Swedish 12‐year‐olds were examined for caries and answered a questionnaire regarding socioeconomic level (SEL), ethnicity and residential area. The examination was repeated in 1997 when 3109 of the teenagers participated. Baseline caries and increments in the incidence of caries were computed. The influence of structural variables on baseline caries as well as a 2‐year increment were analysed by means of Poisson regression. Results: The risk of having caries as 12‐year‐olds was greater in workers' and immigrants' children, as well as in urban teenagers. The risk of developing new caries was most influenced by an earlier experience of caries. The social gradient was, however, still visible when a previous experience of caries was accounted for. The pattern found in the cross‐sectional data from 1995, with more caries in children from workers' families, therefore prevailed in the increment data. Conclusion: Irrespective of earlier caries status there is a social gradient in caries progression. It therefore seems that the preventive methods do not function to the equal benefit of all children.
The Dental Neglect and Dental Indifference scales compared
Authors: Jamieson Lisa M. , Murray Thomson W.
Published: March 2003

Objectives:The objective was to determine whether the Dental Neglect and Dental Indifference scales measure similar constructs and have similar associations in the same population sample.

Methods:A random sample of 600 residents in the Dunedin South Electorate were sent a self‐report questionnaire containing the Dental Neglect scale and the Dental Indifference scale. Socio‐demographic and dental service‐use data were also collected.

Results:In all, 478 people (78.2%) returned the questionnaire. The mean Dental Neglect score was 12.4 (SD 4.4). The mean Dental Indifference scale score was 3.1 (SD 1.9). The association between the scales' scores was moderate (r = 0.58;P < 0.01), and there was only a moderate degree of concordance between the two. The two scales had largely similar associations with socio‐demographic, oral care and self‐care, and oral health impact characteristics, although slightly more associations were found with the Dental Indifference scale. The Dental Neglect scale was found to be easier to use than the Dental Indifference scale because it did not require a complex algorithm to compute scale scores.

Conclusions:  The degree of concordance between the Dental Neglect and Dental Indifference scales was not as high as expected, which suggests that the scales may measure different constructs. However, the largely similar associations with important oral health and socio‐demographic variables of the scales suggest the opposite. Although the Dental Indifference scale was slightly more discriminative, the Dental Neglect scale was easier to use in practice.
Medically administered antibiotics, dietary habits, fluoride intake and dental caries experience in the primary dentition
Authors: Mariri Boipelo P. , Levy Steven M. , Warren John J. , Bergus George R. , Marshall Teresa A. , Broffitt Barbara
Published: March 2003

Abstract –

Objectives: Dental caries continues to be a major public health problem in the US and other nations, particularly among younger children. Unfortunately, understanding of factors contributing to caries in this age group is incomplete and further studies are necessary. The purpose of this study was to assess factors related to extensive caries experience among children aged 4–7 years, including antibiotic use, dietary patterns, fluoride intakes, and tooth brushing habits.

Methods: The case‐control study was nested within a longitudinal cohort study of children's oral health. The larger cohort study collected data on fluoride intakes and behavioral factors, including antibiotic use and dietary patterns of children periodically from birth. A single dental examination was completed for each child at a time between the ages of 4–7 years. A case‐control design was used to compare children with severe caries experience (6 or greater dmfs) to those with no caries experience. Cases (n = 39) included all who met the criteria and had sufficient longitudinal data (n = 39) while a control group was selected to have comparable mean age, exam dates, and an equal number of boys and girls.

Results: Backward elimination logistic regression controlling for demographic variables showed severe caries experience to be related to greater regular pop/other sugared beverage intake, greater frequency of starch foods, and greater frequency of eating occasions. Mother's education and fluoride intake from water were inversely related to severe caries experience. Antibiotic use was generally higher in the control group, but was not significantly different than in the severe caries group.

Conclusions: Although we cannot rule out the possibility that antibiotics may be associated with increased or decreased caries risk, our data suggest that they play only a minor role in caries prevention compared to fluoride. Dietary sugar continues to be a significant risk factor for caries in the primary dentition.
Skin hyporeactivity in relation to patch testing
Authors: Koehler Almuth M. , Maibach Howard I.
Published: March 2003

False‐negative patch tests are clinically relevant. Skin hyporeactivity has been suggested as one possible cause. Evidence supports that failure to respond to a specific antigen might be due either to a faulty immune response, a defective inflammatory response or both. Thus, skin hyporeactivity may have clinical relevance in routine patch testing. Articles on this topic are infrequent and there is no index keyword for skin hyporeactivity as this phenomenon is poorly defined and investigated. This article summarizes several observations of skin hyporeactivity, reviews theories of possible mechanisms and discusses further consequences.
The purpuric patch test in patients with allergic contact dermatitis from azo dyes
Authors: Lazarov Aneta , Cordoba Mario
Published: March 2003

The histopathological features of the purpuric patch test have been described in individual cases only. We report a series of patients with allergic contact dermatitis, who developed purpuric patch tests at the sites of allergens from the azo dye group. 105 patients were clinically evaluated and tested with the TRUE Test and the textile color & finish series (Chemotechnique Diagnostics) because of suspected clothing dermatitis. Positive results to the latter were found in 31 patients (29.5%). In 9 of these, purpuric patch tests were observed at the sites of the allergens Disperse Blue 124, 106 and 85. 10 biopsies were performed and studied. The histopathological changes of the purpuric patch test included: spongiosis (in 90% of cases), exocytosis (70%), and dilated blood vessels (100%) without signs of vasculitis, surrounded by an inflammatory infiltrate composed mainly of T lymphocytes. Extravasated erythrocytes were seen perivascularly, but also in the interstitium, surrounding the acrosyringium, at the dermoepidermal junction, and in the epidermis. Increased number of mast cells were found in 22.2% of cases. Disperse Blue 124, 106, and 85 are potent allergens that can elicit purpuric patch test reactions. The purpuric patch test in our cases was a manifestation of an allergic reaction, based not only on histopathological changes, but also on evolution and relevance of the patch tests.
Provocative use testing of methyldibromo glutaronitrile in a cosmetic shampoo
Authors: Tosti Antonella , Vincenzi Colombina , Smith Karin A.
Published: March 2003

Methyldibromo glutaronitrile (1,2‐dibromo‐2,4‐dicyanobutane, MDGN) is a component of Euxyl K400, a broad‐spectrum preservative increasingly used in cosmetics over the last 10 years. Contact allergy to MDGN is not uncommon, with leave‐on cosmetics and moistened toilet tissue being the most important sources. Rinse‐off products have rarely been reported to elicit allergic reactions in patients sensitized to MDGN and shampoos have only been implicated in hairdressers. To determine whether subjects sensitized to MDGN would react in a provocative use test with a shampoo containing the preservative, we asked 12 pre‐sensitized subjects to use a shampoo containing 0.02% MDGN for a period of 9–13 weeks. During this time, none of the subjects showed any skin reactions indicative of contact allergy. The results of this study provide evidence to support that a shampoo product containing 0.02% MDGN may safely be used by most individuals who are presensitized to MDGN.
An open assay model to induce subclinical non‐erythematous irritation
Authors: Charbonnier Veranne , Morrison Boyce M. , Paye Marc , Maibach Howard I.
Published: March 2003

To avoid the acute irritation and dryness that a single occlusive surfactant application (24‐h patch test) may cause, and to approximate clinical use, an open application model was chosen to define subclinical non‐erythematous irritation in the stratum corneum. This human test combined a supervised washing at the laboratory with at‐home use of the test products by the subjects. Effects of washing with the surfactants on the dorsal hand and volar forearm were compared. The results demonstrated that this situational use model permits the exploration of subclinical surfactant‐induced irritation. The forearm appeared to be more discriminative as compared to the dorsal hand. Squamometry proved to be a sensitive, complementary assessment method for detecting surfactant‐induced subclinical skin surface alterations and for differentiating surfactant effects in this open assay.
Rash related to use of scented products. A questionnaire study in the Danish population. Is the problem increasing?
Authors: Johansen Jeanne Duus , Andersen Tavs Folmer , Thomsen Lars Krogsgaard , Kjøller Mette , Menné Torkil
Published: March 2003

Fragrances are used in many types of cosmetic and household products, which are an important part of everyday life in modern society. The aim of the current investigation was to describe the frequency of self‐reported rash due to scented products in a random sample of the adult Danish population. Further, it was determined whether risk of self‐reported 1st‐time rash from scented products had increased during the past 15 years compared to the preceding period. The sample consisted of 1537 persons, 801 female and 736 male, above the age of 15 years. The participants were interviewed person‐to‐person to obtain a general health profile, and in this connection, questions were asked concerning rash related to the use of scented products. 28.6% (440/1537) had on some occasion experienced rash from scented products, 10.6% had experienced rash within the year prior to interview. A multivariate analysis showed that women had a significantly increased risk of reporting rash from scented products compared to men (odds ratio: 1.56, p<0.0001). Furthermore, it was shown that individuals below the age of 40 years had a significantly increased risk of reporting rash from scented products compared to older age groups. The risk of reporting 1st‐time rash occurring after 1978 was significantly increased (odds ratio: 2.34, p<0.0001), as compared to the preceding period. This may be taken as indicative of an increasing problem with scented products, involving potentially severe public health implications.
Activity of human contact allergens in the murine local lymph node assay
Authors: Ryan C. A. , Gerberick G. F. , Cruse L. W. , Basketter D. A. , Lea L. , Blaikie L. , Dearman R. J. , Warbrick E. V. , Kimber I.
Published: March 2003

The murine local lymph node assay (LLNA) is a predictive test for the identification of chemicals that have the potential to cause skin sensitization. Since its original development, the assay has been the subject of national and international evaluation studies and extensive comparisons with guinea pig tests and human data. On the basis of these investigations, the LLNA has recently been endorsed by ICCVAM (Interagency Coordinating Committee on the Validation of Alternative Methods) as a stand‐alone method for skin sensitization hazard identification. At the same time, ICCVAM confirmed that, although the LLNA is not an in vitro method, it does represent a refinement in the way animals are used and can provide a means for reducing the number of animals used in sensitization hazard assessment. The investigations described here were designed to explore further the ability of the LLNA to identify accurately those chemicals that cause allergic contact dermatitis in humans. To that end we have measured, amongst 3 independent laboratories, LLNA responses induced by a total of 18 test chemicals, 11 of which are known to cause skin sensitization and 7 of which are believed not to be associated with any significant evidence of allergic contact dermatitis in humans. The LLNA correctly classified 16 of the 18 materials. The 11 chemicals tested which are associated with allergic contact dermatitis in humans were found to be positive in the LLNA. Of the 7 materials believed to be non‐sensitizers, 5 were negative in the LLNA and 2 produced positive results. Collectively, these data provide additional evidence that the LLNA is able to discriminate skin sensitizers from those chemicals which do not possess a significant skin sensitization potential and thus provides a method for hazard identification that offers important animal welfare benefits.
Increase in contact allergy to fragrances: patch‐test results 1989–1998
Authors: Lunder Tomaž , Kansky Aleksej
Published: March 2003

We report the results of patch tests with fragrance‐mix as a part of the standard series carried out over the last 10 years (1989–1998) during routine testing of 6129 patients in our department. 5.9% of the total number of patients who were patch tested were positive to fragrance mix. The sex ratio was 2.3:1 with a female predominance. In 1989–1993, the frequency of contact sensitivity to fragrance mix was 3.9% (4.9% for females and 2.1% for males). This rate rose both in female and male patients during the observed period of time and attained 8.9% (females) and 4.1% (males) in 1994–1998; the overall frequency in 1994–98 was 7.5%. This rising trend, which was statistically significant, might be the consequence of an increased use of cosmetics and toiletries containing fragrances in our population.
Allergic contact dermatitis from hydrangea – is it so rare?
Authors: Avenel‐Audran M. , Hausen B. M. , Le Sellin J. , Ledieu G. , Verret J. L.
Published: March 2003

8 cases of allergic contact dermatitis from hydrangea seen in Angers, France, during the last 15 years are reported and compared to other cases found in the literature. In this review, allergic contact dermatitis from hydrangeas appears to be an occupational dermatosis among nursery workers, presenting as an eczema involving the hands and especially the first 3 fingers, with chronic features of fissuring and scaling and with a chronic course. Differential diagnosis from irritant contact dermatitis may be difficult. Patch tests with the stem as well as the leaf of hydrangeas gave strong positive reactions in all patients, and hydrangenol, the allergen of hydrangea, when tested, always also gave a positive reaction. Sensitization seems to occur after close and prolonged contact with the plant, which could explain the relative frequency in Angers because it provides almost 90% of hydrangea seedling production in France.