bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between gingival inflammation and painfulness of periodontal probing
Authors: Heft Marc W. , Perelmuter Steven H. , Cooper Brian Y. , Magnusson Ingvar , Clark William B.
Published: December 2005

Abstract The relationship of gingival inflammation to the pain associated with periodontal probing was assessed at baseline (B), and 1 month (1M) and 3 months (3M) later in 46 subjects. At each of the 3 sessions, clinical measures of gingival inflammation included an observational gingival index and bleeding score. In addition, periodontal probings of all existing teeth was performed with a constant force probe (25 g). Following completion of the probing at each session, subjects rated the global painfulness of the probing using a visual analog scale for pain. Results of this study showed that judged painfulness of probing was related to clinical inflammation (bleeding score) at baseline and 1 month and suggest that the degree of periodontal inflammation is related to the pain and discomfort associated with periodontal probing.
Effects of chlorhexidine on proteolytic and glycosidic enzyme activities of dental plaque bacteria
Authors: Beighton D. , Decker J. , Homer K. A.
Published: December 2005

Abstract Chlorhexidine was tested for its ability to inhibit a wide range of glycosidic and proteolytic enzyme activities produced by Treponema denticola, Porphyromonas gingivalis, Bacteroides intermedius, Actinobacillus actinomycemcomitans, Capnocytophaga sputigena, Capnocytophaga gingivalis, Capnocytophaga orchracea, Capnocytophaga sp., Actinomyces viscosus, Streptococcus mitior, Streptococcus mutans, Streptococus sobrinus, Streptococcus mitis, Streptococcus anginosus, Streptococcus oralis and Streptococcus sanguis. The enzymes produced by Capnocytophaga spp. were the most resistant to inhibition by chlorhexidine while the hydrolysis of proteolytic substrates by all the other species was markedly susceptible to inhibition with < 0.125 mm chlorhexidine inhibiting enzyme activities by ≥ 50%. Glycosidase activities, of all species, were generally more resistant to inhibition, especially neuraminidase activity. Chlorhexidine at < 0.032 mm inhibited the degradation of bovine serum albumin by suspensions of dental plaque bacteria. These observations support an hypothesis that chlorhexidine exerts a bacteristatic effect in vivo, in part, by reducing the ability of dental plaque bacteria to degrade host‐derived proteins and glycoproteins which normally provide essential nutrients for growth.
Acute‐phase protein detection and quantification in gingival crevicular fluid by direct and indirect immunodot
Authors: Sibraa P. D. , Reinhardt R. A. , Dyer J. K. , DuBois L. M.
Published: December 2005

Abstract The development of an assay for markers of active periodontitis, obtained directly from gingival crevicular fluid (GCF) and simply quantified, would be of great importance to the dental practitioner. The purpose of this study was to evaluate direct and indirect immunodot techniques as to their potential in easily quantifying acute‐phase proteins within periodontally diseased and healthy site GCF. Indirect immunodots (GCF eluates dotted onto nitrocellulose membrane) using monoclonal antibodies and a radioactive isotope label were used to identify and establish relative amounts of C‐reactive protein (CRP) and alpha‐2‐macroglobulin (A2M) in 2 diseased and 2 healthy sites in 24 periodontitis patients. Periodontally diseased sites were found to contain significantly lower concentrations of A2M than healthy sites (p < 0.001), but CRP levels did not vary significantly between healthy and diseased locations. Using a direct immunodot assay (GCF absorbed directly into nitrocellulose membrane strips), A2M levels quantified with radioactive isotopes at healthy and diseased sites could be correlated with A2M levels determined by enzyme‐linked antibody‐colormetric probes at those same sites. Such a direct sampling and quantification system shows promise for future “in‐office” diagnostic methodology.
Histologic healing responses in human vertical lesions following the use of osseous allografts and barrier membranes*
Authors: Stahl S. S. , Froum S.
Published: December 2005

Abstract 4 vertical lesions at 3 teeth in 2 volunteer adults with severe periodontitis were treated by open surgical debridement, osseous allografts and barrier membranes. Roots were notched at both gingival margins and the deepest visible calculus and flaps were sutured coronally. Patients were placed on 0.12% chlorhexidine gluconate 2 × daily post‐surgery, and blocks were harvested 5 to 6 weeks after surgery. No abnormal clinical responses were noted during the observation period. In the 4 sites, the average preoperative pocket depth was 9.4 mm; the post‐operative pocket depth averaged 4.9 mm, recession averaged 0.9 mm and gain in clinical closure averaged 3.6 mm. Histologically, new cementum measured coronally‐apically at the treated sites varied from 0.0 mm to 1.7 mm, with an average of 1.1 mm. Osseous remodelling and crestal osteogenesis were seen in association with cemen to genesis. The newly deposited cementum showed insertion of functional oriented fibers. New attachment was present within 2 out of 4 calculus notches in this sample.
Decision making in periodontal therapy
Authors: Claffey Noel
Published: December 2005

Abstract. 7 patients completed 2 years of observation following initial therapy. Triplicate probing measurements were used to identify sites with ≥ 1 mm of probing attachment change between any 2 of the following time points; immediately pre‐instrumentation; immediately post‐instrumentation; 3 months; 12 months and 24 months. 24% of sites lost probing attachment directly due to instrumentation. 12% of sites lost probing attachment at 24 months compared to pre‐instrumentation, but over 1/3 of these lost attachment at the time of instrumentation. 47 sites lost probing attachment from post‐instrumentation to 24 months. 22 of these sites were shallow buccal or lingual sites and their attachment apparatus may have remodelled. The initially deeper of these sites displayed other clinical features more consistent with inflammatory periodontitis. Sites that initially gained probing attachment due to treatment but which later lost were identified. These sites may have had a reversal of the enhanced epithelial adaption. 17 other patients were monitored over a period of 31/2 years and sites losing probing attachment were identified using linear analysis of regression. The diagnostic predictability of clinical signs to reveal probing attachment loss at 31/2 years was calculated. In general, predictability values improved with increasing time interval. Increase in probing depth, particularly if combined with a high frequency of bleeding, showed the highest predictability. The effect of therapy on probing attachment levels should be considered in the identification of sites with probing attachment loss. Persistent bleeding, combined with high residual probing depths or increase in probing depth, may be a useful adjunct to probing attachment loss in identifying diseased sites.
Prosthetic reconstruction of dentitions seriously compromised by periodontal disease
Authors: Lundgren Dan
Published: December 2005

Abstract. Dentitions seriously compromised by periodontal disease are often in need not only of cause‐related periodontal therapy of high quality but also of relevant prosthetic rehabilitation. Contrary to traditional claims, clinical investigations published during the last 2 decades demonstrate that, if adequately treated and controlled, such dentitions can carry fixed, cross‐arch bridges on an extremely reduced amount of periodontium, with a good long‐range prognosis. It has also been shown that a markedly reduced but healthy and favourably distributed periodontium supporting such constructions can withstand occlusal forces of considerable magnitude. Another controversal topic, related to fixed bridges, involves indications and centra‐indications for cantilever segments. Some clinical investigations demonstrate a markedly increased risk of failure if the fixed bridge is provided with cantilever units, while other controlled studies with defined specifications on the design of the constructions exhibit a high success rate after 8 years or more also for bridgework where 2 or 3 cantilever units are included. The force pattern along cantilever segments of both tooth‐supported and implant‐supported bridges has been extensively studied. The results show that the force distribution depends not only on the occlusal contact pattern and the dimensioning of the cantilever beam, but also on the type of prosthetic construction in the opposite jaw occluding with the cantilever segment. The free‐standing, implant‐supported bridge has recently become an important treatment modality for rehabilitation of the partially edentulous jaw, and follow‐up studies demonstrate a high success rate. Prosthetic connections between natural teeth and implants have also been reported to have a good prognosis without incorporation of elastic elements in the constructions, provided that factors such as occlusal force pattern, tooth mobility and beam dimensioning are taken into consideration. Other factors influencing the force distribution in such constructions afe size, type and number of implants as well as the jaw bone quality.
Dental bacterial plaques
Authors: Christersson Lars A. , Zambon Joseph J , Genco Robert J.
Published: December 2005

Abstract. Antony van Leeuwenhoek first described oral bacteria. However, not until almost 200 years later was the famous Koch postulate introduced. Since then, research has extensively been performed regarding the development and microbiology of dental plaques. In spite of the complexity of the developing flora of supragingival plaque, culture studies have shown a remarkably orderly succession of organisms. Lately, the concept of microbial specificity in the etiology of periodontal diseases has been widely suggested, i.e., that different forms of periodontal disease are associated with qualitatively distinct dental plaques. Cross‐sectional and longitudinal studies of the predominant cultivable micro‐flora reveal that only a small number of the over 300 species found in human subgingival plaques are associated with periodontal disease. Among the commonly mentioned are: Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, Bacteroides intermedius, Capnocytophaga sp., Eikenella corrodens, Fusobacterium nucleatum, and Wolinella recta, as well as certain gram‐positive bacteria such as Eubacterium species. Anti‐infective therapy for many systemic infections equals the use of antimicrobial drugs. However, for localized infections like periodontal diseases, treatment may consist of a combination of mechanical wound debridement and the application of an antimicrobial agent. The general effectiveness of mechanical anti‐infective therapy and successful oral hygiene in the management of periodontal disease is well established in the literature and has met the test of success in clinical practice for most cases of periodontitis in adults. The definition of periodontal pathogens as either opportunistic pathogens, or as exogenous pathogens carries with it significant implications. If periodontal disease results from an opportunistic infection by indigenous micro‐organisms, then preventive efforts should be directed toward removing most plaque from all tooth surfaces. However, if periodontal diseases result from a subgingival infection with exogenous pathogens, appropriate preventive strategies may be used for control of oral colonization or subgingival growth.
Anti‐plaque agents. Rationale and prospects for prevention of gingivitis and periodontal disease
Authors: van der Ouderaa F. J. G.
Published: December 2005

Abstract. Oral health surveys have shown that even in countries with established patterns of oral hygiene habits, most individuals have relatively poor gingival health. This is due to a low interest in complying with oral health procedures. A number of factors are apparent when investigating compliance to oral hygiene habits, viz only approximately 50% of the population brushes twice a day or more, brushing time is probably much too short and use of dental floss is not very prevalent. Studies of the effect of motivation on oral hygiene suggest that improvements can be achieved, but these are not maintained unless motivation is continuously reinforced. This suggests that topically applied anti‐plaque agents should be used to augment mechanical plaque control. A number of product forms are available to delivery anti‐plaque agents i.e., mouthrinses, dentifrices, aqueous gels, and additionally floss, chewing gum and lozenges. Any product form should provide a physically, chemically and microbiologically stable environment for the agent concerned. It should facilitate optimal bioavailability of the agents at the site of action and encourage patient compliance. Anti‐plaque agents for topical administration should have the following properties: high intrinsic efficacy against a broad spectrum of oral organisms, toxicological and ecological safety, oral substantivity, no adverse reactions and good chemical stability. A number of classes of anti‐plaque agents have been identified such as positively charged organic molecules, metal salts, phenols, enzymes, peroxides, sugar substitues, fluorides and surface modifying agents. In order to achieve optimal bioavailability, the agent to be dosed should be compatible with the product form used. The 2 major product forms are rinses and dentifrices. With respect to rinses as the product form, the formulation excipients are generally compatible with positively charged organic agents, phenolic agents and some metal salts. In the case of dentifrice formulations, interactions of the agent with the product excipients limit compatibility to some metal salts and non‐charged phenolic agents, triclosan being a well researched example. The combination of metal salts, in particular zinc, and the phenolic agent triclosan has been shown to represent a further powerful route to enhance systems for daily plaque control.
State of the art in oral implants
Authors: Albrektsson Tomas , Sennerby Lars
Published: December 2005

Abstract. Uncontrolled oral implant devices are still being widely used. The documentation of most oral implant systems is poorly backed up or not followed up for an adequate time period. Success rates are being quoted without reference to any defined success criteria. Frequently used oral implant designs such as the Core‐Vent, IMZ and Calcitek hydroxyapatite coated implants are in neither case supported by any adequate clinical reports from minimally 5‐years of follow‐up. Other implant systems such as the ITI, some subperiosteal designs and the Tubingen implant demonstrate well‐controlled and acceptable 5‐year data but are not followed up in a sufficient number or have demonstrated less good results in the 10‐year evaluation. The Small transosteal staple has been adequately reported for more than 10 years of follow‐up, whereas the Branemark implant is the only endosseous design that has demonstrated acceptable 15‐year success rates.
The rehabilitation of oral defects by osseointegrated implants
Authors: van Steenberghe D. , Brånemark P‐I , Quirynen M. , De Mars G. , Naert I.
Published: December 2005

Abstract. So far, preprosthetic surgery for oral defects improved prosthetic retention problems for only a limited amount of time and led to many side‐effects. The alternative offered by the osseointegration technique developed by P.–I. Brånemark changed the concept of preprosthetic surgery dramatically. By means of a few permucosal titanium screws, bridges or overdentures can be retained even in cases of advanced jaw bone resorption. When the latter is extreme, an autologous free bone graft fixed by means of self‐tapping titanium implants can offer the necessary support for sometimes elaborate prosthetic reconstructions. The marginal bone loss around Brånemark implants is very limited after a 1st year of bone remodelling, even when an autologous transplant has been used.
Bone regeneration using the principle of guided tissue regeneration
Authors: Nyman Sture
Published: December 2005

Abstract. The biological principle of “guided tissue regeneration” (GTR) was developed for regenerating periodontal tissues, lost as a result of periodontal disease. This principle was based on the hypothesis that non‐desirable types of tissue cells can be prevented from migrating into a wound by means of a membrane barrier and at the same time giving preference to those particular cells to repopulate the wound, which have the capacity to regenerate the desired type of tissue. This principle may have its application in many areas of surgery, aimed at regeneration of lost tissues. One such area is osseous surgery aimed at bone regeneration. In the present paper, a series of experiments in laboratory animals using the method of GTR for regeneration of various types of bone defects are presented as well as examples of application in humans for regeneration of jaw bone defects in conjunction with the placement of dental implants.
Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis
Authors: Jin L. J. , Cao C. F.
Published: December 2005

Abstract The purpose of the present study was to determine the reliability of several selected signs of trauma from occlusion and their relations with severity of periodontitis. 32 moderate to advanced chronic: periodontitis patients participated in the study, All teeth present were evaluated for various abnormal occlusal contacts, signs of trauma from occlusion, and the severity of periodontitis, Standardized periapical radiographs were also taken for each tooth, The results demonstrated that: (1) no significant difference occurred in probing pocket depth (PD), clinical attachment loss (AL), or percentage of alveolar bone height (BH) between teeth with and without various abnormal occlusal contacts, i.e., premature contacts in centric relation occlusion, non‐working contacts in lateral excursions, premature contacts of anterior teeth or posterior protrusive tooth contacts: (2) teeth with either significant mobility, functional mobility, or radiographically widened periodontal ligament space (PDLS) had deeper PD. more AL and lower BH than teeth without these signs, while teeth with pronounced wear or radiographically thickened lamina dura had less AL than teeth without these findings: (3) 2 combined indices, i.e., the trauma from occlusion index (TOI) and the adaptability index (AI), were proposed for the identification of occlusal trauma and the response of periodontium to excessive biting forces in heavy function, respectively: TOI‐positive teeth exhibit deeper PD, more AL and less osseous support than TOJ‐negative teeth: however, AI‐positive teeth had less AL and more osseous support than Al‐negative teeth; (4) with identical attachment levels, TOI‐positive teeth had less osseous support than TOI‐negative teeth while the magnitude of difference became greater with an increase of attachment loss.
Periodontal aspects of osseointegrated fixtures supporting a partial bridge
Authors: Quirynen M. , Naert I. , van Steenberghe D. , Dekeyser C. , Callens A.
Published: December 2005

Abstract The present paper reports on the use of osseointegrated titanium fixtures (BrånemarkTM) in partially edentulous patients. The tissue reactions around 509 implants in 97 upper and 71 lower jaws of 146 consecutive patients, rehabilitated by means of partial bridges – supported by implants only (60%) or by the combination of teeth and implants (40%) – were observed longitudinally. The mean number of implants per bridge was 2.40 (range 1 5) for the upper jaw and 2.06 (range 1–5) for the lower jaw respectively. Before loading, a total of 23 fixtures were lost, 15 in the upper and 8 in the lower jaw. This loss could partially be correlated to per‐ and post‐operative complications and to fixture characteristics (length, selftapping or not). After a loading time of 30 months (range 2 to 77 months). 6 implants, 2 in the upper and 4 in the lower jaw, showed symptoms of non‐integration. The cumulative failure rate for the individual fixtures after a 6‐year period reached 5.7 and 6.5% for the tipper and lower jaw, respectively. The mean annual marginal bone loss, scored on standardized radiographs, was 0.9 mm during the 1st year and 0.1 mm the following years. This loss in marginal bone height was equal in the upper and lower jaws and not related 10 the type of occlusal material of the bridges. The present data showed that the cumulative failure rate for BrånemarkTM implants supporting partial bridges can be limited to 6% after a 6‐year period, and that the radiographic bone loss is comparable with that found around fixtures supporting full bridges.
Enhanced gingivitis in the deciduous and permanent dentition An experimental study in the dog
Authors: Berglundh T. , Lindhe J. , Ericsson I. , Liljenberg B.
Published: December 2005

Abstract The aim of the experiment was to analyze the reaction of the marginal gingival tissues to 21 days of plaque Formation on buccal tooth surfaces in the deciduous and permanent dentition of beagle dogs. In order to enhance the formation of plaque, the buccal surfaces of the experimental teeth were coated with a composite filling material. 5 beagle dogs were used. The animals were monitored during 2 periods, called period A (42 days during the deciduous dentition) and period B (42 days during the permanent dentition). The dogs were 10 weeks old at the initiation of period A. Following 3 weeks of plaque control, a groove was prepared into the enamel of the buccal surfaces of the mandibular right 3rd (03P) and 2nd (02P) premolars, A cotton ligature was subsequently attached to the groove using an enamel/etch‐technique and a composite filling material. The groove and the ligature did not interfere with the gingival margin but the composite material extended into the subgingival niche. The plaque control measures were abandoned. The animals formed plaque during the following 21 days. A clinical examination was performed and subgingival bacteria sampled on day 21. Moreover, biopsies were harvested from the UP and WP tooth regions. The biopsies were prepared for histometric and morphometric analyses. A 2nd plaque control regimen was initiated. Period B started when the dogs were 15 months old. Following 3 weeks of enhanced plaque control, a cotton ligature was attached as described above at the buccal surfaces of the mandibular left 3rd (P3) and 4th (P4) premolars. The oral hygiene regimen was terminated and plaque allowed to accumulate. The clinical examination, bacterial sampling and biopsy were repeated after 21 days of plaque formation, It was observed that the height of the free marginal gingiva (hFG) was smaller in the deciduous than in the permanent dentition, The volume of the free gingival unit which was occupied by an infiltrated connective tissue (ICT) and the total portion of inflammatory cells residing in the dentogingival epithelium were similar in the 2 dentitions, In the apical 3rd of the dentogingival epithelium, the volume of leukocytes was significantly larger in the deciduous than in the permanent dentition, The proportion of plasma cells within the ICT was about 4–5 × larger in the permanent than in the deciduous dentition, Black‐pigmented Bacteroides occurred in 3 out of 5 dogs in the subgingival microbiota, representing 21 days of plaque formation in the deciduous dentition, whereas in the permanent dentition, black‐pigmented Bacteroides occurred in all and Porphyromonas (Bacteroides) gingivalis in 3 of the 5 dogs.
Phenotypic assessment of early onset periodontitis in sibships
Authors: Boughman J. A. , Astemborski J. A. , Suzuki J. B.
Published: December 2005

Abstract Early onset periodontitis is a group of familial diseases that are not yet clearly defined by etiologic mechanisms, although some risk factors have been recognized. The disorders include a localized form of juvenile periodontitis (JP), and a more generalized form (GP). In a family study, 39 sibships (116 individuals, aged 13–48) were evaluated for clinical indices, neutrophil chemotaxis. and serum antibodies to A. actinomycetemcomitans (Aa). Of 77 siblings, 41 were healthy at examination. In 14 sibships, all affected persons had JP; 14 other sibships had all affected individuals with GP; and 11 had at least one sib with each form. For probands with decreased chemotaxis, 71% of affected sibs and 36% of clinically healthy sibs had decreased chemotaxis. For Aa seropositive probands, 83% of affected siblings and 65% of currently healthy sibs were also seropositive. The associations of disease with these risk factors were stronger in JP‐only sibships. Some affected sibs had neither risk factor, while many currently healthy sibs had 1 or both. While these 2 factors demonstrate population association with disease, neither fits the pattern expected within families to clearly suggest a causal mechanism. The assessment of within and among family variability remains the best approach for recognition of possible causal mechanisms and sources of heterogeneity.
The effect of delmopinol rinsing on dental plaque formation and gingivitis healing
Authors: Collaerf Bruno , Attstrom Rolf , De Bruyn Hugo , Moverl Rolf
Published: December 2005

Abstract The aim of this study was to investigate a possible dose‐response effect of delmopinol hydrochloride, on the development of plaque and on the healing of gingivitis. 64 healthy male volunteers, aged 18–40 years with healthy gingivae and clean teeth, participated. During a 2‐week period, the participants refrained from all oral hygiene and rinsed 2 × daily with a placebo solution. On day 14 of the study, they received professional toothcleaning, and were randomly assigned to 4 groups. For the following 2 weeks, they rinsed 2 × daily for t min with 10 ml of 0.05% (15 subjects), 0.1% (17) or 0.2% (16) detmopinol, respectively. 16 subjects rinsed with 0.2% chlorhexidine. No oral hygiene procedures were performed during the test period. On days 0, 14 and 28, gingival bleeding index and the presence of stamabie plaque were determined. Periodic identical photographs were used for planlmetric determination of buccal plaque extension. No significant difference for the reduction in gingival bleeding index was found between 0.2% delmopinol and chlorhexidine rinsing. The mean plaque index showed its most significant reduction on lingual surfaces of both upper and lower jaws when rinsing with 0.2% delmopinol. Mean plaque extension was reduced by 23%) for 0.05%, 39% for 0.1% and 55% for 0.2% delmopinol. A significant dose‐response effect for 0.05%, 0.1% and 0.2% delmopinol was found for gingival bleeding index, plaque index and plaque extension. The results show that delmopinol favors the healing of gingivitis and reduces plaque formation.
Gingival status during chemical plaque control with or without prior mechanical plaque removal in patients with acute myeloid leukaemia
Authors: Bergmann Olav J. , Ellegaard Birgit , Dahl Martin , Ellegaard Jørgen
Published: December 2005

Abstract The purpose of the study was to evaluate the effect of a mouthrinse regimen comprising both chemical plaque control and mechanical plaque removal. 20 adult patients with acute myeloid leukaemia were assigned to one of the following 2 regimens: (1) (group 1) mouthrinse twice daily with a 0.1% chlorhexidine solution; or (2) (group 2) the same regimen, but preceded by mechanical removal of plaque and calculus on day 1. All patients were followed for 28 days from the initiation of remission‐induction therapy. In group 2, the plaque scores remained lower than those of group 1 throughout the study, although only 3 patients remained completely free of plaque after 28 days. Gingival inflammation as judged by bleeding scores remained unchanged in group 1, whereas in group 2, the degree of inflammation was reduced from 52% (median value) on day 1 to 31% (median value) on day 28. The bleeding scores were also lower in group 2 (31%) than in group 1 (60%) on day 28. No differences were found between the 2 groups with respect to the occurrence of other oral infections. It is concluded that chemical plaque control with chlorhexidine should be preceded by mechanical removal of plaque and calculus, when used in patients with acute myeloid leukaemia and thrombocytopenia.
Maintenance of new attachment gained through guided tissue regeneration
Authors: Gottlow Jan , Nyman Sture , Karring Thorkild
Published: December 2005

Abstract The aim of the present study was to evaluate whether new attachment, gained following guided tissue regeneration (GTR) therapy, can be maintained over longer periods of maintenance therapy. 88 sites at 52 teeth with various types of periodontal defects in 39 patients were treated with the GTR procedure during the period 1984–1989. The effect of treatment was evaluated by assessing probing attachment level (PAL) prior to surgery and 6 months post‐surgery. Only sites which at the 6‐month examination (baseline) had gained 2 mm or more of PAL were regarded as successfully treated and scheduled for further monitoring. At baseline, 80 sites could be identified which fulfilled this criterium. Of the 80 new attachment sites, all have been monitored for 1 year, 65 for 2 years, 40 for 3 years, 17 for 4 years and 9 sites for 5 years. The results demonstrated that the attachment gain, obtained as the result of the GTR treatment, could be maintained over periods up to 5 years.
Effect of 4 days of mouth rinsing with delmopinol or chlorhexidine on the vitality of plaque bacteria
Authors: Rundegren Jan , Hvid Eva Bondesson , Johansson Maria , Åström Mikael
Published: December 2005

Abstract Delmopinol is a new surface active anti‐plaque agent that has demonstrated a low antimicrobial effect in vitro. By use of a vitality staining technique, the antimicrobial effect on bacteria in plaque samples was tested after rinsing with delmopinol or chlorhexidine. 6 healthy male subjects volunteered to rinse for 4 days using a double‐blind cross‐over study design with a wash‐out period between the rinsing regimens. No oral hygiene measures were allowed during the test periods and each test period started with a professional tooth cleaning procedure 2 days before the start of rinsing to allow for plaque formation. Rinsing was performed with 0.2% delmopinol hydrochloride or 0.2% chlorhexidine digluconate 2 × a day. Small samples of plaque were collected from the buccal surfaces of premolars and 1 st molars before the first rinse on day 1 and then before and 1, 2, 4, 7, and 24 h after the last rinse on the 4th day. The plaque samples were immediately stained with propidium iodide and fluoresceine diacetate to visualize dead and vital microorganisms respectively. The vitality of the microflora was evaluated using a fluorescence microscope. The baseline vitality values were 91% for chlorhexidine and 86% for delmopinol. At day 4, the plaque vitality for chlorhexidine was approximately 40% up to 4 h and 50% at 7 h and 60% at 24 h after the last rinse. Corresponding values for plaque vitality after delmopinol rinsing were between 70 and 80% on all sampling occasions. The differences in plaque vitality between delmopinol and chlorhexidine were statistically significant on all sampling occasions (p<0.05) except for the baseline values. The low antimicrobial profile of delmopinol confirmed in vivo suggests a low risk for an ecological shift of the oral microflora due to cidal effects but also that delmopinol has other modes of action as an anti‐plaque agent than an antimicrobial action.
Cathepsin B/L‐, elastase‐, tryptase‐, trypsin‐ and dipeptidyl peptidase IV‐like activities in gingival crevicular fluid
Authors: Cox S. W. , Eley B. M.
Published: December 2005

Abstract 20 chronic periodontitis patients were given a full periodontal examination, including measurements of probing depth, clinical attachment loss, gingival index, bleeding index and plaque index. At a second visit, gingival crevicular fluid (GCF) was collected from the deepest accessible probing site of each tooth. The patients then received scaling, root planing and other appropriate non‐surgical treatment. GCF was collected from the same sites as sampled pre‐treatment and clinical parameters were measured again. Cathepsin B/L‐, elastase‐, tryptase‐, trypsin‐, and dipeptidyl peptidase IV‐like activities in GCF samples were determined by fluorimetric assay with peptidyl derivatives of 7‐amino‐4‐trifluoromethyl coumarin. Following treatment, there were reductions in all clinical parameters and all protease activities. Most were statistically significant both on a patient level using average patient values and on a site level using either individual patient or pooled patient data. As in previous pre‐treatment comparisons, post‐treatment protease levels correlated positively and significantly with the corresponding clinical parameters at patient and site levels. The reductions and correlations were more marked for total enzyme activities than concentrations. GCF protease levels appear to reflect the clinical status of periodontal lesions and may thus be of value in monitoring disease activity.
Comparison of a subgingivally placed cannula oral irrigator tip with a supragingivally placed standard irrigator tip
Authors: Boyd Robert L. , Hollander Brian N. , Eakle Warren S.
Published: December 2005

Abstract This study compared the depth of irrigation of periodontal pockets achieved by a cannula subgingival irrigator tip and a standard oral irrigator tip. They were tested on periodontally involved teeth recommended for extraction from 17 patients. Before extraction, reference grooves were made circumferentially in each study tooth at the level of the gingival margin. In one group of 5 patients (29 teeth), a cannula was inserted halfway into the pocket at the facial, mesiofacial, distofacial, lingual, mesiolingual and distolingual surfaces and the surface irrigated for 5 s at 5 psi with a solution of plaque‐staining dye from an oral irrigator. A 2nd group of 7 patients (29 teeth) was tested similarly with a standard irrigating tip at 80 psi. A 3rd (control) group of 5 patients (26 teeth) rinsed with the dye solution. Teeth were then extracted. The distance on each tooth from the reference notch to the apical extent of the stained plaque, and also to the coronal limit of the connective tissue attachment, was measured at 4 sites (mesial, distal, buccal, lingual) under a dissecting microscope to determine the extent of dye penetration. Mean linear penetration for the control group was only 0.1 mm. Irrigation with the cannula tip penetrated farther into both the medium (3.5–6 mm) and the deep (>6 mm) periodontal pockets (p<0.01) than did irrigation with the standard tip. Mean depth of penetration with the cannula tip was 70.4% in medium pockets and 74.5% in deep pockets, as compared with 29% and 54.3%, respectively, for the standard tip. No differences were found for either method between single‐ or multi‐rooted teeth or between the surfaces irrigated.
Prevalence of juvenile periodontitis in a circumpubertal population
Authors: Neely Anthony L.
Published: December 2005

Abstract A cross‐sectional radiographic screening was performed on bite‐wing pairs (BW) from 1872 10–12 year old schoolchildren in the Greater Worcester, Massachusetts area to assess the prevalence of juvenile periodontitis (JP). The 3‐stage screening process entailed: (1) visual identification of possible cases based upon a visual assessment of BW for interproximal crestal bone levels ≥ 2 mm from the cemento‐enamel junction (CEJ) on ≥ 1 permanent first molar; (2) identification of probable cases based upon BW from possible cases measured with a transparent ruler calibrated in millimeters; (3) finally, clinical confirmation of JP in consenting probable cases. A total of 1038 subjects were eligible to be included in the study (≥3 mesial sites readable). Of the 1038 eligible subjects, 117 possible and 103 probable cases were identified in stage 1 and stage 2, respectively. A total of 99 probable cases could be contacted and 43 were examined clinically. Two cases of JP were confirmed clinically in stage 3, yielding a prevalence rate of 4.6/1000. Specifically, this report defines a rate of JP in 10–12 year‐old schoolchildren for the first time. In addition, these results indicate that BW can be used to identify children with JP from large data sets. However, further studies including complete clinical and radiographic examinations are necessary to determine whether this method is adequate for large epidemiologic studies.
Patterns of de novo plaque formation in the human dentition
Authors: Furuichi Yasushi , Lindhe Jan , Ramberg Per , Volpe Anthony R.
Published: December 2005

Abstract The objective of the present clinical trial was to carefully assess the pattern of de novo plaque formation in the human dentition. 10 subjects aged 24–29 years were recruited for the study. None of the participants showed signs of destructive periodontitis. At the start of the preparatory period, they were given a thorough dental prophylaxis and oral hygiene instruction. For the next 2 weeks, the participants were carefully monitored and 1 × every 2 days examined with respect to plaque and gingivitis. At the re‐examinations, they were also given professional tooth cleaning and instruction in proper plaque control measures. Towards the end of this 2‐week period, the Day 0 examination was performed which revealed that the gingival tissues of all participants were in excellent clinical health. Following the Day 0 examination, all 10 subjects were exposed to professional tooth cleaning. During the next 14 days, they abolished all mechanical tooth cleaning efforts but were examined with respect to plaque on Days 1,4,7 and 14. The amount of plaque formed was examined using the criteria of the Plaque Index system (P1I). Each of 6 surfaces of each tooth in the dentition was given a score from 0 to 3. The results from the re‐examinations demonstrated that in humans with clean teeth and normal gingiva, the abolishment of mechanical tooth cleaning rapidly resulted in de novo plaque formation. Most plaque, as assessed by the plaque index system, formed during the first 4 days of no tooth cleaning after which moderate additional amounts of plaque formed. It was observed that the mean P1I values for individuals, for groups of teeth and tooth surfaces, provide a proper overall estimation of plaque build up. The dynamics of plaque formation between examinations and in different parts of the dentition were more easily disclosed by the data describing % distributions of different score categories and the transition between scores from one examination to the next. The total amount of plaque formed on various tooth surfaces was best presented by so called “plaque pattern displays”. The results also revealed that (i) the mandibular dentition harbored more plaque than the maxillary dentition, (ii) there was a difference in the mean P1I scores between the molar and the anterior tooth regions in the maxilla, but in the mandible such a difference could not be observed (except on Day 1), (iii) plaque accumulated most at the approximal surfaces and least at the palatal surfaces, and that (iv) differences in PII scores between groups of teeth and tooth surfaces observed on Day 4 persisted through the Day 14 examination.
Evaluation of a new periodontal curet
Authors: Singer David L. , Long Barbara A. , Lozanoff Scott , Senthilselvan Ambikaipakan
Published: December 2005

Abstract Removal of plaque and calculus from subgingival root surfaces is a fundamental aspect of periodontal therapy. A new type of periodontal curet (Gracey Curvette Sub‐0) has been designed to better adapt to the root surfaces that may be encountered in periodontal pockets of incisor teeth. The new curet (test) was compared to a Gracey curet 1/2 (conventional) in their ability to remove deposits from the subgingival root surfaces of incisor teeth in an in vitro model. A dentiform model mounted on a dental chair was used with artificial gingiva. 6 mm pocket depths and subgingival root surfaces covered with black enamel paint. 2 groups of 12 hygienists used, on a timed basis, either the test or conventional curet on 4 of the incisor teeth and then switched to the alternate instrument for the remaining four incisors. The extent of surface material removal was determined using a computerized video routine. The test curet removed significantly (p < 0.001) more of the surface material from all subgingival incisor root surfaces than the conventional curet (60.7% versus 46.3%). Both instruments were most effective at labial surfaces. The test curet was least effective at proximal surfaces and the conventional curet least effective at lingual surfaces. The greatest statistical difference between instruments was apparent at lingual surfaces of maxillary incisors and the least at mesial surfaces of mandibular incisors.
An imaging routine for assessing the efficacy of instruments used for scaling and root planning
Authors: Lozanoff Scott , Long Barbara A. , Singer David L. , Deptuch John J.
Published: December 2005

Abstract Deposits of dental plaque or calculus are typically quantified using planimetric techniques. However, error is introduced into a quantitative analysis of plaque deposits using these methods, since they require a significant amount of human intervention. The purpose of this study is to describe and validate a computerized imaging routine which has the potential to objectively identify material on dental roots and measure the area covered by these deposits. Dentiform teeth with simulated plaque were videorecorded. A computer routine was developed based on a flood‐fill algorithm which analyzed images of the dentiform teeth and determined the amount of simulated plaque on their root surfaces. Results showed that the dentiform teeth and their simulated plaque patterns are duplicated by the imaging routine in a rapid and reliable fashion. The system shows a high degree of accuracy with an average error factor of only 0.58%. As well, the system enables precise reproducibility with an average error factor of only 0.71%.
Comparative in vitro studies of sonic, ultrasonic and reciprocating scaling instruments
Authors: Jotikasthira Nitaya E. , Lie Tryggve , Leknes Knut N.
Published: December 2005

Abstract Flat root surface areas of formalin‐stored mandibular incisors with plaque and calculus were scaled by sonic (PHATELUS® SONIC SCALER, SONIC FLEX 2000®, TITAN‐S® SONIC SCALER) or ultrasonic instruments (HY‐GIENIST® ULTRASONIC SCALER, CAVITRON®) or by a new reciprocating scaling insert for the EVA/PROFIN® system. The test areas were photographed by SEM and coded micrographs were independently graded by three examiners using the RCI (Remaining Calculus Index) and the RLTSI (Roughness Loss of Tooth Substance Index). The findings revealed that the sonic sealers as a group removed calculus more completely but also left significantly more roughness and loss of tooth substance than the other instruments tested. No difference was seen between the two ultrasonic sealers. The reciprocating insert gave results similar to those of the ultrasonic except for the scaling time which was significantly longer for the new “cleansing principle”.
Preservation of probing attachment and alveolar bone levels in 2 random population samples
Authors: Papapanou Panos N. , Lindhe Jan
Published: December 2005

Abstract The present study is an attempt to elucidate the relation between ageing and loss of periodontal tissue support, by studying the occurrence of probing attachment and alveolar bone loss in two samples of randomly selected individuals. The 1st sample was recruited in Japan and comprised 319 subjects aged 20–79 years. The 2nd sample was recruited in Sweden and comprised 192 subjects aged 30–65 years. All individuals underwent a radiographic and a comprehensive clinical examination, including recordings of probing attachment level. Within the 2 samples, subsamples of individuals whose periodontal status indicated minimal experience of destructive periodontal disease were selected. In these particular subsamples, it was revealed that a substantial proportion of tooth surfaces, also in older subjects, remained with no attachment or alveolar bone loss. To a lesser extent, this could be also observed when the entire samples were analyzed, despite the presence of abundant plaque and gingival inflammation. The results indicated that intact supporting periodontal tissues can be retained in subjects of increased age and corroborate the suggestion that loss of clinical attachment and alveolar bone is not an obligatory consequence of ageing.
Nifedipine‐induced gingival overgrowth
Authors: Hancock Raymond H. , Swan Richard H.
Published: December 2005

Abstract A review of the literature reveals little evidence that controlling plaque reduces and controls nifedipine‐induced gingival overgrowth. The case presented suggests that significant reduction and control of nifedipine‐induced gingival overgrowth can be achieved by thorough scaling and root planing along with meticulous plaque control.
Observations and concepts of the oral health consequences of tobacco use of Finnish periodontists and dentists
Authors: Telivuo Matti , Murtomaa Heikki , Lahtinen Aira
Published: December 2005

Abstract The observations of Finnish periodontists and other dentists, and their concepts of the oral health consequences of tobacco use as well as their counseling on tobacco use, were surveyed from November 1987 to January 1988. A questionnaire was mailed to all 61 Finnish periodontists and to 535 other dentists; 37 periodontists (61%) and 432 of the other dentists (80%) responded. The periodontists enquired about and advised on smoking significantly more frequently than did the other dentists; 71% of the periodontists often or always enquired about, and 62%o advised their patients on smoking. 31% of all dentists had patients who were users of smokeless tobacco, and 62% of those dentists had often or always advised the users to quit. Nearly all dentists had seen some tobacco‐caused effects. Periodontists reported more frequently than the other dentists that they had observed more periodontitis, impaired healing of periodontitis and more changes in the oral mucosa in smokers compared with non‐smokers. The majority of those who had seen users of smokeless tobacco had noticed changes in the oral mucosa and in the color of the gingiva. The majority of all dentists believed that heavy smoking may impair the host response in the periodontium, with periodontists believing in this more strongly than other dentists.
The effect of tensile strength on the clinical effectiveness and patient acceptance of dental floss
Authors: Hanes Philip J. , O'Dell Norris L. , Bacp Mark R. , Keagle James G. , Davis Harry C.
Published: December 2005

Abstract This study compared the clinical effectiveness and subjective approval of 2 waxed dental flosses that differed significantly in tensile strength and wax content. At the initial appointment, subjects (20 Ist‐year dental students) were instructed to stop interproximal cleaning on 2 contralateral quadrants in order to allow plaque to accumulate on these surfaces for 1 week. 1 week later, subjects were instructed to begin flossing these 2 contralateral quadrants with 1 of the 2 types of floss for the next 1–week period, while withdrawing interproximal cleaning on the opposite 2 contralateral quadrants. After flossing these 2 quadrants for 1 week, the subjects began flossing the opposite 2 contralateral quadrants with the same floss. After 2 weeks of flossing contralateral quadrants, the 1st floss was withdrawn and replaced with the alternative floss for another similar 2–week trial period. At the end of each 2–week trial period, subjects completed subjective questionnaires concerning the floss they had used during the previous 2–week period. Pre‐ and post‐flossing plaque indices were calculated for each week for both flosses, and compared statistically by a repeated measures analysis of variance. The results showed that both flosses significantly reduced interproximal plaque deposits, and had equal subjective approval. However, neither the greater‐strength nor the lower‐wax content of the experimental floss was associated with an increase in clinical effectiveness or with a change in subjective approval.