bluuebunny/crossref_metadata_2025 huggingface dataset:
Cellular, molecular and immunological mechanisms in the pathophysiology of vein graft intimal hyperplasia
Authors: Mitra Amit K , Gangahar Deepak M , Agrawal Devendra K
Published: December 2005

Coronary artery disease, leading to myocardial infarction and ischaemia, affects millions of persons and is one of the leading causes of morbidity and mortality worldwide. Invasive techniques such as coronary artery bypass grafting are used to alleviate the sequelae of arterial occlusion. Unfortunately, restenosis or occlusion of the grafted conduit occurs over a time frame of months to years with a gradual reduction in patency, especially in vein grafts. The events leading to intimal hyperplasia (IH) formation involve numerous cellular and molecular components. Various cellular elements of the vessel wall are involved as are leucocyte–endothelial interactions that trigger the coagulation cascade leading to localized thrombus formation. Subsequent phenotypic modification of the medial smooth muscle cells and their intimal migration is the basis of the lesion formation that is thought to be propagated by an immune‐mediated reaction. Despite intense scrutiny, the pathophysiology of IH remains an enigma. Although several growth factors, cytokines and numerous other biomolecules have been implicated and their relationship to prohyperplasia pathways such as the phosphatidyl‐inositol 3‐kinase (PI3K)‐Akt pathway has been established, many pieces of the puzzle are still missing. An in‐depth understanding of early vein graft adaptation and progression is necessary to improve the long‐term prognosis and develop more effective therapeutic measures. In this review, we have critically evaluated and summarized the literature to elucidate and interlink the numerous established and emerging factors that play a key role in the development of IH leading to vein graft restenosis.
A Case of “Migralepsy”
Authors: Milligan Tracey A. , Bromfield Edward
Published: December 2005

Summary:  Migraine and epilepsy are common neurological conditions that may share a pathophysiologic and genetic basis. The following case is presented to illustrate key aspects of their relationship.
Analysis of Genetically Complex Epilepsies
Authors: Ottman Ruth
Published: December 2005

Summary:  During the last decade, great progress has been made in the discovery of genes that influence risk for epilepsy. However, these gene discoveries have been in epilepsies with Mendelian modes of inheritance, which comprise only a tiny fraction of all epilepsy. Most people with epilepsy have no affected relatives, suggesting that the great majority of all epilepsies are genetically complex: multiple genes contribute to their etiology, none of which has a major effect on disease risk. Gene discovery in the genetically complex epilepsies is a formidable task. It is unclear which epilepsy phenotypes are most advantageous to study, and chromosomal localization and mutation detection are much more difficult than in Mendelian epilepsies. Association studies are very promising for the identification of complex epilepsy genes, but we are still in the earliest stages of their application in the epilepsies. Future studies should employ very large sample sizes to ensure adequate statistical power, clinical phenotyping methods of the highest quality, designs and analytic techniques that control for population stratification, and state‐of‐the‐art molecular methods. Collaborative studies are essential to achieve these goals.
Neurocutaneous Syndromes and Epilepsy—Issues in Diagnosis and Management
Authors: Cross J. Helen
Published: December 2005

Summary: Epilepsy may be seen as a feature of many of the neurocutaneous syndromes. The challenge lies within the diagnosis of the specific disorder and ultimately control of the epilepsy. Tuberous sclerosis is the most common of the disorders with a frequency of 4.9/100,000. An autosomal‐dominant condition, diagnostic features may be unclear under 2 years of age. Population studies suggest a prevalence of epilepsy of 78%, the majority presenting under the age of 12 months, with a high association between the occurrence of seizures and the presence of learning disability. Although an apparent multifocal disease, surgery may have a role to play where seizures are demonstrated to probably arise from a single tuber. Other less common neurocutaneous syndromes also have a high prevalence of epilepsy in association with cerebral malformations; unilateral or lobar malformations should be referred early for surgical consideration. Neurofibromatosis is the second most common of the disorders but the prevalence of epilepsy in this population is relatively low; in addition, a greater proportion may be easier to treat with medication.
Genetic Epidemiology of Epilepsy or What Do We Tell Families?
Authors: Winawer Melodie R. , Shinnar Shlomo
Published: December 2005

Summary:  Over the past few decades, epidemiologic and molecular research has transformed the field of epilepsy genetics. In this review, we discuss the ways in which accumulating evidence on the genetics of epilepsy and febrile seizures can inform health care practitioners advising patients and families with epilepsy. We will review the epidemiologic data from twin and family studies, and illustrate how it can be used to guide genetic counseling. Although there have been many exciting advances in the last few decades—both molecular and epidemiologic—what we have learned has not appreciably changed what we tell families, and what we tell them can remain reassuring.
Genetics of Drug Resistance
Authors: Sisodiya Sanjay M.
Published: December 2005

Summary:  Drug resistance in epilepsy affects about a third of patients and is an important clinical problem, associated with increased morbidity and mortality. It is important to consider carefully the definition of drug resistance. Recent interest in the field has focused on the potential molecular mechanisms underlying drug resistance. Environmental and seizure‐related acquired causes are likely to contribute to the multifaceted basis of resistance in most cases. Genetic causes have attracted particular attention, partly because they may allow prediction of drug resistance and, potentially, rational treatment strategies. Gene mutations, however, are unlikely to cause many cases of drug resistance. However, common variation in genes probably will turn out to generate an important contribution to drug resistance phenomena. Associations between common variations in a number of genes and clinical drug resistance have now been published. However, to date, none of these associations has been unequivocally replicated by others to the extent that the original association has been accepted. Some of these associations are considered. Despite this apparently uninspiring record, the genetics of drug resistance are likely to prove productive in the near future, but their pursuit will require painstaking studies and multicenter collaboration.
Methodologic Issues in Studies of Mortality Following Epilepsy: Measures, Types of Studies, Sources of Cases, Cohort Effects, and Competing Risks
Authors: Logroscino Giancarlo , Hesdorffer Dale C.
Published: December 2005

Summary:  This paper addresses methodologic issues in studies of mortality, and the impact of these issues in studies of mortality in epilepsy. One important issue is to identify the question: Is it whether epilepsy increases the risk of dying? Or is it whether the underlying condition that led to epilepsy, itself associated with an increased risk for death, is the cause of increased mortality observed in epilepsy? Each measure for estimating mortality requires specific study designs. The mortality rate, case fatality, standardized mortality ratio (SMR) are calculated in prospective or retrospective cohort studies of death in epilepsy. Because the SMR is obtained by indirect standardization, it uses the age‐ and gender‐distribution of the study group with epilepsy, which differs across studies. Thus, the SMR is impossible to compare across studies. The proportionate mortality ratio considers only the proportion of deaths that are due to epilepsy and is useful when denominators are unavailable, often the case in the developing world. Mortality studies in prevalent cohorts of people with epilepsy are compared to those in incident cohorts of epilepsy. The impact of different sources of cases on mortality in epilepsy is discussed. Finally, cohort effects and competing risks are examined. We conclude that the gold standard for studies on mortality should be a population‐based cohort of incident cases. Only this type of cohort permits a complete collection of data and the observation of the clinical phase of the disease from the diagnosis of epilepsy to the outcome of the study, death.
One‐Year Mortality in Bordeaux Cohort: The Value of Syndrome Classification
Authors: Loiseau Pierre , Loiseau Jérôme , Picot Marie‐Christine
Published: December 2005

Summary:  Purpose: To evaluate the usefulness of the International Classification of Epilepsy Syndromes for 1‐year mortality in a prospective incidence study of first epileptic seizures.

Methods: Date and cause of death from the treating physician in an incidence study of first afebrile seizures collected 15 years ago in Southwest France. Cases were classified by epilepsy syndrome. A total of 804 patients were included: acute symptomatic (n = 277), unprovoked (n = 439), or unclassifiable (n = 88).

Results: One hundred and fifty‐one patients died within the first year: none with idiopathic partial or generalized epilepsy, 16/104 with symptomatic (standardized mortality ratio (SMR) 6.4, 95% CI 3.6–10.3), 1/59 with cryptogenic (SMR 1.7, 95% CI 0.1–9.7 CI) partial epilepsy, 1/14 (SMR 28.1, 95% CI 0.4–156.6) with symptomatic/cryptogenic generalized epilepsy, 2/23 with undetermined epilepsy, 1/135 with isolated seizure (SMR 0.6, 95% CI 0.1–3.1), and 90/277 (SMR 10.3, 95% CI 8.3–12.7) with acute symptomatic seizures. Unclassifiable seizures could not be classified as acute symptomatic or unprovoked: associated with alcohol abuse (death: 3/32, SMR 7.7, 95% CI 1.6–22.6), brain tumors (death: 31/39, SMR 41.5, 95% CI 28.2–58.9), and dementia (death: 6/17, SMR 5.4, 95% CI 2.0–11.7). Most deaths were due to progression of underlying disease, only 5.9% were seizure‐related.

Conclusions: Although a syndromic diagnosis is important for treatment decisions and some prognostic aspects of seizure disorders, its value in mortality studies is limited. Mortality can be calculated only at the first (partial, generalized, and undetermined epilepsies, and special syndromes) and the second (idiopathic vs. symptomatic or cryptogenic) levels of the International Classification of Epilepsies.
The Use of Verbal Autopsy in Attributing Cause of Death from Epilepsy
Authors: Aspray Terry J.
Published: December 2005

Summary:  Verbal autopsy (VA) is a method used increasingly in low‐income countries to ascertain the likely cause of death. Originally developed for use in pediatrics and infectious disease, it is also useful in situations with poor data on adult mortality. Using information on cause of death ascertained through interviews with relatives or other associates of the deceased, assessment of the likely cause of death is performed by expert clinicians. Methodological issues related to the VA method include robustness when dealing with less‐frequent causes of death; use of open or closed mortality classification; and possible selection bias in assessing cause of death. However, alternatives, including death certification, share many sources of imprecision. The clear advantage of the VA method is that it does not depend on access to clinic services, although clinical experts are used for the classification process. Even this may be challenged by the development of algorithms for the automatic coding of cause of death. VA has not been systematically applied to studies of causes of death in developed countries where physicians are available to complete death certificates. However, in studies of sudden unexplained death in developed countries, techniques similar to VA are used to ascertain circumstances surrounding death to be able to potentially classify it as sudden and unexplained. Thus, family and friends of the deceased are potentially valuable contributors, using the VA methodology: VA is useful in low‐income countries to estimate the burden of epilepsy on all‐cause mortality and, in industrialized nations it offers insights into sudden death from epilepsy.
Mortality of Epilepsy in Developed Countries: A Review
Authors: Forsgren Lars , Hauser W. Allen , Olafsson Elias , Sander J. W. A. S. , Sillanpää Matti , Tomson Torbjörn
Published: December 2005

Summary:  Mortality in people with epilepsy has been studied in many different populations. In population‐based incidence cohorts of epilepsy with 7–29 years follow‐up, there was up to a threefold increase in mortality, compared to the general population (standardized mortality ratios [SMR] ranged from 1.6 to 3.0). When studies include selected epilepsy populations where patients with frequent and severe seizures are more common, the mortality is even greater. Relative survivorship (RS) following the diagnosis of epilepsy was 91%, 85%, and 83% after 5, 10, and 15 years, respectively. In a population with childhood‐onset epilepsy, RS was 94% and 88% after 10 and 20 years.

The level of increased mortality is affected by several factors. In idiopathic epilepsy where the causes of seizures are unknown, the results are conflicting. There was no significant increase in mortality in studies from Iceland, France, and Sweden, a barely increased risk in a study from the United Kingdom, and a significantly increased risk in a study from the United States. In contrast, all studies report a significant increased mortality in remote symptomatic epilepsy (standardized mortality ratios [SMRs] ranging from 2.2 to 6.5). The highest mortality is found in patients with epilepsy and neurodeficits present since birth, including mental retardation or cerebral palsy (SMRs ranging from 7 to 50).

Mortality is also affected by age, with the highest SMRs in children, the combined effect of low mortality in the reference population, and high mortality in children with neurodeficits and epilepsy. The highest excess mortality is found in the elderly, ≥75 years. A pronounced increase in mortality is found during the first year following the onset of seizures due to underlying severe diseases. The increased mortality remains in different studies 2–14 years following diagnosis.

Most of the factors responsible for the increased mortality are related to the underlying disorder causing epilepsy with pneumonia, cerebrovascular disease, and neoplastic disorders (risk remains elevated when primary brain tumors are excluded), as the most frequently recorded causes. The most common direct seizure‐related cause of death in adolescents and young adults is sudden unexpected death, which is 24 times more common than in the general population.
Mortality in Patients with a First Unprovoked Seizure
Authors: Beghi Ettore , Leone Maurizio , Solari Alessandra
Published: December 2005

Summary:  Purpose: The mortality after a first epileptic seizure is affected by the source of cases, the intensity of the diagnostic work‐up, the type and the presumed etiology of the seizure, the length of follow‐up, and the modalities of data collection (retrospective vs. prospective). We review the four studies of this topic.

Methods: Four studies have been identified which focused on the mortality of the first unprovoked seizures or the first afebrile (provoked or unprovoked) seizure. These included two population‐based surveys, one clinic‐based community survey, and a randomized clinical trial on the treatment of the first unprovoked generalized tonic–clonic seizure.

Results: A standardized mortality ratio (SMR) of 2.3 (95% confidence interval, CI 1.5–3.3) for unprovoked first seizures was found in a retrospective cohort study in the population of Rochester, Minnesota. The SMR was higher during the first year after the seizures to progressively decrease thereafter. Acute symptomatic seizures carried the higher risk, followed by remote symptomatic seizures, while idiopathic and cryptogenic seizures carried no risk. The increased SMR found in women and in patients aged 0–19 years enrolled in the randomized trial differs from that seen in other mortality studies in epilepsy (SMR being highest in the youngest age groups) and may be a chance finding.

Conclusions: Mortality is increased in patients with a first unprovoked seizure, particularly during the first year after the seizure. This increased mortality is associated with known etiology of the seizure, and is not present when etiology is unknown.
Mortality in the First 30 Days Following Incident Acute Symptomatic Seizures
Authors: Hesdorffer Dale C. , D'Amelio Marco
Published: December 2005

Summary:  Purpose: Very little is known about short‐term mortality after acute symptomatic seizure. One study found an increased mortality in the first year after acute symptomatic seizure, like mortality following acute symptomatic status epilepticus.

Methods: We studied mortality in the first 30 days after an acute symptomatic seizure in two cohorts. In Washington Heights, New York City, we reviewed the medical records of all adults aged 20 years and older seen at Columbia Presbyterian Medical Center from January 1, 1990 through December 13, 1994 to identify incident acute symptomatic seizure. In Rochester, Minnesota, the medical records of all Rochester residents were reviewed to identify incident acute symptomatic seizure from January 1, 1965 through December 31, 1984. Case fatality (CF) and standardized mortality ratio (SMR) were calculated for deaths in the first 30 days.

Results: A total of 323 adults were identified in Washington Heights and 428 in Rochester. The CF was 20% in both cohorts. CF was greatly increased in the people aged 65 years and older (28.4% in Washington Heights and 40.5% in Rochester) versus younger individuals (17.7% in Washington Heights and 11.2% in Rochester). In both cohorts, the SMR was greatly increased overall (102.1 in Washington Heights and 149.4 in Rochester), and separately for males, females, all etiologies except head trauma in Washington Heights, and younger individuals. In older individuals, the SMR was increased in Washington Heights but not in Rochester.

Conclusion: Acute symptomatic seizures are associated with increased mortality in the first 30 days. It is unknown how seizures contribute to this mortality or whether mortality is due solely to the underlying medical condition.
Effect of Mixing Methods on Mechanical Properties of Alginate Impression Materials
Authors: Frey Gary , Lu Huan , Powers John
Published: December 2005

Background: A commercial mechanical mixer is available to make the mixing of alginate more convenient and more consistent for the practitioner; however, there is very little information on the mechanical properties of alginate mixed with this device as compared with hand mixing.

Purpose: To compare the mechanical properties of alginate impression materials mixed with a mechanical mixer (Alginator II, Cadco) and hand mixing.

Material and Methods: Three alginate impression materials (Identic, Jeltrate, and Kromopan) were tested. Strain in compression, elastic recovery, and compressive strength were measured according to ANSI/ADA specification no. 18‐1992; tear energy was measured using a pants tear test. Five specimens were prepared for each group with 12 groups for the mechanical mixer and 12 groups for hand mixing, for a total of 120 specimens. A two‐way analysis of variance and Fisher's PLSD test at the 0.05 level of significance were used to analyze the data.

Results: There were statistically significant differences in properties among the materials, but mixing technique had no statistically significant effect on strain in compression and tear energy.

Conclusion: The mechanical mixer improved elastic recovery and compressive strength of the alginate impression materials tested and had no effect on strain in compression and tear energy. A mechanical mixer facilitates the mixing of alginate impression materials and improves some mechanical properties.
Subjective Assessment by Patients of the Efficiency of Two Denture Adhesive Pastes
Authors: Kulak Yasemin , Özcan Mutlu , Arikan Ayla
Published: December 2005

Purpose: This study evaluated the subjective responses of 30 denture wearers with regard to the effectiveness of two denture adhesive pastes.

Materials and Methods: Thirty patients responded to questions related to retention, chewing ability, taste, duration of adhesives in the mouth, and removal; comparing the use of two denture adhesives based on polymethylvinylether‐maleic anhydride compounds or carboxymethyl cellulose.

Results: The denture adhesive paste based on polymethylvinylether‐maleic anhydride (PVM‐MA) compound was rated higher (73% and 87%) than carboxymethyl cellulose (CC) adhesive paste (60% and 37%) on chewing ability and duration in the mouth (p= 0.0001 and p= 0.0001, respectively) by experienced denture wearers in both maxilla and mandible. There were no statistically significant differences between the two denture adhesive pastes on the retention of maxillary dentures, taste, and removal of the adhesive (p= 0.08, p= 0.67, and p= 0.41, respectively).

Conclusions: All subjects responded that the retention of their dentures was either a little better or much better when using either of the adhesive pastes.
Anti‐D alloimmunization after D‐mismatched allogeneic hematopoietic stem cell transplantation in patients with hematologic diseases
Authors: Cid Joan , Lozano Miguel , Fernández‐Avilés Francesc , Carreras Enric , Pereira Arturo , Mazzara Roberto , Ordinas Antorio
Published: December 2005

BACKGROUND:  The de novo development of anti‐D after D‐mismatched allogeneic hematopoietic stem cell transplantation (AHSCT) is a possibility that must be considered. The transfusion of D− blood components after AHSCT has been recommended but anti‐D alloimmunization in this setting has been studied little. Thus, the aim of this study was to analyze anti‐D formation after D‐mismatched AHSCT.

STUDY DESIGN AND METHODS:  Thirty patients with a hematologic disease who underwent D‐mismatched AHSCT were retrospectively studied. Support therapy included red blood cells (RBCs) and platelet (PLT) concentrates (PCs) from whole‐blood donations and PLTs from apheresis. After AHSCT, patients received D+ PCs without administering Rh immunoglobulin (RhIG). An antibody screening to detect anti‐D was performed by low‐ionic‐strength saline‐indirect antiglobulin test with the tube test.

RESULTS:  Fifteen D+ patients received stem cells (SCs) of D− donors and 15 D− patients received SCs of D+ donors. After AHSCT, patients received a median of 11.5 (range, 0‐32) D− RBC units. D+ patients received 682 (83%) of 825 PLT units from D+ donors, and D− patients received 573 (85%) of 678 PLT units from D+ donors. None of the 30 patients developed anti‐D after a median follow‐up of 32 weeks (range, 4‐310 weeks).

CONCLUSION:  Anti‐D alloimmunization after performing a D‐mismatched AHSCT is infrequent in patients with hematologic diseases although patients receive D−mismatched PLT transfusions without RhIG administration.
CD34+ cell adhesion molecule profiles differ between patients mobilized with granulocyte–colony‐stimulating factor alone and chemotherapy followed by granulocyte–colony‐stimulating factor
Authors: Ford Clyde D. , Greenwood Jay , Anderson Jeffrey , Snow Greg , Petersen Finn Bo
Published: December 2005

BACKGROUND:  High‐dose therapy with autologous peripheral blood progenitor cell support is widely utilized but requires successful CD34+ cell mobilization and collection. Chemotherapy plus growth factors appear to mobilize more CD34+ cells than growth factors alone. Because alterations in expression of adhesion molecules are important in the trafficking of hematopoietic progenitors, the possibility was explored that the mechanism of this superior mobilization may be greater down regulation of adhesion molecules.

STUDY DESIGN AND METHODS:  The expression of eight adhesion molecules (CD11a, b, and c; 15s; 49d and e; 54; and 62L) on the collected CD34+ cells from 15 patients undergoing mobilization with chemotherapy plus granulocyte–colony‐stimulating factor (G‐CSF) was compared with those of 14 concomitant patients receiving G‐CSF alone.

RESULTS:  Patients receiving chemotherapy plus G‐CSF mobilized more CD34+ cells and did not differ in prior chemotherapy or radiation. There were no significant differences in the percentage of CD34+ cells expressing any of the adhesion molecules examined between the two groups. The chemotherapy plus G‐CSF–mobilized cells consistently showed higher expression intensity, and this showed significance or a strong trend for CD11a and c, CD15s, and CD54. Despite these higher expression levels, there were no differences in engraftment kinetics.

CONCLUSIONS:  CD34+ cells mobilized by chemotherapy plus growth factors appear to have higher intensities of expression of several adhesion molecules. The significance of this observation will require further study.
Listeria monocytogenesin platelets: a case report
Authors: Guevara Ramon E. , Tormey Michael P. , Nguyen Dao M. , Mascola Laurene
Published: December 2005

BACKGROUND: Efforts to reduce bacterial contamination in platelets (PLTs) have led to implementation of tests for bacterial detection before product release. Although relatively rare as a human pathogen,Listeria monocytogenesoften causes serious illness and has a case‐fatality rate of 20 percent.

CASE REPORT: PLTs from an asymptomatic 58‐ year‐old Hispanic male with a long history of PLT donation were culture‐positive for the presence ofL. monocytogenes. The pulsed‐field gel electrophoresis (PFGE) pattern of the isolate matched two otherL. monocytogenesisolates in the CDC National PulseNet database. Public health investigation found no evidence that the other two isolates were epidemiologically related to the PLT donor, who remained asymptomatic.

CONCLUSION: A cluster of listeriosis cases was detected by PFGE but the significance is unknown. Organisms of public health significance should be reported to health departments. Better surveillance and reporting are needed in the efforts to improve blood product safety.
Dressing after reverse bevel flap procedures
Authors: Greensmith Arthur L. , Wade A. Bryan
Published: December 2005

Abstract Effects of withholding a dressing and applying Coe‐Pak after reverse bevel flap procedures in periodontal surgery were compared in 24 patients. Maxillary and mandibular posterior segments were treated using a “split‐month” technique. Slight differences occurred between dressed and undressed segments. Gingival Index scores for the undressed segments were lower than those for the dressed segments at 7 days after operation, but by 21 and 28 days post‐operatively the position was reversed. Changes in gingival fluid flow followed a similar pattern but were not statistically significant. The 0.18 mm difference in crevice depth of the dressed as opposed to the undressed segments noted 28 days post‐operatively was statistically significant. Clinically satisfactory results were achieved in both instances. Post‐operative dressing was associated with a greater incidence of pain and swelling, but a reduced incidence of bleeding, sensitivity and eating difficulty. More patients stated a preference for no dressing should the operation have to be repeated. After reverse bevel flap procedures, no differences between dressed and undressed segments which would be likely to have practical significance were demonstrated, and it is therefore suggested that application of a dressing should be a matter of individual preference.
Gingival reaction to well‐fitted subgingival proximal gold inlays
Authors: Mörmann W. , Regolati B. , Renggli H. H.
Published: December 2005

Abstract Proximal inlays were seated in contralateral teeth in eight subjects with clinically healthy gingivae. After 23 days, the subgingival area and part of the supragingival surface of one of the inlays was roughened with an abrasive instrument up to 1 mm above the gingival margin; the other inlay remained polished. Gingival fluid flow rate was buccally and lingually measured in the papillary area close to the proximal roughened and polished inlay surfaces and also at papillae beside sound proximal surfaces of the same teeth during a period of 85 days. In addition, plaque was scored and also assessed planimetrically.

The mean gingival fluid flow rate was significantly higher adjacent to both the rough and polished filling surfaces when compared with proximal surfaces without restoration. Plaque indices were similar in the vicinity of filled and sound proximal areas irrespective of the gold surface texture. Planimetrically more plaque was formed on the sites of roughened inlays.
Influence of teeth, plaque and dentures on the retention of chlorhexidine in the human oral cavity
Authors: Bonesvoll P. , Olsen I.
Published: December 2005

AbstractThe retention of chlorhexidine in the oral cavity after rinsing with 10 ml 0.2 % [14C]‐chlorhexidine‐digluconate for 1 min was found to be 3.8 mg (S.D. = 1.4 mg) in a group of 12 edentulous patients. By comparison, the mean oral retention in 10 dental students with cleaned and polished teeth was 4.6 mg (S.D. = 0.7 mg). Measurement of the retention in 6 subjects before and after extensive tooth extractions showed no major influence of the teeth on the chlorhexidine retention.

Plaque accumulation for 6 d increased the mean Plaque Index from 0 to 0.82 (S.D.=0.35). The corresponding mean oral retention increased significantly from 4.6 mg (S.D.=0.7 mg) to 5.6 mg (S.D.=1.1 mg).

Chlorhexidine was readily bound to acrylic resin dentures. A mean binding of 4.2 mg (S.D.=2.0) after 16 min immersion in 110 ml 0.2% chlorhexidine solution was found.

The [14C] activity of the saliva showed a sharp fall during the first few hours after insertion of the dentures, followed by a slow release, with activity still present after 24 h.
Inhibitory effect of benzethonium and zinc chloride mouthrinses on human dental plaque and gingivitis
Authors: Compton Frank H. , Beagrie George S.
Published: December 2005

Abstract In a double‐blind study the plaque‐ and gingivitis‐inhibiting capacities of three aqueous mouthrinse solutions of benzethonium chloride, zinc chloride, and benzethonium chloride combined with zinc chloride were compared to those of a placebo mouthrinse. Forty‐three adults with clean teeth and healthy gingiva were randomly assigned to the treatment and control groups. All participants received an initial prophylaxis. Assessments of plaque and gingivitis were made before and after a 10‐day test period. During this time the subjects suspended oral hygiene procedures and rinsed daily with 20 ml of their respective rinse solutions.

According to the measurements made before and after the test period, the mouthrinse containing benzethonium chloride produced 42 to 42.9 % less plaque than any of the other three formulations. The differences were statistically significant (P < 0.05). Gingivitis scores of the four groups did not differ significantly. These findings indicate that benzethonium chloride is a moderately effective antiplaque agent.
The role of occlusion for the stability of fixed bridges in patients with reduced periodontal tissue support
Authors: Nyman Sture , Lindhe Jan , Lundgren Dan
Published: December 2005

Abstract The present investigation reports how occlusion may be utilized to establish and maintain stability of fixed bridges in patients with markedly reduced periodontal tissue support. The material consisted of 20 adult patients, aged 27–69, with advanced periodontal breakdown, often in combination with extensive loss of teeth. After periodontal treatment, the patients were rehabilitated with fixed bridges, whose stability was evaluated once a year for 2 to 6 years. The results show that permanent stability of bridgework can be obtained in patients where there is a minimum of remaining periodontal tissue support, even in combination with marked hypermobility of individual abutment teeth. The stability was achieved by proper treatment of the diseased periodontal tissues, and by establishment of stable occlusion in the intercuspal position. When there was a risk of bridge mobility on excursive movements of the mandible, balancing contacts were established for the prevention of migration, tilting and increasing mobility. The study also shows that cantilever pontics can be used to achieve and maintain the stability of fixed bridgework.
Influence of occlusal adjustment by grinding on gingivitis and mobility of traumatized teeth
Authors: Vollmer Werner H. , Rateitschak Klaus H.
Published: December 2005

Abstract The effect on marginal inflammation and tooth mobility of occlusal adjustment by grinding was investigated in 43 occlusally traumatized teeth in 29 subjects with gingivitis and marginal periodontitis. The material consisted of 4 groups with tooth mobility of varying degrees of severity and bone destruction. In all groups increased tooth mobility decreased subsequent to occlusal adjustment. The latter was without effect on sulcus fluid flow rate or gingivitis scores in either gingivitis or periodontitis patients.
Periodontal treatment of multi rooted teeth.
Authors: Hamp Sven‐Erik , Nyman Sture , Lindhe Jan
Published: December 2005

Abstract This paper describes: (1) a system for classification and treatment of furcation involvements, and (2) a 5‐year post‐operative evaluation of 100 patients treated for periodontal breakdown in the bi/tri‐furction areas.

The results of this study demonstrate that it is possible to arrest further destruction within the root furcation area. The successful treatment of the multirooted teeth was probably the consequence of: (1) the quasi total elimination of plaque retention areas from the bi/tri‐furcation area, and (2) meticulous oral hygiene by the patients.
The effect of a chlorhexidine‐containing gel on oral cleanliness and gingival health in young adults
Authors: Hansen Frode , Gjermo Per , Eriksen Harald M.
Published: December 2005

Abstract Students at a vocational school participated in a double‐blind, cross‐over study to test the effect of brushing with a 1% chlorhexidine‐containing gel once a Jay. In the control period, a placebo gel was used. Each treatment period lasted for 4 weeks. This was subsequently fallowed by 4 weeks of ordinary toothbrushing. Any toothbrushing additional to the therapeutic brushing was performed with a standard commercial dentifrice without abrasives. In addition to the treatment groups, containing a total of 24 subjects, another group of 12 subjects received standardized oral hygiene instruction. Oral hygiene and gingival condition were assessed in all groups throughout the study. The chlorhexidine‐containing gel seemed to have no effect on gingivitis and only a slight inhibitory effect on plaque formation. Furthermore, an increase in the degree and frequency of staining of the tooth surfaces related to the use of active gel were observed.
A radiographic method for assessing changes in alveolar bone height following periodontal therapy
Authors: Rosling Bengt , Hollender Lars , Nyman Sture , Olsson Gulli
Published: December 2005

Abstract A method is described for obtaining reproducible radiographs of several groups of teeth in the same jaw. The method was applied to assess changes in the alveolar bone height following periodontal treatment. An oral device was designed to permit direction of the central rays of the beam perpendicularly to the alveolar process in different parts of the jaws. The exposures were made at 60 kVp and 10mA, and standardized procedures were used for developing, fixing and rinsing the films. Alterations in the marginal alveolar bone level were determined in a stereocomparator system. The reproducibility of the method was determined. A pilot experiment was performed on 5 patients with periodontal disease. Following conservative treatment, including scaling and root planing, all patients were subjected to periodontal surgery, including alveolar bone denudation. Radiographs of the alveolar bone were obtained before and 2 months after the operation. By measuring in the stereocomparator parallaxes of both control points and points of the alveolar bone crest on paired radiographs, a mean decrease in interproximal alveolar bone height of 0.69 mm was found. Taking into account the small errors which are inherent in the method, this change in bone height could be regarded as a reliable measure of actual loss of bone.
A method of studying the effects of reduced alveolar support on the sensibility to axial force on the incisor teeth in humans
Authors: Edel A. , Wills D. J.
Published: December 2005

Abstract A method has been developed for measuring the threshold level of sensibility to axial pressures applied to the incisor teeth in man. Eight subjects were investigated, four with normal alveolar support and four with support reduced by up to 60 % as a result of chronic periodontal disease. Reduced alveolar support appears to have no1 significant effect on the threshold of perception. All subjects had a lower threshold for the removal of force than for its application. Infiltration of local anaesthetic labially over the test tooth resulted in failure to feel forces previously recognised, thus confirming the role of the periodontal receptors in force perception.
The need for periodontal treatment in an urban population
Authors: Johansen Jan R. , Gjermo Per , Haugen Ellen
Published: December 2005

Abstract The need for periodontal treatment was estimated in a group of the citizens of Oslo. A considerable treatment need was found in spite of the high dentist/population ratio in the area. The need for surgical treatment increased with age. Estimated treatment time was higher in males than in females.
The present status of the gingivectomy procedure
Authors: Waite I. M.
Published: December 2005

Abstract The use of the conventional gingivectomy procedure is indicated to achieve optimum gingival contour and to eliminate supra‐alveolar pockets where these do not extend beyond the muco‐gingival junction. The instrument of choice for the procedure is a gingivectomy knife. Where a blood‐free field is required, electrosurgery may be used provided the instrument is not brought into contact with bone. The maintenance of good oral hygiene is essential.
Bone regeneration following damage by polysulphide impression material
Authors: Glenwright H. D.
Published: December 2005

Abstract Two days after polysulphide rubber impressions had been taken of gold inlay cavities in 6 and 7, a 22‐year‐old female dental student developed a painful swelling between 5 and 6. A radiograph revealed the presence of an irregular radiopaque body within the cancellous bone of the interdental septum between 5 and 6. At operation, 1 month later, the interdental septum was seen to have been destroyed and its position occupied by impression material and inflammatory tissue. When the lesion was reopened 2 years later to correct slight recurrent pocketing, significant regeneration of bone was found to have occurred.
The possible pathogenesis of gingival recession
Authors: Baker D. L. , Seymour G. J.
Published: December 2005

Abstract Stages in the pathogenesis of gingival recession were observed in rats in which pocketing had been induced by replacement of natural incisors with dental implants. Suitable conditions were thus created on the palatal aspect of the implant sockets for recession to occur.

The recession process was examined at intervals by taking transverse serial sections. In the epithelial and connective tissues deep to the receding margin, morphological changes were seen which apparently lead to cleft formation and recession. These appeared to be associated with mononuclear cell infiltration of the connective tissue. The study suggests that gingival recession involves a localized inflammatory process which causes breakdown of connective tissue and leads to proliferation of the epithelium into the site of connective tissue destruction. Proliferation of the epithelial cells into the connective tissue brings about a subsidence of the epithelial surface, which is manifest clinically as recession.
Testing therapeutic measures for controlling chronic gingivitis in man: The results of two studies
Authors: Saxton C. A. , Cowell C. R. , Sheiham A. , Wagg B. J.
Published: December 2005

Abstract A previous paper described a suggested protocol which could be used for testing therapeutic measures. In this paper the protocol has been used as a basis for testing experimental toothpastes over short and medium periods of time. The effects on plaque and gingivitis of a chlorhexidine paste used for 4 weeks, and of two other experimental products used over 8 weeks, have been investigated. Statistically significant improvements in gingivitis were observed during the use of chlorhexidine and one of the experimental pastes compared with their respective placebo pastes. The benefit observed for the experimental paste became evident when the data were analyzed considering only participants with‘frank' gingivitis. The findings have also been presented in various ways in attempts to express the benefits of the therapeutic measures in clinical terms by using arbitrarily determined success criteria.
Free grafts of palatal mucosa on the lingual aspect of the mandible
Authors: Schokking C. C.
Published: December 2005

Abstract The importance of an adequate amount of keratinized and attached gingiva to maintain gingival health has been stressed by several authors (Friedman & Levine 1964, Lang & Löe 1972, Bernimoulin & Mühlemann 1973) and though the rationale for increasing the width of the gingiva applies equally well to both the lingual and the vestibular surfaces, only one report of a graft on the lingual aspect of the mandible in dentate patients has been found in the literature (Goldman & Cohen 1973).

The object of this report is to describe the indications, the surgical procedure devised and the results obtained in two patients.
Bone morphology and bone loss in periodontal disease
Authors: Manson J. D.
Published: December 2005

Abstract A clinical study of the distribution of different types of bone defects in chronic pertodontitis was carried out on 30 patients. An analysis of 176 defects suggests that their distribution reflects the original morphology of the alveolar bone. The role of function as a determinant of that morphology is examined. While there appears to be a relationship between functional stress and the phylogenesis of the bone, there is no direct relationship between function and ontogenesis. A study of growth remodelling of the mandible in several animals indicates that the pattern of activity is dictated by a drive to achieve a mature form which is the expression of the genetic endowment. Normal function and normal muscle stress are part of the environment in which complete growth can take place, but they do not appear to play a more active role in determining the form of growth; abnormal function does not allow normal growth to take place.

The relationship between functional stress and the morphology and activity of the mature bone is not clear.

Osteoporosis of age, as measured by the metacarpal index in 101 patients with chronic periodontitis, did not appear to be significantly related to the bone loss score. However, in 54 female patients, aged 35–45 years, a significant correlation was found between the metacarpal index and a “rapidity of bone loss” score.
Retardation of epithelial migration in new attachment attempts in intrabony defects in monkeys
Authors: Ellegaard B. , Karring T. , Löe H.
Published: December 2005

Abstract New attachment procedures were performed in 80 three‐wall intrabony defects produced adjacent to incisors and canines in monkeys. Following a reverse bevel incision, rnucoperiosteaS flaps were raised on the buccal and lingual aspect of 40 intrabony defects, AH soft tissue was removed from the defects and following transplantation of autogenous bone grafts, the tissue flaps were replaced and sutured. On the buccal and lingual aspect of another 40 intrabony defects a split flap procedure was performed. Granulation tissue was removed from the defects and following transplantation of autogenous bone grafts, the defects were covered with free palatal grafts.

The animate were sacrificed (o yield observation periods from 0 to 42 days. After de‐caicification of the specimens and embedding in paraffin, 8‐μm serial sections were cut and stained. The epithelium on the full thickness flap seemed almost unaffected by the surgical procedure and had migrated between 0.2 mm and 2.0 mm along the root surface during the first week of healing. The epithelium on the transplants degenerated almost completely within the first week after surgery and epithelial migration along the root surface was not observed until after 10–12 days.

These results indicate that the migration of epithelium during the postoperative phase of new attachment attempts can be retarded by covering the defects with free palatal grafts instead of full thickness flaps.
Osseous repair of an infrabony pocket without new attachment of connective tissue
Authors: Caton Jack , Zander Helmut A.
Published: December 2005

Abstract This report describes the osseous repair of an infrabony pocket without new attachment of connective tissue between the new bone and root surface. While the width of the connective tissue between the new bone and root surface was of approximately normal dimensions, junctional epithelium was present on the root surface.
The use of chlorhexidine mouthwash compared with a periodontal dressing following the gingivectomy procedure
Authors: Addy M. , Dolby A. E.
Published: December 2005

Abstract The clinical results achieved were compared when a group of 21 patients requiring gingivectomies in comparable bilateral segments received a dressing or a chlorhexidine mouthwash during the first post‐operative week. Initial pre‐operative conditions were comparable. In each of the two treatments highly significant reductions in pocket depths were achieved; the sizes of the reductions were of clinical significance (> 1.5 mm). The observed difference (0.16 mm) between the two treatments in favour of the mouthwash, although significant at the conventional 5 % level, was clinically unimportant. More patients preferred the dressing as a post‐operative treatment, and the clinical implications of the patients' preferences are discussed.
The influence of trauma from occlusion on reduced but healthy periodontal tissues in dogs
Authors: Lindhe Jan , Ericsson Ingvar
Published: December 2005

AbstractThe experiments were performed in five dogs fed a soft diet which allowed dental plaque accumulation. Experimental periodontal breakdown was introduced on Day 0. After 180 days trauma from occlusion was produced in4P and P4, i.e. the mandibular fourth premolars, in the manner described by Svanberg & Lindhe (1973). On Day 280 the periodontal pockets around4P and P4were eliminated. A notch was prepared in the root at the level of the bottom of the surgically eradicated pocket. In addition, the occlusal trauma in the4P region was deleted. From Day 280 to Day 370 the teeth of the animals were brushed twice a day. The animals were then sacrificed, radiographs of the premolar regions were taken, and tissue sections comprising3P4P1M (and P3P4M1) were produced and subjected to microscopic analysis. The results indicate that jiggling type occlusal trauma and tooth hypermobility are not factors which detrimentally affect healing following periodontal surgery.