bluuebunny/crossref_metadata_2025 huggingface dataset:
Local antimicrobial therapy after initial periodontal treatment
Authors: Salvi Giovanni E. , Mombelli Andrea , Mayfield Lisa , Rutar Alexandra , Suvan Jean , Garrett Steven , Lang Niklaus P.
Published: March 2003

Aim:  The aim of this single‐blind, randomized, parallel‐designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three sustained‐release biodegradable polymers delivered into periodontal pockets following initial periodontal therapy.

Methods: Forty‐seven patients (28 females and 19 males) with a mean age of 51 years (range 29–71) underwent a periodontal examination at baseline (i.e. Week 0) and after 18 weeks. This included the assessment of the Plaque Index (PlI), Bleeding on Probing (BOP), Pocket Probing Depths (PPD) and Probing Attachment Levels (PAL) at six sites per tooth. Two to 4 months prior to baseline, all subjects had received initial periodontal therapy including motivation, instruction in oral hygiene practices and full‐mouth scaling and root planing. At the treatment appointment (i.e. Week 2), the patients were randomly assigned to receive either Atridox™, Elyzol® Dental Gel or PerioChip® at all residual periodontal pockets with a probing depth ≥ 5 mm and concomitant BOP. In accordance with the manufacturer's recommendations, Elyzol® Dental Gel was applied for a second time 7 days later. In addition to the clinical evaluation, subgingival microbiological samples were collected prior to treatment (i.e. Week 2) and at Weeks 4 and 18. Analysis of variance/covariance was used to evaluate changes from baseline to Week 18 for the clinical parameters.

Results:  Between the baseline and 18‐week examinations, subjects treated with Atridox showed a significantly greater gain in mean PAL of 0.33 mm ± 0.09 (SD) than subjects treated with Elyzol® Dental Gel [0.03 mm ± 0.09 (SD)](p = 0.03). However, the gain in PAL of 0.16 mm ± 0.10 (SD) found after PerioChip® application did not differ significantly from that obtained following the application of AtridoxTM(p = 0.27). Of the sites treated with AtridoxTM, 42% gained ≥ 1 mm PAL and 9% ≥ 2 mm PAL as opposed to the sites treated with Elyzol® Dental Gel, in which 34% gained ≥ 1 mm PAL and 8% gained ≥ 2 mm PAL. Of the sites treated with PerioChip®, 36% gained ≥ 1 mm and 6% gained ≥ 2 mm PAL following a completed initial periodontal therapy.

Conclusions:  The application of the three biodegradable sustained release devices tested following initial periodontal therapy resulted in a statistically significant gain in mean PAL for AtridoxTM and a significant reduction in PPD for all three devices during the study period. Furthermore, when sites treated with AtridoxTM were compared with sites treated with Elyzol®, a significant difference in mean PAL gain (0.3 mm) was observed.
Relationship of changes in interleukin‐8 levels and granulocyte elastase activity in gingival crevicular fluid to subgingival periodontopathogens followingnon‐surgical periodontal therapy in subjects with chronic periodontitis
Authors: Jin L. J. , Leung W. K. , Corbet E. F. , Söder B.
Published: March 2003

Objectives: To determine the effect of scaling and root planing (SRP) on the interrelations of subgingival periodontopathogens and both interleukin‐8 (IL‐8) and granulocyte elastase activity in gingival crevicular fluid (GCF), and to assess their relations to the short‐term treatment response in management of chronic periodontitis.

Material and methods: GCF and subgingival plaque were collected from 16 subjects with untreated chronic periodontitis at baseline and 4 weeks after SRP. IL‐8 levels were determined by ELISA. Granulocyte elastase activity was analyzed with a specific substrate, pGluProVal‐pNA, and the maximal rate of elastase activity (MR‐EA) was calculated. 5 DNA‐probes were used to detect the presence of A. actinomycetemcomitans (A. a.), B. forsythus (B.f.), P. gingivalis (P.g.), P. intermedia (P.i.), and T. denticola (T.d.), with a sensitivity = 103 cells/paper point.

Results: IL‐8 and MR‐EA levels in GCF decreased significantly after SRP (p < 0.001) with a corresponding reduction of total count of the species. Of the sites with probing depth (PD) ≥ 5.0 mm and co‐infection by B.f., P.g., P.i. & T.d. at baseline, the sites without persistent co‐infection of these species after SRP exhibited a significant reduction of IL‐8 levels (p < 0.02), MR‐EA levels (p < 0.02) and PD (p < 0.01). No such change was found in the sites where such a co‐infection persisted. Moreover, reduction of IL‐8 levels in those pocket sites was accompanied by a concomitant reduction of MR‐EA (p < 0.02) and PD (p < 0.01), while no significant change in MR‐EA levels and PD was noted in those pocket sites that exhibited an increase of IL‐8 levels after SRP. At baseline, the former group of sites showed significantly higher IL‐8 levels than the latter group of sites (p < 0.02).

Conclusions: IL‐8‐related granulocyte elastase activity was related to the change in infection patterns of the target periodontopathogens following scaling and root planing. Varying initial IL‐8 levels in GCF and a corresponding shifting change of granulocyte elastase activity in GCF may characterize the different short‐term treatment responses.
Attachment loss in Moroccan early onset periodontitis patients and infection with the JP2‐type of Actinobacillus actinomycetemcomitans
Authors: Haubek Dorte , Ennibi Ohm‐Keltoum , Abdellaoui Lamia , Benzarti Neji , Poulsen Sven
Published: March 2003

Background: A clone of Actinobacillus actinomycetemcomitans (JP2) with increased leukotoxin production and characterized by a 530‐bp deletion in the leukotoxin gene operon is endemically present in Morocco and strongly associated with the presence of early onset periodontitis (EOP).

Objectives: To compare patterns of attachment loss among EOP‐patients with or without JP2‐type of A. actinomycetemcomitans in dental plaque.

Material and methods: Among 45 Moroccan adolescents with EOP (i.e. one or more teeth with attachment loss ≥ 3 mm) 39 had cultivable plaque samples. Fifteen (38.5%) were culture‐positive for A. actinomycetemcomitans of the JP2‐type as determined by PCR, and 24 (61.5%) were not (mean age 16.5 years in both groups).

Results: EOP‐patients culture‐positive for A. actinomycetemcomitans of the JP2‐type had significantly more teeth with attachment loss (mean 5.1, median 4.0) than EOP‐patients not culture‐positive for A. actinomycetemcomitans of the JP2‐type (mean 2.8 teeth, median 1.0) (p = 0.02), and higher attachment loss (mean 4.3 mm vs. 3.4 mm; median 4.0 mm vs. 3.0 mm) (p = 0.01). No major differences could be detected between the two groups in the pattern of affected teeth in the dentition.

Conclusions: The study demonstrates increased periodontal destruction among EOP‐patients culture‐positive for A. actinomycetemcomitans of the JP2‐type compared with EOP‐patients without the JP2‐clone.
A new method of plaque scoring: a laboratory comparison with other plaque indices
Authors: Dababneh R. H. , Khouri A. T. , Smith R. G. , Addy M.
Published: March 2003

Aim: The aim of this study was to propose a simple, clear and as sensitive as possible numerical plaque index for the use in clinical oral hygiene trials known as the New Method of Plaque Scoring (NMPS), and to evaluate this index for simplicity, clarity and examiner agreement in comparison with the Distal Mesial Plaque Index, Proximal Marginal Index and a modification to the modified Navy plaque Index.

Material and Methods: The scoring system proposed for the NMPS is based on a numerical range from 0 to 10 representing the total stained plaque on the facial or lingual tooth surfaces with the greatest weight of scores placed at the gingival and proximal regions of the surface. For scoring purposes, a horizontal boundary is imagined on the smooth facial or lingual tooth surfaces between the gingival third (A) and coronal two/thirds, the latter being subdivided vertically into thirds, mesial (B), middle (D) and distal (C). Depending on the extent of plaque coverage, whole number scores 0–3 are assigned to A, B, C and 0 or 1 for D. Ten examiners scored four selected tooth surfaces on an acrylic model according to the NMPS and the three comparative indices. The time required for each examiner to score according to each index was recorded. The scores obtained from this trial were analyzed for examiner agreement and correlation between the four indices.

Results: The time required for scoring according to the NMPS was found to be significantly less than the three comparative indices. The variability between examiners was found to be least for the NMPS compared to the three comparative indices. A strong correlation was found between all pairs of indices.

Conclusion: The proposed new method of plaque scoring seems to be simpler, clearer and more reproducible than the three comparative indices. However, clinical testing is warranted.
Healing patterns in calvarial bone defects following guided bone regeneration in rats
Authors: Verna Carlalberta ,   Carles Bosch, Dalstra Michel , Wikesjö Ulf M. E. , Trombelli Leonardo
Published: March 2003

Objective: The objective of this study was to evaluate healing patterns of critical‐size calvarial bone defects treated according to principles of guided bone regeneration using micro‐CT scan analysis. Specifically, the contribution of bone, periosteum and dura mater to the amount and mineralization of newly formed bone was evaluated.

Material and Methods: Surgically induced, critical‐size calvarial bone defects in 48 adult male Wistar rats received the following: an occlusive expanded polytetrafluoroethylene (ePTFE) membrane at the exo‐ and endocranial aspect (OO; n = 12); an occlusive membrane at the exocranial and a perforated membrane at the endocranial aspect (OP; n = 12); a perforated membrane at the exocranial and an occlusive membrane at the endocranial aspect (PO; n = 12); and a perforated membrane at the exo‐ and endocranial aspect (PP; n = 12). The animals were euthanized at 4 weeks for quantitative analysis of bone volume fraction and mineralization in the region of interest (ROI) as well as in the external, middle and central area of the defect using micro‐CT.

Results: Bone volume fraction ranged from 31.4% (OP) to 24.5% (PP). No differences were found among the groups. Bone volume fraction and mineralization in the middle area were significantly greater in group OP than in group PP, and in the central area in group OO and PO than in group PP.

Conclusions: The results of this study suggest that use of occlusive ePTFE membranes enhances bone formation and maturation in the calvarial skeleton. When occlusion of endo‐ and exocranial tissues was compromised by membrane perforation, impaired bone formation and mineralization were observed.
Development of a method in situ to study toothpaste abrasion of dentine
Authors: Addy M. , Hughes J. , Pickles M. J. , Joiner A. , Huntington E.
Published: March 2003

Background/Aims:  The abrasivity of toothpastes is usually determined using in vitro methods; as such, the clinical significance of the findings is uncertain. The aim of the present study was to develop and evaluate a method in situ to study abrasion of dentine by two toothpastes of different Relative Dentine Abrasivity (RDA).

Method: The study was a single blind, randomised, 2 way cross over design involving 10 healthy dentate volunteers. Subjects wore an maxillary removable acrylic appliance containing two flat human dentine specimens, taped to expose a window of tissue, from 9 am to 4 pm during the two 10 working day study periods. No food or drink was consumed when the appliance was in place. On five occasions each day, the appliances were removed and the dentine windows brushed ex vivo with the allocated paste for 60 s each. Dentine abrasion at days 5 and 10 was measured using a profilometer.

Results: Both toothpastes produced measurable abrasion in all subjects and the depth increased in most subjects between 5 and 10 days. There was significant subject and specimen variation both within and between toothpastes. There was significantly increased abrasion by the toothpaste with the higher RDA value and in mean terms the ratio of abrasion between the two pastes was similar to the ratio of the RDA values.

Conclusion: The method in situ, already used to study dental hard tissue erosion, appears ideally suitable to study dental abrasion alone and the interaction between aetiological factors involved in tooth wear.
Two‐part implants inserted in a one‐stage or a two‐stage procedure
Authors: Heydenrijk Kees , Raghoebar Gerry M. , Meijer Henny J. A. , Van Der Reijden Willy A. , Van Winkelhoff Arie‐Jan , Stegenga Boudewijn
Published: March 2003

Objective:  The aim of this study was to evaluate the feasibility of using a two‐part implant system in a one‐stage procedure and to monitor the microflora in the peri‐implant area in relation to clinical and radiographic outcome.

Material and Methods: After randomisation, 40 edentulous patients (Cawood & Howell class V–VI) received two IMZ implants in the anterior mandible inserted by either a one‐stage (n = 20) or a two‐stage (n = 20) surgical procedure for overdenture treatment. A standardised clinical and radiographic evaluation was performed after denture insertion as well as 6 and 12 months thereafter. Twelve months after loading, peri‐implant samples were collected and analysed for the presence of putative periodontal pathogens using culture technique.

Results: No striking differences were found between the two groups with regard to the clinical parameters during the evaluation period. The mean bone loss in the first year of functioning was 0.6 mm in both groups. With regard to the gingiva score, plaque score, bleeding score or bone loss between T0 and T12, no associations were found with the presence of the cultured microorganisms. An association was present between pockets ≥ 4 mm and the presence of Peptostreptococcus micros in the two‐stage group.

Conclusions: The short‐term results indicate that two‐part implants inserted in a one‐stage procedure may be as predictable as inserted in the common two‐stage procedure. The peri‐implant sulcus can and does harbour potential periodontal pathogens without significant signs of tissue breakdown.
Porphyromonas gingivalis, Bacteroides forsythus and other putative periodontal pathogens in subjects with and without periodontal destruction
Authors: Van Winkelhoff A. J. , Loos B. G. , Van Der Reijden W. A. , Van Der Velden U.
Published: March 2003

Background and aims: Bacteria play an essential role in the pathogenesis of destructive periodontal disease. It has been suggested that not all bacteria associated with periodontitis may be normal inhabitants of a periodontally healthy dentition. In particular, Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans have been isolated infrequently from subjects without periodontitis. The aim of the present study was to compare prevalence and proportions of a number of periodontal bacteria in periodontitis patients and control subjects.

Material and methods: In all, 116 consecutive subjects diagnosed with moderate to severe periodontitis (mean age 42.4) and 94 subjects without radiographic evidence of alveolar bone loss (mean age 40.4) were recruited for the study. The gingival condition in the control group varied between gingival health and various degrees of gingivitis. In patients, the deepest pocket in each quadrant was selected for microbiological sampling. In control subjects all mesial and distal sites of all first molars were selected for sampling. All paper points from a patient were pooled and processed for anaerobic cultivation within 6 h after sampling. Clinical variables of sampled sites included bleeding index, probing pocket depth and clinical attachment level.

Results: A. actinomycetemcomitans, P. gingivalis, Prevotella intermedia, Bacteroides forsythus, Fusobacterium nucleatum and Peptostreptococcus micros were significantly more often prevalent in patients than in controls. The highest odds ratios were found for P. gingivalis and B. forsythus (12.3 and 10.4 resp.). Other odds ratios varied from 3.1 to 7.7 for A. actinomycetemcomitans and P. micros, respectively. Absolute numbers of target bacteria were all higher in patients, but only the mean percentage of B. forsythus was significantly higher in patients in comparison to controls (P < 0.001).

Conclusions:
A. actinomycetemcomitans, P. gingivalis, P. intermedia, B. forsythus, F. nucleatum and P. micros are all significant markers for destructive periodontal disease in adult subjects. Based on calculated odds ratios, B. forsythus and P. gingivalis are the strongest bacterial markers for this disease and are infrequently cultured from subjects without periodontal bone loss.
Effect of triclosan dentifrices on mouth volatile sulphur compounds and dental plaque trypsin‐like activity during experimental gingivitis development
Authors: Nogueira‐Filho G. R. , Duarte P. M. , Toledo S. , Tabchoury C. P. M. , Cury J. A.
Published: March 2003

Background: The objective of this study was to evaluate the effect of three commercial anti‐plaque dentifrices containing 0.3% triclosan + 2% pvm/ma (Colgate Total®), 0.3% triclosan + 0.75% Zn (Signal Global®) and 0.3% triclosan + 5% PPi (Crest Complete®) in comparison with an experimental dentifrice (0.3% triclosan + 2% pvm/ma + 0.75% Zn + 4% PPi) and a control dentifrice without anti‐plaque agents on trypsin‐like activity in dental plaque (detected by the hydrolysis of [Na‐Benzoyl‐DL‐Anginine p‐Nitroanilide (BAPNA)] and volatile sulphur compounds (VSCs) in mouth air during experimental gingivitis development.

Method: A 5‐step double blind, crossover experimental gingivitis study was conducted on 19 volunteers during a 21‐day period. The volunteers refrained from brushing an experimental quadrant of teeth. The dentifrices were applied to those teeth via toothshield three times per day; simultaneously they brushed the other teeth with the same dentifrice. After each period, VSCs in mouth air and BAPNA hydrolysis by dental plaque accumulated in the experimental quadrant were determined.

Results: There was an increase (p < 0.05) in VSCs in mouth air when experimental gingivitis was induced in only one quadrant of teeth. None of the dentifrices was able to avoid the increase of VSCs during the experimental gingivitis development. The majority of the antiplaque dentifrices evaluated reduced the increase of VSC formation in comparison with the control (p < 0.05). There was no relationship between the ability of the dentifrices in reducing VSC formation and the inhibition of trypsin‐like activity in dental plaque.

Conclusions: Anti‐plaque dentifrices reduce the increase of VSCs that occurs during the development of experimental gingivitis.
A modification to the experimental gingivitis protocol to compare the antiplaque properties of two toothpastes
Authors: Yates R. J. , Shearer B. H. , Morgan R. , Addy M.
Published: March 2003

Background and Aims:  Randomised, blind, controlled experimental gingivitis and home‐use study protocols are used to evaluate the efficacy of oral hygiene products. The present methodological study combined the two clinical trial designs to compare the preventive and therapeutic potentials of two toothpastes.

Material and Methods:  The study was a parallel group, randomised, double‐blind design, initially involving 73 healthy dentate subjects. A 21‐day experimental gingivitis protocol was combined with a 6‐week (42 days) home‐use protocol. At baseline, modified gingival index (MGI), gingival index (GI) and gingival bleeding (GB) were recorded. A dental prophylaxis was then performed. Subjects were allocated to either control fluoride or stannous fluoride toothpaste based on gender and GI. During the first 21‐day period, subjects applied the allocated toothpaste, for 1 min twice a day, to a group of teeth in a plastic shield and brushed the remaining teeth with the same paste. From day 21 the shield was not placed, and subjects brushed all teeth with the toothpaste for 1 min twice per day up to day 42. MGI, GB and a plaque index (PI) were recorded on days 21 and 42.

Results:  Sixty‐nine and 67 subjects completed to days 21 and 42, respectively. For shielded teeth, PI, MGI and GB increased to day 21 and then after ceasing the use of the shield decreased to day 42. At day 21, PI favoured the stannous fluoride toothpaste, but differences did not achieve statistical significance for any parameter at days 21 or 42. For unshielded teeth, there were no significant differences between the toothpastes for any parameter at either time point.

Conclusion:  The feasibility of combining two gingivitis clinical trial methodologies appears proven, and data on both the preventive and therapeutic chemical and mechanical efficacy of toothpastes can be obtained through such protocols. Specifically from the present study and consistent with some other reports, the plaque inhibitory properties of the stannous fluoride product are limited and do not always translate into an antiplaque/antigingivitis effect.
Effects of an oral health program on the occurrence of oral candidosis in a long‐term care facility
Authors: Budtz‐Jørgensen Ejvind , Mojon Philippe , Rentsch Alain , Deslauriers Noëlla
Published: March 2003

Abstract – Objectives: The aim was to evaluate the effectiveness of a preventive oral health program on the prevalence of oral candidosis in 237 frail or dependent residents in a long‐term care facility. Half of the residents were included in an experimental group which benefited from a preventive oral hygiene program including instruction of the carers and implementation of a recall program for professional oral hygiene care. Methods: Intraoral examinations and yeast cultures from the oral mucosa and the fitting denture surface were carried out at baseline and 18 months later. The outgrowth of yeast was estimated on Oricult‐N dip slides using the scale: no growth; 1–20 colonies; 21–100 colonies; >100 colonies. Results: At baseline (n=237) and at 18 months (n=159) the experimental and the control groups were similar with regard to the residents' distribution by age, sex, dental and prosthetic status and prevalence of denture stomatitis. The 78 residents lost had the same baseline characteristics as the survivors, except for being older. In the experimental group the severity of the inflammation of the palate decreased (P=0.005) as well as the prevalence of glossitis (P=0.005). At baseline high yeast scores from the mucosa (>20) were observed in about 50% of the residents in the experimental as well as the control group. At 18 months this figure was 23.4% for the experimental and 48.7% for the control group (P=0.001). There was also a reduction of the number of residents with positive cultures and the denture yeast scores at 18 months in the experimental group (P=0.05). Conclusions: This study has shown that the preventive program was effective in reducing the colonization of the oral mucosa and dentures by Candida and thereby improving the health of the oral mucosa.
Decline of caries prevalence after the cessation of water fluoridation in the former East Germany
Authors: Künzel W. , Fischer T. , Lorenz R. , Brühmann S.
Published: March 2003

Abstract – In contrast to the anticipated increase in dental caries following the cessation of water fluoridation in the cities Chemnitz (formerly Karl‐Marx‐Stadt) and Plauen, a significant fall in caries prevalence was observed. This trend corresponded to the national caries decline and appeared to be a new population‐wide phenomenon. Additional surveys (N=1017) carried out in the formerly‐fluoridated towns of Spremberg (N=9042) and Zittau (N=6232) were carried out in order to support this unexpected epidemiological finding. Pupils from these towns, aged 8/9‐, 12/13‐ and 15/16‐years, have been examined repeatedly over the last 20 years using standardised caries‐methodological procedures. While the data provided additional support for the established fact of a caries reduction brought about by the fluoridation of drinking water (48 % on average), it has also provided further support for the contention that caries prevalence may continue to fall after the reduction of fluoride concentration in the water supply from about 1 ppm to below 0.2 ppm F. Caries levels for the 12‐year‐olds of both towns significantly decreased during the years 1993–96, following the cessation of water fluoridation. In Spremberg, DMFT fell from 2.36 to 1.45 (38.5 %) and in Zittau from 2.47 to 1.96 (20.6%). These findings have therefore supported the previously observed change in the caries trend of Chemnitz and Plauen. The mean of 1.81 DMFT for the 12‐year‐olds, computed from data of the four towns, is the lowest observed in East Germany during the past 40 years. The causes for the changed caries trend were seen on the one hand in improvements in attitudes towards oral health behaviour and, on the other hand, to the broader availabilty and application of preventive measures (F‐salt, F‐toothpastes, fissure sealants etc.). There is, however, still no definitive explanation for the current pattern and further analysis of future caries trends in the formerly fluoridated towns would therefore seem to be necessary.
Caries prevention with chlorhexidine‐thymol varnish in high risk schoolchildren
Authors: Splieth Christian , Steffen Heike , Rosin Michael , Welk Alexander
Published: March 2003

Abstract – In a prospective, randomised and blinded cohort study, the acceptance and effectiveness of a 3‐monthly chlorhexidine‐thymol varnish application was assessed in 8‐ to 10‐yr‐old children (n=29) with high caries incidence after brushing with a 1.23% fluoride gel. The children of the control group (n=25) brushed with a fluoride gel only. The standardised interview showed good acceptance of the varnish applications in spite of the bitter taste. Caries incidence in one year was 1.2 DMFS (SD 1.5, median 1; 95% confidence interval 0–1) for the test group and 2.1 DMFS (SD 2.3, median 2; 95% confidence interval 0–3) for the control group. Due to a slightly lower reduction in caries incidence (42.3%) than in other studies and a higher standard deviation than in unselected study groups, the power of the present study was not high enough to prove this difference in caries incidence to be statistically significant in the Mann‐Whitney test (P=0.11). This was also found for the difference of 0.4 initial lesions. The distribution patterns of caries incidence for tooth groups (70% in the first permanent molar) and surfaces (58% on occlusal surfaces) did not differ between the test and the control group. The reductions of caries incidence which have been found in highly caries active children of the present study should be evaluated further with a larger study sample.
Caries in the primary dentition, after discontinuation of water fluoridation, among children receiving comprehensive dental care
Authors: Seppä L. , Kärkkäinen S. , Hausen H.
Published: March 2003

Abstract – The city of Kuopio in central Finland had fluoridated piped water for 33 years, beginning in 1959. Due to strong opposition by various civic groups, water fluoridation was stopped at the end of 1992. There is little information on the consequences of stopping fluoridation in a community with comprehensive dental care for all children and adolescents, who are frequently exposed to different fluoride measures both at home and in the dental office. Objectives: The aim of this repeated cross‐sectional survey was to examine how discontinuation of water fluoridation in Kuopio affected caries in the primary dentition. Changes in the mean dmfs values between 1992 and 1995 in Kuopio were compared to those in Jyväskylä, a low‐fluoride community that has repeatedly been used as the reference area for Kuopio. Methods: In 1992 and 1995, independent random samples of all children aged 3, 6 and 9 years were drawn in Kuopio and Jyväskylä. The total number of subjects examined was 421 in 1992 and 894 in 1995. Calibrated dentists registered caries clinically and radiographically. Results: In all age groups both in 1992 and 1995, the point estimates for mean dmfs values were lower in the non‐fluoridated town. In both towns, the observed mean dmfs values were smaller in 1995 than in 1992. Conclusion: Despite discontinuation of water fluoridation, no increase of caries frequency in primary teeth was observed in Kuopio within a three‐year period.
Rugby players’ satisfaction with custom‐fitted mouthguards made with different materials
Authors: Brionnet Jean‐Marc , Roger‐Leroi Valérie , Tubert‐Jeannin Stéphanie , Garson Agnès
Published: March 2003

Abstract – Objectives: This study compared the comfort of two bimaxillary custom‐fitted mouthguards. One type was made with silicone rubber and the other with methyl‐methacrylate (acrylic). Methods: The study was a within‐subject crossover clinical trial with 52 high‐school rugby players who were randomly allocated to one of two groups. The first group wore a silicone mouthguard for 4 months and an acrylic one for the following 4‐month period. The second group wore an acrylic mouthguard followed by a silicone one for similar periods. Comfort, bulkiness, stability, hardness, ability to talk and to breathe, oral dryness, nausea and inclination to chew were evaluated for each period using a Visual Analogue Scale questionnaire. Results: There was no significant difference concerning comfort, bulkiness, ability to talk and to breathe, oral dryness and nausea between silicone and acrylic mouthguards by group and time of examination (Three‐way ANOVA P>0.05). Acrylic mouthguards were more stable and harder than silicone ones (Wilcoxon’s test P<0.01). Tendency to chew was greater for silicone appliances (P<0.01). For stability, hardness and inclination to chew, there was no significant difference in the response of the players based on the sequence of use of the two types of mouthguard during the survey (Mann‐Whitney test –P>0.05). At the end of the study, 56% of the players preferred to keep the acrylic mouthguard and 44% chose the silicone one. This choice did not vary between the groups (χ2, P>0.05). Conclusion: Silicone rubber mouthguards were well accepted by the players but technical improvements in silicone materials are needed to improve hardness and stability of silicone mouthguards for sport.
Assessing risk indicators for dental caries in the primary dentition
Authors: Vanobbergen Jackie , Martens Luc , Lesaffre Emmanuel , Bogaerts Kris , Declerck Dominique
Published: March 2003

Abstract – The aim of the present study was to assess indicators shown to be associated with the prevalence of caries in the primary dentition of 7‐year‐old Flemish schoolchildren. Cross‐sectional first year data of the longitudinal Signal‐Tandmobiel® survey were analysed (n=4468). Gender, age, oral hygiene habits, use of fluorides, dietary habits, geographical factors and parental modelling were the considered predictors. From the multiple logistic regression analysis, including schools as a random effect, and after adjusting for the confounding variables–educational system and province (stratification variables), gender and age–it became clear that the following risk indicators remained significant (at 5% level) for the presence of caries: frequency of toothbrushing (P=0.05) with an OR 1.24 for brushing less than once a day, age at start of brushing (P<0.001) with an OR=1.22 for a delay of 1 year, regular use of fluoride supplements (P<0.001) with an OR=1.54 for no use, daily use of sugar‐containing drinks between meals (P<0.001) with an OR=1.38, and number of between‐meals snacks (P=0.012) with an OR=1.22 for using more than 2 between‐meal snacks. There was a significant difference (P<0.05) in caries experience determined by the geographical spread, with an explicit trend of caries declining from the east to the west. In a model with an ordinal response outcome, the daily use of sugar‐containing drinks between meals had a more pronounced effect when caries levels were high. From this study it became obvious that, in Flemish children, an early start of brushing and a brushing frequency of at least once a day need to be encouraged, while the use of sugar‐containing drinks and snacks between meals needs to be restricted to a maximum of 2 per day. Geographical differences need to be investigated in more detail.
Dental diseases in subjects with β‐thalassemia major
Authors: Al‐Wahadni Ahed M. , Taani D. Quteish , Al‐Omari M. O.
Published: March 2003

Abstract –

Objectives:  The aim of this study was to determine whether β‐thalassemia major is associated with an increase in the severity of periodontal disease and dental caries.

Methods: A total of 61 thalassemia patients and 63 healthy controls (age range = 6–18 years) were examined for plaque deposits, gingivitis, periodontitis and dental caries using Silness and Löe plaque index (Pl.I), Löe and Silness gingival index (GI), probing pocket depth (PPD) and DMFT, respectively.

Results: There were no significant differences in Pl.I, GI and PPD scores between both thalassemia patients and healthy control groups (P > 0.05). Dental caries was significantly higher in thalassemia patients group (P < 0.0001) compared to the healthy controls.

Conclusion: Thalassemia is not associated with increased levels of gingivitis or periodontitis but is associated with higher dental caries experience.
The limitations of a ‘high‐risk’ approach for the prevention of dental caries
Authors: Batchelor Paul , Sheiham Aubrey
Published: March 2003

Abstract –The decline in the prevalence of caries has lead several authors to advocate the adoption of a ‘high‐risk’ approach for caries preventive strategies. This paper analyses such an approach. It argues that the distribution of caries within a population follows certain laws: first, the mean caries score is a function of the prevalence; second, the variance is a function of the mean; and third, for a particular mean score, the distribution within the population is predetermined. Using data from the National Preventive Dentistry Demonstration Programme (NPDDP) in the US and the British Association for the Study of Community Dentistry (BASCD) epidemiological programmes in the UK the functions determining the distribution of caries within the population are examined. The findings indicate the changes in caries experience observed occurred throughout populations and are not confined to subgroups. Strategies limited to individuals ‘at risk’ would fail to deal with the majority of new lesions. The main emphasis should be centred on a population approach.
Inequalities in the dental treatment provided to children: an example from the UK
Authors: Tickle Martin , Milsom Keith , Blinkhorn Anthony
Published: March 2003

Objectives: To identify the relationship between the socioeconomic status of frequently attending children and the dental care of their primary dentition provided by dentists working in the General Dental Service (GDS) of the UK National Health Service (NHS).

Methods: The study design involved a retrospective investigation of the case notes of 658 children who were regularly attending patients of 50 General Dental Practitioners (GDPs) working in the North West of England. The socioeconomic status of each subject was measured using the Townsend score of their electoral ward of residence. Logistic regression models, taking into account the clustering of the subjects within dental practices, were fitted to identify whether or not socioeconomic status was significantly associated with the proportion of carious teeth that were restored, all dental extractions, dental extractions for pain or sepsis alone and courses of antibiotics prescribed after controlling other variables.

Results: A significant association between socioeconomic status and caries experience could not be found. There was also no association between socioeconomic status and the proportion of carious teeth filled or courses of antibiotics prescribed. Disadvantaged children were significantly more likely to have teeth extracted than their more affluent peers, but there was no association between deprivation and extractions for pain or sepsis alone.

Conclusions: Children from deprived backgrounds who regularly attended this group of UK dentists were more likely to have extractions than their more affluent peers, irrespective of their caries experience.
Childhood dental fear in the Netherlands: prevalence and normative data
Authors: Ten Berge Maaike , Veerkamp Jaap S. J. , Hoogstraten Johan , Prins Pier J. M.
Published: March 2003

Objective: This study aimed to present normative data on dental fear for the Dutch child population, by identifying not only highly fearful children but also children at risk for developing this high dental fear. Methods: Fear distribution of samples of high and low fearful children was studied, using the Dutch parent's version of the Dental Subscale of the Children's Fear Survey Schedule (CFSS‐DS). Total fear scores were calculated for both samples, for different age levels and for boys and girls separately. To establish cut‐off scores, mean CFSS‐DS scores were associated with dentists' clinical fear ratings and, in addition, were transformed into stanines. Results: Scores between 32 and 38 were found to represent a borderline area for dental fear, and scores of 39 and higher to represent high dental fear. Conclusion: The results have shown 6% of the Dutch child population to be highly fearful, while another 8% may be at risk to develop high dental fear. By providing extra attention for these children, the development of high dental fear or phobia may be prevented.
Is medication a risk factor for dental caries among older people?
Authors: Thomson W. Murray , Spencer A. John , Slade Gary D. , Chalmers Jane M.
Published: March 2003

Objectives:  This study examined the association between chronic medication exposure and 5‐year dental caries increment among older people, using a theoretical model whereby xerogenic medication is thought to lead to increased caries by either (i) chronically lowering salivary flow, thus reducing salivary buffering of plaque acids, or (ii) producing the symptoms of dry mouth, leading to symptomatic relief through the use of cariogenic drinks and foodstuffs.

Methods: Data were obtained from participants remaining at the 5‐year follow‐up phase of a cohort study of community‐dwelling South Australians aged 60 +. Medication information was available at baseline and at 5 years, enabling only those medications taken on both occasions to be included in the analyses. Dental examinations were conducted at baseline and 5 years, and a reversal‐adjusted 5‐year caries increment was computed. Multivariate modelling was used to control the effects of potential confounders.

Results: Of the original sample, 528 (62.3%) remained after 5 years, with those remaining tending to be younger, healthier and less medicated than those lost to follow‐up. Five‐year coronal caries incidence was 66.9%. The adjusted coronal caries increment (AdjCI) was higher among males and among those taking a β‐blocker or an antiasthma drug for the previous 5 years. The 5‐year incidence of root surface caries was 59.3%. A lower root surface AdjCI was associated with taking daily aspirin. Of the medications shown in earlier analyses to predict dry mouth, only the antiasthma drugs were associated with higher caries experience, and they had predicted more severe xerostomia symptoms.

Conclusions: This study offers no strong evidence for a medication–caries relationship, as only one of the observed medication–caries associations was explicable in terms of the theoretical model. However, it should be acknowledged that older people taking antiasthma drugs may be at higher risk of coronal caries, possibly through measures taken for the symptomatic relief of dry mouth.
Predicting the experience of dentinal caries or restorative dental treatment in adolescents using D1 and D3 visual caries assessments
Authors: Nuttall Nigel , Deery Christopher
Published: March 2003

Standardised epidemiological caries assessments used in oral health surveys have been shown to be poor at predicting whether a tooth surface will be treated restoratively when a patient visits a dentist. However, it has been argued that oral health surveys may be more relevant in determining needs at the level of an individual or groups of individuals. The objective of this study was to determine the discriminatory power of visual caries assessments at two thresholds (D1 & D3) in adolescents of average age 12.1 years to predict experience of dentinal caries 3 years later or the experience of restorative treatment (not re‐treatment) during the 3‐year period. The data was derived from a prospective 3‐year longitudinal study in which the dental care provided by 41 dentists for 403 adolescents was monitored. Dental caries experience was monitored by annual standardised assessments of caries undertaken by a single trained examiner. ROC analysis showed that caries assessed visually at the D1 threshold in 12‐year‐olds was a better predictor (P < 0.001) of experiencing some dentinal caries after 3 years (Az = 0.781) than was caries assessed visually at D3 threshold in 12‐year‐olds (Az = 0.670). Assessing caries visually at either the D1 or the D3 threshold had no discriminatory power for predicting whether an individual would experience some restorative treatment during the ensuing 3‐year period (Az for D1 = 0.507; Az for D3 = 0.518).
Applicability of an abbreviated version of the oral impacts on daily performances (OIDP) scale for use among Tanzanian students
Authors: Masalu J. R. , Åstrøm A. N.
Published: March 2003

Abstract –

Objectives: The objective was to examine the applicability of an abbreviated version of the oral impact of daily performances (OIDP) inventory to Tanzanian adults attending the University of Dar es Salaam.

Method: A total of 1123 students (mean age 26.4 years, response rate 58%) completed a survey instrument designed to measure subjective oral health indicators including the eight‐item OIDP frequency scores. After a period of 4 weeks, 228 students (mean age 24.6 years, response rate 65%) were examined clinically for the presence or absence of oral disorders.

Results: A total of 51% of the participants reported that an oral problem had affected them on at least one daily performance in the 6 months preceding the survey. Cronbach's alpha for the OIDP frequency items was 0.83 and 0.87 on the first and second administration of the questionnaire. A reliability coefficient (Spearman's rho) of 0.87 was obtained for the OIDP frequency scores. For five of the eight OIDP frequency items, the kappa values ranged from 0.60 to 1.0, whereas one scale item had the less satisfactory value of 0.22. Construct validity was demonstrated in that the OIDP frequency scores were statistically significantly associated in the expected direction with clinically observed oral problems and a global self‐report indicator of oral health status, respectively.

Conclusion: The OIDP frequency scale seems to have acceptable psychometric properties in the context of a descriptive questionnaire survey among Tanzanian university students.
A hidden periodontitis epidemic during the 20th century?
Authors: Hujoel P. P. ,   J. Bergström, Del Aguila M. A. , DeRouen T. A.
Published: March 2003

Abstract –Objectives:Increasing evidence suggests a strong causal link between smoking and periodontitis. The goal of this study was to impute how the secular changes in smoking prevalence during the 20th century impacted the advanced periodontitis incidence in the US.

Methods:Epidemiological analyses based on US prevalence data of advanced periodontitis and smoking, and predictions of future smoking prevalence.

Results:Assuming other risk factors for periodontitis remained constant, we estimated that the incidence of advanced periodontitis decreased by 31% between 1955 and 2000. The changes in smoking habits, and consequently the changes in periodontitis incidence, depended strongly on education and gender. Between 1966 and 1998, we estimated a 43% decreased periodontitis incidence among college‐educated individuals versus only an 8% decrease among individuals with less than a high school education. Between 1955 and 1999, we estimated a 41% decrease among males versus a 14% decrease among females. By the year 2020, the incidence of advanced periodontitis may decrease 43% from its level in 1955.

Conclusions:A periodontitis epidemic fueled by smoking remained hidden for most of the 20th century. Because this epidemic was hidden, it distorted our understanding of the treatment and etiology of periodontitis. The socioeconomic polarization of this epidemic will dictate alterations in patterns of periodontal care.
Claim substantiation and efficiency of hydrating body lotions and protective creams
Authors: De Paepe Kristien , Derde Marie‐Paule , Roseeuw Diane , Rogiers Vera
Published: March 2003

In the present work a practical claim substantiation study is shown by the example of 5 commercially available body lotions. Their efficacy with respect to effects on transepidermal water loss (TEWL) and stratum corneum (SC) hydration of ageing skin has been examined. Results were obtained after single and repeated application (14 days, 2 × a day). The best performing product was then selected and further tested for its potential effects on sodium lauryl sulfate (SLS)‐damaged skin. This was done in a younger population and the recovery of the impaired barrier function was followed by TEWL measurements. The selected body lotion had a high efficacy, improving both the TEWL and SC hydration of ageing skin by more than 30%. When applied to SLS‐damaged skin, the product was able to improve skin barrier repair in comparison with physiological barrier repair. The results of this study show that a combination of non‐invasive objective measurements can be used to substantiate product claims. Claims can be made with respect to protective and preventive properties of products, but also as to effectiveness of topical skin treatment in the case of abnormal barrier function or barrier restoration.
Sensitivity, specificity and positive predictivevalue of patch testing: the more you test, the more you get?
Authors: Diepgen Thomas L. , Coenraads Pieter Jan
Published: March 2003

Pathophysiological variability affects the results of patch testing. In addition, even a minimal degree of test‐imprecision due to this variability has a number of important statistical consequencies for the analysis and interpretation of any patch test data set. One such statistical phenomenon that is often overlooked is the dependance of the positive predictive value (i.e., the predictive value of a positive patch test) on sensitivity and specificity, the impact of which is heavily dependent on the proportion of truly allergic subjects that are studied. A 2nd important issue is the fact that patch testing is performed in series, which means multiple tests. If we assume, for example, a patch test series of only 10 allergens, then it can be demonstrated that there is a random probability of over 40% to find, simply by chance, for at least 1 allergen, a statistically significant difference between 2 groups of patients. Comparison of the results of series between patients calls for statistical adjustments in order to prevent erroneously positive differences and/or associations.
Is contact allergy in man lifelong?
Authors: Lee Ernest E. , Maibach Howard I.
Published: March 2003

In contradistinction from certain strains of mice, contact allergy in man is hypothesized to be either lifelong or at least to last for years. We examined follow‐up studies on contact allergy, as evaluated by patch testing, attempting to quantify its natural history. The allergens include colophonium, gold sodium thiosulfate, nickel, and cobalt. At present, due to technical limitations, we cannot state in quantitative terms whether contact allergy in man is lifelong and whether its clinical manifestations change. Thus, we list some criteria for future studies which may help resolve the above question.