bluuebunny/crossref_metadata_2025 huggingface dataset:
The efficacy of a herbal‐based toothpaste on the control of plaque and gingivitis
Authors: Mullally Brian H. , James Jacqueline A. , Coulter Wilson A. , Linden Gerard J.
Published: December 2005

Abstract. A double‐blind controlled clinical trial with parallel groups was designed to investigate the effectiveness of a herbal‐based toothpaste in the control of plaque and gingivitis as compared with a conventional dentifrice. 70 subjects with gingivitis completed the 6‐week study. All participants had at least 20 natural teeth with no probing depths greater than 3 mm and a plaque index of 2 or more at baseline. At baseline, both groups were balanced for the parameters measured: plaque index, plaque vitality, gingival index, bleeding on probing and gingival crevicular fluid flow. At the end of the trial, there were reductions within both groups, however, there were no significant differences between the groups. It was concluded that the herbal based toothpaste was as effective as the conventionally formulated dentifrice in the control of plaque and gingivitis.
No detrimental effect of fibrin glue on the regeneration of intrabony defects
Authors: Cortellini Pierpaolo , Prato Glovan Paolo Pini , Tonetti Maurizio S.
Published: December 2005

Abstract. This controlled clinical trial evaluated the potential of fibrin glue as a biological carrier to locally deliver guided tissue regeneration (GTR) modulators. 2 controlateral, morphologically similar defects were selected in each of 11 patients and randomly assigned to the test (teflon membrane and fibrin glue) and the control treatment (teflon membrane alone). Outcomes were assessed at membrane removal as newly formed granulation tissue and at the 1‐year follow‐up in terms of changes in probing attachment level, probing pocket depth, recession of the gingival margin, probing bone levels and percentage of fill of the intrabony defects. Data confirmed that GTR treatment of deep intrabony defects results in clinically and statistically significant improvements of the clinical parameters. No significant differences, however, were evidenced between the test and the control treatments. It is suggested that, since fibrin glue did not show detrimental effects on GTR, it could be applied as a biological carrier for the delivery of GTR enhancers into the surgical wound.
Cellular source, activation and inhibition of dental plaque collagenase
Authors: Sorsa Timo , Ding Yan‐Li , Ingman Tuula , Salo Tuula , Westerlund Ulla , Haapasalo Markus , Tschesche Harald , Konttinen Yrjö T.
Published: December 2005

Abstract. Dental plaque is the major aetiological factor in periodontal diseases and contains several proteolytic enzymes. The origin of these proteinases is, however, poorly studied. This study was undertaken to characterize collagenase present in dental plaque of adult periodontitis patients. Vertebrate‐type rather than bacterial‐derived collagenase activity was detected in extracts of both supra‐ and subgingival dental plaque extracts of adult periodontitis patients. Dental plaque collagenase was found to exist predominantly in autoactive form. Dental plaque collagenase from periodontally healthy individuals existed in latent form. Latent dental plaque collagenase from periodontitis lesions could be activated by a 95 kD chymotrypsin‐like proteinase from Treponema denticola and human leukocyte cathepsin G but not by human plasmin. Incubation of purified latent leukocyte collagenase with whole cells of Fusobacterium nucleatum, Eubacterium saburreum, Prevotella buccae and Porphyromonas gingivalis, however, did not result to the activation of the enzyme. Doxycycline in vitro inhibited dental plaque collagenase with an IC50‐value of 20μM. Dental plaque collagenase degraded more efficiently type I and 11 collagens than type III collagen. Western‐blot analysis with specific anti‐human neutrophil collagenase‐antibody revealed that both in supra‐and subgingival dental plaque extracts dental plaque collagenase had undergone proteolytic conversion from an 80 kD proform to a 58 kD active form which is associated with catalytic autoactivity as measured by functional collagenase assay. This reflects proteolytic activation of leukocyte collagenase in dental plaque probably by other proteases derived from potent periodontopathogenic bacteria such as T. denticola or other PMN proteases such as cathepsin G. Multiple different molecular weight gelatinases (20‐200 kD) including fragmented low molecular weight human neutrophil 92 kD gelatinase species were detected in both supra‐ and subgingival dental plaque extracts. Leukocyte collagenase, previously found to be the main type of collagenase present in adult periodontitis gingiva, gingiva crevicular fluid and saliva, is also the predominant type of collagenase in the plaque of periodontitis patients. Fragmented but catalytically active neutrophil gelatinase species are also present in dental plaque. The dental plaque has potential to serve as a reservoir and site of activation of neutrophil (PMN)‐derived matrix metalloproteinases in the periodontal inflammation.
An approach to efficacy screening of mouthrinses: studies on a group of French products
Authors: Addy M. , Wade W.
Published: December 2005

Abstract. There is a large and increasing number of oral hygiene products available to the general public. As such, it is difficult to demonstrate efficacy for all in long‐term home‐use studies. The aim of this project was to determine whether screening studies could position the activity and efficacy of a number of antiseptic mouthrinses, available in France, by comparison with an established product. This study reports the experiments in vitro. The products under test were, 4 containing chlorhexidine (Eludril, Hibident, Parodex and Prexidine) with Hibident considered the positive control, one containing cetylpyridinium chloride (Alodont) and one containing hexetidine (Hextril). The 1st study determined the antibacterial profile of the chlorhexidine products against a panel of oral bacteria using an agar dilution method. The 2nd study recorded, by optical density, the propensity of all products to induce tea staining on clear acrylic specimens. The maximum inhibitory dilutions (MID) of the chlorhexidine products against the test organisms, once adjusted for initial concentration differences, were essentially similar. One exception was Eludril which had an increased MID against Capnocytophaga sputigena, an organism normally less sensitive to chlorhexidine. Hibident and Prexidine produced expected levels of tea staining; that produced by Parodex was lower than the expected. Staining by Eludril was little different than water controls suggesting markedly reduced availability of chlorhexidine in this product. Alodont consistent with the very low CPC content also produced little staining and would be expected to show minimal effects against plaque in vivo. Hextril produced similar staining to Hibident but, because of the different antiseptic content, it is difficult to extrapolate the data to clinical effects. For the chlorhextdine products these data in vitro are cautiously extrapolated to indicate an expected similarity in clinical activity for Hibident and Prexidine and probably Parodex. Eludril would be expected to show considerably reduced substantivity and efficacy.
Intrasulcular laser Doppler readings before and after root planing
Authors: Hinrichs James E. , Jarzembinsk Cynthia , Hardie Nancy , Aeppil Dorothee
Published: December 2005

Abstract A reproducible and sensitive laser Doppler periodontal probe has recently been developed for intrasulcular measurement of gingival blood flow. The specific aims of this investigation were to determine the relation between intrasulcular laser Doppler readings (LDR) and traditional diagnostic criteria as well as to evaluate the response to root planing in terms of LDR and traditional criteria. LDR and clinical measurements (bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL) were obtained from 2 healthy and 2 diseased sites in 30 systemically healthy adult volunteers with localized moderate to advanced periodontitis. All 30 subjects were re‐examined 1 month following root planing while 10 subjects were re‐examined at approximately 1 year after treatment. Subject‐adjusted correlations between pretreatment LDR and PD as well as LDR and CAL were 0.74 and 0.71, respectively. I month following root planing, the diseased sites had undergone a significant reduction in LDR and PD with an accompanying gain in CAL. Prior to treatment, 95 of 120 sites (79%) agreed on an ordinal classification (high, low) for LDR and BOP. Mantel‐Haenszel common odds ratios for agreement between LDR and BOP were 9.6 pre‐treatment and 4.3 one month after treatment. A slight rebound of all measurements was noted in a group of 10 subjects followed for 1 year. It was concluded that the laser Doppler periodontal probe is an unbiased non‐invasive method of monitoring the response to periodontal therapy.
Management of furcation‐involved teeth
Authors: Müller H.‐P. , Eger T. , Lange D. E.
Published: December 2005

Abstract In the present study, data from more than 550 periodontally diseased patients with more than 1100 furcation invasions were retrospectively analysed. There were apparent differences in the distribution of different furcation degrees in patient populations treated by 2 differently experienced operators. However, treatment modality patterns were rather similar. Scaling during periodontal flap surgery was the most often performed treatment procedure in degree I (97–98%) and II (75–83%) involvements. About 44% of degree III involved teeth were extracted. In order to determine the influence of degree of furcation involvement, tooth type and operator variability on treatment modality, logistic regression analysis was applied. Degree of furcation involvement was an important indicator variable in all models, Scaling as a sole measure was mainly performed in relation to degree I of furcation involvement. With every increase in degree, the odds of scaling decreased by factor 12.7. The odds of root resection was upper 1st molars 46x higher than in wisdom teeth or lower 2nd molars with the same degree of involvement, but only 3.3x higher than in lower 1st molars. Tunnel preparation as well as regenerative procedures were mainly confined to lower molars. Operator variability was only introduced as a covariate in the extraction model. Hence, despite of different operator skill and severity of periodontal disease in treated populations, decision for one or the other treatment modality seems to depend essentially on degree of furcation involvement as well as tooth type.
Oral fluid elastase as an indicator of periodontal health
Authors: Uitto V.‐J. , Nieminen A. , Coil J. , Hurttia H. , Larjava H.
Published: December 2005

Abstract The study was designed to find out whether oral elastase activity could be used as a simple biochemical indicator of periodontal health. Both stimulated whole saliva and water rinse samples were collected from subjects with different degrees of adult periodontitis. gingivitis or healthy periodontium. In both sample types, elastase was mostly bound to insoluble fraction and preferred valine containing synthetic substrate, similar to neutrophil elastase. The elastase measurement required very little manipulation or time and its reproducibility was found to be good. The elastase levels were found to be negligible in edentulous subjects and usually very low in subjects with healthy periodontium. In about 85% of periodontitis cases having at least 1 deep periodomal pocket (≥6 mm), clearly elevated elastases levels were detected in both the saliva and rinse samples. In advanced periodontitis cases, the colour reaction took place in 0.5 to 2 h. In localized periodontitis cases. 2‐ to 18‐h incubations were required for positive reaction. There was a good correlation between the elastase activity and the number of deep periodontal pockets and the average community periodontal index of the subjects. Elastase activity was not a good indicator of gingivitis. About 45% of gingivitis cases were positive with the elastase test, and the enzyme values were not significantly increased in experimental gingivitis. In a longitudinal study on advanced periodontitis cases, elastase levels dropped dramatically as a result of clinically successful therapy, close to the values of healthy subjects. The oral elastase test could serve as a valuable adjunct in periodomal screening and assessment of treatment efficacy.
Full‐ versus partial‐mouth disinfection in the treatment of periodontal infections
Authors: Bollen Curd M. L. , Vandekerckhove Betty N.A. , Papaioannou William , Van Eldere Johan , Quirynen Marc
Published: December 2005

Abstract A standard periodontal treatment consists of 4 to 6 scalings and root‐planings at a 1‐ to 2‐week interval, which allows reinfection of a previously disinfected area before completion of the treatment. The present pilot study aims to examine the microbiological long‐term effects of a full‐mouth disinfection. 10 patients with advanced chronic periodontitis were randomly allocated to a test and control group. The patients from the control group received scaling and root‐planing and oral hygiene instructions at a 2‐week interval. The full‐mouth disinfection (test group) consisted of a full‐mouth scaling and root planing in 2 visits within 24 h in combination with; tongue brushing with 1% chlorhexidine gel for 1 min, mouth rinsing with 0.2% chlorhexidine solution for 2 min and sub‐gingival irrigation of all pockets (3× in 10 min) with 1% chlorhexidine gel. The patients of the test group were instructed to rinse 2× daily with 0.2% chlorhexidine. Plaque samples were taken at baseline and after 1. 2, 4 and 8 months. Differential phase‐contrast microscopy showed a significantly larger reduction of spirochetes and motile organisms in the test group up to month 2 for the single‐rooted and up to month 8 for the multi‐rooted teeth. Furthermore, the culture data supported the effectiveness of the new treatment strategy. In both groups, the number of anaerobic CPU decreased 1 log around single‐ and 0.5 log around multi‐rooted teeth. The number of anaerobic CPU remained low in the test group, in contrast to the control group. At 1 month, the test group harboured a significantly (p < 0.01) lower proportion of pathogenic organisms, but this difference disappeared with tune. Moreover, the test sites showed a significantly higher (p < 0.02) increase in the proportion of beneficial micro‐organisms up to 4 months. These findings suggest that a full‐mouth disinfection leads to a significant microbiological improvement up to 2 months, which could be consolidated, although not significant, for the next 6 months.
Prevalence of 6 putative periodontal pathogens in subgingival plaque samples from Romanian adult periodontitis patients
Authors: Ali Raouf Wahab , Velcescu Cristina , Jivanescu Miheala‐Cristina , Lofthus Brita , Skaug Nils
Published: December 2005

Abstract The aim of the present study was to determine by standard cultivation procedures the detection frequencies of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum. Actinobacillus actinomycetemcomitans, Bacteroides forsythus, and Capnocytophaga species as well as various enteric rods in subgingival plaque samples form Romanian adult periodontitis patients. DNA probe analysis (AffirmTM DP Microbial Identification Test) was also used, parallel to cultivation, to identify P. gingivalis. A. actinomycetemcomitans, and B. for‐ sythus, in deep (≥6 mm) and intermediate (4–5 mm) pockets in some of the subjects investigated. Paper points were used to sample 86 deep pockets in 36 patients and 27 intermediate pockets in 9 of the 36 patients. The x2 test was used to test for significance of differences between results obtained by cultivation and DMA analysis in both intermediate and deep pockets. P. gingivalis was recovered in a high percentage of the patients (75,8%) and sites (63.6%) examined, followed by P. intermedia, F. nucleatum, and A. actinomycetemcomitans, respectively. Capnocytophaga species were present in almost all subjects. Enteric rods were recovered in 61.1% of the patients and 55.8% of the sites. Except for this high prevalence of enteric rods, the present group of patients had the periodontal species monitored in %s similar to those commonly perceived in the West. The Affirm M DP Test and cultivation showed poor correlation in detecting P. gingivalis. A. actinomycetemcomitans, and B. forsythus. The cultivation prevalence of P. gingivalis and P. intermedia in deep pockets was similar to their prevalence in intermediate ones. Overall, the prevalence of the periodontal pathogens investigated in the present Romanian periodontitis patients is similar to what has been revealed in matching Norwegian and other Western periodontitis patient populations. The high prevalence of enteric rods in the Romanian patients may have been an artifact resulting from prolonged transport of the samples in VMGA III.
Histological and microbiological aspects of ligature‐induced periodontitis in beagle dogs
Authors: Renvert S. , Wikström M. , Mugrabi M. , Claffey N.
Published: December 2005

Abstract This study was designed to investigate, using 6 beagle dogs, the levels of selected putative pathogens in healthy sites, in gingivitis sites, and in sites with histologically confirmed attachment loss. Levels of attachment loss increased with increasing periods of ligation and reached a maximum of 0.15 mm at 57 days. Both histological attachment level and histological pocket depth were found to vary significantly with health/disease status (P<0.0001). Higher numbers of total colony‐forming units were seen for ligated sites than for healthy and gingivitis sites. Levels of Purphyromonas gingivalis and Prevotella intermedia also changed significantly with health/disease status (p<0.001). These organisms showed their greatest increases at the time of the most intense attachment loss. Higher levels of Fusobaeterium nucleatum were seen in the gingivitis sites than in healthy or Heated sites. Low levels of Campylobacter rectus and Capnocytophaga spp. were detected throughout. The morphometric microbiological analysis revealed unexpectedly high %s of motile rods, while spirochetes were found in very low %s. The total number of bacterial cells detected using phase contrast microscopy was not found to vary significantly. None of the morphotypes were demonstrated as showing significant changes with health/disease status.
The relationship between clinical attachment loss and the duration of insulin‐dependent diabetes mellitus (IDDM) in children and adolescents
Authors: Firatli Erhan , Yilmaz Oya , Onan Utku
Published: December 2005

Abstract The periodontal status of 77 diabetic children and adolescents, and 77 paired, systemically‐healthy, sex‐ and age‐matched control subjects, was clinical examined. Fasting blood glucose, fructosamine and glycosylated haemoglobin (HbAl) values were determined. The mean periodontal pocket depths, clinical attachment levels and the parameters to assess diabetes mellitus from the diabetic group were significantly higher than those of the controls. We found a positive correlation between the duration of diabetes and clinical attachment loss, but not with periodontal probing depth, plaque index and gingival index in the diabetic group. A positive correlation was also assessed between the present serum fructosamine and gingival index in the diabetic group, but not in controls.
Systemic antimicrobial treatment and guided tissue regeneration Clinical and microbiological effects in furction defects
Authors: Mombelli Andrea , Zappa Urs , Bragger Urs , Lang Niklaus P.
Published: December 2005

Abstract The purpose of this investigation was to study the microbiota associated with furcation‐involved teeth before and after treatment by the guided tissue regeneration procedure (GTR) with non‐resorbable ePTFE membranes, and to evaluate the benefit of additional systemic antimicrobial therapy (ornidazole). Each of 10 patients contributed 1 pair of bilateral mandibular molars with comparable furcation defects. 5 defects were treated with a membrane and the active drug, 5 were treated without a membrane but with the active drug. 5 were treated with a membrane and a placebo, and 5 were treated with neither a membrane nor the active drug. Considerable differences were found in the healing response of furcation defects treated with or without the antimicrobial agent. More horizontal attachment gain and increase in bone density was obtained in patients receiving the active drug than in patients receiving the placebo. With 1 exception, all sites with increasing horizontal probing depth were found in patients of the placebo group. Treatment with membrane plus ornidazole resulted in 0.7 mm mean recession and ‐1.2 mm mean decrease in horizontal probing depth. Sites treated with membranes generally tended to be positive for 15 target micro‐organisms more often than sites treated without a membrane. This was particularly evident for Fusobacterittm, Prevotella intermedia and Adinomyces odonlolyticus. Whereas GTR‐treated sites were often already positive upon removal of the membrane, re‐emergence of target organisms seemed to be more delayed in the conventionally‐treated sites.
Colonization by Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in adult periodontitis patients as detected by the antibody‐based Evalusite Test
Authors: Boyer Bradley P. , Ryerson Carol C. , Reynolds Homer S. , Zambon Joseph J. , Genco Robert J. , Snyder Brian
Published: December 2005

Abstract Studies were performed lo evaluate the detection of disease‐associated bacterial colonization in adult periodontitis patients by the antibody‐based Evalusite TestTM(Eastman Kodak Company. The association of test results with disease was assessed by collecting 104 duplicate subgingival plaque samples from 26 patients. Samples were tested for Actinobacillus actinomycetemeomitans. Porphyromonas gingivalis and Prevotella intermedia using both microbiological culture and the immunoassay test. The sensitivity and specificity of the 2 methods was calculated using %s of positive results in deep periodontal pockets and negative results in shallow subgingival sites. A cutoff > 104 cultivable counts yielded the greatest discrimination between health and disease on a cross‐sectional basis and established this threshold as clinically relevant for the detection of disease‐associated levels of bacterial colonization by these three microorganisms. The clinical detection limit of the immunoassay test was observed to coincide with this threshold of >104 cultivable counts. Microbiological testing of the 4 deepest pockets using the immunoassay test was determined to be sufficient to yield a 90% confidence of detecting positive patients in a study with 59 adult subjects. The immunoassay test method was also demonstrated to be effective at detecting bacterial colonization in sets of paper point samples that were pooled for analysis. An overall agreement of 94% (288 of 306) was observed when comparing test results for duplicate sets of pooled and individual samples collected from 51 patients. These studies demonstrate that the Evalusite Test is an effective method for detecting clinically relevant colonization by the test bacteria in patients at risk for periodontal disease.
Stress and the progression of periodontal disease
Authors: Linden Gerard J. , Mullally Brian H. , Freeman Ruth
Published: December 2005

Abstract This study examined the association between occupational stress and the progression of periodontitis in employed adults. 23 regular dental attenders, enrolled in a longitudinal study of periodontal disease, were examined on 2 occasions at an interval of 5.5 (SD 0.6) years. The mean age at the 2nd examination was 41.1 (SD 7.3) years. Clinical measurements of periodontal status including clinical attachment level were made at four proximal sites on all teeth. A questionnaire, the occupational stress indicator, was used at the second examination to assess stress retrospectively. The mean change in clinical attachment level was 0.63 (SD 0.42) mm and 9.6 (SD 8.6) % of sites measured at both examination lost ≥3 mm of periodontal attachment. Multiple regression analysis was used to explore the relationship between mean loss of periodontal attachment and measures of occupational stress and sociodemographic data. In the final regression model, an increase in loss of periodontal attachment was significantly predicted by increasing age, lower socio‐economic status, lower job satisfaction and type A personality. In addition, locus of control was included in the regression model which explained 65% of the variance in the loss of periodontal attachment. The results suggest that occupational stress may have a relationship to the progression of periodontitis.
The relationship of gingival crevicular fluid short chain carboxylic acid concentration to gingival inflammation
Authors: Niederman R. , Buyle‐Bodin Y. , Lu B.‐Y. , Naleway C. , Robinson P. , Kent R.
Published: December 2005

Abstract Short‐chain carboxylic acids (SCCA; C≤5: e.g., lactic acid, propionic acid, butyric acid) are metabolic by‐products of bacterial metabolism which accumulate in the gingival crevice, and exhibit significant biological activity, including the ability to alter gene expression. It has been hypothesized that among the activities of SCCAs are their ability to contribute to gingival inflammation. This concept complements the notion that specific periodontal pathogens are the causative agents of gingival inflammation. To begin testing these 2 hypotheses, we examined the relationship between SCCA concentrations, specific putative periodontal pathogens, and gingival inflammation in medically healthy periodontally diseased subjects. We reasoned that if SCCAs and/or specific periodontal pathogens were causative gingival inflammatory agents, gingival inflammation should increase with increasing concentration of the inflammatory mediator. We also recognized that other clinical variables needed to be controlled for, and an objective quantitative assessment of gingival inflammation used. To accomplish these tasks, sites within subjects were stratified by location and pocket depth, and the following quantified: bacteria] presence; SCCA concentration: and gingival inflammation. The results indicated that gingival inflammation directly and significantly correlated with SCCA concentrations in the maxillary and mandibular molars, incisors and canines (all r≥0.47; all p≤ 0.015; too few bicuspids were available for complete analysis). The relationship between gingival inflammation and SCCA concentration was best described by a natural log relationship. Gingival inflammation did not, however, correlate positively with either the total number of specific putative periodontal pathogens, or the sum of subsets of these pathogens (−0.31 ≤r≤ 0.39; 0.08 ≤p 0.75) for any of the locations. Finally, the SCCA concentration did not correlate with the level of individual or groups of pathogens. These data, together with historical work and other preliminary data, support the hypothesis that SCCA, rather than specific putative periodontal pathogens, may be a causative agent in gingival inflammation. This work may, in part, begin to explain the apparent lack of a direct relationship between current gingival inflammation and the prediction of bacterially mediated periodontal attachment loss.
Gingival fluid tetracycline release from bioerodible gels
Authors: Maze Glenn I. , Reinhardt Richard A. , Payne Jeffrey B. , Maze Connie , Baker Robert A. , Bouwsma Otis J. , Damani Nalin C. , Fitzgerald Jamesina , Hamlin Janet C. , Gerlach Robert W.
Published: December 2005

Abstract Intracrevicular antimicrobial therapy is consistent with the site‐specific nature of periodontitis. Considerable research has focused on the use of nonresorbable fibers. However, a bioerodible system is desirable. The purpose of this study was to assess tetracycline release and safety following a single application of a syringable 35% tetracycline hydrochloride in a lactic‐glycolic acid gel. 31 generally healthy adult volunteers (mean age=59 years) were enrolled in and completed this randomized, double‐blind eight day study. 2, 6‐10 mm non‐adjacent interproximal pockets that bled on pocket probing were chosen as experimental sites in each subject. 1 experimental site and the surrounding gingival crevice received small particle size tetracycline m gel while the other site received larger particle size tetracycline in gel. Gingival crevicular fluid (GCF) was collected prior to treatment and 15 min. 1, 2, 3, 4 and 8 days post‐treatment. GCF tetracycline concentrations were determined by agar diffusion bioassay and GCF volume measurements. 61% and 71% of sites had ≥100 μ/ml tetracycline 3 days following application of large (mean concentration = 430±92 μ/ml) and small particle gels (mean concentration = 418±70 μg/ml). respectively. 37% and 55% of sites had measurable tetracycline 8 days after placement of large (mean concentration =86±31 μg/ml) and small particle gels (mean concentration =293 ±79 μg/ml), respectively. The most common adverse event was “bitter taste” (10% of subjects). Based upon the reduction in probing depths and % of sites bleeding on probing at 8 days relative to pretreatment. and the absence of any serious adverse events, it is concluded that these bioerodible gels are safe, and since the bacteriostatic range for most putative periodontopathogens is in the 2‐10 μg/ml range, the tetracycline levels observed at days 3 and 8 likely represent significant antimicrobial efficacy.
Oral mucosal desquamation of pre‐ and post‐menopausal women
Authors: Herlofson Bente Brokstad , Barkvoll Pål
Published: December 2005

Abstract The aim of the present study was to investigate whether a difference in susceptibility to chemically induced irritation of the oral mucosa in 14 pre‐ and 14 post‐menopausal women exists, following local exposure to sodium lauryl sulphate (SLS) in toothpastes. 4 different pastes differing only in detergent concentration present, or not, were used. The participants applied 1 cm of the different test toothpastes to a cap splint covering the teeth and the oral mucosa of the upper jaw 2 × daily for 2 min during a period of 4 days. 42 desquamative reactions of the oral mucosa (in 20 subjects) were observed. 29 and 13 in the pre‐ and the post‐menopausal group, respectively. Desquamation was only experienced following exposure to SLS‐containing toothpastes, not succeeding SLS‐free paste. The results demonstrated that oral mucosa of pre‐menopausal women was significantly more sensitive to SLS than oral mucosa of post‐menopausal women. The difference in mucosal irritation between the 2 groups increased with increasing concentration of SLS.
The pathogenesis of drug‐induced gingival overgrowth
Authors: Seymour R. A. , Thomason J. M. , Ellis J.S.
Published: December 2005

Abstract Gingival overgrowth is a well‐documented unwanted effect, associated with phenytoin, cyclosporin. and the calcium channel blockers. The pathogenesis of drug‐induced gingival overgrowth is uncertain, and there appears to be no unifying hypothesis that links together the 3 commonly implicated drugs. In this review, we consider a multifactorial model which expands on the interaction between drug and/or metabolite, with the gingival fibroblasts. Factors which impact upon this model include age. genetic predisposition, pharmacokinetic variables, plaque‐induced inflammatory and immunological changes and activation of growth factors. Of these, genetic factors which give rise to fibroblast heterogeneity, gingival inflammation, and pharmacokinetic variables appear to be significant in the expression of gingival overgrowth, A more thorough understanding of the pathogenesis of this unwanted effect will hopefully elucidate appropriate mechanisms for its control.
Microbiological monitoring
Authors: Mombelli Andrea
Published: December 2005

Absrtract If periodontal disease is due to a limited number of bacterial species, then continuous maximal plaque suppression is not the only possibility for prevention and therapy. Specific elimination or reduction of pathogenic bacteria from plaque becomes a valid alternative. Recent studies indicate that the elimination of certain putative pathogens is particularly difficult. New diagnostic methods should allow the choice of better suited procedures, make chosen procedures more effective (through better timing, dosage, selection of devices or drugs, increase of specificity, etc.) or lead to the elimination of unnecessary work (e.g., the treatment of non‐susceptible sites or patients). The benefit of newly proposed tests depends on the possible impact of the obtained information on clinical decisions and on the consequences these decisions have for treatment. Thus, diagnostic methods and therapeutical options have to be evaluated together.
The optimization of the BANA test as a screening instrument for gingivitis among subjects seeking dental treatment
Authors: Loesche Walter J. , Kazor Christopher E. , Taylor George W.
Published: December 2005

Abstract Porphyromonas gingivalis, Treponema denticola and Bacteroides forsythus have been implicated in periodontal disease and each possesses an enzyme capable of hydrolyzing the synthetic trypsin substrate, BANA. We have used a chairside test for BANA hydrolysis to diagnose an anaerobic periodontal infection in patients with advanced forms of clinical disease using a 15‐min/55°C incubation protocol. However, the BANA test performance is dependent upon the length and temperature of incubation. In the present study, we have evaluated a 5‐min/35°C. a 5‐min/55°C and a 15‐min/55°C incubation protocol to determine whether the performance of the BANA test could be optimized using plaque samples obtained from subjects seeking dental treatment. Logistic regression models were tested with age, smoking status, and gingivitis scores as covariates. The best fitting model obtained with the 5‐min/35°C protocol had a sensitivity of 71%, a specificity of 68%, a false‐positive proportion of 9%, a false‐negative proportion of 65%, and an overall accuracy of 80%. When maximum likelihood estimates were obtained in this model, plaques from individuals who reported that they currently smoked were 9.57×, and those who quit smoking were 4.73× more likely to have a positive BANA score than someone who never smoked. Plaques were 4.55× more likely to be BANA‐positive if they were removed from sites with gingivitis. These findings indicate that the performance of the BANA test is best using the 5‐min/35°C incubation protocol.
A clinical evaluation of a bioresorbable barrier with and without decalcified freeze‐dried bone allograft in the treatment of molar furcations
Authors: Luepke Paul G. , Mellonig James T. , Brunsvold Michael A.
Published: December 2005

Abstract This study evaluated a bioresorbable barrier with and without decalcified freeze‐dried bone allograft (DFDBA) in the treatment of human molar furcations. 14 subjects with paired class II mandibular molar furcation defects participated in the study (8 male and 6 female). The class‐II furcation defects were randomly treated with either the resorbable barrier alone or resorbable barrier in combination with decalcified freeze‐dried bone allograft (DFDBA). Gingival recession, probing depth, clinical attachment, and bone fill were measured. 6 months post‐treatment measurements were repeated and each site was surgically re‐entered. When the resorbable barrier alone was compared to resorbable barrier in combination with DFDBA. probing depth reduction was significantly (p<0.01) in favor of the combination therapy. Vertical bone gain was significant with the combination treatment demonstrating more bone fill (p<0.02). Smoking was also a variable examined in this study. When compared to smokers, non‐smokers for both treatment groups revealed greater probing depth reduction, vertical bone gain, and horizontal bone gain. Within the non‐smoking group, probing depth reduction was also significantly higher for the resorbable barrier and DFDBA group than the resorbable alone group (p<0.02). These results illustrate that the probing depth reduction is better in the non‐smoker and the best in the non‐smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone.
Periodontal disease related to diabetic status
Authors: Tervonen Tellervo , Karjalainen Kaisa
Published: December 2005

Abstract Variation in the periodontal health status and the response to oral hygiene education, scaling and root planing were studied in 36 subjects with type‐1 diabetes mellitus (DM) and in 10 non‐diabetic control subjects. The age range of the subjects was 24–36 years. The diabetic group was divided into 3 subgroups based on the levels of glycosylated hemoglobin (HbAlc) over a 3 year period and the presence of diabetic complications as follows: (Dl) subjects with good metabolic control and no complications (n=13) (D2) subjects with varying metabolic control with/without retinopathy (n=15) and (D3) subjects with severe diabetes, i.e., with poor long‐term control and/or multiple complications (n= 8). Clinical measurements (plaque, subgingival calculus, probing pocket depth, bleeding after probing and clinical attachment level) were performed at the baseline and 4 weeks and 6 and 12 months after periodontal therapy. The between‐group comparisons were made using the Student r‐test and ANOVA. Based on the plaque scores, the oral hygiene status was similar in all groups during the whole study. No statistically‐significant differences in the periodontal health status could be found between the diabetic group as a whole and the non‐diabetic controls at any examination. The level of periodontal health of the diabetics with good control and no complications (Dl) and those with moderate control with/ without retinopathy (D2) was on the same level with that seen in the non‐diabetic controls. Our findings of the significantly higher extent of al ≥ 2 mm at the baseline and the fast recurrence of pd ≥4 mm during the longitudinal study in diabetic subjects with poor metabolic control and/or multiple complications (D3) indicate increased periodontal breakdown as a complication of DM in these subjects. To be able to assess the periodontal prognosis and the need for periodontal therapy on an individual basis, the clinical practitioner should be well aware of the diabetic status of his/her patients.
The effects of C02, Nd: YAG and Er: YAG lasers with and without surface coolant on tooth root surfaces
Authors: Israel Michael , Cobb Charles M. , Rossmann Jeffrey A. , Spencer Paulette
Published: December 2005

Abstract The objective of this study was to compare and contrast the morphologic changes in tooth root surfaces treated in vitro by scaling and root planing followed by irradiation with the Er: YAG laser using air/water surface cooling and the C02 and Nd:YAG lasers, both with and without surface coolant. The experimental unit consisted of 42 freshly extracted teeth which were divided equally and randomly assigned to the following 7 treatment groups: untreated control, S/RP only. CO2 laser with and without air/water surface cooling, Nd:YAG laser with and without/air water surface cooling, and Er:YAG laser with air/water surface coolant. Specimens treated with CO2 laser irradiation were subjected to energy densities ranging from 100 to 400 J/cm2: those treated with the Nd:YAG from 286 to 1857 J/cm2: and the Er:YAG was used within a range of 20 to 120 J/cm2. The degree of morphologic change following CO2 and Nd:YAG irradiation appeared directly related to energy density but unrelated to the use of surface coolant. Laser induced surface changes included cavitation, globules of melted and resolidified mineral, surface crazing, and production of a superficial char layer. In contrast, the Er:YAG laser produced root surface changes that might be expected from acid etching, i.e., removal of the smear layer and exposure of the collagen matrix. In addition, sharply denned microfractures of the mineralized structure were noted and unlike the CO2 and Nd:YAG lasers, there was no evidence of melting or surface char. Given the parameters of this study, it appears that both the CO2 and Nd:YAG lasers alter the root surface in an undesirable manner. The Er:YAG laser, however, when used at low energy densities shows sufficient potential for root surface modification to warrant further investigation.
Therapy‐resistant periodontitis (II). Compliance and general and dental health experiences
Authors: Axtelius B. , Söderfeldt B. , Edwardsson S. , Attström R.
Published: December 2005

Abstract In this exploratory case‐control study, somatic and psychological factors are used for exploring whether the anamnestic information gives support to the hypothesis of a relationship between therapy‐resistant periodontitis and stress factors. From retrospective comparisons of pocket probing depth charts, we classified 22 patients as either non‐responding or responding to periodontal treatment. The non‐responding patient group, in comparison with the responding patient group, showed a profile over time of less pocket probing depth (PPD) reduction in response to periodontal treatment. Information registered in each patient's file regarding periodontal registrations and dental status was gathered, and an interview was conducted aiming at collecting information on dental experiences and attitudes. Bivariate and logistic multivariate regression analyses were performed. The NR‐group patients experienced significantly more unpleasant feelings towards dental procedures and a higher tendency to experience pain in connection with dental procedures. This group was found to start smoking at an older age than the R‐group. One reason for this may be that smoking debut at an older age is more related to stress conditions than debut at a younger age. The report highlights the possible contribution of stress factors in periodontal disease.
Formulation of enamel matrix derivative for surface coating
Authors: Gestrelius Stina , Andersson Christer , Johansson Ann‐Christin , Persson Eva , Brodin Arne , Rydhag Lisbeth , Hammarström Lars
Published: December 2005

Abstract Enamel Matrix Derivative (EMD) contains a protein complex belonging to the amelogenin family. Enamel matrix as well as EMD have been found to promote periodontal regeneration when applied onto denuded root surfaces in dehiscence models. In the present studies it is shown that propylene glycol alginate (PGA) is a suitable vehicle for EMD for its local application. EMD can be dissolved in PGA at an acidic pH, resulting in a highly viscous solution. At neutral pH and body temperature the viscosity decreases and EMD precipitates. Multilayers of EMD on mineral or protein surfaces have been analysed using ellipsometry, total internal reflection fluorescence (TIRE) and biospecific interaction analysis (BIA). The studies show that EMD adsorbs both to hydroxyapatite and collagen and to denuded dental roots. It forms insoluble spherical complexes, and detectable amounts remain at the site of application on the root surface for two weeks, as shown with radiolabelled protein in rats and pigs. Scanning electron micrograph (SEM) studies on monkey teeth further indicate that EMD in PGA may promote repopulation of fibroblast‐like cells during the first weeks after application.
The relationship of bone loss observed on panoramic radiographs with clinical periodontal screening
Authors: Walsh T.F. , Al‐Hokail O.S. , Fosam E. B.
Published: December 2005

Abstract The aim of this study was to determine the relationship between bone levels observed on dental panoramic tomographs (DPT) and the WHO/FDI recommended periodontal screening technique: the community periodontal index of treatment needs (CPITN). Computer enhancement and digital analysis were used to improve accuracy and reliability. A total of 199 posterior sextants on DPT radiographs from 50 patients (29 female and 21 male) with a mean age of 42 were examined. A statistically significant relationship was found between CPITN and radiographic measurement from the cemento‐enamel junction to the alveolar crestal bone margin (A). The relationship between A and CPITN was found to fit the following equation: √A=βi+F, where, F is constant and βi is the coefficient corresponding to the i th codes of CPITN. It was concluded that there was a close correlation between the CPITN screening codes and bone loss as measured on the DPT radiograph.
Gingival recession Reappraisal of an enigmatic condition and a new index for monitoring
Authors: Smith Roger G.
Published: December 2005

Abstract Gingival recession (GR) is an intriguing Abstract. condition. This brief communication, after proposing a definition for GR, considers the possible relevance of anatomical, physiological, pathological and traumatic factors in its etiology. It is probable that no one factor in isolation leads to the development of GR. Because of the possible influence of several factors, not necessarily acting synchronously, the occurrence of GR at a given site may be difficult to explain fully, and any subsequent changes may be hard to predict. The importance of the CEJ (or other fixed point) in assessment of GR severity is discussed. A new two‐figure Index of Recession (IR) (e.g., F2‐4asterisk) is also described, in which the 1st digit relates to the proportional evaluation of the horizontal extent of GR at the level of CEJ, and the 2nd digit is the vertical extent of GR from CEJ in millimetres; the asterisk denotes involvement of the MGJ. The prefixed F (or L) denotes whether GR is facial (or lingual) to the involved root.
A study to investigate the effect of a propolis‐containing mouthrinse on the inhibition of de novo plaque formation
Authors: Murray M. C. , Worthington H. V. , Blinkhorn A. S.
Published: December 2005

Abstract The results of a study to investigate the effectiveness of a propolis‐containing mouthrinse in the inhibition of de novo plaque formation are presented. Subjects used a propolis‐containing rinse, a negative control and a positive control in a double‐blind, parallel, de novo plaque formation study design. The chlorhexidine mouthrinse was significantly better than the others in plaque inhibition. The propolis‐containing rinse was marginally better than the negative control, but this difference was not significant.
Development of resistance to metronidazole and minocycline in vitro
Authors: Larsen Tove , Fiehn Nils‐Erik
Published: December 2005

Abstract By local delivery of antibiotics to periodontal pockets, very high initial concentrations are often quickly succeeded by subinhibitory concentrations, which may facilitate development of bacterial resistance. The purpose of the present study was to investigate possible development of resistance in suspected periodontal pathogens after exposure to subinhibitory concentrations of metronidazole and minocycline. The minimal inhibitory concentration (MIC) of 18 reference strains and 12 clinical isolates was determined by a broth dilution method. Subsequently, all strains with MIC<8 μg/ml were exposed to serial passage on plates containing subinhibitory and gradually increasing concentrations of antibiotics, until growth was inhibited. Initially, most strains were inhibited at ≤0.250 μg/ml of minocycline and ≤0.5 μg/ml of metronidazole, though A. actinomycetemcomitans was resistant to metronidazole. After growth at subinhibitory concentrations, 8 strains survived 1‐2× and 11 stains survived 8–32× their initial MIC of metronidazole, growing at up to 8 μg/ml. All A. actinomycetemcomitans survived 8–64 × their initial MIC of minocycline, growing at ≥2 μg/ml, while all other strains were inhibited at ≤0.250 μg/ml, corresponding to a 1–8× increase in their initial MIC. Thus, development of resistance was observed for periodontal bacteria growing at up to 64× their initial MIC, but the final level of resistance was moderate.