bluuebunny/crossref_metadata_2025 huggingface dataset:
Variance component modeling of attachment level measurements
Authors: Gunsolley J. C. , Williams D. A. , Schenkein H. A.
Published: December 2005

Abstract The purpose of this study was to investigate the influence of within subject and within tooth variability of attachment‐level measurements on hypothesis testing. Full‐mouth attachment‐level measurements were obtained at 4 sites per tooth in early onset periodontitis subjects (both localized N= 89 and generalized N= 139) and adult periodontitis subjects (N= 309). Variance component models utilizing iterative generalized least squares were employed to estimate the % of variance distributed at the level of the site, tooth and subject in the 3 subject populations. The data indicate that a significant % of the variance is distributed within the tooth and the subject. Ignoring the variance attributable to teeth or subjects can result in inappropriately low type I error rates for hypothesis testing. Thus, both the subjects and the tooth must be considered in the modeling of attachment level measurements. Also in studies in which a limited number of samples are taken, data analysis would be simplified if these samples were taken from different teeth.
Collagenase, gelatinase and elastase activities in sulcular fluid of osseointegrated implants and natural teeth
Authors: Ingman Tuula , Könönen Mauno , Konttinen Yrjö T. , Siirilä Hannu S. , Suomalainen Kimmo , Sorsa Timo
Published: December 2005

Abstract Proteinases play a key rôle in the physiological degradation and remodelling of the periodontal tissues. The rôle of these enzymes in tissue remodelling in connection with the insertion of dental endosseous implants has not been elucidated. Therefore, the aim of the present study was to identify the eventual presence of collagenase, gelatinase and elastase activities in periimplant sulcus fluid (PTSF) of osseointegrated implants. Gelatinolytic activity in the samples was studied with gelatin‐zymograms. Collagenase activity and its susceptibility to tetracycline‐inhibition were monitored with SDS‐polyacrylamide gel electrophoresis and laser densitometry, and elastase activity with synthetic substrate. Low activities of elastase and collagenase were detected in both PISF of osseointegrated implant patients and gingival crevicular fluid (GCF) of the control patients whereas significantly higher activities were delected in GCF of adult periodontitis patients. Also the profiles of gelatinases were similar in PISF of osseointegrated implant patients and GCF of the controls, but differed from the profile of active gelatinases present in GCF of adult periodontitis patients. The similar activities/characteristics of these proteinases in both periimplant sulcus fluid of healthy dental implants and GCF of healthy natural teeth suggest that they comprise the major proteinases for both periodontal and periimplant tissue remodelling or destruction.
Alveolar bone loss in 5‐year‐old New Zealand children: its prevalence and relationship to caries prevalence, socio‐economic status and ethnic origin
Authors: Bimstein E. , Treasure E. T. , Williams S. M. , Dever J. G.
Published: December 2005

Abstract This study investigated the prevalence of alveolar bone loss (ABL) in 5‐year‐old New Zealand children. The relationship of bone loss with the prevalence of caries, socio‐economic status and ethnic origin was examined. Standardized bite‐wing radiographs from 317 children were used to examine the alveolar bone in 1784 sites. Questionable bone loss (QBL) was evident in 8.5% of the children and definite bone loss (DBL) in 2.1%. The children with suitable radiographs had a mean dmft of 1.8. ± 2.9. and mean dmfs of 2.7. ± 5.0. When the children were divided into 3 groups having no bone loss (NBL), QBL only or DBL, analysis of variance on the logarithmic transformation of both the dmft and dmfs scores showed significant differences among the groups. Post hoc tests showed that the means for the DBL group were significantly different from those of the other 2 groups for both dmft and dmfs scores. Logistic regression analysis indicated that the odds ratio for having definite alveolar bone loss was slightly increased in children with a dmft of ≥9.
Tooth mobility and resolution of experimental periodontitis
Authors: Giargia Marco , Ericsson Ingvar , Lindhe Jan , Berglundh Tord , Neiderud Anne‐Marie
Published: December 2005

Abstract The aim of the present experiment was to study alterations in the mobility of teeth that occurred during resolution of experimentally induced periodontitis lesions in the dog. 5, 1‐year‐old, beagle dogs were used in the study. The left and right 4th, 3rd, and 2nd mandibular premolars (4P4, 3P3, 2P2) served as experimental teeth. Periodontal tissue breakdown was initiated by placing plaque‐collecting cotton‐floss ligatures around the neck of the experimental teeth. The ligatures were replaced to the level of the receding gingival margin 1 × every month. On Day 120, the ligatures were removed and debridement was performed. A groove, parallel to the long axis of the mesial root, was prepared in the mesio‐buccal surface of the crowns of 2P and P2. Guided by the groove and with a probing force of 0.5 N, a probe was inserted into the buccal gingival pocket of the mesial root and was attached to the buccal surface. Biopsies including both the mesial and distal root of 2P and P2 and the surrounding hard and soft tissues were harvested. The biopsy procedure was repeated in a similar manner 15 days (i.e. Day 135) and 3 months (i.e. Day 225) after ligature removal in the 4th (4P4) and 3rd (3P3) premolar regions. After fixation, decalcification and sectioning, the biopsy material was exposed to histometric and morphometric measurements. Assessment of the mobility of the experimental teeth was performed on Days 120, 135 and 225 using the Periotest system. The amount of remaining bone at the experimental teeth was evaluated in radiographs obtained in a standardized manner. The findings of the present experiment disclosed that in dogs allowed to form plaque, the placement of cotton‐floss ligatures at the neck of mandibular premolars initiated a process that resulted in (i) the formation of an inflammatory lesion which extended deep into the supracrestal connective tissue; (ii) extensive loss of alveolar bone; (iii) markedly increased tooth mobility. It was also observed that, within a 4‐month period the removal of the ligature and, as a consequence, a substantial portion of the subgingival microbiota, reduced the size and the apical extension of the inflammatory lesion in the supracrestal connective tissue. The alterations in the soft supracrestal tissue were accompanied by a marked decrease in the mobility of the experimental teeth and a reduced probing pocket depth. It was suggested that the reduced penetration of the probe was the result of the change in the size and position of the infiltrate as well as of a reduced mobility of the experimental teeth.
Ankylosis of the mouse molar after systemic administration of 1‐hydroxyethylidene‐1,1‐bisphosphonate (HEBP)
Authors: Wesselink P. R. , Beertsen W.
Published: December 2005

Abstract The proposed homeostasis between fibroblasts in the periodontal ligament and bone cells lining the inner aspect of the alveolar wall is thought to be responsible for maintaining the width of the periodontal ligament space. In the present study, we attempted to interfere with this cellular balance by systemic administration of 1‐hydroxyethylidene‐1, 1‐bisphosphonate (HEBP). The maxillary left molars of mice were extracted. They then received a daily subcutaneous injection of HEBP (10 mg P/kg b.w.) for periods of 10, 30 or 50 days. A 2nd group of animals received HEBP without molar extraction. Control groups were injected with Ringer's solution. The animals were sacrificed after the last injection and the mandibles processed for light and electron microscopy. HEBP treatment caused a significant decrease of the width of the periodontal ligament space which was influenced by time. Ankylosis started to occur after 30 days, predominantly in the interradicular areas and was more common around unopposed teeth. At 50 days, signs of resorption were seen along the acellular cementum layer. During HEBP‐administration, extensive deposition of newly formed cementum matrix was observed along the cellular cementum but this activity was not seen along the acellular cementum. It is concluded that HEBP interferes with the mechanisms that mediate preservation of the periodontal ligament width.
Type I collagen carboxyterminal telopeptide in human gingival crevicular fluid in different clinical conditions and after periodontal treatment
Authors: Talonpoika J. T. , Hämäläinen M. M.
Published: December 2005

Abstract.A total of 126 gingival crevicular fluid (GCF) samples were collected from 20 adults using paper strips. Patients were divided into a periodontitis‐affected group (13 subjects) and a periodontitis‐free group (7 subjects) by pocket depth and radiological bone loss. 4 subjects from the periodontitis‐affected group received a single episode of periodontal treatment (scaling, root planing and curettage) and GCF samples were collected 2, 5, 10, 20 and 40 days after treatment. Type I collagen carfaoxyterminal telopeptide (ICTP) in GCF was extracted into saline solution and determined by a radioimmunological method. Mean GCF ICTP concentration was 425 μg/1 (SEM 45) in periodontitis patients and 148 μg/l (SEM 25) in periodontitis‐free subjects, i.e., GCF ICTP concentrations were about 100 × higher than serum reference values. Significant positive correlations were found between GCF ICTP total amount per site and plaque index (R= 0.362), papilla bleeding index (R= 0.259), pocket depth (R= 0.464) and radiological bone loss (R= 0.418). Periodontal treatment decreased GCF JCTP concentration to the level seen in healthy subjects. However, large variations were seen between subjects and sites. ICTP levels below the detection limit were often found in deep pockets, as well as high values in periodontitis‐free subjects. It was concluded that GCF ICTP reflects the local type I collagen degradation in periodontal tissues, and probably gives information about the tissue destruction process beyond the reach of the clinical parameters.
Osteocalcin, prostaglandin E2 and alkaline phosphatase in gingival crevicular fluid: their relations to periodontal status
Authors: Nakashima Koichi , Roehrich Nicolas , Cimasoni Giorgio
Published: December 2005

Abstract. Prostaglandin E2 (PGE2) and alkaline phosphatase (ALP) have often been measured in gingival crevicular fluid (GCF) as possible indicators of gingival inflammation and bone metabolism. Osteocalcin (OC), a major component of bone matrix, is mainly produced by osteoblasts, and could also be considered as a marker of bone turnover. The aims of this preliminary study were lo examine if OC was present in GCF and to assess the relationships of OC, PGE2, and ALP in GCF to periodontal conditions. GCF samples were collected with durapore strips from 34 healthy, 12 gingivitis and 118 periodontitis sites in 17 subjects. ELISA techniques were used for the determinations of OC and PGE2. ALP was measured spectrophotometrically by using p‐nitrophenyl phosphate as substrate. Total amounts and concentrations of PGE2 and ALP were significantly higher in periodontitis as compared to healthy and gingivitis sites, and were significantly and positively correlated with probing depth (PD) and gingival index (GI). OC was present in GCF from both healthy and diseased sites with mean concentrations more than ten times greater than normal serum levels. Total OC amounts from strips soaked with GCF from periodontitis sites were significantly higher than those Found in healthy and gingivitis sites. When the data were expressed as concentrations, OC showed significantly positive correlations with GI, but not with PD. However, total amounts of OC significantly correlated with both clinical parameters. OC, PGE2 and ALP were found to have significantly positive correlations with each other, both when expressed as total amounts and concentrations. These data suggest that a significant amount of OC present in GCF is produced locally by periodontal tissues. Total OC amounts in GCF, as well as PGE2, and ALP levels, can be considered as potential markers of periodontitis. However, in order to better define the capacity of such mediators for diagnosis, additional longitudinal studies are needed.
Control of supragingival calculus
Authors: Addy Martin , Koltai Robert
Published: December 2005

Abstract. The removal of supragingival calculus by scaling and polishing of the teeth is only one aspect of a dental prophylaxis. However in many countries, a large number of individuals only require and receive, at regular intervals, a supragingival scale and polish. The association of supragingival calculus to gingival and periodontal disease is unclear, however, it is logical to assume a plaque retention role. Moreover, for the individual, supragingival calculus may pose cosmetic problems. Regular calculus removal is both time consuming and exacting for dental professionals and has important financial implications to patients and/or health schemes. The benefits of regular supragingival calculus removal are not established, yet potential detrimental effects for the patient are known, and certain groups are susceptible to systemic disease consequent on scaling and polishing of the teeth. The oral hygiene habits of most individuals appear insufficient to prevent the reformation of supragingival calculus once removed and for this reason chemical inhibition is an attractive proposition. Most success to date has been with agents which inhibit crystal growth, notably pyrophosphates, and toothpaste products are available containing such agents. Clinical studies support efficacy for some products and indicate that the magnitude of calculus inhibition would reduce the need for or frequency of scaling and polishing of teeth in a proportion of individuals. Anticalculus toothpastes would appear to be proven worthy of recommendation for those individuals in whom supragingival calculus formation is a problem.
A comparison of periodontal disease among rural Amish and non‐Amish adults
Authors: Bagramian Robert A. , Farghaly Mahassen M. , Lopatin Dennis , Sowers MaryFran , Syed Salam A. , Pomerville Julie L.
Published: December 2005

Abstract. Periodontal disease can be more efficiently studied within a homogeneous population where genetic influences and lifestyles are similar enough to negate their effect on the disease process. This study focuses on an Amish population in southern Michigan who isolate themselves from outside influences and their non‐Amish neighbors. A total of 425 Amish and 290 non‐Amish were contacted resulting in 330 Amish and 215 non‐Amish who were examined in their homes giving a participation rate of 76.2%. Ages ranged from 18 to 82 years. Prevalence of periodontal disease tended to be higher among males and increased with age. There were slightly more Amish females (52%) than non‐Amish (49%). Means of periodontal conditions for Amish were 1.35 mm for attachment loss, 2.59 mm for pocket depth, 0.24 for calculus, 0.77 for plaque and 0.74 for gingivitis. For non‐Amish, the means were 1.03 mm for attachment loss, 2.38 mm for pocket depth, 0.40 for calculus, 0.95 for plaque and 0.87 for gingivitis. It is of interest that the Amish do not practice routine oral hygiene. Only 36.8% of Amish reported brushing at least 1 × a day compared to 84.6% of non‐Amish. Similarly, only 8.2% of Amish reported flossing at least 1 × a week compared to 40.8% of non‐Amish.
Pulsed laser beam effects on gingiva
Authors: Gold Steven I. , Vilardi Mario A.
Published: December 2005

Abstract. The effects of CO2 lasers on human gingiva have been evaluated. Pulsed Nd:YAG lasers have only been available for clinical use in dentistry since 1990. This study evaluated the efficacy of a low‐power pulsed laser in removing pocket lining epithelium in humans with moderate periodontitis. 24 specimens of gingival tissue, from 6 patients, were studied microscopically following the application of a pulsed Nd:YAG laser (1064 nm) contact probe with a spotsize of 320 μ. Power settings of 1.25 and 1.75 Watts and a frequency of 20 Hz were used. Treatment time varied from 2 to 3 min. The specimens were fixed and processed in the usual manner. Four representative sections for each tooth were examined with the light microscope at 25 and 100 × magnification. Most sections (83%) exhibited complete removal of epithelium except for traces of viable basal cell remnants at the coronal sulcular margin (17%). The underlying connective tissue demonstrated no evidence of necrosis or carbonization. Morphologic features showed minimal change other than removal of pocket lining epithelium, compared to control sites. The pulsed Nd‐YAG laser can remove pocket lining epithelium in moderately deep pockets at 1.25–1.75 W of power.
A comparison of cetylpyridinium chloride, triclosan and chlorhexidine mouthrinse formulations for effects on plaque regrowth
Authors: Jenkins S. , Addy M. , Newcombe R. G.
Published: December 2005

Abstract. A relatively small number of agents are used in mouthrinse products, although the possible variability in the final formulations is enormous. The aim of this study was to compare equal concentrations of 3 antimicrobial agents, in simple formulations, for plaque inhibition. This 4‐day plaque regrowth study was a 5‐cell, randomised, double blind cross‐over design, involving 20 healthy human volunteers. The mouthrinse formulations were aqueous 0.05% solutions of cetylpyridinium chloride (CPC), chlorhexidine and triclosan, together with a 0.1% CPC and a minus active control rinse. On Day 1, from a zero plaque baseline, volunteers ceased normal oral hygiene and rinsed 2 × daily for 1 min. with 10‐ml volumes of the allocated rinses. On Day 5, plaque was scored by index and area. All rinses produced lower mean plaque values compared to control, but unlike the CPC and chlorhexidine rinses, the differences with triclosan did not always reach significance. The CPC and chlorhexidine rinses were always significantly more effective than the triclosan rinse. The greatest plaque inhibition was with 0.1% CPC although rarely significantly greater than the 0.05% CPC and chlorhexidine rinses which were similar in efficacy. The results indicate that further studies on lower concentration chlorhexidine solutions are warranted.
Neurogenic component in ligature‐induced periodontitis in the rat
Authors: Györfi A. , Fazekas Á. , Suba Zs. , Ender F. , Rosivall L.
Published: December 2005

Abstract. Effect of ligation on the vascular permeability in the gingiva and alveolar mucosa encircling the mandibular left 1st molar was studied in rats with and without capsaicin pretreatment. Vascular permeability was assessed by the Evans blue extravasation. Ligation caused a significant augmentation in vascular permeability of the gingivomucosal tissue at day 8 (right: 18.14±1.68 μg g−1; left (ligature): 38.21 ±2.43 μg g−1, n=8, p(0.001) and at day 14 (right: 20.31 ±1.71 μg g−1: left (ligature): 36.98±2.73 μg−1, n= 8, p(0.001). 4 days after ligation, no difference could be observed in vascular permeability in the oral mucosa of the ligated side (left: 23.14±1.21 μg−1) as compared to the side without ligature (right: 23.5±1.45μg g−1, n=8, NS). There was no elevation of vascular permeability of gingivomuscosal tissue around the ligation in rats pretreated with capsaicin either in newborn age (right: 23.92±1.76 μg g−1; left (ligature): 23.51±2.16 μg g−1, n=8, NS) or in adult age (right: 20.61±1.62 μg g−1; left (ligature): 20.85±1.07 μg g−1, n=8, NS). Light microscopical studies of oral mucosa revealed, that 8 and 14 days after the ligature placed around the mandibular left 1st molar of the rat, there resulted an accumulation of inflammatory cells in the connective tissue. There was no inflammatory reaction in the gingivomucosal tissue of the side of the ligature 4 days after ligature, neither could inflammatory reaction be detected 14 days following ligation in the oral mucosa of rats systemically pretreated with capsaicin either neonatally or in the adult. Based on these observations, it can be assumed that neurogenic mechanism plays a crucial role in the development of inflammation in the oral cavity induced by mechanical and/or bacterial stimulation frequently found in clinical practice.
A longitudinal study from prepuberty to puberty of gingivitis
Authors: Nakagawa Satomi , Fujii Hiromichi , Machida Yukio , Okuda Katsuji
Published: December 2005

Abstract A longitudinal study of 24 subjects progressing normally from prepuberty to puberty was undertaken to evaluate the effects of sex hormone levels on clinical and microbiologic parameters and on serum antibodies. During elementary school, at the beginning of the longitudinal monitoring, 2 groups, 12 subjects with gingivitis and 12 gingivitis‐free subjects, were selected and observed through puberty. Bone ages and self‐assessment of secondary sex characteristics were used to confirm puberty. A statistically significant increase in the proportions of Prevotella intermedia including Prevotella nigrescens and serum antibody levels against P. intermedia was seen in gingivitis group throughout the longitudinal study. Serum levels of testosterone in boys and estradiol and progesterone in girls was positively correlated with levels of P. intermedia and P. nigrescens. In puberty, a slight but significant increase in GI scores over prepuberty has been shown; however, there was no significant change in PII from prepuberty to puberty. Our study confirmed that there was a statistically significant increase in gingival inflammation and in the proportion of P. intermedia and P. nigrescens in puberty relative to the baseline value, except in the gingivitis‐free male group. Our findings suggest that these increases are correlated with elevation in systemic levels of the sex hormones.
Evaluation of the efficacy of a redox agent in the treatment of chronic periodontitis
Authors: Gibson M.T. , Mangat O. , Gagliano G. , Wilson M. , Fletcher J. , Bulman J. , Newman H. N.
Published: December 2005

Abstract A redox dye, methylene blue, was compared with subgingival root surface debridement and sterile water in the treatment of adult periodontitis. Plaque and gingival indices, bleeding on probing, and microbiological samples were obtained at baseline, and at 1, 4, 8 and 12 weeks following treatment. All subjects had matched pockets in each of the 4 quadrants, of 5 mm or more. One treatment consisted of 0.1% methylene blue gel irrigated professionally at 0, 1 and 4 weeks, and by subjects at days in between up to 4 weeks, at chosen sites within a randomly selected quadrant (split‐mouth design). A 2nd treatment was sterile water irrigation as above. A 3rd quadrant received subgingival debridement, and sites in the 4th received methylene blue incorporated into a slow‐release device of a biodegradable collagen alginate vicryl composite. All sites showed improvements in clinical and microbiological parameters. However, no statistically significant differences between treatment types were found for clinical measurements. Although plaque index tended to increase after week 1, gingival index was reduced, as was the papilla bleeding index. Probing depth reductions were approximately 1.2 mm for all treatments. Microbiological variables showed an increase in cocci and a decrease in motile organisms for all groups, the latter reaching statistical significance for subgingival debridement. The reductions in spirochaetes were significant for subgingival debridement and methylene blue by slow‐release. Culture demonstrated an increase in the aerobe:anaerobe ratio for all groups, which was statistically significant initially (weeks 1 and 4) for subgingival debridement. Methylene blue was also effective statistically in improving this ratio, both by irrigation and slow‐release (week 4). Methylene blue also significantly reduced the numbers of black‐pigmented anaerobes during the trial period, both by irrigation and slow–release, which sterile water and subgingival debridement failed to do. No serious adverse experiences were seen, however, significantly greater morbidity was associated with subgingival debridement. These results clearly demonstrate that in altering the microflora to one that is more compatible with periodontal health, methylene blue treatment is comparable, or even better, than the currently standard treatment of subgingival debridement, and is better tolerated.
An in vitro study of oscillating instruments for root planing
Authors: Mengel R. , Buns C. , Stelzel M. , Flores‐de‐Jacoby L.
Published: December 2005

Abstract The objective of this in vitro study was to test PER‐IO‐TOR instruments on the Profin Directional System angle piece (Dentatus ‐ Sweden), using extracted human teeth. In the 1st part of the study, 6 root surfaces were treated with the instruments TOR 1, TOR 2, TOR 3 and TOR 4. For comparison purposes, half the samples treated with each instrument were then subjected to further treatment with a Gracey curette. All samples were then examined by SEM. In the 2nd part of the study, 4 root surfaces were given standardized treatment with each PER‐IO‐TOR instrument and the amount of substance removed was determined with a mechanical profilometer. For this purpose, the treated root surface was scanned with a microneedle and the profile depth recorded. The study showed that the PER‐IO‐TOR instruments were efficient with respect to surface planing and protective abrasion. Instrument TOR 3 (spatula with eyelet) in particular yielded simular results to those obtained with a curette. The overall results confirm that the PER‐IO‐TOR instruments have similar planing properties to manual instruments, causing minimum abrasion from the root surface. They thus represent an alternative to manual instruments, not only in inaccessible areas but also on smooth tooth surfaces.
Epithelial expression of HLA class II antigens and Feγ receptors in patients with adult periodontitis
Authors: Nunes Ivana Pereira , Johannessen Anne Christine , Matre Roald , Kristoffersen Tore
Published: December 2005

Abstract The distribution of HLA class II (DR, DP, DQ) and FcγR (I, II, III) was analyzed in the epithelia of patients with advanced marginal periodontitis using cryostat sections incubated with monoclonal antibodies (MoAb) against the Langerhans cell (LC) (CDla) and various subtypes of HLA class II and FcγR, and the indirect immunofluorescence technique. In the oral gingival epithelium (OGE), LC were concentrated subjacent to the connective tissue papillae, while in the pocket epithelium (PE), they were most abundant at the gingival margin. HLA‐DP, DQ, and DR stained LC in both OGE and PE. HLA‐DQ+ LC were significantly fewer than DP+ and DR+ LC. HLA‐DR also stained keratinocytes (KC) in the whole extension of both OGE and PE. HLA‐DP was also observed on KC, but not HLA‐DQ. FcγR II stained both LC and focal areas of KC. In PE FCγR II+ LC were concentrated near the bottom of the pocket, while in the OGE, they were concentrated at the gingival margin. FcγR III was present only on KC, especially in the basal and suprabasal layer. The results indicate that the epithelial cells are actively involved in the development and maintenance of the inflammation of periodontal disease.
Development of automated registration algorithms for subtraction radiography
Authors: Ettinger G. J. , Gordon G. G. , Goodson J. M. , Socransky S. S. , Williams R.
Published: December 2005

Abstract An algorithm is described which provides necessary information for automated registration and computation of alveolar height for subtraction radiographic analysis. This procedure involves identification of the cementoenamel junctions from radiographic images by incrementally comparing a characteristic image signature along computed tooth boundaries. The identification of these anatomically invariant structures provides information necessary to warp images and create automatic superimposition, correcting for geometric misalignment. The present report describes and demonstrates the feasibility of utilizing automated CEJ, edge finding and image warping algorithms to align automatically sequential radiographs and permit their subtraction.
Serum fructosamine correlates with gingival index in children with insulin‐dependent diabetes mellitus (IDDM)
Authors: Firatli Erhan , Ünal Tahsin , Saka Nurcin , Onan Utku , Sivas Ahmet , Öz Hikmet
Published: December 2005

Abstract Fructosamine assay, which is used in diagnosing and monitoring diabetic patients, is compared with the hemoglobin and plasma glucose assays in children and adolescent insulin‐dependent diabetes mellitus patients. We demonstrated that the gingival index scores were correlated with fructosamine values in insulin‐dependent diabetes mellitus patients but not in non‐diabetic controls. We also found that there was no correlation between gingivitis scores and fasting plasma glucose and HbAlc values. Periodontitis was found to be rare in diabetic children and adolescents.
Clinical and radiographical split‐mouth‐study on resorbable versus non‐resorbable GTR‐membranes
Authors: Christgau M. , Schmalz G. , Reich E. , Wenzel A.
Published: December 2005

Abstract The aim of this prospective split‐mouth‐study was to compare the 5‐months‐healing results after implantation of resorbable (Polyglactin‐910) and non‐resorbable (e‐PTFE) GTR‐membranes. 12 healthy patients with 41 periodontal defects were treated. Radiographical and clinical examinations (papillary bleeding index, gingival recession, probing pocket depth, probing attachment level, and furcation depth) were carried out under standardized conditions immediately before and 5 months after surgery. The vertical relative attachment gain (V‐rAG) was calculated as a % of the bony defect depth (intra‐operatively measured) at baseline, and the horizontal relative attachment gain (H‐rAG) as a % of the furcation depth at baseline. The standardized radiographs were evaluated blind by 4 experienced examiners for changes of the alveolar bone. Furthermore, digital subtraction radiography was carried out using the standard deviation of the grey level histograms in the experimental region and in a control region as a test parameter for bone changes. Both types of membranes achieved an attachment gain. Using the split‐mouth‐design, no statistically significant (0.05) difference between the two membranes could be detected (number of defects/median) with regard to V‐rAG (Polyglactin: 12/77.5%, e‐PTFE: 12/73.2%) or to H‐rAG of class‐II‐furcations (Polyglactin: 5/66.7%, e‐PTFE: 5/66.7%), or to bone changes using conventional and subtraction radiographic evaluation. In conclusion based on this 5‐months‐study, the resorbable membranes provided attachment gain comparable to the e‐PTFE‐membranes.
Microbiological features of gingivitis in pubertal children
Authors: Tsuruda Keiko , Miyake Yoichiro , Suginaka Hidekazu , Okamoto Hiroshi , Iwamoto Yoshifumi
Published: December 2005

Abstract The subgingival microflora of 42 pubertal children (aged 12–15 years) and 18 young adults (aged 21–25 years) was investigated by anaerobic culture and phase contrast microscopy. Motile rods, spirochetes and Prevotella intermedia were elevated proportionately in pubertal children with gingivitis (median GI1); however, no statistically significant differences in enumerated organisms on selective media were observed between pubertal children and young adults. These organisms were positively correlated with the index of bleeding on probing and the gingival index of pubertal children. Pubertal children were divided into 3 distinct subject clusters according to the similarity of subgingival microbial features, and the subjects who were then selected for the gingivitis group were distributed into clusters 1 and 2. The proportions of motile rods, P. intermedia and Eikenella corrodens were significantly higher in cluster 2 than in cluster 1. These results suggest that these 2 species and motile rods which differentiated features of clusters, are useful for screening of high‐risk subjects for worsening of inflammation.
Clinical trial of cross‐linked human type I collagen as a barrier material in surgical periodontal treatment
Authors: Al‐Arrayed F. , Adam S. , Moran J. , Dowell P.
Published: December 2005

Abstract This study was undertaken to evaluate freeze‐dried cross‐linked human type I collagen when used as a barrier membrane for guided tissue regeneration (GTR) in periodontal surgery. 14 patients with radiographic evidence of bone loss and residual pocketing of >6 mm on bilaterally matched sites were given preliminary scaling, polishing and oral hygiene instruction before undergoing contralateral flap surgery. At the experimental sites, a collagen membrane was adapted to the root surfaces, extending from 2 mm apical to the bone crest to just subgingival, before replacing the flap and closing with sutures. The control sites underwent a similar procedure but without the placement of the collagen barrier. The experimental sites were selected at random. Plaque index (PLI), gingival index (GI), bleeding index (BI). probing pocket depth (PPD) and probing attachment level (PAL) were recorded at baseline, 6, 12 and 26 weeks post‐operatively. The bony defects were classified and furcation involvement noted. The clinical parameters were recorded by an examiner, previously assessed for accurate reproducibility of measurement, who was not the surgeon and unaware of the experimental sites. PPD and PAL were measured using a constant pressure probe localised by a soft stent. There was significant improvement in the PLI, GI and BI at both test and control sites at 6, 12 and 26 weeks compared to baseline (P<0.001 for PLI; P<0.0001 for GI and BI) but no significant difference between these sites. Probing pocket depths were significantly reduced in both test and control sites at 6, 12 and 26 weeks post‐operatively (P<.0001). Furthermore, the test sites demonstrated a greater reduction in PPD than the control sites. There was a gradual reduction in PAL reaching significant levels by 26 weeks (P<0.001 for both test and control sites). There was a significantly greater gain in PAL at the test sites compared to the controls at 26 weeks (P<0.05). This investigation shows that human collagen as a GTR membrane is beneficial in reducing PPD and producing a gain in PAL.
The effect of triclosan on developing gingivitis
Authors: Ramberg P. , Furuichi Y. , Sherl D. , Volpe A.R. , Nabi N. , Gaffar A. , Lindhe J.
Published: December 2005

Abstract The aim of the study was to examine whether triclosan has an effect on developing gingival inflammation. 10 volunteers, with clinically healthy gingivae were enrolled. The study was performed as a 2‐week, double‐blind, crossover, experimental gingivitis trial. Between each plaque accumulation period, there was a wash‐out phase of 4 weeks. A baseline examination was performed which included assessment of plaque and gingivitis. The volunteers were asked to refrain from mechanical oral hygiene measures for 2 weeks. During this period, they rinsed 2× daily with one of the randomly assigned mouthrinse preparations. Solution A (period A): 0.06% triclosan + 2%tween 80. Solution B (period B): 0.06% triclosan +0.25% sodium lauryl sulphate. Re‐examinations were performed on days 4, 7, 11 and 14. The mean plaque score increased during period A to 2.2 (day 4), 2.8 (day 7), 3.1 (day 11) and 3.1 (day 14). The corresponding scores for period B were significantly lower; 1.2 (day 4), 1.8 (day 7), 2.0 (day 11) and 2.2 (day 14). The mean gingivitis scores at baseline were 0.17 (periods A and B). The mean gingivitis scores increased to 0.45 (day 4), 0.69 (day 7), 0.83 (day 11) and 0.96 (day 14) when the subjects rinsed with solution A and 0.42 (day 4), 0.64 (day 7), 0.78 (day 11) and 0.92 (day 14) in period B. There were no statistically significant differences between periods A and B with respect to gingivitis. Thus, although significantly more plaque formed during period A than period B, no differences could be found between the gingivitis scores in the 2 periods.
Compartmentalization of inflammatory cell phenotypes in normal gingiva and peri‐implant keratinized mucosa
Authors: Tonetti Maurizio S. , Imboden Martin , Gerber Leena , Lang Niklaus P.
Published: December 2005

Abstract The interpretation of studies aimed at understanding the pathophysiology of periodontal breakdown has been hampered by an insufficient understanding of the physiology of host responses in clinically healthy gingiva. This investigation was aimed at the evaluation of the in situ phenotype and topographic distribution of the inflammatory cells in clinically normal gingiva and peri‐implant keratinized mucosa (PIKM). Soft tissue biopsies were obtained from clinically healthy gingiva or PIKM in 14 patients. Acetone fixed, cryostat sections were stained with a panel of monoclonal antibodies with a three stage avidin‐biotin immunoperoxidase technique. Numbers of positive cells/mm2 were determined with a calibrated image analysis system. The major findings of the study were: (i) the presence of significantly higher densities of phenotypically characterized mononuclear cells in the 1CT than in the JE in both gingiva and PIKM; (II) the absence of a significant difference in PMN densities between JE and ICT in both gingiva and PIKM; (iii) the absence of statistically significant differences in densities of phenotypically characterized leukocytes associated with gingiva and PIKM; (iv) the presence of regional differences in the relative proportions of immunocompetent cells in both the gingiva and PIKM. It is concluded that inflammatory cells are selectively distributed in gingiva and PIKM. Unique functional compartments could be identified. The observed compartmentalization requires selective regulatory mechanisms.
Reliability of single and double probing attachment level measurements
Authors: Zappa U. , Simona C. , Graf H. , Case D. , Thomas J.
Published: December 2005

AbstractClarification of the reliability associated with probing attachment level measurements and with diagnostic rules derived from them is necessary to examine the potential of these measurements as reliable markers of the disease process and as an outcome measure in clinical treatment studies. The purpose of the present study was to describe and compare the longitudinal reliability of single and double probing attachment level measurable by estimating false positive and false negative rates. In 20 systemically healthy adults with untreated advanced adult periodontitis, probing attachment levels and probing depth were measured at 6 sites in all teeth at the start of the study, and every 30 days thereafter for 11 months. Attachment levels were double measured, using acrylic onlays providing reference points and an electronic pressure sensitive probe, Attachment loss from baseline of 2.5 mm or more was used to accept dynamic attachment loss. The statistical methods for the cross‐sectional analysis included mean absolute differences between double measurements and cross‐correlations. Longitudinal analyses, expressing estimates of diagnostic error rates were made using maximum likelihood methods. 5 measurement protocols were compared. The results showed that the mean absolute difference between replicate measurements was 0.095 mm in bicuspids and 0.107 mm in molars. The mean absolute differences decreased over time from 0.128 mm in visit 3 to 0.08 mm in visit 7. Correlation coefficients for replicate measurements were higher than 0.98. In general, false positive rates were markedly lower (≤0.02) than false negative rates (≤31). The relative sample size required to obtain comparable statistical power, was minimized in premolars when using the first of 2 measurements or the mean of 2 measurements, and in molars when using the first of 2 measurements. The methodology used in the present study provides guidelines for designing clinical studies which maintain statistical power by balancing off examiner reliability and sample size.
Clinical and microbiological changes associated with an altered subgingival environment induced by periodontal pocket reduction
Authors: Mombelli Andrea , Nyman Sture , Brägger Urs , Wennström Jan , Lang Niklaus P.
Published: December 2005

Abstract The purpose of the present investigation was to study the effect of an altered subgingival environment, induced by changing the local soft tissue morphology, i.e., pocket depth reduction, on the subgingival microbiota and the clinical conditions. 7 patients aged 30–60 years with generalized marginal periodontitis were selected. Patients were instructed in proper oral hygiene and all teeth were cleaned supragingivally. Mucoperiosteal flaps were raised and the bone re‐contoured to eliminate angular bony defects. While the control teeth were carefully debrided and thoroughly root planed, no root instrumentation was performed on the test teeth. Calculus deposits visible to the naked eye were only chipped‐off with the tip of a sealer. The flaps were apically repositioned and sutured at the level of the bone crest. Clinical parameters showed a similar pattern of response in the test and control sites over a one year observation period post therapy. Probing depths and probing attachment levels were significantly reduced one month after surgery and remained at a lower level. A significant decrease was also noted for total anaerobic viable bacterial counts. The proportion of the Gram‐negative anaerobic rods decreased significantly in both groups. P. gingivalis, Fusobacterium sp., C. rectus were detected significantly less often after treatment in both groups. Capnocytophaga and A, odontolyticus, on the other hand, were more frequently isolated after therapy. These findings corroborate the concept that the reduction of selected subgingival microorganisms is the key element for the success of periodontal therapy, rather than the removal of tooth substance and mineralized deposits by root instrumentation.
Comparative staining in vitro and plaque inhibitory properties in vivo of 0.12% and 0.2% chlorhexidine mouthrinses
Authors: Smith R.G. , Moran J. , Addy M. , Doherty F. , Newcombe R. G.
Published: December 2005

Abstract. The mere incorporation of an active ingredient in an oral hygiene product does not necessarily guarantee efficacy. As new formulations appear, it would seem prudent to at least screen for activity by comparison with an established product. The aim of this study was to compare a new 0.12% chlorhexidine containing rinse with a well researched 0.2% chlorhexidine rinse product. The rinses were firstly compared in vitro for dietary staining effects and in vivo for plaque inhibition. Both formulations in vitro produced progressive staining of acrylic specimens with increasing passages through a standard tea solution. The clinical investigation was a 3‐treatment, randomised, double blind, crossover, 4‐day plaque regrowth study, balanced for 1st and 2nd order residual effects and involving 24 volunteers. From a zero plaque baseline, volunteers suspended oral hygiene and rinsed 2×per day with the allocated rinse. The chlorhexidine doses were 18 mg and 20 mg per rinse for the 0.12% and 0.2% formulations, respectively. Plaque was scored by area and index on day 5. The results showed that the 2 chlorhexidine rinses were similar in efficacy by comparison with the control rinse. These studies in vitro and in vivo indicate that the chlorhexidine in the new preparation is available and active and the product could find use in those preventive applications suggested for other chlorhexidine formulations.
Oral microbiota in subjects with a weak or strong response in experimental gingivitis
Authors: Lie M.A. , Danser M.M. , van der Weijden G.A. , Timmerman M.F. , de Graaff J. , van der Veiden U.
Published: December 2005

Abstract. The purpose of the present study was to examine the composition of the oral microbiota in subjects who had previously demonstrated to develop either a weak or strong response to experimental gingivitis. For this study, subjects were selected from a pool of 25 individuals who had participated twice in an experimental gingivitis trial. Out of these 25 panellists, 6 subjects were selected who had developed 2× a weak gingival inflammatory response and 7 subjects who had developed 2× a strong gingival inflammatory response. Approximately 9 months after the 2nd experimental gingivitis trial, we evaluated the clinical condition and the prevalence of a panel of selected oral micro‐organisms in these subjects. The subjects were clinically examined for the presence of plaque, bleeding, pocket depth and loss of attachment. For the microbiological evaluation, samples were taken from the mucous membranes, subgingival sites and saliva. Samples were analyzed for the presence of Actiilobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Peptostreptococcus micros. Actinomyces spp., Fusohacterium mucleatum, Campylobacter rectus, spirochaetes and motile rods. Clinical evaluation showed that most subjects had a relatively healthy periodontal condition. No clinically significant differences could be detected between the weak and strong responding groups. The microbial evaluation showed absence of A. actinomycetemcomitans, P. gingivalis and P. micros in all subjects in either group. Analysis of the microbial data for the weak and strong responding group showed no differences between the groups. This indicates that differences in response to experimental gingivitis are probably not caused by major differences in the compositon of the oral microbiota. The strong or weak inflammatory response may be related to differences in the microflora at the time of the experiments and/or differences in host response.
Human periodontal ligament and gingival fibroblast response to TGF‐β1 stimulation
Authors: Mailhot Jason M. , Schuster George S. , Garnick Jerry J. , Hanes Philip J. , Lapp Carol A. , Lewis Jill B.
Published: December 2005

Abstract. The purpose of this study was to measure the time‐sequence response of RNA and protein synthesis to transforming growth factor‐β1 (TGF‐β1) by human periodontal ligament (HPDLF) and gingival (HGF) fibroblasts in culture. HPDLF and HGF were cultured from explants of healthy gingival tissue and freshly extracted teeth. Cultures of 8×104 cells/ml were exposed to medium containing 3H‐uridine and 35S‐methionine with TGF‐β1 at concentrations from 10‐9 M to 10‐21 M, or control medium, for up to 60 hours in order to assess RNA and protein synthesis. Protein concentrations of comparable cultures were also assayed colorimetrically. Results were reported as specific activity (CPM/μMg protein). The results indicate that 10‐9 M TGF‐β1 treated cultures showed a significant increase in RNA synthesis by HPDLF and HGF over time, as compared to the control cultures. HPDLF showed a significant increase in protein synthesis over time while that by HGF was not significant as compared to the control cultures. Lower concentrations of TGF‐β1 demonstraled no significant differences from control. Results suggest that the effects of TGF‐β1 on HPDLF and HGF are both time and dose dependent, with 10‐9 M TGF‐β1 providing the best response of those concentrations tested. These findings support the concept that TGF‐β1 may play a role in periodontal regeneration due to its ability to promote fibroblast RNA and protein synthesis. The results also demonstrate that although these two cells types appear morphologically similar, they exhibit distinct biological responses to growth factors such as TGF‐β1.