bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative single‐use plaque removal by toothbrushes of different designs
Authors: Claydon N. , Addy M.
Published: December 2005

Abstract Overall literature reviews have concluded that no one design of the manual toothbrush is superior for plaque removal. More recently, a toothbrush with filaments angled away from the head was shown to be more effective in several single‐use studies than conventional designs. The aim of this study was to compare plaque removal by this new toothbrush and 3 other toothbrushes which had more conventional filament arrangements. 36 volunteers participated in this single‐blind, randomised, 4‐cell, crossover single use toothbrushing study On day 1 of each period, volunteers brushed with a standard toothbrush and toothpaste for 60 s and then suspended oral hygiene for 48 h. On day 3, volunteers were scored for plaque by area and then brushed with the allocated test toothbrush with toothpaste for 60 s and plaque area was rescored. A washout of 4 days was allowed between test periods. The plaque areas were used to record the binary scores of the Rustogi et al. modification of the modified Navy plaque index but away from the clinic employing the Claydon and Addy procedural method for the index. Plaque removal scored by area and site were not significantly different between the brushes. This study is at variance with previous similar investigations which suggested that the new design of toothbrush head was superior for plaque removal. It is concluded again that there are no data which demonstrate unequivocally that any one manual toothbrush design is superior to any other for plaque removal.
Association between HLA antigens and early onset periodontitis
Authors: Firat Erhan , Kantarci Alpdoǧan , Cebeci Irfan , Tanyeri Hakki , Sönmez Gülay , Çarin Mahmut , Tuncer Özen
Published: December 2005

Abstract HLA‐A, B, C and DR antigen frequencies were determined in a group of patients with juvenile periodontitis and rapidly progressive periodontitis. In juvenile periodontitis patients. HLA‐A24 and DR4 were found at a significantly higher level than in the control group, and in rapidly progressive periodontitis patients, A9 and DR4 were found at a significantly higher level than the control group. The presence of these antigens gives evidence as to the susceptibility of various forms of early onset periodontitis.
Efficacy of systemically administered acetylsalicylic acid plus scaling on periodontal health and elastase‐α1‐proteinase inhibitor in gingival crevicular fluid
Authors: Flemmig T. F. , Rumetsch M. , Klaiber B.
Published: December 2005

Abstract The purpose of this proof of principle trial was to assess whether conventional periodontal therapy and systemically administrated acetylsalicylic acid (ASA) are functionally synergistic when combined in the treatment of periodontitis, A total of 30 patients with untreated moderate to severe adult periodontitis were enrolled into the study and were given placebo q.i.d. between the baseline and 6‐week examination, and acetylsalicylic acid (ASA) 500 mg q.i.d. between the 6‐week and 12‐week examinations. In addition, they received supra‐and subgingival scaling in 1 quadrant after baseline examination and in 2 further randomly selected quadrants after the 6‐week examination. The study design resulted in the following 4 therapies: (1) scaling plus ASA 500 mg q.i.d.: (2) scaling plus placebo q.i.d: (3)ASA 500 mg q.i.d. alone: (4) placebo q.i.d. alone. Two‐way analysis of variance showed functional synergism of ASA and scaling, resulting in a therapeutic efficacy approximately equivalent to the sum of each individual therapeutic efficacy (i.e., ASA alone and scaling alone) in reducing gingival inflammation and pocket probing depth over the 6‐week observation period (interaction: p >0.05). Only the effect of ASA was significant m reducing the concentration of elastase‐α1‐proteinase inhibitor in gingival crevicular fluid (GCF E‐α1‐PI) (p >0.001), reduction in GCF E‐α1‐PI concentrations by ASA may indicate a decreased risk in periodontal disease progression. The results suggest that the combination of therapies and their different mechanisms of action, i.e., reduction of bacterial plaque and inhibition of destructive components of the immune responses, may result in functionally synergistic therapeutic efficacies in patients with untreated adult periodontitis.
Systemic retinoid medication and periodontal health in patients with Papillon‐Lefèvre syndrome
Authors: Lundgren Tord , Crossner Claes‐Göran , Twetman Svante , Ullbro Christer
Published: December 2005

Abstract Periodontal health in relation to systemic retinoid medication was evaluated retrospectively in patients with Papillon‐Lefèvre Syndrome (PLS). The material consisted of 18 children/young adults ranging from 8 to 28 years of age, all with a confirmed diagnosis of PLS. 9 participants, comprising a medication group, had been on long‐term (range 1.5–9 years) retinoid medication for their cutaneous lesions. The remaining 9 served as controls. Regardless of whether or not retinoid medication was received, every patient experienced an early and devastating periodontitis, with atypical edematous and erythematous gingiva, suppuration from deep gingival pockets and premature loss of teeth. No correlation could be found between the severity of skin involvement and the severity of periodontal involvement. An improvement with age could be seen for the cutaneous lesions but not for the periodontal condition. Systemic medication with retinoids had a favorable therapeutic effect on cutaneous lesions, and no severe compliction/side effect could be seen even after several years of continuous use. However, from the results of this study it can be concluded that, at least in a situation with poor compliance of daily oral home‐care, no positive effect on the periodontal health in patients with PLS could be seen by the retinoid medication.
Medical Status and complications in relation to periodontal disease experience in insulin‐dependent diabetics
Authors: Thorstensson H. , Kuylenstiema J. , Hugoson A.
Published: December 2005

Abstract The aim of this study was to define a population of diabetics exhibiting an increased risk of developing severe periodontitis by comparing the medical status of 2 groups of diabetics, 1 with no/minor periodontal disease and 1 with severe periodontal disease. The case‐control study consisted of 2 parts, a baseline study and a follow‐up study. 39 case‐control pairs were selected. They were adult, long‐duration, insulin‐dependent diabetics matched according to sex, age and diabetes duration. One individual in each pair (the CASE) exhibited severe periodontal disease while the other (the CONTROL) exhibited gingivitis or only minor alveolar bone loss. The median age of the cases was 58 years (range 36 to 70 years) and of the controls 59 years (range 37 to 69 years). The median disease duration in cases and controls was 24 years and 25 years, respectively. The median follow‐up time was 6 years. The medical variables analysed were weight, insulin dose, systolic and diastolic blood pressure, vibratory threshold, triglycerides, total‐cholesterol, HDL‐cholesterol, creatinine, HbA1, proteinuria, ECG, retinopa‐thy. stroke, transient ischemic attacks (TIA), angina, myocardial infarct, heart failure, hypertension, intermittent claudication, foot ulcer, death, cause of death, and smoking habit. Biochemical analyses and clinical variables used as a routine in the monitoring of diabetics failed to differentiate between diabetics with severe and minor periodontal disease. In the follow‐up study, significantly higher prevalences of proteinuria and cardiovascular complications such as stroke, TIA, angina, myocardial infarct and intermittent claudication were found in the case group. An association between renal disease, cardiovascular complications and severe periodontitis seems to exist. This indicates that a closer cooperation between the diabetologist and the dentist is necessary m monitoring the diabetic patient.
Rationale of mechanical plaque control
Authors: Westfelt Elisabeth
Published: December 2005

Abstract Patients who have received extensive periodontal treatment also demonstrate a high susceptibility to periodontal disease. Maintenance of periodontal health following therapy includes a lifelong supportive care consisting of daily removal of the microbial plaque by the patient, supplemented by professional care in an individually designed programme. Mechanical supragingival plaque control by self care is of utmost importance. The goal is to create a positive attitude by information and motivation to give the patient knowledge and confidence. The patient should be advised to use appropriate aids and technique. A soft brush, an interspace brush, interdental tooth brushes or tooth picks are recommended m periodontal patients. Professional tooth cleaning involves removal of supragingival plaque from ail tooth surfaces using mechanically driven instruments and fluoride prophy paste and, when indicated, removal of calculus and subgingival plaque. Disclosing solution is used to visualize the plaque to the patient and to the clinician in order to reinforce instruction in oral hygiene. Oral hygiene measures alone seem to have limited effect on the subgingival microflora in cases of severe disease. In shallow and moderately deep pockets a good plaque control can change the subgingival flora towards a more “healthy” composition. Subgingival plaque removal is performed with hand‐ and/or ultrasonic instruments. Cracks within the cementum, grooves, fissures, resorption lacunae, furcations may create difficulties in cleaning the root surface. Ultrasonic instrumentation has a beneficial effect in creating a smooth surface without extensive removal of cementum. Besides, the cavitational activity contributes to plaque removal which makes the instrument further suitable during maintenance therapy. The result of the de‐bridement is assessed on the healing response in the tissues. The frequency of maintenance visits must be given on an individual basis according to the needs of every special patient. The visit includes plaque evaluation (disclosion), oral hygiene instruction, probing depth measurements, registration of bleeding on probing, scaling (plaque removal) if indicated, tooth polishing, fluoride application and radiographs if indicated. The goal is to identify and treat signs of recurrence of periodontal disease in order to prevent further loss of attachment.
Short‐term effects of triclosan on healing following subgingival scaling
Authors: Furuichi Y. , Ramberg P. , Krok L. , Lindhe J.
Published: December 2005

AbstractThe present clinical trial was performed to evaluate short‐term effects of a triclosan‐containing dentifrice/gel combination on soft tissue healing, when applied supra‐/sub‐gingivally at periodontal sites treated with scaling and root planing. 16 subjects with moderate penodontitis participated in a 2×2‐week, split‐mouth designed clinical trial. 2 combinations of gel/dentifrice (the test combination containing triclosan) were used. 2 pairs of contralateral sites with probing pocket depth (PPD) ≥ 5 mm, and which bled on probing (BoP +) were selected in each patient as experimental units. A baseline examination included assessments of PPD, BoP, gingival index scores, plaque index scores, and the composition of the subgingival microbiota (dark‐field microscopy). The assigned quadrant was anaesthetized and the teeth exposed to meticulous scaling and root planing. Immediately after the completion of mechanical therapy, either the test or control gel was applied sub‐gingivally at the experimental sites. The volunteer was instructed to brush his/her teeth with an assigned dentifrice and to apply the gel (via a custom‐made stent) supragingivally 2× daily for the following 2 weeks. He/she was recalled on day 7 for a second professional subgingival gel application. Re‐examinations were carried out on days 2, 7 and 14 after treatment. 1‐week wash‐out periods separated the 2 experimental periods. The mean PPD reductions (between days 0 and 14) were 1.8 mm and 1.9 mm for the test and control gel/dentifrice sites. The reduction in BoP and gingival index scores was significantly greater during the test than during the control regimen. No significant differences were observed between the 2 regimens regarding plaque scores and composition of the subgingival microbiota. The findings from the present investigation demonstrated that triclosan, applied both sub‐ and supra‐gingivally reduced soft tissue inflammation following scaling and root planing.
Guided tissue regeneration in conjunction with hydroxyapatite‐collagen grafts for intrabony defects
Authors: Kiliç Ali Riza , Efeoǧlu Elvan , Yilmaz Seiçuk
Published: December 2005

Abstract This clinical and radiological study evaluated the healing of 3 + 2 + 1 wall‐combined intrabony defects treated using the guided tissue regeneration technique (GTR) with and without hydroxyapatite‐collagen alloplastic graft materials (HAC), in comparison to that of HAC alone and conventional flap surgery (CF), 40 interproximal defects with probing depth >6 mm were treated in 18 adult periodontitis patients of ages 35–60 years. After non‐surgical therapy, the defects were randomly grouped into 4 groups of 10 defects each. These groups were designated: (1) expanded polytetrafluoroethylene membrane (e‐PTFE), (2) e‐PTFE+HAC. (3) HAC alone and (4) CF. At 6 months, the following changes in parameters were recorded. Mean PPD reduction for each group was 5.83, 5.85, 3.80 and 3.17 mm respectively. PPD reduced very significantly in all groups (P<0.01), the highest and lowest reductions in PPD being for the e‐PTFE + HAC and CF group respectively. Comparison between the 4 groups showed higher PPD reduction in both membrane groups than in either of the non membrane groups (p<0.05) with the difference between the e‐PTFE and CF groups being very highly significant (p<0.001). Mean attachment gain for the 4 groups was 3.70. 3.80. 2.60 and 2.1 mm, respectively. Similarly attachment gain for all groups was very significant (p<0.01) and the highest and lowest attachment gains were for the e‐PTFE+HAC and CF group respectively. Both membrane groups showed significantly more attachment gain than the CF group (p<0.05). Change in probing bone level (BL) for the 4 groups was 1.60. 1.90. 1.0 and 0.65 mm respectively. Again the highest changes in BL were recorded for the e‐PTFE + HAC group. Significant differences were found between both membrane groups and the CF group (p<0.05). Radiological evaluation using standardized radiographs and millimeter grids showed change in radiographic bone level at the deepest point of the defect on the radiograph to be 1.50, 1.55, 0.85 and 0.60 mm, respectively and this was significantly higher in both membrane groups than in the CF group (p<0.05). This study therefore found e‐PTFE membranes both alone and when combined with HAC to lead to more attachment gain and bone fill than did HAC alone or CF. It found HAC combined with e‐PTFE to perform better although not significantly better than e‐PTFE alone.
Possible autosomal‐dominant inheritance of prepubertal periodontitis in an extended kindred
Authors: Shapira Lior , Schlesinger Michael , Bimstein Enrique
Published: December 2005

Abstract This study presents the clinical findings and the distribution of prepubertal periodontitis in an extended family with high prevalence of this entity. The expression of surface markers and adhesion molecules on peripheral lymphocytes were also studied. Approximately 50% of the children in this family suffered from prepubertal periodontitis. All the affected children were otherwise healthy. 2 identical twins were similarly, but not identically, affected. Detailed laboratory tests and analysis of lymphocyte surface marker expression, including CD 18, were all within the normal levels. Both localized and generalized forms of prepubertal periodontitis were found. The high prevalence of prepubertal periodontitis in the 2 branches of this family, and the fact that identical twins were similarly affected, suggest a strong genetic predisposition for prepubertal periodontitis. The family pedigree is consistent with an autosomal‐dominant mode of transmission. The coexistence of localized and generalized forms of the disease in sibs suggests the same genetic etiology for both entities with variability in disease expression. This variability in disease expression is further supported by the fact that 2 identical twins were not identically affected.
Occurrence of invading bacteria in radicular dentin of periodontally diseased teeth: microbiological findings
Authors: Giuliana Giovanna , Ammatuna Pietro , Pizza Giuseppe , Capone Francesca , D'Angelo Matteo
Published: December 2005

Abstract Bacterial invasion in roots of periodontally diseased teeth, which has been recently documented using cultural and microscopic techniques, may be important in the pathogenesis of periodontal disease. The purpose of this investigation was to determine the occurrence and the species of invading bacteria in radicular dentin of periodontally diseased teeth. Samples were taken from the middle layer of radicular dentin of 26 periodontally diseased teeth. 14 healthy teeth were used as controls. Dentin samples were cultured anaerobically. The chosen methodology allowed the determination of the numbers of bacteria present in both deeper and outer part of dentinal tubules, and the bacterial concentration in dentin samples, expressed as colony forming units per mg of tissue (CPU/ mg). Invading bacteria was detected in 14 (53.8%) samples from periodontally diseased teeth. The bacterial concentration ranged from 831.84 to 11971.3 CFU/ mg (mean±standard deviation: 3043.15±2763.13). Micro‐organisms identified included putative periodontal pathogens such as Prevotella intermedia, Porphyromonas gingivalis, Fusobacterium nucleatum, Bacteroides forsythus, Peptostreptococcus micros and Streptococcus intermedius. These findings suggest that radicular dentin could act as bacterial reservoir from which periodontal pathogens can recolonize treated periodontal pockets, contributing to the failure of therapy and recurrence of disease.
A study on factors associated with pathologic tooth migration
Authors: Martinez‐Canut Pedro , Carrasquer Assumpta , Magán Rafael , Lorca Amparo
Published: December 2005

Abstract The purpose of this cross‐sectional epidemiological study was to determine the prevalence of pathologic tooth migration (PTM) among periodontal patients and to investigate the relationship and degree of association between PTM and the following factors: bone loss, tooth loss, gingival inflammation according to the gingival index, age, lingual interposition, parafunctions and oral habits. 852 periodontal patients (36.7% male, 63.3% female) whose ages ranged from 19 to 72 years (mean 42.5± 9.9) were studied. PTM was defined as the presence of a developing diastema in the upper anterior sextant, which was not present in the past or already existed but increased. Statistical analysis was performed using the Wald test and the Mantel‐Haenszel test. Estimates odds ratio were also calculated to assess increased PTM probability as a function of a single variable, or a combination of several. PTM prevalence of 55.8% was found, and it was statistically associated with bone loss (P<0.001), tooth loss (p<0.001) and gingival inflammation (p<0.001), while no association was observed with the remaining variables. The odds ratio indicated that PTM probability increased between 2.95 to 7.97 times as bone loss increased. For tooth loss this probability increased 2.76 times when no tooth loss was compared to 4 or more teeth lost. Likewise the probability increased 2.23 times when the gingival index was above 2. According to the single effect as well as the combined effect of these 3 main factors, it was concluded that: (1) no single factor by itself is clearly associated with PTM: (2) the factor mainly related to PTM is bone loss, followed by tooth loss and gingival inflammation: (3) as bone loss increases, the association of additional factors with PTM, such as tooth loss and gingival inflammation, increases.
Effectiveness of subgingival instrumentation with power‐driven instruments in the hands of experienced and inexperienced operators
Authors: Kocher Thomas , Rühling Andreas , Momsen Hauke , Plagmann Hans‐Christian
Published: December 2005

Abstract Power instrumentation of periodontally‐diseased root surfaces is gaining in significance as an alternative to conventional curette methods. In an experimental study employing manikins with simulated bone loss, we investigated whether inexperienced and experienced operators were able to achieve greater therapeutic success with power‐driven devices than with hand instruments in subgingival scaling. 10 dentists experienced in periodontal treatment and 10 inexperienced dentists instrumented 7 teeth in the upper jaw, which had been covered with artificial deposits. Hand instruments, the Perioplaner system, a sonic and an ultrasonic sealer were used. The time required for treatment was measured and the % of residual deposits was calculated by means of image‐processing techniques. Weight loss was also determined for the teeth that were scaled with the hand instruments and the Perioplaner system. Experienced operators left significantly less % of residual deposits on the teeth (18±7.6%) than the inexperienced (27±8.4%), regardless of the type of instrument selected. Both experienced and inexperienced operators left the smallest amounts of residual deposits with hand instruments (13±9.8%/24±9.5%). Both treatment groups removed more hard tooth structure with hand instruments than with the Perioplaner system (53±48mg versus 47±25.9 mg). Experienced operators needed somewhat more time for debridement than unexperienced. Use of the sonic/ultrasonic device required somewhat less time than hand instrumentation. Inexperienced operators are however, unable to improve their treatment results by using the power‐driven instruments included in the study.
Clinical evaluation of a bioabsorbable regenerative material in mandibular class II furcation therapy
Authors: Bouchard Philippe , Giovannoli Jean‐Louis , Mattout Catherine , Davarpanah Mithridade , Etienne Daniel
Published: December 2005

Abstract 30 periodontally compromised adult subjects with mandibular buccal class II furcation defects were recruited for this study. All selected defects were treated according to the biological principles of guided tissue regeneration. The subjects were randomly assigned to 2 parallel groups. The test group (n=15) received a bioabsorbable polyglycolic‐polylactic membrane (PGA/PLA group); the control group (n=15) received a non‐resorbable expanded polytetrafluoroethylene membrane (ePTFE group). After initial therapy, baseline measurements were recorded including plaque index, gingival index, vertical and horizontal probing depths, clinical attachment level and depth of the recession. Recall visits were made al 1,2, 4, 6, 8, 12, and 24 weeks. At 12 months, all baseline clinical parameters were again measured. The data analysis did not demonstrate a significant difference between the 2 groups. The vertical probing depth and attachment level changes were statistically significant in each group. The postoperative recession was 0.6 mm in the ePTFE group (p<0.05) and 0.8 mm (p<0.05) in the PGAPLA group. Compared to the initial measurements, the mean changes in horizontal probing depth were 2.7 mm and 2.5 mm (p<0.001), corresponding to mean reductions of 41.5% and 40.9% for the ePTFE and the PGA/PLA groups respectively. The results of this study suggest that 12 months after initial surgery, similar clinical improvements can be obtained in GTR therapy of buccal class II furcation lesions, regardless of whether bioabsorbable PGA/PLA membranes or non‐resorbable ePTFE membranes are used.
Selection of the most accurate method of conventional radiography for the assessment of periodontal osseous destruction
Authors: Pepelassi Eudoxie A. , Diamanti‐Kipioti Anthi
Published: December 2005

Abstract The purpose of the present study was to compare the radiographic measurements of periodontal osseous destruction with the surgical measurements, which represent the true value of osseous destruction, and to select the most successful method of conventional radiography in detecting and accurately assessing periodontal osseous destruction. A total of 5072 proximal surfaces in 2536 teeth of 100 patients with periodontitis were evaluated surgically during penodontal flap surgery and radiographically by using periapical and panoramic radiography. Comparative evaluation of the measurements obtained by these 3 different methods of osseous destruction assessment revealed the following. (1) The radiographic detection ability of small osseous destruction (1–4 mm) was very low for both methods of assessment and became even lower for the initial osseous destruction (1 or 2 mm). (2) Periapical radiography was more successful than panoramic in the detection of osseous destruction, especially of the small destruction (4.7X). (3) Panoramic radiography underestimated the osseous destruction, whereas periapical radiography was relatively accurate in the osseous destruction assessment. (4) Periapical radiography was more accurate in the osseous destruction assessment than panoramic, regardless of the location of the dental surfaces (jaw. tooth group, mesial or distal) and the degree of osseous destruction. (5) The deviation of the radiographic measurements of osseous destruction from the surgical measurements, as well as the difference between the two radiographic methods, depended on the jaw location, the tooth group and the degree of osseous destruction. (6) The radiographic assessment of osseous destruction underestimated the osseous destruction in initial periodontitis, it was relatively accurate in moderate periodontitis. But overestimated it in severe periodontitis. The radiographic measurements of osseous destruction deviated least from the surgical measurements in the group of moderate periodontitis and most in that of severe osseous destruction. (7) The 2 radiographic methods agreed most in the assessment of osseous destruction in the severe periodontitis group and least in the initial periodontitis group. (8) The indirect Schei method was less successful in detecting the small osseous destruction and less accurate in assessing the osseous destruction than the direct millimetric method of radiographic evaluation. (9) The osseous destruction as assessed from periapical radiographs by the Schei method was not significantly different from that assessed by the radiopaque Fixot‐Everett grid. The results of the present study suggest that periapical radiography is more successful in detecting periodontal osseous destruction and more accurate in assessing it than panoramic radiography.
Effects of metronidazole in patients with “refractory” periodontitis associated with Bacteroides forsythus
Authors: Winkel E.G. , Van Winkelhotf A.J. , Timmerman M.F. , Vangsted T. , Van der Velden U.
Published: December 2005

Abstract The aim of the present study was to monitor the microbiological and clinical effects of renewed supra and sub gingival debridement in conjunction with systemic metronidazole therapy (500 mg TID for 7 days) in 27 “refractory” periodontitis patients, culture positive for Bacteroides forsythus and negative for Actinobacillus actinomycetemcomitans. Clinical evaluation included assessment of plaque, bleeding upon probing, probing pocket depth and clinical attachment loss at the deepest, bleeding site in each quadrant. Microbiological evaluation was carried out by anaerobic cultivation of sub gingival plaque samples from the same sites. 6 months after renewed debridement and systemic metronidazole (RD + M). a statistically significant improvement of all clinical parameters was observed, except for the plaque index. After RD + M, B. forsythus was suppressed below detection level in 17 of the 27 patients, P. gingivalis in 9 out of 15 patients and P. intermedia in 14 of the 21 patients. Before RD+M. 12 patients harboured simultaneously B. forsythus, P. gingivalis as well as P. intermedia. Out of these 6 patients were culture negative for the 3 species after therapy and showed the greatest reduction in pocket depth (3.1 mm) and gain of clinical attachment level (2.5 mm). In the treatment of refractory periodontitis. associated with patients culture positive for B. forsythus and negative for A. actinomycetemcomitans, metronidazole can significantly improve the clinical and microbiological parameters.
Clinical significance of Actinobacillus actinomycetemcomitans in young individuals during orthodontic treatment
Authors: Paolantonio Michele , Pedrazzoli Vinicio , di Murro Carlo , di Placido Giacinto , Picciani Carla , Catamo Giovanni , De Luca Massimo , Piccolomini Raffaele
Published: December 2005

Abstract The aim of the present study was: (I) to assess longitudinally the occurrence of Actinobacillus actinomycetemcomitans (Aa) in young subjects wearing fixed orthodontic appliances compared to matched appliance‐free controls: (2) to determine whether the presence of the micro‐organism at baseline could influence the periodontal status assessed 3 years later. 70 subjects. 27 male and 43 female. aged between 12 and 20 years participated in the study: 35 subjects under orthodontic treatment with fixed appliances for at least 6 months, and 35 appliance‐free individuals matched for age and gender. All subjects were free of clinically demonstrable loss of attachment. They all received oral hygiene instructions 2× during the 2 months preceding the first clinical and microbiological examination. No subgingival instrumentation was performed between baseline and the 3‐year examination. Clinical parameters included gingival bleeding index (GBI). pocket probing depth (PPD) and measurements of attachment level (AL). Statistically significant differences were reported regarding frequency of detection of Aa between both groups at each examination. The %s of orthodontic subjects infected with Aa at the baseline and at the 3‐year examination were 86% and 80%, respectively, while the corresponding figures for control subjects were 16.6% and 26.6%. The frequency distribution of %s of Aa in the total anaerobic subgingival flora among control subjects remained fairly stable, whereas the proportion of orthodontic subjects yielding Aa at a concentration 1.0% dropped significantly from 32% at baseline to 19% at the 3‐year visit. Calculations of the relative risk for increasing GBI and PPD in both groups when Aa was present at baseline, revealed that the orthodontic subjects positive for Aa had a negligible relative risk of experiencing worse periodontal conditions compared to orthodontic patients where Aa was not detected at baseline. In contrast, control subjects initially infected with Aa presented with a risk for increased GBI 6.6×higher than that for subjects without Aa. In conclusion, the present study confirmed previous cross‐sectional findings reporting that young individuals with an integer periodontium wearing fixed orthodontic appliances harbor Aa with a statistically significant greater frequency than appliance‐free matched controls. However, although orthodontic patients exhibited more inflammation, their deteriorated clinical conditions could not be accounted for by the sole presence of Aa in their sulci. In contrast, appliance‐free young subjects initially infected with Aa had a higher risk of experiencing more gingival inflammation than subjects without the bacterium during a 3‐year observation period.
An 18‐week home‐use study comparing the oral hygiene and gingival health benefits of triclosan and fluoride toothpastes
Authors: Owens J. , Addy M. , Faulkner J.
Published: December 2005

Abstract Several triclosan and stannous fluoride toothpastes have been shown to have plaque inhibitory and more particularly gingival health benefits when compared to minus active controls. There have been relatively few studies to compare such products with conventional fluoride toothpastes in home use. The aim of this study was to compare the relative gingival health benefits of a triclosan/zinc citrate, triclosan/copolymer, stannous fluoride and conventional fluoride toothpastes in a home use study. The study was a double blind, parallel design with a total 143 healthy dentate volunteers (41 male. 102 female) who tooth‐brushed 2× daily with 1 of 4 toothpastes over an 18 week period. At the beginning of the trial, each volunteer was scored for plaque and gingivitis and then received a thorough prophylaxis. Each volunteer was allocated a toothpaste according to a predetermined randomisation scheme. The volunteers were then re‐examined after 6, 12 and 18 weeks. No other oral hygiene products were used during this period. The results showed no statistically significant treatment differences between products for the gingival index throughout the 18 week‐trial. No statistically significant treatment effects between products for plaque index were found at 6 or 18 weeks. However, a small but statistically significant treatment effect for plaque index was seen at 12 weeks in favour of the triclosan/copolymer toothpaste compared to the stannous fluoride and conventional fluoride toothpastes, this difference had disappeared by the 18 week examination. All volunteers oral hygiene and gingivitis scores improved after the baseline examination, and this improvement continued throughout the trial. This is a feature of nearly all toothbrushing studies and can be attributed to the initial prophylaxis and the Hawthorne phenomenon. Such phenomena, noted in home use clinical trials, may mask the efficacy of proven antiplaque formulations.
A 4‐day plaque regrowth study comparing an essential oil mouthrainse with a triclosan mouthrinse
Authors: Moran J. , Addy M. , Newcombe R.
Published: December 2005

Abstract The adjunctive use of antiplaque mouthrinses with normal oral hygiene procedures may produce a significant beneficial effect on gingival health. At present, numerous products are available with various claims for efficacy. Although for many of these products, well‐controlled studies have been carried out comparing the product against a negative control or placebo, very few studies have been carried out directly comparing the efficacy of one commercial product with another. In this observer‐blind, 4‐day plaque regrowth, crossover study, the efficacy of a commercial triclosan mouthrinse was compared to that of an essential oil mouthrinse and 2 placebo controls. Starting from zero plaque at the commencement of each trial period. 32 volunteers used only the allocated rinses as the method of oral hygiene over 4 days, and on the 5th day returned for measurement of plaque index and area. The essential oil rinse produced a plaque reduction of 52% for plaque area and 17% for plaque index compared to its placebo, whilst the triclosan rinse produced a 45% reduction for plaque area and 12% reduction for plaque index against its placebo. Analysis of variance and construction of 95% confidence intervals showed that both active rinses significantly reduced plaque compared to their respective placebo. In addition, the essential oil rinse significantly reduced plaque compared to the triclosan rinse for plaque index but not for plaque area. The findings of this study would suggest that of the 2 rinses, the essential oil rinse would be expected to be more effective at reducing plaque formation in the longer term.
Clinical safety of enamel matrix derivative (EMDOGAIN®) in the treatment of periodontal defects
Authors: Zetterström Olle , Andersson Christer , Eriksson Leif , Fredriksson Anders , Friskopp Johan , Heden Gunnar , Jansson Bernt , Lundgren Tord , Nilveus Rolf , Olsson Anders , Renvert Stefan , Salonen Lars , Sjöström Lars , Winell Anders , Östgren Anders , Gestrelius Stina
Published: December 2005

Abstract The aim of the present clinical trial was to test tolerability during 2 treatments with EMDOGAIN® in a large number of patients. An open, controlled study design in 10 Swedish specialist clinics was chosen, with a test group of 107 patients treated with EMDOGAIN® in connection with periodontal surgery at 2 surgical test sites per patient. The procedures were performed 2 to 6 weeks apart on one‐rooted teeth with at least 4 mm deep intraosseous lesions. A control group of 33 patients underwent flap surgery without EMDOGAIN® at I comparable site. In total 214 test and 33 control surgeries were performed. Serum samples were obtained from test patients for analysis of total and specific antibody levels. 10 of the patients had samples taken before and after the first surgery. 56 other samples were taken after one treatment with EMDOGAIN®, and 63 after 2 treatments. None of the samples, not even from allergy‐prone patients after 2 treatments, indicated deviations from established baseline ranges. This indicates that the immunogenic potential of EMDOGAIN® is extremely low when applied in conjunction with periodontal surgery. Comparison between the test and control groups demonstrated the same type and frequency of post‐surgical experiences, i.e., reactions caused by the surgical procedure itself. Clinical probing and radiographic evaluation was performed at baseline and 8 months postsurgery. About half of the patients (44 test and 21 control) were also evaluated after 3 years. There was a significant difference between the test and control results at 8 months post surgery. and this difference had increased further at the 3 year follow‐up. The 2.5–3 mm increase in attachment and bone level after treatment with EMDOGAIN® was of the same magnitude as seen in the studies with split‐mouth design aiming for lest of effectiveness of EMDOGAIN®.
Studies on stannous fluoride toothpaste and gel (1). Antimicrobial properties and staining potential in vitro
Authors: Wade William , Addy Martin , Hughes Julie , Milsom Susan , Doherty Frances
Published: December 2005

Abstract Stannous fluoride (SF) in a toothpaste vehicle has the potential to provide anticaries and plaque inhibitory benefits through the fluoride and antimicrobial stannous moieties respectively. Dental staining, however, can occur by precipitation of dietary chromogens onto the tooth surface by stannous ions. These studies in vitro compare the antimicrobial profile and propensity to cause tea staining of a number of stannous fluoride formulations, The formulations used were 2 SF toothpaste products (SFl. SF2). 2 experimental SF plus stannous pyrophosphate toothpastes (SFSP1. SFSP2). a SF gel (G| and a NaF toothpaste (C). Maximum inhibitory dilution values against a range of oral bacteria were determined by agar dilution. Tea staining was measured spectrophotometr‐ically on saliva coated dear acrylic blocks exposed to slurries of the paste or gel. All formulations showed antimicrobial activity with the order of greatest activity downwards being C. SF2. SFl, SFSP1, SFSP2 and G.Tea staining at 10 exposures was in the following descending order of optical density SFSP1, SFSP2. G‐C. SFl, SF2. water control. The antimicrobial profile of G was similar to that of SF. whereas that of the other formulations were varied but similar to a detergent profile. The difference in staining suggested considerable variation in availability of stannous ions in the formulations. However, the propensity for stannous ions to stain must be balanced against the stain removal propensity of the contained detergents in the toothpaste formulations. In conclusion, the variation in antimicrobial activity and more particularly staining activity of the formulations suggest the products will vary in activity in vivo.
Guided tissue regeneration with non‐resorbable and biodegradable barriers: 6 months results
Authors: Eickholz Peter , Kim Ti‐Sun , Holle Rolf
Published: December 2005

Abstract The aim of the present study was to compare the effects of guided tissue regeneration (GTR) with non‐resorbable (ePTFE [G]) and biodegradable barriers (Polyglactin 910 (V)). In 20 patients, providing 25 pairs of symmetrical periodontal defects (7 pairs of interproximal intrabony lesions. 12 pairs of degree II and 6 pairs of degree III furcation involvement), each defect was randomly assigned to treatment with either non‐resorbable (control) or biodegradable (test) devices. At baseline and 6 months after surgery, clinical measurements (GI. PPD. PAL‐V. PAL‐H. PII) and standardized radiographs were obtained. On the radiographs, the linear distances from the cemento‐enamel junction (CEJ) to the alveolar crest (AC), and from the CEJ to bottom of the bony defect (BD) were measured using a computer‐assisted analysing method (LMSRT). Both treatments revealed a significant (p <0.05) PPD reduction (‐2.90±1.33 mm (V), ‐2.71±41 mm (G)). PAL‐V gain (1.78± 1.27 mm (V), I.46±1.35 mm (G)), PAL‐H gain (2.00±0.82 mm (V), 1.60±0.59 mm (G)), and radiographic changes (CEJ‐AC: 0.4S±0.75 mm (V). 0.73±0.92 mm (G); CEJ‐BD: ‐0.76±0.79 mm (V). ‐0.41 ±0.72 mm (G)) after 6 months. The mean differences between the changes for test and control were not significant for most clinical and radio‐graphic parameters. Similar clinical and radiographic results were found 6 months after surgical treatment using either non‐resorbable or biodegradable barriers. More favorable results concerning PAL‐H gain could be observed with biodegradable barriers after 6 months. Therefore, based on these results, the use of biodegradable barriers in GTR may be recommended and. thereby, a surgical reentry to remove non‐resorbable barriers can be avoided.
Detection of neutral protease (Periocheck) and BANA hydrolase (Perioscan) compared with traditional clinical methods of diagnosis and monitoring of chronic inflammatory periodontal disease
Authors: Hemmings K.W. , Griffiths G.S. , Bulman J. S.
Published: December 2005

Abstract Perioscan requires a plaque sample to detect the presence of enzymes capable of degrading N‐benzoyl‐DL‐arginine‐2‐naphthylamide (BANA) from relatively few anaerobic periodontal pathogens. Periocheck assays the presence of neutral proteases in crevicular fluid. The aim of this study was to compare these test kits with traditional clinical methods of detecting periodontal disease and to monitor the ability of the kits to reflect the response to initial therapy. 19 patients with moderately severe chronic periodontitis were seen before and after a course of oral hygiene and root instrumentation consisting of 4 appointments. Clinical measurements and test assays were collected at 5 diseased sites and 2 healthy sites in each subject. Complete data from 125 sites were available for statistical analysis. At baseline Periocheck had a sensitivity of 88% and a specificity of 61% whereas Perioscan had a sensitivity of 99% and a specificity of 55%, when related to the clinical diagnosis. A composite clinical assessment, based on improvement or deterioration of one whole unit change of the subjective clinical indices and 2mm changes or greater in probing depth or probing attachment level, revealed 75 sites which improved following treatment, whereas 45 sites did not change and 5 sites deteriorated. The probability that the tests agreed with the clinical outcome after treatment, was calculated as 50.4% for Periocheck and 52% for Perioscan. The diagnostic kits did not reliably reflect the clinical assessment of periodontal disease in the cross sectional study, or the outcome following treatment.
The propensity of different brands of tea and coffee to cause staining associated with chlorhexidine
Authors: Leardand A. , Addy M.
Published: December 2005

Abstract Dental staining is a well known and probably the most problematic side effect of using chlorhexidine oral products. Whatever mechanisms are involved, there is no doubt that cationic antiseptics, such as chlorhexidine, can precipitate or bind to surfaces anionic chromogens contained in foods and beverages. The aim of this study in vitro was to determine whether, under controlled conditions, different brands of tea or coffee varied in their propensity to cause staining associated with chlorhexidine. Optically clear acrylic specimens were cycled through saliva, chlorhexidine and different tea and coffee solutions. Staining was measured using a spectrophotometer. After 15 cycles, it was apparent that staining varied at the extreme, both within and between the tea and coffee groups. All coffee brands produced less staining than the tea brands. The least staining coffee and least staining tea brands were approximately 3x less chromogenic than the most staining equivalent beverage. Previous randomised controlled clinical trials have indicated that tea and coffee contribute to dental and tongue staining associated with chlorhexidine mouthrinses. Additionally, abstinence from tea and coffee significantly reduces staining. The results of this study in vitro suggest that when abstinence is difficult, tea and coffee brands of low chromogenicity may be recommended. Clearly these data in vitro require validation in vivo.
Composition of plaque‐associated lesions in the gingiva and the peri‐implant mucosa in partially edentulous subjects
Authors: Liljenberg B. , Gualini F. , Berglundh T. , Tonetti M. , Lindhe J.
Published: December 2005

Abstract The purpose of the present investigation was to study characteristics of the plaque associated lesions in the gingiva and the adjacent periimplant mucosa sampled from the same subjects. 20 partially edentulous patients (12 female and 8 male. 30–60 years of age) volunteered to participate in the study. They had all been treated for moderate to advanced periodontal disease. Edentulous regions had been restored with implants. The restorative therapy had been completed 6–24 months prior to soft tissue biopsy. Samples of gingival tissue (GM) and periimplant mucosa (PIM) from an “interproximal surface” of one tooth site and one implant site of the same jaw were harvested. One portion of the biopsy was embedded in EPON®. stained in PAS and toluidine blue and used for histometric and morphometric analyses. The 2nd portion of the biopsy was snap frozen in liquid nitrogen. 15 sections, about 5 μm thick, were prepared in a cryostat and used for immune histochemical staining. The analysis of the sections included determination of the size of the lesions as well as assessments of various cells and cell markers. In all samples of both PIM and GM discrete infiltrates of inflammatory cells (ICT) were found in the connective tissue lateral to the junctional epithelium. The ICT of PIM occupied on the average 0.17±0.14 mm2 of the soft tissue, while the corresponding lesion in GM occupied an area that was 0.25 mn2±0.21 mm2 large. The density of CD19 positive cells was 7 times higher in GM than in PIM (3.7 versus 0.5) while the densities of CD3 positive cells were 7.5 (GM) and 4.7 (PM> respectively. The density of PMN elastase positive cells was about 3 times higher in GM than in PIM (3.7 versus 1.2). Care must be exercised when these differences are interpreted. It is possible that a prolonged exposure of the implant site to the oral environment may induce both qualitative and quantitative changes of the infiltrate in PIM.