bluuebunny/crossref_metadata_2025 huggingface dataset:
Location of the mucogingival junction 18 years after apically repositioned flap surgery
Authors: Anjcamo Anja , Bergenholtz Axel , Hugoson Anders , Ainamo Jukka
Published: December 2005

Abstract The apically repositioned flap procedure, by definition, implies that the mucogingival junction (MGJ) is shifted into an apical location. That this actually would be the case has never been shown in long‐term studies. The 13 subjects in the present study had during the years 1964–1965 received treatment of moderately advanced periodontal disease (probing pocket depths ≤5 mm) in the lower jaw. An apically repositioned flap (ARF) procedure was applied in the left or right half of the mandible and a gingivectomy (GE) was performed in the contralateral side. Starting in December 1981, the patients were recalled for clinical and radio‐graphic determination of long‐term results. The width of the band of keratinized gingiva was measured clinically and the distance from the MGJ to the lower border of the mandible (LBM) was measured from orthopantomograms. Slightly less keratinized gingiva was observed on the sides where GE had been used. There was no statistically significant difference in the orthopantomographic distance from the MGJ to the LBM between ARF and GE operations. The results indicate that the apically repositioned flap procedure does not result in a permanent apical shift of the MGJ.
Surgical lengthening of the clinical crown
Authors: Brägger U. , Lauchenauer D. , Lang N. P.
Published: December 2005

Abstract The aim of the present study was to assess the changes in the periodontal tissue levels as an immediate result of the surgical crown lengthening procedure and over a 6–months healing period. 25 patients ranging between 20 to 81 years of age were included in the study. A total of 85 teeth (43 test and 42 control teeth not exposed to surgery) were evaluated over 6 months. After initial therapy, the indication for crown lengthening comprised need for increased retention and accessibility to deep subgingival preparation margins hampering impression taking. During surgery, the alveolar crest was reduced, thereby creating a distance of 3 mm to the future reconstruction margin. The results of this study demonstrated that the mean probeable changes in the levels of the periodontal tissues from those defined after surgery were minimal, resulting in changes comparable to the shifts observed at control teeth not exposed to any surgical procedures. Frequency analysis of the number of sites with dislocation of the free gingival margin demonstrated that 12% of the sites with crown lengthening procedure showed 2–4 mm recession of the free gingival margin between 6 weeks and 6 months postoperatively. In esthetically critical, visible areas of the dentition, recessions must be closely observed in the healing period after surgical crown lengthening, when prosthetic reconstructions are planned on such teeth.
Effects of ultrasonic and sonic sealers on dental plaque microflora in vitro and in vivo
Authors: Baehni P. , Thilo B. , Chapuis B. , Pernet D.
Published: December 2005

Abstract The effects of ultrasonic and sonic sealers on the subgingival microflora were investigated in vitro and in vivo. In the in vitro investigation, 27 plaque samples collected from periodontal pockets were submitted to ultrasonic and sonic vibrations for 10, 30 and 60 s. Bacterial suspensions were examined by dark‐field microscopy to detect qualitative changes and cultured to evaluate the total number of cultivable bacteria. Microscopic counts following both instrumentations showed a decrease in the proportions of spirochetes and motile rods and an increase in the % of coccoids and rods. The changes were directly related to the time‐period of instrumentation. Comparison between both types of instrumentation showed significant differences and more pronounced changes were observed with the ultrasonic than the sonic sealer. Spirochetes and motile rods were reduced to approximately 0.1% after ultrasonic treatment versus 24.7% after sonic instrumentation. Cultural observations showed a marked increase in total number of colony‐forming units following both treatments. The clinical investigation included 66 periodontal pockets which were instrumented subgingivally for 10 and 30 s with ultrasonic or sonic sealers. Qualitative changes were similar to those observed in vitro, i.e., reduction in spirochete and motile rod counts as well as the other morphotypes with an increase in coccoid cells. Total counts of bacteria were reduced following debridement. No difference in the microscopic or cultural data was found between ultrasonic and sonic instrumentation.
Cleaning effectiveness of chewing sticks among Tanzanian schoolchildren
Authors: van Palenstein Helderman W. H. , Munck L. , Mushendwa S. , Mrema F. G.
Published: December 2005

Abstract The oral hygiene of habitual chewing stick and toothbrush users who participated in an oral health education (OHE) programme in schools was evaluated. The study comprised all chewing stick users (n=45) in standard 4 in 8 randomly selected experimental schools and all chewing stick users (n=17) in standard 4 in 4 randomly selected control schools. Each chewing stick user was randomly matched with a toothbrush user of the same sex, age and school. Their ages ranged from 10 to 13 years with a mean of 11.5 years. The children in standard 4 of the 8 experimental schools received OHE. Among many topics aiming to improve oral health of children, the practice of systematic brushing was taught. The children practised weekly brushing sessions in schools under the supervision of instructed teachers. At baseline, the chewing stick users exhibited statistically significant more plaque, but their gingival condition was comparable with their matched toothbrush counter‐pans. After 3 months, the chewing stick and the toothbrush users in the experimental schools, had reduced their plaque and gingival bleeding scores significantly to the same extent, whereas no substantial changes in oral hygiene occurred in the control group. The findings show that schoolchildren who participated in a school programme that emphasizes effective toothbrushing were able to improve their oral hygiene regardless of whether they were habitual chewing stick or toothbrush users.
The use of irradiated‐crosslinked human collagen membrane in guided tissue regeneration
Authors: Quteish D. , Dolby A. E.
Published: December 2005

Abstract Irradiated glutaraldehyde‐crosslinked human collagen membrane was evaluated for its effects on new attachment formation in clinical trials, using the principle of guided tissue regeneration (GTR). 19 adult periodonthis patients with 52 matched bilateral periodontal defects received scaling and polishing with oral hygiene instruction. The bilateral periodontal defects were treated by reflecting a flap with collagen membrane (test) or flap reflection alone (control). Plaque (PII) and gingival index (GI) scorings, probing pocket depth (PPD) and probing attachment level (PAL) along with classification of furcation involvement (FI) and bony defects were made at pre‐ and post surgery (6 weeks, 3 and 6 months!. Improvement of PII and GI scores was seen in both test and control sites following the surgical therapy. Reductions in PPD and PAL were significantly (p< 0.001) more pronounced at 6 months in the test sites compared to the controls. The 2 Class I furcations in the graft‐treated teeth showed complete resolution, while the corresponding furcations in the control teeth showed incomplete closure. The use of human collagen membrane based on the GTR technique for treatment of human periodontal defects provided greater gain of clinical attachment than when flap surgery‐ alone was undertaken.
The relation between periodontitis and systemic bone mass in women between 46 and 55 years of age
Authors: Elders P. J. M. , Habets L. L. M. H. , Netelenbos J. C. , van der Linden L. W J. , van der Sieit P. F.
Published: December 2005

Abstract It has been suggested that periodontitis and systemic bone mass might be related. In order to evaluate this possible relationship, we performed an intra‐oral examination and measured lumbar bone mineral density (lumbar BMD) and metacarpal cortical thickness (MCT) in 286 female volunteers between 46 and 55 years of age. In addition, the alveolar bone height was measured on bite wing radiographs of the dentate subjects. Of the subjects, n=60 (21%) were edentulous. Compared to the dentate subjects, the lumbar BMD and MCT of the edentulous women were not significantly different. In the dentate subjects, no significant correlation was observed between the clinical parameters of periodontitis (mean probing depth, occurrence of bleeding after probing and number of missing teeth) and the bone mass parameters (lumbar BMD and MCT); nor was a significant relation observed between the bone mass measurements and alveolar bone height. We therefore suggest that systemic bone mass is not an important factor in the pathogenesis of periodontitis.
The effect of strontium chloride hexahydrate dentifrices on plaque accumulation and gingival inflammation
Authors: Gillam D. G. , Newman H. N. , Bulman J. S.
Published: December 2005

Abstract. 2 strontium chloride hexahydrate‐containing dentifrices (SCH), similar except for their respective abrasive systems, diatomaceous earth or silica‐based, were compared for their effects on plaque accumulation and gingival inflammation as part of a 2‐month randomised double‐blind parallel clinical study. No attempt was made to change the patients' oral hygiene prior to participation in the study. Plaque was assessed using the Silness & Löe index and the gingival condition by the Löe & Silness index GI. There was a slight and non‐significant increase in plaque accumulation at 2 weeks from baseline, but relatively negligible change thereafter, the effect being identical in both groups. Similarly, the gingival condition showed a slight index change from baseline, although it tended to be slightly higher in the diatomaceous earth group. The results do not support the conclusions of previous studies which indicated that SCH dentifrices increased plaque accumulation. Neither plaque accumulation nor gingival condition significantly changed from baseline levels during the course of the study.
The effect of supragingival plaque control on the composition of the subgingival flora in periodontal pockets
Authors: Katsanoulas Thomas , Reneè Ingrid , Attström Rolf
Published: December 2005

Abstract. The effect of mechanical supragingival plaque control on the composition of the subgingival microflora in untreated 4‐6 mm deep periodontal pockets was investigated. 13 subjects with chronic periodontitis were recruited for the study. Periodontally‐diseased sites were subjected to professional plaque control 3 × weekly for a period of 3 weeks. Contralateral sites received no prophylaxis and served as controls. No instructions in oral hygiene procedures were given to the patients who maintained their habitual oral hygiene regime during the observation period. Clinical examination and darkfield microscopic analysis of bacterial samples were performed every week. The PII scores for the experimental sites were reduced markedly, while those for the control sites remained stable throughout the observation period. No changes in the other clinical parameters were detected during the study. The composition of the subgingival microflora at the control sites did not change during the experimental period. In contrast, at the test sites, the proportion of spirochetes + motile rods decreased continuously. This decrease reached statistical significance at the end of the experiment. The results indicate that at periodontally diseased sites with an established subgingival ecosystem, supragingival plaque removal may influence the composition of the subgingival microflora.
Guided tissue regeneration in the treatment of infrabony defects on maxillary premolars
Authors: Proestakis George , Bratthall Gunilla , Soderholm Göran , Kullendorff Boel , Grondahl Kerstin , Rohlin Madeleine , Attström Rolf
Published: December 2005

Abstract. The present study evaluated clinically and radiographically the short‐term results of the healing of infrabony defects at maxillary premolars treated according to guided tissue regeneration (GTR). 9 patients with bilateral presence of infrabony defects with or without furcation involvements at maxillary premolars were selected. At baseline assessments of plaque and gingival indices, bleeding, probing pocket depth and attachment level, and furcation measurements were recorded. Conventional radiographs were obtained in a way that assured a reproducible projection geometry. One premolar was randomly treated with GTR and the contralateral with open debridement. Clinical and radiographic examinations were performed again 6 months postoperatively. The bone tissue changes were assessed by means of conventional radiographs and subtraction images. Sites treated by both procedures demonstrated an improvement of gingival conditions and a reduction of pocket depths. A statistically significant attachment gain was obtained for the test (mean 1.2 mm), but not for the control sites (mean 0.6 mm). The differences, though, were not significant between the test and control sites. Limited improvement in furcation closure was recorded. The radiographic examination demonstrated loss of bone tissue in four sites treated with GTR. The findings suggest that the regeneration of the periodontal soft and bone tissues was not significantly enhanced with the GTR therapy.
Intrafamily influences on health behavior
Authors: Rossow Ingeborg
Published: December 2005

Abstract. The purpose of this study was to assess quantified measures of intrafamily patterns of influence on interdental cleaning behavior based on a conceptual model of family influences on health behavior. Data stemmed from the Norwegian National Health Survey 1985, comprising 295 two‐parent families with 2 children above 6 years of age. Analyses were performed with the family as the sampling unit. Logistic regression analyses were applied. The results showed that there were statistically significant associations of interdental cleaning behavior among all pairs of family members, the strongest association being between siblings (OR = 36.6). The multivariate analyses of interdental cleaning behavior of the children showed that the strongest explanatory factor was the interdental cleaning behavior of the mother(OR = 2.4).Thus, the mother seems to play an important role in the formation and maintenance of the elder child's interdental cleaning behavior. The highly correlated interdental cleaning behavior of the 2 siblings could be explained by correlated measurement errors as well as equity in rules and parental control and reinforcement of the behavior, in addition to substantive influential effect of the elder sibling's interdental cleaning behavior on that of the younger sibling.
The power of tests to detect differences between periodontal treatments in published studies
Authors: Hujoel P. P. , Baab D. A. , DeRouen T. A.
Published: December 2005

Abstract. 10 studies comparing periodontal treatment modalities were re‐examined to see if they had adequate power to detect true differences. Attachment level (AL) and pocket depth (PD) were the 2 variables assessed. A statistical test's power refers to its probability of detecting a significant sample difference in treatment means, given a predetermined value for α (level of significance), Δ (a clinically meaningful underlying difference), and the sample size. Studies were included that stratified their data by initial pocket depths, reported sample size, and lasted at least 6 months. Power calculations were done for 173 treatment comparisons, using Δ‐0.5 mm and α= 0.05. For shallow pockets (1‐3 mm), most studies had a strong chance of detecting true differences (median power = 83%). For moderate pockets (4‐6 mm), median power dropped to 38%. However, median power dropped to 14% for deep pockets (> 6 mm), with 75% of the tests having less than a 20% chance of detecting a 0.5 mm difference. Many of the modalities reported as “not significantly different” from each other have not had a fair trial, especially for deep pockets. In order to improve a study's power, 4 factors are discussed: the number of compared treatments, the expected noise or random error, the patient sample size, and the average number of sites per patient for each pocket depth category.
Relationship between periapical and periodontal status
Authors: Jansson L. , Ehnevid H. , Lindskog S. , Blomlöf L.
Published: December 2005

Abstract The purpose of the present investigation was to explore possible relationships between clinical periodontal status in periodontally involved teeth with and without endodontic infection. The investigation was conducted as a retrospective study on a consecutive referral population. The periapical conditions in endodontically‐involved single‐rooted teeth from a selected patient sample were evaluated and correlated to their periodontal status. There was a significant correlation between periapical pathology and vertical bony destructions. An intra‐individual comparison between pocket depth in teeth with and without periapical pathology showed that periapical pathology was significantly correlated to an increased pocket depth in the absence of a vertical bony destruction. It was concluded that an endotontic infection, evident as a periapical radiolucency. promotes periodontal pocket‐formation on an instrumented marginal root surface and, consequently, should be regarded as a risk factor in periodontitis progression and be given appropriate consideration in periodonlal treatment planning.
Evaluation of anti‐calculus efficacy
Authors: Gaengler P. , Kurbad A. , Weinert W.
Published: December 2005

Abstract A double‐blind, cross‐over study was carried out to assess the anti‐calculus effectiveness of a pyrophosphate containing cleaning gel. 2 groups of 30 heavy calculus formers were followed up comparing conventional clinical scoring systems (Volpe‐Manhold‐Index and Marginal‐Line‐Calculus‐index) and micromorphologic SEM criteria of calculus formation and inhibition. The results indicated that after a 3‐month period, there was a significant reduction of calculus formation compared to a placebo gel. The proposed SEM calculus index (SEMCI) objectively reflects the reduction of supragingival calculus formation.
Utility of Ramfjord index teeth to assess periodontal disease progression in longitudinal studies
Authors: Rams Thomas E. , Oler Jacqueline , Listgarten Max A. , Slots Jørgen
Published: December 2005

Abstract The feasibility of using the Ramfjord index teeth to estimate whole‐mouth periodontal disease activity was investigated. Whole‐mouth examinations were carried out semi‐ammally over a 36‐month period in 98 maintenance patients previously treated for adult periodontitis. Recurrent periodontitis was defined as either a 3‐mm or greater probing depth increase from baseline, or a 2‐mm or greater probing depth increase together with 2‐mm or greater of relative attachment loss measured from a reference stent. Whole‐mouth disease activity was compared lo Ramfjord index teeth data, with and without adjustment. Adjustment was made by multiplying disease activity rates on Ramfjord index teeth by the ratio formed from the sum of all teeth present over the sum of all Ramfjord index teeth in the study population. Without adjustment, Ramfjord index teeth markedly underestimated subjects with recurrent disease activity when compared to whole–mouth findings. However, with adjustment, the hypothesis that upper and lower limits on whole‐mouth incidence of recurrent periodontitis could be estimated from Ramfjord index teeth disease‐activity rates were not rejected (P > 0.20, z‐test) at any 6‐month interval. At 5 of 6 examinations, the % of disease active subjects as determined from whole‐mouth evaluations was below the upper limit for disease incidence calculated, with 95% confidence, from point estimates derived from adjusted Ramfjord index teeth data. Partial‐mouth examinations with appropriate adjustment of Ramfjord index teeth data may be useful for assessing periodontal disease progression in longitudinal population studies of human periodontitis.
Relative effectiveness of various alternating frequencies of a power toothbrush
Authors: Kühner M. , Raetzke P.
Published: December 2005

Abstract The influence on‐removing efficiency of the alternating frequency of a powered brush has never been established. In the present study, a mechanical brush was tested at various alternations per minute (Fl = 2100, F2 = 500, F3 = 3500). A double‐blind, randomized, triple crossover design was applied. After a plaque growth phase, the testbrushes were used under supervision for 90 s and the remaining plaque scored. A ridit analysis yielded significant differences between F2 and F1/F3. Odds ratios and frequency distributions demonstrated a clinically meaningful advantage for F2. Subjective evaluation by the participants confirmed the positive performance of F2. The results can be generalized in 3 ways: (1) the alternating frequency of a power brush influences its effectiveness. (2) high frequencies are not generally superior, (3) the test brush has its optimal cleaning efficiency at F2. which does not necessarily need to be true for other brands. It seems imperative to determine the optimal frequency for any new brush in a controlled study.
Dimensional alterations of the gingiva related to changes of facial/lingual tooth position in permanent anterior teeth of children
Authors: Andlin‐Sobocki Anna , Bodin Lennart
Published: December 2005

Abstract Maxillary and mandibular anterior permanent teeth in 38 children aged 7–12 years were examined 2 × with an interval of 2 years to determine whether spontaneous facial/lingual tooth position changes were related to alterations of the widths of keratinized and attached gingiva and the clinical crown height. Measurements included dental plaque, gingival inflammation, probing depth, and width of keratinized and attached gingiva. In addition, study casts from the baseline and 2‐year examinations were used to measure clinical crown height and tooth position. The results showed that significant alterations in the widths of the keratinized and attached gingiva took place when the teeth changed positions in facial or lingual directions. The changes in gingival widths could to some extent be coupled to changes in clinical crown height. In teeth moving lingually, the gingival widths increased and the clinical crown height decreased. In teeth moving facially, the gingival widths decreased, and the facial gingiva sometimes receded. These gingival alterations call for examination of the facial gingiva as part of the monitoring of the development of the permanent dentition.
Periodontal healing in teeth with periapical lesions
Authors: Ehnevid H. , Jansson L. , Lindskog S. , Blomlöf L.
Published: December 2005

Abstract The purpose of the present investigation was to compare clinical periodontal healing in periodontally involved teeth with and without pulpal pathosis. The investigation was conducted as a retrospective study on a consecutive referral population. The periapical conditions in endodontically involved single‐rooted teeth from a selected patient sample were evaluated and correlated with their periodontal healing pattern. Multiple regression analysis of the registered variables showed that initial mean pocket depth and time elapsed after treatment significantly influenced change in pocket‐depth. Non‐surgical treatment of periodontal pockets exceeding 2.5 mm in teeth with horizontal marginal defects, over the observation period, showed significantly reduced mean pocket depth reduction in teeth with periapical pathology compared to teeth without periapical pathology. It was, furthermore, evident that proximal restorations, abutments for fixed bridges and root fillings with and without dowels did not significantly influence pocket depth reduction in the present material. It was concluded, based on the present results, that a root‐canal infection, evident as a periapical radiolucency, if left untreated may in the long term perspective result in retarded or impaired periodontal healing following periodontal therapy and, consequently, should be given appropriate consideration when coordinating endodontic therapy and periodontal treatment.
Periodontal disease in an Amish population
Authors: Bagramian Robert A. , Farghaly Mahassen M. , Lopatin Dennis , Sowers Maryfran , Syed Salam A. , Pomerville Julie L.
Published: December 2005

Abstract Epidemiological studies of periodontal disease have attempted to focus on defined groups in which the variables thought to be responsible for disease could be controlled or more easily identified, This study documents periodontal disease parameters in a unique population of Amish farmers. A total of 371 Amish were contacted and 282 were examined in their homes giving a participation rate of 76%. Ages ranged from 18 to 79 years. Overall means for periodontal conditions were 1.54 mm for attachment loss, 2.63 mm for pocket depth, 0.17 for calculus, 0.63 for plaque and 0.61 for gingivitis. One dental examiner conducted all examinations. Prevalence of periodontal disease tended to be higher among males and increased with age. The majority of Amish examined had little evidence of destructive periodontal disease; about 3.4% of teeth examined had attachment loss of 6 mm or more. These findings indicate a modest level of periodontal disease among the Amish. It is of interest that this population does not generally seek routine dental care. Preliminary analyses of health behavior data collected indicate a lack of regular oral hygiene practices. It appears that the Amish may have protective factors which affect their level of disease.
The effect of a triclosan‐containing dentifrice on established plaque and gingivitis
Authors: Lindhe J. , Rosling B. , Socransky S. S. , Volpe A. R.
Published: December 2005

Abstract The aim of the present clinical trial was to study the effect on existing plaque and gingivitis of an oral hygiene regimen which utilized a dentifrice which contained triclosan. 120 subjects were recruited for the trial. They were examined for plaque and gingivitis using the criteria of (i) the Turesky modification of the Quigley & Hein plaque index and (ii) the Löe & Silness gingival index. Plaque and gingivitis were assessed in all parts of the dentition and at 6 location points around each tooth. Following a baseline examination, the subjects were stratified in 2 balanced groups based on age, plaque and gingivitis scores. The subjects were randomly assigned to the following treatment: 1 test group used a dentifrice containing triclosan/copolymer/fluoride and 1 control group used a traditional fluoride containing dentifrice. The participants were given the assigned dentifrice and a soft‐bristled toothbrush for home use. They were instructed to brush their teeth in the morning and in the evening for one minute each time. They were re‐examined 6 weeks, 3 and 6 months after the baseline examination. The findings from the re‐examinations revealed that an oral hygiene regimen which utilized a dentifrice which contained triclosan/copolymer significantly reduced pre‐existing plaque and gingivitis above what was accomplished by a traditional fluoride containing dentifrice. The improvement of the gingival conditions occurred in all parts of the dentition and at all tooth surfaces and units. In addition, the present data support the hypothesis that triclosan may induce alterations in the quality of existing plaque.
The effect of a mouthrinse based on nisin, a bacteriocin, on developing plaque and gingivitis in beagle dogs
Authors: Howell T. H. , Fiorellini J. P. , Blackburn P. , Projan S. J. , de la Harpe J. , Williams R. C.
Published: December 2005

Abstract The aim of this study was to evaluate the effect of nisin, an antimicrobial peptide, on the development of plaque and gingivitis in beagle dogs when compared with 0.12% chlorhexidine and a placebo. 16 female beagle dogs 1 year of age were brought to optimum gingival health by scaling, root planing and polishing. At the conclusion of the pretreatment phase, the dogs were divided into 4 groups for the application of the test agents and were placed on a plaque promoting diet of Purina Dog Chow softened with water. Test agents included 100 μg/ml nisin and 300 μg/ml nisin formulated in a vehicle containing 1 mM NaEDTA; negative control comprised of exactly the same formulation but omitting nisin; and 0.12% chlorhexidine as Peridex®. Throughout the treatment period, formulations were applied 2 × daily to premolar teeth in each quadrant for 1 min using a Monojet syringe. The development of plaque and gingivitis was monitored at 15, 27, 39, 53, 74 and 88 days during the treatment phase using standard measurements of gingival index, plaque index, stain index and bleeding to probing. Throughout the treatment phase, plaque accumulation increased in all groups, but the rate of plaque build‐up was less in groups treated with either nisin or chlorhexidine formulations compared with the placebo treated group. The gingival index of dogs in all groups increased throughout the study period. However, from day 27 onward, the groups receiving nisin had lower gingival index scores than did the placebo group. At day 39 and onward, the chlorhexidine group had significantly lower gingival index scores than the placebo group. All groups demonstrated an increased in % Weeding sites. However, from day 27 onward, the 300, μg/ml nisin group and from day 39 the 100 μg/ml group, had significantly fewer % bleeding sites than the placebo group. An evaluation of the staining intensity index revealed that staining for the chlorhexidine‐treated group was significantly greater than that of placebo and nisin at days 27, 74 and 88. In conclusion, nisin is an antimicrobial agent and is effective in the reduction of plaque build‐up and gingivitis in the beagle dogs.
Gingivitis, plaque accumulation and plaque composition under long‐term use of Meridol®
Authors: Zimmermann A. , Flores‐de‐Jacoby L. , Pan P. , Pan P.
Published: December 2005

Abstract The effectiveness of amine fluoride and stannous fluoride in the prophylaxis of caries and gingivitis is well‐known from the literature. The aim of this study was to assess whether these agents could be recommended for long‐term use. Under conditions of a clinical double‐blind study, the influence of an amine/stannous fluoride rinse on gingivitis, plaque accumulation and the composition of the supragingival plaque was tested over a period of 7 months. 102 persons with signs of chronic gingivitis participated in the study. Gingival indices (GI, SBI) and plaque indices (PlI, API) were recorded at baseline, after 3.5 and 7 months. The composition of the supragingival plaque was evaluated by dark‐field microscopy. During the 7 months, the GI decreased in the test group from 1.36 to 0.95, and the SBI from 52.0% to 29.3%. The PlI fell from 1.17 to 0.68, and the API from 61.3% to 50.6% (p<0.001). No significant changes were recorded in the control group. In the test group, the proportion of cocci in the plaque increased from 58.4% to 68.9% (p<0.001) while the proportion of rods and other plaque bacteria underwent a significant decrease (p<0.001). The microflora was stable in the control group throughout the study period. No side‐effects of the drug were reported by the pro‐bands. The results suggest that long‐term use of the amine/stannous fluoride rinse is of benefit to gingival health.
The periodontally‐involved root surface
Authors: Corbet E. F. , Vaughan A. J. , Kieser J. B.
Published: December 2005

Abstract Recent years have seen much research on the periodontally‐involved root surface. Many of these studies have produced results which suggest that plaque contaminants of the root surface are only superficially placed, and capable of being removed by gentle means. Further research has attested to the difficulties in rendering periodontally‐involved root surfaces free of calculus deposits by instrumentation, yet clinical studies show that periodontal disease can be managed by root planing. It is concluded that root surface debridement is best assessed on the basis of the healing response and that it should aim to disrupt plaque on and remove plaque from the periodontally‐involved root surface rather than to remove part of the root surface itself.
Long‐term control of diabetes mellitus and periodontitis
Authors: Tervonen Tellervo , Oliver Richard C.
Published: December 2005

Abstract The purpose of this study was to evaluate the association between long‐term control of diabetes mellitus (DM) and periodontitis, A total of 75 diabetics (Type I or II) aged 20–70 years with long‐term records of their diabetic control were selected for the study. The following periodontal variables were recorded in a randomized half‐mouth examination: plaque, calculus (+/−), probing depth (pd) and attachment loss (al). The mean of glycosylated hemoglobin measurements (IIbAlc) over the past 2–5 years was used to indicate the long‐term control of DM. The study participants were divided into well‐, moderately‐ and poorly‐controlled diabetics. An increase in the prevalence, severity and extent of periodontitis with poorer control of diabetes was observed. The extent of calculus also increased with poorer control. In a multiple regression analysis, calculus and long‐term control of diabetes were significant variables when pd≥4 mm was used as the dependent variable. Age was a significant predictor for al > 3 mm but not for pd ≥4 mm. Sex, duration and type of DM were not significant variables in the regression models. Less than 2% of sites with no calculus demonstrated pd≥4mm. When calculus was present, the frequency of pd ≥4 mm increased from 6% in the well‐controlled diabetics to 16% in the poorly‐controlled ones. We conclude that periodontitis in diabetics is associated with long‐term metabolic control and presence of calculus. Therefore, regular maintenance care, including patient motivation and instruction as well as professional calculus removal, is important for diabetic patients.
The use of topical flurbiprofen as an adjunct to non‐surgical management of periodontal disease
Authors: Heasman P. A. , Benn D. K. , Kelly P. J. , Seymour R. A. , Aitken D.
Published: December 2005

Abstract Non‐steroidal anti‐inflammatory drugs (NSAIDs) have been used as systemic and topical preparations to control chronic periodontal disease in both animal and clinical human trials. Equivocal findings have failed to confirm whether any one NSAID is particularly efficacious, although flurbiprofen appears to be one of the most promising. 49 patients were allocated at baseline to test (25) and control (24) groups in a 12‐month, controlled clinical trial. The groups were of similar age and sex distributions. During the first 3 months, both groups were given oral hygiene instruction and received scaling and root planing. The test patients were prescribed a 1% w/w flurbiprofen toothpaste to use 2 × daily for the entire 12 months. Control subjects were prescribed a placebo dentifrice. Plaque scores, bleeding scores, crevicular fluid flow, probing pocket depths and attachment levels were assessed at baseline and at 3, 6, 9 and 12 months. Radiographs were taken at baseline and 12 months using a modified intraoral, repositionable film holder. Both the flurbiprofen and placebo showed significant improvements in the clinical parameters over 12 months and there were no significant differences between the groups. Flurbiprofen‐treated patients however, demonstrated a significantly greater proportion of sites (8.0%) with bone gain when compared to the placebo group (3.3%). There were no significant differences between the groups in the number of sites showing bone loss or no change. It is concluded that the 1% w/w flurbiprofen toothpaste exerts a small, yet significant effect on bone metabolism in the absence of any apparent effects on clinical parameters.
Evaluating the efficacy of a new flossing aid
Authors: Spolsky V. W. , Perry D. A. , Meng Zhi , Kissel P.
Published: December 2005

Abstract The purpose of this clinical trial was to compare the efficacy of a new flossing aid (Flosser®) with finger flossing on preventing plaque and gingival inflammation. 35 adults who did not use dental floss routinely were assigned randomly to one of 2 treatment groups (Flosser® or finger flossing) in a 2‐period, single‐blind crossover study. After prophylaxis, subjects were instructed to use the flossing aid or finger floss 1 × per day and to continue brushing for 30 days. Gingival inflammation (GI & BPI) and plaque (PI) were assessed prior to the prophylaxis and at 30 days. After a 30 day “washout” period, subjects were again reassessed for gingival inflammation and plaque, given a prophylaxis, assigned the opposite treatment (2nd treatment period) that they received the first treatment period, and assessed (GI, BPI & PI) after 30 days. Comparing the mean difference of the 30‐day buccal interproximal scores between the treatment groups (flossing aid scores minus finger flossing scores) showed that the mean differences with 95% CI were: −0.013±0.067 [GI], −0.017±0.044 [BP] and 0.019±0.014 [PI]. No statistically significant differences from zero (0.05 alpha) were observed using the t‐test. There was a high levei of compliance (90%) with the prescribed regiment, and subjects preferred (56%) the flossing aid slightly over finger flossing. Even though there were no statistically or clinically significant differences in gingivitis and plaque scores between the 2 flossing groups, the positive inclination for the flossing aid makes it a desirable addition to the armamentarium of preventive dentistry.
Secnidazole concentrations in plasma and crevicular fluid after a single oral dose
Authors: Tenenbaum H. , Cuisinier F. J. G. , Le Liboux A. , Pichard E. , Montay G. , Frydman A.
Published: December 2005

Abstract Metronidazole and related nitroimidazole derivatives, including ornidazole and tinidazole, have been used successfully in the treatment of periodontal diseases. The purpose of this study was to measure secnidazole (another nitroimidazole derivative) concentrations in plasma and gingival crevicular fluid (GCF) after intake of a single oral dose. Secnidazole concentrations were estimated in 11 human healthy volunteers after a single dose of 2 g taken orally. Samples of blood and GCF were collected before intake and during (he following 72 h. A high‐performance liquid chromatography (HPLC) method has been developed for the determination of secnidazole in microsamples (1 to 3 μl) of GCF. The mean peak blood and GCF levels were equal to 40.5±9.4 μg ml−1 at 2 h in blood and 26.4±7.0 μ ml−1 at 1 h in GCF, respectively. Apparent elimination half‐life was 28.8 h (blood) and 30.4 h (GCF), respectively. These results show that the rate and extent‐absorption of secnidazole are slightly higher in blood than in GCF, but the elimination of the drug is similar in the two body fluids.
Healing in periodontal defects treated by decalcified freeze‐dried bone allografts in combination with ePTFE membranes
Authors: Guillemin M. Reina , Mellonig James T. , Brunsvold Michael A.
Published: December 2005

Abstract This study clinically evaluates the use of decalcified freeze‐dried bone allograft (DFDBA) in conjunction with an expanded polytetrafluoroethylene (ePTFEJ membrane specifically designed for the treatment of interproximal intraosseous defects. It also examines by SEM, plaque contaminated membranes retrieved from patients. 15 advanced periodontitis patients with two bilateral interproximal probing depths of >6 mm participated. After hygiene phase, measurements were made to determined soft tissue recession, pocket depth, clinical attachment levels and amount of keratinized tissue. Defects from each pair were randomly treated with ePTFE plus DFDBA (experimental) or DFDBA alone (control). Measurements were made during the surgery to determine crestal resorption, defect resolution and defect fill. Membranes were removed at 4 to 6 weeks and analyzed by SEM. Each site was surgically reentered and measurements repeated at sis months. Both groups showed clinical and statistically significant changes when compared to baseline (P <0.01), but no difference between groups. The experimental group showed increased soft tissue recession vs control group, 0.9 versus 0.4 mm, and loss of keratinized tissue 1.6 versus 0.1 mm (P <0.0001). Control sites showed a 58% bone fill while experimental sites had 70% bone fill. There were no clear patterns of microbial colonization or cell adherences in either side of the membrane. It was concluded that the presence of plaque on the membranes did not compromise the initial clinical healing during the first 4–6 weeks. Results suggest a beneficial effect with the use of either technique for the treatment of intraosseous defects.
Autotransplantation of a tooth using guided tissue regeneration
Authors: Hürzeler Markus B. , Quiñones Carlos R.
Published: December 2005

Abstract Autotransplanlation is an alternative treatment to replace missing or periodontally‐involved hopeless teeth. A prerequisite for performing this procedure is having a recipient site with sufficient bone volume to support the transplant. Often, however, crestal bone resorption following tooth extraction or periodontitis results in a reduced alveolar ridge with inadequate dimensions to properly house the transplant. In these cases, the procedure is contraindicated. A case is presented in which the biologic principle of guided tissue regeneration was used to gain periodontal support around an autotransplanted 3rd molar. The results suggest the potential use of guided tissue regeneration in conjunction with autotransplantation. This may represent a new area in reconstructive dentistry.
Compliance perceived by Dutch periodontists and hygienists
Authors: Berndsen Mariëtta , Eijkman Michiel A. J. , Hoogstraten Johan
Published: December 2005

Abstract Compliance is defined here as the extent to which a patient's behavior is in accordance with the health advice he has received. On the basis of factors which could affect compliance, a quantitative survey was conducted for a group of 38 periodontists and their senior dental hygienists. The opinions of periodontists and hygienists in perceiving compliance were examined. Although there was agreement between periodontists and hygienists on some well‐established aspects of compliance, the survey revealed that the rôle of the hygienist is of considerable consequence; hygienists appear to be more patient‐oriented than periodontists. Furthermore, it is stated that poor understanding of recommendations by patients needs more attention.
Effect of periodontal root planing on dentin permeability
Authors: Foget Howard M. , Pashley David H.
Published: December 2005

Abstract The purpose of this study was to quantitate the effects of root planing on the permeability of human root dentin in vitro. Unerupted 3rd molars were used. The crowns were removed and longitudinal slices made of the root. The hydraulic conductance of the root dentin was measured before and after root planing, acid etching and potassium oxalate application using a fluid filtration method. The results showed that root planing creates a smear layer that reduces the permeability of the underlying dentin, However, this smear layer is acid labile, Thus, root planing may ultimately cause increased dentin permeability and the associated sequelae of sensitive dentin, bacterial invasion of tubules, reduced periodontal reattachment and pulpal irritation.
The effect of sibling relationship on the periodontal condition
Authors: van der Velden U. , Abbas F. , Armand S. , de Graaff J. , Timinerman M. F. , van der Weijden G. A. , van Winkelhoff A. J. , Winkel E. G.
Published: December 2005

Abstract The purpose of this investigation was to study clinically as well as microbiologically the effect of sibling relationship on the periodontal condition in a young population with a relatively high prevalence of periodontal disease and deprived from regular dental care. In this study, 23 family units consisting of 3 more siblings were evaluated. In all, 78 subjects aged 15 to 25 years were included in the study, The mean interproximal amount of Joss of attachment in this population was 0.29 mm. The individual mean ranged from 0 to 1.27 mm. In 33% of the subjects, 1 sites with a probing depth of 5 mm or more in conjunction with 2 mm of attachment loss were present. The results show a significant sibship effect for: plaque, calculus, loss of attachment, spirochetes on the tongue and in the pocket, Porphyromonas gingivalis on the gingiva and in the saliva and Prevotella intermedia in the saliva. These results support the hypothesis that periodontitis aggregates in families.
A socio‐ecologic model for periodontal diseases
Authors: Hansen B. Frode , Bjertness Espen , Gronnesby Jon Ketil
Published: December 2005

Abstract A socio‐ecologic conceptual model for periodontal diseases has been proposed. The model, which includes 4 items: health‐care organization, human biology, behavioral factors, and environment, has been tested on a random‐sample of 50‐year‐old Oslo citizens. The investigation is based on a clinical examination as well as a questionnaire and structured interview. A logistic regression mode] was used to study associations between risk factors and the probability of deep periodontal pockets (>5.5 mm). The risk of periodontal pockets was positively associated with: short duration of education, being of male gender, previous periodontal treatment, poor oral hygiene and infrequent toothbrushing. Variables describing behavioral factors and human biology were the items found to be most closely associated with periodontal pocketing.
Excretion of lignocaine and its metabolite Amonoethylglycinexyliclide in breast milk following its use in a dental procedure
Authors: Lebedevs Tamara H. , Wojnar‐Horton Richard E. , Yapp Patrick , Roberts Malcolm J. , Dusd Leon J. , Hackett L. Peter , IIett Kenneth
Published: December 2005

Abstract The excretion of lignocaine in breast milk has been documented in a 34‐year‐old woman following the injection of 20 mg lignocaine for a dental alloy restoration in the right upper quadrant. Lignocaine and its primary metabolite monoethylglycinexylidide in milk and plasma were quantified by high‐performance liquid chromatography. The concentration of lignocaine in milk ranged from 44–66 μgl−1 while that for monoethylglycinexylidide ranged from 35–41 μgl−1. The milk: plasma ratios for lignocaine and monoethylglycinexylidide were 1.1 and 1.8, respectively. The calculated daily infant doses for the parent drug and metabolite were both less than 0.01 mg kg−1 day−1. With the exception of very rare allergic reactions, these levels of infant exposure are extremely low and of no toxicological significance. Nursing mothers receiving lignocaine for standard dental procedures can be advised that continuation of breast feeding is safe.
The prevalence and severity of cyclosporin and nifedipine‐induced gingival overgrowth
Authors: Thomason J. M. , Seymour R. A. , Rice N.
Published: December 2005

Abstract The gingival health of 32 renal transplant patients who were medicated with cyclosporin was compared with a similar cohort of 23 renal transplant patients medicated with both cyclosporin and nifedipine. Both groups of patients had been taking the above medication for at least 3 months. Plaque scores, gingival inflammation and probing depths were similar for both groups. Patients medicated with the combination of nifedipine and cyclosporin had a significantly higher gingival overgrowth score (p= <0.046) when compared with the group receiving cyclosporin alone. The incidence of clinically significant overgrowth (i.e., overgrowth >30% which would require surgical intervention) was similar in both groups. Gingival overgrowth was not related to cyclosporin dosage. It is concluded that patients taking cyclosporin or cyclosporin and nifedipine experience gingival overgrowth and that the severity of the overgrowth is greater in patients taking the combined therapy. The levels of plaque and gingival inflammation appear to be associated with this phenomenon.