bluuebunny/crossref_metadata_2025 huggingface dataset:
A clinical comparison of three powered toothbrushes
Authors: Van Der Weijden G. A. , Timmerman M. F. , Piscaer M. , IJzerman Y. , Van Der Velden U.
Published: March 2003

Aim:  The purpose of the present study was to compare the ability of the Braun Oral‐B 3D Excel power toothbrush (BPT), the Sonicare power toothbrush (SPT) and the Philips Sensiflex 2000 (HX 2550) power toothbrush (PPT) to control plaque and reduce experimentally induced gingivitis.

Materials and methods: Two experiments were carried out in two different groups of subjects using a split‐mouth design whereby the two halves of the mandible which had been allowed to develop gingivitis were brushed over a 4‐week period with the test toothbrushes. Experiment 1 compared the BPT with the SPT (n = 35) and experiment 2 compared the BPT with the PPT (n = 32). The study used a run‐in period of 2 weeks, which, together with the 3‐week experimental gingivitis phase, represented the pretrial phase of the experiment. The purpose of this phase was two‐fold: first, to enable the subjects to become acquainted with the two power brushes and for them to receive proper oral hygiene instruction, and, second, to develop a reasonable level of gingivitis on the mandible. Those subjects with at least 40% of sites exhibiting bleeding in each quadrant in the mandible at day 21 of the experimental gingivitis phase were allowed to continue with the trial. During the next 4 weeks (treatment phase) of each experiment, subjects were told to brush according to a split‐mouth design, the right and left sides of the mouth being randomly allocated to a toothbrush. During this period, no rinsing with an antiseptic mouthwash or flossing was allowed and a standard toothpaste (Zendium®) was used. After 1, 2 and 4 weeks, the plaque index (Quigley & Hein) and the bleeding tendency on marginal probing were assessed in the mandible.

Results: Experiment 1 showed that the bleeding score was reduced from 1.63 to 1.12 at 4 weeks by the BPT and from 1.65 to 1.26 by the SPT. This reduction was more rapid and greater with the BPT (P < 0.05). The plaque index was reduced from 2.19 at day 21–1.03 at 4 weeks by the BPT, and from 2.18 to 1.20 by the SPT. The difference between the two toothbrushes was not significant. Experiment 2 showed that the bleeding score was reduced from 1.77 at day 21 to 1.07 at 4 weeks by the BPT and from 1.75 to 1.24 by the PPT. This reduction was more rapid and greater with the BPT (P < 0.05). There was no significant difference in plaque index at 4 weeks (BPT, 1.09; PPT, 0.95). Data from the questionnaire at the end of the study revealed that, in both experiments, most subjects preferred the BPT.

Conclusions:  The data from this study show that the design and action of the Braun Oral‐B 3D Excel power toothbrush are more effective in resolving gingivitis than the Sonicare & the Philips Sensiflex 2000 power toothbrushes.
Interleukin‐1 gene polymorphisms and experimental gingivitis
Authors: Jepsen Søren , Eberhard Jörg , Fricke Dörte , Hedderich Jürgen , Siebert Reiner , Açil Yahya
Published: March 2003

Background: Recently, an association between the severity of periodontitis and specific variations in the interleukin‐1 (IL1) α and β genes has been demonstrated.

Aim: The purpose of this study was to evaluate the relationship of the IL1 genotype to the development of experimental gingivitis.

Materials and Methods: Twenty young adult subjects presenting with healthy gingival conditions participated after giving their informed consent. The group included 10 risk genotype positive (P+) and 10 risk genotype negative (P−) individuals. The IL1 genotypes were determined on DNA samples from peripheral blood using PCR‐RFLP analyses for the IL1α and IL1β polymorphisms. Experimental gingivitis was allowed to develop in two posterior sextants per subject. Bleeding on probing (BOP%) and gingival crevicular fluid volume (GCF) were assessed at baseline and days 2, 7, 9, 14, 16 and 21. The day 21 results for BOP and GCF as well as the rate of increase of these parameters – mean area under the curve (AUC) and mean increase per day (slope) – were evaluated using risk analyses for IL1 genotype, smoking status and gender.

Results: Experimental gingivitis developed with a gradual increase in BOP scores and GCF values (expressed as Periotron units=PU) from baseline to day 21 (BOP, P+: 0.5 to 26.0%; P−: 1.0 to 28.1%; GCF, P+: 36.8 to 138.5 PU, P–: 43.1 to 143.4 PU). No significant risk was associated with P+ and P− for day 21 results, AUC or slope.

Conclusion: The results of this study failed to provide evidence that the IL1 risk genotype was associated with higher GCF volume and percentage BOP during the development of experimental gingivitis.
Some soft tissue characteristics at implant abutments with different surface topography
Authors: Wennerberg Ann , Sennerby Lars , Kultje Christina , Lekholm Ulf
Published: March 2003

Background: If an implant with a rough surface is exposed to the oral cavity, it may accumulate greater amounts of plaque than a smooth surface, which may lead to severe problems with mucositis and peri‐implantitis. The purpose of the present paper was to investigate the early inflammatory response to mucosa‐penetrating abutments prepared with varying surface roughness.

Methods: Nine patients had all five of their original abutments exchanged to test abutments for a 4‐week period. The test abutments were prepared with five different roughnesses. The surface roughness was measured with an optical profilometer. At the end of the test period, clinical evaluation was performed; the health of the surrounding mucosa, the amount of accumulated plaque and marginal bleeding were registered. One biopsy was taken from each test abutment. Qualitative and quantitative histological evaluations were performed.

Results: There was a statistically significant difference between patients regarding the amount of accumulated plaque on the abutment surfaces and inflammatory cells, but no difference between the surface modifications in relation to plaque accumulation or number of inflammatory cells.

Conclusion: No relation was found between inflammatory response and abutment surface roughness after an evaluation time of 4 weeks in a human test model.
Ovine periodontitis as a potential model for periodontal studies
Authors: Duncan W. J. , Persson G. R. , Sims T. J. , Braham P. , Pack A. R. C. , Page R. C.
Published: March 2003

Objectives:  To investigate infection and host immunity patterns in sheep with naturally occurring “broken‐mouth” periodontitis.

Materials and Methods:  Eight periodontally healthy (HS) and eight periodontally diseased ewes (PDS) were selected. Subgingival plaque and sera were collected and examined for evidence of human periodontitis‐associated pathogens. Serum IgG titers were measured by ELISA to multiple strains of Porphyromonas gingivalis, Bacteroides forsythus, Dichelobacter nodosus, Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Fusobacterium nucleatum as well as several purified antigens (cysteine proteases, LPS, K, and fimbriae).

Results:  Neither the organism Aa nor antigens to Aa were found in any animal. Most animals were positive for Pg, Bf, and Pi, but DNA probes detected no difference between HS and PDS relative to amounts of pathogens in subgingival plaque. PDS had significantly higher serum IgG titers to all Pg strains, to 50% of Bf strains, to the Pi and Fn strains, and to fimbriae and the two cysteine proteases (p‐values ranging from 0.05 to 0.001). Regression analysis demonstrated a significant association between number of teeth lost and serum IgG antibody titers to whole‐cell sonicate antigens of P. gingivalis strains (p<0.01) and body weight (p<0.01).

Conclusions:  The presence of pathogens associated with periodontitis was reflected in differences in serum IgG titers between healthy and diseased sheep. This may have influenced animal body weight and might have systemic health and economic consequences. The data suggest that susceptible and non‐susceptible sheep can be identified for periodontal research.
Clinical and radiographic treatment evaluation of class III furcation defects using GTR with and without inorganic bone matrix
Authors: Palioto Daniela Bazan , Joly Julio Cesar , De Lima Antonio Fernando Martorelli , Mota Luis Fernando , Caffesse Raul
Published: March 2003

Objective:  The aim of this study was to evaluate the effect of guided tissue regeneration (GTR) alone and in conjunction with a bovine inorganic bone matrix in furcation defects.

Material and methods:  Twenty class III furcation defects were treated in 18 non‐smoker patients, 35–75 years old. Horizontal (CAL‐H) and vertical clinical attachment levels (CAL‐V), probing depths (PD), gingival margin levels (GML), horizontal (BDL‐H) and vertical bone defect levels (BDL‐V), and alveolar crest levels (ACL) were performed at baseline and at 6‐month re‐entry procedures. Subtraction radiography was used to assess gain or loss in optical density (OD) and area of bone fill (A) (baseline/6 months). After flap elevation, the sites were randomly assigned to receive GTR + Bio‐Oss® (test) or GTR treatment alone (control). Results were evaluated using anova.

Results: Differences were statistically significant between baseline and re‐entry for PD, ACL (p < 0.01) and GML (p < 0.05) for the control group, and for BDL‐V (p < 0.01) for the test group. There was a gain in ACL for the test group and a reduction in ACL for the control group (p < 0.01). No differences were observed for OD and A.

Conclusion: The results of this study indicate that class III furcation defects are not predictably resolved utilizing GTR or GTR in combination with an inorganic bone matrix.
Prevalence of IL‐1A and IL‐1B polymorphisms in a Greek population
Authors: Sakellari Dimitra , Koukoudetsos Stavros , Arsenakis Minas , Konstantinidis Antonis
Published: March 2003

Objectives:  Given the possible ethnic diversity in distribution of genetic variants, aim of the present study was to estimate the prevalence of the polymorphisms of IL‐1A+4845 and IL‐1B+3954 in a Greek population of unknown periodontal status and to compare this prevalence with one from a group of patients with chronic (adult) periodontitis.

Material and methods:  110 healthy subjects of unknown periodontal status and 45 patients with chronic periodontitis were genotyped, using a PCR‐based method and primers described in the literature. The differences in genotype, allele frequencies, allele carriage rate and presence of positive composite genotype as described by ) were analyzed using Fisher's exact test and calculating two‐sided p‐value, odds ratios and confidence intervals.

Results: No differences were observed in any of the parameters tested between the two groups.

Conclusions:  Given the high prevalences of these polymorphisms observed in the general population,findings of the present study do not support a possible predictive value of the presence of allele 2 at IL‐1A+4845 and IL‐1B+3954 or the positive composite genotype for presence or absence of periodontal disease,in a Greek population.
A split‐mouth study on periodontal and microbial parameters in children with complete unilateral cleft lip and palate
Authors: Quirynen M. , Dewinter G. , Avontroodt P. , Heidbüchel K. , Verdonck A. , Carels C.
Published: March 2003

Background: Complete unilateral cleft lip and palate (UCLP) is a hereditary or multifactorial malformation that can be corrected successfully with a combined orthodontic, surgical and restorative treatment. Such multidisciplinary treatment takes many years and demands a lot of attention to both patients' teeth and periodontium.

Objectives: This split‐mouth study aimed to compare the periodontal health as well as the microbial parameters between cleft and non‐cleft region.

Material and methods:  75 patients (52 males, 23 females) between 8 and 20 years with a complete unilateral cleft lip and palate (before (n = 30), during (n = 34) and after (n = 11) the active orthodontic treatment) volunteered for this study. Four regions were defined for the split‐mouth comparison: teeth neighbouring cleft (site 1), tooth in cleft (site 2), and the corresponding contra‐lateral teeth, respectively, in the unaffected quadrants (sites 3 and 4). At all sites the following periodontal parameters were recorded: plaque and gingivitis indices, pocket depth, attachment loss, bleeding on probing, tooth mobility (visual and Periotest), radiographic bone loss and gingival width. In addition, three pooled subgingival plaque samples were taken (around tooth in cleft, teeth facing the cleft, and contra‐lateral teeth of the latter).

Results:  The differences between the teeth neighbouring the cleft and the corresponding contra‐lateral opponents were of borderline significance (P ≤ 0.05) for the plaque index, the approximal probing depths and the attachment loss (teeth facing the cleft always had slightly higher parameters). When the tooth in the cleft was compared to the contra‐lateral tooth, differences were only found for both the approximal probing depths, attachment loss and bone loss, which were significantly higher for the tooth in the cleft. The microbial analysis did not reveal differences between the different sites, neither in the proportion of aerobic and anaerobic bacteria (differences < 0.5 log), nor in the detection frequency of periopathogens.

Conclusions:  These data indicate that the periodontium in UCLP patients can cope well with a long‐term orthodontic treatment, even in unfavourable conditions (like absence of attached gingiva and poor oral hygiene).
Caries prevalence and distribution in 3–20‐year‐olds in Jönköping, Sweden, in 1973, 1978, 1983, and 1993
Authors: Hugoson Anders , Koch Göran , Hallonsten Anna‐Lena , Norderyd Johanna , Åberg Annette
Published: March 2003

Abstract – Four cross‐sectional studies were carried out in 1973, 1978, 1983, and 1993 to collect clinical and radiographic epidemiological data on the dental health status of the inhabitants of Jönköping, Sweden. The aim of the present paper was to use these data to analyze trends in the development of caries among children and adolescents between 1973 and 1993. Approximately 500 randomly selected individuals evenly distributed among the age groups 3, 5, 10, 15, and 20 years participated in each study. The main results show that the numbers of caries‐free individuals increased in all age groups. In 1993, the mean number of decayed and filled tooth surfaces in the primary (dfs) and the permanent (DFS) dentition in all age groups was less than half of that found in 1973. Most of this decrease took place during the first 5 years, i.e., between 1973 and 1978. Between 1978 and 1983, only minor changes were observed. There was a further reduction of approximately 30%–50% in dfs/DFS between 1983 and 1993 in 3‐, 5‐, 10‐, and 20‐year‐olds. The frequency distributions of dfs/DFS for 5‐ and 15‐year‐olds revealed an increasing skewness over time: in 1993, a large majority of the children and adolescents had a low or moderate caries severity while only a small group had high scores of dfs/DFS.
An investigation of factors influencing patients' use of new complete dentures using structural equation modelling techniques
Authors: Fenlon Michael Robert , Sherriff Martyn , Douglas Walter John
Published: March 2003

Abstract – A review of the literature demonstrated that research had not identified a set of prognostic indicators for prospective complete denture patients, with different authors publishing contradictory results. Objective: To investigate possible relationships between patient and clinical factors and denture wear and use of dentures for eating. Methods: Patients attending Guy's Dental Hospital, London, for provision of complete dentures were recruited. For each patient relevant history was recorded and an examination of the edentulous mouth and existing dentures, where present, was undertaken at the beginning of treatment. At the first post‐insertion appointment the edentulous mouth, previous and new dentures were examined. Three months after the review appointment patients were sent a postal questionnaire to assess patient use of dentures and patient satisfaction. Data were analysed using structural equation modelling techniques. Results: 723 patients were recruited. Significant relationships were found between quality of complete dentures and patients' use of complete dentures and between quality of residual edentulous ridges and patients' use of complete dentures. These results contrast with most previous research into prognostic indicators for success in complete denture treatments. Conclusions: Quality of residual edentulous ridges and quality of new complete dentures predict patients' use of new complete dentures.
Efficiency in provision of public dental services in Norway
Authors: Grytten Jostein , Rongen Gunnar
Published: March 2003

Abstract – The paper examines productivity in the provision of public dental services in Norway. The main responsibility of the public dental services is to provide care for all children up to 18 years of age. Most dental care is provided by public dental officers. Productivity was measured by estimating a stochastic production frontier from input and output data from the public dental service in Norway. The results indicate that there are increasing returns to scale. Our measure of technical efficiency showed that the level of inefficiency is fairly small. However, the inefficiency is greater when estimated from a deterministic production frontier rather than from a stochastic frontier. One limitation of the present methodology is that it does not say anything about the level of efficiency in the Norwegian public dental service in absolute terms. A greater level of inefficiency would have been identified if a few counties had performed clearly better than the rest.
Surveillance of primary dentition caries in Germiston, South Africa, 1981–97
Authors: Cleaton‐Jones Peter , Williams Shaun , Fatti Paul
Published: March 2003

Abstract – Objective: This 17‐year‐long study examined trends of dental caries rates in the primary dentition of 6843 preschool children in a South African city. Methods: Calibrated dentists did repeated cross‐sectional epidemiological surveys of dental caries in 2‐ to 5‐year‐old nursery school children using WHO diagnostic criteria between 1981 and 1997. Results: Both the percentage of children with dmft>0 and mean dmft increased between 1981 and 1989 and have slowly declined ever since in the absence of organised prevention to produce a secular trend of decreasing caries rates. The dt/dmft percentage ranged between 60% and 100% except in 1991 when it dropped to 40% and the ft/dmft percentage component rose proportionally, probably due to an economic effect. Conclusions: The percentage of children with dmft>0 and mean dmft decreased over the study period at all ages, the reason for which is unknown but is speculated to be due to a change in mutans streptococci strains.
Dietary habits and dental health over the first 18 months of life
Authors: Habibian Mina , Roberts Graham , Lawson Margaret , Stevenson Rebecca , Harris Selina
Published: March 2003

Abstract – Objectives: The main objective of this study was to describe the dental health of infants and toddlers with special reference to their dietary habits and oral hygiene behaviour over the first 18 months of life. Methods: The longitudinal dietary data were obtained at 6, 12 and 18 months of age by using a 3‐day weighed diet diary. Dental examinations were carried out at 12, and again at 18 months of age. The information on demographic factors and oral hygiene behaviours over the first 18 months of life was gathered by using a structured questionnaire at 12 and 18 months. Results: 163 children were studied. Visible dental plaque was present in 18% and 25% of children at 12 and 18 months of age, respectively. No child had dental caries at either 12 or 18 months of age. There was a statistically significant correlation between visible plaque measured as plaque index at 12 months and the mean daily eating/drinking episodes at 6 months (r=0.25, P=0.001) and 12 months (r=0.15, P=0.05). The correlations between plaque index at 18 months and the mean eating/drinking episodes at both 12 months (r=0.2, P=0.04) and 18 months (r=0.2, P=0.02) were low but statistically significant. Nevertheless, there was no significant correlation between accumulation of plaque at either 12 or 18 months and the mean daily frequency consumption of food and drink containing non‐milk extrinsic sugars (NMES) at any age. Children who brushed their teeth themselves were more likely to have visible plaque compared with children whose teeth were cleaned by their parents. The partial correlation showed that positive relation between mean daily eating/drinking episodes and plaque was not influenced by tooth brushing.
Oral melanin pigmentation related to smoking in a Turkish population
Authors: Ünsal Elif , Paksoy Candan , Soykan Emel , Elhan Atilla Halil , Şahin Meltem
Published: March 2003

Abstract – Objective: Besides genetic factors, tobacco smoking has been found to be the major cause of oral melanin pigmentation. The purpose of the present study was to evaluate the frequency of oral melanin pigmentation in a Turkish population and to present its correlation with clinical parameters relevant to periodontal status in current smokers, non‐smokers, former smokers. Method: A sample of 496 patients was randomly selected. The subjects were interviewed regarding their smoking habits. They were clinically examined by a single examiner for the presence of oral melanin pigmentation in different oral mucosal regions. The same examiner recorded the clinical parameters including GI (gingival index), PI (plaque index), BOP (bleeding on probing), PD (probing depth) and GR (gingival recession). Examiner 2 completed a questionnaire concerning skin color and smoking habits. Results: In the study group, 41% were current smokers, 46% non‐smokers and 13% former smokers. The frequencies of pigmented areas were significantly higher in current smokers than in those without any smoking habits. The clinical parameters revealed similar findings for all groups. Low GI and BOP values were observed for current smokers when compared with non‐smokers and former smokers, respectively. GI values were significantly associated with the pigmentations in gingiva. Conclusions: The results of our study show that smokers in a Turkish population had significantly more pigmented oral surfaces than non‐smokers.
Caries preventive effect of sugar‐substituted chewing gum
Authors: Machiulskiene Vita , Nyvad Bente , Baelum Vibeke
Published: March 2003

Abstract – Objectives: The aim of this 3‐year community intervention trial was to determine the caries preventive effect of sugar‐substituted chewing gum among Lithuanian school children, and to assess compliance with the instructions for gum use. Methods: A total of 602 children, aged 9–14 years, from 28 school classes in five secondary schools in Kaunas, Lithuania, were given a baseline clinical and radiographic caries examination. The schools were randomly allocated to receive one of the following interventions: sorbitol/carbamide gum; sorbitol gum; xylitol gum; control gum; and no gum. Children in the four active intervention groups were asked to chew at least five pieces of gum per day, preferably after meals. The children were reexamined clinically after 1, 2 and 3 years, and radiographically after 3 years. Self‐reported compliance was monitored anonymously four times during the study. Results: A total of 432 children were available at the 3‐year clinical follow‐up examination. The crude mean 3‐year caries increments (DMFS – all stages of lesion formation) were 11.8 for the sorbitol/carbamide gum group; 9.0 for the sorbitol gum group; 8.1 for the xylitol gum group; 8.3 for the control gum group; and 12.4 for the no gum group. The adjusted 3‐year caries increments were statistically significantly lower in the sorbitol gum group, the xylitol gum group and the control gum group than in the no gum group, whereas no statistically significant difference was seen between the no gum group and the sorbitol/carbamide gum group. Adjusted 3‐year caries increments in the xylitol gum group and the sorbitol gum group did not differ statistically significantly from the caries increments in the control gum group. Compliance with the study protocol was better in School C (xylitol gum) than in the other schools. In all schools, compliance decreased over time. Conclusion: The results indicate that the caries preventive effect of chewing sugar‐free gum is related to the chewing process itself rather than being an effect of gum sweeteners or additives, such as polyols and carbamide.
The fluoride content of foods and beverages from negligibly and optimally fluoridated communities
Authors: Jackson Richard D. , Brizendine Edward J. , Kelly Sue A. , Hinesley Rose , Stookey George K. , Dunipace Ann J.
Published: March 2003

– In the spring of 1996, foods and beverages most commonly consumed by adolescents were analyzed for fluoride as part of a larger investigation. These foods were selected by interviewing 711 adolescents, 12–14 years of age, who were long‐time residents of either an optimally or negligibly fluoridated community. The brand names of the identified foods and beverages most commonly purchased were determined by interviews with the parents. A total of 441 brand‐name food and beverage items were purchased from both communities and were individually analyzed for fluoride. These analyses were done in order to estimate the fluoride content of various kinds of foods and beverages and to determine whether or not there was a significant difference between the two communities in the amount of fluoride ingested from these dietary sources. The food and beverage items were classified into dietary groups based on US Department of Agriculture (USDA) guidelines. Overall, the fluoride content of the sampled foods and beverages was low. In addition, there was no significant difference in the fluoride content of the same pre‐packaged or ready‐to‐eat food or beverage items purchased in the two communities. However, a significant difference was found between the two communities in the fluoride content of fountain beverages and in cooked or reconstituted foods prepared using local water from the respective communities. Based on these results, we have estimated the mean daily, dietary fluoride intake for 3–5‐year‐old children who are more susceptible to developing dental fluorosis.
Family impact of child oral and oro‐facial conditions
Authors: Locker David , Jokovic Aleksandra , Stephens Marlene , Kenny David , Tompson Bryan , Guyatt Gordon
Published: March 2003

Abstract –

Objectives: The aim of this study was to develop and evaluate the Family Impact Scale, a measure of the family impact of child oral and oro‐facial disorders. This formed one component of the Child Oral Health Quality of Life Instrument©.

Methods: The scale was developed using a process described by Guyatt et al. (1987) and Juniper et al. (1996). An item pool was developed using a review of existing child health status and family impact questionnaires, interviews with 41 parents–caregivers of children with paedodontic, orthodontic and oro‐facial conditions and discussions with dental specialists. The resulting pool of 21 items was used in an item impact study in which 93 parents–caregivers provided data on the frequency and importance of these items. The 14 items identified most frequently or rated the most important were selected for the final questionnaire. The discriminant and construct validity and internal consistency reliability of this 14‐item scale were assessed in a study of 266 parents–caregivers from the three clinical groups. Seventy‐nine of these participants completed a second copy of the questionnaire to facilitate assessment of test–retest reliability.

Results: Family Impact Scale scores ranged from 0 to 33, indicating that the measure was sensitive to variations in family impact. Floor effects were minimal with only 10.2% of subjects having a score of zero and there were no ceiling effects, that is, subjects with maximum scores. Almost three‐quarters of parents–caregivers reported some family impact ‘sometimes’ or ‘often/everyday’ over the previous 3 months. Impact on parental or family activities of this frequency was reported by 53.0%, impact on parental emotions by 44.0%, conflict in the family by 31.6% and financial difficulties by 31.2%. The measure and its component items were reasonably good at discriminating between the three clinical groups included in the study and showed good construct validity. It had excellent internal consistency reliability with a Cronbach's alpha of 0.83 and was reproducible for parent–caregivers who reported that their child's condition was stable (ICC = 0.80).

Conclusions: The study provides some data to suggest that child oral and oro‐facial conditions have a pervasive impact on the family. The Family Impact Scale had good technical properties. Its evaluative properties need to be tested in longitudinal studies.
A prospective study of the validity of data on self‐reported dental visits
Authors: Gilbert Gregg H. , Rose John S. , Shelton Brent J.
Published: March 2003

Objective: To measure the validity of self‐reported dental visits from a diverse sample of adults.

Methods: The Florida Dental Care Study was a longitudinal cohort study of a diverse sample of residents of north Florida, USA. In‐person interviews and dental examinations were conducted at baseline, 24 and 48 months after baseline, with half‐yearly telephone interviews in between. Dental record information was abstracted afterward.

Results: Agreement between self‐report and dental record at each half‐yearly interview ranged from 84 to 91%. Validity did not differ between persons of key sociodemographic groups (sex, race, age group, rural/urban residence, poverty status, level of formal education, or problem‐oriented/regular approach to dental care). In a single bivariate multiple logistic regression (two outcomes: (i) self‐reported use; and (ii) use measured from the dental chart), odds ratio estimates over‐lapped for each of the 20 predictors.

Conclusions: Validity of self‐reported dental care use was good. There would have been few differences in conclusions made about predictors of dental care use had chart data been available earlier.
Risk factors for dental erosion in 5–6 year old and 12–14 year old boys in Saudi Arabia
Authors: Al‐Majed Ibrahim , Maguire Anne , Murray John J.
Published: March 2003

Material and methods: Dental examinations were carried out on 354 boys aged 5–6 years, and 862 boys aged 12–14 years, attending 40 schools in Riyadh. The prevalence of dental erosion was assessed using diagnostic criteria similar to those employed in the 1993 UK National Survey of Child Dental Health. Results: Pronounced dental erosion (into dentine or dentine and pulp) was observed in 34% of 5–6 year olds and 26% of 12–14 year olds. Information on food and drink consumed and dietary habits was obtained by means of a questionnaire. Parents reported that 65% of 5–6 year old boys took a drink to bed. Water was the commonest drink consumed (37%) followed by carbonated soft drinks (21%). One third of parents reported that their son had something to eat in bed or during the night and 60% of this was sweet food or confectionery. Seventy per cent of 12–14 year old boys reported consuming drinks at night; these were mainly water (30%), carbonated soft drinks (27%) and tea or coffee, with sugar (18%). Forty‐six per cent of the 12–14 year olds reported that they ate in bed at least once a week and 54% of this was sweet food or confectionery. When the dental examination and questionnaire results were correlated, a statistically significant relationship was found between the number of primary maxillary incisors with pronounced erosion of their palatal surfaces and the consumption of carbonated soft drinks at night (P=0.015). A significant relationship was also found between the number of permanent maxillary incisors with pronounced erosion on their palatal surfaces and the frequency of drinks at night (P=0.020), as well as the duration of drinks retained in the mouth (P=0.038). Conclusion: It is concluded that dental erosion is more common in the primary and permanent dentitions of Saudi Arabian boys compared with results for similar age groups from the United Kingdom.
Oral self‐care among adults with diabetes in Finland
Authors: Karikoski Aija , Ilanne‐Parikka Pirjo , Murtomaa Heikki
Published: March 2003

Objectives: The importance of maintenance and promotion of periodontal health is emphasized among people with diabetes because of their high risk for periodontal diseases. Our aim was to evaluate oral health behavior and its determinants among adults with diabetes in Finland.

Methods: The population of the questionnaire study consisted of 420 systematically selected adults with diabetes, who were members of a national diabetes register. The response rate was 80%. Questions focused on self‐treatment, ‐prevention, and ‐diagnosis of oral diseases, utilization of dental services, and knowledge and attitudes toward oral health among adult people with diabetes. Oral self‐care was evaluated in the framework of the New Century model of oral health promotion.

Results: The proportion of edentulous subjects was 23%, and these were excluded from further analysis. Self‐reported twice‐a‐day brushing among dentate participants was significantly more common among women and the highly educated, but was less common compared with earlier studies among Finnish adults. A quarter of those surveyed reported never cleaning interdental surfaces, with the number of daily cleaners being nearly equal (27%). Age 40 years or over and recent treatment by a private dentist were significant predictors for daily interdental cleaning. The proportion of those who had attended a dental appointment within the last year was 63%, and the main reason for the last dental visit was an emergency among almost one‐fifth of those surveyed.

Conclusions:A need exists for further promotion of oral self‐care among adults with diabetes. Support by dental and other health care professionals involved in diabetes care should be encouraged.
Efficacy of a barrier cream and its vehicle as protective measures against occupational irritant contact dermatitis
Authors: Berndt U. , Wigger‐Alberti W. , Gabard B. , Elsner P.
Published: March 2003

The actual advantage of barrier creams over bland emollients for skin protection is still hotly debated. In a randomized, double‐blinded study, a newly‐introduced barrier cream and its moisturizing vehicle were compared regarding their skin compatibility, efficacy and resulting acceptance. Thus, 2 panels of 25 hospital nurses with mild signs of skin irritation were asked to use 1 of the test products provided (verum or vehicle) over a period of 4 weeks. Effects of both types of preparations were studied weekly by clinical examination and the instrumental assessment of bioengineering parameters. Results showed no significant differences between barrier cream and vehicle. In both groups, clinical skin status improved and stratum corneum hydration increased significantly during the study period. Both preparations were tolerated and accepted well, thus showing both skin protection and skin care. These results contribute to the debate as to whether a strict distinction between “skin care” and “skin protection” products is justified. The vehicle alone is capable of positively influencing skin status. Emphasis must be laid on regular, frequent, and correct application of a product for it to be effective.
Relevance of multiparametric skin bioengineering in a prospectively‐followed cohort of junior hairdressers
Authors: John S. M. , Uter W. , Schwanitz H. J.
Published: March 2003

There is conflicting evidence concerning predictors of individual susceptibility to develop irritant contact dermatitis in wet work. A cohort of initially 92 hairdresser apprentices was prospectively followed for 3 years. The association between anamnestic and clinical findings, and multiparametric skin bioengineering data (transepidermal water loss [TEWL], microcirculation, capacitance, pH, sebum, temperature) was investigated. The observation intervals were 3 months in the 1st year of training and 12 months thereafter. Of the 92 apprentices, 6 had already developed hand dermatitis on 1st examination, 20 dropped out or had occupational exposure longer than 7 weeks prior to investigation. Of the remaining 66 participants considered here, 19 (29%) developed moderate or severe dermatitis (“cases”), 32 minimal skin changes, 15 none within the observation period. Average incidence rate of hand dermatitis was 21.1 cases per 100 person years. Atopy score was not associated with the development of dermatitis, nor were the investigated basal bioengineering parameters, including TEWL, in a multivariable model. However, there was a significant increase in TEWL within the 1st year of training in presumptive “cases”. The aim to develop an objective and predictive instrumentary for pre‐employment counselling in wet work, by a combination of (a) clinical and (b) relevant non‐invasive bioengineering parameters, has not yet been accomplished. Skin‐provocation tests employing bioengineering seem to be required. Notwithstanding, work‐related monitoring of basal biophysical skin‐functions may become useful in the secondary prevention of occupational dermatitis.
Dyshidrotic eczema and occupation: a descriptive study
Authors: Lehucher‐Michel M. P. , Koeppel M. C. , Lanteaume A. , Sayag J.
Published: March 2003

Dyshidrotic eczema (DE) is a chronic and/or recurrent vesicular eczema of the palmar sides of the hands and sometimes the soles of the feet. The major aetiologies to be considered are atopic DE, contact DE, systemic contact DE and DE due to fungal or microbial allergy. To clarify the role of occupational contact allergens, 59 workers with DE were examined to determine whether they had atopy, environmental contact sensitization and/or contact allergy coupled with work activity. For all, patch testing was carried out using the European standard series and the material brought in by the patients. No significant difference was found between the rate (42.4%) of history of atopy among the 59 workers with DE and that (30.6%) observed among 160 workers with other forms of hand eczema (HE). Positive patch test reactions were found in 72.8% of dyshidrotic patients. A relationship to occupational activity was strong for 18 (30.5%) of them but this rate was significantly lower than that (55%) observed among the 160 with other types of eczema. Results of the present study showed that contact sensitization is as much involved in workers with DE as in workers with other form of HE, even though the relationship to work is significantly less frequent for DE. It also suggests that atopic histories are no more involved in DE than in other forms of HE.
Modified short‐term guinea pig sensitization tests for detecting contact allergens as an alternative to the conventional test
Authors: Yanagi Masashi , Hoya Masatoshi , Mori Masaaki , Katsumura Yoshio
Published: March 2003

The conventional adjuvant and patch test (APT) method of guinea pig sensitization testing was modified in 2 ways, s‐APT and s‐APT(2), in order to shorten the test period. These short‐term test methods consist of 72‐h closed application of test material with intradermal injection of emulsified Freund’s complete adjuvant (E‐FCA) for 1st induction, 48‐h closed application of test material with (s‐APT) or without (s‐APT(2)) intradermal injection of E‐FCA on the 7th day for 2nd induction, and open application on the 14th day for challenge. They were compared with conventional APT by using 8 allergenic chemicals (formaldehyde, nickel sulfate, cobalt sulfate, ethyl‐p‐aminobenzoate (benzocaine), isoeugenol, 2‐mercaptobenzothiazole, 2,4‐dinitrochlorobenzene (DNCB) and 1‐phenylazo‐2‐naphthol (Sudan I)). The short‐term methods gave similar results to those of conventional APT in terms of mean response, sensitization rate and sensitization potency (challenge concentration that induces a mean response equal to 1.0). Thus, our short‐term methods, which are capable of evaluating skin sensitization within 17 days, are sufficiently sensitive to detect potentially hazardous contact allergens.
Intra‐individual variations in acute and cumulative skin irritation responses
Authors: Robinson Michael K.
Published: March 2003

It is well‐known that humans show a wide range of variation in skin reactivity to irritant chemicals. This has been established through population studies, through the examination of inter‐subject variability, and (to a limited extent) through studies of skin site variation in response within subjects. However, simple response variability within individual test subjects has not been examined as carefully, and this has implications for our ability to predict irritant reactivity. Some key questions are: (i) how consistently do human beings respond, even within a given study, to different equally irritating chemicals, or to the same chemical when comparing different concentrations or durations of exposure, and, (ii) Do individual test subjects’ responses to one chemical (or exposure scenario) correlate with their responses to another? To examine these questions in some detail, we reexamined individual study subjects’ responses from earlier published studies involving both acute and cumulative irritation patch test protocols. Acute irritation responses were compared across chemicals with similar irritation profiles. Cumulative irritation responses were compared across different concentrations of the anionic surfactant, sodium dodecyl sulfate (SDS). Acute (high concentration) and cumulative (low concentration) patch test responses to SDS were also compared. The analysis showed that, as might be expected, response correlations were greatest within test types, either when comparing chemicals of similar overall irritancy, or when comparing similar concentrations of a single chemical. However, individually divergent responses were also frequent, reinforcing the conclusion that a given individual’s response to one chemical or exposure condition does not always predict their response to another. This has important ramifications for other questions related to population differences in skin reactivity.
Degradation of triglycidyl isocyanurate as a cause of false‐negative patch test reaction
Authors: Erikstam Ulrika , Bruze Magnus , Goossens An
Published: March 2003

Triglycidyl isocyanurate (TGIC) is mainly used in polyester‐based powder paints, but also in laminates, insulating varnishes, coatings and adhesives. Several cases of contact allergy to TGIC have been reported during the last 10 years. Contact allergy to TGIC has developed in a factory producing the chemical, in a factory producing powder paints containing TGIC, and in industries using powder coating. In this paper, we report a man who developed a work‐related dermatitis when working on the painting of metal frames. He was exposed to polyester powder pigments containing TGIC. When patch tested, he was negative to TGIC (prepared in 1988) 3× and positive to polyester powder pigment. Only when a new test preparation of fresh TGIC powder was tested, was a positive reaction obtained. Chemical analyses showed that there was no TGIC in the test preparation from 1988, and that in the TGIC powder from 1988, there was only 30% of the expected amount of TGIC. The investigations, clinical and chemical, strongly indicate degradation of TGIC in the test preparation and powder. Both substances and the test preparations made from them may change over time. Therefore, if a false‐negative reaction due to a test preparation is strongly suspected, we recommend a re‐test of the patient with a new test preparation of fresh material. As a general rule, patch testing should be performed with fresh substances and test preparations made from them, unless their stability and durability are known.
Occupational contact dermatitis in nurses with hand eczema
Authors: Strauss Roland M. , Gawkrodger David J.
Published: March 2003

Occupationally related dermatitis is a common problem in nurses, who are exposed to a wide variety of allergenic and irritant substances. In a group of 44 nurses with hand dermatitis (40 female, 4 male), 18 were thought to have a predominantly allergic contact dermatitis, 15 an irritant dermatitis, 7 other form of eczema, 3 atopic dermatitis and one pompholyx. 10 of the 15 irritant cases were diagnosed as occupational. Of the 18 patients with allergic contact dermatitis, the allergens were thought to be occupationally relevant in 8 cases. In 6 of these 8 the dermatitis was due to natural rubber latex (3) or other rubber chemicals (3). 2 had additional evidence of immediate‐type hypersensitivity to natural rubber latex (one was patch test allergic to latex, the other to thiuram mix). Natural rubber latex allergy, both delayed and immediate, is a significant problem, and nurses at risk should be tested for both types of hypersensitivity, as well as being patch tested to standard, rubber and medicaments series.
UV filters in sunscreen products − a survey
Authors: Rastogi Suresh Chandra
Published: March 2003

The contents of 18 permitted chemical UV filters in 75 sunscreen products have been determined to check the compliance of these products with the EU Cosmetic Directive, as well as to generate data for quantitative exposure assessments. 81% of the products were found to contain 14 of the target chemical UV filters. The remaining products contained only the physical UV‐filters titanium oxide and zinc oxide, which were not determined in the present study. Maximum content (29.3%) of chemical UV filters was found in a product that contained 6 of the target UV filters. Octyl methoxycinnamate (1.4–4.7%) and butyl methoxydibenzoylmethane (0.4–4.8%) were the most frequently used UV filters, present, respectively, in 49% and 44% of the investigated products. Correlation between declared sun protection factor (SPF) and the contents of chemical UV filters in the respective products was not significant (correlation coefficient 0.5362). The content of UV filters in all products complied with the maximum allowed concentration of these according to EU Cosmetic Directive.
Patch test reactions to Biobans in metalworkers are often weak and not reproducible
Authors: Brinkmeier Thomas , Geier Johannes , Lepoittevin Jean‐Pierre , Frosch Peter J.
Published: March 2003

Contact allergy to the industrial preservative group of Biobans has been reported in individual cases. We have performed a prospective study on 408 metalworkers who were tested with 6 different Biobans, formaldehyde and 5 other preservatives. Furthermore, retesting was performed after a time interval of 6 months to 4 years. The test results were also compared with those of the multicentric data provided by the Information Network of Departments of Dermatology in Germany and Austria (IVDK), particularly with regard to cross‐reactivity between the various Biobans and formaldehyde. In 408 metalworkers 14 (3.4%) showed positive reactions to Biobans (2.2% P 1487, 2.0% CS 1246, 1.5% CS 1135), the majority being + reactions. On retesting 10 patients, the reactions were confirmed in only 2 cases (P 1487 and CS 1135). 4 patients showed positive reactions to 3 Biobans (P 1487, CS 1135, CS 1246), while 9 patients had only solitary sensitizations. Concomitant sensitization to formaldehyde was present in 5 out of 10 patients, being reproducible in 3 of them. In the IVDK data, sensitization prevalence in 3400 patients ranged from 1.8% (P 1487) to 0.8% (CS 1246). A high proportion of doubtful or irritant reactions as well as weak + reactions was observed. Cross‐reactivity between the various Biobans was low, moderate agreement being calculated for CS 1135 and CS 1246 (kappa coefficient 0.43). The consensus pattern between formaldehyde and the tested Biobans was even lower. In conclusion, patch test reactions to Biobans are not rare among metalworkers but are often weak and not reproducible. Simultaneous reactivity to various Biobans and formaldehyde may be due to cross‐reactivity or cosensitization from common exposure.