bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevention of plaque growth with chewing gum containing chlorhexidine acetate
Authors: Ainamo Jukka , Etemadzadeh Hossein
Published: December 2005

Abstract The purpose of the study was to assess the anti‐plaque effect of chlorhexidine (CHX) in chewing gum. The 0.80 g pieces of test gum contained 5 mg chlorhexidine acetate with or without a hydrogen peroxide releasing agent. The gum base with flavouring agents but containing neither CHX nor H2O2 was used as a control. 12 dental hygiene students volunteered to participate in the 3x crossed‐over double blind clinical trial. During the 4‐day test periods, no other oral hygiene measures were allowed than chewing 2 pieces of gum at the time for approximately 10 min. 5 times daily. Between test periods, meticulous mechanical oral hygiene measures were practised for 3 days. At the beginning and at the end of each test period, the quantity of plaque was assessed using the plaque index, plaque wet weight, and the area of plaque on the tooth surface as criteria. The results indicated that both CHX gums completely inhibited the increase in plaque index and plaque weight. With regard to area of plaque, the difference between the 2 test gums and the control gum was less marked but still present. The test persons subjectively assessed the gum base to have a poor cleansing effect hut also the least unpleasant taste. It was concluded that use of both the chlorhexidine gum and the gum‐containing chlorhexidine in addition to the hydrogen peroxide releasing agent had an excellent plaque growth inhibiting, effect during the 4‐day lest periods.
The effect of subgingival debridement with hand and ultrasonic instruments on the subgingival microflora
Authors: Oosterwaal P. J. M. , Matee M. I. , Mikx F. H. M. , van't Hof M. A. , Renggli H. H.
Published: December 2005

Abstract The effect of hand or ultrasonic instrumentation on the subgingival microflora of periodontal pockets was investigated. Pockets with probing depths of 6‐9 mm were selected in 12 patients and were randomly assigned per patient to the experimental and control groups. After oral hygiene instruction, instrumentation of the experimental pockets was carried out either by ultrasonic or by hand instruments in a split‐mouth design. The treatment effect on the subgingival microbiota was evaluated by microscopic and culture studies of subgingival plaque samples, while in addition, supragingival plaque, bleeding after probing and probing pocket depth were scored. Examinations were carried out before and 7,21 and 49 days after treatment. The hand and ultrasonic treatments were equally effective in reducing probing pocket depths and bleeding scores. At the end of the experimental period, the probing depths of 54% of the hand‐treated pockets and 43% of the ultrasonic‐treated pockets were reduced to 4 mm or less while the bleeding scores were reduced to 29% and 22%, respectively. The analysis of microscopical and cultural data did not show any differences between hand and ultrasonic debridement. Both treatments reduced the microscopical counts of rods, spirochetes and motiles and reduced the total colony‐forming units and number of black‐pigmented Bacteroides and Capnocytophaga, resulting in a subgingival microbiota consistent with periodontal health.
Clinical immunologic and microbiologic features of active disease sites in juvenile periodontitis
Authors: Mandell Robert L. , Ebersole Jeffrey L. , Socransky Sigmund S.
Published: December 2005

Abstract Eight juvenile periodontitis (JP) patients, with progressing disease were evaluated for clinical, immunologic, and microbiologic features. Clinically, bleeding on probing, pocket depth, and attachment level were unrelated to progressing disease. Only Actinobacilitts actinomycetemcomitans was related to a marked increase in attachment loss when examined on both a site and patient basis. Eikenella corradens was significantly elevated in progressing sites with A. actinomycetemcomitans as opposed to non‐progressing sites harboring A. actinomycetemeomitans. Eikenella corrodent may function synergistically with A. actino‐mycetemcomitans to enhance disease in JP patients. Darkfield microscopy was of no value in distinguishing disease activity. All patients screened had elevated serum IgG levels to the same serolype of A. adinomycetemcomitans as that isolated from the subgingival flora. Other elevated serum IgG responses were noted to various organisms including F. nudeuiuni, B. intermedius, B. gracilus, B. gingivalis and E. corrodent.
Periodic subgingival antimicrobial irrigation of periodontal pockets
Authors: Wennström Jan L. , Heijl Lars , Dahlén Gunnar , Gröndahl Kerstin
Published: December 2005

Abstract The present investigation was undertaken to study the clinical effect of professionally performed periodic subgingival irrigation per se and as an adjunct to scaling and root planing. 10 patients suffering from moderate‐severe periodontal disease participated in the study. Following an initial 3‐month period of supervised supragingival plaque control, a total of 102 periodontal sites with probing pocket depth ≥6 mm and “bleeding on probing” were selected and subjected to a Baseline examination comprising assessments of oral hygiene and gingival conditions, probing depths and probing attachment levels. The pockets in the various jaw quadrants were randomly assigned to one of the following treatment groups: (1) periodic subgingival irrigation with hydrogen peroxide. (2) periodic subgingival irrigation with chlorhexidine. (3) periodic subgingival irrigation with saline and (4) no subgingival treatment. During the first part of the study (baseline ‐ 32 weeks), no mechanical debridement of the subgingival area was performed. The irrigation treatment was carried out by the operator 3 times per week during weeks 1 + 2 and 5 + 6 of the trial. In the 2nd part of the trial (32‐52 weeks), the sites were subjected to scaling and root planing combined with professional irrigation during weeks 32‐38. The previously non‐irrigated control sites were not subjected to adjunctive irrigation when mechanically debrided. During the entire study, the patients were recalled for professional tooth cleaning once every 4 weeks. Re‐examinations were carried out at 4, 6, 32, 40 and 52 weeks.

The results revealed that repeated professional irrigation of unsealed periodontal pockets with chlorhexidine or hydrogen peroxide resulted in a temporarily reduced frequency of bleeding sites, but not in any clinically significant changes in probing assessments. A similar improvement of bleeding scores was observed in the saline‐irrigated control group. Scaling and root planing, in combination with an optimal supragingival plaque control, resulted in a marked resolution of the clinical symptoms of periodontal disease. Adjunctive irrigation with chlorhexidine or hydrogen peroxide did not improve the healing result above and beyond that obtained after mechanical debridement alone or in combination with saline irrigation. Hence, the study failed to demonstrate that professionally performed periodic subgingival irrigation with chlorhexidine or hydrogen peroxide, used alone or in combination with thorough mechanical debridement, has a significant therapeutic effect.
Growth potential of peripheral ossifying fibroma
Authors: Bodner Lipa , Dayan Dan
Published: December 2005

Abstract The peripheral ossifying fibroma (POF), a benign gingival overgrowth, occurs mainly in the anterior portion of the maxilla in young adults. The size of the lesion is usually less than 1.5 cm. A unique case of POF in the posterior mandible of a 70‐year‐old female is presented. The lesion was 6 cm in the largest diameter. It is apparent that POF can become a sizeable tumor unless it is surgically excised in an early stage.
Prevalence of periodontal disease in young diabetics
Authors: Rylander Harald , Ramberg Per , Blohme Göran , Lindhe Jan
Published: December 2005

Abstract In the present study, the frequency of sites exhibiting gingival inflammation and periodontal tissue breakdown was assessed in one group of 46 individuals (19–25 years old; test group T) who had suffered from diabetes mellitus (Type I) for 10 years or more, and in another group of 41 non‐diabetic controls (18–26 years old; control group C). Each individual was examined regarding oral hygiene status, gingival conditions, probing depths, probing attachment levels and gingival recessions. The interproximal marginal bone level was assessed in bitewing radiographs.

No significant differences were found between the 2 groups regarding their oral hygiene status, frequency of sites with probing depths of > 3 mm and the position of the interproximal alveolar bone margin. The mean distance between the cemento‐enamel junction (CEJ) and the interproximal bone crest was in group T. 0.91±0.14 (SD) mm and in group C, 0.95±0.18 (SD) mm. About 80% of the individuals in both groups were free from signs of marginal bone loss and only 1 subject in each group had >6 sites with definitive bone loss. The group of diabetic patients had higher frequencies of inflamed buccal/lingual gingival units, gingival recessions and sites with attachment loss of ≥2 mm. Most of the sites (85%) with attachment loss were located at the buccal and lingual surfaces. There were no significant correlations between the periodontal variables and the duration of diabetes, insulin dosage and HbA1 level. Individuals with both retinopathy and nephropathy had significantly more gingival inflammation than diabetic individuals without complications.
The distribution of plaque and gingivitis and the influence of toothbrushing hand in a group of South Wales 11–12 year‐old children
Authors: Addy M. , Griffiths G. , Dummer P. , Kingdom A. , Shaw W. C.
Published: December 2005

Abstract Numerous factors may affect the distribution of plaque and gingivitis in any individuals mouth. Of considerable importance must be the oral hygiene habits of each person, which will be influenced by compliance and dexterity with tooth cleaning methods. The pattern of gingivitis seen at a young age may. with time, reflect the eventual distribution of attachment loss. This in part, could explain the considerable variation in chronic periodontal disease seen between individuals and at different sites within the same mouth. This study reports the baseline data for the distribution of plaque and gingivitis in 1105. 11–12‐year‐old children in South Wales. The children were selected by disproportionate stratified random sampling and examined by a multidisciplinary group with the long‐term aim of evaluating the importance of malocclusion to dental health and psychosocial variables. Toothbrushing frequency had a very low but significant correlation with the distribution of plaque and gingivitis, accounting therefore for only a small % of the variance in the group. For the total group and right‐handed toothbrushers, buccal plaque and gingivitis was significantly increased on right contralateral teeth. No specific pattern for plaque and gingivitis distribution by side was seen for 100 left‐handed toothbrushers. Plaque and gingivitis also showed significant differences dependant upon arch, tooth number, and surface. The population is being followed at 4‐year intervals to monitor the pattern of periodontal disease with time and correlate changes with these baseline findings.
Periodic subgingival antimicrobial irrigation of periodontal pockets
Authors: Wennström Jan L. , Dahlén Gunnar , Gröndahl Kerstin , Heijl Lars
Published: December 2005

Abstract The purpose of this study was to evaluate the microbiological effects of repeated subgingival irrigation of deep periodontal pockets as a single measure of treatment as well as combined with mechanical debridement, and to study the concomitant radiographical changes of the alveolar bone. 2–3 interproximal sites per jaw quadrant in 10 patients showing a probing depth of ≥ 6 mm and bleeding on pocket probing were selected for the study. The pockets in the various quadrants were randomly assigned to professionally performed subgingival irrigation with 0.2% chlorhexidine gluconate, 3% hydrogen peroxide or saline or to non‐irrigation. During a first phase of treatment, the pockets were periodically irrigated (every 2nd–3rd day during weeks 1–2 and 5–6) and no subgingival mechanical debridement was performed. During a second phase, subgingival scaling and root planing were carried out with adjunctive subgingival irrigation of the pockets. During the entire trial, the patients' plaque control was carefully supervised. Sampling of the subgingival microflora was performed before and after the first and second treatment phases and 3 months after the termination of the active treatment. Dark‐field assessment and cultivation of the bacterial samples were performed. The radiographical examination was carried out at the start of each treatment phase and 3 months after the termination of phase U and the radiographs were analysed by the use of a subtraction technique. The results demonstrated that periodic subgingival antimicrobial irrigation per se had only limited and transient effects on the subgingival microflora. Repeated irrigation with chlorhexidine or hydrogen peroxide did not induce any changes in total viable counts, anaerobes, rods. Gram‐negative anaerobic rods, black‐pigmented Bacteroides, B. gingivalis or motile rods and spirochetes that were diverse from those of control sites irrigated with saline. Neither were there any differences between the treatment groups with respect to radiographical bone changes.
Validity of a hinged constant force probe and a similar, immobilised probe in untreated periodontal disease
Authors: Simons Paul , Watts Trevor
Published: December 2005

Abstract The validity of a hinged constant force probe (0.25 N) was compared with that of a similar but immobilised instrument, using the same interchangeable tip for both (0.64 mm diameter, 2 mm divisions). 60 sites were measured on teeth which were extracted subsequently, in patients with untreated periodontal disease, and the connective tissue attachment level was used as validity criterion, The clinical measurements of both probes correlated well with each other, but they differed significantly from the post‐extraction connective tissue attachment level measurements, indicating a. point 1.2 mm coronally, to this, on average. A companion investigation of intra‐operator probing depth reproduciability with the 2 probes, was undertaken in 14 patients, at 2 visits separated by 1 week in each case. All patients had untreated periodontal disease. A difference between probes was found at the first visit, but not at the second; the immobilised probe showed a difference between visits, reducing mean probing depth slightly at the second; when the immobilised probe was used first, there was a difference between probes. Further analysis of the results indicated that there was greatest agreement between probes when the constant force probe had been used before the immobilised probe at the second visit. The results suggested that these probes indicated a point above the connective tissue attachment level, related to pocket morphology, and that there was a moderate learning effect due to operator use of the constant force probe, which modified use of the immobilised probe.
Short‐term effect of Keyes' approach to periodontal therapy compared with modified Widman flap surgery
Authors: Whitehead S. P , Watts T. L. P.
Published: December 2005

Abstract Keyes' method of non‐surgical therapy was compared with modified Widman flap surgery in 9 patients with symmetrical periodontal disease. Following an initial oral hygiene programme, baseline measurements were recorded and paired contralateral areas were subjected randomly to the 2 techniques. 42 teeth receiving surgery were compared with 40 treated by Keyes' method. 6 sites per tooth were scored immediately prior to therapy and 3 months later, using a constant force probe with onlays. Consistent data were recorded for the 6 separate sites, which showed no baseline difference between treatments, slightly greater recession with surgery at 3 months, but no difference between treatments in probing depth and attachment levels. Mean data for individual patients showed similar consistency. Probing depth in deep sites was reduced slightly more with surgery, and there were no differences in bleeding on probing at 3 months. Both techniques gave marked improvements in health. Surprisingly, only 2 subjects preferred Keyes' technique of mechanical therapy, 6 preferred surgery, and 1 had no preference.
Guided tissue regeneration in the treatment of furcation defects in man
Authors: Pontoriero R. , Nyman S. , Lindhe J. , Rosenberg E. , Sanavi F.
Published: December 2005

Abstract The regenerative potential of the periodontal tissues in degree II and III furcation detects at mandibular molars was assessed in a clinical trial using a surgical treatment technique based on the principles of guided tissue regeneration. The patient sample included 37 subjects who had periodontal lesions in the right and left mandibular molar regions, including advanced periodontal destruction within the radicular area. Following a baseline examination, the furcation‐involved molars were randomly assigned in each patient to either a test or a control treatment procedure. The test procedure included the elevation of mucoperiosteal flaps and the placement of a teflon membrane to cover the entrance of the furcation area and the adjacent root surfaces as well as a portion of the alveolar bone apical to the crest. The flaps were repositioned and secured with interdental sutures. A procedure identical to the one used at the test teeth was performed at the control tooth regions with the exception of the placement of the teflon membrane. Following surgery, all patients were placed on a plaque control regimen which involved daily rinsing with chlorexidine gluconate and, in addition, professional tooth cleaning once every 2 weeks for 6 months. After 6 months of healing, the test and control sites were re‐examined. The findings demonstrated that the treatment of degree II furcation defects at mandibular molars using the principles of guided tissue regeneration in 19 sites out of 21 resulted in the resolution of the furcation defect. Conventional therapy reached the same goal in less than 20% of the cases treated. At degree III furcation defects, complete resolution occurred in 4 out of 16 sites treated with guided tissue regeneration. Partial resolution occurred in 9 out of 16 sites, while at 3 sites, a degree III involvement persisted. Treatment of degree III furcation involvements in the Control group failed to result in the resolution of any of the furcation defects.
Periodontal repair of periapical lesions: the borderland between pulpal and periodontal disease
Authors: Gold Steven I. , Moskow Bernard S.
Published: December 2005

Abstract A series of cases demonstrating the destruction of periapical periodontal structures, without pulpal involvement has been presented. Treatment using both surgery and antibiotics resulted in extensive healing without any concommitant endodontic therapy. The results suggest that lesions affecting the apical periodontium are either periodontal or pulpal in origin. Careful diagnosis allows the maintenance of pulp vitality in cases where apical destruction has a source other than an infected pulp. The commonly held belief that lateral and accessory canals are a significant source of pulpal contamination from deep periodontal pockets has been questioned.
The effects of a 0.2% chlorhexidine gluconate mouthrinse on plaque, toothstaining and candida in aphthous ulcer patients
Authors: Addy M. , Hunter L.
Published: December 2005

Abstract Despite the known effectiveness of 0.2% chlorhexidine gluconate mouthwash in preventing plaque formation, relatively few studies have assessed adjunctive benefit to normal unsupervised oral hygiene measures. Furthermore, there have been few accurate measurements of toothstaining in the presence of normal oral hygiene and little data of effects on oral candidal carriage. This study was a double‐blind placebo‐controlled cross‐over study of a 0.2% chlorhexidine gluconate mouthwash used 3 times daily on plaque, staining and candidal carriage in a group of recurrent aphthous ulcer sufferers who maintained normal oral hygiene measures. At the end of 2 6‐week treatment periods, baseline plaque scores were reduced by active and placebo mouthwashes. Chlorhexidine significantly reduced plaque compared to the placebo. Staining has markedly and significantly increased during chlorhexidine rinsing. Candidal carriage was present in 22.2% of this group and there was no significant effect of chlorhexidine on the mean number of candidal colonies. The distribution of plaque and staining by tooth was plotted and observationally studied. Baseline and placebo treatment plaque distributions indicated the considerable relevance of tooth brushing behaviour for plaque distribution. The effects of tooth brushing on plaque distribution were minimised during the use of chlorhexidine. Staining associated with chlorhexidine showed a distribution again suggesting the influence of tooth brushing. In conclusion, chlorhexidine has significant adjunctive effects on plaque inhibition in the presence of normal unsupervised oral hygiene, but tooth brushing did not prevent tooth staining.
Clinical efficacy of listerine in inhibiting and reducing plaque and experimental gingivitis
Authors: Mankodi S. , Ross N. M. , Mostler K.
Published: December 2005

Abstract 103 adult subjects completed a supervised 2‐week double‐blind controlled clinical study to determine the effect of using either listerine antiseptic (LA) or its vehicle control (VC), as the only oral hygiene procedure, in inhibiting the development of and in reducing plaque and experimental gingivitis. Following baseline examinations, half‐mouth prophylaxes were performed on each subject, who continued normal oral hygiene and returned 4 or 5 days later for a second baseline. Subjects then rinsed, under supervision, either 2 or 4 times daily for 2 weeks with LA or twice daily with VC, but suspended all other oral hygiene measures. Plaque and gingivitis were evaluated at baselines and after 2 weeks. Subjects using LA 2 or 4 times a day as the only oral hygiene procedure for 2 weeks demonstrated highly significant inhibition and reduction of both supragingival plaque and gingival inflammation compared to those using VC.
Cellular colonization of denuded root surfaces in vivo: cell morphology in dentin resorption and cementum repair
Authors: Lindskog Sven , Blomlöf Leif , Hammarström Lars
Published: December 2005

Abstract Cellular colonization of denuded root surfaces on replanted teeth was examined with scanning electron microscopy. The dentin surface was rapidly colonized by a few macrophage‐like cells which resorbed dentin in limited areas. They had well‐developed ruffled borders but no clear zones. The resorptive activity‐was gradually inhibited by the ingrowth of a monolayer of fibroblast‐like cells from the periphery of the denuded area. At the advancing front, the ingrowing fibroblast‐like cells were long and slender, with long tail‐like projections trailing the nuclear domain. The invading cells behind these were well‐spread and tightly packed. They had a granulated surface and showed morphological signs of fibre synthesis. After 6 weeks, the entire cavity was covered by a monolayer of these cells. Removal of the cells with sodium hypochlorite revealed that a cementum‐like tissue had been formed under the invading cells, indicating that they were cementoblasts. It was concluded that wound repair on the root surface is dependent upon the differentiation and proliferation of pre‐cementoblasts in the periphery of the wound and that cells in the main body of the periodontal membrane are of little significance in the healing process on the root surface.
Constant force probing with and without a stent in untreated periodontal disease: the clinical reproducibility problem and possible sources of error
Authors: Watts Trevor
Published: December 2005

Abstract There is presently no satisfactory method of detecting periodontal disease activity at a specified site by means of clinical measurements. This study was designed to examine the possible sources of error with regard to probing measurement reliability. Intra‐examiner reproducibility of probing measurements was studied at 766 sites in 10 patients with untreated periodontitis, using a 0.25 N hinged constant force probe (a) with a stent for guidance and landmark, and (b) without stent. The stent made little difference to overall reproducibility of probing depths, though it appeared to reduce variation in different areas. Repeated probing led to an increase in some measurements, perhaps by an effect on tissues. Reproducibility of probing depth was lower in deep pockets, and about 2% of all probing depth scores varied by 3 mm or more at the same site. 4 possible sources of measurement error were noted: visual and tactile observational error, positional error and tissue change. The results are discussed in relation to the clinical detection of periodontal disease activity.
Effect of periodontal therapy on specific antibody responses to suspected periodontopathogens*
Authors: Vincent Jack W. , Falkler William A. , Cornett Willy C. , Suzuki Jon B.
Published: December 2005

Abstract The effects of clinically successful periodontal therapy were studied in juvenile periodontitis (JP) and rapidly progressive periodontitis (RP) patients and compared with periodontally healthy subjects (HS). Serum samples were obtained in 35 HS prior to the study and in 12 of these subjects 3–4 years later. Serum samples were obtained from 50 JP patients initially, 9 subjects immediately following surgical therapy and 29 of these subjects 3–4 years later. RP patients provided 46 initial serum samples. 9 following therapy and 27 samples 3–4 years later. Antibody levels were determined utilizing a standardized enzyme‐linked immunosorbent assay with Bacteroides gingivalis, B. ochracea, Fusobacterium nucleatum and Actinobacillus actinomycetemcomitans serving as antigens. The JP patients showed an initial rise in antibody levels immediately following therapy followed by a significant decrease in antibody levels 3 to 4 years later. The RP patients did not show an early change in antibody levels but by 3 to 4 years post‐therapy, antibody levels had significantly decreased. However, during this study, the antibody levels of JP and RP patients remained significantly higher when compared with HS patients.
The effect of cigarette smoking on gingival blood flow in humans
Authors: Baab David A. , Öberg P. Åke
Published: December 2005

Abstract This paper presents the acute effects of cigarette smoking on blood flow to the gingiva in 12 young smokers. Relative gingival blood flow (GBF) was measured by a laser Doppler fiberoptic probe placed 1 mm into the buccal sulcus of tooth no. 26. The probe continuously measured the flux of blood cells (velocity×number of cells) in the gingival crest. Relative skin blood flow (SBF) to the forearm and heart rate were also monitored continously; blood pressure (BP) was assessed at 5‐min intervals. After resting for 5 min, subjects sham smoked an unlighted cigarette for 5 min. then smoked the cigarette, and finally rested for 25 min afterwards. Mean changes from resting for all variables were compared to sham smoking for each 5 min block. Mean GBF rose significantly above sham smoking values during smoking, and remained elevated during the first 5 min after smoking (p<0.05). Mean SBF decreased slightly during and after smoking, but the changes were not significantly depressed compared to sham smoking (p>0.05). During smoking, BP and heart rate increased significantly over sham smoking (p<0.05). GBF increased almost linearily when the probe was placed into the gingival sulcus; this phenomenon did not occur when the probe was placed externally to the gingival crest. The theory that smoking impairs gingival blood flow may not be true in humans.
Maintenance care for treated periodontitis patients
Authors: Ramfjord Sigurd P.
Published: December 2005

This paper is a review of current literature combined with clinical observations. Well‐controlled maintenance care is a key consideration in the long‐term prognosis of treated periodontitis patients. Periodic professional tooth cleaning every 3 to 4 months often is recommended. Furthermore, recent studies indicate a potential need for selected retreatment in problem areas, since minute residual accretions may be left behind during active therapy ‐ even with “open” surgery. While efficient plaque control is essential for optimal results during the healing phase of periodontal therapy, periodic prophylaxis may prevent loss of clinical attachment over long periods of time even for patients with less than perfect oral hygiene.
Cigarette smoking and alveolar bone height in subjects with a high standard of oral hygiene
Authors: Bergström Jan , Eliasson Sören
Published: December 2005

Smokers and non‐smokers were compared with respect to alveolar bone height. The study covered 235 subjects aged 21 60 years, 72 of whom were smokers. Oral hygiene status and dental care habits were above average and of equal standard in both groups (P11 = 0.9). Alveolar bone height was assessed on radiographs and expressed as % of the root length, Alveolar bone height was significantly reduced in smokers as compared to non‐smokers, the mean ± SEM being 77.9 ± 1.3% and 82.8, ± 0.6%. respectively (p < 0.001), Regression analysis suggested that periodontal breakdown judged from loss of alveolar bone over time was more accelerated m smokers than non‐smokers. The lower hone height in smokers remained when age and oral hygiene were followed for. It is concluded that smoking is a risk factor for periodontal health.
Observations on the initial stages of healing following human experimental gingivitis A clinical and morphometric study
Authors: Brecx M. C. , Lehmann B. , Siegwart C. M. , Gehr P. , Lang N. P.
Published: December 2005

Abstract The aim of the present study was to investigate stereologically the histologic alterations occurring during gingival healing after experimental gingivitis and to compare clinical parameters with histological findings. 8 dental students volunteered for the investigation. After a prophylaxis, they performed optimal oral hygiene to reach mean plaque and gingival indices approaching zero. They then abolished all oral hygiene procedures for a period of 21 days. After this experimental gingivitis phase, they again performed optimal oral hygiene for 8 days to restore gingival health. At days 0. 1, 2, 4, and 8 after experimental gingivitis, the plaque index (PII), the gingival index (GI) and the gingival exudate flow rate (GEFR) were assessed and their buccal gingiva was biopsied. Point counting procedures were performed at 2 different levels of magnification on light microscopic sections to estimate the volume fractions of epithelium, infiltrated and non‐infiltrated connective tissue, and collagen. The relative numbers of fibroblasts, polymorphonuclear neutrophils. lymphocytes, plasma cells and macrophages were estimated by counting the number of profiles of these cells in a specific connective tissue area adjacent to the apical end of the junctional epithelium. A rapid drop in the PII was noted with increasing time after oral hygiene, followed by a slower decrease in the GI and GEFR scores. The histological picture during the entire experiment was that of an initial gingival lesion. At day 0, no chronic inflammation of the gingiva characterized by a predominance of plasma cells was observed. After resumption of oral hygiene when the relative cell numbers at day 0 and day 8 were compared, only an increase in the PMN population was observed. As GI and GEFR scores decreased no significant changes were noted in the relative numbers of the various cell types. These observations suggest that the “physiogenesis during experimental health” appears first clinically and then histologically, and hence, it may take more than 8 days to observe significant variations in cell populations.
Variation in prevalence of radiographic alveolar bone loss in subgroups of 14‐year‐old schoolchildren in Oslo
Authors: Aass A. M. , Albandar J. , Aasenden R. , Tollefsen T. , Gjermo P.
Published: December 2005

Abstract The aim of the present study was to assess the prevalence of radiographic alveolar bone loss, as related to selected background variables in 2767 14‐year old schoolchildren. Bone loss was recorded when the distance from the cemento‐enamel junction to the alveolar crest exceeded 2 cm. The radiographs were magnified approximately 10 times. 3% of the subjects and 18.5% of the sites were excluded because of indistinct radiographic reference points. Radiographic bone loss was found in 5% of the subjects. Horizontal lesions were more prevalent than vertical defects. Most subjects with bone loss had 1 (75%) or 2 (22%) lesions. No subject was diagnosed with juvenile periodontitis kind of lesion. The prevalence of bone loss depended on the variables sex. orthodontic treatment and ethnic background.
Description and clinical evaluation of a new computerized periodontal probe‐the Florida Probe
Authors: Gibbs Charles H. , Hirschfeld John W. , Lee James G. , Low Samuel B. , Magnusson Ingvar , Thousand Robert R. , Yemeni Prasad , Clark William B.
Published: December 2005

Abstract A new periodontal probing system has been developed which incorporates the advantages of constant probing force, precise electronic measurement to 0.1 mm and computer storage of the data. The system includes a probe handpiece, displacement transducer with digital readout, foot switch, computer interface and personal computer. A unique movable arm design enables the probe handpiece to maintain smooth operation and makes it easy to clean and sterilize. Electronic recording of the data (actuated by pressing a foot switch) eliminates errors which occur when probe tip markings are read visually and the data are called to an assistant. Computer storage and analysis of the data facilitates detecting changes in pocket depth and attachment level by rapidly comparing data recorded at different visits. The system was evaluated in 3 experiments using a 0.4 mm diameter tip and a 25 g probing force. The standard deviation of repeated pocket depth measurement was less (0,58 mm versus 0.82 mm) than that of a common probe. With paired readings referenced to an occlusal stent, the standard deviation of repeated attachment level measurements was 0.28 mm. A loss of attachment level was detected to a certainty of 99% with less than a I mm change. This is a significant improvement over common probes, which require a 2–3 mm change for equivalent positive identification of change in attachment level.
Detection of high‐risk groups and individuals for periodontal diseases
Authors: Wilton J. M. A. , Griffiths G. S. , Curtis M. A. , Maiden M. F. J. , Gillett I. R. , Wilson D. T. , Sterne J. A. C. , Johnson N. W.
Published: December 2005

Abstract The evidence for systemic predisposition to periodontal diseases is reviewed in relation to cellular and humoral immunity, drug therapy, diet and nutrition and stress. It is concluded that, apart from defects of polymorphonuclear leukocytes (PMN) and Ehlers‐Danlos Syndrome, little firm evidence exists for other diseases, though insulin‐dependent diabetes and acquired immune deficiency syndrome (AIDS) may accelerate and/or potentiate the damage of existing disease. The precise role of drugs, diet and nutrition and stress remain to be elucidated, but recent advances in these areas offer the prospect of assessing risk using carefully controlled studies.
A comparison of 4 methods of data presentation for lysosomal enzyme activity in gingival crevicular fluid
Authors: Lamster Ira B. , Oshrain Richard L. , Fiorello Laura A. , Celenti Romanita S. , Gordon Jeffrey M.
Published: December 2005

Abstract In previous studies, we have emphasized the importance of considering the methods used for analysis of gingival crevicular fluid (GCF). This study evaluated 4 different approaches for data presentation of lysosomal enzyme activity in GCF. GCF was collected from patients displaying at least 2 mm of clinical attachment loss at a minimum of 3 sites in the mouth (DA), and patients who did not display clinical attachment loss of 2 mm or more at any site in the mouth (DI), during a 3‐month interval following entry into a longitudinal trial. GCF was collected by the timed intrasulcular placement of precut filter paper strips. 16 to 28 individual GCF samples were collected from each patient. The lysosomal enzymes studied were B‐glucuronidase (BG) and arylsulfatase. The mean values for the DA and DI groups at baseline and 3 months are reported. The results indicate that when the data is expressed as total enzyme activity (unit activity) per 30‐s collection (UA) or UA x GCF volume (μl) per mm of probing depth, the DA group demonstrated significantly greater mean values than the DI group at baseline and 3 months. In contrast, when the data was expressed as concentration (UA/μl), or UA per mm of probing depth, differences between the DA and DI groups were observed only at the 3‐month evaluation. The difficulty in using concentration when reporting GCF lysosomal enzyme activity is emphsized by comparison of the data from the DA group and the high and low enzyme activity subsets of the DI group. At baseline, the DA group had a significantly lower BG concentration than the DI high enzyme subset, but a significantly higher BG concentration compared to the DI low enzyme subset. In addition, determination of true volume presents a potential source of error in the calculation of concentration of any factor in GCF. When GCF is collected for diagnostic purposes with a timed insertion of a precut filter strip, our data indicates that the preferred method of presentation for lysosomal enzyme activity is UA.
Treatment of intraosseous periodontal defects with a combined adjunctive therapy of citric acid conditioning, bone grafting, and placement of collagenous membranes
Authors: Garrett Steve , Loos Bruno , Chamberlain Durwin , Egelberg Jan
Published: December 2005

Abstract A total of 25 proximal, intraosseous periodontal defects were treated in 21 adult patients. A 3‐prong adjunctive, regenerative treatment approach was used. The treatment included (1) citric acid conditioning of the root surfaces, (2) grafting of particles of decalcified, freeze‐dried homologous bone, and (3) placement of freeze‐dried, homologous dura mater sheets between the replaced surgical flaps and the tooth surfaces. The results, as evaluated by probing attachment and probing bone level measurements, during 1 year of observation, demonstrated limited improvements of the treated defects. The limited results were similar to previous observations in our clinics following treatment of intraosseous defects using different treatment modalities. It appears that new treatment approaches need to be sought to accomplish clinically significant and predictable regeneration in proximal, intraosseous periodontal defects.
Mouthrinses in “experimental gingivitis” studies
Authors: Wennström Jan L.
Published: December 2005

Abstract The experimental gingivitis study design is a frequently used clinical model for the evaluation of the effects of antimicrobial agents on developing plaque and gingivitis. In individuals who at the start of the experiment have clean teeth and healthy gingivae and who use a mouthrinse containing the test agent as the only tooth cleaning measure during a period of 14–21 days, the anti‐plaque and anti‐gingivitis potential of the agent can be properly evaluated. The present paper describes different designs of experimental gingivitis studies for the evaluation of chemotherapeutic agents used to control supragingival plaque formation. Findings reported in the literature with respect to the effects obtained by various antimicrobial compounds are also reported.
Computer‐assisted densitometric image analysis in periodontal radiography
Authors: Brägger Urs , Pasquali Lee , Rylander Harald , Carnes David , Kornman Kenneth S.
Published: December 2005

Abstract A videobased computer assisted densitometric image analysis (CADIA) system to quantify alveolar bone density changes on standardized dental radiographs was tested. An algorithm was used for grey level correction of a subsequent image to the baseline image. Quantitative information regarding positive and/or negative grey level changes were obtained automatically. Comparison of the ability of CADIA to detect surgically induced bone loss with interpretation of digital subtraction images and conventional radiographic interpretation revealed that CADIA was the most sensitive of the 3 methods, followed by interpretation of digital subtraction images which was considerably more sensitive than conventional radiographic interpretation. CADIA was capable of assessing differences in alveolar bone changes due to periodontal surgery between sites exposed to ostectomy/osteoplasty and control sites and sites exposed to periodontal surgery without ostectomy/osteoplasty. Finally. CADIA was capable of assessing differences in remodeling activity over 4–6 weeks after periodontal surgery between 45 surgical sites and 45 control sites. The system offers an objective method to quantitatively follow alveolar bone density changes over time and appears to be the most sensitive of previously described radiographic interpretation techniques.
The relationship of initial clinical parameters to the long‐term response in 112 cases of periodontal disease
Authors: Wasserman Bernard , Hirschfeld Leonard
Published: December 2005

Abstract The purpose of the present study was to determine whether any of the clinical parameters recorded during an initial periodontal examination would relate to the course of periodontal cases maintained for long periods of time. Based on available documentation, cases which had a downhill course were assembled from a population previously studied. In addition, long‐term cases currently under maintenance care were drawn from our private practice. On average, the patients had been under care for 23 years. The study population was heavily weighted toward downhill cases to better compare these cases with those usually found in periodontal practice. Positive statistical correlations were found between the amount of subgingival calculus and the degree of gingival inflammation at initial examination. Disease severity initially was positively correlated to long‐term course of disease. The amount of subgingival calculus did not relate to the long‐term result. There was a strong correlation between inflammatory gingival hyperplasia initially and good long‐term maintenance. The results suggest that, in combination, initial characteristics of periodontal cases coupled with long‐term results of treatment may aid in further subclassifying the periodontal diseases.
Quality‐specific taste impairment following the application of chlorhexidine digluconate mouthrinses
Authors: Lang Niklaus P. , Catalanotto Frank A. , Knöpfli Roland U. , Antczak Alexia A. A.
Published: December 2005

Abstract Although chlorhexidine has been widely used in the prevention and treatment of gingivitis, its effects on taste sensation have not been well studied. The purpose of the present study was to evaluate taste alterations following regular applications of 0.2yo chlorhexidine mouthrinses. 24 healthy and nonsmoking clinical instructors, dental assistants and dental students were divided into 3 groups after having reached a status of clinical gingival health by 4 weeks of supervised oral hygiene procedures. Following this, they were asked to abolish all mechanical oral hygiene for a period of 14 days, during which time they rinsed twice daily with different mouthrinses. Group A rinsed with a 0.2% chlorhexidine solution, group B served as control and utilized a 0.001 molar solution of quinine hydrochloride as a placebo rinse, A second control group (C) rinsed with distilled water. At days −3 and −2, as well as at days 1, 2, 13 and 14 of the experimental period, and I and 2 days after cessation of the rinsing, taste sensitivity was evaluated by a magnitude estimation, supralhreshold scaling procedure for the 4 taste qualities – sweet, salty, sour and bitter. 6 different concentrations of each of sucrose, sodium chloride, citric acid and quinine hydrochloride were utilized. Magnitude estimations of the perceived intensities of each series of test solutions were calculated. The analysis of co–variance revealed significant differences at the short‐term and treatment‐related suprathreshold scaling responses between both control groups (B. C) and the test group (A) for the sodium chloride magnitude estimation function. However, no significant inter‐group differences in the magnitude estimation function were found for the remaining taste qualities. While no significant changes were observed in the intra‐group comparison between baseline, short‐term, treatment‐related or post‐treatment suprathreshold scaling responses for any of the taste qualities in the 2 control groups (B, C). the test group (A) rinsing with 0.2% chlorhexidine revealed a significant change in the magnitude estimation function for the sodium chloride solutions. This change was noted in the short–term evaluation and persisted throughout the experimental period. After cessation of the rinsing period, the magnitude estimate for sodium chloride was almost identical to baseline data. The results therefore suggest a specific short–lasting taste impairment for salty taste following rinses with a 0.2% aqueous solution of chlorhexidine.
Microbial colonization patterns of loosely adherent subgingival plaque in adult periodontitis
Authors: Offenbacher S. , Costopoulos S. V. , Odle B. M. , Van Dyke T. E.
Published: December 2005

Abstract Periodontal plaque is a complex bacterial ecosystem that carries an innate history of colonization, selection and maturation. Detailed examination of this balanced environment can reveal developmental sequences and certain interrelationships, much like an archeological record, that can provide insight in the understanding of plaque formation and maturation. For the present investigation, methods are employed which enable the retrospective elucidation of the historical data of plaque development and the nature of bacterial interactions. Non‐parametric statistical methods are used to analyze risk, agreement and interdependence, following analytical techniques which are well established in medical epidemiology, but not generally employed in dentistry. The fundamental concept is that many organisms which are present in plaque prefer or require a preexisting bacterial milieu for colonization and growth to steady‐state level. Plaque samples and Ramfjord attachment level measurements were obtained from 60 adult periodontitis patients. Loosely adherent plaque was sampled and different morphotypes were enumerated by darkfield1 microscopy. The colonization of small spirochetes (S‐SP) within the loosely adherent plaque was essential for the colonization of medium spirochetes (M‐SP), odds ratio – 15.7 and filaments (FIL), odds ratio = 22.2. Thus, a temporal colonization sequence is inferred for FIL and M‐SP, both requiring S‐SP as a prerequisite morphotype. Medium spirochetes, in turn, are required for fusiform (FUS) colonization. M‐SP also enhance the colonization of FIL and large motile rods (L‐MO‐R) within the loosely adherent plaque. These morphotypes were inferred to be sequentially interdependent, each preferring or requiring the presence of the preceding morphotype. This interdependence was statistically significant at P<0.05 as determined by the Z value of the κ, coefficient (intraclass correlation coefficient). The log mean number and % of small and medium spirochetes, as well as L‐MO‐R were found to be positively associated with increasing attachment loss and pocket depth. A model is proposed, demonstrating morphotype interaction, interdependence and colonization sequence.