bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemiluminescent assay of alkaline phosphatase in human gingival crevicular fluid: investigations with an experimental gingivitis model and studies on the source of the enzyme within crevicular fluid
Authors: Chapple Iain L. C. , Socransky Sigmund S. , Dibart Serge , Glenwright Donald H. , Matthews John B.
Published: December 2005

Abstract The purpose of this study was to investigate how levels of gingival crevicular fluid (GCF) alkaline phosphatase (ALP) change in relation to levels of plaque and gingival inflammation in 20 adults during a 21 day period of experimental gingivitis. The source of ALP within GCF was also investigated using a repeat sampling protocol: by determining enzyme levels derived from 30 putative periodontal pathogenic and non‐pathogenic species: and by examining inhibition profiles from a variety of host and bacterial ALP isoenzymes. Total 30‐s GCF ALP levels increased significantly (p<0.002) during experimental gingivitis and preceded an increase in gingival index (GI) by approximately 7 days. Enzyme levels correlated with GCF volume (R=0.7; p<0.0001), but repeat sampling indicated that entry of ALP into the gingival crevice was independent of the rate of fluid flow. Only 5 of the bacterial species investigated produced clearly detectable levels of ALP in culture supernatants, these were P. gingivalis (381). P. intermedia (581). P. nigrescens (8944). Dentin P. gingivalis (TW 471: clinical isolate) and C. ochracea (25). Levamisole inhibition and studies on suspensions of washed plaque demonstrated that host‐derived ALP contributed to >80% of the enzyme in GCF. We conclude that elevated 30‐s GCF ALP levels measured using the chemiluminescent assay reported, are detectable before increases in gingival indices and appear to be a better marker of gingival inflammation than ALP concentrations. The major source of ALP within GCF is host derived and in early inflammatory disease is likely to be of polymophonuclear leukocyte origin.
The effect of a single mechanical treatment on the subgingival microflora in patients with HIV‐associated gingivitis
Authors: Hofer Dominik , Hämmerle Christorph H.F. , Grassi Markus , Mombelli Andrea
Published: December 2005

Abstract The purpose of the present study was to investigate the effect of a single episode of scaling and root planing on clinical periodontal parameters and on the subgingival microflora in human immunodeficiency virus (HIV)‐positive and HIV‐negative subjects. 13 subjects participated and were clinically scored at days ‐7. 7, 30 and 90. 7 subjects were infected with HIV and presented an HIV‐associated gingivitis. 6 subjects were HIV‐negative with at least 12 teeth affected by conventional gingivitis. No significant differences were seen between both groups regarding the presence of P. gingivalis. P. intermedia and A. actinomycetemcomitans. The mean plaque index (PII) was 1.79 in the HIV‐negative and 1.29 in the HIV‐positive group. The mean gingival index (GI) was higher in the HIV‐positive group (HIV‐positive: 1.55; HIV‐negative: 1.47). Whereas, the PII decreased significantly in the HIV‐negative group during the course of the study, no change was observed in the HIV‐positive group. GI as well as bleeding upon sampling decreased significantly in both patient groups during the same period. The bacterial counts decreased from day –7 to day 7 and generally remained on a lower level until day 90. Small differences were seen in the microbiological flora of the HIV‐positive and the HIV‐negative subjects following mechanical treatment.
Evaluation of the healing response following placement of Coe‐pak and an experimental pack after periodontal flap surgery
Authors: Cheshire P.D. , Griffiths G.S. , Griffiths B.M. , Newman H.N.
Published: December 2005

Abstract 2 periodontal dressings. Coe‐pak* and RD8 (a product under development). were assessed following periodontal surgery, using a double‐blind study of randomised split‐mouth design, with each patient acting as their own control. Matched sites were selected for periodontal flap surgery under local analgesia. Sites were randomly allocated to each group. The dressings were applied by a single operator and both patients and clinical assessors were blind as to the dressing employed. The dressings were assessed as to their handling properties, m addition to a 7‐day post‐operative assessment of the surgical sites and a subjective patient report. Maximum pain levels were relatively low (4 in a scale 0–10); subjects reported more pain and analgesics required with RD8 than with Coe‐pak, This was reflected in the results of the patient assessment which indicated that 5O% preferred Coe‐pak, compared to 25%. who preferred the RD8 dressing. The results showed RD8 to be an acceptable periodontal dressing when compared to Coe‐pak, There were no statistically significant differences between treated sites in both groups with regard to post‐operative plaque scores, bleeding scores or tissue healing.
A 6‐month home‐usage trial of 0.1% and 0.2% delmopinol mouthwashes
Authors: Claydon N. , Hunter L. , Moran J. , Wade W. , Kelty E. , Movert R. , Addy M.
Published: December 2005

Abstract Delmopinol is a morpholinoethanol derivative which, in mouthrinses used in the absence of normal oral hygiene, has been shown effective in the inhibition of plaque and gingivitis. The aim of this study was to determine the adjunctive oral hygiene benefits and safety of delmopinol rinses when used alongside normal toothcleaning. This 6‐month home use study was a placebo‐controlled, double‐blind, randomised parallel design evaluating 0.1% and 0.2% delmopinol rinses and structured to conform with the ADA Council of Dental Therapeutics guidelines, A total of 450 dentate male and female subjects were recruited who had no relevant medical or pharmacotherapy histories determined from a full medical examination, including haematoiogical and biochemical tests. Subjects had moderate levels of plaque and gingivitis. At baseline, 3 and 6 months subjects were scored for plaque, gingivitis, tooth stain and supragingival calculus, with plaque sampled for microbiological analysis. Additionally, oral mucosal examinations were performed and subjects questioned for adverse symptoms. Baseline special tests were repeated at the end of the study. After baseline examinations, the subjects received a professional prophylaxis, provided with the allocated mouthwash and instructed to use 10‐ml volumes for 60 s 2Xdaily and where appropriate after tooth brushing and meals. Demographic features of the 3 groups were similar and losses to trial were small. Adverse signs and symptoms included transitory numbness of the tongue, tooth and tongue staining, taste disturbance and rarely mucosal soreness and erosion. All local side‐effects were less commonly reported at 6 compared to 3 months and only 6 subjects were withdrawn because of adverse event. No systemic effects attributable to the agent were observed and no significant shifts in haematological or biochemical parameters occurred. All groups showed considerable improvements in oral hygiene and gingival health with some significant differences in favour of 0.2% delmopinol compared to placebo for gingivitis and more particularly plaque. Staining was also significantly increased in the delmopinol groups but not calculus. In the present study, a considerable Hawthorne effect occurred, which must in part explain why only a modestly significant effect was achieved.
Risk assessment of recurrence of disease during supportive periodontal care
Authors: Ainamo J. , Ainamo A.
Published: December 2005

Abstract Although it is accepted that the primary cause of periodontitis is bacterial infection of long duration, there are a number of risk factors which may increase the probability of recurrence of periodontal disease during supportive periodontal care. The risk may in such cases be caused by other factors than poor oral hygiene measures per se. Cross‐sectional and longitudinal studies show conflicting results concerning age as a risk factor for periodontal disease. The effect of smoking on the periodontal tissues has been discussed for decades and only lately has it been possible to demonstrate that smokers definitely have more periodontal problems than non‐smokers. Another important risk factor for periodontitis relates to the insulin dependent and non‐insulin dependent forms of diabetes mellitus. Poorly‐controlled long‐duration diabetics have more periodontitis and tooth loss than well‐controlled or non‐diabetics. Finally, the issue of compliance deserves attention. The medical literature has suggested that patients with chronic illnesses tend to comply poorly, especially if the disease is not perceived to be particularly threatening, if the therapy is time‐consuming, or if the symptoms are non‐disturbing. Suggestions for improved compliance are called for.
Periodontal diagnosis in treated periodontitis
Authors: Lang Niklaus P. , Tonetti Maurizio S.
Published: December 2005

Abstract The objective of clinical periodontal diagnosis in maintenance patients is to monitor the risk for periodontal disease progression. Risk for progression should be continuously monitored at the patient, tooth and site level at each recall appointment. At the patient level, the significance of systemic diseases, cigarette smoking, compliance with the recall program, loss of support m relation to the patient's age, full mouth plaque and/or bleeding scores, and prevalence of residual pockets are of key importance. At the tooth and tooth‐site levels, residual periodontal support, inflammatory parameters and their persistence, presence of ecological niches with difficult access such as furcations, and presence of iatrogenic factors have to be put into proportion with the patient s overall risk profile. The information gathered by clinical monitoring and continuous multilevel risk assessment facilitates an immediate appreciation of the periodontal health status of an individual and the possible risk for further infection and/or disease progression in the dentition and at a particular tooth or site.
Cost effectiveness of periodontal services
Authors: Douglass Chester W. , Fox Christopher H.
Published: December 2005

Abstract This paper presents the combined use of decision trees and cost‐effectiveness analysis to determine on which patients new diagnostic tests can be useful, and whether they can change the dentist's decision to provide different services and thus improve patient outcomes in 5 different categories of patients. A decision tree is constructed in which the primary decision branches are “test” and ““no test””. The treatment and outcome branches in the test branch are affected by the results of the test which is then either negative or positive. In contrast, the treatment and outcome branches in the no–test branch represent pathways for patient therapy when the new (or additional) test is not used. Results show that even with excellent test efficacy parameters (sensitivity 0.87 and specificity 0.84) it is not cost effective to use a diagnostic test in the general population or for adults under age 45 years. However for adults >45 years, patients referred to a periodontist, and patients with a history of periodontal disease, the test would change treatment decisions and improve patient care outcomes.
Psychological intervention in patients with poor compliance
Authors: Weinstein R. , Tosolin F. , Ghilardi L. , Zanardelli E.
Published: December 2005

Abstract In this article, the authors examine the compliance of periodontal patients from a behavioral psychology perspective. The causes of non‐compliance are analyzed along with the main methods of intervention. An experiment was carried out in which various behaviour modification techniques were compared. This study, in particular, examined the effect of periodontist's use of behaviour modification techniques on patient compliance in four treatment maintenance conditions. A functional analysis of compliance and non‐compliance behaviour revealed various treatment opportunities. Hence. 4 treatment conditions (which included basic oral hygiene instructions, performance feedback, behavioural self‐management, and positive reinforcement) were compared in 3 phases. Data collected over a period of 3 months indicated that behavioural self‐management plus positive reinforcement increase patient compliance significantly. Implications for further research are discussed in terms of analyzing the cost of each component procedure for both the patient and the doctor in terms of time, money and effort required. Hence, the present study demonstrates that behavioural strategies can make a significant contribution to the area of patient management.
Refractory periodontitis: critical questions in clinical management
Authors: Kornman Kenneth S.
Published: December 2005

Abstract Refractory periodontitis appears to be a patient phenomenon with a clinical pattern that may be the result of different influences including genetic factors and exogenous factors that alter the host response to the bacterial challenge. Different patients may have different mechanisms involved in their disease and therefore may show different response patterns following therapy. Although localized non‐responsive sites in otherwise responsive patients should not be considered refractory periodontitis such sites do present substantial therapeutic problems. Initial evidence suggests that local delivery tetracycline provides significant advantages in the management of such sites. Although refractory periodontitis cases appear to be primarily the result of host alterations, the most predictable approach to therapy at present involves systemic antibiotics in conjunction with local therapy. The goal of antibiotic therapy should be to eliminate from detection the target bacteria that were present prior to therapy. Good plaque control, regular professional maintenance therapy, regular microbial monitoring, and control of risk factors are important aspects of the long term maintenance of these cases.
Plaque removal with variable instrumentation
Authors: Checchi Luigi , Forteleoni Gianni , Pelliccioni Gian Andrea , Loriga Gabriela
Published: December 2005

Abstract The purpose of this study was to evaluate dental plaque removal in a normal healthy mouth, during routine oral hygiene appointments using different techniques and without the use of any disclosing agents. 12 dental hygienists, randomly selected from a continuing education course, were asked to perform oral hygiene on the same patient to remove all the supra‐gingival plaque without any time restriction and without the use of any disclosing agents. The plaque index score (O'Leary) was assessed before and after each session with the use of fluorescine and UV light source by an independent examiner. 3 groups of instruments were utilized: group A: ultrasonic scalers+prophy cups: group B: ultrasonic scalers+prophy cups+dental floss: group C: Gracey curettes+prophy cups. While no group was able to remove all the plaque, groups B and C performed significantly better.
Alveolar bone anatomic profiles as measured from dry skulls
Authors: Becker William , Ochsenbein Clifford , Tibbetts Leonard , Becker Burton E.
Published: December 2005

Abstract The purpose of this study was to evaluate the relationship of alveolar bone morphology to tooth shape and form. 111 dry skulls were evaluated at Baylor College of Dentistry (Dallas, Texas). The skulls were arbitrarily divided into flat, scalloped and pronounced scalloped anatomic profiles according to alveolar bone anatomy. The number of buccal dehiscences and fenestrations was determined for each skull according to their anatomic morphotype. 10 skulls from each group were selected for bone height measurements. The measurements were made with a periodontal probe and ruler from the height of the interproximal bone to the buccal alveolar crest. Kodachrome slides were used to measure mesial‐distal tooth width and length from ten skulls from each anatomic category. The average number of fenestrations for each group was 3.5. The mean number of dehiscences for flat and scalloped skulls was 0.5. The average number of dehiscences for pronounced scalloped was 1.2. There were no significant differences when the groups were compared. The mean distance from the height of the interdental bone to the alveolar crest was statistically significant when the groups were compared (flat 2.1 mm, scalloped 2.8 mm. pronounced 4.1mm) (Tukey, p=0.05). There were no significant differences when tooth shapes were compared with bone anatomy. Pronounced scalloped anatomic profiles were slightly narrower when compared with the other groups. The observations reported have treatment ramifications when patients with scalloped or pronounced scalloped morphotypes are being considered for dental implant placement.
Clinical comparison of resorbable and non‐resorbable barriers for guided periodontal tissue regeneration
Authors: Caffesse Raul G. , Mota Luis F. , Quiñones Carlos R. , Morrison Edith C.
Published: December 2005

Abstract The purpose of this study was to compare the clinical results of guided periodontal tissue regeneration (GPTR) using a resorbable barrier manufactured from a copolymer of polylactic and polyglycolic acids (Resolut® Regenerative Material) with those of non‐resorbable e‐PTFE barrier (Gore‐Tex® Periodontal Material). 12 subjects participated, 6 with similarly paired class II furcations and 6 with 2 similar 2,3‐wall periodontal lesions. The resorbable and non‐resorbable barriers were randomly assigned to 1 defect in each subject. Non‐resorbable barriers were removed in six weeks. Plaque index (PII), gingival index (GI), probing depth (PD), clinical attachment level (CAL) and gingival recession (R) were recorded at baseline, (i.e., immediately prior to surgery) and at 12 months postsurgically. The clinical healing was similar and uneventful in both groups. Intrabony pockets depicted significant changes from baseline (p < 0.05) for probing depth reduction and gain in clinical attachment levels. No differences were found between treatments. Class II furcations showed significant improvements from baseline (p < 0.05) for probing depth reduction and clinical attachment gain. No differences were detected between treatments. It is concluded that the resorbable barrier tested is as effective as the nonresorbable e‐PTFE barrier for the treatment of class II furcations and intrabony defects.
Subgingival temperature in smokers and non‐smokers with periodontal disease
Authors: Dinsdale Christopher R. J. , Rawlinson Andrew , Walsh Trevor F.
Published: December 2005

Abstract The purpose of this study was to compare subgingival temperature in a group of smokers to that of a group of non‐smokers with similar levels of periodontal disease. 40 adult subjects. 20 cigarette smokers and 20 non‐smokers with evidence of adult periodontitis were examined. Subgingival temperature was measured at 6 sites around each of 4 maxillary anterior teeth. Probing depth, and the presence or absence of bleeding was also recorded. In addition, the sublingual temperature was recorded. All sites were classified as diseased or healthy. Healthy sites did not bleed and had a probing depth of ≥ 4mm. diseased sites were any site which had a probing depth ≥ 5 mm. or which bled on probing. Mean sublingual and site temperatures were calculated for smokers and non‐smokers. Mean temperature differentials (ΔT) between the sublingual temperature and the site temperature were calculated for each site. Smokers had a warmer mean sublingual temperature than non‐smokers. A significant difference in subgingival site temperature was demonstrated between the smokers and non‐smokers, with the mean site temperature being 0.4°C warmer in smokers (p < 0.01). When healthy or diseased sites were compared between smokers and non‐smokers, smokers also had warmer mean site temperatures than non‐smokers for both healthy and diseased sites (p < 0.01). When the mean temperature differentials (ΔT) between healthy and diseased sites were compared across each group, significant differences were also found. For healthy sites, the smokers had a mean ΔT 0.2°C lower (p < 0.01) than the non‐smokers, representing warmer sites. In diseased sites however. ΔT was 0.3°C higher (p < 0.01) in smokers, representing cooler sites.
Clinical and microbiological features of subjects with adult periodontitis who responded poorly to scaling and root planing
Authors: Haffajee A.D. , Cugini M. A. , Dibart S. , Smith C. , Kent R. L. , Socransky S. S.
Published: December 2005

Abstract In a previous report, it was shown that scaling and root planing (SRP) decreased mean pocket depth and attachment level in subjects with adult periodontitis, as well as the levels and prevalence of Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola. However, a subset of subjects in that study exhibited mean loss of attachment following SRP. The purpose of the present investigation was to seek clinical and microbiological differences between subjects who responded well or poorly to SRP. 57 subjects with adult periodontitis were treated by full‐mouth SRP under local anaesthetic. Clinical assessments of plaque, redness, suppuration, BOP, pocket depth and attachment level were made at 6 sites per tooth prior to and 3 months post‐SRP. Attachment level measurements were repeated at each visit and differences in means between visits used to assess change. 18 subjects showed mean attachment loss 3 months post‐SRP (poor response group), while 39 showed mean attachment level gain (good response group). The prevalence and levels of 40 subgingival taxa in subgingival plaque samples from the mesiobuccal site of each tooth (maximum 28 sites) in each subject prior to and 3 months post‐SRP were assessed using checkerboard DNA‐DNA hybridization. The prevalence of each species was computed for each subject and averaged across subjects in the 2 treatment‐response groups at each visit. Differences between groups were sought using the Mann‐Whitney test. There were no statistically significant differences between the 2 response groups in any clinical parameter prior to therapy. Subjects in the good response group showed more attachment level gain at sites with baseline pocket depths of < 4 mm, 4–6 and > 6 mm than poor response subjects. Of 40 species evaluated. A. naeslundii genospecies 2 (A. viscosus), T. denticola, C. gracilis and C. rectus were significantly higher and more prevalent pre‐therapy in the good response subjects. Mean attachment level change post SRP could be predicted using multiple linear regression with A. naeslundii genospecies 2 (A. viscosus) and T. denticola as the predictor variables (r2=0.373, p < 0.00001). Sites that gained ≥ 2 mm of attachment post therapy showed a significant decrease in the counts of P. gingivalis (7.5±3.5 to 0.2±0.2×105), T. denticola (8.2±3.5 to 1.8±1.1×105) and B. forsythus (11.1 ± 5.7 to 0.3±0.2×105). The data of the present investigation indicate that SRP is most effective in subjects and sites with high levels of the subgingival species that this therapy affects.
Bone morphogenetic proteins: background and implications for oral reconstruction
Authors: Lee Michael B.
Published: December 2005

Abstract For over 30 years now, research has been carried out to isolate and purify bone morphogenettc protein (BMP), a substance which has been shown to induce heterotopic bone formation in various animal species. Recent advances in the fields of developmental biology, molecular biology, genetics and wound healing, have shown that the BMPs are not only responsible for postfetal bone induction (including normal bone remodeling, healing and repair), but are also critical during embryogenesis, not only in regards to the skeletal system, but quite possibly in the morphogenesis and pattern formation of other tissues and organs as well, Therefore. BMPs have the potential as a therapeutic utility in orthopedic and dento‐alveolar reconstruction.
Retrospective analysis of factors related to clinical outcome of guided tissue regeneration procedures in intrabony defects
Authors: Trombelli Leonardo , Kim Chong‐Kwan , Zimmerman Grenith J. , Wikesjö Ulf M. E.
Published: December 2005

Abstract The purpose of this retrospective study was to determine factors affecting clinical outcome of guided tissue regeneration (GTR) in the treatment of intrabony periodontal defects. 38 patients each contributing 1 isolated intrabony defect treated with GTR were included in this analysis. Patient and defect characteristics, and defect‐specific recordings relative to clinical outcome 6 months postsurgery were assessed. GTR treatment resulted in clinically and statistically significant improved probing depths (PD), clinical attachment levels (CAL), and probing bone levels (PBL). Presurgery PD and PBL were of predictive value for CAL gain and PBL gain, respectively. CAL and PBL gain did not correlate to defect depth or configuration. Cigarette smoking exhibited a highly significant negative correlation to parameters of clinical outcome.
Multifocal eosinophilic granuloma with sequential periodontitis‐like lesions
Authors: Ünlü Füsun , Gürses Nurcan , Seçkin Turgay , Ünal Taha
Published: December 2005

Abstract Eosinophilic granuloma (EG) is the localized and mildest form of the triad commonly known as Langerhans cell histiocytosis. This report describes a case manifesting itself as a periodontal problem with the localized osseous lesions in jawbones which was first diagnosed as early‐onset periodontitis. Later on. the diagnosis of EG was established, relying on histopathological and immunohistochemical evaluations. Immunohistochemical findings confirm that a minor component of cell aggregates is phenotypically related to Langerhans cells among the sheet‐like accumulations of histiocytes and eosinophils. The aetiology of the disease remains largely unknown. Although surgical curettage of lesions is usually effective in treatment of EG of bone, corticosteroids might be used as an adjunctive. This multifocal case of EG stresses the importance of clinical follow‐up examinations, since the sequential lesions appear with irregular intervals, and this may cause diagnostic problems as well as a delay in starting the treatment regimen.
An investigation of bioadhesion for periodontal and oral mucosal drug delivery
Authors: Needleman Ian G. , Smales Frederick C. , Martin Gary P.
Published: December 2005

Abstract Gel delivery vehicles have ideal placement characteristics for periodontal and oral mucosal drug delivery. However, the retention of the vehicle at the site may be of short duration thereby limiting its therapeutic effect. Bioadhesion has received little attention as a means of enhancing vehicle retention in the periodontal pocket and this study aimed to investigate the possible role of this phenomenon to aid oral drug delivery. Chitosan, xanthan gum and poly (ethylene oxide) were selected as potential vehicles from previous in vitro studies, since all 3 had shown good bioadhesive properties. Retention in the periodontal pocket was assessed by means of an insoluble fluorescein marker in 8 patients, and to the oral mucosa by the retention of a small plastic film in 12 subjects. The results showed that fluorescein release from the periodontal pocket was significantly longer for chitosan than for other gels or a water control. In contrast, xanthan gum gave the most prolonged adhesion time on the oral mucosa (153.5 min) followed by poly (ethylene oxide) (89.3 min) and chitosan (42.6 min), and these times were all significantly different from each other (p<0.05). The results from this study would tend to suggest that the bioadhesive properties of an aqueous gel may be directly related to its retention both in the periodontal pocket and on the oral mucosa. However, other important factors for mucosal adhesion include the patient acceptability of the formulation and the choice of application site.
Antimicrobial susceptibility tests on anaerobic oral mixed cultures in periodontal diseases
Authors: Pacini N. , Zanchi R. , Ferrara A. , Canzi E. , Ferrari A.
Published: December 2005

Abstract The ecosystem of the dental plaque in periodontal diseases is very complex: the study of such micro‐organisms, which are mostly strict anaerobes, requires the use of specific techniques under conditions of strict anaerobiosis. The aim of the present study was to design a rapid method to evaluate the activity of antimicrobials on mixed bacterial plaque of subjects with periodontal diseases. The study was carried out using a computerised instrument generally used for simultaneous diagnostic tests with aerobic bacteria. Operative and methodological modifications were made to obtain conditions of strict anaerobiosis and the balanced growth of all the microbial forms present in the mixed cultures of the plaque. Penicillins and cephalosporins were active on all the samples, whereas colistin. gentamicin, kanamycin and nalidixic acid showed no activity. Clindamycin, tetracycline, erythromycin and penicillin G were effective only against some samples. The activity of the antimicrobials towards isolated strains was analogous to that towards the corresponding mixed culture.
Particulate bioglass® as a grafting material in the treatment of periodontal intrabony defects
Authors: Zamet J.S , Darbar U. R. , Griffiths G.S. , Bulman J.S. , Brägger U , Bürgin W. , Newman H. N.
Published: December 2005

Abstract The present clinical trial was designed to evaluate the effects of a bioactive glass. Perioglas®, in the treatment of periodontal intrabony defects. 20 patients. 23–55 years of age (44 sites), with intrabony defects completed the 1‐year study. Teeth with furcation involvement were excluded. After completion of initial therapy, defects were randomly assigned to either a test or control procedure. Following flap reflection, root planing and removal of chronic inflammatory tissue in both groups, the test defects were restored with the bioactive glass particulate material. Mucoperiosteal flaps were replaced, sutured and a periodontal dressing was used. All the patients received postoperative antibiotics and analgesics and were seen at 1 week for suture removal. Follow‐up was then carried out weekly and at 3 months, 6 months. 9 months and 1 year post‐surgery. Plaque score, bleeding score, probing pocket depth (PPD), probing attachment level (PAL) and gingival recession were recorded at baseline, 3 months and 1 year. Standardised radiographs for computer‐assisted densitometric image analysis (CADIA) were taken at baseline, immediately post‐operatively and at 1 year. The CADIA data showed a significant increase (F‐ratio: 15.67, p<0.001) in radiographic density and volume between the defects treated with the Perioglas® when compared to those treated with surgical debridement only. PPD and PAL showed significant improvements in both experimental and control sites, with a greater trend to improvement in the experimental sites. It was concluded that this bioactive glass is effective as an adjunct to conventional surgery in the treatment of intrabony defects.
A clinical evaluation of a novel toothbrush design
Authors: Kieser Jules , Groeneveld Hennie
Published: December 2005

Abstract A new toothbrush design, the Snakebrush®, was clinically evaluated along with the Flexible® and Precision® brushes. In this parallel, random‐allocation investigation, the plaque removing qualities of the 3 brushes were evaluated over a period of 30 days. 60 patients of good dental health between the ages of 20 and 30 years formed the basis of the clinical trial. Mean plaque area scores were evaluated and recorded after a 1‐min brush at baseline, day 15 and day 30. Gingivitis indices and bleeding on probing indices were also recorded at the same time intervals. Both uni‐ and multivariate analyses of our data suggested that the Snakebrush removed significantly more plaque than the 2 controls. For both lingual and buccal surfaces, subjects who had used the Snakebrush showed a significant decline in bleeding on probing and qinqivitis indices.
The bactericidal effects of dental ultrasound on Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis
Authors: O'Leary R. , Sved A.M. , Davies E.H. , Leighton T.G. , Wilson M. , Kieser J. B.
Published: December 2005

Abstract This study investigated the possible bactericidal acoustic effects of the dental ultrasonic sealer. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis suspensions, were subjected to the vibrations of a Cavitron PI insert for 2.5 and 5.0 rain in an acoustically‐simulated pocket model and the survivors enumerated. The extent of any cavitation occurring within the pocket model to which the statistically significant bactericidal activity observed might be attributed, was determined by ‘sonoluminescence’, which was then investigated by photomultiplication techniques. However, these failed to detect any sonoluminescence within the pocket space and moreover, the necessary deflection of the water coolant away from the insert tip. to avoid flooding of the experimental pocket, proved to result in temperatures of 47.6®C and 52.3®C at the respective time intervals, and thereby constituted an alternative possible bactericidal mechanism. Examination of the effects of such temperature changes on the target bacteria then revealed statistically significant differences in the viable counts of both microorganisms after 5.0‐min periods, and as such were comparable to those previously detected in relation to the pocket model. Whilst it must be presumed that the bacteriolytic effect observed in the main investigation was due to the incidental temperature changes, in the absence of acoustic cavitation the influence of any associated acoustic microstreaming cannot be discounted. Further investigations to assess the bactericidal potential of acoustic phenomena using a modified experimental to exclude any hyperthermic effects are therefore necessary.
Effect of delmopinol hydrochloride mouthrinse on plaque formation and gingivitis in “rapid” and “slow” plaque formers
Authors: Zee Kwan‐yat , Rundegren Jan , Attström Rolf
Published: December 2005

Abstract The aim of the present study was to investigate differences in the plaque and gingivitis inhibiting effect of delmopinol rinsing between “rapid” and “slow” plaque formers. 23 subjects (12 “rapid” and 11 “slow” plaque formers) were selected from 71 healthy young adults. The selection was based on the plaque index on the buccal surfaces of all premolars and 1st molars after 3‐days without plaque control. The 23 subjects were randomly assigned into 3 groups with different mouthrinses, i.e., 0.1% delmopinol, 0.2% delmopinol, and placebo. The study was double‐blind with parallel design between the “rapid” and “slow” plaque formers and cross‐over design between 2 active periods and a placebo period. Each rinsing period lasted for 5 days. During the 3 test periods, the subjects refrained from all oral hygiene and rinsed 2 × daily with either one of the 3 solutions. Gingival crevicular fluid (GCF) was collected from buccal surfaces of upper canines and premolars and bleeding on probing (BOP) recorded at 6 sites around each tooth before and after each test period. Plaque assessment, including plaque index (PI) and standardized color slides for planimetric analyses obtained from the canines and premolars, were only recorded after each test period. Results showed that the mean PI and planimetry values for both the “rapid” and “slow” plaque formers were lower than the placebo, for either the 0.1% or the 0.2% delmopinol mouthrinse. The differences between the “rapid” and “slow” plaque formers were not statistically significant. There was a small reduction in BOP in both groups for the delmopinol periods, as against a slight increase in the placebo period: the difference between the placebo group and the 2 groups of plaque formers was not statistically significant (p>0.6 for both 0.1% and 0.2% delmopinol). Results suggested that both 0.1% and 0.2% delmopinol reduce plaque formation and gingivitis to a similar extent in subjects with extreme rates of plaque formation.
β‐lactamase producing bacteria in adult periodontitis
Authors: van Winkelhoff A.J. , Winkel E.G. , Barendregt D. , Dellemijn‐Kippuw N. , Stijne A. , van der Velden U.
Published: December 2005

Abstract In 23 untreated adult periodontitis patients, the occurrence of β‐lactamase producing periodontal bacteria was determined. In addition to non‐selective isolation media, selective isolation and growth of β‐Mactamase positive subgingival bacterial species was carried out on blood agar plates supplemented with amoxicillin and plates with amoxicillin + clavulanic acid. Porphyromonas gingivalis, Prevolella intermedia, Actinobacillus actinomycetemcomilans, Peplostreploc‐occus micros, Fusobaclerium nucleatum, Bacleroides forsythus and Campylo‐bacter rectus isolates from the non‐selective medium were tested for β‐Mactamase activity by a nitrocefin disk method (DrySlide®) and by a laboratory chromo‐genic nitrocefin‐ based test. Isolates from the amoxicillin plates that were absent on the amoxicillin/clavulanic acid plates were identified and tested for β‐Mactamase production. Based on the non‐selective plates, six of 23 P. intermedia isolates, 2 of 19 B. forsythus isolates and 3 of 23 F. nucleatutm isolates were β‐Mactamase positive. The β‐Mactamase positive species Prevoleila loescheii, Prevotella buccae, Prevolella buccalis and Actinomvces spp were recovered from the selective amoxiciliin plates. β‐Lactamase positive subgingival species were recovered from 17 of 23 patients (74%) but usually comprised low proportions of the sub gingival microbiota (range < 0.01–15%). Comparison of the DrySlide® test and the nitrocefin‐based laboratory test revealed full agreement of test results. β‐lactamase activity in whole sub gingival plaque was detected in 12 patient samples (52%). It was concluded that β‐Mactamase activity in sub gingival bacteria in adult periodontitis is a common feature. However, since the majority of the samples showed only low‐level enzymatic activity, the clinical relevance of this observation with regard to therapy with unprotected enzyme‐susceptible β‐lactamase is uncertain, though failure on the other hand, is difficult to rule out when a mechanism of resistance is present. The majority of β‐Mactamase positive strains was found among species of the Prevotella genus.
Guided tissue regeneration using a collagen membrane in chronic adult and rapidly progressive periodontitis patients in the treatment of 3‐wall intrabony defects
Authors: Benqué E. , Zahedi S. , Brocard D. , Oscaby F. , Justumus P. , Brunel G.
Published: December 2005

Abstract This study, confined to non‐smokers, evaluated guided tissue regeneration using a diphenylphosphorylazide‐cross‐linked bovine type I collagen membrane in deep 3‐wall intrabony defects in 52 adult periodontitis (AP) and 16 rapidly progressive periodontitis (RPP) patients, previously treated for the acute phase of the disease, no more than one defect being randomly selected for each patient. Before surgery and 6 months after surgery, plaque (PI) and sulcus bleeding (SBI) indices, as well as probing pocket depths (PPD), gingival margin locations (GML) and probing attachment levels (PAL) were recorded. During the post‐surgical period, the membranes were very well tolerated in all patients and PI and SBI were kept at a low level. 6 months post‐surgical, there was a significant gain in PAL (3.6 mm for AP: 2.6 mm for RPP) and reduction in PPD (5.5 mm for AP; 4.1 mm for RPP) for both groups of patients (p<0.05). However, neither the change in GML (1.9 mm for AP: 1.5 mm for RPP). nor PPD or PAL yielded a statistically significant difference between AP and RPP patients. The results of this study demonstrated that the treatment of deep 3‐wall intrabony defects with a diphenylphosphorylazide‐cross‐Iinked collagen membrane in both AP and RPP patients during the quiescent phase of the disease is a treatment modality where the conquences are predictable. However, longer observation periods are necessary to evaluate the stability of the improvements obtained for the 2 groups of patients and the differences between them.
The comparative effect of acidified sodium chlorite and chlorhexidine mouthrinses on plaque regrowth and salivary bacterial counts
Authors: Yates R. , Moran J. , Addy M. , Mullan P.J. , Wade W.G. , Newcombe R.
Published: December 2005

Abstract Acidified sodium chlorite (ASCI is recognised as a highly potent, broad spectrum antimicrobial system that has been successfully developed for uses in veterinary, food processing and medical device fields. The current studies aimed to investigate the persistence of antimicrobial action and plaque inhibitory properties of 3 ASC mouthrinses by comparison with positive control, chlorhexidine 0.12%, and placebo control, water, rinses. Both studies were randomised, double‐blind, cross‐over 5‐cell designs balanced for carryover. The 1st study involved 15 healthy subjects who immediately before and at 30, 60, 180, 300 and 420 min after rinsing provided 2 ml saliva samples. The samples were immediately processed for total anaerobic bacterial counts recorded after 96 h incubation. Washout periods were a minimum of 3 days. The second study involved 20 healthy subjects who on day 1 of each study were rendered plaque free, suspended normal oral hygiene methods and commenced rinsing twice daily with the allocated rinse. On day 5, plaque was scored by index and area after disclosing with erythrosin. Washout periods were 2 1/2 days. The 3 ASC and chlorhexidine rinses produced similar reductions in salivary bacterial counts which remained significantly below the placebo control to 7 h. There were no significant differences between ASC and chlorhexidine rinses except at 30 and 60 min when significantly greater reductions were produced by 2 ASC rinses compared to the chlorhexidine rinse. Plaque indices and areas were considerably and significantly lower with the ASC and chlorhexidine rinses compared to the placebo rinse. There were no significant differences between plaque scores for the 3 ASC rinses and the chlorhexidine rinse, although for 2 ASC rinses plaque scores were lower than for the chlorhexidine rinse. The results indicate that the 3 ASC rinses have equivalent plaque inhibitory action to chlorhexidine as a rinse. Similar to chlorhexidine. the plaque inhibitory action of the rinses appears to be derived from a persistence of antimicrobial action in the mouth.
Comparisons of modalities of mechanical stimulation with a toothbrush on improvement of oxygen sufficiency in dog gingiva
Authors: Tanaka M. , Hanioka T. , Kishimoto M. , Shizukuishi S.
Published: December 2005

Abstract Mechanical stimulation with a toothbrush was applied to each quadrant of 10 dogs at a force of 200 g for 10 s using following modalities: vibration at attached gingiva. pressurization at attached gingiva. vibration at marginal gingiva and no treatment as a control. Hemoglobin oxygen saturation (SO2) in the gingiva was measured by non‐invasive tissue reflectance spectrophotometry. Simultaneously, oxygen tension (PO2) in gingival tissue was monitored with an oxygen microelectrode. Both SO2 and PO2 increased within 10–20 min after stimulation and then slowly returned to the initial level at all treatment sites. The response was most prominent after vibration at attached gingiva. SO2 and PO2 increased by 12% and 42%. respectively, and significant increase continued for 75–85 min. Response after vibration at marginal gingiva was moderate in PO2 and transient in SO2. Pressurization at attached gingiva caused moderate response in SO2. but the increase in PO2 was slight. Control showed little change in both indices. These results suggest that vibration with a toothbrush at attached gingiva may cause a maximal response in improving oxygen sufficiency to gingival tissue.
Therapy‐resistant periodontitis (I). Clinical and treatment characteristics
Authors: Axtelius B. , Söderfeldt B. , Edwardsson S. , Attström R.
Published: December 2005

Abstract The aim of this study was to evaluate the clinical criteria for classification of 2 different patient groups. From retrospective comparisons of pocket probing depth (PPD) charts, we classified 22 patients as either non‐responding or responding to periodontal treatment. The non‐responding patient group, in comparison with the responding patient group, showed a profile over time of less PPD reduction in response to periodontal treatment. Information registered in each patients file regarding clinical periodontal conditions, as well as treatment procedure characteristics, was gathered. Bivariate analyses were performed. 3 clinical variables (frequency of mean PPD ≥6 mm during the treatment period; at final registration: and the mobility score at the final registration) indicated that 2 separate patient groups had been identified. Although the patient groups exhibited advanced periodontitis at the beginning of treatment, both groups at the end of treatment had lost very few (1–2) teeth, probably as a result of regular supportive treatment. The characteristics of the selected clinical criteria warrant the use of these 2 patient groups in further analysis of the relation of psychosocial stress and microbiological characteristics of therapy‐resistant periodontitis.
Enamel matrix, cementum development and regeneration
Authors: Hammarström Lars
Published: December 2005

Abstract Studies during the last 20 years have indicated that enamel‐related proteins are involved in the formation of cementum. In the present article, this relation is further explored. Attention is called to the fact that coronal a cellular extrinsic fiber cementum is formed on the enamel surface in a number of species. The composition of the enamel matrix proteins and the expression of these proteins during root formation are briefly reviewed. The dominating constituent of the enamel matrix, amelogenin, is shown by means of immunohistochemistry to be expressed in human teeth during root formation. Amelogenin was also found to be present in Tomes' granular layer of human teeth. When mesenchymal cells of the dental follicle were exposed to the enamel matrix a non‐cellular hard tissue matrix was formed at the enamel surface. Application of porcine enamel matrix in experimental cavities in the roots of incisors of monkeys induced formation of a cellular cementum that was well attached to the dentin. In control cavities without enamel matrix, a cellular, poorly attached hard tissue was formed. The present studies provide additional support to the idea that enamel matrix proteins are involved in the formation of a cellular cementum and also that they have the potential to induce regeneration of the same type of cementum.
Prevalence of suspected periodontal pathogens identified using ELISA in adolescents of differing ethnic origins
Authors: Ellwood R. , Worthington H.V. , Cullinan M.P. , Hamlet S. , Clerehugh V. , Davie R.
Published: December 2005

Abstract The aim of this study was to determine the prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in a group of adolescents and investigate the association of these organisms with various clinical parameters. A total of 527, 11‐13‐year‐old children, of whom 333 (63%) were white Caucasian, 187 (35%) Indo‐Pakistani and 7 (1%) Afro‐Caribbean, participated in the study. Subgingival plaque samples, collected from the mesio‐buccal of both upper first permanent molars using sterile paper points, were stored in phosphate buffered saline with 0.01% thiomersal and analysed for the presence of A. actinomycetemcomitans, P. gingivalis and P. intermedia using ELISA. The mesio‐buccal sites of both upper 1st permanent molars were also examined and the presence/absence of supragingival plaque, subgingival calculus, bleeding on probing and pocket depths greater than 3 mm were recorded. The % of white Caucasian children in whom the monoclonal antibody identified at least 1 site with A. actinomycetemcomitans, P. gingivalis and P. intermedia were 4%, 3% and 2%, respectively, and for Indo‐Pakistanis were 3%, 17% and 2%. The difference for P. gingivalis was statistically significant (p < 0.001). The associations between the clinical parameters and the 3 organisms were considered separately for both upper first molar sites. The prevalence of P. gingivalis was higher for sites with subgingival calculus, pockets >3 mm and bleeding on probing (p < 0.001).