bluuebunny/crossref_metadata_2025 huggingface dataset:
Periodontal treatment needs of 35‐year‐old citizens in Oslo
Authors: Hansen B. Frode , Iohansen Jan R.
Published: December 2005

Abstract The periodontal condition was evaluated according to the PI and the Periodontal Treatment Need System (PTNS) in a random sample of 35‐year‐old citizens of Oslo. The study demonstrated that periodontal disease was a major dental health problem despite the fact that 88.9 % of the subjects visited a dentist regularly. No statistically significant differences were found in PI, PTNS and OHI‐S values among the different sexes and educational groups. Although the majority of the subjects (77.8 %) brushed their teeth more than once a day, the oral hygiene status was not satisfactory (mean OHI‐S 1.56). The frequency of toothbrushing did not influence the mean PI scores. Dental hard and soft tissue lesions related to toothbrushing were found in 30.0 and 6.8 % of the subjects respectively, and more often among persons brushing more than once a day than among persons brushing less frequently.
The effect of orthodontic tilting movements on the periodontal tissues of infected and non‐infected dentitions in dogs
Authors: Ericsson I. , Tehlander B. , Lindhe J. , Okamoto H.
Published: December 2005

Abstract The aim of the present investigation was to study (1) whether it was possible, by orthodontic tooth movement, to shift a supragingivally located plaque into a subgingival position, and (2) periodontal tissue reactions around tilted and intruded plaque‐infected teeth.

The experiments were performed on five dogs which were fed a diet that allowed dental plaque accumulation. The lower third premolars (3P and P3) were extracted and a phase of experimental periodontal breakdown was initiated on day 0. The periodontal pockets around the lower fourth premolars (4P and P4) were eliminated on day 210. During surgery, a notch was prepared in the root at the level of the marginal alveolar bone in order to facilitate measurements in radiographs and histological sections. After 60 days of healing with plaque control, i.e. on day 270, orthodontic appliances producing tipping forces on 4p and P4 were inserted. From day 270 to day 450, plaque was allowed to accumulate on 4P (test = T) while P4 (control = C) was brushed twice daily. The dogs were sacrificed on day 450. Following sacrifice, tissue sections comprising 4P, 1M and P4, M1 were produced and subjected to microscopic analysis.

The present investigation showed that it was possible by orthodontic tooth movement to shift a supragingivally located plaque into a subgingival position. The mesial‐apical movement of the plaque‐infected teeth resulted in the formation of infrabony pockets. In four out of five dogs the displacement of the plaque‐infected tooth resulted in an apical shift of the connective tissue attachment. When similar orthodontic forces were acting on plaque‐free teeth, the tilting movement did not result in the formation of infrabony pockets. In only two dogs did the treatment result in loss of connective tissue attachment.
The reversal of localized experimental gingivitis
Authors: Bosman C. W. , Powell R. N.
Published: December 2005

Abstract. Twenty dental students randomly divided into four groups of five participated in this trial. Three weeks of supervised oral hygiene preceded the study in order to ensure a optimum state of gingival health. The gingival condition was assessed by means of the Gingival Index and measurements of gingival exudate. Plaque accumulation was assessed by means of the Plaque Index. Using plaque‐guards, two 21‐day periods were allowed for the induction of localized experimental gingivitis around a lateral incisor and adjacent canine in each jaw. The contralateral areas served as controls. Habitual oral hygiene procedures were maintained in all other areas of the mouth throughout the experimental periods. Following 21 days of localized plaque accumulation in the mandibular experimental areas, mechanical toothcleaning procedures were introduced at intervals of once a day (Group A), once every second day (Group B), once every third day (Group C) and once every fourth day (Group D). Groups A and B regained gingival health in 10 days. The experiment was then repeated in the maxillary experimental areas. Group A, rinsing once daily with chlorhexidine solution regained gingival health in 4 days. The results obtained in the localized experimental gingivitis model were similar to those reported when totally withdrawing oral hygiene.
Gingival condition in areas of minimal and appreciable width of keratinized gingival
Authors: Miyasato Myles , Crigger Max , Egelberg Jan
Published: December 2005

Abstract. Sixteen dental, dental hygiene, and dental assisting students and dental faculty members who had contralateral or unilateral areas of minimal (≤ 1.0 mm) and appreciable (≥ 2.0 mm) widths of keratinized gingiva on mid‐buccal plaque‐free surfaces of mandibular bicuspids were examined. Gingival exudate amounts and clinical inflammation based on color change and/or swelling and bleeding on probing were evaluated. The result showed that gingiva with “appreciable” width as well as gingiva with “minimal” width of keratinized tissue exhibited only minute amounts of gingival exudate. Also, there were generally no clinical signs of inflammation for both types of tissue.

From the groups of 16, six subjects were selected who had contralateral pairs of minimal and appreciable keratinized gingiva. They were instructed to cease oral hygiene in the lower bicuspid area for 25 days. At day 0, 4, 7, 11, 14, 18, 21, and 25, plaque, gingival exudate, and clinical gingival inflammation were evaluated. Results revealed increases in plaque, gingival exudate scores and clinical gingival inflammation over the 25‐day period with no apparent difference between the areas with minimal and appreciable width of keratinized gingiva.
Osseous repair in infrabony periodontal defects
Authors: Polson Alan M. , Heul Lars C.
Published: December 2005

Abstract The present investigation was undertaken to quantitate the osseous changes which occur throughout the entire circumferential extent of infrabony periodontal defects in patients with optimal plaque control. Fifteen defects were selected in nine patients. Periodontal surgery was scheduled after each patient had shown an ability to practice efficient plaque removal. Muco‐periosteal flaps were raised and the osseous defects debrided. The dimensions of each defect were measured at several specific location points within the defect. The flaps were replaced at their original location and, post‐operatively, optimal plaque control was maintained in the area (Mean Plaque Index 0.04). Six to 8 months after the initial surgery all areas were re‐operated and the osseous defects were remeasured at the same specific location points. Each defect showed osseous regeneration at every location point. The mean initial osseous defect depth at a location point was 3.5 mm and the mean amount of bone regeneration which occurred was 2.5 mm. Crestal alveolar bone resorption occurred at almost half of the location points and averaged 0.7 mm. Eleven of the 15 deefcts had resolved completely. There were isolated areas where a shallow defect persisted in the remaining four defects. The behavior of an osseous defect throughout its circumferential extent was characterized by a combination of coronal hone regeneration (mean 77%) and marginal bone resorption (mean 18%). Infrabony periodontal defects may predictably remodel after surgical debridement and establishment of optimal plaque control.
Clinical assessment of periodontal dressings
Authors: Haugen Ellen , Gjermo Per
Published: December 2005

Abstract Forty‐one patients requiring gingivectomy in one or more areas were used for a clinical evaluation of three different periodontal dressings. Sixty‐five operations were performed. Whenever possible different dressings were tested in the same patient. The type of dressing was chosen randomly, applied by one operator and left in place for 1 week. The patients were supplied with analgetic tablets. At day 7 the condition of the dressing was evaluated before removal. The patients' subjective experiences of pain, swelling, bleeding and fever, as well as use of pain relieving tablets, were recorded. The wound was evaluated with regard to the degree of epithelialization, presence of denuded bone and granulation tissue. The tendency to bleeding and the sensitivity of the teeth to a water spray (15°C) were tested. At day 14 and 21 the same evaluation procedure was repeated. In addition the presence of plaque in the operated area was assessed.

One of the dressings more frequently induced pain and swelling than the others. Tablet consumption was also higher when this dressing had been used. No statistically significant differences were found in the clinical assessment of wound healing, tendency to bleeding and the sensitivity of teeth.
Effect of experimentally induced marginal periodontitis and periodontal scaling on the dental pulp
Authors: Bergenholtz Gunnar , Lindhe Jan
Published: December 2005

Abstract Experimental breakdown of the periodontal attachment apparatus was produced in six young adult monkeys to study the effect on the tissue of the dental pulp by (1) periodontitis, (2) scaling and plaque accumulation on exposed root dentin. Periodontal tissue breakdown was induced by the placement of ligatures around the neck of 92 permanent teeth. Subsequent plaque formation caused marked loss of periodontal tissue support, which after a period of 5–7 months amounted to 30‐40% of the roof length. One group of teeth received no further treatment. Other teeth were subjected to scaling and root planning. Following treatment, plaque was allowed to accumulate for 2, 10, and 30 days on the freshly planed root dentin surfaces. Histoiogic examination revealed that in comparison to teeth with normal periodontal conditions, 57% of the teeth exposed to periodontitis exhibited pathologic pulp tissue alterations. Secondary dentin formation and/or inflammatory cell infiltrates were observed within localized areas of the pulp subjacent to root surfaces exposed to periodontal tissue destruction. The changes within the pulp were of “mild” nature and only one tooth displayed signs of total pulp necrosis. Lateral canals communicating with both the pulp cavity and the exposed root surface were never detected. Teeth subjected to seating and subsequent plaque accumulation in comparison with teeth with periodontitis alone exhibited no obvious aggravation or increased incidence of pathologic pulp reactions. The findings show that in the monkey (1) periodontal destruction limited to the cervical half of the root and (2) plaque accumulation on exposed root dentin does not cause severe alteration in the pulp of the roots involved.
Effect of controlled oral hygiene procedures on caries and periodontal disease in adults
Authors: Axelsson P. , Lindhe J.
Published: December 2005

Abstract The present investigation was carried out to determine if the occurrence of caries and the progression of periodontitis can be prevented in adults, and maintained at a high level of oral hygiene by regularly repeated oral hygiene instructions and prophylaxis. An attempt was also made to study the progression of dental diseases in individuals who received no special oral hygiene instruction but regularly received dental care of a traditional type. Two groups of individuals from one geographic site were recruited in 1971‐72 for the trial; 375 were assigned to a test and 180 to a control group. A baseline examination revealed that the socio‐economic status, the oral hygiene status, the incidence of gingivitis and the caries experience were similar among the test and control participants prior to the start of the study. During the subsequent 3‐year period, the control patients were seen regularly once a year and given traditional dental care. The test group participants, on the other hand, were seen once every 2 months during the first 2 years and once every 3 months during the third year. On an individual basis they were instructed in a proper oral hygiene technique and given a careful dental prophylaxis including scaling and root planing. Each prophylactic session was handled by a dental hygienist. A re‐examination was carried out towards the end of the third treatment year. The results of the trial clearly showed that it is possible, by regularly repeated tooth cleaning instruction and prophylaxis, to stimulate adults to adopt proper oral hygiene habits. The findings also demonstrated that persons who utilized proper oral hygiene techniques during a 3‐year period had negligible signs of gingivitis, suffered no loss of periodontal tissue attachment, and developed practically no new carious lesions. The control patients, who during the same period received merely symptomatic treatment, suffered from gingivitis, lost periodontal tisssue support and developed several new as well as recurrent, carious lesions. These results indicate that dental treatment is a highly ineffective means of curing caries and periodontal disease.
Periodontal bone loss in English secondary school children
Authors: Davies P. H. J. , Downer M. C. , Lennon M. A.
Published: December 2005

Abstract The prevalence and incidence of periodontal bone loss during a 3‐year period was investigated in 373 English secondary school children aged initially 11‐12 years. Bone loss was diagnosed from standard radiographs obtained at the baseline and third year examinations of a caries prophylactic clinical trial in which the children were participating. The interproximal spaces mesial and distal to the first permanent molar teeth were examined: 18.5 % of subjects had evidence of bone loss at these sites at baseline and 44.0 % at third year. In 60 subjects who had all second premolars and first and second permanent molars fully erupted and present at both examinations, the prevalence of bone loss was 36.7 % at baseline and 68.3 % at third year. Those children who had bone loss recorded at both the initial and final examinations had evidence of significantly more bone destruction at the conclusion of the study than those in whom bone loss was recorded only at the final examination (P < 0.001).
Prevalence of chronic periodontitis in 13–15–year‐old children
Authors: Blankenstein R. , Murray J. J. , Lind O. P.
Published: December 2005

Abstract The bitewing radiographs of 1,731 English and Danish schoolchildren aged 13‐15 years were examined to assess the prevalence of chronic periodontitis. Only one child (0.06 %) was found to be affected in comparison with the high prevalence of 51.5 % reported by Hull et al. (1975). Minute qualitative changes in the radiographic appearance of the alveolar crest, or changes in the visual representation of the width of the periodontal ligament space are not reliable or valid criteria for assessing chronic periodontitis. Horizontal bone loss observed on radiographs, which can be accurately measured using the cemento‐enamel junction as a reference point, is a useful diagnostic criterion for the measurement of chronic periodontitis.
Effects of removal of posterior overhanging metallic margins of restorations upon the periodontal tissues
Authors: Highfield J. E. , Powell R. N.
Published: December 2005

Abstract. Periodontal patients with overhanging amalgam restorations were randomly assigned to four groups so that the effects of removal of the overhangs could be observed in terms of Gingival and Plaque Index scores and in reversal of the early radiographic signs of alveolar bone destruction during a period of 3 months. A total of 80 overhanging restorations were studied, 20 in each group. Group I served as a control group, overhangs were left in situ, and the subjects practised their habitual oral hygiene methods. In Group II the overhangs were removed and habitual oral hygiene methods practised. In Group III the overhangs were left in situ but professional plaque control including prophylaxis and interdental flossing was carried out at 2‐week intervals. In Group IV overhangs were removed and a similar professional plaque control programme followed.

Gingival Index and Plaque Index scores were obtained at the commencement of the study and 3 months later. Reproducible intra oral radiographs were obtained at the same examinations and the differences in mean bone height changes calculated for each group.

Analysis of the transformed values for Plaque and Gingival Indices by Anova demonstrated (Table 2) a significant effect on gingival inflammation when both plaque and overhang were removed. The treatments showed no significant effect on plaque accumulation. Bone scores initially and after 3 months showed a highly significant treatment interaction. The greatest improvement occurred in Group IV.

The results suggest that regular plaque removal results in disappearance of gingival inflammation and in increased alveolar bone support, and is more effective when overhanging margins are removed.
Comparison of the in vivo and in vitro antibacterial properties of povidone iodine and chlorhexidine gluconate mouthrinses
Authors: Addy M. , Wright R.
Published: December 2005

Abstract. Clinical and laboratory studies were carried out to compare the antibacterial properties of two antiseptic mouthwashes, namely 1 % povidone iodine and 0.2 % chlorhexidine gluconate. In a group of 10 subjects after a single rinse with povidone iodine, an immediate mean fall in total salivary aerobes and anaerobes occurred, followed by a return to normal levels by 1‐hour postrinsing. With chlorhexidine gluconate a similar but greater reduction in salivary bacterial counts was observed, which was still present up to the 7‐h postrinsing period. Saliva samples obtained from the subjects 2 min after rinsing with povidone iodine produced little or no inhibition to the growth of a test organism in vitro, whereas following chlorhexidine gluconate, antibacterial activity was present in the saliva specimens up to the 3‐h sampling time. Using culture media containing comparable levels of soluble protein to saliva, the minimum inhibitory concentrations of povidone iodine against several standard test organisms were much higher than those of chlorhexidine gluconate. The results suggest that povidone iodine, as a mouthwash, exerts only an immediate antibacterial effect and unlike chlorhexidine, is not retained at antibacterial levels within the oral cavity after expectoration. This lack of prolonged action of povidone iodine in the oral cavity would appear to be relevant to its reported lack of antiplaque activity.
Application of a dehydrated test strip, HEMASTIX®, for the assessment of gingivitis
Authors: Tenovuo J. , Nttonen T. A.
Published: December 2005

Abstract. In order to develop a rapid and simple method based on chemical alterations in gingival pockets during inflammation, the HEMASTIX(r) strips were used to record the degree of gingivitis. This dehydrated test strip records the presence of both hemoglobin derived from erythrocytes and myeloperoxidase from PMN‐leukocytes. The intensity of the blue color that appeared and the amount of adsorbed fluid were recorded.

The correlation of the Strip Index with Gingival Index was highly significant (P <0.001) and with Gingival Bleeding Index significant (P < 0.01). When determined both from the left side of the upper jaw and from the Ramfjord teeth, the correlation between these two areas was highly significant (P < 0.001) in the case of Strip Index but only slightly significant (P < 0.05) with Gingival Index.

According to the present results the Strip Index can be used for the assessment of biochemical changes in gingival pockets resulting from the development of gingivitis.
The effect of progressive tooth mobility on destructive periodontitis in the dog
Authors: Nyman Sture , Lindhe Jan , Ericsson Ingvab
Published: December 2005

Abstract. The aim of the present study was to assess the influence of traumatic forces causing a gradually increasing tooth mobility on an ongoing destructive periodontitis.

The experiments were performed in five dogs fed a diet which permitted dental plaque accumulation. Periodontal breakdown was induced around the mandibular third and fourth premolars (4P, 3P and P3, P4) by the placement of plaque retention ligatures around the neck of the teeth. After 330 days, when approximally 50 % of the supporting tissues had been lost, mucoperiosteal flaps were raised around the four premolars and notches prepared in the buccal root surfaces at the marginal termination of the alveolar bone. The notches served as landmarks for measurements to be made in histological sections. The flaps were resutured and new plaque retention ligatures placed around the roots of all four teeth.

One week later (Day 0), P3 and P4 (test teeth) were subjected to jiggling forces in a bucco‐lingual direction with the use of an elevator. The jiggling procedure which had a duration of 30 seconds, was repeated on Days 4, 8, 12 and 16, and was guided in such a way that the tooth mobility gradually increased during the experimental period. The animals were sacrificed on Day 26, and sections of 4P,3P and P3, P4 were prepared for light microscopic examination.

The results of the study demonstrated that jiggling forces, resulting in a progressive increase of tooth mobility, mediated an enhanced rate of destruction of the supporting apparatus in dogs with an ongoing process of periodontal tissue breakdown.
The effect of tetracycline and/or scaling on human periodontal disease
Authors: Helldéan L. B. , Listgarten M. A. , Lindhe J.
Published: December 2005

Abstract The objective of this study was to test the efficacy of scaling and root planing with or without adjunctive tetracycline therapy in the treatment of periodontitis in humans. The presence of plaque, gingival inflammation, probing depths and attachment levels was assessed for all teeth in 12 patients with chronic, advanced periodontitis. After an initial examination all patients were given detailed oral hygiene instructions. The teeth in one‐half of each arch were then scaled and root planed. The teeth in the contralateral half were not treated. Six patients were given tetracycline (1 gm/day) during the first and second weeks and the seventh and eighth weeks of the trial. The study thus included four different treatment groups: 1) no treatment, 2) scaling and root planing alone, 3) tetracycline administration alone, and 4) scaling and root planing combined with tetracycline administration. All patients were reexamined at 8 and 25 weeks subsequent to the initiation of therapy. Both PII and GI scores decreased significantly in all groups. The GI scores were significantly lower in the scaled and root planed areas as compared to the contralateral sides at both the 8‐ and 25‐week examinations. The PII score was lower in the scaled and root planed areas only at the 25‐week interval. The gingival probing depths were reduced in all groups. A significantly greater decrease in probing depth, however, was noted in scaled and root planed areas. There was a trend to gain of attachment in the treated areas but the magnitude of the gain was very small. The findings of the trial also revealed that the administration of tetracycline had only a minor effect on the parameters examined.
Conversion of a stable T‐cell lesion to a progressive B‐cell lesion in the pathogenesis of chronic inflammatory periodontal disease: an hypothesis
Authors: Seymour Gregory J. , Powell R. N. , Davies W. I. R.
Published: December 2005

Abstract Changes in the host's immunological response or, alternatively, changes in the oral microflora have been implicated as possible mechanisms by which a stable lesion of chronic inflammatory periodontal disease may become a progressive lesion leading to tissue destruction and tooth loss. It has recently been established that the progressive lesion in humans can be unequivocally considered as a B‐cell response. Circumstantial evidence exists which suggests that the stable lesion is in fact a T‐cell‐mediated mechanism. An hypothesis is presented to explain the change from a stable to a progressive state in terms of a shift from a predominantly T‐cell lesion to one involving large numbers of B‐cells. Mechanisms of this shift in cell populations are considered together with a discussion of possible means of preventing such a shift.
A study of the bacteria associated with advancing periodontitis in man
Authors: Tanner A. C. R. , Haffer C. , Bratthall G. T. , Visconti R. A. , Socransky S. S.
Published: December 2005

Abstract Samples of apical plaque were taken by means of an anaerobic gas‐flushed syringe from 21 sites in eight patients, The samples were anaerobically dispersed, diluted and plated and incubated in an atmosphere of 80% N2, 10% H2 and 10% CO2 for 7–21 days. All colonies on plates containing 20–50 isolates were picked, repeatedly restreaked, characterized and identified where possible by a probabilistic computer identification program. The sites were divided into four groups on the basis of clinical features. The significance of differences between bacterial populations in the groups was determined by the Kruskal Wallis and Mann‐Whitney U tests, while the Spearman rank correlation coefficient was used to determine the rank correlation of clinical features of disease and micro‐bial species.

The subgingival microbiota in advanced destructive sites was predominated by Gram‐negative rods. The microbiota of two young adult patients with generalized extensive bone loss, extensive clinical inflammation and suppuration was dominated by Bacteroides asaccharolyticus and an organism with characteristics consistent with Actinobacillus actino‐mycetemcomitans. The predominant cultivable microbiota in two patients with extensive bone loss but minimal clinical inflammation was predominated by Bacteroides melaninogenicus ss intermedius and Eikenella corrodens in one patient and E. corrodens and a slow growing fusiform‐shaped Bacteroides in a second patient. A third group of four patients demonstrated moderate levels of clinical inflammation and evidence of continued bone loss in the last year. Predominant organisms in this group were more heterogeneous and included B. asaccharolyticus, Fusobacterium nucleatum, the “fusiform”Bacteroides and anaerobic vibrios. Sites with minimal disease in the patients revealed higher proportions of Gram‐positive organisms including Rothia dentocariosa, Actinomyces naeslundii and Actinomyces viscosus.

A positive rank correlation could be detected between clinical inflammation including suppuration and B. asaccharolyticus and a negative rank correlation between inflammation and E. corrodens.
Repair or regeneration following periodontal therapy?
Authors: Sigmund Stahl S.
Published: December 2005

Abstract A reading of recent literature leads this reviewer to the conclusion that healing processes of treated periodontal lesions express variations of repair rather than regeneration. Specifically, the treated periodontal lesion repairs by 1) epithelial adhesion; at times occlusal to the base of the original pocket; 2) collagen adhesion; most frequently observed immediately apical to the newly adhering junctional epithelium but occlusal to the marginal alveolar crest, and 3) in the infrabony portion of periodontal lesions, simultaneous and/or sequential deposition of repair cementum, functionally oriented ligament fibers and narrowing of the vertical defect by osteogenesis. The supracrestal portion of such a periodontal lesion repairs as described above with new epithelial and collagen adhesions closing the gingival unit to the oral environment. The establishment of the supracrestal (trans‐septal) fiber attachment may be the result of the remodelling of the vertical defect where repair cementum forms along the tooth wall of the vertical defect and acts as an anchor for fiber insertion. With the resorption of the crestal margin, repair cementum and inserted fibers are present on the root surface occlusal to the alveolar crest and may well serve as the new anchoring site for supracrestal fibers. Another possibility is the occlusal spill of connective tissue primarily from the periodontal ligament which includes supracrestal cementogenesis, thereby creating an environment for the insertion of new supracrestal fibers as part of flap healing. While the exact sequence of supracrestal fiber formation after treatment of vertical defects is not known, it should be emphasized that all specimens studied have shown their presence as part of a successful “fill”. Obviously, these repair sequences do not occur after every therapeutic intervention. However, sufficient documentation is available to acknowledge their possibility following various treatment modalities.

The description of the reviewed repair processes takes us a long step forward from the rather limited repair projected by Orban in 1948. Yet, it does not provide us with information regarding the viability of these repair tissues when confronted with continuing assault by plaque or other irritants. Do such tissues resist local injury as well as the normal attachment? Is the loss of adhesion following insult accomplished more quickly because the length of adhering tissues is significantly increased in an occlusoapical direction? Do host factors affect the repair tissues differently than normal tissues? The answers to these questions need extensive exploration regarding the nature of the repair tissues. But the recognition of the process has profoundly influenced clinical therapy and raised new questions regarding the factors controlling repair and possibly even regeneration following periodontal therapy.
Gingival blood circulation after experimental wounds in man
Authors: Mörmann Werner , Meierand Christoph , Firestone Allen
Published: December 2005

Abstract Capillary blood circulation following experimental wounding was observed by fluorescein angiography. Contralateral punch wounds 1.5 mm in diameter were made in healthy mandibular labial attached gingiva of 31 volunteers. Areas of ischemia were clearly visible angiographically 6 hours after wounding and were significantly greater in area (P < 0.05} and wider (P < 0.01} for wounds in the long axis of mandibular incisors (N = 14) than those on the vertical midline of the gingival papillae (N = 17), The ischemic changes occurred exclusively cranial to the experimental wounds. By the third day the epithelium adjacent to the wound margin in the central part of the ischemic area had necrotized, thus extending the wound coronally. By the seventh day the axial wounds were significantly (P < 0.001) larger than the papillary wounds. The data strongly suggest that the blood supply of mandibular labial attached gingiva is preferentially oriented in an apico‐coronal direction and that the capacity for collateral circulation is dependent upon local differences in vascular structure. The findings are applicable to flap design in periodontal surgery.
Electron microscopic study of junctional and oral gingival epithelia in the juvenile and adult beagle dog
Authors: Matsson Lars , Theilade Jørgen , Attström Rolf
Published: December 2005

Abstract A previous study demonstrated structural differences in the junctional epithelium between juvenile and adult dogs. In juveniles the junctional epithelium showed some resemblances to the oral gingival epithelium, and a cuticular structure at the dento‐gingival junction was of particular interest. The oral gingival epithelium is considered to be less permeable than the junctional epithelium. As cytoplasmic filaments are held to be the main component in the process of keratinization, and to have a stabilizing influence on the cells and tissues, the present investigation was designed to study the relative amounts of cytoplasmic filaments in the junctions! and the oral epithelia of beagle dogs during juvenile and adult stages. In addition, the ultrastructure of the dento‐gingival junction was characterized.

Six beagle dogs were used. The material consisted of gingival biopsies sampled when the dogs were 3 and 12 months old, respectively. On these occasions the gingiva was in excellent health. The biopsies were prepared for electron microscopic analysis and three randomly selected fields were recorded photographically from each of the following epithelial strata: basal and granular cell layers of the oral epithelium and basal and superficial cell layers of the junctional epithelium. Morphometric analysis was performed in order to estimate the density of cytoplasmic filaments of the cells in these epithelial strata.

The amount of cytoplasmic filaments was considerably lower in the cells of the junctional epithelium than in those of the oral epithelium. In the oral epithelium the amount increased from basal towards superficial cells, whereas no such increase was seen in the junctional epithelium. The pattern was the same in the juvenile and the adult stage.

At the dento‐gingival junction all dogs had a thick, laminated layer of dental cuticle material in the juvenile stage. In the adult stage a similar structure was seen only infrequently, and it never attained the thickness observed in the juvenile stage.
Free gingival graft and coronally repositioned flap A 2‐year follow‐up report
Authors: Matter Jacques
Published: December 2005

Abstract Eleven cases are described in which the width of attached gingiva was increased by a free gingival graft, followed 2 months later by a coronally repositioned flap. This two‐step operation was performed on 36 areas of recession in 11 patients. In all cases, the procedure has much improved the periodontium functionally as well esthetically. In two patients, a clinically stable reattachment has taken place within preexisting dentinal cavities.

The relationship of the probe tip to periodontal tissues during probing and the reattachment of both epithelium and connective tissues are discussed.
The angular bone defect and its relationship to trauma from occlusion and downgrowth of subgingival plaque
Authors: Waerhaug Jens
Published: December 2005

Abstract. Sixty‐four sets of human teeth were collected with the aim of evaluating the role of trauma from occlusion in the etiology of destructive periodontal disease. Before the jaws were taken out, a careful bite analysis was carried out. After fixation of the jaws, impressions were taken and plaster of Paris models were made. Finally, a set of 14 radiographs were taken. On the baqis of the “clinical” records postmortem, the study models and the radiographs, the jaws were sectioned. Only mesio‐distal sections were included in the present analysis. The total number of interdental spaces examined was 106. The following observations were made;

Before any loss of periodontal fiber attachment has taken place, the configuration of the interdental septum is entirely dependent on the location of the cemento‐enamel junction (CEJ) of the two neighboring teeth. The alveolar crest does not approach the apical border of the junctional epithelium closer than about 1 mm. Thus, if the CEJ is located at different levels on two neighboring teeth, the marginal termination of the interdental septum will be oblique, forming an acute angle with the “lowest” tooth.

Loss of periodontal fiber attachment could invariably be related to the apical growth of subgingival plaque, and downgrowth of plaque was always associated with an inflammatory process which involved lysis of the attachment fibers within a distance varying between 0.2 and 1.8 mm from the apical border of the plaque. Subsequently, the IE proliferated down to cover the denuded root surface.

Reduction in height of the alveolar crest could also be related to the downgrowth of plaque. The distance from plaque to bone was never found to be less than 0.5 mm and never more than 2.7 mm. The configuration of the interdental septum always seemed to be determined by the level of the plaque on the two neighboring tooth surfaces. Thus, if the plaque had reached the same level on both sides, the crest of the interdental septum assumed a horizontal outline; if plaque had proliferated down to different levels, the crest of the interdental septum was oblique and an angular defect hereby established.

In the present material no evidence was found to indicate that functional (traumatic) forces can act as a co‐factor in the causation of angular defects. In fact, such defects were found equally often adjacent to “nontraumatized” as to “traumatized” teeth.

Infrabony pockets were invariably associated with downgrowth of subgingival plaque.
Identification of inflamed gingival surfaces
Authors: Meitner Sean W. , Zander Helmut A. , Iker Howard P. , Polson Alan M.
Published: December 2005

Abstract. The present study was undertaken to clarify whether visual inflammation or gingival bleeding on probing is the earlier indicator of gingivitis. A dental prophylaxis was given to 90 male students and 1 month later the gingiva adjacent to the mesio‐buccal, mid‐buccal and mid‐lingual surfaces of all teeth was evaluated. Two subsequent examinations were done at 1‐month intervals. Each gingival margin was examined visually and classified as either non‐inflamed or inflamed and these same surfaces were then probed for bleeding. The number of gingival surfaces at each examination was 6990 and, at the first examination, 16798 of these combined absence of visual inflammation and bleeding (healthy). One month later only 766 of these surfaces were still healthy. Inspection of the data from the surfaces which had changed since the first examination showed that there were a significantly greater number of surfaces which bled after probing compared to either a color change only or combined both a color change plus bleeding. The same trend was seen between the second and third examinations. It was concluded that substantial changes in healthy gingival surfaces occur in as brief a period as 1 month. When healthy gingival surfaces (no visual inflammation and no bleeding) developed clinically detectable signs under investigation, a significantly greater number manifested bleeding alone compared to either visual inflammation alone or a combination of visual inflammation plus bleeding. These findings support an emphasis on gingival bleeding indices for detection of early deviations from health.
Amalgam restorations, plaque removal and periodontal health
Authors: Gorzo I. , Newman H. N. , Strahan J. D.
Published: December 2005

Abstract. A total of 156 approximal subgingival amalgam overhanging margins were assessed in the buccal segments of 13 patients for plaque accumulation, gingival inflammation, pocket depth and gingival shrinkage. Recordings were made immediately before and 2, 4 and 8 weeks fallowing scaling, removal of overhangs, and oral hygiene instruction. Surfaces with overhangs were compared with control surfaces, which were either intact or contained supragingival amalgams. Initially it was found that gingival inflammation and pocket depth were more extensive adjacent to subgingival amalgam overhangs than to sound teeth or those with supragingivally located amalgams. This appeared to be due to preferential plaque accumulation in relation to subgingival overhangs. For all parameters compared, differences apparent at the baseline had disappeared by the end of the 8‐week study period. Contouring of defective subgingival restorations, followed by effective scaling and oral hygiene instruction produced approximately 1 mm of gingival shrinkage, sufficient in most cases to produce clinical gingival health. Of the 156 subgingival fillings 83 (53%) became supragingival and 43 (28 %) reached the gingival crest by the end of the 8‐week study period.
Probing force and the relationship of the probe tip to the periodontal tissues
Authors: Van Der Velden U.
Published: December 2005

Abstract. Recently an increasing pocket depth was found to be related to an increasing probing force. The purpose of the present study was to investigate whether or not a plateau value in pocket depth measurements exists and to study, with different probing forces, the location of the tip of the probe in relation to the periodontal fibers and the alveolar bone. Two groups of patients were selected for this study; in one group a number of teeth had to be extracted for periodontal reasons (the extraction group) and in the other a single periodontal surgical procedure was required (the surgery group). All patients received preliminary treatment consisting of plaque control and removal of subgingival deposits. At the time of the investigation the gingival condition was assessed by means of a new index, the Periodontal Pocket Bleeding Index (P.P.B.I.) The criteria were: 0 ‐ no bleeding of the pocket after probing with a force of 0.75N, and 1 ‐ bleeding of the pocket within 30 sec after probing with a force of 0.75N. After local anesthesia in the extraction group, reference marks parallel to the long axis of the experimental teeth were cut with a cylindrical diamond burr. By means of the pressure probe, pocket depth measurements were performed with increasing forces of 0.50, 0.75, 1.00 and 1.25N. After extraction and staining of the remnants of the periodontal fibers, the distance from the most coronal intact connective tissue fibers to the most apical point of the reference marks was measured. In the surgery group using the same pressure probe, interproximal measurements with increasing forces of 0.50, 0.75, 1.00 and 1.25N were made from the apical border of the restorations to the bottom of the pocket. The same measurement, this time to the crest of the alveolar bone, was repeated after a flap had been raised.

Results with the P.P.B.I. showed that oral hygiene procedures resulted in a mean index of 0.36 in the surgery group and 0.43 in the extraction group. The results of the present study indicated that 1) using a probe of 0.63 mm diameter, the optimal force level for clinical pocket depth measurements is 0.75N, 2) a force of 0.75N is clinically well tolerated and meets with few objections from patients, 3) when a probing force of 0.75N is used the tip of the probe in both shallow and deep periodontal pockets is located at the most coronal intact connective tissue fibers, 4) a plateau value in pocket depth measurements is found when a probing force of 1.25N is employed, and 5) the mean width of the connective tissue attachment is approximately 1.9 mm.
Effect of hydrogen peroxide on developing plaque and gingivitis in man
Authors: Wennström Jan , Lindhe Jan
Published: December 2005

Abstract. The present experiment was undertaken to assess the effect of hydrogen peroxide release during mouth rinsings on the composition of the mierohiota of developing plaque in humans and the amount and pathogenecity of the plaque formed. The trial was designed as a double‐blind crossover study of the effect of a mouthwash (Amosan(r)) and a placebo rinse on the development of plaque and gingivitis in young adults. The active compound was available as a powder; the rinse consisted of 1.7 g powder dissolved in 30 ml hot tap water. Fourteen dental students participated in the trial. The students were examined during two consecutive periods, each consisting of one preparatory (during which active tooth cleaning measures were carefully practiced) and one main test period (during which mouth rinsings were the only plaque control measure). Each of the two test periods was initiated by a baseline examination following which the participants rinsed either with the active or the placebo mouthwash. The rinsings were performed immediately after breakfast, after lunch and after dinner. Measureanents of Plaque and Gingival Index scores were perfornied 4, 7 and 14 days after the start of the no‐toothbrushing period. Bacteria were sampled and examined after 7 and 14 days of trial. The results demonstrated that a mouthwash which released hydrogen peroxide effectively prevented the colonization of filaments, fusiforms, motile and curved rods as well as spirochetes in developing plaque. The mouthwash which was used as the only oral hygiene measure during a 2‐week period furthermore markedly reduced the amount of plaque formed and significantly retarded gingivitis development. It is suggested that H2O2, released by mouthwashes during rinsing may prevent or retard the colonization and multiplication of anaerobic bacteria.
Local tetracycline delivery using hollow fiber devices in periodontal therapy
Authors: Llindhe J. , Heijl L. , Goodson J. M. , Socransky S. S.
Published: December 2005

Abstract. The present investigation was performed to assess the effect of tetracycline, locally administered via hollow fiber devices, on the microflora of periodontal pockets in humans and on various clinical parameters describing periodontitis. Five patients with advanced periodontal disease were used in the study. Each patient had at least four pairs of contralateral teeth where approximally located pockets could be probed to 6 mm or more. The amount of supragingival plaque present on the tooth surface adjacent to the eight diseased sites was determined as well as the degree of gingival inflammation. Probing depths were recorded with a graduated probe. The clinical measurements were repeated 7, 14, 28, and 37 days following the start of treatment. From the eight pockets bacterial samples were collected from deep subgingival sites. The bacteria were examined in a dark‐field microscope and categorized into the following groups: cocci and non‐motile rods, filaments and fusiforms, motile and curved rods and spirochetes. The percentage distribution of the various forms was calculated. Following the initial examination the patients were given detailed instruction in proper oral hygiene techniques. Three of the diseased sites were treated by scaling and three by tetracycline application using the hollow fiber device. One pair of sites was used as untreated controls. On day 28 the three initially mechanically debrided sites were scaled anew and active fiber material inserted in the three contralateral sites.

The experiments showed that it is possible by the use of tetracycline‐filled hollow fiber devices to markedly change the composition of the subgingival flora of initially diseased periodontal sites. Locally delivered tetracycline proved effective in reducing or eliminating clinical symptoms of periodontal pathology.
Assessing the periodontal treatment needs of a population
Authors: Ekanayaka N. I. , Sheiham A.
Published: December 2005

Abstract. A longitudinal study was conducted on 106 patients attending a dental school and undergoing periodontal treatment, to assess the relationship between some commonly used periodontal indices and the time taken to treat periodontal disease. The data were analysed by assessing the times taken for examination, motivation, scaling and surgery for persons with ranges of indices such as D.I., C.I., O.H.I., G.P.I. (Ging), G.P.L.(Perio), G.P.I. (Comp) and P.I. A one‐way analysis of variance was carried out to test the significance of trends. Next, a spearman correlation coefficient was calculated for each index and its components and treatment time. The index which correlated most closely with examination time was the P.I., the G.P.I. (Ging) was the hest predictor of motivation time and three indices, C.I. G.P.I. (Perio) and P.I. correlated significantly with scaling times. The P.I. and G.P.I. (Perio) correlated with surgery time. By converting periodontal indices into treatment times, planners can estimate with a fair degree of accuracy the time and resources required to carry out periodontal treatment for a population.
Gingival bleeding in an experimental clinical trial design
Authors: Watts Trevor L. P. , Lennon Michael A. , Davies Robin M.
Published: December 2005

Abstract. An experimental clinical trial design is described in which the onset of gingival bleeding was used as an indicator of early gingivitis. Twenty‐nine dental students participated in a double‐blind crossover trial utilising chlorhexidine as a known plaque inhibitor. The onset of gingival bleeding was assessed in three ways, one of which yielded a statistically significant difference in favour of the active mouthrinse (P = 0.02). The method has a role in screening agents believed to be active against gingivitis.