bluuebunny/crossref_metadata_2025 huggingface dataset:
Periodontal ligament tissue reactions to trauma and gingival inflammation
Authors: Biancu S. , Ericsson I. , Lindhe J.
Published: December 2005

Abstract The aims of the present study were to analyze (i) which tissue changes may occur in the zone of co‐destruction to better understand why trauma from occlusion may induce additional attachment loss, and (ii) whether changes occur in the periodontal ligament tissue when an inflammatory lesion (ICT) approaches the periodontal ligament space. 16, 1‐year‐old beagle dogs, were selected and divided into 2 groups, group A and group B, consisting of 6 and 10 dogs, respectively. In group A, on day 0. a bucco‐lingual jiggling type movement was induced resulting in increasing tooth mobility at P3 (test tooth) by the application of an orthodontic elastic which traversed the buccal surface of the crown of the test tooth. The elastic was exchanged either in a buccal or in a lingual position 2x a week during a 3‐month period. 3P served as non‐jiggled control tooth. Tooth mobility measurements were recorded on days 0, 30, 60, 90. A plaque control regimen was maintained until the end of the experiment (day 90). On day 90, biopsies including P3 and 3P were harvested. The dogs representing group B, were divided into 2 subgroups of 5 each, group BI and group BII. On day 0, a 4‐month period of experimental periodontal tissue breakdown was initiated by placing cotton floss ligatures submarginally around the mandibular fourth premolars (4P4) in group BI and around the mandibular third premolars (3P3) in group BII. All ligatures were exchanged, replaced 1X every month, and on day 120 permanently removed. On the same day, biopsies included 4P4 were harvested. Following supragingival debridement 3P3 were allowed to accumulate plaque until the end of the study (day 225). On this occasion, biopsies including 3P3 were harvested. The results of the histological measurements revealed that in the most coronal portion of the periodontal ligament of teeth exhibiting increasing mobility, there was an increased width, a reduced % tissue volume of collagen, and an increased volume of vascular structures and leukocytes. Furthermore, the number of osteoclasts bordering this portion of the alveolar bone was increased and the number of collagen fibers inserting into the root cementum and into the alveolar bone was reduced. It was also demonstrated that in teeth with normal mobility, the position of the gingival ICT failed to influence the composition of the tissue within the coronal portion of the periodontal ligament.
A 6‐month home‐usage trial of 0.1% and 0.2% delmopinol mouthwashes (II). Effects on the plaque microflora
Authors: EIworthy A.J. , Edgar R. , Moran J. , Addy M. , Movert R. , Kelty E. , Wade W.G.
Published: December 2005

Abstract. The effects of 0.1% and 0.2% delmopinol mouthwashes on supragingival plaque flora were investigated in a 6‐month home‐use study. 141 subjects were studied from whom plaque was collected at baseline. 12. 24 and 36 weeks. Overall, there were no consistent effects on microscopic or total counts. However, there was a significant reduction in the proportion of dextran‐producing streptococci in the active groups compared to the control group throughout treatment. There was no colonisation by Candida or Gram‐negative aerobic bacilli in the active groups nor was there any decrease in susceptibility to delmopinol. Delmopinol appears to mediate its anti‐plaque effect without causing a major shift in bacteria! populations, although dextran‐producing bacteria appear to be affected, which may have relevance to this agent's mode of action.
Effects of citric acid treatment on the Ca, P and Mg contents of human dental roots
Authors: Hennequin Marline , Douillard Yves
Published: December 2005

Abstract. An electron microprobe analyser associated with a scanning electronic microscope was used to measure Ca. P and Mg contents of the human dental root hard tissues, before and after a citric acid treatment (pH= 1). The measurements were made on transverse sections through the cervical 1/3 of the molar roots. The measurements were performed at the following 8 levels: the internal cementum. the cementum‐dentine junction, cementum‐related dentine, 4 external dentine levels located at 220 μm, 420 μ,620 μ and 820 μ from the cementum‐dentine junction, and finally the juxta‐pulpal dentine. After the citric acid treatment, the losses in Ca and P. but not in Mg. varied significantly with the level: an acid‐resistant dentine layer of ~600 μ was found under the cementum‐dentine junction. An increase in the Ca/P ratio was also observed in this layer. Since this external dentine zone is less demineralized by the citric acid than the underlying dentine, the collagen matrix in this region may also be less exposed. These differences in the response to citric acid that depend on the distance from the root surface may explain the unpredictability of periodontal healing after citric acid treatment of diseased root surfaces, because the amount of tissue removed during root planing is not constant.
Comparison of periodontal disease in HIV seropositive subjects and controls (ll).
Authors: Cross D.L. , Smith G.L.F.
Published: December 2005

Abstract. The aims of this study were to compare the prevalence of suspected periodontal pathogens in subgingival plaque from 29 HIV seropositive and 27 control subjects and to determine the association of these bacteria with periodontal destruction. Subgingival plaque was collected from the mesiobuccal sites of all teeth, except 3rd molars. Bacteria were identified and enumerated using non‐isotopic whole chromosomal DNA probes and a colony lift method. At baseline. HIV seropositive subjects had significantly higher mean % of Porphyromonas gingivalis than control subjects. This difference could be attributed to a subgroup of HIV seropositive subjects with widespread attachment loss. No correlations were observed between the mean %s of DNA probe species and mean attachment loss. CD4 and CDS T lymphocyte counts or CD4: CDS ratio. No significant microbiological differences were detected between active and control sites in HIV seropositive subjects on a longitudinal basis. There appeared to be an inverse relationship between the mean %s of P. gingivalis and V. parvula. with respect to progression of HIV infection. The ability of microbiological parameters to predict site‐specific breakdown in HIV seropositive subjects requires further investigation.
Gingival overgrowth induced by nifedipine and cyclosporin
Authors: O'Valle Francisco , Mesa Francisco , Aneiros José , Gómez‐Morales Mercedes , Lucena Miguel Angel , Ramírez César , Revelles Francisco , Moreno Esther , Navarro Nieves , Caballero Trinidad , Masseroli Marco , del Moral Raimundo García
Published: December 2005

Abstract. In this study, we developed a quantitative method with digital image analysis to evaluate the degree of gingival overgrowth (GO), and compared GO in kidney transplant patients treated with cyclosporin A (CsA) (n=21) or CsA+ nifedipine (n= 8) and a group of healthy controls (n= 30). The method was reproducible and reliable. Our findings showed significant differences in papillary and gingival surface between controls and transplant patients treated with GO inducers. Gingival overgrowth index also differed significantly between controls and each patient group (p < 0.01, Kruskal‐Wallis test). The administration of the calcium channel blocker nifedipine potentiated the adverse effect of CsA: comparison of the morphometric findings revealed significant differences between patients treated with CsA alone and CsA+ nifedipine in papillary area, dental area, and GO index (p < 0.01, Mann‐Whitney U‐test). We conclude that the method of image analysis we developed is useful in assessing the degree of GO.
Factors associated with different responses to periodontal therapy
Authors: Haffajee A.D. , Dibart S. , Kent R.L. , Socransky S. S.
Published: December 2005

Abstract. In a study of the efficacy of modified Widman flap surgery and scaling and root planing accompanied by 1 of 4 systemic adjunctive agents, Augmentin, tetracycline, ibuprofen or placebo, it was observed that subjects differed in their response to therapy. The difference was only partially accounted for by the adjunctive agent employed. The purpose of the present investigation was to examine clinical and microbiological features in subjects who showed different levels of attachment change post‐therapy. 40 subjects were subset into 3 groups based on mean attachment level change post‐therapy. 10 poor response subjects showed mean attachment loss; 19 moderate response subjects showed mean attachment gain between 0.02‐0.5 mm and 11 good response subjects showed a mean gain of attachment >0.5 mm. Clinical parameters were measured at 6 sites per tooth both pre‐ and post‐therapy. Microbiological samples were taken from the mesial aspect of each tooth and evaluated individually for their content of 14 subgingival taxa using a colony lift method and DNA probes. % of sites colonized by each species was computed for each subject both pre‐ and post‐therapy. Significant differences were observed among treatment response groups for mean probing pocket depth, attachment level and % of sites with plaque pre‐therapy. The poor response subjects had the lowest mean probing pocket depth and attachment level, but the highest plaque levels. Post‐therapy, the poor response group exhibited the greatest degree of gingival inflammation as assessed by gingival redness and bleeding on probing. Subjects in the good response group showed decreases in the % of sites colonized for 9 of 14 test species, while subjects in the poor response group showed an increase in % of sites colonized for 12 species. The differences in change in % of sites colonized among groups were significant for B. forsythus and P. gingivalis. The majority of attachment loss in poor response subjects occurred at sites with pre‐therapy probing pocket depths 4 mm. Subjects with moderate or good treatment responses had fewer shallow or moderate sites showing attachment loss and a large proportion of sites in all probing pocket depth categories showing attachment gain. Sites that lost attachment ≥2 mm post‐therapy showed a significant increase in counts of P. intermedia, B. forsythus and A, actinomycetemcomitans b, while sites that gained attachment showed a decrease in these species. The data indicated that subjects who showed a good treatment response exhibited a decrease in the level of gingival inflammation and a marked reduction in the % of sites colonized by suspected periodontal pathogens. In subjects showing a poor treatment response, the level of gingival inflammation was not decreased and levels of periodontal pathogens increased.
Lack of furcal bone loss following the tunneling procedure
Authors: Little Lori A. , Beck F. Michael , Bagci B. , Horton John E.
Published: December 2005

Abstract. Treatment of molar teeth with severe furcation involvement allows for differing therapies of which the tunneling procedure has been least studied. While subsequent root caries in furcal exposed teeth was believed a major shortcoming, successful periodontal therapy is primarily dependent upon the stability of the attachment and intrafurcal and interproximal bone. We evaluated in each of 18 subjects (10 female, 8 male) a molar tooth with deep grade II/III furcation involvement at time of presentation (T‐0), to 1st post‐surgical recall following a tunneling procedure (T‐1), to most immediate last recall (T‐2; mean time T‐0 to T‐2, 5.80±0.83 years). Assessments included O'Leary's plaque index (P1‐I), attachment levels (AL), root caries and radiographic bone loss. The mean P1‐I from T‐0 to T‐2 decreased 56.8% with some plaque at T‐2 detected in furcations of 7/18 teeth. AL across all time periods were not significantly difference except for palatal/lingual AL which from T‐0 to T‐2 were significantly different. Root caries was found in only 3 teeth at T‐2. Adequate radiographs were available for 8 surgically tunneled mandibular molars for analysis of 5 measurements of osseous levels i.e. the mesial and distal levels of the intrafurcal and the interproximal osseous crests, and the distal interproximal osseous crest of a mesial adjacent single‐rooted reference tooth which received osseous surgery at the same time. Mean time change values (T‐1 to last radiograph taken. T‐2a; mean time 3.0±0.7 years) showed no significant difference among the 5 points measured. These results indicate no difference in AL nor loss of furcal or proximal crestal bone in surgically tunneled mandibular molars when compared with an adjacent tooth receiving osseous surgery.
Comparison of 2 electric toothbrushes in plaque‐removing ability Professional and supervised brushing
Authors: van der Weijden G. A. , Timmerman M. F. , Reijerse E. , Snoek C. M. , van der Velden U.
Published: December 2005

Abstract. The purpose of the present study was to compare the Braun Plak Control® (D7) and Philips HP 500® (MM) in their plaque removing efficacy. Furthermore the brushing force applied by the panellist on the brush‐head with both these brushes was evaluated. For this study, 35 university students (non‐dental) were selected. The study consisted of 3 experiments. Prior to each experiment, all subjects were asked to abstain from all oral hygiene procedures for at least 48 h. In Exp. I, the efficacy of toothbrushing was studied when one of the investigators brushed the teeth of the panellists. In Exp. II, the efficacy of the brushing was studied after the students had received a professional instruction. In Exp. III, the brushing force used during a single brushing exercise was evaluated. The available time for the brushing amounted to a total of 2 min per mouth. Dental plaque was evaluated by means of the Silness and Löe and Quigley and Hein plaque indices assessed at 6 sites per tooth. Results showed that both in Exp. I and Exp. II, the D7 removed significantly more plaque than the MM electric toothbrush. The plaque reduction assessed according to Silness and Löe in Exp. I was for the D7, 1.07 and for the MM, 0.78. In Exp. II, the reduction was 1.08 and 0.88, respectively. The results of Exp. III show that the mean brushing force was comparable for both brushes (D7=I73 g, MM=I75 g). All 35 subjects were allowed to choose one electric toothbrush as compensation for their participation. The majority (n=26) of subjects preferred the D7 to the MM. In conclusion, the results of the present study show that given a choice, there was a preference of the panellists for the D7. No difference in brushing force was observed between the 2 brushes. Evaluation of plaque removing efficacy showed that the Braun Plak Control® is more effective than the Philips HP 500®.
Maintenance of new attachment 1 and 4 years following guided tissue regeneration (GTR)
Authors: Weigel C. , Brägger U. , Hämmerle C. H. F. , Mombelli A. , Lang N. P.
Published: December 2005

Abstract. The aim of the present study was to evaluate periodontal tissue alterations during the maintenance phase following GTR therapy. 18 patients (average age 54 years, range 39–79 years) with 19 local periodontal defects were monitored longitudinally using clinical periodontal parameters and radiographic assessments of bone level changes. 6 out of originally 24 patients were not available at the 4‐year examination (2 patients were unwilling to participate and in 4 patients root amputations or tooth extractions had to be performed). Evaluations were perfomed at baseline. 3 months, 1 year and 4 years following GTR therapy (using non‐resorbable Gore‐Tex® Periodontal Material). The changes observed at the deepest site of each tooth treated by GTR were compared to those encountered in the entire dentition. Supportive periodontal therapy was performed according to the patient's individual needs between 3 and 12 times between the 1 and 4 years examination. The plaque index and the gingival index at the 4 years examination were assessed and had increased to almost double the value of baseline, although the BOP remained lower compared to baseline data. Between the 1 and 4 years examinations, 1.27 mm of clinical attachment was lost as a mean. Regarding the site of each tooth treated with GTR with the initially deepest probing pocket depth, 1.42 mm of clinical attachment was lost during the maintenace phase. However, compared to baseline data, 1.37 mm of new attachment could be maintained. The clinical attachment level was maintained within ±1 mm in 12 out of 19 sites during the 4 years of maintenance. At 7 sites, a loss between 2 and 5 mm occurred during the maintenance phase. Compared to the baseline values, 4 sites had lost ≥2 mm of clinical attachment resulting in a net loss. Between the 1 and 4 years observation, no significant change in bone height was observed. Multiple regression analyses showed correlations between the maintenance of the new attachment (expressed as change in probing attachment level) and a combination of factors such as number of recall visits during maintenance phase, age of the patient and % of loser sites in the corresponding dentitions. It was concluded that a low incidence of gingival inflammation was a. prerequisite for the maintenance of attachment levels gained by the GTR technique.
The subgingival microflora and gingival crevicular fluid cytokines in refractory periodontitis
Authors: Lee Hae‐Joon , Kang In‐Ku , Chung Chong‐Pyoung , Choi Sang‐Mook
Published: December 2005

Abstract Refractory periodontitis manifests as a rapid, unrelenting, progressive loss of attachment despite the type and frequency of therapy. This study examined possible relationships between cytokine levels in gingival crevicular fluid (GCF), occurrence of specific periodontopathic microflora. and disease activity in patients with refractory periodontitis. Refractory periodontitis patients (7 male and 3 female) were selected on the basis of history and longitudinal clinical observations. In each patient. 2 teeth with pocket depths greater than 6 mm were selected and individual acrylic stents were fabricated with reference grooves for each site. The sites were examined at both baseline and 3 months later. The pattern and amount of alveolar bone resorption were assayed by quantitative digital subtraction radiography. Pocket depth and attachment loss were measured with a Florida Probe. The gingival index was measured at 4 sites around each sample tooth. Sites were divided into active sites (2.1 mm loss of attachment in 3 months) or inactive sites (2.0 mm loss of attachment in 3 months). The distribution and prevalence of the predominant microflora in active and inactive sites were compared using anaerobic culture and indirect immunofluorescence. Interleukin‐1β, 2, 4, 6 and tumor necrosis factor‐α (TNF‐α) levels in gingival crevicular fluid (GCF) were quantified by ELISA. Prevotella intermedia and Eikenella corrodens significantly decreased in inactive sites but remained the same in active sites after 3 months. The active sites revealed significantly higher GCF levels of IL‐2 and IL‐6 than inactive sites at both baseline and at 3 months. IL‐1β was also significantly greater in active sites than in inactive sites at 3 months. Alveolar bone loss in active sites correlated with increased GCF levels of IL‐1β and 1L‐β. These results suggest that GCF levels of IL‐1β, IL‐2 and IL‐6 and P. intermedia and E. corrodens in subgingival plaque may serve as possible indicators of disease activity in refractory periodontitis.
Ultrastructure of hypersensitive and non‐sensitive dentine
Authors: Rimondini Lia , Baroni Chiara , Carrassi Antonio
Published: December 2005

Abstract Patients with cervical dentine exposures do not always complain of dentine hypersensitivity. The identification of morphological features connected to symptoms is important for both prevention and management of dentine hyper‐sensitivity. The aim of the study was to determine the relationship between the dentine ultrastructure and clinical symptoms in patients with cervical dentine exposures. Replica models for a total of 28 teeth (from 10 patients) with cervical non caroius lesions and dentine exposures were obtained before and after acid etching. The replica models were studied blindly in the scanning electron microscope (SEM). 12 of these were classified clinically as hypersensitive and 16 as non‐sensitive. Because of the morphological heterogeneity of all specimens, a grid was used to isolate smaller, more homogeneous areas. 120 (75 non‐sensitive and 45 hypersensitive areas) grid areas randomly selected from the 28 dentine surfaces were analyzed. The presence and morphology (amorphous or crystalline) of smear layers and the density and diameter of dentine tubules were recorded. The %2 test was used for statistical analysis. In unetehed specimens, the surfaces classified as non‐sensitive were frequently coated by an amorphous smear layer (88.0 %) and occasionally by a crystalline smear layer (2.7%). Only a few and narrow tubules were observed (9.3%). On the other hand, the unetehed specimens of the hypersensitive dentine exhibited less frequently (3l.3%) an amorphous smear layer. The presence of crystalline smear layer (33.3%), many and wider patent tubules and, sometimes, loss of intertubular dentine manifested as grooves between tubules, were observed (35.6%). The differences were significant (p<.00l). In hypersensitive dentine, the acid etching always removed the smear layer whereas removal in non‐sensitive dentine was partial or absent. These morphological findings underline the role of smear layer in reducing permeability of dentine in patients with dentine sensitivity.
Collagen gel and membrane in guided tissue regeneration in periodontal fenestration defects in dogs
Authors: Tal Haim , Pitaru Sandu , Moses Ofer , Kozlovsky Avital
Published: December 2005

Abstract The effect of a collagen gel matrix as a submembranous space‐maintaining material was evaluated in guided tissue regeneration procedures. In 4 dogs, contralateral surgical circular fenestration defects, 5 mm in diameter, were produced at the midbuccal aspect of the alveolar bone in 8 maxillary canines. Removal of bone, PDL and cementum was complete. Experimental sites were filled with collagen gel and covered with collagen membranes; control sites were covered with collagen membranes and the underlying space was spontaneously filled with blood. Mucogingival flaps were repositioned. Histological and histomorphometric observations, 6 weeks post‐surgery, indicated that defects covered by collagen membranes presented the most impressive regeneration with almost complete coverage of the denuded root by new cementum (98.4%) and new bone (63.2%). In the experimental defects. 83.5% coverage of new cementum with only 21.9% new bone regeneration was observed. These results suggest that collagen gel. interfered with healing by PDL and bone‐derived cells in the submembranous space.
Root cementum appearance in healthy monkeys and periodontitis‐prone patients after different etching modalities
Authors: Blomlöf Johan
Published: December 2005

Abstract The purpose of the present study was to compare cementum surfaces after etching at neutral or low pH in both healthy monkey teeth and periodontitis‐affected human teeth. 16 monkey teeth and 16 human periodontitis‐affected teeth were used. Etching with phosphoric and citric acids as well as EDTA was performed on the following surfaces: healthy monkey cementum, human cementum surfaces coronal and apical to the level of periodontal breakdown as well as exposed human dentin surfaces. Results indicate a profoundly higher capacity of EDTA to selectively expose collagen fibers in both healthy cementum surfaces and periodontitis‐affected dentin surfaces compared to agents operating at low pH which seemed to erode the surfaces to varying degrees. Variable results were seen on cementum surfaces which had been exposed to the environment of the periodontal pocket or the oral cavity. In view of this, it would seem preferable to mechanically remove the superficial layer of “diseased” cementum prior to the etching procedure. In conventional periodontal surgery, etching may be of limited value. However, in regenerative procedures, exposure of an intact collagenous matrix provides a matrix for retention of implants of biologically active substances such as growth factors, in addition to serving as a biocompatible surface for periodontal ligament cell colonization.
Topical metronidazole application compared with subgingival scaling
Authors: Stelzel M. , Florès‐de‐Jacoby L.
Published: December 2005

Abstract The aim of this study was to compare the topical application of a metronidazole 25% dental gel with subgingival scaling. 30 patients from the recall program participated in this open randomised study with split‐mouth design. Pocket probing depths (PPD) and bleeding on probing (BOP) were measured before and 2, 12 and 24 weeks after the end of the treatment period. In addition, subgingival plaque samples were taken from all mesial sites and analysed with dark‐field microscopy. All patients had at least 1 tooth in each quadrant with a PPD of 5 mm or more that should bleeding on probing, when entering the study. The treatment consisted of 2 applications of the dental gel in 2 randomly selected quadrants (on days 0 and 7) as well as simultaneous subgingival scaling of the remaining quadrants. Oral hygiene instruction was given on day 21. The average PPD and the average frequency of BOP were calculated for all sites with an inital PPD of 5 mm or more and continued at each examination, using the same sites. The statistical analyses showed that both treatments were effective in reducing PPD and BOP over the 6‐month period. At the end of the follow‐up period, the mean reduction in PPD was 1.3 mm after gel treatment and 1.5 mm after subgingival scaling. BOP was reduced by 35% and 42%, respectively. No significant differences between the 2 treatments were detected. Dark‐field microscopy showed a shift towards a more healthy microflora for both treatment modalities; this persisted throughout the 6‐month period. Application of a 25% metronidazole dental gel on recall patients seems to be as effective on the investigated clinical and microbiological parameters as subgingival scaling.
Increased release of free oxygen radicals from peripheral neutrophils in adult periodontitis after Feγ‐receptor stimulation
Authors: Gustafsson A. , Åsman B.
Published: December 2005

Abstract The release of free oxygen radicals and degranulation was studied in neutrophils from 14 patients with adult periodontitis and 14 age‐ and sex‐matched healthy controls. The neutrophils were activated by Fcγ‐receptor stimulation, using Staphylococcus aureus opsonized with gamma globulin. Release of oxygen radicals was measured as luminol‐enhanced chemiluminescence. Degranulation was assessed as release of elastase, measured with a specific substrate and as release of lactoferrin measured with ELISA. The neutrophils from the patients showed a significantly higher chemiluminescence and a slightly higher release of elastase, whereas the release of lactoferrin was the same in both groups. In contrast, the ratio between the 2 degranulation products, elastase and lactoferrin, was significantly higher in the group with periodontitis. A flow cytometric analysis of the membrane expression of the adhesion molecules CD 11a, CD 11b, CD 15, CD 16, CD 35 and Mel 14 showed no differences in the median immunofluorescence between the 2 groups. This study showed a more than 2‐fold higher release of free oxygen radicals from Fcγ‐receptor stimulated neutrophils compared with healthy controls, which indicates a specific neutrophil‐associated host response in adult periodontitis.
Root surface etching at neutral pH promotes periodontal healing
Authors: Blomlöf Johan , Jansson Leif , Biomlöf Leif , Lindskog Sven
Published: December 2005

Abstract The purpose of the present investigation was to examine whether an etching agent operating at neutral pH (EDTA) can enhance healing compared to a low pH etching agent (citric acid) in an animal model. Maxillary molars and premolars. in total 32 teeth, in 4 monkeys were divided between test (EDTA or citric acid treatment) and matched control groups. Periodontal surgery on both palatal and buccal roots using the dehiscence model was performed with or without root surface etching. Healing results were evaluated histomorphometrically after 8 weeks. The statistically significant differences between EDTA treated surfaces (n= 15) and control surfaces (n=11) were approximately 10% less failure (gingival recession and periodontal pocket), 10 to 15% more total histological attachment (long epithelial junction, connective tissue and reparative cementum), approximately 20% less long epithelial junction and approximately 20% more connective tissue in roots etched with EDTA. The statistically significant differences between citric‐acid‐treated surfaces (n=14) and control surfaces (n=11) were approximately 10% more connective tissue and 15% less long epithelial junction in the citric acid etched roots. Thus, etching with EDTA appeared to improve healing, avoiding the superficial necrotizing effect on exposed periodontal tissues by citric acid documented in previous studies. Although etching at present is not routinely‐applied in conventional periodontal therapy, future potential applications of etching at neutral pH may include exposure of the collagenous matrix of dentin for retention of biologically active substances, such as growth factors. Such treatment may be argued to produce a biocompatible surface more conducive to periodontal membrane cell colonization after removal of root‐surface‐associated smear without compromising the vitality of the surrounding periodontium.
Detection of Eikenella corrodens and Actinobacillus actinomycetemcomitans by use of the polymerase chain reaction (PCR) in vitro and in subgingival plaque
Authors: Furcht Claudia , Eschrich Klaus , Merte Knut
Published: December 2005

Abstract The purpose of the present investigation was to identify 2 putative penodontal pathogens: Eikenella corrodens and Actinobacillus actinoinycetemcoiniiuns by polymerase chain reaction (PCR) in vilro and in subgingival plaque. On the basis of published sequences coding for 16S rRNA two primer pairs were designed which amplify a 410 bp sequence from E. corrodens DNA and a 547 bp fragment from A. actinomycetemcomitans DNA. respectively. As few as 50 cells could be detected from pure bacterial cultures. Each of the two primer pairs was found to be specific in that it did not give any amplification product neither with cell lysates from the respective alternative bacterium nor with lysates obtained from other putative periodontal pathogens and other bacteria. The PCR method developed turned out to be a simple, rapid and reliable diagnostic tool for the detection of the target microorganisms in clinical samples.
Topographic distribution of black‐pigmenting anaerobes before and after periodontal treatment by local delivery of tetracycline
Authors: Mombelli A. , Tonetti M. , Lehmann B. , Lang N.P.
Published: December 2005

Abstract The purpose of this study was to determine the distribution of black‐pigmenting Gram‐negative bacteria in the dentition of 10 adult periodontitis patients before and after treatment by local delivery of tetracycline. The subjects were selected based on a screening for high counts of Porphyramonas gingivalis and multiple deep pockets. Subgingival microbial samples were taken from the mesial and distal aspect of every tooth (44 to 56 sites per patient) before treatment, and after one and two months. Therapy included full mouth scaling and root planing, chlorhexidine mouth rinsing and placement of tetracycline HCI fibers (Actisite®) on all teeth. 63.4% of 524 baseline samples yielded total anaerobic viable counts 2106 CFU/ml: P. gingivalis was found in 59.2% and Prevotella intermedia in 56.9%. One month after treatment, the % of samples with 106 CPU/ml was reduced to 9.4%, 5.3% were P. gingivalisand 5.1%P. intermedia‐positive. After 2 months, 9.6% samples yielded 106 CFU/ml, 5.2% were P. gingivalisand 9.4% P. intermedia‐ ositive. 20 of the 39 sites with a persistence of P. gingivalis were located on second molars. Logistic regression models were utilized to explain the persistence of P. gingivalis, using site location and other clinical parameters as indepedent variables. These analyses indicated a strong association of site location, pocket depth and bleeding on sampling with persistence of P. gingivalis. The study shows that local delivery of tetracycline is highly effective in reducing the prevalence and proportions of black‐pigmenting anaerobes within a dentition. Bleeding deep pockets of second molars have an increased risk for persistence of these anaerobes.
Discrepancy between culture and DNA probe analysis for the detection of periodontal bacteria
Authors: van Steenbergen T.J.M. , Timmerman M.F. , Mikx F.H.M. , de Quincey G. , van der Weijden G.A. , van der Velden U. , de Graaff J.
Published: December 2005

Abstract The purpose of this study was to compare a commercially available DNA probe technique with conventional cultural techniques for the detection of Actinobacillus actinomvcelemconntans. Porplivrotnonas gingivalis and Prevotella intermedia in subgingival plaque samples. Samples from 20 patients with moderate to severe periodontitis were evaluated at baseline and during a 15 months period of periodonlal treatment. Paperpoints from 4 periodontal pockets per patient were forwarded to Omnigene for DNA probe analysis, and simultaneously inserted paperpoints from the same pockets were analyzed by standard culture techniques. In addition, mixed bacterial samples were constructed harbouring known proportions of 25 strains of A. actinomycetemcomitans, P. gingivalis and P. intermedia each. A relatively low concordance was found between both methods. At baseline a higher detection frequency was found for A. actinomycetemcomitans and P. gingivalis for the DNA probe technique; for P. intermedia the detection frequency by culture was higher. For A. actinomycetemcomitans, 21% of the culture positive samples was positive with the DNA probe. Testing the constructed bacterial samples with the DNA probe method resulted in about 16% false positive results for the 3 species tested. Furthermore. 40% of P. gingi‐valis strains were not detected by the DNA probe. The present data suggest that at least part of the discrepancies found between the DNA probe technique used and cultural methods are caused by false positive and false negative DNA probe results. Therefore, the value of this DNA probe method for the detection of periodontal pathogens is questionable.
Testing the consistency of measurements of the distance between the cemento‐enamel junction and the alveolar bone crest on bitewing radiographs
Authors: Schuller A.A. , Hoist D.
Published: December 2005

Abstract The purpose of the research described in this paper is to test the consistency of measurements of the distance between the cemento‐enamel junction and the alveolar bone crest (CJ‐AC) on bitewing radiographs. The present paper shows how the consistency tests were organized and which statistical analyses were used. Since the actual characteristic (CJ‐AC) could not alter, the variations of the results had to be due to one more of the 5m‐factors (man. material, machine, method and manipulation). To test the consistency of the measurements of CJ‐AC. a pretest and an en route test were performed. Both the bitewing radiographs for the pretest and the en route test were sampled at random from the principal material. The principal material consisted of 856 sets of bitewing radiographs from persons born 1930–1949. The pretest of 40 sets of bitewing radiographs were read twice by 2 independent readers. The en route test consisted of 85 sets of bitewing radiographs which were read twice by 1 reader. Neither the results of the pretest nor the results of the en route test showed statistical or clinical differences of significance. In conclusion: the consistency of this method of measuring is satisfactory for the 2 readers.
Prevalence of cervical dentine sensitivity in a population of patients referred to a specialist Periodontology Department
Authors: Chabanski M.B. , Gillam D.G. , Bulman J. S. , Newman H.N.
Published: December 2005

Abstract The reported prevalence of cervical dentine sensitivity (CDS) ranges from 8 to 35%. Detailed epidemiology of the condition, particularly with regard to possible causal factors, is lacking. In particular, no published data appear to exist on its prevalence in periodontal patients. The aim of the present study was therefore to determine the prevalence, distribution and severity of CDS in a population of patients referred to a Periodontology Department of a specialist postgraduate hospital. 507 patients (181 M: 326F, mean age 44.2 (SD 10.31) years) attending a periodontal clinic were assessed for CDS by a questionnaire. The results demonstrated a prevalence of CDS of 84% with no significant gender difference. 71.1% of patients perceived cold as the most common cause of discomfort. A higher prevalence of self‐reported discomfort was observed between 40 and 49 years. Of the patients with a reported history of periodontal surgery (34.7%), those treated within 6 months prior to assessment appeared to be more at risk to CDS. Of the patients who received hygienist treatment (88.2%). only 10.5% reported discomfort persisting ≥3 days after treatment. Generally, patients who complained of varying degrees of discomfort over time (84.5%) did not perceive the condition as severe and consequently did not seek treatment. The prevalence of CDS in these referred patients was very high, suggesting that periodontal diseases and/or treatment effects play a role in its aetiology.
Efficacy of a potassium nitrate mouthwash in alleviating cervical dentine sensitivity (CDS)
Authors: Gillam D.G. , Bulman J.S. , Jackson R.J. , Newman H.
Published: December 2005

Abstract Potassium nitrate (KNO3) has been used previously in a dentifrice or gel to alleviate cervical dentine sensitivity (CDS). The aim of this study was lo compare a 3% KNO3 Silica/NaF mouthwash with a NaF/silica mouthwash in a 6‐week multi‐centre double‐blind study. 47 subjects (12M; 35F. mean age 36.2 ISD 11.46) years) participated in the study. Subjects were evaluated for tactile (Yeaple probe) and air sensitivity (dental air syringe) together with subjective perception of pain (0–10 scale) at 0. 2 and 6 weeks. Results for Yeaple probe (gm wt) (Wilcoxon paired rank test) between 6 weeks and baseline, were highly significant for both groups. Differences between groups at 6 weeks were statistically significant. Subjective Yeaple probe scores (paired t‐tests) between 6 weeks and baseline were significant for both groups. There were no significant differences (unpaired t‐tests) between groups over 6 weeks for subjective Yeaple probe scores. Subjective air scores (paired t‐tests) between 6 weeks and baseline were significant for both groups. There were significant differences (unpaired t‐tests) between groups in favour of the 3% KNO3./Silica/NaF group at 6 weeks. The 2 weeks and baseline results for both groups were the same as reported for 6 weeks and baseline. The results demonstrated that a 3% KNO3/Silica/NaF mouthwash compared to a Silica/NaF control significantly reduced CDS when evaluated by tactile and thermal stimuli. A 3% KNO3/silica/NaF mouthwash would, therefore appear to have therapeutic potential to alleviate CDS.
Azithromycin in the treatment of periodontal disease Effect on microbial flora
Authors: Sefton A.M. , Maskell J.P. , Beighton D. , Whiley A. , Shain H. , Foyle D. , Smith S.R. , Smales F.C. , Williams J.D.
Published: December 2005

Abstract Azithromycin is an azalide antibiotic with excellent in vitro activity against a wide variety of oral bacteria. It has a long half‐life, good tissue penetration and is preferentially taken up by phagocytes. We investigated the microbiological efficacy of azithromycin as an adjunct to the non‐surgical treatment of adult chronic periodontitis: its clinical efficacy is dealt with in a separate paper. 46 patients were treated in a double‐blind placebo controlled trial. Microbiological assessment of the same periodontal pocket (initially >6 mm) was made at weeks 0, 2, 3, 6, 10 and 22. Either azithromycin 500 mg 1×daily for 3 days or placebo was given at week 2. Particular attention was paid to the numbers of black pigmented anaerobes and spirochaetes present since these are the most commonly implicated pathogens in periodontal disease. Pigmented anaerobes were significantly reduced at weeks 3 and 6 in patients who received azithromycin compared to placebo and remained lower, although not significantly so. throughout the study. Counts of spirochaetes were significantly reduced throughout the study in patients who received azithromycin compared to placebo. Our microbiological study suggests that azithromycin may be useful as an adjunct in the treatment of periodontal disease.
Increased human gingival blood flow induced by sodium lauryl sulfate
Authors: Herlofson Bente Brokstad , Brodin Pål , Aars Harald
Published: December 2005

Abstract Laser Doppler flowmetry was used in 14 subjects to investigate the effect of sodium lauryl sulfate (SLS) on gingival microcirculation. SLS, the most widely used detergent in toothpastes, exhibits a denaturing property, increases oral mucosal permeability and may cause epithelial desquamation of oral soft tissues. Gingival blood flow (GBF) was measured bilaterally 3 mm above the gingival margin, between the central and lateral maxillary incisors, before and after application of 1.5% SLS for 90 s to the gingiva on one side. The contralateral side served as a control with water application only. Relative changes in GBF were measured for 15 min on both sides. SLS increased the median GBF significantly between the 2nd and 10th min with a peak at 8 min. whereafter the flow decreased towards baseline. On the contralateral side. GBF initially declined before returning to baseline. 10 subjects felt a burning pain from the gingiva after SLS application and GBF increased in all of them. SLS increased the relative gingival blood flow presumably due to its penetrating and irritative properties, which resulted in vasodilatation. Laser Doppler flowmetry may be a useful non‐invasive method for intraoral testing of different agents meant for oral use.
A 3‐month home use study comparing the oral hygiene and gingival health benefits of triclosan and conventional fluoride toothpastes
Authors: Binney A. , Addy M. , Owens J. , Faulkner J. , McKeown S. , Everatt L.
Published: December 2005

Abstract A number of triclosan toothpastes are available which have been shown to benefit gingival health when compared to triclosan free control formulations. There have been few studies to compare such active products with conventional fluoride toothpaste products. The aim of this study was to compare, in home use, a triclosan product with conventional fluoride products already found to show slightly less plaque inhibition in a short term plaque regrowth study. The study was a single‐blind, parallel design with a total of 129 healthy dentate volunteers (32 male. 97 female) who toothbrushed with one of 4 toothpaste products at home, twice a day over a period of 12 weeks. At the beginning of the trial, each volunteer was scored for plaque and gingivitis and then received a thorough prophylaxis. Each volunteer was allocated a toothpaste according to a predetermined randomisation scheme. The volunteers were re‐examined after 6 and 12 weeks. The volunteers refrained from using any other oral hygiene products during the period of the trial. The toothpastes tested were two conventional fluoride toothpastes, a children's fluoride toothpaste and a triclosan/copolymer toothpaste. Results indicated that there were no overall significant treatment differences for either plaque index or gingival index and ordering of toothpastes was not possible. All volunteers' oral hygiene and gingivitis improved following the 6‐week period and continued to improve to the 12th week. This is a feature of most oral hygiene trials and presumably arises from the initial prophylaxis and a Hawthorne response of improved toothcleaning by the subjects. It must be concluded from this study that in normal home use the triclosan/copolymer toothpaste provides oral hygiene and gingival health benefits no greater than achievable with conventional toothpaste products.
Periodontal probe precision using 4 different periodontal probes
Authors: Mayfield L. , Bratthall G. , AttStröm R.
Published: December 2005

Abstract The aim of this study was to compare the relative intra‐ and inter‐examiner reproducibility of 4 different periodontal probes. (1) The Hu‐Friedy LL 20 Probe, a manual probe. (2) The Vivacare TPS Probe, a plastic manual probe with a standardised pressure of 0.20 N. (3) The Vine Valley Probe, an electronic probe using a standardised pressure of 0.25 N. 4. The Peri Probe Comp, a computerised electronic probe with a controlled pressure of 0.45 N in 2 mm pockets to 0.25 N in 13 mm pockets. Duplicate probing measurements were taken by 2 examiners in 10 patients on 3 index teeth, 1 molar, 1 premolar and i incisor at 6 sites per tooth. Teeth were selected to incorporate both shallow (<5 mm) and deeper (>5 mm) periodontal sites. The order of probes and examiners were changed in a systematic manner and measurements were repeated 1 week later to avoid bias due to examiner memory. Results show that the manual probe had the lowest degree of variation, with a correlation coefficient of 0.83. The manual and Peri Probe Comp frequently recorded deeper probing pocket depths compared to the TPS and Vine Valley probes. The results may have been influenced by the lack of familiarity with the automated probes.
Effects of treatment on gingival crevicular collagenase, stromelysin and tissue inhibitor of metalloproteinases and their ability to predict response to treatment
Authors: Haerian A. , Adonogianaki E. , Mooney J. , Manos A. , Kinane D.F.
Published: December 2005

Abstract Fibroblast collagenase (FIB‐CL) and stromelysin (SL) are members of a family of enzymes which are capable of degrading most of the extracellular matrix macromolecules. Extracellular control of these enzymes is performed by tissue inhibitor of metalloproteinases (TIMP). During healing, inflammation and normal tissue turnover, levels of MMPs and TIMP will change. The effect of treatment on the levels of FIB‐CL. SL and TIMP as well as their ability, at baseline, to predict the outcome of therapy was investigated. 21 patients each provided 8 gingival crevicular fluid (GCF) samples from sites with probing depths ≥4 mm. Clinical recordings and GCF sampling H‐ere performed at 3 time points. Assays for SL, FIB‐CL and TIMP were performed by a sandwich ELISA. Attachment level changes were detected by the “tolerance method”. The ability of the GCF constituents to predict the response to treatment was assessed by comparing pre‐treatment levels between sites which did or did not show attachment gain after therapy. Although no GCF constituents could reliably predict the response to treatment, SL reduced significantly (p=0.029) after the hygiene phase of therapy. In addition, both SL and TIMP levels showed a highly significant reduction at follow‐up visit (p=0.003 and p=0.005 respectively). Thus. SL and TIMP levels are reduced by treatment, but these GCF proteins do not appear to have an ability lo predict treatment outcome from baseline.