bluuebunny/crossref_metadata_2025 huggingface dataset:
The presence of phage‐infected Actinobacillus actinomycetemcomitans in localized juvenile periodontitis patients
Authors: Preus Hans R. , Olsen Ingar , Namork Ellen
Published: December 2005

Abstract Electron microscopy revealed 2 different types of bacteriophages isolated from Actinobacillus actinomycetemcomitans colonizing exclusively diseased sites in 4 patients with localized juvenile periodontitis (LJP). All sites infected with phage were undergoing periodontal destruction, as judged from consecutive routine radiographs. The phages isolated had a wide host range as assessed from their ability to infect a series of reference strains of A. actinomycetemcomitans. A 5th patient harboured non‐infected A. actinomycetemcomitans in a surgically treated site which had undergone no bone destruction during the last 12 months. The present findings suggested that the pathogenic potential of A. actinomycetemcomitans in LJP may increase due to phage infection.
Cryosurgical depigmentation of the gingiva
Authors: Tal Halm , Landsberg Jacob , Kozlovsky Avital
Published: December 2005

Abstract Gingival melanin pigmentation (GMP) occurs in all races of man. Although clinical melanin pigmentation does not present a medical problem, demand for cosmetic therapy is commonly made by fair‐skinned people with moderate GMP. The present study was undertaken to test the effectiveness of Cryosurgical destruction of the gingival epithelium in the removal of gingival melanin pigmentation. The patient was a fair‐skinned Ashkenazi Jew with moderate GMP who demanded any possible “cosmetic therapy” which would convert her “black gums” to “normal”. Gingival cryosurgery was carried out by segments. A gas expansion cryoprobe cooled to −81° C was applied to the gingiva for 10 s.

Frozen sites thawed spontaneously within 1 min. Superficial necrosis became apparent within a week. Treated sites were covered by epithelium within 2 weeks following freezing and keratinization was completed after 3–4 weeks. The treated gingiva appeared normal and remained depigmented until the present time, 20 months following freezing. It is concluded that cryosurgery may prove to be the treatment of choice when gingival depigmentation is indicated.
Periodontal status of secondary crowded mandibular incisors
Authors: Årtun Jon , Osterberg Stig K.
Published: December 2005

Abstract The present study was undertaken to examine whether secondary crowded mandibular incisors experience more periodontal breakdown than aligned lower incisors long‐term after orthodontic treatment. Patients from 19 to 35 years after active treatment were selected. 2 groups were established: 1 with crowded mandibular incisors and 1 with aligned incisors. The groups were matched according to age time after treatment, gender and periodontal disease classification. A separate group with crowded and aligned incisors within the same individual was established. Accumulation of plaque, gingival inflammation, probing pocket depth and probing attachment level were registered at 6 locations around each incisor. Among the patients studied, the oral hygiene level was high. In both groups, the loss of connective tissue attachment was largely due to periodontal pocket formation in inter proximal areas and gingival retraction in buccal and lingual areas. A small but statistically significant difference in probing attachment level was found between crowded and aligned inter proximal areas within the same individual (P<0.05). No differences in accumulation of plaque or in gingival inflammation were found. No differences were found for any of the dependent variables between the groups with crowded and aligned incisors.
Dentine hypersensitivity
Authors: Addy M. , Absi E. G. , Adams D.
Published: December 2005

Abstract Evidence indicates that teeth exhibiting cervical dentine hypersensitivity have open dentine tubules at the dentine surface. The identification of factors which render dentine exposed and tubules open is important both to the prevention and management of dentine hypersensitivity. In this study, recently extracted teeth were root planed or burred to expose the root dentine. Specimens were horizontally sectioned and then using the apical portion as control, the coronal portions placed in a variety of strong and weak acids and dietary fluids. Examination under the scanning electron microscope revealed a smear layer covering completely underlying tubules on the control root planed or burred portions. Test portions exposed to strong and weak acids showed loss of the smear layer and exposure of large numbers of tubules. Formic and tannic acids produced no changes. Some dietary fluids, in particular red and white wine, citrus fruit juices, apple juice and yogurt produced similar etching effects to the acids. The low pH carbonated drink, coca‐cola, and a black current cordial produced no effects. The results of this study in vitro cannot necessarily be extrapolated to the clinical situation, but suggest that certain dietary factors could play a role in the actiology of dentine hypersensitivity. Dietary advice to patients may prove important in the management of this often recurrent condition.
Dentine hypersensitivity
Authors: Absi E. G. , Addy M. , Adams D.
Published: December 2005

Abstract Based on the hydrodynamic theory for stimulus transmission across dentine, it would be logical to conclude that teeth exhibiting the clinical symptoms referred to as dentine hypersensitivity should have dentinal tubules open at the root surface and patent to the pulp. With the exception of studies on cut dentine, there is little direct evidence to support this conclusion. In this study, caries‐free teeth with exposed cervical root areas scheduled for extraction which were classified as non‐sensitive or hypersensitive after suitable stimulation were examined by scanning electron microscopy. Hypersensitive teeth showed highly significantly increased numbers of tubules per unit area (approximately 8 ×) compared with non‐sensitive teeth. Tubule diameters were significantly wider (approximately 2 ×) in hypersensitive compared to non‐sensitive teeth. The number of teeth showing the penetration of methylene blue through the zone of exposed cervical dentine was larger and the depth of penetration greater in hypersensitive teeth compared to non‐sensitive teeth. The results provide further evidence that stimulus transmission across dentine in hypersensitive teeth is mediated by a hydrodynamic mechanism. An understanding of factors which open dentinal tubules would seem important if attempts to prevent or treat dentine hypersensitivity are to be successful.
Salivary IgG, a parameter of periodontal disease activity?
Authors: Sandholm Leena , Tolo Kåre , Olsen Ingar
Published: December 2005

AbstractThe concentration of salivary IgG and IgA and the levels of salivary IgG and IgA antibodies toActinobacillus actmomycetemcomitansY4 were measured by ELISA in 205 persons including patients with juvenile and adult periodontitis as well as healthy subjects. Compared to the concentration observed in subjects with a healthy periodontium. a significantly increased concentration of salivary IgG was found in 34% of the patients with moderate adult periodontitis and in 57% of the patients with severe adult periodontitis. The level of salivary IgA was less influenced by the periodontal condition. The level of salivary IgG antibody toA. actinomycetemcomitanswas significantly elevated in 55% of the patients with untreated juvenile periodontitis and in 28% of the patients treated for JP. 28% of the patients with adult periodontitis had a significantly elevated level of IgG antibody toA. actinomycetemcomitansY4. Significantly elevated levels of IgA antibody to this bacteria was found less frequently, 27% in untreated JP, 20% in treated JP and 17% in adult periodontitis.
The effect of plaque control after scaling and root planing on the subgingival microflora in human periodontitis
Authors: Lavanchy D. L. , Bickel M. , Baehni P. C.
Published: December 2005

Abstract The aim of the present study was to evaluate the effect of a strict supragingival plaque control regimen on bacterial repopulation following scaling and root planing. 7 patients with moderate to severe inflammatory periodontal disease received a full‐mouth scaling and subgingival curettage. Using a split‐mouth design. 2 sites of opposite quadrants were submitted to professional supragingival plaque control 3 × a week while the contralateral sites served as controls. Clinical and bacterial examination were performed on days 7, 14. 28, 49, 56, 63 and 70 following therapy. All clinical parameters (PII, GI, probing depth, attachment levels) showed significant improvement after scaling and root planing. Shifts in the subgingival bacterial population observed by dark field were also noticed following curettage: there was a decrease in the proportions of spirochetes and motile rods and an increase in that of coccoid cells. However, bacterial distribution tended to return to base line values towards the end of the observation period. No difference in the pattern of bacterial recolonization of the subgingival area could be detected between the sites under strict supragingival plaque control and the control sites.
Surface‐free energy and bacterial adhesion
Authors: van Dijk Johan , Herkströter Frank , Busscher Henk , Weerkamp Anton , Jansen Henk , Arends Joop
Published: December 2005

Abstract Conflicting reports have been presented on the rôle of substratum surface free energy (s.f.e.) on bacterial adherence. It is the aim of the present study to evaluate the effect of the s.f.e. of substrata on bacterial adherence in vivo.

The following substrata with s.f.e. varying from 23.3.–124.9 erg·cm−2 were cut into facings of 5 by 6 mm. polished and cleaned: polytetrafluorethylene (PTFE). Parafilm. polyvinylchloride (PVC). polymethylmethacrylate (PMMA), bovine dentin, bovine enamel and glass. In 5 beagle dogs, 7–9 years old. part of the buccal periodontium of the upper cuspids was excised and crowns were made and cemented with a non‐fluoridated cement. The facings were placed in the crowns and placed in the oral cavity for 2 h. After removal, the facings were rinsed in saline.

S.f.e. was assessed from contact angles with water, water/n‐propanol mixtures and a‐bromonaphthalene. according to the concept of dispersion and polar components, firstly on clean air dried facings and later on facings exposed to the oral cavity for 2 h. Immediately after rinsing, the water contact angle was measured as a function of time, to monitor the evaporation of free water from the protein layer adsorbed on the substrata which had been exposed to the oral cavity. It appeared that after a rapid increase in contact angle, a stable maximum value was obtained after 40–120 min depending on the substratum. S.f.e.'s of the protein‐coated substrata were subsequently determined after a 120 min drying period. Following the contact angle determinations, the exposed facings were stained with ethidram bromide, enabling fluorescence microscopical counting of the adhered microorganisms.

The oral environment markedly changed the substratum s.f.e.'s. Salivary protein adsorption reduced differences originally present in s.f.e. Low values increased, while high values decreased, yielding an average value of about 80 erg·cm−2. More micro‐organisms adhered to substrata with an initially high s.f.e. than to substrata with an initially low s.f.e. (PTFE and Parafilm). The highest number of micro‐organisms adhered to PVC (60·104 cm−2), the lowest to Parafilm (60·104 cm−2). It is interesting to note, that this relation was obtained, despite the fact that surfaces in the oral cavity are almost immediately covered with an adsorbed protein layer, shielding the physicochemical characteristics of the underlying substrata.
Effect of sanguinaria extract on development of plaque and gingivitis when supragingivally delivered as a manual rinse or under pressure in an oral irrigator
Authors: Southard G. L. , Parsons L. G. , Thomas L. G. , Woodall I. R. , Jones B. J. B.
Published: December 2005

Abstract The effects on developing plaque and gingivitis following rinsing with a placebo oral rinse or an oral rinse containing 300 μg/ml sanguinaria extract (sanguinaria) were compared to effects produced by supragingival irrigation with dilute solutions of the rinse corresponding to 22.5 μg/ml sanguinaria and 90 μg/ml sanguinaria. The study design was a repeated measures, single‐blind crossover with no oral hygiene over 2 weeks duration. After 7 and 4 days, significantly lower plaque and gingivitis scores were obtained with use of the sanguinaria‐containing rinse and irrigating solutions compared with the placebo rinse. There were no significant differences in plaque and gingivitis scores between the groups using the sanguinaria rinse and the sanguinaria irrigating solutions. A comparisons of % distribution of 0, 1 and 2+ scores also indicated that rinsing and supragingival irrigation with sanguinaria was more effective in plaque and gingivitis control than rinsing with the placebo. The results suggest that sanguinaria oral rinse may be effective in controlling plaque and gingivitis when delivered by manual rinsing or supragingival irrigation.
Comparative effects of parathyroid hormone on osteoblasts and cementoblasts
Authors: Lindskog Sven , Blomlöf Leif , Hammarström Lars
Published: December 2005

Abstract Although bone, dentin and dental cementum are mesenchymal mineralized tissues composed mainly of collagen and hydroxy apatite, they differ markedly in their suceptibility to resorption. Bone undergoes physiological resorption to which the dental tissues appear to be resistant. Recently, the cells covering bone surfaces have been attributed a regulatory role in osteoclastic bone resorption by exposing the bone surface following stimulation with hormones and inflammatory mediators, thereby allowing osteoclasts to colonize the bone surface. In the present study, it was shown that reparative cementum‐forming cells covering an experimental cavity in the root surface of replanted monkey incisors were unaffected by parathyroid hormone, a potent mediator of bone resorption. In parallel experiments, endocranial oteoblasts exposed bone surface by widening their intercellular spaces. It was concluded that the layer of cells covering the root surface forms a protective barrier against resorption which serves to preserve the integrity of the dental root.
α 2‐macroglobulin in the sera of patients with periodontal disease
Authors: Skalerič Uroš , Zajšek Peter , Cvetko Erika , Lah Tamara , Turk Vito , Zalokar Velislava
Published: December 2005

Abstract The concentration of α 2‐macroglobulin (α 2‐M) in the sera of 86 blood donors was measured by laser nephelometry. Plaque index (P1I), gingival index (GI) and probing depth were recorded around all existing teeth. All measured clinical parameters correlated positively with the concentration of α 2‐M in the sera of the examined persons, but statistically significant positive correlation was found only in with the following: average gingival index and α 2‐M concentration in the sera of females and average probing depth and α 2‐M concentration in the sera of all examined females and males. This study supports the hypothesis that in long–standing chronic periodontal disease, the increased levels of proteinases might trigger the synthesis of α 2‐macroglobulin in the host. The role of α 2‐M as a proteinase scavenger and immunosuppressive agent is discussed briefly.
4‐year observations of basic periodontal therapy
Authors: Badersten Anita , Niveus Rolf , Egelberg Jan
Published: December 2005

A total of 2214 sites from incisors, cuspids, and premolars were studied in 46 adult periodontitis patients following treatment consisting of plaque control and root debridement. The periodontal status at 24 months was used as baseline for observations during the subsequent 24‐48 month interval which included 4 recall visits for debridement at the 24‐, 30‐, 36‐, and 42‐month time points. The data were analyzed for pooled groups of sites of different probing depth at 24 months: ≤3.5 mm, 4.0‐6.5 mm. and ≥7.0 mm. The results showed little change during the 24‐48 month interval in mean scores for bleeding on probing, probing depth, and probing attachment level for all 3 groups of sites. Individual sites with probing attachment loss during the 24‐48 month period were identified. The frequency of such sites was similar, irrespective of 24‐month probing depth. The sites identified with probing attachment loss during the 24‐48 month interval generally differed in location from those identified as having probing attachment loss during the proceeding 0‐24 month period. Often, the loss of probing attachment during the 24‐48 month interval seemed to be a reversal of a prior gain in probing attachment during the 0‐24 month interval. This study in non‐molar teeth of subjects with generally good level of compliance failed to demonstrate that sites with deeper probing depth were more difficult to maintain than shallower sites.
4 modalities of periodontal treatment compared over 5 years*
Authors: Ramfjord S. P. , Caffesse R. G. , Morrison E. C. , Hill R. W. , Kerry G. J. , Appleberry E. A. , Nissle R. R. , Stults D. L.
Published: December 2005

The purpose of the present study was to assess in a clinical trial over 5 years the results following 4 different modalities of periodontal therapy (pocket elimination or reduction surgery, modified Widman flap surgery, subgingival curettage, and scaling and root planing). 90 patients were treated. The treatment methods were applied on a random basis to each of the 4 quadrants of the dentition. The patients were given professional tooth cleaning and oral hygiene instructions every 3 months. Pocket depth and attachment levels were scored once a year. 72 patients completed the 5 years of observation. Both patient means for pocket depth and attachment level as well as % distribution of sites with loss of attachment ≥2 mm and ≥3 mm were compared.

For 1‐3 mm probing depth, scaling and root planing, as well as subgingival curettage led to significantly less attachment loss than pocket elimination and modified Widman flap surgery. For 4 6 mm pockets, scaling and root planing and curettage had better attachment results than pocket elimination surgery. For the 7‐12 mm pockets, there was no statistically significant difference among the results following the various procedures.
Periodontal status in university students
Authors: Murtomaa H. , Meurman J. H. , Rytömaa I. , Turtola Lauri
Published: December 2005

The periodontal status of 217 5th‐year students (aged 25‐26 years and born in Helsinki) at the University of Helsinki was assessed. The students had been eligible for community‐based dental care free of charge until the age of 18 years, after which they could obtain low‐cost dental care from the Helsinki Student Health Service. Their periodontal status was determined according the community periodontal index of treatment needs; gingival retraction was recorded when 1 mm or more of the cementum was exposed. Code 0 sextant was found for 67% of the women and 57% of the men. 20% of the students examined had sextant scoring of code 3; no‐one had code 4 sextants. 69% of the women and 49% of the men had gingival retraction, in average 1.5 ± 0.5 mm. No correlation was found between the frequency of tooth brushing or the hand used for brushing and the number of retractions, nor did the number of healthy sextants correlate with the frequency of retractions. The findings emphasize the importance of better guidance regarding qualitative aspects of oral hygiene at home.
The presence of methanobacteria in human subgingival plaque
Authors: Brusa T. , Conca R. , Ferrara A. , Ferrari A. , Pecchioni A.
Published: December 2005

Through a procedure of setting up a strictly anaerobic chain from sampling subgingival plaque to incubation in an anaerobic cabinet (O2 < 10 ppm), it was possible to, for the first time, isolate methanobacteria from human subgingival plaque.
Gingival attachment level measurements with an automated periodontal probe
Authors: Birek Peter , McCufloch C. A. G. , Hardy V.
Published: December 2005

The accurate and reproducible measurement of gingival attachment level is essential for studying the progression of periodontitis in human populations. An automated periodontal probe has been developed which measures gingival attachment level using the occlusal or incisal surface of the tooth as a fixed landmark and which transfers data directly to a computer. The probing force is adjustable and is regulated by changing the air pressure. A mercury level switch maintains uniform probe angulation during measurements. The reproducibility of measurements obtained with the automated periodontal probe was examined by making duplicate gingival attachment level measurements at 784 sites in 9 patients 1 week apart and comparing the difference between the paired values. A probing force of 0.30 N was used. There was no significant difference in the frequency distributions of measurement differences between either maxillary versus mandibular teeth or anterior versus posterior teeth. The data demonstrate that this device can be used to measure gingival attachment level without the need for stents or estimation of the level of the cementoenamel junction and that reproducible data can be obtained and automatically stored in a computer for subsequent analysis.
Lack of bacterial invasion in experimental periodontitis
Authors: Ericsson Ingvar , Lindhe Jan , Liljenberg Brigitta , Persson Anna‐Lena
Published: December 2005

The present study in the beagle dog was performed to analyze whether micro‐organisms from a subgingival microbiota could be translocated into or had the potential to invade the pocket epithelium and the gingival connective tissue during a phase of rapid breakdown of the attachment apparatus. An attempt was also made to assess whether tetracycline therapy suppressed the subgingival microbiola and changed the size and quality of the lesions in the gingival tissue. 5 inbred beagle dogs were used. Throughout the period of experimentation, the animals were fed a soft diet permitting gross accumulation of plaque and calculus. No mechanical plaque control measures were performed during the course of the study. On day 0, a 120‐day period of periodontal tissue breakdown was initialed at the right mandibular 3rd and 4th premolars by tying cotton floss ligatures around the neck of these teeth. The process of tissue breakdown at the mandibular left 3rd and 4th premolars was started 3D days later. The ligatures were replaced once every 2 weeks during the subsequent 4‐month period. On experimental day 120, the first biospy was performed and gingival tissue sections prepared for light and electron microscopic assessment of a series of histometric characteristics. On day 120, a 30‐day period of tetracycline (per os) administration was initiated. Each dog was given a dose of 500 mg tetracycline twice daily. On day 150, the biopsy procedure was repeated in the mandibular left premolar regions. The results failed to demonstrate that bacteria from the subgingival microbiota penetrated the pocket epithelium and the gingival tissues of dogs, showing signs of advanced breakdown of the attachment apparatus. The data furthermore disclosed that tetracycline, administered via the systemic route in dogs with gingivitis and advanced loss of alveolar bone, markedley reduced the size of the inflammatory cell infiltrate of the gingiva and reduced the number of neutrophils and macrophages in the pocket epithelium. Tetracycline therapy however, failed to aller the connective tissue attachment level and failed to affect clinical parameters of gingivits.
Clinical evaluation of plaque removal with a double‐headed toothbrush
Authors: Gibson M. T. , Joyston‐Bechal S. , Smales F. C.
Published: December 2005

Abstract A blind, two‐way, crossover clinical trial, completed by 44 adult subjects, instructed in specific oral hygiene techniques, was carried out to compare the effectiveness of plaque removal between a new Scandinavian double‐headed toothbrush and a popular single‐headed brush, each used for one week. The results showed that the double‐headed brush was significantly more effective in removing plaque overall than a conventional brush. The effect was most evident on all lingual surfaces, especially in the lower arch and molar regions. It was also particularly pronounced when the double‐headed toothbrush was allocated for use in the 2nd week of the study. There was no significant difference in the cleaning ability of the 2 brushes on the buccal surfaces of the teeth.
Surgical versus non surgical treatment and recurrent periodontal disease in beagle dogs
Authors: Aukhil I. , Schaberg T. V. , Greco G. W. , Simpson D. M.
Published: December 2005

Abstract The present study was designed to compare clinical, micro bio logic and histometric parameters of recurrent periodontal disease in areas which had been treated either surgically (SU) or nonsurgically (NS). Periodontal disease was induced for 6 months in 3 quadrants in each of 6 beagle dogs. 2 of the 3 diseased quadrants were treated by definitive surgical or nonsurgical therapy followed by plaque control for 4 months. 2 dogs were then sacrificed to provide histometric data. Periodontal disease was reinduced in the remaining 4 dogs by allowing plaque accumulation for 6 months after which the dogs were sacrificed for histometric analysis. Clinical parameters were recorded and darkfield microscopic analysis of subgingival plaque samples was performed at regular intervals. Following 6 months of plaque accumulation during disease reinduction, there were significant changes (p < 0.05) in the pocket depths, bleeding scores and attachment levels in both the SU and NS areas. These changes were accompanied by significant increases (p < 0.05) in the proportions of spirochetes and motile rods and decreases in the proportions of coccoid cells in both the SU and NS areas. There were, however, no significant differences between the SU and NS areas when clinical and microbiologic parameters were compared. At the end of disease reinduction phase, the length of inflammatory cell infiltrate and % inflammed connective tissue had increased significantly in both the SU and NS areas. However, there were no significant differences in any of the histometric parameters between the SU and NS areas after disease reinduction. The present landings suggest that progression of disease recurrence, measured in clinical, microbiological and histometric parameters, may be independent of the mode of previous periodontal therapy.
Photographic assessment of the antiplaque properties of sanguinarine and chlorhexidine
Authors: Gazi M. I.
Published: December 2005

Abstract The purpose of this study was to assess the effect of rinsing and topical application of sanguinarine on labial surface plaque accumulation, compared with topically applied water, and compared with rinsing with chlorhexidine, while refraining from all oral hygiene measures for 5 days. Color photographs of the disclosed plaque were taken at the end of each phase of treatment and blindly traced using an Apple 11 micro‐computer graphic tablet digitizer. The plaque score for each tooth was calculated by dividing the computer reading of the labial plaque surface area by the total labial surface area of the tooth. Topically applied sanguinarine showed better plaque reduction than mouthrinsing with sanguinarine. There was a significant reduction in plaque accumulation after rinsing with chlorhexidine compared with topically applied sanguinarine, water, and mouthrinsing with sanguinarine. The results of this study indicate that chlorhexidine is a more superior antiplaque agent than sanguinarine. The use of an Apple II micro‐computer graphic tablet digitizer provided a valuable method for accurate plaque assessments.
Relationship between lactate dehydrogenase and myeloperoxidase levels in human gingival crevicular fluid and clinical and microbial measurements
Authors: Wolff L. F , Smith Q. T. , Snyder W. K. , Bedrick J. A. , Liljemark W. F. , Aeppli D. A. , Bandt C. L.
Published: December 2005

Abstract The present study was designed to determine, in a cross‐sectional study, whether there was any relationship between levels of lactate dehydrogenase (LDH) and myeloperoxidase (MPO) in gingival crevicular fluid (GCF) and clinical periodontal status or microbial parameters. Another objective was to determine, in a longitudinal study, the effect of a single session of root planning on GCF levels of LDH and MPO and the relation to changes in clinical and microbial measurements. 15 and 12 test subjects with moderate to severe periodontal disease were seen in the cross‐sectional and longitudinal study, respectively. 1 healthy and 2 diseased sites were evaluated in each subject. Higher LDH and MPO levels in GCF were closely associated with higher clinical and microbial signs of periodontal disease. Root planning was effective in reducing these enzymes in GCF, with an accompanying decrease in clinical and microbial signs associated with disease. The return of LDH to baseline levels at 3 months after instrumentation, without a corresponding return of clinical signs of disease, may serve as a marker for subclinical periodontal pathology.
Microbial succession in recolonizing deep periodontal pockets after a single course of supra‐ and subgingival debridement
Authors: van Winkelhof A. J. , van der Velden U. , de Graaff J.
Published: December 2005

Abstract In the present study, the effect of supra and subgingival plaque debridement on the dynamics of the subgingival microflora in deep pockets was investigated. 8 adult periodontitis patients participated in the study. In each patient, 4 clinically diseased sites were investigated microbiologically by phase contrast microscopy for the determination of both the %s as well as the total numbers of spirochetes and motile rods and by anaerobic cultivation for the determination of the different black‐pigmented Bacteroides species. After base‐line examination, patients were treated by mechanical removal of supra‐ and subgingival plaque deposits, 2 and 8 weeks after treatment, clinical and microbiological parameters were re‐evaluated. During the experimental period, no oral hygiene procedures were performed in order to achieve fast recolonization of the pockets. Treatment resulted in a significant reduction in probing pocket depth and gain of probing attachment. 2 weeks after treatment, no further improvements could be observed‐ A positive correlation was found between the reduction in probing pocket depth and decrease in Bacteroides gingivalis (P<0.009) and between gain in probing attachment and reduction in the % of B. gingivalis (P<0.009). No correlation between these clinical parameters and B. Intermdius, spirochetes or motile rods was apparent. An inverse relationship between B. gingivalis and B. intermedius was observed. We found that changes in %s of spirochetes and motile rods are not correlated with changes in total numbers of these bacterial groups. It was concluded that monitoring of %s of micro‐organisms may not supply rational information on the microbiological conditions of the subgingival area.
Combined antibiotic (metronidazole) and mechanical treatment effects on the subgingival bacterial flora of sites with recurrent periodontal disease
Authors: Gusberti F. A. , Syed S. A. , Lang N. P.
Published: December 2005

Abstract 5 patients in maintenance, 1‐3 years after periodontal therapy who showed sites with reinfected pockets and bleeding despite regular recall visits were selected. Darkfield microscopy from 3 sites in each patient showed an average of 41% spirochetes and 21% motile rods. Probing depths ranged from 7 to 9 mm and loss of clinical attachment from 6 to 13 mm in these sites. The patients were given 3 times 250 mg/day of metronidazole (Flagyl*) for 10 days. Darkfield microscopy and microbiological cultures of the subgingival plaque were performed twice prior to the study, at the end of the medication and after 3 weeks, 3 and 6 months. The plaque and gingival indices, probing depth and loss of clinical attachment were recorded. During the medication and at 3 and 6 months, the teeth were scaled and root planed. The samples were obtained with 3 paper points and cultured anaerobically in the glove box on non‐selective and selective media and representative bacterial colonies identified by aerobic growth, gram stain and rapid biochemical tests. Presumptive pathogenic micro‐organisms including Bacteroides were identified. The % of spirochetes, motile rods and non‐motile bacteria were enumerated by darkfield microscopy. The clinical results show that administration of metronidazole and repeated root planing significantly decreased gingival inflammation, probing depth and loss of clinical attachment in reinfected sites. After treatment, these sites harbored significantly less spirochetes and more non‐motile bacteria, while motile rods tended to return to baseline levels with time. The combined antibiotic and mechanical therapy resulted in a statistically significant decrease of gram‐negative rods, Fusobacteria and Bacteroides gingivalis over 6 months. The strongest microbiological effects were evident at the end of the medication.
Dentin resorption in replanted monkey incisors
Authors: Lindskog S. , Blomlöf L. , Hammarström L.
Published: December 2005

Abstract Dentinoclast colonization of a dentin surface was examined with special reference to changes in plasma membrane morphology during spreading and development into actively resorbing cells. Experimental cavities on the root surfaces of freshly extracted and replanted monkey incisors with infected pulps were examined with scanning electron microscopy after perdetermined time intervals. The surface morphology of the dentinoclasts during the different spreading stages, and the fact that the stages appeared in a time–related mode indicated that dentinoclasts follow the general pattern of cell attachment and spreading on solid substrata, with a few exceptions unique to mineralized tissue resorbing cells. As a result, a 3‐stage speading model was proposed. In stage 1, dentinoclasts were characterized by an abundance of filopodia projecting towards the dentin surface. The cells appeared to be exploring the surface to find an area suitable for resorption. This was followed by an increase in cell size accompanied by a progressive disappearance of the peripheral filopod fringe (stage 2). Stage 3 apparently represented the final stage of adaptation and was characterized by an active resorption of the dentin surface.
Clinical, microbiological and immunological features of subjects with refractory periodontal diseases
Authors: Haffajee A. D. , Socransky S. S. , Dzink J. L. , Taubman M. A. , Ebersole J. L.
Published: December 2005

Abstract 27 subjects with active destructive periodontal diseases were treated by modified Widman flap surgery and systemic tetracycline and divided into 4 groups based on pre‐ and post‐therapy hazard rates (% of sites losing > 3 mm of attachment in 1 year). Pre‐ and post‐therapy hazard rates were respectively: group T (3 subjects) < 4 and < 4; group II (8 subjects) > 4 and < 4; group III (3 subjects) < 4 and > 4; group IV (refractory group of 13 subjects) > 4 and > 4. Baseline mean pocket depths and attachment loss of groups 1 and II subjects were less than groups III and IV subjects and exhibited less suppuration. 6 group IV subjects lost a total of 38 teeth after therapy, in contrast to no tooth loss in subjects in the other 3 groups. Redness, bleeding on probing, plaque levels and age did not differ among groups. Subjects in the 4 groups differed in the subgingival species to which they showed elevated serum antibody responses. Group IV subjects showed elevated responses to a select range of gram‐negative species, including A. actinomycetemcomitans strains Y4 or ATCC 29523, F. nucleatum and B. intermedius. No subject in any of the other groups exhibited an elevated response to B. intermedius. The mean % of each species in all sampled sites, both before and after therapy, was computed for each subject. Subjects in groups III and IV (high post‐therapy hazard rates) exhibited elevated mean levels of B. forsythus, F. nucleatum, S. intermedius, E. corrodens, and B. gingivalis. Groups I and II subjects showed elevated mean levels of an unnamed Actinomyces species. Refractory subjects (group IV) did not constitute a homogeneous group. While subjects in this group had higher levels of pathogens, it appeared that they differed in the combinations of predominant species. 3 major microbial complexes were observed: (1) B. forsythus, F. nucleatum and W. recta (3 subjects); (2) S. intermedius, B. gingivalis and P. micros (3 subjects); (3) S. intermedius and F nucleatum (7 subjects) with or without B. gingivalis.
Tooth hypersensitivity after periodontal treatment
Authors: Haugen Ellen , Johansen Jan R.
Published: December 2005

Abstract Sensitive teeth after periodontal treatment are a rather common finding. Therefore, it has been questioned whether all the cementum on the root surfaces ought to be removed during periodontal therapy, since the sensitivity is caused by exposure of the dentin. Usually, the hypersensitivity represents a minor problem and will decrease or disappear with time. However, the following case demonstrates that repeated instrumentation of periodontally involved teeth can lead to an extreme degree of hypersensitivity.
The role of dental plaque in gingivitis and periodontitis
Authors: Listgarten M. A.
Published: December 2005

Abstract A dynamic equilibrium between the periodontal microbiota and the host generally results in a clinical state of periodontal health, characterized by minimal inflammatory changes in the marginal gingival tissues. Maintenance of health is most easily achieved by controlling the resident mass of bacteria. In rare instances, control of specific microorganisms may be indicated. Lack of microbial control may lead to an imbalance between the microbiota and the host due to a markedly increased microbial mass and/or increased virulence of the micro‐organisms present. Such alterations in the host‐parasite equilibrium may result in transient episodes of tissue destruction and. in the long term, to cumulative damage to the periodontal tissues.
Microbiological effects of mouthrinses containing antimicrobials
Authors: Walker Clay B.
Published: December 2005

Abstract A number of mouthrinse formulations containing antimicrobials have been evaluated to détérmine their effectiveness as antiplaque and/or antigingivitis agents. These have included the bis‐biguanides, phenols, quaternary ammonium compounds., oxygenating compounds, plant extracts, fluorides, antibiotics and antimicrobial combinations. These mouthrinses have often been tested as adjuncts to normal oral hygiene procedures as well as in the experimental gingivitis model. 2 agents in particularly, chlorhexidine gluconate and listerine. have been shown to both inhibit or reduce plaque accumulation and the severity of gingivitis. Chiorhexidine has been reported to reduce the accumulation of plaque by 60% and the severity of gingivitis by 50‐80% as détérmined by improvements in clinical indices. A 0.12% chlorhexidine gluconate rinse resulted in significant reductions after both 3 and 6 months use in the numbers of total anaerobes, total aerobes, streptococci, and actinomyces recovered from supragingival plaque. Listerine has been reported to retard the development of plaque by 45 to 56% and to reduce existing plaque by 39 to 48%. Gingivitis scores were reduced as much as 59%. Microbial studies have shown that the effect of listerine is exerted against the total microbial mass and results in an overall decrease in both the biomass and the activity. Long‐term use of neither mouthrinse, chlorhexidine or listerine. resulted in the emergence of opportunistic or oral pathogens. Preliminary data obtained following the use of a novel mouthrinse consisting of a combination of povidone‐iodine and hydrogen peroxide appears promising. This combination was more effective than either single component alone in reducing gingivitis scores. The combination resulted in a net decrease in microbial mass as détérmined by total microbial counts but did not specifically reduce one bacterial taxa in relation to the others.
Clinical index systems used to assess the efficacy of mouth‐rinses on plaque and gingivitis
Authors: Fischman Stuart L.
Published: December 2005

Abstract The American Dental Association's Council on Dental Therapeutics has adopted Guidelines for acceptance of hemo therapeutic products for the control of supragingival dental plaque and gingivitis. The most widely used plaque indices are the plaque index (PI) and the Turesky index. Gingivitis has usually been assessed by the Loe and Silness method, although the modified gingival index of Lobene and a bleeding index reported by Caton and Poison have also been used. To date. 2 products have been accepted by the Council as being effective in helping control supragingival plaque and gingivitis. These products were evaluated using clinical indices described in this review. The indices were selected from the many in the literature as being valid, reliable, and easily learned. Suggestions are made for criteria to be used in comparability studies.
Longitudinal clinical studies with antimicrobial mouthrinses
Authors: Overholser C. Daniel
Published: December 2005

Abstract This chapter examines the use of long‐term clinical studies to evaluate the effectiveness of antimicrobial mouthrinses in the prevention and/or treatment of plaque and gingivitis. Such studies should be double‐blind, compare the active agent to a control, and last a minimum of 6 months. Such a time interval simulates a common recall interval, enables one to utilize a thorough dental prophylaxis at the initiation of the study, and is sufficient time to observe the development of toxic and other side‐effects of therapy. The microbiological component should estimate plaque quantitatively and demonstrate that no pathogenic, opportunistic or resistant micro organisms develop. The indices and microbiology should be performed at baseline, and intermediate period and at 6 months. Thus far, published studies meeting these criteria support the efficacy of listerine and chlorhexidine as agents useful in reducing plaque and gingivitis. Preliminary evidence indicates that sanguinarine may also be effective. The most common side effect of listerine was the complaint of poor taste. Increased stain and Calculus formation were cited as the most significant side‐effects of chlorhexidine. Such side‐effects must be taken into consideration when recommending effective antimicrobial mouthrinses for patient use.
Use of mouthrinses for professional indications
Authors: Ciancio S. G.
Published: December 2005

Abstract In view of the relationship between supragingival and subgingival plaque, chemical agents which alter supragingival plaque may also alter subgingival plaque. As a result, a beneficial effect on gingival health may be anticipated. This article reviews the use of chemotherapeutic agents which reduce plaque and gingivitis. Indications for the use of these agents include patients with problems with mechanical plaque control, extensive splinting or fixed prostheses, intraoral fixation, orthodontic appliances, overdenture abutments and implants, and for patients in the immediate post‐surgical period. Improvement of wound healing following periodontal surgery may represent one of the most valuable aspects of use of these agents. As mouthrinses, these agents cannot be expected to significantly alter subgingival plaque. However, for this purpose, their use in irrigation devices deserves further study. Since recent reports have suggested benefits of various mouthrinses when used as irrigants as compared to rinses may also reduce the bacterial back‐spray associated with ultrasonic devices and high‐speed handpieces, and thus provide a protective effect for dental personnel. The practitioner in the United Staes is encouraged to recommend products accepted by the American Dental Association's Council on Dental Therapeutics in order to insure both safety and efficacy.
Ultrastructure of the periodontal lesion in a case of Papillon‐Lefèvre syndronne (PLS)
Authors: Vrahopoulos T. P. , Barber P. , Liakoni H. , Newman H. N.
Published: December 2005

Abstract In this study, 11 permanent teeth and their associated soft tissues from an 11‐year‐old boy with PLS were examined. Plaque, cementum and periodontal tissues were examitied by scanning (SEM) and transmission electron microscopy (TEM), Except for depressed lymphocyte transformation, there were no abnormal haematological data. Local findings included abnormally thin cementum, extensive destruction of the periodontal ligament were still attached to the root, and severe inflammation of the soft tissues. Few bacteria were found in any of the soft tissue layers. The apical border plaque was restricted to gram‐ cocci and rods. The features observed in this case of PLS may indicate primary defects of cementum or ligament attachment, or disruption of fibroblast and cementoblast function due to the rapid advance of the disease process. Lack of bacterial invasion in the pocket soft tissue casts doubt on its involvement in the present case of severe periodontitis. The restricted range of morphotypes observed suggests a limited range of associated organisms. Further research is required to clarify the rôle of the host response and to identify the organisms involved.
Personality differences and stressful life events. Differences between treated periodontal patients with and without maintenance
Authors: Becker Burton E. , Karp Cheryl L. , Becker William , Berg Laurence
Published: December 2005

Abstract The purpose of this study was to determine whether personality differences exist between patients who have had periodontal therapy and continued in maintenance compared with those who have had periodontal therapy and no maintenance. In addition, an attempt was made to determine whether there were differences in reactions to stressful life events among the 2 groups of patients. Patients were evaluated for personality differences using the adjective check list, A background questionnaire was used to gather personal data and information pertinent to stressful life events. The maintained group had a more positive image of themselves. They had higher achievement, endurance and affiliation scores than did the patients without maintenance. The unmaintained group had higher negative aggression scores, a higher incidence of stressful life events, and less stable personal relationships in their lives.