bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of Transactional Style Deviance in the TAT's of Parents of Schizophrenics
Authors: JONES JAMES E.
Published: August 2004

Parents of schizophrenics show more transactional style deviance in diverse situations than do other parents. In a sample of families of nonschizophrenic outpatient adolescents, a manual for scoring such deviance on stories told for seven TAT cards was developed. This scoring system was shown to be composed of six meaningful factors. When this system was applied to the TAT's of parents of offspring with a variety of psychiatric diagnoses, a total deviance score did not discriminate among the parents. High scores on two particular factors were found only in parents of hospitalized schizophrenics, but four factors were nondiscriminating. Parents of young adults with schizophrenia spectrum disorders were more likely to show high scores on at least one of these six factors than other parents. Considering the scores of mothers and fathers together yielded the best discrimination of parents of schizophrenia spectrum disorders from other parents.
“She is Just Not an Open Person.”: A Linguistic Analysis of a Restructuring Intervention in Family Therapy
Authors: TROEMEL‐PLOETZ SENTA
Published: August 2004

A short exchange from a family therapy treatment with a couple is analyzed in detail according to what the speakers, in this case husband and therapist, do with each other and with the third participant, the wife, in making their utterances. They are seen to be performing a number of different acts with each utterance and an attempt is made to connect these acts with the actual linguistic properties of the utterances used; in this connection the semantic‐pragmatic function of the operator, “just,” in one particular reading is discussed. These acts receive further support when the wider linguistic and situational context is considered.

The exchange is of linguistic interest because the response of the therapist to the husband seems to be a non sequitur. It is shown, however, that pragmatic coherence, i.e., coherence with respect to the sequence of linguistic acts and moves between the speakers in the given situation, forces an interpretation of the two utterances as a connected text.

The exchange is interesting therapeutically because the therapist's intervention brings immediate change in the husband. This striking therapeutic effect is attributed to the restructuring character of the intervention which sufficiently shifts the balance in the relationship between husband and wife. An analysis of the linguistic properties of the therapist's utterance shows that the restructuring is achieved by particular syntactic, semantic and pragmatic features of the utterance. It turns out that restructuring, as manipulative as it may appear on the surface, is a highly complex, sophisticated and powerful technique. It is not peculiar to family therapy; comparable procedures can be found in other forms of psychotherapy, e.g., psychoanalysis and client‐centered therapy, and in general in everyday conversation situations where it is necessary for one speaker to get another speaker to modify what he is saying and to adopt a different view.
Owning and Disowning: The Structural Dimension
Authors: KLUGMAN JEFFRY
Published: August 2004

Stierlin (11) recently examined owning and disowning in the parent‐child relationship from a psychoanalytic‐developmental perspective. This paper examines the same phenomena from a structural viewpoint, deriving implications for the conduct of therapy.
Family Therapy After the Divorce: Developing a Strategy
Authors: GOLDMAN JANICE , COANE JAMES
Published: August 2004

Family therapy with the whole family after a divorce has taken place provides a unique opportunity for intervention. Though the spouses have legally terminated their relationship, their parenting function remains. However, this reality is often clouded by the emotional conflicts generated by the divorce. Family therapy can be useful in facilitating life in the post‐divorce period.

A four‐part model for intervention is described. The first task is to redefine the family as existentially including all members. Next, generational boundaries are firmed in order to reduce the parentification process, often intensified by the parents physical absence. Third, the family needs to have a replay of the history of the marriage to correct developmental distortions and offer a chance to mourn the loss of the intact family. Finally, the therapists attempt to facilitate an emotional divorce. A case study is presented to elucidate the manner in which these steps unfold in treatment.
The Family Interactional Perspective: A Study and Examination of the Work of Don D. Jackson
Authors: GREENBERG GEORGE S.
Published: August 2004

This article presents an overview of the primary contributions of the late Don D. Jackson. It analyzes and attempts to unify the central concepts of what he first referred to as “conjoint family therapy.” Emphasis is upon the theoretical components leading to the development of a behaviorally oriented, nontransference, focused‐treatment format, labeled by the author as “family interactional psychotherapy.”
Divorce Therapy: An In‐Depth Survey of Therapists' Views
Authors: KRESSEL KENNETH , DEUTSCH MORTON
Published: August 2004

In‐depth interviews were conducted with 21 highly experienced therapists on the criteria of a constructive divorce, the obstacles to achieving such a divorce, and the strategies and tactics of divorce therapy. The primary criterion of a constructive divorce was the successful completion of the process of psychic separation and the protection of the welfare of minor children. Therapy may focus on the decision to get divorced and/or the negotiation of the terms of a divorce settlement.

Three types of therapeutic strategies were identified: reflexive interventions by which the therapist orients himself to the marital problems and attempts to gain the trust and confidence of the partners; contextual interventions by which he tries to promote a climate conducive to decision‐making; and substantive interventions intended to produce resolution on terms the therapist has come to believe are inevitable or necessary.

The nascent state of divorce therapy as an area of therapeutic specialization is noted. The problem of diagnostic criteria for divorce, the relationship between therapists and lawyers, the nature and consequence of therapist impartiality, and the degree to which therapists should mediate the terms of divorce are considered central issues meriting further study.
Family Rituals A Powerful Tool in Family Therapy
Authors: PALAZZOLI MARA SELVINI , BOSCOLO LUIGI , CECCHIN GIAN FRANCO , PRATA GIULIANA
Published: August 2004

The use of systemic models in family therapy obliged our team to devise therapeutic tasks involving the entire family. Among these, one was found to be extremely effective: the prescribing of a family ritual. This article gives details of one such example aimed at the destruction of a myth that had been created by three generations of a family. In order that the reader may have an adequate understanding of this ritual, we shall fully describe the story of the family and of the transgenerational evolution of this myth. In the description of the treatment of the family, certain errors were made by the therapists that will come to light — errors that, as usual, were far more instructive than the actual successes.

Eventually, it was the very understanding of these errors and their repercussions that led us to the successful prescription of the ritual. Finally, detailed analysis of the substance and aim of the ritual will illustrate and explain exactly what we mean by the term ritual.

For this case history, we shall call the family Casanti.
A Systems Theory Approach to a Case of Anorexia Nervosa
Authors: CAILLÉ PHILIPPE , ABRAHAMSEN PÅL , GIROLAMI CHARLOTTE , SØRBYE BENTE
Published: August 2004

Systems theory views mental and psychosomatic illness as the natural consequences of a dysfunctional human interactional group. The symptom chosen is affected by the symptom carrier's age, sex, and unique individual characteristics. However, the reason the symptom develops and is maintained is to be found in the system(s) of which the symptom carrier is a part.

A human system consists of two or more individuals who have an ongoing, often goal‐directed, relationship with each other. The most important human system today is undoubtedly the family. The welfare of the individual is usually related to membership in a vital, well‐adjusted family. A dysfunctional family easily becomes dependent on mental or behavioral deviations in one of its members as a means of preventing disintegration.

We hope this article's description of a typical treatment situation will demonstrate how a systems theory approach differs from other forms of family therapy in its evaluations and techniques.
Parental Focus of Attention in a Videotape Feedback Task as a Function of Hypothesized Risk for Offspring Schizophrenia
Authors: LIEBER DEBORAH J.
Published: August 2004

The families of 29 disturbed but nonpsychotic adolescents were observed in a structured task in which they discussed their reactions to viewing themselves interacting on videotape. Measures derived from the Singer‐Wynne concept of transactional style deviance were applied to the parental behaviors and related to prior assessments of parental communication disorder based on individual parental TAT protocols. The results confirm the Singer‐Wynne hypothesis of the cross‐situational stability of transactional style deviance. The most striking finding, however, is that an index of positive focusing behavior differentiates more strongly parents of adolescents hypothesized to be at varying levels of risk for schizophrenia than does the measure of transactional style deviance.
Family Therapy Training for Paraprofessionals in a Community Mental Health Center
Authors: MEYERSTEIN ISRAELA
Published: August 2004

An ecologically oriented family therapy training program is advocated for teaching paraprofessionals to work with high‐risk clients in a community mental health setting. The context of training as well as the particular abilities and needs of beginning paraprofessional family therapists are explored in order to design a flexible and effective program in the face of limited resources. This paper describes a variety of educational and supervisory formats such as group supervision, peer supervision, and live supervision. The usefulness of these different models in facilitating skill development and growth in paraprofessionals is evaluated. Recommendations are made to trainers concerning problems encountered in teaching paraprofessionals and in implementing family systems training in community mental health centers.
On the Reclaiming of Denied Affects in Family therapy
Authors: BERKOWITZ DAVID A.
Published: August 2004

A central developmental task of the family is to help its members develop the capacity to cope with the grief attendant on separation and loss. In order to work through such feelings, each member must first be able to acknowledge the affect as present, internal, and belonging to the self. Depending on the degree of intrapsychic differentiation, and the dread of abandonment, family members may seek to avoid awareness of such feelings within themselves. The disclaimed emotions remain powerful unconscious motivators of behavior, exerting their influence despite their denial. Some typical clinical illustrations of this are provided. Excerpts from conjoint family therapy are then presented to illustrate the therapeutic interventions made in assisting a family to acknowledge denied grief over the separation of one of its members along with unspoken tender feelings within the family. This paper affirms the continued relevance of a psychodynamic, interpretative approach for families struggling with unresolved grief.
The Effects of Family Presence and Brief Family Intervention on Global Outcome for Hospitalized Schizophrenic Patients
Authors: GOULD EDWARD , GLICK IRA D.
Published: August 2004

Virtually all modern inpatient psychiatric units operate on the assumptions that family presence, when the identified patient has schizophrenia, does affect outcome and that adding brief family intervention to the treatment prescription will enhance hospital and posthospital outcome. Often the family intervention is believed not adequate in terms of duration or frequency or quality (since trainees are the family therapists), given the standards of some experienced family clinicians. This report addresses these issues by comparing outcome measures for hospitalized patients with schizophrenia by (a) presence of a family and (b) amount and/or kind of family intervention. Most importantly, we wished to learn if global outcome would show change by virtue of family therapy (within the constraints imposed by the above limitations of family intervention).
Coherent Accounts of Coping with a Chronic Illness: Convergences and Divergences in Family Measurement Using a Narrative Analysis
Authors: FIESE BARBARA H. , WAMBOLDT FREDERICK S.
Published: August 2004

Researchers and clinicians have shown increasing interest in family narratives as an avenue for accessing the family meaning‐making process. In this study, we examine the convergences and divergences between narrative assessment, family self‐report, and verbal accounts of family climate. Sixty‐two families with a child with pediatric asthma were interviewed about the impact that asthma had on family life. These interviews were coded for narrative coherence, relationship expectations, and engagement with the interviewer. Primary caregivers were also interviewed using the Five Minute Speech sample (FMSS) and completed self‐report assessments of family functioning (Family Assessment Device [FAD] Impact on the Family Scale [IOF]). Contrary to prediction. Narrative coherence was higher in those cases where Emotional Over‐involvement (EOI) was present on the FMSS. Narrative coherence and engagement with the interviewer were positively related to self‐report of family problem solving, communication, and affective responsiveness as measured on the FAD. Divergences and convergences between different types of family measurement are discussed in light of meaning‐making processes associated with coping with a chronic illness.
Prognostic factors for alveolar regeneration: effect of a space‐providing biomaterial on guided tissue regeneration
Authors: Polimeni Giuseppe , Koo Ki‐Tae , Qahash Mohammed , Xiropaidis Andreas V. , Albandar Jasim M. , Wikesjö Ulf M. E.
Published: August 2004

Objectives: There is a limited understanding of the effect of bone biomaterials on the healing potential when used in conjunction with guided tissue regeneration (GTR). The objective of this study was to evaluate the effect of a space‐providing coral‐derived biomaterial on alveolar bone regeneration in conjunction with GTR.

Methods: Bilateral, critical‐size, 6‐mm, supra‐alveolar, periodontal defects were created in four young adult Beagle dogs. In a split‐mouth design, the animals received an ePTFE device to provide for GTR in contralateral defect sites with or without the coral biomaterial. The animals were euthanized at 4 weeks post surgery. A histometric analysis assessed vertical regeneration of alveolar bone relative to space‐provision by the ePTFE device. Because of the correlation of within‐dog measurements, a mixed model anova was used to analyze the data.

Results: There was significantly greater mean bone regeneration in sites receiving calcium carbonate coral implant GTR (cGTR) compared to GTR (p<0.0001). Sites providing larger wound areas exhibited greater bone regeneration compared to sites exhibiting smaller wound areas (p<0.0001). However, grouping the sites by wound area thresholds showed that bone regeneration was not significantly different in sites receiving cGTR compared to sites receiving GTR alone, irrespective of the size of the wound area (p>0.5).

Conclusions: Space‐provision has a significant effect on bone regeneration following GTR. The coral biomaterial effectively enhances space‐provision, and this appears to be the principal mechanism by which this biomaterial supports bone regeneration rather than postulated osteoconductive properties.
Prognostic factors for alveolar regeneration: effect of tissue occlusion on alveolar bone regeneration with guided tissue regeneration
Authors: Polimeni Giuseppe , Koo Ki‐Tae , Qahash Mohammed , Xiropaidis Andreas V. , Albandar Jasim M. , Wikesjö Ulf M. E.
Published: August 2004

Objectives: Design criteria for guided tissue regeneration (GTR) devices include biocompatibility, cell occlusion, space‐provision, tissue integration, and ease of use. The objective of this study was to evaluate the effect of cell occlusion and space‐provision on alveolar bone regeneration in conjunction with GTR.

Methods: Routine, critical‐size, 6 mm, supra‐alveolar, periodontal defects were created in 6 young adult Beagle dogs. Space‐providing ePTFE devices, with or without 300‐μm laser‐drilled pores were implanted to provide for GTR. Treatments were alternated between left and right jaw quadrants in subsequent animals. The gingival flaps were advanced for primary intention healing. The animals were euthanized at week 8 post surgery. The histometric analysis assessed regeneration of alveolar bone relative to space‐provision by the ePTFE device.

Results: A significant relationship was observed between bone regeneration and space‐provision for defect sites receiving the occlusive (β=0.194; p<0.02) and porous (β=0.229; p<0.0004) GTR devices irrespective of treatment (p=0.14). The bivariate analysis showed that both space‐provision and device occlusivity significantly enhanced bone regeneration. Hence, sites receiving the occlusive GTR device and sites with enhanced space‐provision showed significantly greater bone regeneration compared to sites receiving the porous GTR device (p=0.03) or more limited space‐provision (p=0.0002).

Conclusions: Cell occlusion and space‐provision may significantly influence the magnitude of alveolar bone regeneration in conjunction with guided tissue regeneration.
Periodontal repair in dogs: evaluation of a bioresorbable calcium phosphate cement (CeredexTM) as a carrier for rhBMP‐2
Authors: Sorensen Rachel G. , Wikesjö Ulf M. E. , Kinoshita Atsuhiro , Wozney John M.
Published: August 2004

Background: Recombinant human bone morphogenetic protein‐2 (rhBMP‐2) has been shown to induce clinically relevant bone formation for orthopedic, craniofacial, and oral indications. It appears critical, in particular for onlay indications, that the associated carrier technology exhibits structural integrity to offset compressive forces in support of rhBMP‐2‐induced bone formation. The objective of this study was to evaluate a calcium phosphate (CP) cement, Ceredex™, as a candidate carrier for rhBMP‐2 in a defect model with limited osteogenic potential.

Materials: Bilateral, critical size, 6‐mm, supra‐alveolar, periodontal defects were created in six, adult, male, Hound Labrador mongrels. Three animals received rhBMP‐2/Ceredex™ (rhBMP‐2 at 0.20 and 0.40 mg/ml) in contralateral defect sites (implant volume/defect ∼1 ml). One defect site in each of the three remaining animals received Ceredex™ without rhBMP‐2 (control). The animals were euthanized at 12 weeks postsurgery for histologic and histometric analysis.

Results: Mean induced bone height exceeded 80% of the defect height for supra‐alveolar periodontal defects receiving rhBMP‐2/Ceredex™ without major differences between rhBMP‐2 concentrations compared with approximately 40% for the control. The newly formed bone, a mixture of lamellar and woven bone in fibrovascular tissue, circumscribed relatively large portions of the residual Ceredex™ biomaterial. Inflammatory lesions were associated with limited bone formation in some sites. From a periodontal perspective, sites receiving rhBMP‐2/Ceredex™ exhibited increased cementum formation compared with control, but without a functionally oriented periodontal ligament, and increased ankylosis and root resorption. Control sites exhibited early wound failure and exposure, loss of the Ceredex™ biomaterial, and limited bone formation.

Conclusions: The Ceredex™ CP cement appears a potentially promising carrier technology for rhBMP‐2 onlay indications. However, a slow resorption rate may prevent its wider use. This study does not support use of the rhBMP‐2/Ceredex™ combination for periodontal indications.
Tissue plasminogen activator (t‐PA) and placental plasminogen activator inhibitor (PAI‐2) in gingival crevicular fluid from patients with Papillon–Lefèvre syndrome
Authors: Ullbro Christer , Kinnby Bertil , Lindberg Pia , Matsson Lars
Published: August 2004

Objectives: Numerous patients with Papillon–Lefèvre syndrome (PLS) express a severe periodontal inflammation that results in premature loss of deciduous and permanent teeth. The plasminogen activating (PA) system is involved in physiological and pathological processes including epithelial healing, extracellular proteolysis and local inflammatory reactions. The aim of the study was to explore a possible role of the PA system in patients with PLS.

Material and Methods: Samples of gingival crevicular fluid (GCF) were collected from areas with gingival infection in 20 patients with PLS and in 20 healthy controls. The concentration of tissue plasminogen activator (t‐PA) and inhibitor (PAI‐2) was measured with ELISA.

Results: The median level of PAI‐2 was significantly higher (p<0.01) in PLS patients than in the controls, while the median value of t‐PA did not differ between the groups. No difference in t‐PA or PAI‐2 levels was found regarding age, gender or presence of active periodontal disease.

Conclusion: The findings indicate an atypical activity of the PA system with a disturbed epithelial function in PLS patients, suggesting that the periodontal destruction seen in patients with PLS is secondary to a hereditary defect in the defense system.
Evaluation of additional amine fluoride/stannous fluoride‐containing mouthrinse during supportive therapy in patients with generalized aggressive periodontitis
Authors: Guarnelli Maria Elena , Zangari Francesca , Manfrini Roberta , Scapoli Chiara , Trombelli Leonardo
Published: August 2004

Objectives: The objective of the present randomized controlled trial was to evaluate the efficacy of a mouthrinse containing a combination of AmF/SnF2 in controlling supragingival plaque accumulation and gingival inflammation during a 12‐week period in patients affected by generalized aggressive periodontitis (GAP).

Methods: Eighteen subjects, six males and 12 females, mean age: 32.2 years, were evaluated. One‐half of the patients was either prescribed an AmF/SnF2‐containing mouthrinse (test mouthrinse) or a control mouthrinse in addition to mechanical plaque control for 12 weeks. After a 2‐week wash‐out period, the patients received the alternative mouthrinse. Before and after treatment plaque index (PlI), gingival index (GI), angulated bleeding index (AngBI), tooth stain (GMSI), and tongue stain were recorded.

Results: Test mouthrinse resulted in a statistically significant decrease in PlI (p=0.029) and GI (p=0.017). After treatment, PlI was significantly lower in test compared to control mouthrinse (p=0.027). GMSI significantly increased post‐treatment for both mouthrinse regimens (p<0.001), a significantly higher score being observed for the test compared to control mouthrinse (p=0.002).

Conclusions: The 12‐week use of a AmF/SnF2‐containing mouthrinse as an adjunct to conventional mechanical oral hygiene procedures in GAP patients was effective in controlling the amount of supragingival plaque deposits.
Matrix metalloproteinase‐1 and ‐3 gene promoter polymorphisms in Japanese patients with periodontitis
Authors: Itagaki Manami , Kubota Takehiko , Tai Hideaki , Shimada Yasuko , Morozumi Toshiya , Yamazaki Kazuhisa
Published: August 2004

Background/aims: Matrix metalloproteinase (MMP)‐1 and MMP‐3 have important roles in the connective tissue remodelling and destruction processes in periodontitis. MMP‐1 1G/2G (−1607) and MMP‐3 5A/6A (−1171) polymorphisms have been identified and appear to influence the transcription of the genes. The aim of this study was to investigate whether these gene promoter polymorphisms were associated with the susceptibility to periodontitis.

Material and Methods: Genomic DNA was obtained from 37 generalised aggressive, 205 slight‐to‐severe generalised chronic‐periodontitis patients and 142 healthy subjects. All subjects were non‐smoking Japanese. We genotyped by using TaqMan® PCR assay. The statistics were analysed by χ2‐test.

Results: We found no significant differences in genotype distributions, allele frequencies, carriage rates and haplotype frequencies in the MMP‐1 and the MMP‐3 gene promoter polymorphisms among all groups. The distributions of MMP‐1 and MMP‐3 genotypes in our study were different from those of previously reported in Caucasians or Brazilians, but consistent with previously reported in Japanese.

Conclusion: Our data did not support the hypothesis that MMP‐1 and/or MMP‐3 gene promoter polymorphisms influenced the susceptibility to periodontitis in Japanese patients, indicating MMP‐1 and MMP‐3 expressions were regulated by complex processes such as cytokine network in periodontal disease rather than gene polymorphisms.
P‐glycoprotein drug transporter MDR1 gene polymorphism in renal transplant patients with and without gingival overgrowth
Authors: Drozdzik M. , Mysliwiec K. , Lewinska‐Chelstowska M. , Banach J. , Drozdzik A. , Grabarek J.
Published: August 2004

Objective: To determine whether there is association between genotypes of drug transporter multidrug resistant (MDR)1 gene coding drug transporter P‐glycoprotein and gingival overgrowth in kidney transplant patients.

Methods: Fifty‐four unrelated kidney transplant patients suffering from gingival overgrowth as well 120 control transplant patients without overgrowth were enrolled into the study. Gingival overgrowth was assessed by two independent periodontal specialists at 6 months after transplantation. During the post‐transplant period all patients were given medication, which included cyclosporine A, diltiazem or verapamil, prednisone, azathioprine. MDR1 C3435T polymorphism was determined using the polymerase chain reaction‐restriction fragment length polymorphism assay.

Results: In kidney transplant patients suffering from gingival overgrowth mean score of gingival overgrowth was 1.43±0.63, whereas in control subjects was 0.0. Patients with gingival overgrowth induced by immunosuppressive medication were characterized by similar distribution of MDR1 genotypes. There were no significant differences of 3435CC, 20.4% and 22.5%, 3435CT, 61.1% and 54.2% and 3435TT, 18.5% and 23.3% genotypes (frequencies) between patients with and without gingival overgrowth. The risk of gingival overgrowth was the highest among patients carrying 3435CT genotype (OD 1.33), but did not differ markedly from the other genotypes, i.e. 3435CC (OD 0.88) and 3435TT (OD 0.75). Likewise to genotypes, distribution of alleles was similar in patients with gingival overgrowth and healthy gingiva. The wild‐type allele 3435C was found in 50.9% and 49.6% of subjects whereas the mutated allele 3435T was revealed in 49.1% and 50.4% of patients with and without gingival overgrowth, respectively. The evaluated risk of gingival overgrowth in patients with 3435C allele was 1.06 versus 0.95 in those with healthy gingiva. The medication regimen administered in both groups of the study was comparable. Immunohistochemical studies revealed expression of P‐glycoprotein in ducts of the salivary gland.

Conclusion: No association between the MDR1 gene polymorphism and gingival overgrowth was revealed in kidney transplant patients administered cyclosporine A as a principal immunosuppressive agent. Further studies are needed to elucidate the role of P‐glycoprotein in drug transport in salivary glands.
Prevalence of horizontal attachment loss in extracted teeth
Authors: Yamamoto Tatsuo , Ishikawa Akira , Watanabe Yutaka , Hirano Naoya , Shibata Yoshihiro , Watanabe Tatsuo
Published: August 2004

Objective: Probing attachment level provides useful information on patterns of destruction of the periodontium. It is difficult to detect complex attachment loss in clinics. The purpose of this study was to estimate prevalence of vertical and horizontal attachment loss in extracted teeth.

Material and Methods: We collected 10,212 extracted teeth from 130 dentists in Japan. After staining of periodontal membrane with erythrosine, linear loss of vertical and horizontal attachment was measured using a digital caliper.

Results: Mean vertical attachment loss varied from 5.3 to 8.6 mm. Incisors had severe attachment loss at mesial sites. Specific local attachment loss at palatal sites was observed in maxillary premolars and molars as well as in mandibular canines and premolars. Horizontal attachment loss was observed in 23% of the teeth. Frequency of horizontal attachment loss of 2.1 mm was 6.4%.

Conclusion: Severe attachment loss was observed on the palatal side of maxillary premolars. More than 1/3 of the maxillary first molars showed horizontal attachment loss. It may be impossible to debride 6.4% of teeth in cases of severe periodontitis because horizontal attachment loss may be deeper than the curette blade length.
Microbiological shifts in intra‐ and extraoral habitats following mechanical periodontal therapy
Authors: Beikler Thomas , Abdeen Ghiath , Schnitzer Stefan , Sälzer Sonja , Ehmke Benjamin , Heinecke Achim , Flemmig Thomas F.
Published: August 2004

Objectives: The aim of the present study was to analyze the intra‐ and extraoral colonization dynamics of periodontal pathogens following supra‐ and subgingival debridement.

Material and Methods: Thirty five patients with chronic periodontitis were enrolled in the study. Supra‐ and subgingival plaque samples, saliva, and swab samples from mucosa and extraoral sites were taken at baseline and 6 weeks, 3 months and 6 months after mechanical periodontal therapy. Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Eikenella corrodens (Ec), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), and Treponema denticola (Td) were identified by PCR.

Results: Supra‐ and subgingival debridement decreased the number of subgingival sites infected with the analyzed pathogens only transiently, if at all. However, the detection frequencies of Tf, Td, Ec, Pi, and Pn in the supragingival region, of Pg, Td, and Pn at the oral mucosa sites (mostly the tongue), and of all pathogens except Aa in saliva increased over the 6‐month observation period. Td was the only pathogen recorded in notable quantities in the extraoral habitat (external ear canal).

Conclusion: The results indicate that supra‐ and subgingival debridement results in a dissemination of periodontal pathogens within the oral cavity.
Subantimicrobial dose doxycycline as adjunctive treatment for periodontitis
Authors: Preshaw Philip M. , Hefti Arthur F. , Jepsen Søren , Etienne Daniel , Walker Clay , Bradshaw Mark H.
Published: August 2004

Background: Subantimicrobial dose doxycycline (SDD – 20 mg doxycycline twice daily) is indicated as an adjunctive treatment for periodontitis. Doxycycline downregulates the activity of matrix metalloproteinases (MMPs), key destructive enzymes in periodontal disease. Current understanding of periodontal pathogenesis suggests that MMPs play a major role in the destruction of periodontal tissues, leading to the clinical signs of periodontitis. Research supports that downregulation of MMPs by SDD confers benefit to patients with periodontitis.

Method: We review the clinical, microbiological and safety data relating to the use of SDD in patients with periodontitis, and consider the historical events that led to the development of adjunctive SDD as a treatment for periodontitis.

Results: Studies have shown that SDD, when prescribed as an adjunct to scaling and root planing (SRP), results in statistically and clinically significant gains in clinical attachment levels and reductions in probing depths over and above those that are achieved by SRP alone. SRP must be thorough and performed to the highest standard to maximise the benefits of adjunctive SDD. SDD does not result in antibacterial effects, or lead to the development of resistant strains or the acquisition of multiantibiotic resistance. The frequency of adverse events is low, and does not differ significantly from placebo.

Conclusions: Adjunctive SDD confers clinical benefit to patients with periodontitis. A comprehensive treatment strategy is suggested, involving patient education and motivation, reduction of the bacterial burden by SRP, host response modulation with SDD, and periodontal risk factor modification.
A clinical comparison of an oscillating/rotating powered toothbrush and a manual toothbrush in patients with chronic periodontitis
Authors: McCracken G. I. , Heasman L. , Stacey F. , Steen N. , DeJager M. , Heasman P. A.
Published: August 2004

Objectives:

Primary objective: To compare the relative efficacy of an oscillating/rotating powered toothbrush to that of a conventional manual toothbrush in a group of periodontal patients over a 16‐month period with respect to plaque control.

Secondary objective: To compare differences in pocket depth (PD) and bleeding index (BI) between the two groups over a 16‐month period.

Material and Methods: Forty patients were recruited to a 16‐month, single‐blind, two‐group, randomised, parallel group clinical trial to compare the effects of manual and oscillating/rotating powered toothbrushes in a cohort of patients with chronic periodontitis. None of the patients had previous experience of using an oscillating/rotating brush and had a mean plaque index (PI) of >2.0 (modified Quigley and Hein index) at baseline. Patients were stratified by gender, age and smoking status then randomised to using a manual or an oscillating/rotating brush for the duration of the study. Conventional non‐surgical periodontal therapy was undertaken within the first month after baseline. PI was the primary outcome measure with PDs and BI also recorded at baseline and months 3, 6, 10 and 16.

Results: Mean full‐mouth (FM) scores at baseline for oscillating/rotating brushing and manual brushing groups were as foolows: PI, 3.4 and 3.5; BI, 1.7 and 1.5; and PD, 3.4 and 3.3. The mean reduction in FM scores from baseline to 16 months were: PI, 0.72 and 0.75; PD, 0.43 and 0.57; and BI, 0.74 and 0.83, respectively. Repeated measures anova were used to compare differences between groups (adjusted for baseline levels) at months 3, 6, 10 and 16 and showed no statistically significant difference between groups for PI and PD (p>0.05). A difference of 0.2 BI units was detected in favour of the manual brushing group (p=0.04).

Conclusion: Over a 16‐month period, there were no differences in PI reduction or PD reduction between patients who underwent non‐surgical management of chronic periodontal disease and used either an oscillating/rotating powered toothbrush or a conventional manual toothbrush. A difference in gingival bleeding reduction was detected in favour of the patients allocated the manual brush.
Effect of platelet‐released growth factors and collagen type I on osseous regeneration of mandibular defects
Authors: Fuerst Gabor , Reinhard Gruber , Tangl Stefan , Mittlböck Martina , Sanroman Fidel , Watzek Georg
Published: August 2004

Objective: To study the effects of platelet‐released growth factors (PRGF) and collagen type I on bone defect healing in minipig mandibles.

Material and Methods: In eight adult minipigs defects were trephined in the facial mandibular wall from extra‐oral and filled with collagen+PRGF or with collagen alone. Control defects were left untreated. PRGF were defined as the supernatants obtained after centrifugation of washed, thrombin‐activated allogenic cells of platelet‐rich plasma. The animals were sacrificed at 4 and 8 weeks. For histological analysis, undecalcified ground specimens stained with the Levai–Laczko stain were used.

Results: For the entire follow‐up, the amount of newly formed bone was 35.49±3.84% in the collagen+PRGF group, 46.34±3.84% in the collagen‐only group and 33.83±4.11% in the controls. The differences between the collagen+PRGF and the collagen‐only group (p=0.0343), and between the collagen‐only group and the controls (p=0.0305) were significant. Histologically, defects filled with collagen+PRGF showed inflammatory reactions at 4 weeks, and new bone formation near the remnants of the filler collagen was reduced.

Conclusion: The data suggest that collagen type I alone, but not its combination with PRGF can support the early stages of cortical bone repair.
Clinical outcomes following treatment of human intrabony defects with GTR/bone replacement material or access flap alone
Authors: Tonetti Maurizio S. , Cortellini Pierpaolo , Lang Niklaus P. , Suvan Jean E. , Adriaens Patrick , Dubravec Dominik , Fonzar Alberto , Fourmousis Ioannis , Rasperini Giulio , Rossi Roberto , Silvestri Maurizio , Topoll Heinz , Wallkamm Beat , Zybutz Michael
Published: August 2004

Aim: This prospective multicenter randomized controlled clinical trial was designed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of a guided tissue regeneration (GTR)/bone replacement material.

Materials and Methods: One hundred and twenty‐four patients with advanced chronic periodontitis were recruited in 10 centers in seven countries. All patients had at least one intrabony defect of 3 mm. The surgical procedures included access for root instrumentation using either the simplified or the modified papilla preservation flap in order to obtain optimal tissue adaptation and primary closure. After debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CALs), probing pocket depths (PPDs), recession, full‐mouth plaque scores and full‐mouth bleeding scores (FMBS) were assessed.

Results: One year after treatment, the test defects gained 3.3±1.7 mm of CAL, while the control defects yielded a significantly lower CAL gain of 2.5±1.5 mm. Pocket reduction was also significantly higher in the test group (3.7±1.8 mm) when compared with the controls (3.2±1.5 mm). A multivariate analysis indicated that the treatment, the clinical centers, baseline PPD and baseline FMBS significantly influenced CAL gains. Odds ratios (ORs) of achieving above‐median CAL gains were significantly improved by the test procedure (OR=2.6, 95% CI 1.2–5.4) and by starting with deeper PPD (OR=1.7, 1.3–2.2) but were decreased by receiving treatment at the worst‐performing clinical center (OR=0.9, 0.76–0.99).

Conclusions: The results of this trial indicated that regenerative periodontal surgery with a GTR/bone replacement material offers an additional benefit in terms of CAL gains, PPD reductions and predictability of outcomes with respect to papilla preservation flaps alone.
The long‐term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults
Authors: Axelsson P. , Nyström B. , Lindhe J.
Published: August 2004

Background: The biofilm that forms and remains on tooth surfaces is the main etiological factor in caries and periodontal disease. Prevention of caries and periodontal disease must be based on means that counteract this bacterial plaque.

Objective: To monitor the incidence of tooth loss, caries and attachment loss during a 30‐year period in a group of adults who maintained a carefully managed plaque control program. In addition, a comparison was made regarding the oral health status of individuals who, in 1972 and 2002, were 51–65 years old.

Material and Methods: In 1971 and 1972, more than 550 subjects were recruited. Three hundred and seventy‐five subjects formed a test group and 180 a control group. After 6 years of monitoring, the control group was discontinued but the participants in the test group was maintained in the preventive program and was finally re‐examined after 30 years. The following variables were studied at Baseline and after 3, 6, 15 and 30 years: plaque, caries, probing pocket depth, probing attachment level and CPITN. Each patient was given a detailed case presentation and education in self‐diagnosis. Once every 2 months during the first 2 years, once every 3–12 months during years 3–30, the participants received, on an individual need basis, additional education in self‐diagnosis and self‐care focused on proper plaque control measures, including the use of toothbrushes and interdental cleaning devices (brush, dental tape, toothpick). The prophylactic sessions that were handled by a dental hygienist also included (i) plaque disclosure and (ii) professional mechanical tooth cleaning including the use of a fluoride‐containing dentifrice/paste.

Results: Few teeth were lost during the 30 years of maintenance; 0.4–1.8 in different age cohorts. The main reason for tooth loss was root fracture; only 21 teeth were lost because of progressive periodontitis or caries. The mean number of new caries lesions was 1.2, 1.7 and 2.1 in the three groups. About 80% of the lesions were classified as recurrent caries. Most sites, buccal sites being the exception, exhibited no sign of attachment loss. Further, on approximal surfaces there was some gain of attachment between 1972 and 2002 in all age groups.

Conclusion: The present study reported on the 30‐year outcome of preventive dental treatment in a group of carefully monitored subjects who on a regular basis were encouraged, but also enjoyed and recognized the benefit of, maintaining a high standard of oral hygiene. The incidence of caries and periodontal disease as well as tooth mortality in this subject sample was very small. Since all preventive and treatment efforts during the 30 years were delivered in one private dental office, caution must be exercised when comparisons are made with longitudinal studies that present oral disease data from randomly selected subject samples.
A possible association between preterm birth and early periodontitis
Authors: Radnai Márta , Gorzó István , Nagy Erzsébet , Urbán Edit , Novák Tibor , Pál Attila
Published: August 2004

According to many studies, generalised periodontitis can be a risk factor for preterm birth (PB). A case‐control study was carried out to examine if early localised periodontitis could be a risk factor for adverse pregnancy outcome.

Material and Methods: Postpartum women without any systemic disease were included into the study. Similar numbers of patients belonged to the case (41) and to the control (44) groups. A PB case was defined if a patient had a threatening premature labour during pregnancy, preterm premature rupture of membranes, or spontaneous preterm labour, and/or the weight of the newborn was 2499 g. Control women had delivery after the 37th gestational week and the newborn's weight was 2500 g. Known risk factors like smoking, alcohol, drug consumption, socio‐economic status and the periodontal status were recorded.

Results: A significant association was found between PB and early localised periodontitis of the patient with the following criterion having bleeding at 50% of the examined sites (6 at each tooth) and having at least at one site 4 mm probing depth (p=0.001). The odds ratio was 5.46 at the 95% confidence interval. The average weight of the newborns in the periodontitis group was less than in the control group, the difference is significant (p=0.047).

Conclusion: The results indicate that early localised periodontitis of the patient during pregnancy can be regarded as an important risk factor for PB.
Implementation of a Multivariable Control
Authors: Larkin Louis J. , Philpott James
Published: August 2004

A multivariable control (MVC) was designed and implemented for the Joint Technology Demonstrator Engine (JTDE) XTE65-2. The engine control system utilized an existing MC68000 processor that used fixed point ADA for its programming language and was limited in throughput and memory. A canonical formulation for the MVC compensator was used to minimize memory and calculation load on the processor. Use of this formulation resulted in a number of numerical difficulties. This paper relates the issues associated with the implementation of a MVC in this environment, and some approaches to solve these difficulties.
One-Disk Nutating-Engine Performance for Unmanned Aerial Vehicles
Authors: Korakianitis T. , Meyer L. , Boruta M. , McCormick H. E.
Published: August 2004

The nutating engine is a new type of internal combustion engine. The engine has unique advantages over conventional piston engines and gas turbines in small power ranges suitable for unmanned aerial vehicles (UAV), and other applications. This publication is the original presentation of the performance potential of the simplest version of the engine, a one-disk engine operating at constant compression ratio, for light airframe propulsion. In its basic configuration the core of the engine is a nutating nonrotating disk, with the center of its hub mounted in the middle of a Z-shaped shaft. The two ends of the shaft rotate, while the disk “nutates,” performs a wobbling motion without rotating around its axis. The motion of the disk circumference prescribes a portion of a sphere. A portion of the area of the disk is used for intake and compression, a portion is used to seal against a center casing, and the remaining portion is used for expansion and exhaust. The compressed air is admitted to an external accumulator, and then into an external combustion chamber before it is admitted to the power side of the disk. The external combustion chamber enables the engine to use diesel fuel in small engine sizes, giving it unique capabilities for UAV propulsion. The performance of the one-disk engine configuration for flight Mach numbers from 0 to 1 and altitudes from 0 to 20 km is presented and discussed. The performance with equal compression and expansion volume is compared with the higher-efficiency version with expansion volume higher than compression volume. A companion paper examines multidisk alternative engine configurations and load control schemes.