bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of open flap root debridement with rubber cups, interdental plastic tips and prophy paste
Authors: Schwarz Jean‐Pierre , Raleitschak‐Plüss Edith M. , Guggenheim Richard , Düggelin Marcel , Rateitschak Klaus H.
Published: December 2005

Abstract This study was designed to ascertain whether conservative cleaning of surgically‐exposed root surfaces can achieve complete plaque removal. 10 single‐rooted teeth (40 surfaces) from 4 patients with advanced periodontitis were included in the study. After flap reflection, the root surfaces were cleaned using only rubber cups, EVA plastic tips and prophy paste. No attempt was made to remove calculus. Immediately after treatment, the teeth were extracted. Then root surfaces were systematically examined in the scanning electron microscope to detect any residual bacteria (plaque). 27 of the 40 treated root surfaces were plaque‐free. On the other 13 root surfaces, only a few isolated small islands of plaque were detected. On the other hand, relatively extensive areas of the root surfaces exhibited calculus. Bacterial plaque accumulation was routinely observed on the rough calculus surfaces and at the periphery of the hard deposits. These results demonstrate that the instruments used in this study can successfully remove plaque from exposed root surfaces. However, subgingival calculus that is firmly attached to root surfaces virtually always harbors plaque bacteria; such deposits require more aggressive instrumentation (sealers, curettes) for removal.
Evaluation of reliability and reproducibility of dental indices
Authors: Marks R. G. , Magnusson I. , Taylor M. , Clouser B. , Maruniak J. , Clark W. B.
Published: December 2005

Abstract Evaluation of periodontal therapy involves the use of several oral indices to describe the health status of hard and soft tissues. It was the objective of the present study to evaluate the reliability and reproducibility of some of these indices. A calibration and standardization session was designed to calibrate 10 examiners and a “gold standard” (an experienced examiner) in evaluating the following indices: the Volpe‐Manhold calculus index (VM), the Lobene stain index (SI), a non‐invasive modification of the Löe‐Silness gingival index (GI), the papillary bleeding score (PBS) of Loesche, and the plaque index (PI) of Quigley‐Hein as modified by Turesky. For each index, the average intraclass correlation was calculated between two subject visits. The highest intraclass correlation, 0.94, was found for PBS. The intraclass correlation for PI was 0.70 and for VM. 0.65. The lowest intraclass correlations were for stain, 0.47, and GI, 0.25. Intra‐subject correlations between the 2 visits were good for all indices, but were best for PBS, followed by VM. PBS seems to be the most reliable index (both intra‐ and inter‐examiner) for measuring the oral health status and is therefore recommended for use in clinical studies.
Altered relation between granulocyte elastase and α‐2‐macroglobulin in gingival crevicular fluid from sites with periodontal destruction
Authors: Gustafsson A. , Åsman B. , Bergström K.
Published: December 2005

Abstract Granulocyte elastase activity and α‐2‐macroglobulin (α‐2‐MG) were studied in the gingival crevicular fluid (GCF) from 3 categories of sites in 6 patients with gingivitis and 6 patients with periodontitis. 6 inflamed sites in each gingivitis patient were sampled on paper strips and 12 sites, 6 with and 6 without attachment loss and periodontal pockets, were selected in each periodontitis patient. To avoid the influence of increase GCF volume from deep pockets, the elastase activity and the α‐2‐MG were calculated per μl of GCF. The proteolytic activity of elastase was measured with a low molecular weight substrate and the antiprotease, α‐2‐MG, with ELISA. The measured activity could be ascribed to elastase that had been released into the gingival tissues and into the GCF prior to sampling. In the periodontitis patients, the sites with tissue destruction had a significantly higher elastase activity per site and per μl GCF and a significantly lower α‐2‐MG per μl than the 2 other categories of sites without tissue destruction. The destructive inflammation seems to be associated with increased release of elastase, either from more numerous or from more active granulocytes and with an increased proteolytic consumption of the inhibitor accompanied by the fast elimination of the protease‐inhibitor‐complex. In conclusion, the study shows a strong relationship between elastase activity and tissue destruction, a finding that supports the pathogenic theory of an involvement of granulocytes and their proteolytic enzymes in the mechanism of periodontal destruction.
Gingival fluid IL‐1β and IL‐6 levels in menopause
Authors: Reinhardt Richard A. , Masada Marvin P. , Payne Jeffrey B. , Allison Anthony C. , DuBois Linda M.
Published: December 2005

Abstract Menopause and oophorectomy without estrogen therapy (ED) have been associated with increased production of bone‐active cytokines by peripheral blood mononuclear cells. The current study extended evaluation to gingival crevicular fluid (GCF) levels of interleukin (IL)‐1β and IL–6 in such subjects compared to premenopausal and postmenopausal estrogen‐treated females (ES). 13 ED and 13 ES Caucasians with a history of moderate‐severe adult periodontitis provided GCF from 1–3 clinically identical sites each (5–6 mm probing depth, 5–7 mm clinical attachment loss, bleeding on probing). 30 s GCF samples were obtained and evaluated for IL‐1β and IL‐6 levels using two‐site enzyme‐linked immunosorbent assays (ELISAs). The frequency of GCF IL‐1β‐positive subjects was elevated in ED versus ES (92% versus 23%; p < 0.0004, X2; analysis). IL‐6 was detected more frequently in ED subjects (23% versus 8%; not significant); however, the frequency of IL‐6 detection was low in both groups due to short sampling times. These data support the concept that clinical conditions causing low estrogen environments allow increased local production of the bone‐active cytokine IL‐β, and perhaps IL‐6.
The influence of gingival inflammation on de novo plaque formation
Authors: Ramberg P. , Lindhe J. , Dahlén G. , Volpe A. R.
Published: December 2005

Abstract The aim of the present clinical trial was to examine the influence of gingival inflammation on de novo plaque formation. In addition, the effect of a varying number of salivary bacteria on early plaque formation was evaluated. 10 subjects were recruited for the trial which was designed to establish 2 different starting points for de novo plaque formation. 1 in a healthy dentition and 1 in a gingivitis dentition. On Day 0 and at regular intervals during a 5‐week period, the panelists were examined with respect to gingivitis, plaque and number of salivary bacteria. The findings from the study demonstrated that the condition of the marginal gingiva plays an important role in the early stages of plaque formation. Thus, in both phases of the study, it was observed that at sites with initially healthy gingival units, less plaque formed (PII=0.93 and 0.82) than at sites with G1 > 0 (PII= 1.24 and 1.28) at the 2 different starting points. The number of salivary bacteria seemed to be less important than the state of the gingiva for the amount of plaque that formed during a 4‐day period of no active mechanical tooth cleaning.
Microbiological and clinical effects of metronidazole and amoxicillin in Actinobacillus actinomycetemcomitans associated periodontitis
Authors: Pavičič M. J. A. M. P. , van Winkelhoff A. J. , Douqué N. H. , Steures R. W. R. , de Graaff J.
Published: December 2005

Abstract In this study, we evaluated the microbiological and clinical effects of mechanical debridement in combination with metronidazole and amoxicillin therapy in 48 patients with Actinobacillus actinomycetemcomitans‐associated periodontitis, 3 months and at least 24 months after active treatment. The results of this study showed that 47 out of 48 patients were still negative for A. actinomycetemcomitans subgingivally, at the mucous membranes, the tonsillar area and in the saliva, 2 years after therapy. The clinical results showed that a reduction of probing pocket depth, probing attachment level, bleeding index and plaque index was not only seen in the time between baseline and 3 months after therapy, but further clinical improvement was observed between 3 and 24 months after active treatment. We conclude that combined mechanical debridement and metronidazole plus amoxicillin therapy is very effective in suppressing A. actinomycetemcomitans below cultivable levels over a long period of time, suggesting elimination of this organism, and that recolonization of A. actinomycetemcomitans seems to be a rare event. The elimination of A. actinomycetemcomitans is paralleled by a further improvement of the periodontal status of the patients, even up to 24 months after active treatment.
A cohort study of radiographic alveolar bone loss during adolescence
Authors: Aass Anne Merete , Tollefsen Tore , Gjermo Per
Published: December 2005

Abstract The aim of the present study was to assess the changes in prevalence of early radiographic alveolar bone loss in a birth cohort (all subjects born 1970) over a period of 8 years as related to sex, ethnic origin, orthodontic treatment and socio‐economic status. In 1984, the target population consisted of 2767 subjects. In 1986, 1988 and 1992, sets of bite–wing radiographs were obtained from samples of the same population. Alveolar bone loss was recorded if the distance from the cemento‐enamel junction to the alveolar crest exceeded 2 mm measured on posterior bite‐wing radiographs. The frequency of subjects with radiographic alveolar bone loss increased significantly with age (p≤ 0.05). The number of subjects with 3 or more lesions also increased with age. The demographic variables studied did not seem to influence the prevalence of bone loss significantly in the present cohort study.
The topography of the vascular systems in the periodontal and peri‐implant tissues in the dog
Authors: Berglundh T. , Lindhe J. , Jonsson K. , Ericsson I.
Published: December 2005

Abstract The present investigation reports an animal experiment the objective of which was to study the vascular topography of the periodontium and the peri‐implant soft and hard tissues in the beagle dog. 2 beagle dogs were used. The right mandibular premolars were extracted and healing allowed for 3 months. 2 titanium fixtures a.m. Brånemark were installed in the right premolar region. Abutment connection was performed 3 months later. The contra‐lateral mandibular sites were used as tooth harboring control units. A 4‐month period of meticulous plaque control was initiated. A clinical and radio graphical examination was performed towards the end of this period and revealed that the gingiva and peri‐implant mucosa were clinically healthy and that the bone tissue at teeth and implants had a normal height. The carotid arteries were perfused with a mixture of carbon and calf serum. 2 bucco‐lingual sections, about 100–150 film thick, and one mesio‐distal section comprising the Functional epithelium and underlying connective tissue were sampled. The sections were treated, cleared and examined in a microscope. The results of the present investigation demonstrated that the vasculature of the gingiva and the supracrestal connective tissue at teeth is derived from two sources, namely the supraperiosteal vessels lateral of the alveolar process and the vessels of the periodontal ligament. The blood vessels of the peri‐implant mucosa were found to be terminal branches of larger vessels orginating from the periosteum of the bone of the implant site. The microscopic examinations further revealed that in both the gingiva and in the peri‐implant mucosa, the blood vessels lateral to the junctional epithelium formed a characteristic “crevicular plexus”. While, however, the supracrestal connective tissue lateral to the root cementum was found to be richly vascularized, the corresponding site in the peri‐implant tissue was almost devoid of vascular supply.
The relation of preventive dental behaviors to periodontal health status
Authors: Lang W. Paul , Farghaly Mahassen M. , Ronis David L.
Published: December 2005

Abstract Current recommendations for periodontal health maintenance emphasize toothbrushing, flossing and periodic dental checkups. The purposes of this study were to examine (1) the effects of these practices on periodontal health and (2) the relationships of demographic and socioeconomic variables with these behaviors and with periodontal health. Adults (n= 319) in the Detroit, Michigan tri‐county area were asked how frequently they performed the 3 preventive behaviors. Levels of plaque, gingivitis, calculus, and periodontal attachment were then assessed during in‐home dental examinations. There were no statistically significant differences in these health measures between those with acceptable and unacceptable brushing behavior. About 20% of the subjects reported acceptable flossing behavior, and these individuals had significantly less plaque and calculus than other participants. Over 3/4 of subjects reported having a dental checkup at least 1 × a year, and these persons were found to have significantly less plaque, gingivitis, and calculus compared to less frequent attenders. Acceptable brushing behavior was not associated with any particular demographic or socio‐economic characteristic, while differences in acceptable flossing behavior were found among age groups. Frequencies of yearly dental checkups varied significantly within every demographic and socioeconomic characteristic.
Microorganisms in polytetrafluoroethylene barrier membranes for guided tissue regeneration
Authors: Nowzari Hessam , Slots Jorgen
Published: December 2005

Abstract This study examined the microflora in 11 barrier membranes around teeth with furcation involvement or 2 to 3 wall intrabony defects and in 16 membranes around implants with various types of bony defects. Total viable counts and the occurrence of selected microbial species were determined by non‐selective and selective culture and by DNA probes. Study sites were examined for probing pocket depth and attachment level. All tooth‐associated membranes yielded high levels of microorganisms. 4 of 5 teeth with membranes harboring less than 10s organisms gained 3 mm or more in probing attachment, whereas 6 teeth with membranes with more than 108 organisms exhibited loss or only small gains in attachment. 3 membranes with high levels of black‐pigmented anaerobic rods lost 1 to 2 mm of attachment. Ten implant‐associated membranes with no cultivable microorganisms demonstrated a mean probing gain of 4.9 mm. 6 implants with infected membranes only gained an average of 2.0 mm of supportive bone. The present findings underscore the importance of controlling or eliminating periodontal pathogens on barrier membranes in order to gain new attachment.
Treatment of furcation defects
Authors: Andersson Berit , Bratthall Gunilla , Kullendorff Boel , Gröndahl Kerstin , Rohlin Madeleine , Attström Rolf
Published: December 2005

Abstract The present study was designed to compare the healing results after treatment of buccal class II furcation defects in mandibular molars utilizing guided tissue regeneration (GTR) technique or coronally positioned flap (CPF) technique. The patient sample consisted of 8 subjects with 18 bilateral furcation defects in mandibular molars. At baseline, 6 and 12 months postoperatively assessments of plaque index, gingival index, probing pocket depths, probing attachment level and bleeding on probing were recorded. Radiographic assessment was performed using conventional radiographs and subtraction images at baseline and 12 months postoperatively. The furcation defects were randomly assigned in each patient to either the GTR or the CPF technique. 12 months postoperatively, there was a statistically significant reduction in probing pocket depths in the GTR treated teeth and a tendency to gain of probing attachment levels 6 months postoperatively. The CPF group showed a statistically significant reduction of probing pocket depths at 6 months and a tendency to reduction after 12 months. The radiological assessment demonstrated gain of interradicular bone tissue in 2 furcation defects of the GTR group. Gain of bone tissue could not be demonstrated in the CPF group. No statistically significant differences were observed between the 2 treatment modalities.
Dose response of chlorhexidine against plaque and comparison with triclosan
Authors: Jenkins S. , Addy M. , Newcombe R. G.
Published: December 2005

Abstract The optimum dose of chlorhexidine delivered by mouthrinse, which balances efficacy against local side‐effects, is generally considered to be in the region of 20 mg 2 × daily. Unfortunately, there have been few dose‐response studies for chlorhexidine mouthrinses and for these, only limited details are published. The aims of this study were to determine the dose response of chlorhexidine to plaque inhibition and position a 0.1% triclosan rinse within this model. 28 subjects took part in this 7‐treatment, double‐blind, randomised cross‐over 4‐day plaque regrowth study. The rinses were 0.01%, 0.05%, 0.1% and 0.2% chlorhexidine, 0.1% triclosan and minus active controls for chlorhexidine and triclosan. On day 1 from a zero plaque baseline, volunteers suspended tooth‐cleaning and commenced supervised 2 × daily rinsing with 10 ml volumes of the allocated rinses. On Day 5, plaque was scored by index and area. Treatment differences between the 7 rinses were highly significant. A clear dose‐response pattern was seen for chlorhexidine with mean plaque scores decreasing with increasing dose. Even at 0.01%. chlorhexidine showed considerable and significant plaque inhibition compared to control. Triclosan at 0.1% showed limited plaque inhibition and less than 0.01% chlorhexidine. The findings of this study suggest that consideration could be given to low concentration chlorhexidine rinses as adjuncts to oral hygiene.
Effects of denture‐wearing habits on periodontal health of abutment teeth in patients with overdentures
Authors: Budtz‐Jörgensen E.
Published: December 2005

Abstract The effect of denture‐wearing habits was studied in 31 overdenture wearers (17 day‐and‐night wearers, 14 day wearers) during a period of 5 years with controlled oral hygiene. Prior to prosthetic treatment, intensive instruction and motivation in oral hygiene were carried out and the patients were recalled 2–4 × yearly during the study period. Before treatment, mean plaque index (P1I) and gingival index (GI) were 1.5 and 1.6, respectively, in both groups of patients. During the study period, mean P1I and GI were 0.3‐0.6 and 0.6‐0.8. respectively, in the group of day wearers and 0.5–1.0 and 1.0–1.2. respectively, in the group of day‐and‐night wearers. With regard to the GI, this difference was statistically significant. Furthermore, during the study period, 20% of the abutment tooth surfaces showed attachment loss (1–4 mm) in the group of day‐and‐night wearers against 8% of the tooth surfaces in the group of day wearers. This difference was statistically significant. During the 5 years, 40 carious lesions developed in the group of day‐and‐night wearers against 3 in the group of day wearers. The results of this study have shown that day‐and‐night wearing of dentures is a major periodontitis and caries risk factor in complete overdenture wearers with controlled oral hygiene.
Amlodipine‐induced gingival overgrowth
Authors: Seymour R. A. , Ellis J. S. , Thomason J. M. , Monkman S. , Idle J. R.
Published: December 2005

Abstract Amlodipine is a calcium channel blocker used in the management of angina and hypertension. We report 3 cases of gingival overgrowth in adult dentate patients associated with chronic usage of this drug. Gingival changes occurred within 3 months of dosage and appeared to be compounded by the patient's existing periodontal condition. In all 3 patients, there was sequestration of amlodipine in their crevicular fluid. The significance of this finding in relation to the pathogenesis of this unwanted effect remains to be elucidated.
The recovery efficiency of various materials for sampling enzymes and polymorphonuclear leukocytes from gingival crevices
Authors: Nakashima Koichi , Demeurisse Christiane , Cimasoni Giorgio
Published: December 2005

Abstract The present investigation was designed to assess the effects of strips made of different materials on the recovery of enzymes in gingival crevicular fluid (GCF) (Experiment 1), and to examine a possible relationship between lysosomal enzyme activities and number of crevicular polymorphonuclear leukocytes (PMNs) (Experiment 2). In Experiment 1, GCF was collected with capillaries from 14 patients with periodontal disease, and applied on various test strips in microcentrifuge tubes or directly into tubes (controls). Strips were then shaken and centrifuged to elute GCF enzymes. The supernate was used for determinations of alkaline phosphatase (ALP), β‐glucuronidase (BG) and aspartate aminotransferase (AST) activities. The % recoveries were calculated as relative percentages to controls. When using saline as eluent, 90% or more ALP, BG and AST were found to be recovered from strips of durapore and papers. More than 35% of ALP and BG was found to remain on paper points. However, the % recoveries from paper points were improved using eluent with 0.1% (w/v) cetyl pyridinium chloride. In Experiment 2, 54 GCF samples were collected from 3 periodontitis patients by using durapore strips, in order to measure both PMN numbers and BG activities in the same samples. The 2 parameters showed strong and positive correlation with 0.847 (p<0.001) of the Pearson's correlation coefficient. These findings suggest that durapore is a useful material not only for counting PMNs but also for measuring activities of GCF enzymes. Elevation of BG activities in GCF can be due to increasing numbers of PMNs.
Patient compliance with maintenance therapy in an Italian periodontal practice
Authors: Checchi Luigi , Pelliccioni Gian Andrea , Gatto Maria Rosaria Antonella , Keiescian Luisa
Published: December 2005

Abstract. A sample of 414 patients, treated between 1985 and 1988 by an Italian periodontal practice for supportive periodontal therapy, was studied to determine compliance with recommended maintenance programmes. Patients included in the study had attended for supportive periodontal therapy for at least 1 year prior to the close of data collection in 1989. Based on their compliance with the suggested maintenance schedule, patients were classified as complete attending (100% of programmed visits), partial (at least 50% of programmed visits), or insufficient (less than 50% of programmed visits). Only 30%) of the initial patient sample was found to be compliant at the end of 1989. Complete compliance decreased as the number of years after active therapy increased, from 38% at 1 year to 20% at 4 years. The % of patients with insufficient compliance increased from 37% to 46% from the 1st to the 2nd year, then remained stable over the following years, indicating that the 1st year represented the critical period when subjects decided whether to follow recommended maintenance therapy. No significant relationships were found between degree of compliance and patient gender, recall schedule or type of treatment procedure performed. However, complete compliant subjects were younger than the other groups (p<0.03), and compliance increased with the number of surgeries (p<0.002).
The effect of mouthrinses containing zinc and triclosan on plaque accumulation and development of gingivitis in a 3‐week clinical test
Authors: Schaeken M. J. M. , van der Hoeven J. S. , Saxton C. A. , Cummins D.
Published: December 2005

Abstract. Experimental mouthrinses containing 0.4% zinc sulphate and 0.15% triclosan were compared with a chlorhexidne and a negative control mouthrinse in a 3‐week clinical trial. The zinc/triclosan mouthrinses 1 and 2 differed in their ethanol and humectant contents used to deliver the triclosan. The experimental protocol employed the partial mouth gingivitis design, whereby participants wear a toothshield during toothbrushing. Gingival health at baseline was established by professional cleaning, oral hygiene instruction and effective toothbrushing 3 × per day during a pre‐experimental period of 2 weeks. The mouthrinses were subsequently used 2 × daily following normal toothbrushing during 3 weeks. The pre‐experimental oral hygiene phase very effectively reduced plaque levels and gingival bleeding. During the rinsing period, in the absence of mechanical removal of plaque from the protected teeth, gingival bleeding rose to above the prestudy level in the negative control group. The increments (change from baseline to 21 days) of plaque and bleeding scores for the zinc/triclosan mouthrinse 1 were significantly lower than those in the negative control group. As expected, plaque and gingivitis scores were lowest in the group that rinsed with chlorhexidine. The results extend previous observations on the efficacy of the zinc/triclosan system to maintain gingival health.
The magnitude and duration of the effects of some mouthrinse products on salivary bacterial counts
Authors: Jenkins S. , Addy M. , Wade W. , Newcombe R. G.
Published: December 2005

Abstract. The persistence of action or substantivity of an antimicrobial agent in the mouth relates to the plaque inhibitory action of that compound. Substantivity can be assessed by measuring the magnitude and duration of the fall in salivary bacteria following single rinses with antimicrobials. This was a randomised single‐blind, cross‐over study measuring the effects of single 60‐s rinses of 5 mouthwash products on salivary bacterial counts in 14 healthy human volunteers. Effects over a 7‐h period were compared with a chlorhexidine rinse product (positive control) and saline (negative control). All but one rinse, containing cetylpyridinium chloride (CPC), significantly reduced bacterial counts compared to saline up to 5–7 h. No rinse produced the magnitude or duration of effect noted for chlorhexidine and decrements from baseline, with one exception, were highly significantly lower than with the chlorhexidine product. Comparing the 2 CPC rinses, the findings suggest that the activity of one product was vitiated by some other ingredient. The triclosan/copolymer, the essential oil/phenolic and one CPC products exhibited similar persistence. In those cases where information is available, these data are consistent with comparative plaque inhibitory findings for the products or their active ingredients. Again, it is concluded that the method is a useful screening and comparison test for the potential plaque inhibitory activity of antimicrobial oral hygiene products.
Comparison of different approaches to assess bleeding on probing as indicators of gingivitis
Authors: Van der Weijden G. A. , Timmerman M. F. , Nijboer A. , Reijerse E. , Van der Velden U.
Published: December 2005

Abstract. The purpose of this study was to evaluate different methods of eliciting gingival bleeding as indicators of gingival inflammation in the experimental gingivitis model. Following a period of stringent oral hygiene, 103 dental students were scored for plaque and gingival bleeding assessed by 4 methods. From this group, 41 volunteers were randomly allocated to 2 treatment groups. Dental students with clean teeth and healthy gingivae were asked to abolish all mechanical tooth cleaning in the lower jaw for a period of 3‐weeks. During the 21‐day experimental period, chlorhexidine (Peridex®) or a placebo mouthrinse was applied to the lower jaw. Subjects brushed the upper jaw with a standard toothpaste. In principal, 2 different methods were employed to provoke bleeding: (1) at the marginal gingival tissue by running a probe along the soft tissue wall at the orifice of the pocket, and (2) by probing to the “bottom” of the pocket. Variations in the methods were based on angulation (AngBI, ParBI) of the probe in relation to the tooth surface and to the probing force (PPBI.25N, PPBI.757V). 1 randomly selected quadrant in the lower jaw was scored using the AngBI. The opposing quadrant was scored with a randomly‐allocated bleeding index, either ParBI, PPBI.25N or PPBI.75N. The results of this study confirm earlier findings that the angulation of the probe determines the number of sites with bleeding observed. It also indicates that bleeding as elicited by probing to the bottom of the pocket is a poor indicator of early gingivitis. It is recommended that gingivitis should be assessed by probing the marginal gingiva.
Periodontal regeneration of infrabony defects (V). Effect of oral hygiene on long‐term stability
Authors: Cortellini Pierpaolo , Pini‐Prato Giovanpaolo , Tonetti Maurizio
Published: December 2005

Abstract. The aim of this investigation was to assess the role of supportive periodontal care in the maintenance of clinical attachment gained, after surgical treatment according to the principles of GTR, in deep infrabony defects. Following GTR treatment, 40 deep infrabony defects in 23 patients gained 4.1 mm of probing attachment level (PAL) after 1 year of stringent plaque control. In the subsequent 3 years, 15 patients (22 sites, group A) were recalled every 3 months. In this group, the gained attachment level remained stable. Conversely, 8 patients (18 sites, group B), who received only sporadic care, lost at 4 years, 2.8±2.7 mm of the PAL gained at 1 year. Group A patients had significantly lower full mouth plaque and bleeding scores than group B at 4 years. Furthermore, detection of bleeding on probing, plaque, P. gingivalis and P. intermedia was significantly more frequent in regenerated sites of group B patients. Risk assessment analysis indicated that GTR sites in patients receiving only sporadic care had a 50‐fold increase in risk of PAL loss between 1 and 4 years with respect to patients undergoing regular recall. It was concluded that stability of gained clinical attachment was dependent upon stringent oral hygiene.
The effect of porcelain laminate veneers on gingival health and bacterial plaque characteristics
Authors: Kourkouta S. , Walsh T. T. , Davis L. G.
Published: December 2005

Abstract. The aim of this study was to evaluate the response of microbial plaque and gingival inflammation to the placement of porcelain laminate veneers on anterior teeth. 9 patients, 7 female and 2 male (mean age of 30 years), with a total of 35 veneers were examined. The volume of gingival crevicular fluid (GCF), level of neutral proteolytic enzyme activity, gingival index (GI), plaque index (PII) and plaque bacteria vitality were measured at baseline and after the placement of veneers. The volume of GCF increased after the placement of veneers (p=0.03). No statistically significant differences were found in proteolytic enzyme activity or GI (p>0.05). There were statistically significant reductions in PII (p=0.000) and plaque bacteria vitality (p=0.018). Further research is required to assess the long‐term influence of porcelain laminate veneers on gingival health and microbial plaque characteristics.
Service mix in general dental practices employing and not employing dental hygienists
Authors: Brown Louise Frances , Spencer Andrew John , Keily Pamela Anne
Published: December 2005

Abstract Service mix studies conducted in Australia have indicated a low provision of periodontal services. The service mix in Australian general dental practices employing dental hygienists has not been studied. This study compares the service mix between 18 practices employing hygienists and 29 practices not employing hygienists in Adelaide. Practices employing hygienists tended to be larger group practices, with younger dentists seeing a younger set of patients. Practices employing dental hygienists provided a mean of 97.9 services to 57.2 patients over 2 days, significantly higher than the mean of 68.8 procedures to 39.1 patients in practices not employing dental hygienists. Comparing the % of procedures provided in treatment categories as a ratio of total procedures, practices employing dental hygienists provided significantly more periodontal procedures and less oral surgery, prosthetic and restorative procedures. Periodontally‐related services accounted for an average of 37.7% of procedures in practices employing dental hygienists compared with 18.9% in practices not employing dental hygienists (p(0.05). Periodontal and preventive treatment of 50.7%) of patients in practices employing hygienists was delegated to a hygienist, and the level of delegation of periodontally‐related procedures was 77.2%. Over 90% of procedures performed by hygienists were periodontally‐related, with the removal of subgingival calculus accounting for 57.7% of all procedures provided by dental hygienists. In conclusion, practices employing hygienists had a more periodontally‐orientated service mix, with hygienists acting to complement the services of dentists in the provision of periodontal services, rather than as a substitute for the dentist.
Effect of a new pre‐brushing rinse on dental plaque removal
Authors: Vouros J. , Sakellari D. , Konstantinidis A.
Published: December 2005

Abstract Non‐prescription prebrushing rinses to facilitate dental plaque removal have been advertised in recent years. The purpose of the present study was to determine the plaque removal effectiveness of Plax (Colgate) prebrushing rinse by comparing it to a placebo solution. 19 dental students volunteered for this double blind study which consisted of 2 experimental periods. The following procedure was followed: 3 weeks after scaling and polishing, the participants abstained from oral hygiene for 3 days to allow dental plaque to accumulate. After plaque disclosing, the 4 mandibular incisors were photographed using a strictly defined technique, as described by Quirynen et al. Then the volunteers mouthrinsed for 30 s with 15 ml of a solution provided to them. Neither the volunteers nor the examiners knew which solution (test or control) was used. After mouthrinsing, the participants were allowed to brush their teeth and the remaining plaque was photographed again. During the 2nd experimental period, the same procedure was followed, and the 2nd solution was used for mouthrinsing. The effectiveness of the solutions was evaluated by comparing the proportion of dental plaque removed during the 2 experimental periods. The area of dental plaque was measured by an electronic high–precision device (planimeter). The proportion of plaque removed after rinsing with Plax was 0.40±0.23 and after rising with placebo 0.42±0.24, of the tooth surface (p=0.962). Analysis of data by means of paired t‐test between the 2 experimental periods revealed no beneficial effect regarding plaque removal when Plax was used.
Chronic lymphocytic leukaemia with gingival and palatal deposits
Authors: Porter S. R. , Matthews R. W. , Scully C.
Published: December 2005

Abstract The oral features of a patient with notable maxillary and mandibular gingival enlargement secondary to leukaemic infiltration in chronic lymphocyte leukaemia are presented.
Increased collagen degradation by experimentally‐induced granulation tissue inoculated with bacteria
Authors: Åsman Björn , Wijkander Peter , Hjerpe Anders
Published: December 2005

Abstract Periodontitis is characterized by asymptomatic periodic collagen degradation, which is accompanied by the formation of granulation tissue induced by bacteria. The lesions sometimes contain micro‐organisms and/or micro‐abscesses that are of unknown significance. The aim of this study was to determine whether bacteria in a sterile granulation tissue could enhance its collagenolytic capacity. The formation of granulation tissue was induced by implanting a cellulose sponge in the subcutaneous tissue in the back of the rat. Bacteria were injected every other day into the sponge from day 8 to day 18. The cell‐dependent degradation of a homologous 3H‐collagen powder enveloped in the sponge was measured by the radioactivity of the urine excreted 8–18 days after the implantation. The injections increased the excretion of radioactivity by about 40% compared with the controls (n=8, p0.005), but caused no clinical signs of acute infection or inflammation. On day 18, 2 days after the last injection of bacteria, no bacteria or increased cell infiltration were observed in the granulation tissue. The appearance of the latter could not be distinguished from that of the control tissues injected with buffer alone. It seems reasonable to assume that the increased collagen degradation results from enhanced activity of phagocytes, which may also be related to an increased release of tissue‐destructive proteases and free oxygen radicals into the extracellular space. In conclusion, brief recurrent episodes of bacteria in granulation tissue can increase its collagen degrading‐capacity. The latter may be due to augmented cell activity in the tissue. This response seems to have some features comparable to the pathogenesis of episodic periodontitis, e.g., by mimicking the collagen degradation.
Gingival crevicular fluid glycosaminoglycan levels in patients with chronic adult periodontitis
Authors: Smith A. J. , Addy M. , Embery G.
Published: December 2005

Abstract This study investigated levels of hyaluronan and chondroitin‐4‐sulphate in the crevicular fluid of patients with chronic adult periodontitis at diseased and healthy sites before and after treatment. The relationship between clinical diagnostic parameters and levels of glycosaminoglycans in gingival crevicular fluid were also analysed. Within each patient. 4 sites either mesial or distal and on single rooted teeth were classified as diseased or healthy using a modified gingival index, pocket depth and attachment loss. Crevicular fluid was collected from each site using glass micropipettes and analysed for glycosaminoglycan content by cellulose acetate electrophoresis. Significantly higher levels of chondroitin‐4‐sulphate were detected at diseased sites prior to treatment correlating with increased pocket depth or attachment levels. Following a period of treatment consisting of oral hygiene instruction and root planing, the patients were reassessed for their response to treatment by measuring the modified gingival index, pocket depth, attachment loss and levels of glycosaminoglycans. Analysis of glycosaminoglycan levels at diseased sites that demonstrated a poor response to treatment also demonstrated significantly higher levels of chondroitin‐4‐sulphate than those sites that responded well to treatment. Hyaluronan levels were less significantly associated with clinically succesful treatment. This study confirmed the use of the sulphated glycosaminoglycan chondroitin‐4–sulphate as a potential diagnostic aid of periodontal tissue destruction; however, further longitudinal studies are required to assess their performance.
Bacterial resistance following subgingival and systemic administration of minocycline
Authors: Preus Hans R. , Lassen Jørgen , Aass Anne M. , Ciancio Sebastian G.
Published: December 2005

Abstract The aim of the present study was to compare total numbers of cultivable bacteria and prevalence of resistance to minocycline among periodontal bacteria following subgingival or systemic application of minocycline in patients suffering from periodontal disease. 10 adult patients were administered 2% minocycline ointment subgingivally into their periodontal pockets at baseline, week 2 and months 1,3,6 and 9. Patients had scaling/root planing at baseline and month 6. In addition, 10 patients undergoing scaling/root planing followed by a 10‐day course of systemic minocycline therapy, were studied and compared with the subgingival application group. Bacterial samples were taken from the 4 deepest pockets before each subgingival application of the drug. The systemic administration group was sampled at baseline and at week 2, as well as months 1 and 3 after completing the antibiotic treatment. For each patient at each sampling, bacterial samples were pooled, diluted, seeded on parallel blood agar plates and incubated aerobically and anaerobically. After incubation, 30 colonies were picked at random and transferred to blood agar plates supplemented with 10 μg/ml minocycline, to estimate prevalence of minocycline‐resistant bacteria. The results of this study indicate that subgingival application of minocycline ointment resulted in an initial reduction in total numbers of cultivable bacteria, which then remained depressed during the full year of the study. No such observation was made in the systemic administration. Both in the subgingival and the systemic administration group, the % of cultivable aerobic and anaerobic minocycline‐resistant bacterial strains increased transiently following administration of the drug, but returned to baseline levels within 3 months post‐treatment. The median of cultivable aerobic minocycline‐resistant bacterial strains decreased or remained unchanged in both groups during the study periods. Thus, subgingival application of minocycline seems no more likely than systemic administration of the drug to select for an increased proportion of resistant organisms in the periodontal pockets.
A radiographic survey of periodontal conditions in Greece
Authors: Diamanti‐Kipioti A. , Afentoulidis N. , Moraitaki‐Tsami A. , Lindhe J. , Mitsis F. , Papapanou P. N.
Published: December 2005

Abstract The present study used radiographic assessments to evaluate the pattern of destructive periodontal disease in a rural and an urban sample of 25—64 year old Greek adults. The rural sample (A) comprised 190 subjects and the urban sample (B) 400 subjects. 13% of the subjects in sample A and 8% in sample B were edentulous. Full‐mouth intraoral radiographs were obtained from the 503 dentate subjects and were examined with respect to (i) number and type of teeth present, and (ii) alveolar bone level (ABL), i.e., the distance between the cementoenamel junction and the alveolar bone crest at the approximal tooth surfaces. The results revealed that alveolar bone loss was ubiquitous in both samples. Pronounced bone loss, however, (i.e., a subject mean ABL of >6 mm) affected 18% (sample A) and 8% (sample B) of the individuals. Although an ABL of >6 mm was scored at 7.2 sites/subject in sample A and at 4.5 sites/subject in sample B, more than 10 such sites were found in 23% (A) and 11% (B) of the examined subjects. 25%) of the subjects in the rural sample (A) and 12% in the urban sample (B) accounted for 75% of the total number of tooth sites with pronounced bone loss. Multiple regression revealed that age and number of remaining teeth were the parameters most strongly correlated with the amount of bone loss on both the individual subject and the tooth site level. The present findings (i) demonstrated a high prevalence and severity of destructive periodontal disease in these 2 samples, and (ii) confirmed the skewed distribution of advanced disease in the population.
The relationship between alveolar bone height and age in the primary dentition
Authors: Shapira Llor , Tarazi Eyal , Rosen Lea , Bimstein Enrique
Published: December 2005

Abstract The natural history of changes in attachment level in the primary dentition should be determined before considering diagnostic criteria for periodontal diseases in children. The present study was designed to describe longitudinal changes in the distance between the alveolar bone crest and the cementoenamel junction (ABC‐CEJ) determined radiographically. Bite‐wing radiographs were obtained from 33 children as part of a routine annual dental examination in a rural community. The ABC‐CEJ distance of 1500 sites located at the mesial and distal aspects of primary molars and distal aspect of primary cuspids were measured. An analysis of variance model was used to assess the effect of age, sex, tooth, side of the mouth, jaw, site and patient on the ABC‐CEJ measurements. The side of the mouth (left, right) and the site (mesial, distal) had no significant effect on the ABC‐CEJ distance. ABC‐CEJ distances in the upper jaw were greater than in the lower jaw, and different teeth exhibited different ABC‐CEJ distances. Canines had the greatest distance and second molars the smallest. The most interesting relationship was between alveolar bone height and age. The overall ABC‐CEJ distance seemed to increase with age; however, this was not a linear relationship but followed the pattern of facial growth, with two spurts separated by a period of minimal increase. The results indicate that different levels of ABC‐CEJ distance might be considered as a cut‐off value for radiographic diagnosis of alveolar bone loss at different ages, for different primary teeth and for different jaws.
The effect of oxidising mouthrinses compared with chlorhexidine on salivary bacterial counts and plaque regrowth
Authors: Moran J. , Addy M. , Wade W. , Milson S. , McAndrew R. , Newcombe R. G.
Published: December 2005

Abstract For various clinical indications, oxidising agents have been used in dentistry for many years. Little is known, however, of their antibacterial activity and their ability to inhibit plaque formation. In this study, 2 mouthrinses containing peroxyborate (Bocasan) and peroxycarbonate (Kavosan) were compared alongside a negative control saline rinse and a positive control chlorhexidine rinse (Corsodyl) for their ability to inhibit plaque reformation. Employing a randomised four replicate 4x4 latin square cross over design and, whilst omitting all other oral hygiene, plaque was measured by area and index after rinsing for 4 days. In a second study, in vivo antibacterial effects of the rinses were assessed by measuring salivary bacterial counts following single rinses with the preparations at various time intervals over 7 h, Plaque inhibition by chlorhexidine was significantly greater than the other rinses. All rinses were significantly better than the saline rinse at inhibiting plaque. For plaque area, the peroxycarbonate rinse was significantly better than the peroxyborate rinse at inhibiting plaque. Salivary bacterial count reductions were significantly greater compared to saline with chlorhexidine at all time intervals up to 7 h. Whilst both peroxyborate and peroxycarbonate rinses produced greater reductions in bacterial counts than saline up to 3 h, at no time interval were the differences significant. The findings of these studies would suggest oxidising mouthrinses may inhibit plaque formation not by a direct antibacterial effect, but by some other mechanism. The magnitude of plaque reductions obtained with the peroxyborate and more so peroxycarbonate rinses would suggst a need for further study of these preparations when used as adjuncts to normal toothbrushing.