bluuebunny/crossref_metadata_2025_split huggingface dataset:
New attachment formation on teeth with a reduced but healthy periodontal ligament
Authors: Karring Thorkild , Isidor Flemmino , Nyman Sture , Lindme Jan 
Published: December 2005

Abstract The present investigation was undertaken to examine whether a new connective tissue attachment will form on previously periodontitis‐involved roots when a reduced but healthy periodontal ligament tissue persists following periodontal treatment and the epithelium is prevented from migrating into the wound.In each of 4 monkeys, periodontal tissue breakdown was induced around one maxillary and one mandibular second premolar or first molar by placing orthodontic elastics around the teeth. The elastics were kept in situ until about 50% of the supporting tissues had been lost. 3 months following removal of the elastics, the crowns of the teeth were resected. The pocket epithelium and subjacent granulation tissue were excised and the cementum of the periodontitis‐involved part of the roots was removed using a diamond bur. The roots were covered with a mucosal flap. The animals were sacrificed after 3 months of healing. The jaws were removed and histological sections of the experimental roots including their surrounding periodontal tissues were produced.The microscopic analysis disclosed that in all roots, new cementum with inserting collagen fibers had formed in the apical portion of the previously exposed root surfaces. It was always in continuity with the original cementum layer apical to the instrumented part of the root and was thickest in its apical portion, becoming gradually thinner in the coronal direction. In the roots, which for the entire length of the study remained covered by the oral mucosa, the extension in the coronal direction of this newly formed fibrous attachment amounted to an average of 1.0 mm with a range from 0.1 mm to 2.6 mm. These findings were interpreted to mean that new attachment in formed by coronal migration of cells originating from the periodontal ligament.
Effects of short‐term administration of metronidazole on the subgingival microflora
Authors: Giedrys‐Leeper Elaine , Selipsy H. , Williams B. L. 
Published: December 2005

Abstract The effect of a 5‐day course of systemic metronidazole was investigated in 11 recall maintenance patients over a period of 3 months. Crevicular fluid flow, bleeding on probing, pocket depth, and composition of the subgingival microbiota as observed by dark‐field microscopy, were measured.The study design allowed patients to act as their own controls. At baseline 1 (day 0), each patient had a randomly assigned quadrant scaled and root‐planed, and received oral hygiene instruction. Microbiological and clinical parameters were measured at baseline 1 (before treatment) and at 3, 6, and 12 weeks in both the root‐planed and a designated no‐treatment quadrant. At baseline 2 (12 weeks), the contralateral quadrant was scaled and root‐planed, and the oral hygiene instruction was reinforced. At this appointment, each patient was given 15 metronidazole tablets (250 mg), 1 to be taken 3 times per day for 5 days. At the end of this period, patients were seen 1–2 h after taking their last tablet, and blood and crevicular fluid samples were taken lo determine the concentration of metronidazole by microbiological assay in the serum and crevicular fluid. Microbiological and clinical parameters were measucd at baseline 2 (before treatment) and at 13, 15, 18, and 24 weeks in both the root‐planed and designated non‐root‐planed (metronidazole only) quadrants.Results demonstrated, that in this group of recall maintenance patients, metronidazole was no more effective than root‐planing alone in reducing the relative % of total motile organisms and spirochetes in 5–8 mm pockets. Crevicular fluid flow was, however, significantly reduced for 11 weeks; serum and crevicular fluid levels of metronidazole were similar 1 to 2 h after drug ingestion.
Periodontal conditions in adolescents with cleft lip, alveolus and palate following treatment in a co‐ordinated team approach
Authors: Brägger U. , Schürch E. , Gusberti F. A. , Lang N. P. 
Published: December 2005

Abstract The aim of the present investigation was to evaluate the oral hygiene habits and the periodontal conditions of a group of cleft lip, alveolus and palate patients at the end of a longitudinal multidisciplinary treatment. From a total of 120 patients who had been supervised at the University of Berne, Clinic for Pediatric Surgery for at least 18 years in a co‐ordinated team approach, 80 were selected on the basis of availability. Plaque control record (PCR), calculus index (CI), gingival bleeding index (GBI), pocket probing depth (PD), loss of attachment (LA) and furcation involvement were recorded. Using the technique and the ruler described by Schei et al., the radiographic height of the alveolar crest from the cemento‐enamel junction was determined.Between the different groups of deformities, no statistically significant differences were found for all the clinical parameters with the exception of the mean PD orally and the mean PD bucally which were shallower in the isolated cleft lip group. These differences were attributed to the long‐term orthodontic therapy with fixed appliances.When the PD and the LA at the sites adjacent to the cleft region were compared to two “unaffected” control sites, no statistically significant differences were found, whereas the comparison with the radiographic bone loss showed a statistically significant lower bone height. These results may indicate the presence of a long connective tissue attachment without bony support in the cleft region.As a result of inadequate oral hygiene, the patients with cleft lip, alveolus and palate showed beginning periodontitis with loss of attachment and beginning furcation involvement in most of the cases. Since these patients need long‐term orthodontic therapy with fixed appliances, they should be incorporated in intensive prophylaxis programs as early in age as possible.
Healing after treatment of periodontal intraosseous defects
Authors: Durwin A. , Chamberlain H. , Garrett Steven , Renvert Stefan , Egelberg Jan 
Published: December 2005

Abstract 2 regenerative surgical approaches using citric acid conditioning, were compared in the treatment of deep intraosseous periodontal defects. The first approach was non‐resective in that no osseous tissue was removed. The second, a partially resective approach, involved reduction of the osseous defect depth by removal of some supporting bone. 16 patients and a total of 26 defects, with probing pocket depth ≥7 mm. were included in the study. The depths of the corresponding osseous defect, as revealed during surgery were ≥5 mm.The results demonstrated mean gains in probing attachment level of 0.7 mm for the partially resected group and 1.1 mm for the non‐resected group. Corresponding gains in probing bone levels were recorded in the defect sites for each group. Probing pocket depth was reduced from 7.5 mm to 4.0 mm in the partially resected group and from 7.9 mm to 5.3 mm in the non‐resected group. Both procedures caused loss of attachment and bony support from adjacent tooth surfaces involved by the surgical procedure. Slightly more loss of attachment and bone was experienced by the partially resected group (range 1.2–1.5 mm) than by the non‐resective group (range 0.1–0.9 mm).
Healing after root reimplantation in the monkey
Authors: Houston Frank , Sarhed Gun , Nyman Sture , Lindhe Jan , Karring Thorkild 
Published: December 2005

Abstract The aim of the present investigation was to evaluate the regenerative potential of the periodontal tissues following tooth reimplantation using a model which excluded the dentogingival epithelium from the process of healing. Maxillary and mandibular incisors, premolars and molars of 5 monkeys were used. Following root filling of all experimental teeth, the teeth were divided into 3 experimental groups. In I group, the teeth were extracted following the elevation of full thickness flaps. The crowns were separated from the roots at the level of the buccal cementoenamel junction and the roots immediately reimplanted into their sockets. The flaps were replaced and sutured to accomplish complete coverage of the roots. In a 2nd group, the teeth were subjected to the same experimental procedure, but in addition, the buccal alveolar bone was removed to about half its original height prior to root reimplantation. The teeth of the 3rd group were subjected to identical experimental procedures as for group II with the addition that the buccal root surfaces were planed to the level of the surgically created bone crest. The animals were sacrificed after 6 months of healing. The jaws were removed and histological specimens prepared for microscopic examination.The results showed that a complete fibrous re‐attachment formed onto roots on which the original periodontal ligament tissue was preserved. This occurred irrespective of whether the roots were reimplanted into sockets with normal (group I) or reduced (group II) bone height. When the original periodontal ligament tissue was removed by root planing before reimplantation (group III), healing resulted in a significant amount of new connective tissue attachment. However, coronal to the newly formed fibrous attachment, the root surface frequently showed signs of resorption and particularly so in those roots which remained covered by the soft tissue during the entire course of healing. In the majority of the roots which perforated the covering soft tissue during the early phase of healing, the dentogingival epithelium had migrated apically into contact with the coronally generated fibrous attachment. In these cases, root resorption was never discernible. New bone formation occurred to a variable extent in the roots of groups II‐III. No relationship was found, however, between the amount of connective tissue reattachment or new attachment and newly formed alveolar bone, which in turn indicates that bone tissue regrowth and periodontal ligameni regeneration are unrelated phenomena.
The effect of Keyes' method of oral hygiene on the subgingival microflora compared to the effect of scaling and/or surgery
Authors: Greenwell H. , Bakr A. , Bissada N. , Debanne S. , Rowland D. 
Published: December 2005

Abstract. The present study was conducted on 18 individuals to determine if Keyes' method of oral hygiene would present an alternative to traditional periodontal therapy in terms of establishing a subgingival microflora compatible with periodontal health. Oral hygiene, gingival conditions and subgingival microbial proportions assessed by dark field microscopy were measured at baseline, then once every 2 weeks for the remainder of this 8‐week study. In addition, probing depths and bleeding on probing were evaluated. Group I (9 patients) was treated non‐surgically, while Group II (9 patients) had received surgical therapy within the last 4 years. Both groups received routine scaling and root planing (Sc/RP) on one arch at time 0. and both were instructed To use Keyes' method of oral hygiene on one side of the mouth while the other side served as a control. This yielded a split‐plot experimental design which permitted examination of the effects of Keyes' method of oral hygiene. Sc/RP and surgery.The results revealed no statistically significant differences between Keyes' method of oral hygiene and conventional oral hygiene in patients treated with a single session of Sc/RP, When scaling was not employed, Keyes' method was more effective than conventional oral hygiene. Surgical status was found to be the most significant factor in reducing clinical indicator values and establishing control of the subgingival microflora.In summary, oral hygiene alone had only minimal effects on subgingival microbial proportions. The primary antimicrobial effect observed, as evidenced by shifts in subgingival morphotype proportions, was produced by the Sc/RP procedure. This effect was enhanced by improved access (surgical status).
Frequency distributions of periodontal attachment loss Clinical and microbiological features
Authors: Haffajee A. D. , Socransky S. S. 
Published: December 2005

Abstract The present investigation attempted to determine if the pattern of past periodontal destruction could be (1) concisely summarized, and (2) related to other clinical and microbiological parameters. 61 subjects between the ages of 12 and 61 years with destructive periodontal disease were evaluated at 6 sites per tooth for redness, plaque, suppuration, bleeding on probing, pocket depth, and attachment level. The frequency distribution of baseline attachment level measurements was computed for each individual. A curve fitting algorithm was used to fit the frequency distribution to 1‐, 2‐, and 3‐term normal distributions. The parameters of the fit could be used to summarize concisely all of the frequency distributions.3 major patterns of attachment loss could be distinguished. Pattern I required a two‐term distribution with localized destruction at < 34% of sites and was further divided into 3 groups, depending on average attachment loss at diseased sites. The means of the second peak for the subgroups were 2.7, 5.3, and 8.6 mm, respectively. Pattern II exhibited more widespread disease (>33% of sites affected) with multiple peaks in the frequency distribution requiring a 3‐term distribution for satisfactory fit. However, a significant proportion of sites was not affected. Pattern III exhibited a single‐peaked normal distribution in which virtually all sites were affected. Mean attachment levels of the peaks in this group ranged from 2.7 to 8.4 mm.23 of the 61 subjects showed significant attachment loss at 1 or more sites during the course of bi‐monthly monitoring, as determined by the tolerance method of analysis. Subgingival plaque samples were taken from these active sites and matched with control sites prior to therapy. The proportions of Fuso‐bacterium nucleatum, Streptococcus intermedius, and Eikenella corrodens were significantly elevated in active and control sites of subjects in groups II and III combined (the widespread disease groups), and proportions of Actinobacillus actinomycetemcomitans and Propionibacterium acnes were elevated in active and control sites of the more localized disease group I subjects. Group I subjects showed a 13‐to 15‐fold decrease in hazard rates of periodontal sites after Widman flap surgery and systemic tetracycline, whereas groups II and III subjects showed 2‐to 6‐fold decreases.
Failure of a microbial assay to reliably predict disease recurrence in a treated periodontitis population receiving regularly scheduled prophylaxes
Authors: Listgarten M. A. , Schiller C. C. , Sullivan P. , George C. , Rosenberg E. S. 
Published: December 2005

Abstract The purpose of this study was to evaluate the reliability of differential dark‐field microscopy (DDFM) of subgingival bacteria to correctly predict the recurrence of periodontitis in treated patients on 2 different recall schemes. The results are based on data from 51 patients on 3‐month recalls (C group) and 39 patients (T group) who received periodontal prophylaxes according to a customized regimen based on DDFM of subgingival bacterial morphotypes. No significant differences were detected in the rate of recurrence of periodontitis between the 2 groups, although the incidence of disease recurrence tended to be greater in the C group. The proportions of spirochetes and motile rods observed at base line, or the average of the values observed at base line, 3 months and 6 months, were compared between subjects with and without disease recurrences. Significantly elevated proportions of these bacterial morphotypes were observed in patients of the T group who demonstrated evidence of disease recurrence during the first year as compared to subjects without disease recurrence. No significant differences could be detected in bacterial morphotypes between patients resistant to disease recurrence and those who developed recurrences at some time during the 3‐year period covered by this report.The ability of DDFM of subgingival bacterial morphotypes to predict future disease occurrence was tested for 1‐ and 3‐year periods, in both the C and T groups. The test appears to be reliable only for subjects on the experimental maintenance regimen (group T) and for prediction of disease recurrence for the initial 1‐year period. The reliability of the test to predict disease recurrence over a 3‐year period fails off significantly in the T group. The test was not reliable in predicting disease recurrence in the C group, presumably because of the disrupting effect of regularly scheduled tri‐monthly prophylaxes on the composition of the subgingival microbiota.
The antimicrobial and clinical effects of a single subgingival irrigation of chlorhexidine in advanced periodontal lesions
Authors: Lander P. E. , Newcomb G. M. , Seymour G. J. , Powell R. N. 
Published: December 2005

Abstract The antimicrobial effects of subgingival chlorhexidine (CH) irrigations on the pathogenic flora in advanced periodontal lesions were assessed. Changes in the patterns of colonization within the subgingival sites were monitored by differential dark‐field microscopy, in 16 patients, over a period of 10 weeks. In addition, changes in the clinical parameters of the diseased sites were also monitored.Initial base‐line evaluations were made for both the clinical and microbiological parameters. 4 sites of moderate to advanced periodontal disease were selected in each patient. These were randomly irrigated with a single dose of either 0.2% CH gel, 0.2% CH solution, or physiological saline, while 1 site was left as a control. The patients were seen weekly, until the 5th week, then at the 7th and 10th weeks. At each appointment, a microbiological sample was taken from the subgingival region of each site, together with an assessment of the clinical indices. Results indicated that a single irrigation of an 0.2% solution of CH or 0.2% CH gel had a marked effect in decreasing the % of spirochaetes and, to some extent, motile bacteria. There was a concomitant shift in colonization to cocci, fusiform and filamentous organisms in pockets that were irrigated; this coincided with a reduction in the % of bleeding sites. Various patterns of colonization were observed which have been described and may assist in differential dark field (DDF) monitoring of lesions. Bleeding on blunt probing was found to be correlated with a flora dominated by spirochaetes. No other correlations were found over the 10‐week period between the other parameters.The therapeutic effect of a single application of CH gel and solution did not exceed 10 weeks and a peak response was recognised at 2 to 4 weeks. It was concluded that treatment regimes involving CH irrigation could be undertaken on a monthly basis. No differences in efficacy could be found between the use of CH gel and solution.
The significance of coronal growth of periodontal ligament tissue for new attachment formation
Authors: Isidor Flemming , Karring Thorkild , Nyman Sture , Lindhe Jan 
Published: December 2005

Abstract The present study was designed to examine whether coronal growth of granulation tissue originating from the periodontal ligament is a prerequisite for new attachment formation.In each of 4 monkeys, 1 central incisor and 2 first molars in the maxilla and the mandible were selected for experimentation. Angular bony defects were surgically produced to the mid‐root level around each single root after crown resection and root separation of the multirooted teeth. The periodontal ligament tissue and the root cementum were removed to the bottom of the bony defects. In half the number of the teeth, an elastic ligature was placed tightly around each root at the bottom of the defects (test roots). In the remaining teeth, an elastic ligature was placed loosely around each root at the same level (control roots). All roots were subsequently covered by laterally displaced flaps. After 3 months of healing, the animals were sacrificed and the jaws removed and placed in fixative. Following decalcification, histological sections of the experimental roots and their surrounding periodontal tissues were produced.The histological analysis disclosed that new attachment had former to a level coronal to the elastic ligature in 10 of 14 control roots but in only 1 of 18 test roots. The results indicate that the repopulation of a detached root surface by cells from the periodontal ligament is a prerequisite for new attachment formation.
Radiographic quantification of alveolar bone level changes
Authors: Albandar Jasim M. , Rise Jostein , Gjermo Per , Johansen Jan R. 
Published: December 2005

Abstract The “random burst” theory has recently been proposed as an explanation of the pattern of periodontal disease progression. The theory predicts that the progression of bone loss at individual sites is not dependent upon previous bone loss and age. A longitudinal radiographic study was designed to test this hypothesis, and to describe the changes in bone level over 2 years in a group of 180 subjects (18–68 years of age) who were not under systematic periodontal treatment.The results indicated that 94% of the sites did not show significant changes in the alveolar bone level during the observation period. The mean annual bone loss for the total population was 0.11 mm. By regressing longitudinal bone loss upon age, it was shown that the rate of bone loss increased rapidly between 33 and 56 years of age while a different pattern was shown for the age intervals 18–32 and 57–68 years. Also, the rate of bone loss increased with increasing initial bone loss. This was less evident in the oldest age group. It was concluded that the progression of bone loss in the present material is consistent with a “burst” theory. However, the progression did not occur randomly with regard to previous loss of alveolar bone and time.