bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival analysis of periodontal sites before and after periodontal therapy
Authors: Haffajee Anne D. , Socransky Sigmund S. , Ebersole Jeffrey L. 
Published: December 2005

Abstract Periodontal diseases appear to progress with bursts of destructive activity at individual sites. One effect of treatment might be to diminish the frequency of such bursts. Survival analysis was employed to seek such effects on the periodontal sites of 16 individuals with prior evidence of destructive periodontal disease. The subjects were monitored at bi‐monthly intervals and actively breaking down sites were detected using attachment level measurements and the tolerance method of analysis. When active sites were detected, control sites of equal pocket depth and attachment loss were selected and microbiological and immunological samples were taken. The subjects were treated by modified Widman flap surgery and systemically administered tetracycline. On completion of therapy, bi‐monthly monitoring was reinstituted. Life tables were constructed for periodontal sites in each of the 16 subjects prior to and after therapy. A site losing more than 3 mm of attachment at any time interval was considered to have relapsed or “died”. Survivor functions were calculated for each time period indicating the % of sites which survived at any time. The subjects were divided into 3 categories on the basis of post‐therapy survivor functions. The annual hazard rate in 9 good treatment response subjects (group I) was reduced from 0.10/year to 0.01/year. The hazard rate of 5 intermediate treatment response subjects (group 2A) was reduced from 0.16/year 10 0.04/year and that of 2 poor treatment response subjects (group 2B) from 0J5/year to 0.07/year.Group 2A and 2B individuals were combined and differences were sought in clinical, microbiological and immunological parameters between the good and poor treatment response groups, 5 out of 7 of the poor responding individuals showed elevated humoral antibody responses to 3 or more gram‐negative subgnigival species tested. Many of the elevated responses in this group were to organisms which are widely distributed and return quickly after therapy such as Fusobacterium nucleatum, Eikenella corrodens, Bacterodes intermedius and Capnocytophaga sputigena. The predominant cultivable microbiota in subgingival samples taken prior to therapy from the good responding group had significantly greater proportions of Actinobacillus actinomycetemcomitans, C. ochracca and B. intermedius than the poor responding group. The latter group showed significantly elevated proportions of F. nucleatum Peptostreptococcus micros and Streptococcus intermedius.
Antimicrobial irrigation of deep pockets to supplement oral hygiene instruction and root debridement
Authors: MacAlpine Robert , Magnusson Ingyar , Kiger Robert , Crigger Max , Garrett Steven , Egelberg Jan 
Published: December 2005

Abstract 64 sites with probing pocket depth 6 mm from 11 patients were treated with plaque control instruction and one episode of root planing. Subsequently, selected sites in each patient were irrigated with either chlorhexidine, tetracycline, saline or served as non‐irrigated control sites. Irrigation immediately followed instrumentation, and was repealed every 2 weeks for 24 weeks. Healing was monitored at 8, 16, and 24 weeks clinically and at 7, 15, and 23 weeks with subgingival washings for determination of % as well as total number of spirochetes.The following changes were apparent from comparing pooled site means al 24 weeks with pre‐treatment data: (1) bleeding sites decreased from 62 of 64 sites initially to 22 of 64 at 24 weeks; (2) spirochetes decreased from 34% to 2%; (3) probing pocket depths decreased from 7.6 to 4.7 mm; (4) probing attachment levels showed a gain of 1.2 mm. The improvement of the chlorhexidine and tetracycline irrigated sites was similar to that of the saltne irrigated and non‐irrigated control sites.Thus, biweekly chlorhexidine, tetracycline or saline irrigation of deep pockets did not appear to augment the effects of non‐surgical periodontal therapy.
Effect of age on healing following periodontal therapy
Authors: Lindhe Jan , Socransky Sigmund , Nyman Sture , Westfelt Elisabeth , Haffajee Anne 
Published: December 2005

Abstract The present investigation was performed in order to analyze the effect of age on healing of the periodontal tissues following treatment. The patients included in the present analysis consisted of 2 different samples. One group of 62 patients (sample A) was examined and treated between 1980 and 1982. 13 of these subjects were <40 years of age, 26 subjects were 40–49 years of age and 23 subjects were >49 years old. The patients were subjected to periodontal surgery using the modified Widman flap procedure. During the active phase of treatment and for the subsequent 6 months of healing, all 62 patients were subjected to professional tooth cleaning. Instruction in proper oral hygiene measures was repeated and scaling was carried out when indicated. Sample B consisted of 21 subjects treated for advanced periodontal disease in 1969. Six of these patients were between 26 and 29 years of age at the start of treatment and 15 were at least 60 years old. The criterion for acceptance for the study in 1969 was that the patient should have lost 50% or more of his/her periodontal tissues. Following an initial examination, all patients were subjected to scaling and root planing and surgical elimination of pathologically deepened pockets. After the termination of active treatment, the patients were placed in a maintenance care program which included recall appointments every 3–6 months. Once a year after the completion of active treatment, all patients in this sample were examined regarding probing depths and clinical attachment levels.The findings from the present retrospective analyses failed to demonstrate that the age of patients with moderately advanced or advanced forms of periodontal tissue breakdown had an influence on the results of periodontal therapy. If anything, the younger patients appeared to heal with a higher frequency of shallow pockets and more gain of probing attachment than older patients.
Healing following reimplantation of teeth subjected to root planing and citric acid treatment
Authors: Nyman Sture , Houston Frank , Sarhed Gun , Lindhe Jan , Karring Thorkild 
Published: December 2005

Abstract. The aim of the present study was to examine the effect of citric acid treatment on periodontal healing around teeth which were extracted, root planed and then reimplanted. Maxillary incisors and mandibular incisors, premolars and molars of 5 monkeys were used. The teeth were divided into 3 experimental groups. In 1 group, the teeth were extracted and immediately reimplanted into their own sockets. In a 2nd group, the teeth were extracted, root planed to a level corresponding to 50–75% of the root length and then reimplanted. In the 3rd group, periodontal breakdown extending to 50‐75% of the root length was first induced by placing orthodontic elastic ligatures around the teeth. They were then extracted and root planed and transplanted into the sockets of the contralateral, periodontally healthy teeth which had just been extracted. Half the number of the teeth of groups 2 and 3 were treated with citric acid before reimplantation or transplantation. The animals were sacrificed after 6 months of healing. The jaws were removed and histological specimens prepared for microscopic examination.With the exception of a limited coronal regrowth of new cementum in the apical part of the planed portion of a few roots, connective tissue attachment failed to reform on most root surfaces deprived of their periodontal ligament tissue. Healing was most frequently characterized by root resorption and ankylosis. These were the most predominant features of healing both on root surfaces which had been deprived of the ligament tissue by mechanical means or during a course of experimentally‐induced periodontal disease, and occurred in citric acid as well as non‐citric acid treated roots. The findings imply that the result of healing following tooth reimplantation or transplantation is determined by the type of cells that repopulate the wound area adjacent to the denuded root surface.
Effect of implants on healing of experimental furcation defects in dogs
Authors: Klinge Björn , Nilveus Rolf , Bogle Gary , Badersten Anita , Egelberg Jan 
Published: December 2005

Abstract. The present study was performed to find out whether implants placed around periodontally involved teeth during reconstructive surgery would support replaced flaps and prolong gingival coverage of the treated root surfaces facilitating new attachment.Through‐and‐through furcation defects were made in the mandibular second, third, and fourth premolars of 10 beagle dogs. Bone was surgically removed from the furcation and from the circumference of each tooth to a level 3 to 4 mm apical to the cementoenamel junction. Steel wires were passed through the furcations and ligated to enhance plaque formation. At 6 weeks, the wires were removed. At 12 weeks, during reconstructive surgery, 4 dogs received implants of autogenous intraoral cancellous bone, 2 of autogenous iliac cancellous bone and marrow, 2 of Proplast®, and 2 of Avitene®. The results demonstrated that none of 12 teeth implanted with Avitene® or Proplast® showed new attachment. Only 2 of 6 teeth implanted with autogenous iliac bone showed new attachment, combined with extensive root resorption and ankylosis. Of 12 teeth implanted with autogenous intraroral bone, 6 showed new attachment. Our findings suggest that flap support by intraoral cancellous bone implants may facilitate new attachment. A more predictable technique, however, needs to be developed.
Human gingival attachment responses to subgingival crown placement Marginal remodelling
Authors: Tarnow D. , Stahl S. S. , Magner A. , Zamzok J. 
Published: December 2005

Abstract 13 teeth in block were extracted from 2 patients. Their facial periodontal condition was essentially within normal clinical limits. Temporary crowns covering the bevel were placed below the base of the crevice 1 to 8 weeks prior to extraction. At time of extraction, all blocks were decalcified, the temporary crown dissolved, and the blocks prepared for histologic examinations using bucco‐lingual cut, step serial sections.Histologic data revealed reformation of a new supracrestal attachment unit within 1 week following crown placement. The reformation of the gingival unit consisted of marginal recession with apical and lateral migration of the junctional epithelium to the level of remaining cementum inserted fibers. With gingival recession and migration of junctional epithelium, resorption of crestal portions of the facial plate occurred. However, periodontal fibers anchored into cementum opposite the resorbed bone were not lysed. Rather, the attached fibrillar ends appeared to interdigitate with fibers from the corium of the facial gingiva at this site, thereby forming a more apically located crestal attachment. This response may be one mechanism of reformation of the gingival attachment unit taking place following mechanical and/or surgical injury to this site and is completed often, within 2 weeks after injury.
Frequency distributions of periodontal attachment loss
Authors: Socransky S. S. , Haffajee A. D. 
Published: December 2005

Abstract 3 patterns of attachment loss were described based on curve fitting the frequency distributions of baseline attachment level measurements of 61 subjects with destructive periodontal diseases. The frequency distributions of attachment level measurements of 30 group I individuals were satisfactorily fit by tachment level measurements of 30 group I individuals were saticfactorily fit by the sum of 2 normal curves, while those of 14 group II individuals were fit by the sum of 3 normal curves. Frequency distributions of 17 group III subjects were fit by a single normal curve. A computer algorithm was used to simulate attachment level loss frequency distributions by varying the “burst size” at active lesions and by imposing “immunity” for varying periods of time on sites which had been attacked.Frequency distributions of group I subjects could be simulated using burst sizes between 0.3 and 3.4 mm. These subjects could be divided into 2 groups: 14 subjects with localized minimal attachment loss required an average burst size of < 1 mm, while 16 subjects with more destruction at diseased sites required an average burst size of > 1 mm to simulate their frequency distributions. Frequency distributions of 16 of 17 group III subjects could be simulated using an average burst size of < 1 mm. However, the frequency distributions could also be simulated using larger burst sizes with the imposition of “immunity” for substantial periods of time at the attacked sites.The frequency distributions of group II subjects were more difficult to simulate. A better simulation could be obtained using a large average burst size (> 1 mm) than a small burst size. However, the most satisfactory fit was obtained by the superimposition of a large burst pattern of attack on a distribution created using small bursts. The optimal average sizes of the small and large bursts varied from subject to subject as did the mean attachment level at which the burst size was changed. The simulations suggest that the different frequency distributions result from different modes of progression of attachment loss with burst size and possibly local “immunity” playing major rôles.
Clinical effects on chronic periodontitis of a simplified system of oral hygiene including subgingival pulsated jet irrigation with chlorhexidine
Authors: Watts E. A. , Newman H. N. 
Published: December 2005

Abstract The aim of this study was to investigate the effects of a simplified system of oral hygiene, comprising Bass brushing, scaling, root planing and subgingival irrigation using a pulsated monojet oral irrigator, in patients with chronic periodontitis.After initial assessment, patients received scaling, root planing and instruction in Bass brushing and in use of a pulsated jet oral irrigator (Water Pik + Imax attachment) to irrigate subgingivally. 11 patients with 262 approximal periodontal pockets used 0.02% chlorhexidine (CH), or a placebo as the irrigating solution once daily for 28 days. Plaque index (P1I), sulcus bleeding index (SBI), and probing pocket depth (PPD) were assessed on days 0, 28, 56 and 84. Within procedure comparisons for all groups showed that the regime was highly effective in reducing P1I, SBI and PPD, improvements being maintained at least until day 84. Between procedure comparisons showed that benefits were improved only marginally by the use of 0.02% CH as the irrigation fluid. The patients found the procedure pleasant and neither injuries nor staining were noted during the study.It was concluded that this simplified oral hygiene system was effective in reducing periodontal inflammation and pocket depth, although no significant added benefit with 0.02% CH was apparent. The technique may be useful in patients who cannot achieve high levels of routine mechanical oral hygiene, particularly interdentally. The effects of using higher concentrations of chlorhexidine should be investigated.
Subgingival microflora in bleeding and nonbleeding pockets
Authors: Baab D. A. , Opsvig E. J. 
Published: December 2005

Abstract The subgingival flora of bleeding and nonbleeding 4–6 mm pockets was investigated using phase‐contrast microscopy. Subgingival plaque was sampled from 11 patients with generalized moderate periodontitis. 4 subgingival samples were obtained from each patient, 2 from sites that bled upon standardized probing force and 2 from sites that did not. The amounts of gingival inflammation, supragingival plaque, attachment level and pocket depth were also assessed at each site. The %s of 4 bacterial morphotypes were assessed using phase‐contrast microscopy.No significant differences were found in the %s of cocci, motile rods, or spirochetes between bleeding and nonbleeding sites. Significant correlations were found, however, between the % of spirochetes and probing depth, attachment level, and gingival inflammation. The observations indicate that the use of bleeding on probing may not be justified as an indicator of infection by those “periodontopathic” bacteria identifiable by phase‐contrast microscopy. However, limitations in the microscopic method may have prevented us from observing differences between the 2 types of sites on a species level.
The occurrence of gingival brushing lesions during 3 phases of the menstrual cycle
Authors: Niemi Maija‐Liisa , Ainamo Jukka , Sandholm Leena 
Published: December 2005

Abstract Since hormonal changes during the menstrual cycle may alter the vulnerability of the female gingiva, the present study was undertaken to investigate whether there are any differences in the number of toothbrushing lesions occurring during different phases of the menstrual cycle. 45 women of 20–35 years of age and with healthy gingiva were examined for overt signs of gingival laceration or ulceration. Such signs were recorded as a brushing injury. Dental plaque was assessed using the visible plaque index (VPI) and gingival inflammation using the gingival bleeding index (GBI). The examinations were made on the 1st day of menstruation (MD), on the estimated ovulation day (OD), and on the day with the predominance of progesterone secretion (PD). The examinations were made during 1–3 menstrual cycles for each individual; the study includes 78 cycles.No statistically significant differences were found between the numbers of brushing injuries on the 3 days of examination (MD, OD & PD). During PD, a significantly positive correlation (p < 0.01) was observed between VPI and GBI scores, but on OD and MD, the correlations were highly significant (p < 0.001). A weak significant positive correlation (p < 0.05) was found between GBI scores and the number of brushing injuries on the 1st day of menstruation, while during other phases of the menstrual cycle, no such correlation was found. The present study gave little evidence that the hormonal status of women could be of clinical significance in the development of soft tissue trauma from habitual toothbrushing.
The effect of mouthririses on parameters characterizing human periodontal disease
Authors: Wennström Jan , Lindhe Jan 
Published: December 2005

Abstract The objective of the present clinical trial was to assess the efficacy of mouthwashes containing antiseptic agents on established and developing plaque and periodontal disease in adult subjects using a newly described clinical research model. The study was carried out in 21 patients with periodontal disease. At the baseline examination, all tooth surfaces‐sites were studied with regard to dental plaque, gingivitis, bleeding on probing to the base of the pocket and probing pocket depths. The patients were subsequently randomly assigned to 1 of 3 groups, each consisting of 7 individuals. Group A rinsed with a 0.01% solution of Sanguinarine, group B rinsed with a 0.2% solution of chlorhexidine and group C rinsed with a placebo solution. No instructions regarding mechanical plaque control measures or information regarding the etiology and pathogenesis of periodontal disease were given to any of the patients during the course of the 6‐weeks of trial. The clinical examination was repeated after 2 weeks use of the mouthwash preparations. Following the re‐examination, all patients were subjected to scaling and root planing in 2 jaw quadrants chosen at random. After another 2 weeks, the 2nd re‐examination was performed and the teeth in the 2 remaining jaw quadrants were thoroughly scaled. The final examination was performed 2 weeks later.During the 4 weeks of rinsing, without adjunctive professional mechanical debridement, the frequency distribution of plaque Index scores 2 + 3 did not change in the group of patients using the placebo solution, but was significantly reduced in both the chlorhexidine and the Sanguinarine groups. The gingival index scores and the probing depths were not, however, significantly affected by the 4 weeks use of any of the 3 mouthrinse preparations tested.Professional debridement made the tooth surfaces free from plaque accumulations. In the placebo group, about 32% and 29% of the tooth surfaces received a PII score of 2 + 3 at the 2 and 4 week examinations, respectively. The corresponding figures for the chlorhexidine group were 2.4% and 2.8% and for the Sanguinarine group 9.6% and 8.1%.The professional debridement markedly reduced signs of gingivitis. Compared to the baseline data, the frequency of gingival index scores 2 + 3 was after 4 weeks reduced by 55% in the Sanguinarine group and by 63% in the chlorhexidine group. The corresponding figure for the placebo group was 35%. For all 3 groups of patients, scaling and root planing resulted in the establishment of a larger number of shallow pockets and a lower number of deep pockets.
Depth‐force‐patterns in periodontal probing
Authors: Mombelli A. , Graf H. 
Published: December 2005

Abstract This investigation was undertaken to study penetration‐depth and simultaneous force development during the insertion of a standard periodontal probe tip into a pocket to gain information about the tissue resistance to probing and its relation to the accuracy of depth determination. A piezoelectric force transducer and a linear position transducer were incorporated into a periodontal probe. Depth‐force diagrams were obtained on an x–y plotter. In 5 patients requiring treatment for chronic periodontitis, 50 sites were selected and measured 3 times before and 3 times after a treatment phase consisting of hygiene instruction, systematic deep scaling and root planing. The minimal required probing force for reproducible values within a limit of 0.5 mm up to a force of 1.2 N was determined for each record (“b‐value”) and correlated in a multiple linear regression analysis with a number of clinical parameters of the sites.Depth‐force diagrams recorded with the probe showed the characteristics of saturation curves flattening off in the range of 1 N and more. When the probing force was increased from 0.41 N up to 1.2 N, 50% of all measurements showed an increase in depth of more than 0.5 mm. However, increasing from 0.9 to 1.2 N resulted in a change of more than 0.5 mm in only 5% of the measurements. Differences in b‐values before and after the treatment were significant (p < 0.01). Differences related to tooth type (M, PM, I) and conventional pocket depth before treatment were also significant (p < 0.05). In general, minimal probing force had to be 0.075 N higher after the treatment and 0.101 N higher in pockets originally deeper than 5 mm to maintain the same depth reading up to a force of 1.2 N.It was concluded that the influence of probing force on the reproducibility of probing depth was more important after treatment by oral hygiene, deep scaling and root planing.