bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of gingivitis
Authors: Stamm John W. 
Published: December 2005

Abstract In recent years, tremendous strides have been made in understanding the etiology of gingivitis. This increase in knowledge has come, for the most part, from basic research in oral microbiology, immunology, histology and pathology. Over the past decade, less progress has been made in further refining the epidemiological relationships between gingivitis and various host and environmental factors. The major restraint has been the great difficulty in reliably measuring gingival inflammation. This problem has resulted in great inter‐ and intra‐study variation in diagnosing the prevalence and severity of gingivitis in human populations. Consequently, it is almost impossible to estimate longitudinal trends in gingivitis and it is nearly as difficult to make comparisons among different population groups studied by different examiners. Nevertheless, by focusing on the most apparent and robust epidemiological relationships, an instructive overview of the epidemiology of gingivitis can be gained. A number of host and environmental factors have been studied in relation to gingivitis and some of these will be reviewed.With respect to age, there is general concensus that marginal gingivitis begins in early childhood, increases in prevalence and severity to the early teenage years, thereafter subsiding slightly and leveling off for the remainder of the second decade of life. Gingivitis during the adult period is much more difficult to characterize due to paucity of data. Estimates of the general prevalence of adult gingivitis vary from approximately 50 to 100% for dentate subjects. In terms of gingivitis prevalence, the dentate elderly do not deviate appreciably from the general adult pattern. When adjusted for cohort effects, gingival disease appears to be on the decline.With the exception of the puberty period, females generally exhibit lower gingivitis prevalence and severity than males. An appreciable number of women exhibit more severe gingivitis during periods of pregnancy.Accurate data comparing gingivitis prevalence between blacks and whites indicate that the former generally experience higher mean levels of gingival inflammation. Frequently, this difference has been partially explained by co‐factors such as oral hygiene, socio‐economic status and access to dental care. Longitudinal data on race and gingivitis prevalence are not particularly reliable. Bacteria in the gingival crevice and on the gingival margin are most directly responsible for gingivitis. Epidemiologically, this factor may be indirectly assessed by an oral hygiene index. Not surprisingly, the oral hygiene score is most closely correlated with gingivitis among all epidemiological factors. Additional factors which have been assessed for their impact on gingivitis are smoking habits, fluoride use and recent antibiotic history.
Design of clinical trials for chronic diseases: implications for periodontal disease
Authors: Goldberg Judith D. , Weiss Arnold I. , Koury Kenneth J. 
Published: December 2005

Abstract In order to make effective use of the statistical theory of design of clinical trials for chronic diseases such as periosontal disease, certain issues must be considered. Any clinical trial requires that the disease definition be well‐specified; that patient eligibility be explicit; that the observation times be explicit; that the duration and endpoint of therapy be specified; that the duration of subsequent followup observation be specified; and that the unit of observation (e.g., tooth, set of teet, patient) be defined. In a chronic disease, the potential biases that can readily be introduced by self‐selection of patients who enter the trial and/or who return for subsequent observation become more important, because subjects are required to remain on treatment and/or observation for prolonged periods. Further, the cyclical nature of some chronic diseases may require special attention to baseline definitions of active disease and disease outcome.These issues are illustrated with examples from clinical trials of hypertension, breast cancer screening, and Polycythemia Vera. Implications for periodontal disease are discussed.
Design of clinical trials of traditional therapies of periodontitis
Authors: Lindhe Jan , Socransky Sigmund , Wennström Jan 
Published: December 2005

Abstract The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the “experimental unit”. For a number of years, the “experimental unit” in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site‐to‐site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites.Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely:

to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium;
to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re‐establishment of the subgingival infection;
to gain attachment as a result of treatment;
to assess the effect of a certain chemotherapeutic agent on periodontal disease.
The effect of dentifrices containing zinc citrate on plaque growth and oral zinc levels
Authors: Saxton C. A. , Harrap G. J. , Lloyd A. M. 
Published: December 2005

Abstract. Zinc salts have previously been shown to possess antiplaque activity in solution but this activity has as yet not been reported for dentifrices. The purpose of the present investigation was to establish the effect of dentifrices containing zinc citrate (ZCT) on plaque growth and on the concentration of zinc in saliva and plaque. Plaque growth inhibition was studied over periods of time approximating to intervals for normal oral hygiene procedures. Zinc in saliva and plaque was measured by atomic absorption spectroscopy.Elevated zinc levels in saliva were observed for 3–4 h after brushing with the zinc citrate dentifrice. Similarly, raised levels of zinc were encountered in plaque 1 h following contact with a slurry of a dentifrice containing ZCT. Increased concentrations of zinc were observed in plaque fluid and plaque residue.The plaque growth data from 88 participants in 5 studies revealed that plaque regrowth over 16 h or 22 h was reduced by dentifrices containing 0.5% ZCT, compared to placebo dentifrices. Dentifrices which contained 0.5% ZCT or 0.4% stannous fluoride, had similar inhibitory effects on plaque.Further analysis of the data showed that subjects with high rates of plaque growth benefited more from the zinc dentifrices than those with low rates of plaque growth. It is suggested that the effect on plaque was related to zinc concentration in the dentifrice rather than total dose applied, and that the main effect of zinc was to inhibit the extension of existing plaque.
False results associated with darkground microscopy of subgingival plaque
Authors: Omar A. A. , Newman H. N. 
Published: December 2005

Abstract. This study considers false results which may arise due to problems in the preparation or examination of specimens for darkground microscopy of subgingival plaque. Subgingival plaque samples obtained with a sterile curette were placed in 0.1–0.3 ml sterile full or 1/4 strength Ringer's solution: 0.85% saline, 1% gelatin in 0.85% saline, formal saline or pyrogen‐free water for injection. Test slides were prepared from the original dispersion, and control slides from the corresponding sterile solution. Optimal dispersion solution, syringe dispersion frequency and the effect on motility of delay in processing samples were tested. Slides were also prepared from dispersions of 11 representative subgingival “periodontopathic” organisms. Problems in sampling included variability in counts between sites with comparable pocket depths, contamination of the sample and reduction of the sample volume after scaling. Problems in dispersion included contamination, uneven distribution of the different morphotypes and destruction of delicate organisms. Problems in slide preparation included slide contamination, limitation in the number of samples that can be assessed by one examiner at a given time without loss of activity of motile cells, and preparation of a cell monolayer. Problems in identification and counting included confusion of Brownian movements with motility, coccoid particles with cocci, spirochetes with campylobacter, flagella with flagella‐like structures, size of cocci, counting of fragmented spirochetes and non‐motile flagellated organisms and motile cells, and also bias in counting. Problems in morpbotype grouping included the observation that many (10 of the 11 representative) periodontitis‐related organisms were in the non‐motile groups and not all cells of the motile species (Campylobacter, Capnocytophaga) showed motility.The results indicate that each stage of subgingival plaque darkground microscopy, sampling, dispersion, slide preparation, counting, morphotype grouping and interpretation may lead to false results if not representative or reproducible. Procedures are suggested for the minimisation of problems in the preparation and examination of subgingival plaque specimens for darkground microscopy.
In vivo differentiation of progenitor cells of the periodontal ligament
Authors: Aukhil I. , Simpson D. M. , Suggs C. , Pettersson E. 
Published: December 2005

Abstract. The present study was designed to test the hypothesis that during regeneration of cementum, the progenitor cells from periodontal ligament must come in contact with root dentin in order to differentiate into cementoblasts. After reflecting mucoperiostea flaps, fenestration wounds were made in the buccal cortical plates of mandibular canines in 6 beagle dogs. The exposed root surfaces were curretted to remove all cementum. The exposed root surface on one side was demineralized with citric acid while the contralateral wound had saline treatment. The exposed root surfaces were then dried and pieces of Nucle‐pore membrane (pore size 0.1 μ) were attached to part of the exposed root surface to prevent contact of progenitor cells with root dentin. The fenestration wounds were then covered with Millipore filter to facilitate the population of wounds by progenitor cells from the periodontal ligament. Histologic analysis was performed after 3 months of healing.In specimens where the Nuclepore membrane had remained attached to root dentin, no new cementum was seen over the membrane. At the borders of the wounds and in specimens where the Nuclepore membrane had detached from root dentin. new connective tissue attachment was consistently seen. Also, root resorption was very rarely observed in both the acid‐treated and control specimens.The present findings suggest that contact with root dentin may be necessary for progenitor cell differentiation into formative cells like cementoblasts.
A new measure of teeth‐cleaning efficiency and periodontal disease
Authors: Maizels Alfred , Sheiham Aubrey 
Published: December 2005

Abstract This paper presents a new measure of teeth‐cleaning efficiency based on information from a random sample of 400 factory employees and a separate (non‐random) sample of some 400 skilled manual workers and their wives. Regression analysis showed that only 1/3 of the variance in calculus levels in the random sample was explained by age, frequency of visits to a dentist, socio‐economic group and smoking habits (other variables tested ‐ gender, date of last dental visit, frequency of teeth‐brushing and sugar consumption ‐ were not significant). The corresponding regression for the skilled manual sample gave a broadly similar result, though the proportion of explained variance (1/5) was lower than for the random sample. These results indicated the presence of one or more additional factors, of which teeth‐cleaning efficiency is likely to be the most important. A new measure of cleaning efficiency was then constructed by expressing the actual calculus level as a proportion of the level estimated from the regression equation, and deducting this proportion from unity.If this new measure is, indeed, a genuine indicator of teeth‐cleaning efficiency, then one should expect it to be an important element in an explanation of the level of periodontal disease, but not of dental caries (which is a resultant essentially of dietary habits). This hypothesis was tested and confirmed by multiple regression analysis. Though the new measure of teeth cleaning efficiency is essentially experimental, and has yet to be validated by clinical testing, the results strongly suggest that efficient cleaning can have a major beneficial impact on the level of periodontal disease, thus underlining the importance which effective dental health education could have in reducing the level of this disease.
Periodontal conditions of teeth adjacent to extraction sites
Authors: Grassl Markus , Tellenbach Roger , Lang Niklaus P. 
Published: December 2005

Abstract The purpose of the present clinical study was to evaluate the effect of tooth extractions on the periodontal conditions of adjacent teeth. 40 patients were selected for the study. Prior to the extractions, baseline data of the adjacent teeth were obtained. Plaque (PII) and gingival indices (GI), pocket probing depths and probing attachment levels were scored. In addition, the alveolar bone height was determined radiographically in relation to the CEJ adjacent to the extraction sites. The contralateral side of the jaw. where no tooth had to be removed, was examined as a control. A limited hygienic phase (scaling and root planing of all surfaces examined) was performed immediately prior to the extractions. Using the same parameters, all sites were reexamined 2–4 months and 6–9 months following the extractions.After the hygienic phase, the teeth adjacent to the extraction sites indicated a decrease in the pocket probing depths by 0.5 to 1.5 mm. In shallow pockets (1–3 mm), this decrease was less pronounced than in moderate to deep pockets (4–9 mm), where it was composed of shrinkage of the gingival tissues and gain of probing attachment. The radiographic level of the bony alveolar crest in relation to the CEJ of the adjacent teeth was not altered by the extraction procedure. The oral hygiene performances of the patients were not influenced during the 9‐month observation period. Therefore, neither PII nor GI scores showed relevant improvements. Although the extraction had n beneficial effect on the periodontal conditions of the adjacent teeth, decisions for or against removing teeth for periodontal reasons must be made in the light of a comprehensive treatment plan and on the basis of individual patient considerations.
The effect on early plaque formation, gingivitis and salivary bacterial counts of mouthwashes containing hexetidine/zinc, aminefluoride/tin or chlorhexidine
Authors: Hefti Arthur F. , Huber Brigitte 
Published: December 2005

Abstract This study was designed to investigate the effectiveness of mouthwashes containing hexetidine/zinc (HZA) or tin (ASF) in inhibiting plaque formation and gingivitis in humans. 24 dental students and assistants participated in the study (latin square design) with 7‐day test periods. They rinsed twice daily for 1 min with one of the following formulations: HZA = 750 ppm hexetidine/750 ppm zinc acetate, ASF = 100 ppm aminefluorid/310 ppm stannous fluoride, CHX=0.1% chlorhexidine and M = negative control. Plaque accumulation was determined planimetrically and gravimetrically. Gingivitis was evaluated with the papillary bleeding index. Total colony forming units and S. mutans counts were estimated from saliva samples.The results showed that HZA and CHX almost completely inhibited plaque accumulation and gingivitis. ASF was less effective than HZA and CHX but still reduced plaque significantly compared to the negative control. Furthermore. CHX reduced salivary S. mutans counts.
Lipopolysaccharide (endotoxin) from individual periodontally involved teeth
Authors: Maidwell‐Smith M. , Wilson M. , Kieser J. B. 
Published: December 2005

Abstract.The amount of lipopolysaccharide (LPS) in the root surface‐associated material from individual periodontally‐involved teeth was found in the (surface material from all of the tee ranged from 19‐394 ng/tooth. No significant correlation was found between the associated with the tooth. However, a weak correlation(r=+ 0.0461, 0.05 > p > 0.01) was found between the amount of LPS and the % loss of attachment.
The influence of a dentifrice containing a zinc salt and a nonionic antimicrobial agent on the maintenance of gingival helath
Authors: Svatun B. , Saxton Ca. A. , van der Ouderaa F. , Rölla G. 
Published: December 2005

Abstract.The purpose of the present investigation was to test the concept that a dentifrice containing zinc citrate and Triclosan could maintain gingival health. The gingival health of 101 young predominately female student nurses in Oslo was brought to a high level by professional cleaning supported by oral hygiene instruction. The criterion of gingival health was ≤5 elicited bleeding sites from a full mouth assessment. The mean bleeding value attained for the whole group was 3.5. 2 balanced groups were formed, based on the initial number of elicited bleeding sites and plaque values. One group used the test dentifrice and the other group the placebo for 6 months, with an intermediate assessment after 3 months. The placebo group failed to maintain the standard of oral hygiene and gingival health that had been achieved by professional care. In contrast, the group using the test dentifrice for 6 months exhibited similar levels of plaque and gingival health to that observed at baseline following oral hygiene instruction. After 6 months. <7% of the subjects in the placebo group possessed healthy gingivae in contrast to 60% of the test group. Thus a dentifrice containing a zinc salt and nonionic germicide had successfully maintained gingival health in a group of young adults.
Chemotherapeutic agents for controlling plaque and gingivitis
Authors: Mandel Irwin D. 
Published: December 2005

Mandel ID: Chemotherapeutic agents for controlling plaque and gingivitis.Abstract There has been a vigorous search for many years for chemical agents that could supplement or even supplant patient‐dependent mechanical plaque control and thus reduce or prevent oral disease. 5 categories of agents or approaches have been considered: (1) broad spectrum antiseptics, (2) antibiotics aimed at specific bacteria. (3) single or combinations of enzymes that could modify plaque structure or activity, (4) non‐enzymatic dispersing or modifying agents and (5) agents that could affect bacterial attachment. The success of these approaches can be evaluated clinically by the use of standard scoring methods for measuring plaque and gingivitis and their safety established by soft tissue and microbiologic examination. Antiseptic agents have received the bulk of the attention over the years. At present, only 2 antiseptics, the bis‐biguanide, chlorhexidine gluconate (Peridox) and a combination of phenol related essential oils (Listerine). have developed sufficient supporting data in 6–month (or longer) studies to gain the approval of the Council On Dental Therapeutics of the American Dental Association. On the basis of short‐term studies, cetylpyridinium chloride, zinc and copper salts, sanguinarine and octenidine warrant continued study as does stannous fluoride at an appropriate concentration. On the basis of current research, a new generation of more specific antibacterial agents that interfere with attachment to pellicle can be developed. It is hard to predict, however, that they will affect gingivitis, at least until there is more information on what specific organisms should be targétéd.
Morphological changes in the attached and keratinized gingiva and gingival sulcus in the mixed dentition period
Authors: Bimstein Enrique , Eidelman Eliecer 
Published: December 2005

Abstract A longitudinal study was undertaken to examine the changes in the sulcus probing depth, keratinized and attached gingiva during the mixed dentition period. 54 children aged 7 to 9 years at the first examination were examined twice, with an interval of 5 years. Sulcus probing depth and keratinized gingiva were examined at the buccal aspect of the incisors, and either right or left cuspids and posterior areas. The width of the attached gingiva was obtained by substracting the probing depth from the width of the keratinized gingiva. When compared to primary predecessors, the permanent teeth had a deeper probing depth, narrower attached gingiva and at the maxillary teeth, a wider keratinized gingiva. When a pennanent tooth was present at both examinations, there was a significant increase in width of the attached gingiva with a corresponding decrease in probing depth, and a slight beginning of an increase in the width of keratinized gingiva.Previous and the present findings indicate that during the early years after eruption of the permanent tooth, an increase in width of the attached gingiva takes place, without occlusal migration of the marginal gingiva whereas, at later stages, this coronal migration takes place, concomitant to tooth eruption.