bluuebunny/crossref_metadata_2025_split huggingface dataset:
Free gingival graft and coronally repositioned flap A 2‐year follow‐up report
Authors: Matter Jacques 
Published: December 2005

Abstract Eleven cases are described in which the width of attached gingiva was increased by a free gingival graft, followed 2 months later by a coronally repositioned flap. This two‐step operation was performed on 36 areas of recession in 11 patients. In all cases, the procedure has much improved the periodontium functionally as well esthetically. In two patients, a clinically stable reattachment has taken place within preexisting dentinal cavities.The relationship of the probe tip to periodontal tissues during probing and the reattachment of both epithelium and connective tissues are discussed.
The angular bone defect and its relationship to trauma from occlusion and downgrowth of subgingival plaque
Authors: Waerhaug Jens 
Published: December 2005

Abstract. Sixty‐four sets of human teeth were collected with the aim of evaluating the role of trauma from occlusion in the etiology of destructive periodontal disease. Before the jaws were taken out, a careful bite analysis was carried out. After fixation of the jaws, impressions were taken and plaster of Paris models were made. Finally, a set of 14 radiographs were taken. On the baqis of the “clinical” records postmortem, the study models and the radiographs, the jaws were sectioned. Only mesio‐distal sections were included in the present analysis. The total number of interdental spaces examined was 106. The following observations were made;

Before any loss of periodontal fiber attachment has taken place, the configuration of the interdental septum is entirely dependent on the location of the cemento‐enamel junction (CEJ) of the two neighboring teeth. The alveolar crest does not approach the apical border of the junctional epithelium closer than about 1 mm. Thus, if the CEJ is located at different levels on two neighboring teeth, the marginal termination of the interdental septum will be oblique, forming an acute angle with the “lowest” tooth.
Loss of periodontal fiber attachment could invariably be related to the apical growth of subgingival plaque, and downgrowth of plaque was always associated with an inflammatory process which involved lysis of the attachment fibers within a distance varying between 0.2 and 1.8 mm from the apical border of the plaque. Subsequently, the IE proliferated down to cover the denuded root surface.
Reduction in height of the alveolar crest could also be related to the downgrowth of plaque. The distance from plaque to bone was never found to be less than 0.5 mm and never more than 2.7 mm. The configuration of the interdental septum always seemed to be determined by the level of the plaque on the two neighboring tooth surfaces. Thus, if the plaque had reached the same level on both sides, the crest of the interdental septum assumed a horizontal outline; if plaque had proliferated down to different levels, the crest of the interdental septum was oblique and an angular defect hereby established.
In the present material no evidence was found to indicate that functional (traumatic) forces can act as a co‐factor in the causation of angular defects. In fact, such defects were found equally often adjacent to “nontraumatized” as to “traumatized” teeth.
Infrabony pockets were invariably associated with downgrowth of subgingival plaque.
Probing force and the relationship of the probe tip to the periodontal tissues
Authors: Van Der Velden U. 
Published: December 2005

Abstract. Recently an increasing pocket depth was found to be related to an increasing probing force. The purpose of the present study was to investigate whether or not a plateau value in pocket depth measurements exists and to study, with different probing forces, the location of the tip of the probe in relation to the periodontal fibers and the alveolar bone. Two groups of patients were selected for this study; in one group a number of teeth had to be extracted for periodontal reasons (the extraction group) and in the other a single periodontal surgical procedure was required (the surgery group). All patients received preliminary treatment consisting of plaque control and removal of subgingival deposits. At the time of the investigation the gingival condition was assessed by means of a new index, the Periodontal Pocket Bleeding Index (P.P.B.I.) The criteria were: 0 ‐ no bleeding of the pocket after probing with a force of 0.75N, and 1 ‐ bleeding of the pocket within 30 sec after probing with a force of 0.75N. After local anesthesia in the extraction group, reference marks parallel to the long axis of the experimental teeth were cut with a cylindrical diamond burr. By means of the pressure probe, pocket depth measurements were performed with increasing forces of 0.50, 0.75, 1.00 and 1.25N. After extraction and staining of the remnants of the periodontal fibers, the distance from the most coronal intact connective tissue fibers to the most apical point of the reference marks was measured. In the surgery group using the same pressure probe, interproximal measurements with increasing forces of 0.50, 0.75, 1.00 and 1.25N were made from the apical border of the restorations to the bottom of the pocket. The same measurement, this time to the crest of the alveolar bone, was repeated after a flap had been raised.Results with the P.P.B.I. showed that oral hygiene procedures resulted in a mean index of 0.36 in the surgery group and 0.43 in the extraction group. The results of the present study indicated that 1) using a probe of 0.63 mm diameter, the optimal force level for clinical pocket depth measurements is 0.75N, 2) a force of 0.75N is clinically well tolerated and meets with few objections from patients, 3) when a probing force of 0.75N is used the tip of the probe in both shallow and deep periodontal pockets is located at the most coronal intact connective tissue fibers, 4) a plateau value in pocket depth measurements is found when a probing force of 1.25N is employed, and 5) the mean width of the connective tissue attachment is approximately 1.9 mm.
Local tetracycline delivery using hollow fiber devices in periodontal therapy
Authors: Llindhe J. , Heijl L. , Goodson J. M. , Socransky S. S. 
Published: December 2005

Abstract. The present investigation was performed to assess the effect of tetracycline, locally administered via hollow fiber devices, on the microflora of periodontal pockets in humans and on various clinical parameters describing periodontitis. Five patients with advanced periodontal disease were used in the study. Each patient had at least four pairs of contralateral teeth where approximally located pockets could be probed to 6 mm or more. The amount of supragingival plaque present on the tooth surface adjacent to the eight diseased sites was determined as well as the degree of gingival inflammation. Probing depths were recorded with a graduated probe. The clinical measurements were repeated 7, 14, 28, and 37 days following the start of treatment. From the eight pockets bacterial samples were collected from deep subgingival sites. The bacteria were examined in a dark‐field microscope and categorized into the following groups: cocci and non‐motile rods, filaments and fusiforms, motile and curved rods and spirochetes. The percentage distribution of the various forms was calculated. Following the initial examination the patients were given detailed instruction in proper oral hygiene techniques. Three of the diseased sites were treated by scaling and three by tetracycline application using the hollow fiber device. One pair of sites was used as untreated controls. On day 28 the three initially mechanically debrided sites were scaled anew and active fiber material inserted in the three contralateral sites.The experiments showed that it is possible by the use of tetracycline‐filled hollow fiber devices to markedly change the composition of the subgingival flora of initially diseased periodontal sites. Locally delivered tetracycline proved effective in reducing or eliminating clinical symptoms of periodontal pathology.
Comparison of results following three modalities of periodontal therapy related to tooth type and initial pocket depth
Authors: Knowles J. , Burgett F. , Morison E. , Nisle R. , Ramfjord S. 
Published: December 2005

Abstract Results following three modalities of periodontal therapy (subgingival curettage, modified Widman flap surgery, and pocket elimination or reduction surgery) in 78 patients over 8 years were compared for variations in pocket depth and clinical attachment level related to tooth types (maxillary molars, mandibular molars, maxillary biscupids, mandibular biscupids, maxillary anterior teeth, mandibular anterior teeth). The analysis was based on a classification of three severity groups according to initial crevice or pocket depth (Class I, 1–3 mm; Class II, 4–6 mm; and Class III, 7–12 mm) and with patient's means of measurements being the experimental units for the statistical analysis.Reduction in pocket depth and gain of clinical attachment for pockets 4 mm or deeper occurred following all three methods of treatment, and was well sustained over 8 years. No one modality of treatment was consistently superior to any of the other two with regards to sustained reduction of pocket depth and gain of clinical attachment.Surgical pocket elimination or reduction did not enhance the prognosis for maintenance of periodontal support in either moderate or advanced periodontal lesions anywhere in the mouth compared with more conservative modalities of treatment.In spite of prophylaxis and instruction in home care every 3 months, there was a slight progressive loss of attachment over time in areas of shallow crevices (1–3 mm).
Plaque removal by various triangular toothpicks
Authors: Bergenholtz Axel , Bjorne Assar , Glantz Per‐Olof , Vikström Bert 
Published: December 2005

Abstract Two intraindividual studies were performed on 35 persons treated for periodontal disease to investigate the plaque preventing effect of five different types of triangular toothpicks: Stim‐U‐Dent® (Balsa), Jordan® (Birch), Te‐Pe® (Lime), Sanodent® (Birch) and Alfa® (a polymeric one) and four toothpicks of which three were wooden of the same shape and one was polymeric with a similar shape: Birch, Lime, Limba (Jordan A/S), and polymer (Fixident). Only teeth in contact with neighboring ones and with open interdental spaces were included in the study. The plaque‐removing ability of the toothpicks was registered by estimating the amount of plaque accumulation at the end of each experimental period (2 weeks) according to a Plaque Index (Silness & Löe 1964) modified for plaque registration on 10 surfaces around each tooth.In a laboratory study, relevant properties of the toothpick material (modulous of elasticity, surface roughness, water absorbing capacity, surface hardness) were investigated and compared to the plaque preventing effect of the different triangular toothpicks.Using a questionnaire, the test person's opinions on the surfaces, sizes, forms and rigidities of the toothpicks also were examined.Minor differences were observed between the plaque‐removing ability of the different triangular toothpicks. No clear relations were observed between any of the properties of the toothpick materials, however, the surface hardness as well as the strength values of the toothpick materials seemed to be of importance.The conclusions of the present studies are that the plaque‐removing ability of a toothpick seems to be more dependent on the shape of the toothpick than on existing minor differences among the materials used for their manufacturing. Low surface hardness and high strength values seem to be of importance for interdental cleaning.
Periodontal probing: What does it mean?
Authors: Listgarten M. A. 
Published: December 2005

Abstract The periodontal probe has been and continues to be used as an important diagnostic instrument by the dental profession. The measurements recorded with the probe have generally been considered to represent a reasonably accurate estimate of sulcus or pocket depth. Recent reports on the histopathology of the periodontal lesion and the histological features of a healing lesion, together with histological studies on the relationship of the probe to periodontal tissues, have shed some new light on periodontal probing.It is now apparent that probing depth measured from the gingival margin seldom corresponds to sulcus or pocket depth. The discrepancy is least in the absence of inflammatory changes and increases with increasing degrees of inflammation. In the presence of periodontitis the probe tip passes through the inflamed tissues to stop at the level of the most coronal intact dento‐gingival fibers, approximately 0.3–0.5 mm apical to the apical termination of the junctional epithelium. Decreased probing depth measurements following periodontal therapy may be due in part to decreased penetrability of the gingival tissues by the probe. Following treatment aimed at obtaining new attachment in periodontal defects, wider variations may occur between the location of the probe tip and the most coronal dento‐gingival fibers than in the case of untreated sites. This is due in part to the formation of a so‐called “long” junctional epithelium. In the absence of inflammation this epithelium may not be penetrable during ordinary probing, but could account for a rapid increase in probing depth measurements when inflammatory changes allow the probe to traverse the epithelium and/or the adjacent infiltrated connective tissue.In view of the difficulty inherent in relating periodontal probing measurements to actual sulcus or pocket depth, the interpretation of periodontal probing in the practice of periodontics may need reappraisal.
Short‐term effects of initial, nonsurgical periodontal treatment (hygienic phase)
Authors: Morrison E. C. , Ramfjord S. P. , Hill R. W. 
Published: December 2005

Abstract Longitudinal studies have reported the effect of various modalities of periodontal surgery on pocket depth and attachment levels related to pretreatment measurements. However, possible changes in these measurements as a result of scaling, oral hygiene improvements and occlusal adjustment during the hygienic phase were not considered. The purpose of the present study was to examine the short‐term effect of treatment of the hygienic phase in 90 patients with some pockets extending 4 mm or more apically to the CEJ. Pretreatment pocket depths and attachment levels related to the CEJ were measured by a thin probe in five sites at all 2,355 teeth in the sample. Scaling, root planing, instruction in oral hygiene and occlusal adjustment were completed during four to six sessions for each patient.Four weeks after completion of the hygienic phase, all variables were recorded. Mean measurements for pocket depths 1–3 mm, 4–6 mm. and ≥ 7 mm prior to treatment were compared to their posttreatment scores. Pocket depth decreased significantly for pockets extending 4 mm or more apically to the FGM. For pockets 4–6 mm there was a mean difference in pocket depth of 0.%± 0.47 mm (P < .0001) between pretreatment and post‐treatment observations. For pockets 7 mm or greater the mean difference was 2.22 ± 1.35 mm (P < .0001). Reduction in depth of pocket and improvement in attachment levels were related to the initial level of severity. Pocket reduction was in part due to the improvement in attachment levels. This study has demonstrated that the clinical severity of periodontitis is reduced significantly 1 month following the hygienic phase of periodontal therapy, and that need for surgical pocket treatment cannot be assessed properly until completion of the hygienic phase of treatment.
Histometric evaluation of periodontal surgery I. The modified Widman flap procedure
Authors: Caton Jack , Nyman Sture 
Published: December 2005

Abstract The present investigation was performed in the Rhesus monkey to determine the effect of the modified Widman flap procedure on the level of the connective tissue attachment and supporting alveolar bone. Two adult male Rhesus monkeys were used. Eighteen contralateral pairs of periodontal pockets were produced in a standardized manner. Surgical treatment of the pockets was performed around experimental teeth and the contra‐lateral teeth were used as the unoperated controls. Twelve months following treatment the animals were sacrificed and histological sections obtained. Using the cemento‐enamel junction (CEJ) as a fixed reference point, linear measurements along the. root surface were made to the most apical cells of the junctional epithelium (JE), to the crest of the inter‐proximal alveolar bone (CR), and to the apical extent of angular bony defects (AAD). These measurements from operated and unoperated pockets were then compared.The data revealed that treatment of periodontal pockets using the modified Widman flap procedure produced no gain in connective tissue attachment and no increase in crestal bone height. In angular bony defects a certain degree “bone fill” was noted. This bone repair was never accompanied by new connective tissue attachment.
Access to subgingival plaque by disclosing agents using mouthrinsing and direct irrigation
Authors: Pitcher G. R. , Newman H. N. , Strahan J. D. 
Published: December 2005

Abstract Teeth destined for extraction and exhibiting periodontal pockets had reference grooves cut on the proximal surfaces at the level of the gingival margin. A disclosing agent was then applied either as a mouthrinse or by direct irrigation at the entrance of the pocket. After extraction, the extent of apical penetration of the solution was measured from the reference point. Subsequently, the tooth was stained enabling similar measurements from the reference point to the level of the apical plaque border and the coronal level of the residual periodontal ligament.Analysis of these measurements indicated that neither mouthrinsing nor direct irrigation routinely achieved penetration of the solution to the apical plaque border. While mouthrinsing failed to achieve any significant penetration of pockets, the direct irrigation technique was partially effective.It was concluded that direct irrigation offers promise as a mode of application of chemical agents to subgingival plaque.
Influence of eating frequency upon plaque formation and periodontal bone loss
Authors: Savoff K. , Rateitschak K. H. 
Published: December 2005

Abstract The normal oral flora of weanling Osborne‐Mendel rats was suppressed with penicillin, then bone resorption was induced in the test group by inoculation with Actinomyces viscosus Ny 1. In the control group the oral flora was suppressed with erythromycin. A programmable feeding machine forced the rats into extremely varied eating frequencies.Rats which ate less frequently than normal exhibited significantly less bone loss. Frequent eating was correlated with elevated plaque accumulation.AVIS‐inoculated animals exhibited significantly (P < 0.001) more plaque than antibiotic‐treated rats. Both inoculated as well as non‐inoculated animals exhibited significantly more plaque (P < 0.001) when fed 28 times per day, in comparison to all other feeding schedules.AVIS‐inoculated animals exhibited significantly (P < 0.001) more bone loss than the antibiotic‐treated rats. Inoculated animals which were fed only seven times per day exhibited significantly (P < 0.05) less bone loss than similarly inoculated animals fed more frequently. Bone loss in the antibiotic‐treated animals was independent of feeding frequency. Among the other feeding frequencies (14 and 28 x/day, and ad libitum), there were no significant differences either in AVIS‐inoculated or in antibiotic‐treated animals.
Influence of free gingival grafts on the health of the marginal gingiva
Authors: de Trey Eric , Bernimoulin Jean‐Pierre 
Published: December 2005

Abstract In order to evaluate the effect of increasing the width of inadequate attached gingiva on the health of the marginal gingiva, 12 free gingival grafts were performed on 12 patients with less than 1.0 mm of attached gingiva on homologous contralateral pairs of mandibular teeth.A baseline examination, which included measurements of plaque, gingival exudate, sulcus bleeding, sulcus probing depth and width of attached gingiva, was done before surgery. One week after surgery, plaque was eliminated mechanically on the test and control sides. All measurements were repeated 7 and 14 weeks after surgery. During the week following the first postsurgical examination, individual oral hygiene instruction was given until the patient could show plaque‐free test and control sites.The width of the attached gingiva increased significantly on the side where the grafting was performed (test side). The only other significant changes observed during the experiment were a decrease of the mid‐buccal plaque index on the test side during the first 7 weeks following surgery and a decrease of the buccoproximal plaque index on the test and control sides during the total experimental period (14 weeks). None of the other clinical parameters measured showed significant differences when test and control sites were compared or when the same sites were compared longitudinally.
Effect on gingival health of removing overhanging margins of interproximal subgingival amalgam restorations
Authors: Rodriguez‐Ferrer H. J. , Strahan J. D. , Newman H. N. 
Published: December 2005

Abstract. This study was designed to clarify the relationship between amalgam restorations with subgingival overhanging margins and gingival health. This required the presence of such a restoration defect as the sole variable parameter. This was achieved by pairing 26 defective premolar and molar amalgams with similarly defective restorations in the same mouths, test and control being allocated randomly. Test amalgams were contoured to remove overhangs. All other procedures, namely, scaling, polishing and oral hygiene instruction were applied with equal emphasis. Plaque accumulation, gingival inflammation and pocket depths were recorded at 0, 4, 8 and 12 weeks. At the baseline (week 0) there were no significant differences between test and control sides for any of the parameters. Significant differences between test and control sides for all parameters were apparent at all other times.The greatest change took place during the first 4 weeks of the study. It was concluded that the presence of a subgingival overhanging defective margin may be the only important clinically significant feature of an amalgam restoration related to the pathogenesis of chronic inflammatory periodontal disease. It was also demonstrated that correction of defective restorations should be effected during the initial phase of periodontal therapy.