bluuebunny/crossref_metadata_2025_split huggingface dataset:
A longitudinal evaluation of varying widths of attached gingiva
Authors: Kennedy James E. , Bird William C. , Palcanis Kent G. , Dorfman Howard S. 
Published: December 2005

Abstract 32 patients with bilateral areas of inadequate attached gingiva on the facial surface of homologous contralateral teeth have been followed for 6 years. Treatment consisted of scaling, root planing, oral hygiene and maintenance at 3‐ to 6‐month intervals or as needed to control inflammation. A free gingival graft was placed on one side (experimental), while the other side served as the unoperated control.Areas of inadequate attached gingiva on control sides, to include those with recession and no attached gingiva, did not demonstrate additional recession or further loss of attachment. Gingival inflammation and plaque were significantly reduced. On experimental sides, the dimension of keratinized and attached gingiva increased and was stable over 6 years. Areas which began with recession and no attached gingiva exhibited a reduction in recession and gain in clinical attachment following the placement of a gingival graft.Examination of patients who had discontinued participation in the study for a period of 5 years revealed a reestablishment of gingival inflammation on the control sides associated with additional recession. Similar changes were not observed in areas treated by a free graft.The findings demonstrate that it is possible lo maintain periodontal health and attachment through control of gingival inflammation despite the absence of attached gingiva.
Actinobacillus actinomycetemcomitans in human periodontal disease
Authors: Zambon Joseph J. 
Published: December 2005

Abstract Recent evidence implicates Actinobacillus actinomycetemcomitans in the etiology of localized juvenile periodontitis. This paper reviews the morphological, biochemical and serological characteristics of A. actinomycetemcomitans, evidence incriminating it as a periodontopathogen, its importance in human nonoral infections, and virulence factors which may be involved in the pathogenesis of A. actinomycetemcomitans infections. A. actinomycetemcomitans is a non‐motile, gram‐negative, capnophilic, fermentative coccobacillus which closely resembles several Haemophilus species but which does not require X or V growth factors. The organism has been categorized into 10 biotypes based on the variable fermentation of dextrin, maltose, mannitol, and xylose and into 3 serotypes on the basis of heat stable, cell surface antigens. A. actinomycetemcomitans primary human ecologic niche is the oral cavity. It is found in dental plaque, in periodontal pockets, and buccal mucosa in up to 36% of the normal population. The organism can apparently seed from these sites to cause severe infections throughout the human body such as brain abscesses and endocarditis.There is a large body of evidence which implicates A. actinomycetemcomitans as an important microorganism in the etiology of localized juvenile periodontitis including: (1) an increased prevalence of the organism in almost all localized juvenile periodontitis patients and their families compared to other patient groups; (2) the observation that localized juvenile periodontitis patients exhibit elevated antibody levels to A actinomycetemcomitans in serum, saliva and gingival crevicular fluid; (3) the finding that localized juvenile periodontitis can be successfully treated by eliminating A. actinomycetemcomitans from periodontal pockets; (4) histopathologic investigations showing that A. actinomycetemcomitans invades the gingival connective tissue in localized juvenile periodontitis lesions; (5) the demonstration of several pathogenic products from A. actinomycetemcomitans including factors which may: (a) facilitate its adherence to mucosal surfaces such as capsular polysaccharides; (b) inhibit host defense mechanisms including leukotoxin, a polymorphonuclear leukocyte chemotaxis inhibiting factor, and a lymphocyte suppressing factor (c) cause tissue destruction such as lipopolysaccharide endotoxin, a bone resorption‐inducing toxin, acid and alkaline phosphatases, collagenase, a fibroblast inhibiting factor and an epitheliotoxin.Although A. actinomycetemcomitans is an apparently important micro‐organism in the etiology of localized juvenile periodontitis, additional research is needed to pinpoint subjects at risk of contracting this disease, to develop means of preventing localized juvenile periodontitis, and to examine the role of this organism in other forms of periodontal disease.
The influence of gingival stimulation on recovery from human experimental gingivitis
Authors: Bonfil J. J. , Fourel J. , Falabregues R. 
Published: December 2005

Abstract The present study concerns an investigation carried out to determine the effects of gingival stimulation on the resolution of a human experimental gingivitis. 10 young male Dental students participated in the experiment. Following the baseline examination (day 0). the participants were instructed to abstain from all oral hygiene procedures during a 21‐day period. Heavy plaque accumulation and gingivitis developed during the 21‐day induction period. On the evening of the 21st day active oral hygiene measures were reinstitued, for an 8‐day period, using 2 different methods. For the left side of the maxillary arch, a hygiene procedure including gingival stimulation was prescribed. On the other hand, for the right side, a hygiene method without gingival stimulation was instituted. On both sides of the upper arch, the gingival condition was assessed by means of the gingival index and soft deposits were assessed by the plaque index (selected teeth: 13, 14, 15, 23, 24, 25). Measurements were performed on days 0, 21, 22, 23, 24, 25, 26, 27, 28, 29.On day 29, ideal oral hygiene conditions and gingival health were re‐established on both sides. However, a statistical analysis of the data collected during the recovery period revealed that gingival index scores were temporarily, but significantly, higher on the side where mechanical stimulation was performed, although plaque deposits there decreased more rapidly. Thus the present work supports the idea that gingival stimulation does not in any way improve recovery from experimental gingivitis.
Gingival inflammatory reaction in children at different ages
Authors: Matron Lars , Goldberg Per 
Published: December 2005

Abstract Earlier studies have demonstrated that, with similar levels of plaque accumulation, the tendency to develop gingivitis is lower in pre‐school children than in young adults. No studies are available in which the gingival reaction in older children and adults to a given amount of plaque has been compared. The aim of the present study was to compare the gingival reaction to dental plaque in children of different ages and in adults.3 groups of children (4–6. 7–9 and 14–16 years of age) and 1 group of adults (20–22 years of age) were studied. The degree of gingivitis was determined using the gingival index and the amount of dental plaque was assessed in terms of the plaque index.The results showed that with a given plaque score, the % of high gingivitis scores was less in the 4–6‐year‐old children than in the older children and adults. At all levels of plaque accumulation, the highest degree of gingival inflammation was noted in the 14–16‐year‐old children and in the adults. The results indicate that the gingival reactivity increases gradually front early childhood to adult age.
The removal of root surface deposits
Authors: Eaton K. A. , Kieser J. B. , Davies R. M. 
Published: December 2005

Abstract The importance of adequate root surface instrumentation has received increasing emphasis. The purpose of this study was to determine the extent to which root planning could produce surfaces free of stainable deposits. Initial laboratory investigations on extracted, periodontally involved roots demonstrated that after meticulous root preparation, totally non‐stainable surfaces could be obtained. These surfaces were shown to consist of either thin cementum or dentine.The efficacy of instrumenting periodontally involved buccal root surfaces on the anterior teeth of 33 instrumented either before or after the reflection of surgical flaps. Remaining bacterial deposits were disclosed with a gentian violet solution and their root surfaces then photographed. Further root planning, disclosure and photography were then carried out. These photographic slides were analysed for stainable deposits on the root surfaces using an image analysis system, based on densitometric principles, to measure the areas of stainable root surface deposits. The findings revealed that root planning under direct vision at the time of surgery was more effective than blind instrumentation. However, in no instance was any root surface found to be completely free of stainable deposits.
Ultrastructure of developing subgingival plaque in beagle dogs
Authors: ten Napel J. H. , Theilade J. , Matsson L. , Attström R. 
Published: December 2005

Abstract The aim of this study was to describe the infrastructure of developing subgingival plaque. In 6 beagle dogs, healthy gingiva prevailed after a pre‐experimental period of intensive plaque control. At the start of the experiment, all oral hygiene measures were withdrawn. Biopsies comprising buccal gingiva and adjacent dental tissues were obtained from premolars and molars on days 0, 4, 7, 21, and 28 and processed for electron microscopy.Sections of day 0 exhibited a junctional epithelium in close contact with the tooth and absence of subgingival aggregations of bacteria on the tooth surface. For each of the subsequent periods studied, some sections did not exhibit subgingival plaque. In the remaining sections with subgingival plaque, almost all bacteria appeared in aggregates attached to the tooth surface. The number of bacteria at the orifice of the gingival sulcus increased with time. Further apically, the micro‐organisms formed either a continuous layer of even thickness or more frequently, discrete microcolonies along the tooth surface. The bacteria comprised practically entirely Gram‐negative cocci, rods or spirochetes. The latter were present either mixed with the other types in the discrete microcolonies or constituted the bulk of the continuous layer of plaque. In the apical part of the sabgingival plaque, a shift from Gram‐negative cocci and rod during the early stages of gingival inflammation, to a predominance of spirochetes in later stages was noted.The study shows that in dogs, starting from a plaque‐and gingivitis‐free baseline, a predominantly Gram‐negative subgingival flora may form within a few days after withdrawal of all oral hygiene measures and that a shift in the bacterial composition of the subgingival plaque rakes place during a 4‐week period of no oral hygiene.
The effect of citric acid and fibronectin application on healing following surgical treatment of naturally occurring periodontal disease in beagle dogs*
Authors: Caffesse Raul G. , Holden Michael J. , Kon Simao , Nasjlett Carlos E. 
Published: December 2005

Abstract It has recently been suggested that following the exposure of root surface collagen with citric acid, the addition of topically applied fibronectin might promote healing with a fibrous re‐attachment. The purpose of this study was to determine the benefit of citric acid demineralization and fibronectin application in the surgical treatment of severe, naturally occurring periodontal disease in Beagle dogs.The 4 treatment modalities employed were: (1) surgery alone (mucoperiosteal flaps); (2) surgery plus fibronectin; (3) surgery plus citric acid; (4) surgery plus citric acid followed by fibronectin application. Coronal and root surface notches were used as biometric and histometric reference points. Final clinical measurements were recorded 6 weeks post surgically, on the day of sacrifice.Significantly increased amounts of connective tissue reattachment were observed in the areas treated with the citric acid/fibronectin combination. Fibrous re‐attachment was enhanced at the expense of epithelial downgrowth and occurred directly to both new and old cementum and exposed dentin, often in a functional manner, i.e., perpendicular to the root surface. Areas treated with the surgery and citric acid technique attained moderate amounts of fibrous re‐attachment while the other treatment modalities were associated with a long junctional epithelium. The enhanced fibrous re‐attachment may be the product of an accelerated coalescing of exposed soft tissue and root surface collagen fibrils, while under the mediating effect of fibronectin.
New attachment – reattachment following reconstructive periodontal surgery
Authors: Isidor Flemming , Karring Thorkld , Nyman Sture , Lindhe Jan 
Published: December 2005

Abstract The present study was designed to evaluate if the conditions for reformation of a connective tissue attachment are less favorable on root surfaces which have lost their fibrous attachment because of periodontal disease than on root surfaces surgically deprived of their attachment apparatus.In each of 4 Green monkeys. 2 maxillary and – mandibular teeth were selected for experimentation. Periodontal breakdown was produced and allowed to progress to the mid‐root level around one of the experimental teeth in both the maxilla and mandible by placing elastic ligatures around the neck of these teeth. 3 months after removal of the ligatures, the crown of the teeth was resected and the epithelium and the subjacent granulation tissue were removed. Using a diamond bur. circumferential defects similar to those obtained by the ligature induced destruction were then produced around the remaining 2 experimental teeth following resection of the crown. The root cementum on both groups of teeth was removed to the level of the reduced bone height. Finally, all roots were submerged to complete coverage by a mucosal flap. After 3 months of healing, the animals were sacrificed and the jaws removed and placed in fixative. After decalcification. histological sections of the experimental roots and their surrounding periodontal tissues were produced. No histological differences in the result of healing were discernible between the specimens of previously periodontitis‐affected roots and roots with surgically created defects. New cementum with inserting collagen fibers had formed in the apical part of the instrumented surface in both groups of teeth. The length of the new fibrous attachment on the root surfaces surgically deprived of their periodontal ligament tissue was 0.7 mm (mean) with a range from 0.1 to 1.9 mm. On the root surfaces exposed by ligature‐induced periodontal breakdown, the newly formed cementum had an average length of 1.0 mm with a range between 0.1 mm and 2.6 mm. This difference between the groups was not statistically significant. The results indicate that the potentials for reformation of fibrous attachment are similar on planed root surfaces previously exposed to periodontal disease and on surfaces surgically deprived of their attachment apparatus.
The microbial morphotypes associated with periodontitis health and adult periodontitis: composition and distribution
Authors: Offenbachbr S. , Odle B. , Van Dyke T. 
Published: December 2005

Abstract Subgingival plaque samples were obtained from 162 sites in 27 adult periodontitis patients and 162 sites in 27 healthy patients using a standardized lavage technique. The distribution of 10 different microbial morphotypes was determined by darkfield microscopy. The lavage technique selectively samples the loosely adherent plaque at the base of the periodontal pocket and not the tooth‐associated, adherent plaque. This standardized technique permits quantitative comparisons of numerical density of morphotype composition at different sites, in addition to qualitative comparisons or relative proportions. There was a significant positive association between the numerical density of each morphotype within the non‐adherent plaque and the number of sites at which the organism was detected in both healthy and diseased subjects.A previously undescribed darkfield morphotype, has been detected with this method. This morphotype. a small motile coccobacillus (S–MO‐CB) has been found to be the numerically dominant species in both health and disease. This morphotype has been recovered in pure culture following passage through a 0.4 μ filter and includes organisms of the Wollinella and Campylobacter genus, Non‐motile organisms comprised less than 1–2% of the sample from healthy and diseased sites. Motile forms, such as spirochetes, had a high frequency of detection in healthy individuals. Analysis of pooled plaque samples revealed that the prevalence of cocci and fusiforms was significantly elevated in patients with healthy periodontium, as compared to patients with adult periodontitis. In adult periodontitis patients, the frequency of occurrence of medium spirochetes, filaments and small non‐motile rods was significantly elevated in pooled plaque. Analysis of individual sites indicated that the proportion and numerical density of most morphotypes within the non‐adherent plaque were not significantly different in disease as compared to health. Disease is characterized by an increased % of small spirochetes and fusiforms at each site. At diseased sites which harbor small spirochetes, the numerical density is elevated four‐fold, as compared to healthy sites which have small spirochetes. The numerical density of other morphotypes is not significantly different comparing healthy sites to diseased sites. Thus, the increase in the % of small spirochetes in disease in due to a site‐localized four‐fold increase in numerical density within the non‐adherent plaque.
Improved periodontal conditions following therapy
Authors: Wlstfelt E. , Bragd L. , Socransky S. S. , Haffajee A. D. , Nyman S. , Lindhe J. 
Published: December 2005

Abstract. The aim of the present clinical trial was to evaluate the effect of different modes of periodontal therapy on patients with moderately advanced periodontal disease and to express the findings in terms of probing pocket depth and attachment level alterations at periodontal sites with different initial probing depths.The material consisted of 16 patients, 35–65 years of age. Following a Baseline examination including assessments of oral hygiene status, gingival conditions, probing pocket depths and probing attachment levels, the patients were subjected to periodontal treatment. A “split‐mouth” design approach of therapy was used and the jaw quadrants were randomly selected for the following different treatment procedures: (1) scaling and root planing, (2) scaling and root planing in con junction with a gingivectomy procedure, (3) scaling and root planing m conjunction with an apically repositioned flap procedure without bone recontouring. (4) scaling and root planing in conjunction with an apically repositioned flap procedure including bone recontouring, (5) scaling and root planing in conjunction with a modified Widman flap procedure without bone recontouring and (6) scaling and root planing in conjunction with a modified Widman flap procedure including bone recontouring. The patients were following active treatment enrolled in a supervised maintenance care program including “professional tooth cleaning” once every 2 weeks during a 6‐month period of healing, after which a final examination was performed.The investigation demonstrated that active therapy including meticulous subgingival debridement resulted in a low frequency of gingival sites which bled on probing, a high frequency of sites with shallow pockets (<4 mm) and the disappearance of pockets with a probing depth of >6 mm. Between the Baseline examination and the 6‐month re‐examination, the probing attachment level for initially shallow‐pockets remained basically unaltered, but with a tendency of a minor apical shift. This occurred in all 6 treatment groups. For sites with initial probing depths of 4–6 mm and >6 mm, there was in all groups some gain of probing attachment. This gain was most pronounced in the initially deeper (>6 mm) pockets.With the use of regression analysis, the “critical probing depth” (CPD) value (i.e. the initial probing depth value below which loss of attachment occurred as a result of treatment and above which gain of probing attachment level resulted) was calculated far each of the 6 methods of treatment used‐ A comparison of the CPD‐values between the 6 treatment groups did not reveal any major differences.
The occurrence of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and Bacteroides intermedius in destructive periodontal disease in adults
Authors: Slots Jörgen , Bragd Lennart , Wikström Maude , Dahlén Gunnar 
Published: December 2005

Abstract A total of 235 subgingival sites, including 104 progressive deep lesions from 61 untreated patients, 26 progressive deep lesions from 10 treated patients, 33 nonprogressive deep sites from 20 untreated patients, and 72 nonprogressive sites from 55 treated patients were examined for Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and Bacteroides intermedius. The periodontal disease progression was mainly determined on the basis of radiographic changes in the crestal alveolar bone level. A. actinomycetemcomitans isolation was carried out using the selective TSBV medium and B. gingivalis and B. intermedius isolations were performed using a nonselective blood agar medium.1 or more of the 3 bacteria studied appeared in 99.2% of progressive periodontal lesions but only in 40.0% of nonprogressive sites. Culture‐positive progressive periodontal sites in comparison with culture‐positive nonprogressive sites showed higher median recovery rates of A. actinomycetemcomitans(0.5% vs 0.3%), B. gingivalis(30.5% vs 0.3%) and B. intermedius(4.9% vs 0.5%). Of total progressive lesions, 12.3% yielded solely A. actinomycetemcomitans, 21.5% demonstrated solely B. gingivalis, and 20.8% revealed solely B. intermedius. The A. actinomycetemcomitans‐B. intermedius combination was found in 24.6% of progressive lesions. A. actinomycetemcomitans appeared in significantly higher prevalence in treated‐progressive lesions (80.8%) than in nontreated‐progressive lesions (42.3%). 32 of the 42 culture‐positive nonprogressive sites yielded B. intermedius as the sole test organism.The main conclusion is that A. actinomycetemcomitans, B. gingivalis and B. intermedius are closely related to disease‐active periodontitis, and more closely than to periodontal pocket depth. This finding is important in understanding periodontal disease etiology and pathogenesis and may also aid in a clinical setting to differentiate progressing and nonprogressing periodontal sites.