bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antiplaque biocides and bacterial resistance: a review
Authors: Sreenivasan Prem , Gaffar Abdul 
Published: March 2003

AbstractModern dentistry emphasizes the importance of dental plaque control to improve oral health. The use of oral care formulations with antiplaque biocides plays a crucial role in patient‐directed approaches for plaque control. The antiplaque efficacies of these formulations have been extensively studied in many long‐term clinical studies designed in accordance with well‐accepted guidelines. The results from these studies conclusively demonstrate that long‐term use of oral care formulations with well‐known antiplaque biocides such as chlorhexidine and triclosan reduce supragingival plaque and gingivitis. This review summarizes microbiological results from clinical studies conducted with oral care formulations containing antiplaque biocides. Results from a number of long‐term clinical studies conducted under real‐life use conditions indicate no adverse alterations in the bacteria found in dental plaque or emergent microbial resistance. Additionally, microbial sampling of dental plaque subsequent to extended use of antiplaque biocides reveals no increase in resistant microflora. Large numbers of common oral bacteria isolated from patients using chlorhexidine indicate no increase in microbial resistance to chlorhexidine or to commonly used antibiotics. The effects of antiplaque biocides containing oral care formulations on dental plaque that exists naturally as a biofilm are examined. These formulations contain biocide, surfactants, polymers and other components that are effective against the biofilm. In summary, the results of studies on the real‐life use of oral care formulations with antiplaque biocides show no emergence of resistant microflora or alterations of the oral microbiota, while such formulations have been found to provide the benefits of reducing plaque and gingivitis.
Interactions between stress, interleukin‐1β, interleukin‐6 and cortisol in periodontally diseased patients
Authors: Mengel Reiner , Bacher Michael , Flores‐de‐Jacoby Lavin 
Published: March 2003

AbstractBackground/Aims: The aim of the present study was to measure interleukin‐1β, interleukin‐6 and cortisol levels in the peripheral blood of periodontally diseased patients in order to record any interactions with psychosocial stress.Material and methods: The test group comprised 16 patients with untreated and 14 with treated aggressive generalized periodontitis (AGP), five patients with untreated aggressive localized periodontitis (ALP) and five with chronic generalized periodontitis (CGP). The control group comprised 40 periodontally healthy probands. Blood was taken from the cephalic vein of all patients and controls at the same time (8 a.m.) each day. IL‐1β, IL‐6 and cortisol levels were then measured with a sensitive ELISA, the ‘Quantikine HS Immunoassay Kit’ (Biermann Diagnostica, Bad Nauheim, FRG). The clinical examination covered probing depth, gingival recession, gingival index, plaque index and clinical attachment level. A questionnaire was used to ask the patients and controls about their attitude to life and the stress induced by their jobs and their families. Previous and current levels of tobacco consumption were also recorded. Statistical evaluation was based on the Mann–Whitney U–Wilcoxon test for comparison of blood serum values and clinical parameters between patients and controls, and the Kruskal–Wallis test for intergroup comparison. All data were correlated by means of Spearman's rank correlation coefficient, and significance levels relating to stress and smoking were determined with the chi‐square test.Results: With respect to cortisol, the results showed no significant differences either between the patient groups or in comparison with the controls. IL‐1β was detected only in the AGP patients and their controls, but with no significant differences. IL‐6 was detected in virtually all patients and controls, but with no significant differences. Only in the untreated AGP patients was IL‐6 significantly elevated (P < 0.05) and a slight correlation with attachment loss recorded. In all AGP patients a slight correlation between IL‐1β and IL‐6 was recorded. Evaluation of the questionnaire revealed a higher proportion of untreated AGP patients than of controls with a pessimistic attitude to life. In all AGP patients, family‐induced stress and smoking were found to correlate with attachment loss. In the untreated AGP patients, smoking correlated with IL‐1β protein content, and in the controls there was a moderate correlation between smoking and IL‐6 levels. Conclusions: The present study found no correlation between the immunological mediators (IL‐1β, IL‐6), glucocorticoids (cortisol) and the registered stress values. However, the patients with untreated AGP showed signs of a pessimistic attitude to life, and an elevated IL‐6 level was recorded in the peripheral blood. As a restrictive factor it should be borne in mind that the number of patients investigated was too small for adequate conclusions to be drawn.
Immunohistochemical characteristics of inflammatory lesions at implants
Authors: Gualini Federico , Berglundh Tord 
Published: March 2003

AbstractObjective: The aim of the present investigation was to study some immunohistochemical features of peri‐implant mucositis and peri‐implantitis lesions.Materials and methods: Two groups of subjects (Groups A and B) were included. Group A consisted of 10 partially edentulous subjects (eight females and two males; 45–72 years of age) who had been restored with implants (Brånemark System®, Nobel Biocare AB, Göteborg, Sweden). The implants had been in function between 2 and 5 years. In each subject, one implant site demonstrating signs of peri‐implant mucositis, i.e. soft tissue inflammation but no bone loss, was selected. The site was anaesthetized and a soft tissue biopsy was collected. In Group B, six subjects were included. They had been restored with implants (Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) between 5 and 11 years prior to the current study. In each individual ≥ 1 implant site exhibited signs of peri‐implantitis and was selected for biopsy. All sites of peri‐implantitis had (i) a history of continuous marginal bone loss (assessed in radiographs), (ii) clinical symptoms of soft tissue inflammation (bleeding on probing and suppuration) but (iii) no implant mobility. From each selected peri‐implantitis site a 4 × 4 mm large soft tissue biopsy was obtained. All specimens were snap frozen and prepared for immunohistochemical analysis regarding the proportions of cells positive for the CD3, CD4, CD8, CD19 and elastase markers.Results: Peri‐implantitis lesions were considerably larger and contained significantly greater proportions of B cells (CD19+) and elastase‐positive cells than mucositis lesions. Peri‐implantitis sites, in contrast to sites with mucositis, consistently displayed elastase‐positive cells in the central portions of the infiltrate.Conclusion: It is suggested that peri‐implantitis lesions exhibit properties that are different from mucositis lesions.
Systemic medications: clinical significance in periodontics
Authors: Ciancio Sebastian G. 
Published: March 2003

AbstractSystemic medications are of value as adjuncts to periodontal therapy. These medications can be divided into two major categories: antibiotics and agents for host modulation. Antibiotics have been shown to be valuable adjuncts in specialized types of periodontal disease, such as localized and generalized aggressive periodontitis, and of possible value in severe chronic periodontitis. Antibiotics have been studied individually, in combination and in sequential therapy. Host modulators include Periostat, non‐steroidal anti‐inflammatory agents, alendronate (Fosamax), hormone replacement therapy and anti‐arthritic medications. These agents produce their beneficial effects by a variety of mechanisms of action, including inhibition of matrix metalloproteinases, inhibition of prostaglandin production, stimulation of osteoblasts, inhibition of osteoclasts, and other anti‐inflammatory mechanisms of action.
Longitudinal study on periodontal conditions in healthy elderly people in Japan
Authors: Hirotomi Toshinobu , Yoshihara Akihiro , Yano Masatoshi , Ando Yuichi , Miyazaki Hideo 
Published: March 2003

Abstract –Objectives: A strategy for the control of periodontal disease progression is required to prevent tooth loss in older people. However, detailed epidemiological data on periodontal conditions in elderly people is limited. The purpose of the present study is to describe the natural history of periodontal disease and to evaluate the intraoral factors relating to the disease progression in systemically healthy elderly people.Methods: In the cross‐sectional study, 599 and 162 subjects aged 70 and 80 years, respectively, were examined. Of those subjects aged 70 years, 436 (73%) participated in the 2‐year longitudinal study. Pocket depth (PD) and attachment level (AL) were measured for all functioning teeth at six sites per tooth. In the cross‐sectional study, AL of 4 mm or greater and 7 mm or greater were defined as moderate and severe disease, respectively. In the longitudinal study, a change in AL of 3 mm or greater at each site was defined as periodontal disease progression.Results: In the cross‐sectional study, 97.1% of the subjects had at least one site of AL of 4 mm or greater (4+ mm). The prevalence of AL of 7 mm or greater (7+ mm) was 47.9%, with 2.8 affected teeth per person in those with AL 7+ mm. These findings reveal that periodontal disease is extremely widespread in the elderly population. However, very few had many teeth with severe periodontal conditions. In the longitudinal study, 75.1% experienced attachment loss of 3 mm or greater (3+ mm) during the 2‐year study period. Of those subjects who experienced attachment loss, a mean of 4.7 teeth exhibited attachment loss. Multivariate logistic regression showed that both the highest AL in each tooth at baseline and abutment teeth for removable partial dentures were significantly related to periodontal disease progression as well as tooth loss incidence.Conclusions: These results suggest that teeth with poor periodontal conditions as well as abutment teeth for removable partial dentures were significant intraoral factors relating to periodontal disease progression as well as tooth loss.
Development of clinical practice guidelines for dentists: methods for topic selection
Authors: Van Der Sanden Wil J. M. , Mettes Dirk G. , Grol Richard P. T. M. , Plasschaert Alphons J. M. , Verdonschot Emiel H. 
Published: March 2003

Abstract –Objectives: The aim of this study was to compare four methods for assessing the preferences of the dental profession for topics to be considered for the development of clinical practice guidelines.Methods:  The methods were: (1) a survey among dentists, (2) an analysis of topics discussed in dental peer groups, and (3) screening of dental journals. A fourth method was obtained from method number 3. The frequencies of the reported topics were calculated for each of the methods. For the fourth method, the number of publications per topic were plotted against the year of publication, and the slope of the linear regression line was used as an indicator. Within each of the four methods, the topics were ranked according to the frequency in which they were reported, and to the slope value. The reliability of the methods was tested by the “item‐rest sum correlation”, which is the correlation of the rank positions of one method with the sum of the rank positions obtained by the remaining three methods.Results:  In using all methods, a total of 1027 topics were obtained. Reclassification resulted in 34 topics. Moderate item‐rest sum correlations ranging from 0.34 to 0.48 were found for all methods, indicating that the rank order of every method moderately predicts the sum of the rank orders obtained by all other methods. The topic ‘prevention of cross‐infection’ had the highest overall rank position.Conclusion:  It is concluded that the four applied methods appeared to provide a consistent ranking of potential topics. In view of the fact that the questionnaire method is generally applicable, this method should be preferred for assessing dentists' preferences for topics to be considered for the development of clinical practice guidelines.
Dentistry between pathology and cosmetics
Authors: Marthaler Thomas M. 
Published: March 2003

AbstractIn ancient and medieval times, the prevalence of caries and periodontal disease varied. There were no treatments for dental hard tissue, but dental cosmetics played an important role. In the late 19th century, caries levels reached a maximum in Europe and North America after refined sugar became a cheap staple food. Toothlessness became frequent even in young adults. Caries prevention, effective on a public health scale, began with the introduction of water fluoridation in the 1940s. By 1985, dental academia had acknowledged that substantial declines could also be obtained in entire populations through topical fluorides, mainly in toothpastes. While decreasing caries prevalence is irrefutable in affluent countries, the specific reasons of the decline are still a matter of debate.In countries where caries has declined substantially, activities of dentists are shifting towards cosmetic dentistry. However, caries continues to be a problem for the lower socioeconomic strata, even in affluent countries, and is a serious problem in developing countries. Thus, water fluoridation is still important, and salt fluoridation should be considered where water fluoridation is not feasible. Both measures are extremely cheap to implement. Controlled fluoridation has a great potential for developing countries and low social strata of affluent countries. Its reduced effectiveness in high socioeconomic strata of affluent countries, due to the widespread usage of fluoride in toothpastes and other oral care products, should not detract from the public health value of fluoridation.
Psychological factors and perceptions of pain associated with dental treatment
Authors: Maggirias J. , Locker D. 
Published: March 2003

AbstractAlthough pain during dental treatment has been identified as playing a major role in the onset of dental anxiety and is a major concern of patients when seeking dental care, there have been very few studies of the prevalence of pain during dental treatment and the factors associated with patients' perceptions of pain. This study used data from a longitudinal population‐based study to assess the proportion of dental attenders who experienced pain while having dental treatment and the psychological characteristics which predisposed them to experience pain. Of 1422 subjects who completed questionnaires at baseline and five‐year follow‐up, 96.4% had visited a dentist over the observation period. Two fifths, 42.5%, reported having pain during treatment and one‐fifth, 19.1%, had pain that was moderate to severe in intensity. Reports of pain were associated with the types of treatment received, and a number of baseline sociodemographic and psychological factors. In a logistic regression analysis predicting the probability of pain, a variable documenting the number of types of invasive treatment received (restorations, extractions, crowns/bridges, root canal therapy and periodontal treatment/surgery) had the strongest independent effect. Pain was also more likely to be reported by those with previous painful experiences and those who were anxious about dental treatment, expected treatment to be painful and felt that they had little control over the treatment process. Pain was less likely to be reported by those who said they were unwilling to accept or tolerate pain. Younger subjects and those with higher levels of education were more likely to report pain than older subjects and those with a lower educational level. These results indicate that pain is as much a cognitive and emotional construct as a physiological experience. They also have implications for dentists' behaviour when providing dental care.
Keratotic melanocytic nevus: a clinicopathologic and immunohistochemical study
Authors: Horenstein Marcelo G. , Prieto Victor G. , Burchette James L. , Shea Christopher R. 
Published: March 2003

Background: Epidermal hyperplasia in melanocytic nevi is a common but little‐investigated phenomenon.Methods: We prospectively examined all melanocytic nevi diagnosed in our department over an 8‐month period, for the criteria of keratotic melanocytic nevus (KMN), namely the presence of marked epidermal hyperplasia with or without horn pseudocyst formation, hyperkeratosis, and papillomatosis. In addition to routine histologic review, we studied 12 representative cases with immunohistochemistry to examine expression of Ki‐67, epidermal growth factor receptor (EGFR), Bcl‐2, and Bax.Results: From a total of 1527 melanocytic nevi, 95 were KMN (prevalence 6%). The average age was 34 years, with a male:female ratio of 1:2. The predominant location was the trunk (76%), followed by head and neck (20%), and extremities (4%). Clinical diagnoses were atypical nevus (44%), nevus not otherwise specified (43%), and others including seborrheic keratosis, acrochordon, and basal cell carcinoma. Two KMN were junctional, 44 compound, and 49 intradermal. Twenty‐three KMN (24%) had histologic features suggesting congenital onset, and 15 (16%) had mild to moderate dysplastic features. Two cases demonstrated induction of sebaceous glands. Significantly increased Ki‐67 expression was detected in the hyperplastic epidermis, particularly in deeper areas related to keratinous cysts and hair follicles. Bcl‐2 and Bax (anti‐ and pro‐apoptosis proteins, respectively) and EGFR were expressed similarly in both normal and hyperplastic epidermis overlying the KMN.Conclusions: KMN are commonly biopsied skin lesions, mostly located on the trunk. Many such lesions are clinically considered atypical, in contrast to their benign histologic appearance. The epidermal hyperplasia on top of KMN demonstrates increased cellular proliferation, in the context of adequately regulated apoptosis and EGFR expression. The cellular proliferation seems to commence in hair follicles.
A case of intravascular large B‐cell lymphoma mimicking erythema nodosum: the importance of multiple skin biopsies
Authors: Kiyohara T. , Kumakiri M. , Kobayashi H. , Shimizu T. , Ohkawara A. , Ohnuki M. 
Published: March 2003

Background: Intravascular lymphoma is a rare disease characterized by the proliferation of neoplastic monuclear cells within the lumens of small blood vessels. The neoplastic cells are usually of B‐cell origin, and rarely of T‐cell or histiocytic origin. Although this clinicopathological entity of lymphoma has not been listed in general pathological classifications such as REAL classification or the Working Formulation, it is recently in the WHO classification scheme, which is essentially an updated REAL scheme, and the EORTC classification scheme.Methods: In this report, a 62‐year‐old woman with intravascular large B‐cell lymphoma was observed by clinical, histopathological, immunohistochemical and molecular methods.Results: A 62‐year‐old woman presented with large erythematous macules on the bilateral thighs and lower legs. The lesions were accompanied with hard, tender, intradermal or subcutaneous nodules mimicking erythema nodosum. Histopathological examination in the first biopsy revealed non‐specific panniculitis compatible with erythema nodosum. The second biopsy revealed emboli of atypical lymphocytes within many of the dilated and proliferated vessels in the deep dermis and subcutaneous tissue. These cells were positive for L‐26 and kappa light chain, and negative for lambda light chain, factor VIII‐related antigen, CD30, CD34, CD68 and UCHL‐1. These findings confirmed the diagnosis of intravasular large B‐cell lymphoma. A laboratory examination showed a high level of LDH and abnormal cells in the bone marrow. An MRI of the brain and computed tomographic (CT) scans of the chest and abdomen revealed no evidence of malignancy. Before the treatment, the size of the nodules decreased spontaneously by about 50% in one month and significantly in two months. Although combination chemotherapy, which consisted of CHOP, brought her partial remission, she experienced neurological symptoms 6 months after the initial treatment and died of brain metastasis 9 months after the treatment.Conclusions: This is a unique case for two following reasons: 1) the first biopsy revealed non‐specific findings compatible with erythema nodosum; and 2) before the treatment, the nodules regressed spontaneously. Dermatologists should take multiple skin biopsies for EN lesions with the non‐specific histopathological findings not to refute the existence of this disease.
Restrictive dermopathy: report of a case and review of the literature
Authors: Wesche W. A. , Cutlan R. T. , Khare V. , Chesney T. , Shanklin D. 
Published: March 2003

Background: Restrictive dermopathy is a rare autosomal recessive skin disorder that is fatal in the neonatal period. Clinical and pathologic findings are distinctive and allow for a specific diagnosis in most cases.Methods: We present a case of an affected infant and a review of the previously reported cases in the literature.Results: The infant had thick shiny skin with reduced compliance and multiple spontaneous linear splits. Additional findings included an abnormal facies with a distinctive small, round and open mouth, low set ears, small nose, widely spaced sutures, flexion contractures of the extremities, and poorly expanded lungs. The infant expired 65 h after birth. Histologic findings of the skin at autopsy included a relatively unremarkable epidermis, a flat dermal‐epidermal junction (absent rete ridges), an overall thinned dermis with hypoplastic appendage structures, a dense fibrotic reticular dermis with collagen parallel to the epidermis, a sharp subcutaneous margin, and an abnormally thick layer of subcutaneous adipose tissue. Electron microscopic findings included dense dermal patches of collagen and fibroblasts with abundant endoplasmic reticulum and unusually small tonofilaments. Review of previously reported cases reveals strikingly consistent findings.Conclusions: This rare condition illustrates that abnormal cutaneous development may produce fetal hypokinesia, leading to profound effects on intrauterine growth and development. The autosomal recessive pattern of inheritance and morphologic changes of the skin and skeletal system in this disorder suggest that a structural protein or enzyme defect, perhaps of collagen metabolism, may underlie the pathogenesis.