bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of initial periodontal therapy on sulcular/tongue sulfide level
Authors: Morita Manabu , Wang Hom‐Lay 
Published: March 2003

AbstractBackground : Volatile sulfur compounds (VSC), such as hydrogen sulfide, methyl mercaptan and dimethyl sulfide, are toxic metabolites produced by periodontal pathogens. These VSC are also released from the tongue dorsum. Currently, limited data are available on how periodontal treatments may affect sulcular/tongue sulfide level. The aim of this study was to determine effect of initial therapy including oral hygiene instruction and scaling and root planing (SRP) on sulcular/tongue sulfide level.Methods : Thirteen subjects diagnosed with chronic periodontitis and having three representative periodontal pocket depth (PD) strata in one quadrant (PD ≤ 3.0 mm: healthy, 4.0 mm ≤ PD ≤ 6.0 mm: moderate, and PD ≥ 7.0 mm: severe disease sites) were selected. Clinical periodontal parameters were recorded at baseline and 3 weeks after completion of the initial therapy. The sulfide levels in three representative periodontal pockets (pS) and on three parts (anterior, middle, and posterior) of the tongue dorsum (tS) were measured using a commercial sulfide‐monitoring device.Results : The pS levels of the three representative sites were reduced significantly following the initial therapy (p < 0.05). However, there was no significant reduction of the tS level in all three parts of the tongue.Conclusions : The initial periodontal therapy such as oral hygiene and SRP reduces the sulcular sulfide level but not the tongue sulfide level. This suggests that sulcular sulfide level may be a possible indicator for assessing the outcome of initial periodontal treatment.
Efficacy of a prototype brush head for a powered toothbrush
Authors: McCracken G. I. , Chapple I. L. , Milward M. , Steen N. , DeJager M. , Heasman P. A. 
Published: March 2003

AbstractPrimary objective: To evaluate a multicentre clinical trial design for testing powered toothbrushes.Secondary objective:  To compare the efficacy of a prototype brush head (N2.3) for the Philips Jordan Sensiflex 2000 powered toothbrush (PTB) to that of Braun Oral‐B D15 PTB in removing dental plaqueMaterial and methods:  137 volunteers (ages 18–25 years) were recruited to this 3‐centre, 2‐week, 2‐group, 2‐treatment, single‐blind trial. Plaque was recorded at screening and again 14 days later at baseline. Stratification of subjects, for gender and screening PI, occurred at baseline. Subjects were then asked to abstain from all oral hygiene measures for 48 h followed by a supervised episode of brushing for 3 min with the allocated PTB. The allocated PTB was used at home for the next 12 days before a second abstinence from all oral hygiene measures for the 48 h prior to a second supervised brushing episode. Plaque levels were scored using a modification of the Quigley & Hein plaque index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (SS). To enable the means of the within subject differences (pre to postbrushing) to be compared between groups PIs were recorded before and after the supervised brushing episodes, differences between centres, groups and visits were examined.Results: No significant differences in PI between groups at screening, baseline or prior to the supervised brushings were detected (P > 0.05 anova). The results of the analysis of variance showed there to be a highly significant difference (P < 0.001) between brushing groups, but, significant differences between centres (P < 0.001) and a significant interaction effect between centre and brushing group (P < 0.001) was also detected. Therefore the difference between groups was not present at all three centres. Further examination of the single centre data showed there to be greater levels of plaque removed by the N2.3 compared to the D15 (FM reduction in PI 1.95 vs. 1.13, respectively) at centre 3 in contrast to the other two centres where no difference was detected. The precise reason for these differences could not be established.Conclusions:  A multicentre study design is applicable for evaluating PTBs but a minimum of 3 centres should be included so that differences between centres can be identified. The prototype brush head N2.3 for the Philips Jordan Sensiflex 2000 PTB has comparable plaque removal efficacy to the Braun Oral‐B D15 PTB at FM, IP and SS sites.
Antibody‐based diagnostic for ‘refractory’ periodontitis
Authors: Levine M. , LaPolla S. , Owen W. L. , Socransky S. S. 
Published: March 2003

AbstractObjective: About 10–15% of US adults are ‘refractory’ to therapy for chronic periodontitis. Recently, studies suggest that these patients have elevated lysine decarboxylase activity in the sulcular microbiota. The aim of this study was to determine whether an elevated IgG antibody response to lysine decarboxylase, alone or with antibody to other bacterial antigens and baseline clinical measurements, would predict ‘refractory’ patients with high accuracy.Methods: Chronic periodontitis patients were treated using scaling and root planing (SRP) followed by maintenance SRP and 3‐monthly re‐examinations. If there was a loss of mean full mouth attachment or more than three sites appeared with > 2.5 mm new loss within a year, the subjects were re‐treated (modified Widman flap surgery and systemically administered tetracycline). If attachment loss as above recurred, the subjects were ‘refractory’. Baseline clinical measurements and specific antibody responses were used in a logistic regression model to predict ‘refractory’ subjects.Results: Antibody to a peptide portion of lysine decarboxylase (HKL‐Ab) and baseline bleeding on probing (BOP) prevalence measurements predicted attachment loss 3 months after initial therapy [pIAL = loss (0) or gain (1)]. IgG antibody contents to a purified antigen from Actinomyces spp. (A‐Ab) and streptococcal d‐alanyl glycerol lipoteichoic acid (S‐Ab) were related in ‘refractory’ patients (R2 = 0.37, p < 0.01). From the regression equation, the relationship between the antibodies was defined as linear (pLA/S‐Ab = 0) or non‐linear pLA/S‐Ab = 1). Using pLA/S‐Ab, pIAL and age, a logistic regression equation was derived from 48 of the patients. Of 59 subjects, 37 had 2–4 mm attachment loss and were assigned as ‘refractory’ or successfully treated with 86% accuracy.Conclusion: HKL‐Ab facilitated an accurate prediction of therapeutic outcome in subjects with moderate periodontitis.
Meta‐analysis of the effect of scaling and root planing, surgical treatment and antibiotic therapies on periodontal probing depth and attachment loss
Authors: Hung Hsin‐Chia , Douglass Chester W. 
Published: March 2003

AbstractObjective: This paper reports a meta‐analysis of studies that have investigated the effect of scaling and root planing on periodontal probing depth and attachment loss.Material and methods: The criteria used for inclusion of studies were as follows: root planing and scaling alone was one of the primary treatment arms; patients or quadrants of each patient were randomly assigned to study groups; 80% of patients enrolled were included in first year follow‐up examinations; periodontal probing depth and attachment loss were reported in mm; the sample size of each study and substudy was reported. Sample size was used to weight the relative contribution of each study since standard errors were not reported by many studies and sample size is highly correlated with standard error and therefore statistically able to explain a substantial portion of the standard error on studies that use similar measures.Results: The meta‐analysis results show that periodontal probing depth and gain of attachment level do not improve significantly following root planing and scaling for patients with shallow initial periodontal probing depths. However, there was about a 1‐mm reduction for medium initial periodontal probing depths and a 2‐mm reduction for deep initial periodontal probing depths. Similarly, there was about a 0.50‐mm gain in attachment for medium initial periodontal probing depth measurements and slightly more than a l‐mm gain in attachment for deep initial periodontal probing depth measurements. Surgical therapy for patients with deep initial probing depths showed better results than scaling and root planing in reducing probing depths. When patients were followed up over 3 years or more, these differences were reduced to less than 0.4 mm. Antibiotic therapy showed similar results to scaling and root planing. However, a consistent improvement in periodontal probing depth and gain of attachment is demonstrated when local antibiotic therapy is combined with root planing and scaling.
Residual periodontal defects distal to the mandibular second molar 6–36 months after impacted third molar extraction
Authors: Kan Kwok Wing , Liu Jerry K. S. , Lo Edward C. M. , Corbet Esmonde F. , Leung W. Keung 
Published: March 2003

AbstractAim: This retrospective study investigated the periodontal conditions distal to mandibular second molars 6–36 months after routine surgical extraction of adjacent impacted third molars.Method: Subjects were randomly selected by systematic sampling from computer records of 3211 surgical mandibular third molar extractions in the Hong Kong dental teaching hospital. Records and pre‐extraction radiographs of the selected cases were retrieved. Selected subjects (n = 283) were invited for an interview followed by a clinical examination. Community Periodontal Index (CPI) protocol was used for the assessment of the general periodontal status (excluding the mandibular second molar of interest, i.e. the subject tooth) followed by a detailed periodontal examination of the subject tooth.Results: In all, 158 subjects, aged 29 ± 7 years, were examined with only 6% (nine subjects) having a highest CPI score of 4 (excluding the subject tooth), but local periodontal defects were prevalent at the distal surface of subject mandibular second molars: mean probing pocket depth (PPD) was 5.4 ± 1.9 mm with 67% (106 subjects) exhibiting PPD ≥ 5 mm and 23% (36 subjects) exhibiting PPD ≥ 7 mm; mean recession was 0.8 ± 1.0 mm; bleeding on probing 96% and suppuration on probing 5%. Multiple linear regression analysis was used to analyse the effects of 12 independent variables on the PPD at the distal surface of the involved mandibular second molar. Three possible risk indicators (P < 0.001, R2 = 0.27) associated with localised increased PPD at the distal surface of the mandibular second molars were identified: 1) third molar ‘mesio‐angular’ impaction; 2) pre‐extraction crestal radiolucency and 3) inadequate post‐extraction local plaque control.Conclusion: The results suggest that periodontal breakdown initiated and established on the distal surface of a mandibular second molar in the vicinity of a ‘mesio‐angular’ impacted third molar evidenced by pre‐extraction crestal radiolucency in association with inadequate plaque control after extraction can predispose to a persistent localised periodontal problem.
Quantitative assessment of apoptotic and proliferative gingival keratinocytes in oral and sulcular epithelium in patients with gingivitis and periodontitis
Authors: Jarnbring F. , Somogyi E. , Dalton J. , Gustafsson A. , Klinge B. 
Published: March 2003

AbstractBackground:  Periodontal disease is caused by a chronic infection inducing an inflammatory reaction that leads to a breakdown of tooth‐supporting tissue. The maintenance of an equilibrium between the host defence and microorganisms in the sulcus is essential to preserve health. All multicellular organisms have mechanisms for killing their own cells, and use physiological cell death for defence, development, homeostasis and ageing. Apoptosis and proliferation are very important phenomena in regulating this and a disturbance is often associated with disease e.g. cancer, AIDS, Alzheimer's disease, rheumatoid arthritis.Objective: The aim of this study was to determine whether the number of apoptotic and proliferative gingival keratinocytes differed between patients with gingivitis and those with periodontitis.Material and methods: The distribution of neutrophil elastase, PCNA/cyclin, DNA fragmentation (apoptosis) and p53 was determined with immunocytochemical techniques. We used paraffin‐embedded sections from gingival biopsies and did quantitative analyses.Results and conclusion: These showed that 5–12% of the keratinocytes in the basal layers of the epithelium proliferated in the two groups. Fewer apoptotic cells were seen in the oral epithelium than in the sulcus in all subjects in both groups. Only in the most apical part of the sulcus, close to the junctional epithelium, did the number of apoptotic keratinocytes exceed the proliferative ones in patients with periodontitis.
Periodontal treatment practices of Finnish dentists
Authors: Heinikainen Mia , Vehkalahti Miira , Murtomaa Heikki 
Published: March 2003

Abstract Objectives: To evaluate the treatment practices of Finnish general practitioners (GPs) and dental teachers (DTs) regarding periodontal treatment modalities, and their knowledge of possible contraindications for periodontal surgery. Material and methods: A questionnaire on two periodontal cases was mailed to 400 GPs, selected by stratified randomization from the public and private sector, and to 47 DTs. The response rate was 77%. Respondents were asked to choose the optimal treatment for a patient with a bleeding, 8‐mm‐deep periodontal pocket and to consider the influence on their treatment decision of the six possible contraindications for periodontal surgery presented, two of which were absolute (inadequate oral hygiene and poorly controlled diabetes) and four of which were relative contraindications. The respondents' treatment decisions were compared with recommendations from textbooks and the Consensus Report from the 1996 World Workshop of Periodontology. Results: The majority of public (65%) and private (70%) dentists and almost all of the DTs chose treatment in agreement with recommendations. Correct answers from dentists were associated with a greater number of days in continuing education (OR = 1.5; p= 0.005). The two absolute contraindications were known by 38% of public and 31% of private sector dentists, and by 29% of DTs. The respective figures for relative contraindications were 40, 58 and 53%. Conclusion: The majority of Finnish dentists followed the recommendations, but elaboration of international guidelines for good clinical practice is still needed to help clinicians to make optimal treatment decisions.
Effectiveness of chlorhexidine–thymol varnish for caries reduction in permanent first molars of 6–7‐year‐old children: 24‐month clinical trial
Authors: Baca Pilar , Muñoz M. José , Bravo Manuel , Junco Pilar , Baca Adela P. 
Published: March 2003

AbstractObjectives: To determine the effect of chlorhexidine varnish on the prevention of caries in permanent first molars.Methods: Two groups of 6–7‐year‐old school children were followed up in a clinical trial, a group of 86 children whose teeth were treated with a chlorhexidine–thymol varnish (Cervitec®) and a control group of 95 children. The varnish was reapplied every 3 months and the caries increments were compared at 24 months.Results: The DFS (decayed and filled surfaces in permanent first molars) increment in the control group (mean = 1.85; SD = 2.27) was higher than in the test group (mean = 0.95; SD = 1.38), resulting in a 48.6% caries reduction. This difference was statistically significant (P = 0.032).Conclusions: Chlorhexidine–thymol varnish is effective in preventing caries in permanent first molars.
Oral health care education and its effect on caregivers' knowledge and attitudes: a randomised controlled trial
Authors: Frenkel Heather , Harvey Ian , Needs Kathy 
Published: March 2003

Abstract Objectives: The effect of an oral health care education programme (OHCE) upon nursing home caregivers was assessed in a randomised controlled trial. Methods: A self‐administered questionnaire assessed oral health care knowledge and attitudes at baseline among 369 caregivers working in 22 nursing homes. Homes were randomly allocated to two groups. The intervention was a workplace OHCE. Caregivers assessed the value of the presentations. Questionnaires were re‐administered 1 month (time 2) and 6 months (time 3) after the OHCE was delivered. The knowledge and attitude score means of the groups were compared. Open‐ended questions solicited qualitative data. Results: Questionnaire response rates at the three time points ranged from 76.3% to 85.4%. Two‐thirds of caregivers employed at the time of the intervention attended the presentations. The OHCE was favourably assessed in 79% of responses. The intervention group significantly improved their scores over the control group at times 2 and 3 for knowledge (P<0.003) and attitude (P<0.001). Analysed across both arms at baseline, the main predictors for knowledge and attitude scores were age and dental attendance pattern. Qualitative responses showed an acceptance of caregivers' roles in oral health care and criticism of existing provision within homes. Conclusions: The OHCE was well received and resulted in improved oral health care knowledge and attitudes. When viewed with separately reported trial results of clients' oral health status, knowledge and attitude score improvements coincided with improved delivery of oral health care.
Dental fluorosis decline after changes to supplement and toothpaste regimens
Authors: Riordan Paul J. 
Published: March 2003

AbstractIn 1989/90, in 659 12‐year‐olds in Perth (F 0.8 mg/L) and the Bunbury region of Western Australia (WA) (F ∼0.25 mg/L), dental fluorosis prevalences were 40.2% and 33.0%. Fluoride supplements (OR 4.63) and extended residence in a fluoridated area (OR 4.06) were significant risk factors; toothpaste ingestion variables had ORs greater than unity; in 1990, DMFT for this age group was 0.84. School Dental Service took steps to discourage supplement and toothpaste ingestion and to promote low fluoride toothpaste for children < 6 years of age.Objectives: To evaluate the effect of this campaign on fluorosis and caries.Methods: Between May–July 2000, 582 10‐year‐olds were examined for dental fluorosis (TF index) and dental caries (DMFT) in school dental clinics.Results: Fluorosis prevalence was 22.2% in Perth and 10.8% in the Bunbury region. Overall prevalence was 18.0% and of this, 80.2% was TF 1, 17.9% was TF 2 and just 1.9% was TF 3. In 1989/90, 79 children had used supplements before the age of 4 year; in 2000 only 40 had done so (P < 0.001). Mean DMFT values in Perth and Bunbury were 0.32 and 0.28 (P > 0.05). Low F toothpaste, unavailable in 1989/90, had been used by 24.5%. The only significant risk factor was residence, OR 2.0.Conclusions: Fluorosis prevalence seems to have fallen in parallel with a reduction in discretionary intake from supplements and toothpaste. No increase in dental caries experience was recorded. Because the teeth examined in this study were at risk of fluorosis in 1992–95, very soon after policies changed, and because people are slow to change health habits, it seems reasonable to expect a further improvement when teeth mineralised in the late 1990s become visible.
A rippled‐pattern trichoblastoma: an immunohistochemical study
Authors: Yamamoto Osamu , Hisaoka Masanori , Yasuda Hiroshi , Nishio Daisuke , Asahi Masakazu 
Published: March 2003

Background: Since the first description by Hashimoto et al., there have been only a few case reports of rippled‐pattern tricogenic tumor. In addition, there are no reports on detailed immunohistochemical analyses of this rare neoplasm. We describe here an additional case of rippled‐pattern trichogenic tumor with a special reference to its immunohistochemical features.Methods: A nodule arising on the occipital area of a 62‐year‐old Japanese woman was histologically and immunohistochemically investigated.Results: Histopathologically, the lesion contained various‐sized lobular nests, which consisted of oval to elliptical shaped basaloid cells without any atypia and were embedded in the collagenous stroma. Some elongated basaloid cells were arranged in a palisading fashion forming parallel rows of epithelial ribbons in a rippled‐pattern. Cytokeratin (CK) immunohistochemistry showed constant expressions of CK1/5/10/14, CK5/8, CK14 and CK7, and focal expressions of CK17 and CK19 in the basaloid cells, suggesting a keratin phenotypical similarity to the cells in small nodular type trichoblastoma.Conclusions: The present tumor is a variant of trichoblastoma, and considered to be in close association with the outer root sheath and/or follicular germinative cells.
Acantholysis and spongiosis are associated with loss of syndecan‐1 expression
Authors: Bayer‐Garner Ilene B. , Dilday Brad R. , Sanderson Ralph D. , Smoller Bruce R. 
Published: March 2003

Background: Syndecan‐1, a heparan sulfate proteoglycan present on the membrane of keratinocytes, functions in intercellular adhesion. Acantholysis and spongiosis are both characterized by diminished intercellular adhesion that may lead to blister formation. In spongiotic conditions, desmosomal stretching occurs prior to cell separation while in acantholytic conditions, cell separation occurs without stretching. While many of the structural relationships have been described, the molecular interactions regulating keratinocyte to keratinocyte adhesion are not yet fully understood.Methods: Sections from ten cases of Grover’s disease, two pemphigus vulgaris, one pemphigus foliaceus, one bullous pemphigoid, two herpes simplex, and ten spongiotic dermatitis were stained with BB‐4, a monoclonal anti‐syndecan‐1 antibody.Results: Nine of ten Grover’s, all three pemphigus, and both herpes cases showed absent or markedly decreased syndecan‐1 expression by acantholytic keratinocytes, with a sharp delineation from adjacent unaffected skin. The remaining Grover’s case showed moderate loss of syndecan‐1 expression. The pemphigus foliaceus case showed retention of staining along the basal cell layer, but expression was lost in the mid stratum spinosum. All ten spongiotic cases showed a diffuse mild decrease in staining, with loss of syndecan‐1 expression surrounding microvesicles. Bullous pemphigoid, as expected, did not show loss of syndecan expression.Conclusions: The loss of syndecan‐1 expression evident in acantholytic conditions and, to a lesser extent in spongiotic conditions, may contribute to the decreased intercellular adhesion characteristic of these lesions.
Histologic criteria for the diagnosis of mycosis fungoides: proposal for a grading system to standardize pathology reporting
Authors: Guitart Joan , Kennedy John , Ronan Salve , Chmiel Joan S. , Hsiegh Yi‐Ching , Variakojis Daina 
Published: March 2003

Background: The histological diagnosis of early lesions of mycosis fungoides (MF) is often difficult for dermatopathologists and prior studies have shown a low agreement rate among pathologists. An important reason for such difficulty may be the lack of specific histological criteria.Methods: We tested a new method to interpret and report biopsies suspicious for MF. The method is based on a grading system reflecting the pathologist’s degree of diagnostic certainty. A panel of four pathologists independently assessed a set of 50 biopsies suspicious for MF first without (Phase I) and subsequently with specific histological criteria (Phase II). A third Phase was carried out after a training session, using a new set of cases with corresponding immunophenotyping and gene rearrangement analysis. Weighted and unweighted kappa statistics were used to assess inter‐ and intra‐pathologist variation.Results: The consensus rate among pathologists improved from 48% in Phase I to 76% in Phase III. Overall precision weighted kappas increased from 0.630 in Phase I to 0.854 in Phase III, indicating excellent inter‐pathologist agreement by Phase III. There was a significant association between the presence of an abnormal phenotype and/or T‐cell clonality and a higher diagnostic score.Conclusions: The use of uniform criteria and training sessions can substantially improve the consensus rate among pathologists in the diagnosis of MF.