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Notes: Abstract The aim of the present investigation was to study longitudinally the periodontal condition of married couples. The data are derived from a longitudinal study in a young population living in a remote village in Indonesia and showing a relatively high prevalence of periodontal destruction. In 23 married couples, clinical measurements were carried out in 1987 and 1994. During the latter examination, a pooled gingival sample was obtained for microbiological evaluation. In 1994. the mean age of the group was 29.1 years and the couples were married for on the average 10 years. In each couple, the partner showing in 1994 the highest score for mean loss of attachment (LA) was classified as the diseased proband and the other partner as the spouse. Evaluation of the clinical data showed that: (11 the diseased probands already had in 1987 a worse periodontal condition compared to that of the spouses; (2) in both groups the mean LA increased during the 7-year period;13) the difference in mean LA between diseased probands and spouses increased between 1987 and 1994. The microbiological evaluation revealed a relatively high prevalence of Actinobadllus actinomycetemcomitans (50%). Porphyromonas gingivalis (67%) and Prevotella intermedia 61%. Analysis showed no differences in microbiota between diseased probands and spouses. The 23 Actinobadllus actinomycetemcomitans positive subjects included 2 positive couples. Furthermore, the 31 Porphyrormmas gingivalis and 28 Prevotella intermedia positive subjects included 9 and 7 positive couples respectively. In conclusion, 10 years of cohabitation showed no influence on the periodontal condition of the spouses.

Notes: Abstract In the present investigation, a number of histological and immunohistochemical characteristics of periodontal tissues as well as the phase-contrast microscopy of dental plaque were studied after experimentally-induced gingival inflammation in relation to susceptibility to periodontal disease. The study included a younger (mean age 34.1 years) and an older age group (mean age 48 years) with a reduced but healthy periodontium. Both age groups had the same amount of loss of attachment which may suggest that they had different degrees of susceptibility to periodontal disease. At the start of the experiment, each patient was instructed to abstain from oral hygiene in one quadrant of the mouth for a period of 18 days. At the end of the 18-day period, supra-gingival plaque and gingival tissue samples were taken. As determined by phase-contrast microscopy, the plaque samples of both age groups contained relatively high proportions of spirochetes. This may indicate that the patients are at risk for recurrence of periodontal breakdown. The general histopathologic picture of the gingival tissue samples of both age groups was similar to the so-called ‘early lesion’. However, IgA-producing plasma cells were found in most tissue samples of both age groups. The first part of this study showed that the younger, in comparison to the older, patients developed inflammation in terms of bleeding on probing more rapidly. These clinical results cannot be explained by the host-parasite parameters investigated in the present study.

Notes: Abstract The purpose of the present investigation was to study the effect of age on the rate of development of gingival inflammation in individuals not susceptible to periodontal destruction. 7 younger (mean age 37 years) and 7 older (mean age 58 years) individuals were selected on the basis of the presence of at least 18 teeth, no evidence of extraction due to periodontal destruction, no loss of attachment, shallow pockets, gross amounts of plaque and a history of no interdental cleaning. All individuals were subjected to a carefully controlled oral hygiene program and experimental gingivitis was induced in 1 quadrant of the mouth during a period of 33 days. The amount of plaque, redness and swelling of the gingivitis, and bleeding on probing were assessed before, during and after the experiment. Al day 33, supra-gingival plaque samples were taken for bacteriological examination and gingival biopsies were taken for histopathological and immunohistochemical investigation. Results showed no differences between the 2 age groups with regard to the amount of plaque accumulation and the rate of development of gingival inflammation. Furthermore phase-contrast microscopy of plaque samples showed no differences between the 2 age groups. Neither his to-logical nor immunohistochemical investigation showed any differences between the 2 age groups. All biopsies diffusely showed presence of IgG, whereas in most biopsies, IgA plasma cells and in one biopsy IgM plasma cells were found. Neither IgD, IgE nor complement deposits were found. It was concluded that age is of minor importance in the development of experimentally-induced gingivitis in individuals not susceptible to periodontal destruction.

Notes: Objectives: The purpose of this split-mouth study was to evaluate the clinical response of enamel matrix proteins (EMPs, Emdogain Gel®) in intra-osseous defects with or without a combined application of a tetracycline-coated expanded polytetrafluoroethylene barrier membrane (e-PTFE, Gore-Tex®).Methods: Twelve pairs of intra-osseous periodontal defects in 11 patients received the application of EMPs on the exposed root surface (EMP). One of the two defects received randomly, as an adjunct to EMP treatment, a tetracycline-coated e-PTFE membrane (MEMP). At baseline, 6- and 12-month probing pocket depth (PPD), clinical attachment level (CAL) and probing bone level (PBL) were measured.Results: After 12 months, the EMP defects showed a significant mean PPD reduction of 2.86±0.75 mm, a mean gain in CAL of 1.28±2.04 mm, a mean PBL gain of 1.63±1.21 mm and a mean increase of recession (REC) of 1.56±2.30 mm. The MEMP defects showed a significant mean PPD reduction of 3.02±1.55 mm, a mean gain in CAL of 1.65±1.29 mm, a mean PBL gain of 1.58±1.92 mm and a mean increase of REC of 1.38±1.63 mm. Except for significantly more post-operative discomfort at the MEMP sites, no significant differences were found between EMP and MEMP defects.Conclusion: Within the limits of this study, it is concluded that in the treatment of intra-osseous defects with EMP, the adjunctive use of a tetracycline-coated e-PTFE membrane failed to show more gain of CAL and PBL.

Notes: Background/aims: In an Indonesian population deprived of regular dental care, the experienced progression of disease between baseline (1987) and follow-up (1994) was investigated in relation to the composition of the subgingival microbiota at follow-up. At baseline the age ranged from 15 to 25 years. Clinical and microbiological evaluation was completed in 158 of the 167 subjects available at follow-up.Methods: Plaque index (PI), pocket depth (PD), bleeding on probing (BOP), and attachment loss (AL) were scored at the approximal surfaces of all teeth and subgingival calculus on the approximal surfaces of the Ramfjord teeth only (number of sites with subgingival calculus: NSC). A pooled sample of the deepest pocket in each quadrant was evaluated using microbiological culture techniques.Results: At baseline the mean values of the clinical parameters were AL=0.35 mm, PI=1.01, BOP=0.80 PD=3.25 mm and NSC=6.04 and at follow-up AL=0.75 mm, PI=1.16, BOP=1.19, PD=3.34 mm and NSC=5.85. All parameters except PD and NSC showed a statistically significant increase. At follow-up the prevalence of Actinobacillus actinomycetemcomitans was 40%, of Porphyromonas gingivalis 67%, of Prevotella intermedia 66%, of Fusobacterium nucleatum 79%, of Bacteroides forsythus 16%, of Campylobacter rectus 4%, and of P. micros 6%. No differences in clinical parameters were found between groups with or without these micro-organisms. In 129 subjects AL of 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE280703:ges" location="ges.gif"/〉2 mm at 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE280703:ges" location="ges.gif"/〉1 site was found. Logistic regression showed three significant odds-ratio’s for experienced progressive periodontitis: Plaque index (12.2), gender (3.4) and Actinobacillus actinomycetemcomitans (2.9).Conclusions: The results of this retrospective study suggest that plaque is the most important parameter related to experienced disease progression, and that the presence of A. actinomycetemcomitans may be associated with increased chance of disease progression.

Notes: Abstract In a recent publication, it was hypothesized that the ratio between bleeding and plaque scores may act as a prognostic indicator for periodontal breakdown. Furthermore, it was found that the rate of development of gingival inflammation in terms of bleeding on probing during experimental gingivitis is more rapid in patients susceptible to periodontal breakdown than in subjects insusceptible to periodontal breakdown. The purpose of the present investigation was to compare the gingival reaction to dental plaque in an experimental gingivitis study in individuals without periodontal breakdown, having either a low or a high bleeding/plaque ratio. A group of 8 volunteers (18–23 years) with a low bleeding/plaque ratio and 7 volunteers (19–22 years) with a high bleeding/ plaque ratio were selected. In both groups, an experimental gingivitis study of 23 days duration was carried out. Results showed that individuals with a high bleeding/plaque ratio developed significantly more clinical inflammation in terms of bleeding and swelling of the gingiva than individuals with a low bleeding/plaque ratio. After 23 days of plaque accumulation, gingival biopsies as well as supragingival plaque samples were taken from both groups. Phase-contrast microscopy of the plaque samples showed no significant differences between the 2 groups. Low %s of spirochetes and motile rods were found. Stereologic point-counting procedures snowed equal amounts of infiltrated connective tissue in both groups. However, significant differences in composition of the infiltrate appeared to be present. The high ratio group showed more IgA producing plasma cells and complement activation than the low ratio group. The results of the present study suggest that the bleeding/plaque ratio of an individual may be regarded as a prognostic indicator for the degree of experimentally induced gingival inflammation in terms of bleeding and swelling of the gingiva as well as complement activation and IgA-plasma cell activity.

Notes: Abstract The purpose of the present study was to investigate the effect of mechanical oral hygiene procedures on bleeding on probing in relation to age and periodontal status. The study was carried out on 49 indivuals divided into 7 experimental groups according to age and having been either treated for destructive periodontal disease or having an intact healthy periodontium. In order to eliminate any pre-existant gingival inflammation, all subjects received a carefully controlled oral hygiene program. At the start of the experiment, all subjects were instructed to abstain from oral hygiene procedures for 24 h. Thereafter, clinical baseline measurements were carried out, including bleeding on probing (BOP) using a standardized probing pressure. Next, all subjects cleaned their teeth according to their normal oral home care protocol using a multitufted toothbrush, toothpicks and interdental brushes. BOP scores were again assessed 30 min after completed tooth cleaning procedures. The results revealed a significant increase in BOP after the mechanical oral hygiene procedures in every individual in all experimental groups (p 〈0.05). Further analysis showed that the increase in BOP was independent of the periodontal status of the subjects. However the BOP scores after mechanical oral hygiene procedures were higher in the young age groups. It was concluded that the diagnostic predictability of BOP in the treatment of periodontal diseases might be affected by temporarily elevated BOP scores shortly after mechanical oral hygiene procedures.

Notes: Abstract Both epidemiological and clinical studies indicate that not all individuals are equally susceptible to periodontal breakdown. Therefore, the clinical differences were investigated between subjects highly susceptible and subjects insusceptible to periodontal breakdown. The highly susceptible group consisted of patients with a diagnosis of juvenile periodontitis. The insusceptible group consisted of older individuals with gross amounts of plaque and no periodontal breakdown. Results indicated that a high value of the bleeding/plaque ratio may possibly act as a prognostic indicator for periodontal breakdown. However, longitudinal data are indispensable for substantiation of this hypothesis. Since longitudinal research takes many years, the experimental gingivitis model was chosen for further investigation. 4 groups of individuals were selected on the basis of a different history of inflammatory periodontal disease: 2 younger age groups without periodontal breakdown, having either a low or a high bleeding/plaque ratio—a hypothetically susceptible and a hypothetically insusceptible group, respectively; one older age group with presence of gross amounts of plaque, no periodontal breakdown and a low bleeding/plaque ratio—an insusceptible group; and an adult group who previously suffered from severe periodontal disease—a susceptible group. Results of the experimental gingivitis studies indicated that the older insusceptible group developed only small amounts of bleeding, whereas the younger hypothetically insusceptible group developed a comparable low bleeding index. The younger hypothetically susceptible group developed a much higher bleeding index comparable to that of the susceptible group, the periodontal patients. In conclusion, comparison of the results of the experimental gingivitis studies in subjects with differing histories of inflammatory periodontal disease supports the concept that the bleeding/plaque ratio may act as a prognostic indicator for periodontal breakdown.