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Notes: Abstract Numerous desensitizing agents have been utilized in an effort to alleviate the discomfort associated with cervical dentine sensitivity (CDS). Recently several new tubule-occluding and sealant systems have been marketed for treatment. The aim of this study was to compare two desensitizing agents (ALL-BOND 2 and Butler Protect) in a 3-month clinical study. Ten subjects (6F; 4M mean age 45.1 years (SD 8.81) who had provided voluntary written informed consent participated in a single-blind 3-month clinical study. Subjects were evaluated for tactile (Yeaple probe) and air sensitivity (dental air syringe) together with subjective perception of pain (VAS scores) at 0.5 min, 1, 2 and 3 months. There was an overall trend in reduction of CDS over the study period in all groups with no significant differences detected between groups. The results suggested that while subjects reported overall reductions in sensitivity levels, this may not necessarily be substantiated when assessed objectively. Furthermore, there appeared to be a strong placebo effect in this study.

Notes: Abstract This study compared 2 proprietary chlorhexidine (CH) products, Corsodyl (CO - 0.2% CH. then ICI. U.K.) and Eludril (EL - 0.1% CH. Pierre Fabre. France) as subgingival irrigants adjunctive to Simplified Oral Hygiene. 19 subjects. 8M, HE aged 30-57 years, mean 44 years, took part. Probing pocket depth (PPD) ranged from 5-10 mm, mean 6.5 mm (CO and EL), with 60 CO and 65 EL sites. After oral hygiene instruction, without stress on interdental cleaning, patients received one visit supra- and subgingival debridement. and instruction in subgingival irrigation using the Max-I-Probe system (Smith & Nephew MPL, USA). For baseline, days 28 (end of irrigation). 56 and 84. data were respectively: GI (medians): 1.7. 1.2. 1.2. 1.0 (CO). 1.9. 1.5, 1.3. 1.0 EL): BOP (medians): 1.2, 0.4. 0.7. 0.4 (CO), 1.5. 0.6. 0.6, 0.25 (EL): PPD (mm) (means): 6.3. 4.8, 4.2, 4.5 (CO). 6.8, 5.2, 5.3. 4.7 (EL); PAL (mm) (means-change relative to day 0): 0.6, 0.5. 0.8 (CO), 0.8. 0.8. 1.5 (EL). By Wilcoxon for non-parametric and /-tests for parametric data, both groups showed significant improvement for all variables at all times relative to baseline, with only one significant difference between the groups, in favour of EL, for PAL at day 84 (p〈0.05). This pilot study indicates that both simplified oral hygiene regimes are effective in periodontitis. but that there was no difference between the 2 commercial irrigants as adjunctives.

Notes: Abstract The present clinical trial was designed to evaluate the effects of a bioactive glass. Perioglas®, in the treatment of periodontal intrabony defects. 20 patients. 23–55 years of age (44 sites), with intrabony defects completed the 1-year study. Teeth with furcation involvement were excluded. After completion of initial therapy, defects were randomly assigned to either a test or control procedure. Following flap reflection, root planing and removal of chronic inflammatory tissue in both groups, the test defects were restored with the bioactive glass particulate material. Mucoperiosteal flaps were replaced, sutured and a periodontal dressing was used. All the patients received postoperative antibiotics and analgesics and were seen at 1 week for suture removal. Follow-up was then carried out weekly and at 3 months, 6 months. 9 months and 1 year post-surgery. Plaque score, bleeding score, probing pocket depth (PPD), probing attachment level (PAL) and gingival recession were recorded at baseline, 3 months and 1 year. Standardised radiographs for computer-assisted densitometric image analysis (CADIA) were taken at baseline, immediately post-operatively and at 1 year. The CADIA data showed a significant increase (F-ratio: 15.67, p〈0.001) in radiographic density and volume between the defects treated with the Perioglas® when compared to those treated with surgical debridement only. PPD and PAL showed significant improvements in both experimental and control sites, with a greater trend to improvement in the experimental sites. It was concluded that this bioactive glass is effective as an adjunct to conventional surgery in the treatment of intrabony defects.

Notes: Abstract. Because of their importance in mediating cellular interactions in chronic inflammatory diseases, this study has examined the expression of a number of adhesion molecules in adult (n= 11), generalized early onset (n= 5) and localized early onset (n= 2) forms of periodontitis. In comparison with immunostaining profiles of cryostat sections of healthy gingival tissue (n= 7), the β1 integrins VLA-1, VLA-2 and VLA-4 were found to be up-regulated in periodontitis, with VLA-6 being markedly elevated. Although only small differences were observed in ICAM-1 and LFA-3 expression in the gingival epithelium, there was particularly notable up-regulation of these adhesion molecules within the inflammatory infiltrates of the diseased tissues. However, there were no statistically significant differences between the serum levels of a soluble form of LFA-3 in periodontitis patients (n= 47) compared with healthy control subjects (n= 40), although the generalized early onset and adult periodontitis groups exhibited wider ranges of circulating LFA-3. These findings show that there is localized modulation of adhesion molecule expression in the chronic inflammatory periodontal diseases studied, but that the levels of LFA-3 in the circulation nevertheless remain unaffected.〈section xml:id="abs1-1"〉〈title type="main"〉ZusammenfassungExpression des lokalisierten Adhäsionsmoleküls und die zirkulierenden LFA-3 Titer bei der Erwachsenenparodontitis und bei früh einsetzenden ParodontitsformenWegen ihrer Wichtigkeit in der Zellkommunikation bei chronisch Entzündungskrankheiten wurde in dieser Studie die Expression einer Anzahl von Adhäsionsmolekülen sowohl bei Erwachsenenparodontitis (n= 11), als auch generalisierter (n= 5) und lokalisierter früh ensetzender (n= 2) Parodontitisform untersucht. Im Vergleich mit den Immunmarkierungssprofilen von Kryostatschnitten gesunden Gingivagewebes (n= 7), wurde bei Parodontitis eine Hoch-Regulation der β1-Integrine VLA-1, VLA-2 und VLA-4 sowie eine deutliche Erhöhung von VLA-6 vorgefunden. Obwohl in der Expression deer ICAM-1 und LFA-3 im Gingivagewebe nur kleine Unterschiede beobachtet wurden, gab es innerhalb des Entzündungsinfiltrates der erkrankten Gewebe eine besonders bemerkenswerte Hoch-Regulation dieser Adhäsionsmoleküle. Jedoch gab es im Vergleich mit gesunden Kontrollpersonen (n= 40) bei Parodontitispatienten (n= 47) keine statistisch signifikanten Unterschiede zwischen den Serumtitern der löslichen Formen von LFA-3, obwohl die Gruppen mit generalisierter, früh einsetzender Parodontitis und Erwachsenenparodontitis in breiteres Spektrum der Werte für LFA-3 zeigten. Diese Ergebnisse zeigen, daß bei chronischen Parodontalerkrankungen eine lokalisierte Modulation der Adhäsionsmoleküle vorhanden ist, jedoch die Titer von LFA-3 im Blutkreislauf unbeeinflußt bleiben.〈section xml:id="abs1-2"〉〈title type="main"〉RésuméExpression localisée des molecules d'adhésion el niveaux de LFA-3 circulant, dans la parodontite de l'adulte et les formes à début précoceEn raison de leur importance dans la médiation des interactions cellulaires dans les maladies inflammatoires chroniques, nous avons examine dans la présente étude l'expression d'un certain nombre de molécules d'adhésion dans la parodontite de l'adulte (n= 11), la forme généralisée à début précoce (n= 5) et la forme localisée à début précoce (n= 2). Par comparaison avec les profils d'immuno-coloration de coupes de tissu gingival sain faites dans un cryostat (n= 7), on constatait que les intégrines β1 VLA-1, VLA-2 et VLA-4 avaient été augmentées dans la parodontite, avec une forte élévation de VLA-6. Bien que les différences observées dans l'expression d'ICAM-1 et de LFA-3 dans l'épithélium gingival aient été faibles, il y avait une augmentation particuliérement marquée de ces molécules d'adhésion au sein des infiltrate inflammatoires des tissus atteints. Cependant il n'y avait pas de différences statistiquement significatives entre les niveaux d'une forme soluble de LFA-3 dans le sérum de patients atteints de parodontite (n= 47) par rapport aux sujets témoins sains (n= 40), bien que les groupes de parodontite généralisée à début précoce et de parodontite de l'adulte aient présenté une variation plus large des niveaux de LFA-3 circulant. Ces résultats montrent qu'il se produit une modulation localisée de l'expression des molecules d'adhésion dans les maladies parodontales inflammatoires chroniques considérées, mais que cela reste cependant sans influence sur les niveaux de LFA-3 dans la circulation.

Notes: Abstract. Psychological disturbances may lead patients to neglect oral hygiene. This study investigated whether a number of psychosocial factors (depression, state and trait anxiety, total and average perceived stress, and loneliness) could predict dental plaque levels in patients with adult onset rapidly progressive periodontitis (RPP) and routine chronic adult periodontitis (RCAP), before periodontal treatment. It was also examined whether RPP and RCAP patients differed on plaque and smoking. Plaque was scored in a sample of 6 teeth in each of 80 subjects, 40 with RPP, 40 with RCAP, before psychosocial questionnaire completion. Multiple regression was performed between plaque as the dependent and psychosocial factors, gender, education, form of periodontitis and smoking as independent variables. Only gender contributed significantly to prediction of plaque, t=-2.70, p=0.01, partial regression coefficient -0.37, 95% CI; -0.64 to -0.10, indicating that plaque was on average 0.37 lower for females than males, after adjusting for the other predictor variables. It was confirmed that RPP and RCAP patients did not differ significantly on plaque, univariate r-test(69.99)= 0.65, p=0.13. However, RPP patients smoked significantly more than RCAP patients t(69.72)=2.36, p=0.02. There was also a marginally significant correlation between depression and smoking, r=0.l6, p=0.01. One possible reason advanced for the lack of an association between psychosocial factors and plaque, and the absence of a difference in plaque between RPP and RCAP patients is the fact that the patients involved in the present study were seen as secondary referrals. The gender difference in plaque levels and the greater incidence of smoking in RPP patients may be of significance in planning interventions with patients with periodontitis.

Notes: Abstract On the basis of clinical observations, some periodontologists have suggested an association between psychosocial factors such as depression, stress and anxiety, and adult onset rapidly progressive periodontitis (RPP). This study investigated more formally possible associations between a number of relevant psychosocial factors and RPP The significance of the psychosocial variables was assessed by comparing 3 groups: 50 patients with RPP, 50 patients with routine chronic adult periodontitis (RCAP). and 50 patients without significant periodontal destruction (controls). It was anticipated that the RPP group would show higher levels of psychosocial maladjustment than the RCAP and control groups. A between-subjects multivariate analysis of covariance indicated that the combined psychosocial variables were significantly related to the periodontal diagnosis. 2 psychosocial factors, depression and loneliness, were significant in distinguishing between groups. The RPP group presented significantly increased depression and loneliness compared to the RCAP and control groups. Future research is indicated to further clarify the significance of these psychosocial differences in relation to the onset and progression of RPP.

Notes: Abstract Several previous studies have evaluated the effects of 0.12% chlorhexidine digluconate (ChD) mouthrinses on plaque and gingival inflammation. However, previously, none have been based in general dental practices. The aim of this study was to evaluate the potential to conduct controlled periodontal clinical trials in co-operation with general dental practitioners (gdps). The project took place in 5 general dental practices in the South of England. 121 healthy subjects (24 at 4 sites and 25 at the 5th). aged 18-65 years, mean 35 ± 12) years participated in a double-blind, randomised study during which they received full mouth assessments for plaque and gingival bleeding at baseline, 6 and 12 weeks. 60 subjects were randomly asigned to use the 0.12% ChD mouth wash and 6i the placebo. The assessments were carried out by 5 gpds, who had previously achieved inter-examiner κ scores of 0.78–0.85 (mean 0.81) for the plaque index (PlI), and of 0.73–0.94 (mean 0.87) for a modified gingival index (mGI), and who maintained κ scores of 0.51–0.90 for PII and of 0.73–1.00 for mGI during the 12 months required to complete the study. 98 subjects (48 ChD and 50 placebo) completed the study. Even though the baseline levels of plaque and gingivitis were low, by week 12, mean whole mouth piaque score of the ChD mouthwash users had fallen from 1.33 at baseline to 0.96 and was significantly lower (p 〈 0.001) than for the placebo users, 1.31 at baseline to 1.13. Whole-mouth gingival bleeding score fell from 0.56 to 0.42 in the ChD mouthwash group but was unchanged (0.54–0.55) in the placebo group. A subsidiary data analysis which considered the effects at sites indicated that within these overall differences, the ChD users experienced almost 2× the reduction from plaque score 2 at baseline at proximal molar sites over a 12-week period (50.6% ChD versus 27.6% placebo). It was concluded that 0.12% ChD mouthwash reduced plaque accumulation fay 28% and gingival inflammation by 25% over a 12–week period, that it is feasible for a group of gdps to maintain high levels of inter–examiner consistency in the use of PlI and mGI, that it is also feasible to carry out such a multicentre study in general dental practice, and that the use of mean mouth scores per subject to analyse the effects of mouthrinses may well mask variations in response throughout the mouth.

Notes: Recent studies have attempted to determine the prevalence of dentine hypersensitivity (DH) in both hospital and general practice. Results indicate that DH prevalence is higher in patients referred for specialist treatment than in general practice. The aim of this study was to determine perception and prevalence of DH in general practice. Completed questionnaires from 277 patients (115 males, 162 females, mean age 41·7 years [SD 14·36]) were collected. Self-reported DH prevalence (52%) was observed between the third and fourth decades, peaking in the third and in good agreement with that previously published (45·2%), and significantly more females complained of DH than males (SND=2·24, 95% CI 0·01734–0·2661). Cold was perceived as the most common cause of DH, in agreement with other studies. Only 12·6% of patients reported periodontal surgery compared to 15·5% previously. Of those who received hygiene therapy (67·9%) only 15·5% reported DH following treatment which mainly did not last ≥5 days. Most patients with DH did not perceive the condition as severe and did not seek treatment (75·1%). Only 23·3% used a desensitizing dentifrice. The results indicated that self-reporting of DH is lower than reported in a dental hospital population and was not perceived as a major dental problem by most patients in a general dental practice population.

Notes: Abstract The selective bradykinin analogue, RMP-7, transiently increases the permeability of the blood brain barrier and the delivery of hydrophilic agents into brain tumours. In 87 recurrent glioma patients (WHO Grade III/IV, median age 46, Karnofsky 70%) clinical and Magnetic Resonance Imaging (MRI) responses to i.v. cycles (q 28 days) of RMP-7 (300 ng/kg given as a 10 min infusion) and carboplatin (AUC 4-9) were assessed. 45 of these patients were chemotherapy naive (CN-RMP) and 42 had received one prior course of chemotherapy (CP-RMP). Neurological impairment, performance status and steroid use were measured prior to dosing at each cycle and tumour volume by 3-D MRI at the end of cycles 2, 4, 6, 9 and 12. Clinical evaluation of response demonstrated that 61% of CN-RMP patients were either stable or improved whilst this was 39% for CP-RMP patients, of which 37% and 8% improved respectively. Radiological evaluation showed 79% of CN-RMP patients were either stable, partial or complete responses and 24% for CP-RMP patients, of which 32% and 5% were CR or PR respectively. The median duration of response was 30.3 weeks in CN-RMP patients and 19.6 weeks in the CP-RMP group. Lack of response was associated with substantial baseline tumour volume. Drug toxicity was as previously reported for carboplatin. 11 patients had treatment-associated transient focal seizures. These results indicate that RMP-7 and carboplatin have significant activity in recurrent malignant glioma following radiotherapy.