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Notes: Background, aims: Conventional treatment of chronic periodontitis involves mechanical debridement of periodontal pockets. Recently, subgingival antimicrobials have been used adjunctively following such debridement. This 2-centre study compared the clinical effects of subgingival scaling (SRP) with SRP plus subgingival application of 25% metronidazole gel, Elyzol® (SRP+gel), in patients with chronic adult periodontitis.Method: Voluntary informed written consent was obtained from 45 subjects at the Eastman (mean age 46, range 34–63) and 43 subjects at RAF Halton (mean age 47, range 34–71) who participated in this blind, randomised split-mouth design study. All had at least 2 sites in each quadrant with probing pocket depth (PPD) 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE27012910:ges" location="ges.gif"/〉5 mm. PPD, bleeding on probing (BOP), and clinical probing attachment levels (CAL) measured using a stent, were recorded at baseline and at 1, 3, 6 and 9 months post-therapy. After subgingival scaling of all quadrants, 2 quadrants were randomly selected to be treated with metronidazole gel.Results: A paired t-test on baseline values showed no bias between groups. Both treatments effectively reduced the signs of periodontitis. At each follow-up visit, reduction in PPD, CAL and BOP after the combined treatment was greater than for SRP alone. Paired t-tests showed that the improvement in the SRP+gel group was statistically significantly better (p〈0.001) than for SRP alone (mean 0.5±0.6 mm. 95% CI 0.4–0.6 mm.) Similarly, the % of sites which improved to a final pocket depth of 〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE27012910:les" location="les.gif"/〉3 mm and the % of sites which improved over the 9 months of the study by as much as ≥2 mm were greater for SRP+gel than for SRP alone.Conclusions: At the end of the study, the mean reductions for PPD were 1.0 mm (SRP) compared to 1.5 mm (SRP+gel), and for CAL they were 0.4 mm (SRP) compared to 0.8 mm (SRP+gel), with mean difference for CAL between treatments of 0.4±0.6 mm (95% confidence intervals of 0.3–0.6 mm). The combination therapy of SRP+gel was superior to the conventional treatment of SRP alone, and these differences were maintained for 9 months.

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: 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: The aim of the present investigation was to determine by questionnaire, UK dentists' perception of Dentine Hypersensitivity (DH) and knowledge of its treatment. A total of 403 questionnaires were sent to a selected group of UK dentists who had either inquired about further postgraduate education or had attended a course at the Eastman Dental Institute/Hospital. A total of 181 of 403 dentists (44·9%) (118M; 36F, 17 no response, mean age 38·2 years [s.d. 8·97]) returned the questionnaire. About 92·8% (n=168) of responding dentists claimed to see patients with DH in their practice. According to the dentists' replies at least one of four of their patients suffered from the complaint. About 71·8% (n=130) of dentists reported that DH was a severe problem in at least 10% of their patients and that pain from DH lasted no more than 4 weeks. Most of responding dentists claimed to be asked about DH by their patients and stated that they offered advice or treatment to their patients. Nearly 87·3% (n=158) of responding dentists provided a wide range of treatment options/advice which included both In-office and over-the-counter (OTC) products. Popular responses included desensitizing pastes/gels, Topical F– varnishes and toothpastes/rinses/gels, advice on atraumatic tooth brushing, dentine bonding agents (DBA), glass–ionomer cements (GIC) and other unspecified restorations. Of the various In-office treatments Duraphat was the most cited choice of varnish/primer options. Sensodyne toothpaste was the most popular of the specified OTC products. Most dentists appeared to understand the aetiological features associated with DH and provided a wide range of factors including the effects of incorrect tooth brushing, dietary acids as well as the possible influence on non-dental topics such as stress. Most responding dentists believed that their advice on DH was generally effective although they did highlight that certain aspects on the condition were lacking such as appropriate scientific information including the prevention of DH and its treatment. The results from the present study highlight several discrepancies in the perception and knowledge of the treatment of DH between dentists and their patients. The results from this study are, however, reasonably consistent with those previously reported by Dutch investigators. The results from this study also highlighted a need for guidelines on the aetiology, prevention and treatment of DH for both dentists and their patients. The reported average frequency and duration of discomfort from DH by the responding dentists appeared to be consistent with the available literature.

Notes: Relatively few studies have reported on the frequency, distribution and severity of dentine hypersensitivity (DH) in subjects recruited for clinical trials of desensitizing agents. Potential subjects (n= 48 M, 81 F, mean age 35·1 years) for inclusion into such a study were screened to determine the extent of the problem. 117 subjects (41 M, 76 F) mean age 24·9 years were clinically examined. Evaluation by questionnaire indicated that the prevalence of DH was proportionately higher in the 20–29·9 years (34·9%), and 30–39·9 years groups (33·3%), respectively. Sensitivity to cold was the main presenting symptom. Tactile (probe) and cold air (dental air syringe) stimuli were used to clinically evaluate DH. Of the teeth eligible for evaluation 1561/3136 (49·8%) responded to either one or both of the test stimuli; 274/3136 (8·7%) responded to tactile only stimulation, 779/3136 (24·8%) to thermal only stimulation and 508/3136 (16·2%) to both tactile and thermal stimulation. Of those teeth responding to the stimuli, 477 (30·6%) were premolars, 437 (28%) incisors, 415 (26·8%) molars and 232 (14·9%) canines. The results agree with those of previously reported studies in that DH is most frequently observed on premolars and that proportionately more teeth are sensitive to evaporative than to tactile stimulation. Furthermore it would appear from the results of the study that tactile is less effective than thermal/evaporative stimulation in the evaluation of DH.

Notes: Epidemiological data on dentine hypersensitivity (DH) prevalence are limited. Few studies have compared prevalence between populations. The aim of this investigation, therefore, was to compare the perception and prevalence of DH in two distinct non-periodontal practice populations, one U.K. and one Korean. Completed questionnaires from 557 patients (230 males and 327 females, comprising 115 males and 162 females, mean age 41·7 years (s.d.=14·36), U.K. and 115 males and 165 females, mean age 29·7 years (s.d.=11·86), Korean) were collected. Analysis was by frequency distribution and cross-tabulation (Statistical Package for the Social Sciences (SPSS)). DH prevalence was similar and at levels comparable with those reported previously. Prevalence was higher in the third and fourth decades in both populations. Although there were no differences between U.K. or Korean males and U.K. or Korean females, there was a significant difference between gender reporting of DH, with more females complaining of DH than males (standard normal deviation (SND)=4·3, 95% confidence interval (CI)=0·1134–0·2736). DH appeared to be regarded by patients as not severe in most cases, so treatment was not generally sought. Of those who claimed to have sought treatment, a significant number had received restorative treatment. Of those patients, only 23·3% of U.K. and ≤2% of Korean patients claimed to have used a desensitizing dentifrice. Pain from DH was reported as low grade (slight, occasional) occurring over 5 years in both populations. Cold appeared to be the most reported stimulus in the two populations. Less periodontal surgery had been undertaken in these two populations (12·6% U.K. and 7·1% Korean) compared with those referred to a teaching hospital periodontal department (34·5%). This compared favourably with previous findings in the general dental population (15·5%). Discomfort following hygiene therapy did not appear to last ≥7 days in either population. The results indicated that there were no significant differences between U.K.- and Korean-based populations in their perception of DH, with the exception that more females complained of sensitivity than males in both groups. Overall, DH was not considered a major dental problem by most patients in either of the populations.

Notes: summary  Previous in vitro permeability and scanning electron microscopic (SEM) studies have demonstrated the effectiveness of the oxalate ion in dentine permeability reduction and effective tubule occlusion. The aim of this randomized double-blind, split mouth 4-week clinical study, therefore was to determine whether a 1-min application of ferric oxalate (Sensodyne Sealant) on exposed root dentine was effective in reducing dentine hypersensitivity (DH). Thirteen subjects [8F:5M, mean age 46·2 (s.d. 4·15) years] completed the study. The subjective response was evaluated by tactile, thermal and evaporative methods of assessment. Data were collected at baseline and post-application at +5 min and 4 weeks. Analysis was based on paired t-test (P=0·05) and Wilcoxon–Mann–Whitney tests. No statistically significant differences were noted between ferric oxalate and placebo preparations at +5 min and 4 weeks for any of the test stimuli. There was, however, a clear trend towards immediate reduction (+5 min) in DH reverting back to baseline values at 4 weeks with the exception of the Biomat Thermal Probe mean values, which maintained the reductions in DH compared with placebo. The results of the present study demonstrated that a 1-min application of ferric oxalate is both rapid and effective in reducing DH although its long-term effectiveness still needs to be determined.

Notes: Abstract This study compared CPITN with plaque index (PII), gingival index (GI), papilla bleeding index (PBI), and probeable pocket depth (PPD). 52 patients were examined, mean age 43 years. Partial mouth random recording (2 upper and 1 lower or 1 upper and 2 lower sextants) was made by CPITN of 150 sextants, and at 6 sites around each tooth in each sextant for each index using a pressure-sensitive probe, with Newman tip and Williams markings, and a WHO 621 tip, probing pressure 0.25 N. Ranges of each index were compared with corresponding CPITN data. Most (71%) sextants had CPITN scores of 4, indicating periodontitis. None had CPITN scored 0 or 1. A given CPITN code was found to represent extremes of ranges for all other indices evaluated. There was no relation between CPITN and PII or GI, nor did CPITN reflect the number of sites affected per sextant, but there was a tendency for CPITN to relate with PBI and PPD. It was concluded that CPITN may be used as a general indicator of bleeding and pocket depth, but not of plaque or gingivitis. Other indices are required to reliably assess chronic inflammatory periodontal disease status in a given mouth.

Notes: Abstract The reported prevalence of cervical dentine sensitivity (CDS) ranges from 8 to 35%. Detailed epidemiology of the condition, particularly with regard to possible causal factors, is lacking. In particular, no published data appear to exist on its prevalence in periodontal patients. The aim of the present study was therefore to determine the prevalence, distribution and severity of CDS in a population of patients referred to a Periodontology Department of a specialist postgraduate hospital. 507 patients (181 M: 326F, mean age 44.2 (SD 10.31) years) attending a periodontal clinic were assessed for CDS by a questionnaire. The results demonstrated a prevalence of CDS of 84% with no significant gender difference. 71.1% of patients perceived cold as the most common cause of discomfort. A higher prevalence of self-reported discomfort was observed between 40 and 49 years. Of the patients with a reported history of periodontal surgery (34.7%), those treated within 6 months prior to assessment appeared to be more at risk to CDS. Of the patients who received hygienist treatment (88.2%). only 10.5% reported discomfort persisting ≥3 days after treatment. Generally, patients who complained of varying degrees of discomfort over time (84.5%) did not perceive the condition as severe and consequently did not seek treatment. The prevalence of CDS in these referred patients was very high, suggesting that periodontal diseases and/or treatment effects play a role in its aetiology.

Notes: Abstract The aim of this study was to assess the effect of difference in tine diameter on probing pocket depth measurement. 2 sets of tines with Williams markings at 1, 2, 3, 5, 7, 8, 9 and 10 mm, and with a “round” tip, diameter 0.5 mm, were compared. One set was described as parallel-sided, the other as tapered. The parallel-sided tine was almost parallel from the 10 mm marking to the tip (tip diameter x̄= 0.46 mm, 95% C.I. 0.456–0.464), while the corresponding diameter for the tapered tine varied (tip diameter x̄= 0.48 mm, 95% C.I. 0.473–0.489). Calibration markings appeared highly consistent with the expected value to within 0.01 mm. The tines were mounted in Brodontic handles at 0.25 N. Examiner probing repeatability yielded κ 0.86 for “parallel-sided” and 0.81 for “tapered” tines in vivo. 412 approximal pockets were assessed in 53 patients with routine chronic adult periodontitis, mean age 42.1 years. Each site had a probing depth of ≥5 mm, P1I≤ 1, GI≥ 1, PBI≤ 1. Each site was probed 2 × with a 15-min interval. At the first 251 sites, the parallel-sided tine was used initially, and the tapered at the remaining 161 sites. Results indicated a highly significant tendency for the parallel-sided tine to yield a deeper reading when a difference occurred. These findings indicate that with adequate training providing high examiner repeatability, one source of error in probing data can be minimised.