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40 periodontal defects with probing depths of 5 mm in 10 patients were treated with a conventional flap or with the "papilla preservation flap". In addition, half of the defects received granular hydroxyapatite. In terms of pocket depth and probing attachment-level no significant differences were seen between the 4 groups after 3 and 6 months. Regarding the development of gingival recession, however, the papilla preservation technique has significant advantages and showed better aesthetic results.

Interpretation of serial radiographs without sufficient information of projection geometry is hardly possible. We obtained 51 pairs of bite-wing radiographs in 12 patients by use of a modified filmholder (Duckworth et al. 1983). Two orthodontic wires of different profile, placed coaxially on the perpendicular, cast shadows on the film, which were differentiated by their respective shape. By placing each wire a known distance from the film plane, the angular difference between the perpendicular to the film and the actual direction of the central ray could be calculated. In 63% of pairs the angular deviation of the central rays between the serial exposures was below 0.9 degrees. The results of the present study show that utilization of this type of device can provide radiographs of sufficient quality to allow their use in image subtraction.

The present study was carried out to delineate the parameters influencing the extracerevicular oral colonization of Actinobacillus actinomycetemcomitans. Numbers of cultivable A. actinomycetemcomitans in subgingival plaque samples, saliva, and samples from buccal and tongue mucosae were determined in 33 patients with A. actinomycetemcomitans-associated periodontitis. Subgingival samples from patients with localized juvenile periodontitis (LJP) had significantly higher levels of A. actinomycetemcomitans than samples obtained in non-LJP patients (740,000 vs. 59,000, median, p less than 0.05). Samples from buccal mucosae and saliva were infected with A. actinomycetemcomitans in 85 vs. 70%, and 77 vs. 65%, respectively. Multiple regression analysis of log 10-transformed counts of A. actinomycetemcomitans in samples from cheek as dependent variable yielded a significant influence of numbers of deep periodontal pockets and diagnosis. The occurrence of A. actionomycetemcomitans on buccal mucosa seems to reflect the overall subgingival load with the organism.

3 teeth developed carious lesions within the furcation. 9 tunnel preparations showed soft tissue closure. 5 teeth were extracted for various reasons.

In the present study we examined alterations in the proportions of cultivable flora of A. actinomycetemcomitans (A.a.) in subgingival plaque of 25 patients with different forms of periodontitis, 7 days after systemic administration of 200 mg/d Minocycline-HCl. Remarkable shifts in the flora were apparent. Sites with low or extremely low initial levels of A.a. (less than 10%) showed an increase in mean proportions from 2.7% to 15.7% (p less than 0.01). A.a. was eliminated in only 18% of sites after 1 week of minocycline therapy. Subgingival scaling resulted in 80% of sites without detectable A.a. However, if present, the organism accounted for 51% of the cultivable microflora, on average. Our data emphasize the importance of a sufficiently extended period of antibiotic therapy and efficient mechanical debridement of all tooth surfaces to eliminate the organism.

Cyclosporine-induced gingival hyperplasia was investigated in a clinical study of 80 renal transplant patients. 34% of the patients exhibited at least mild gingival hyperplasia in the anterior, and 9% presented this finding also in the posterior region. No direct correlation was found between the oral dose or the whole blood concentration of cyclosporine and the presence of gingival overgrowth. Young and female patients were at a significantly greater risk of developing cyclosporine-induced gingival hyperplasia than the other patients. The presence of dental plaque or gingival inflammation was not found to be related to the incidence of gingival hyperplasia.

The variation of selected bacteriological parameters was investigated in 25 untreated A. actinomycetemcomitans-associated periodontitis patients. Samples of subgingival plaque were collected twice within 6 weeks with paper points for cultivation as well as with curettes for analyses of the morphological composition. Total counts of colony forming units, counts of A. actinomycetemcomitans as well as proportions of spirochetes were determined. Our results suggest a high reproducibility of quantitative data if a standardised sampling procedure with paper points is employed. On the other hand, considerable differences were observed in the morphological composition of subgingival plaque.

After periodontal therapy 12 patients with advanced alveolar bone loss were orthodontically treated and recalled for approximately 51.1 months. Orthodontic tooth movement resulted in a mean overjet reduction of 1.7 mm, a mean overbite reduction of 1.3 mm and closure of the anterior spaces. No significant differences were observed in the probing depths and attachment levels between the test and control teeth. 31% of the treated teeth showed signs of root resorption. The results indicate that orthodontic therapy in patients with successfully treated advanced periodontal disease does not lead to further attachment loss if the patients are periodontally well maintained.

This investigation worked at temperature measurements in cylindric pieces of copper for determination of surface temperatures and in root dentin of calves using ultrasonics by varying intensity, water flowing and pressure. In each experiment two different dental ultrasonic devices were used with two tips. The experiments with sufficient water flowing showed that the spray temperature which was determined separately in further experiments influenced the measurements mainly. On the other hand an insufficient water flowing resulted in remarkable findings showing for example temperatures in the pieces of copper higher than 195 degrees C and macroscopic changes on the root surface in form of carbonization and alterations of cementum and root dentin.

The effect of new, automatic tooth cleaning instruments on tooth surface and surfaces and margins of amalgam and composite fillings were studied by profilometric measurements and SEM and compared with each other. On the surfaces of teeth and fillings, in particular at the margins, ultrasound treatment resulted in the significantly highest maximum roughness values. These values were lower when turbin-operated scalers were used. Results demonstrate that during tooth cleaning direct contact between ultrasound and turbine-operated scalers and tooth and filling surfaces should be prevented.

Independent of chosen stimulus, age or differences in selected groups of teeth, a reduction in pain intensity of about 50% can be attained following initial treatment with fluoride iontophoresis. The second treatment after 4 weeks leads to a nearly complete reduction in dentin-hypersensitivity. Subsequent to a third application of fluoride iontophoresis only minimal hypersensitivity is detectable. Precipitation of calcium-fluoride and blockage of dentinal tubules should be discussed. A decrease in hypersensitivity is likewise observed in the control group. The results of the final clinical examination show that slightly greater sensitivity remains. Electroanalgetic effects are probably responsible for the reduction of dentinal pain. Treatment of hypersensitivity is dependent upon such factors as age and oral hygiene. Supervised therapy for refractive dentinal pain appears to have greater success when fluoride iontophoresis is used.

In order to study the effect of active additives in toothpastes, three different toothpastes were tested in 60 persons for a period of four weeks. The toothpastes used contained allantoin, pyridyl carbinol, alpha-tocopherol, potassium aluminum sulfate, and tartaric acid. In addition, a control paste without additives was used. In a double blind study plaque incidence of the Ramfjord teeth was determined by means of the indices of Silness and Löe and Quigley and Hein. The tissue reactions were studied by means of the S-B index and the keratinization index. After an initial examination for extablishing the origianl values, the indices were determined after 2 and 4 weeks. Statistical analysis of the data obtained allows the conclusion that none of the tested active additives in the concentrations applied had any applied had any medicamentous influence on the gingival inflammation. The therapeutical consequences are discussed.

The mobility of normal teeth and teeth with periodontal lesions could be measured by means of the newly constructed HSE-digital-periodontometer and specially developed measuring head. After obtaining norm values, measurements of pethological changes allowed us to determine to what degree the clinically increased mobility of teeth was subject to subjective influences (range of error 36.5 to 70.5%). These results suggest that the scale of clinical grades of tooth mobility be increased to 5 altogether and that practical objective measuring apparatus be developed especially for dental practice.

Local short term and long term topical applications of a sodium fluoride jelly and an aminofluoride jelly were tested in a comparative clinical and cytological study of the reaction of the alveolar mucosa and the attached gum. Neither after short term use (single application) nor after long term use (four times continuous daily application) of the fluoride jelly was any change detected in the oral mucosa or gingiva. No clinically manifest epithelial damage or changes in cytology were observed outside the range of normal variations.

In animal experiments guinea pigs were subjected three times weekly for 4 weeks to cleaning with a plane multitufted or a toothed "space tufted" toothbrush for 20 seconds by a standardised method comparing opposing quadrants on each side. Scan electronmicroscopic evaluation of the tissue exfoliation from the area of attached gum before cleaning, after 2 and 4 weeks, shows that localised though different epithelial lesions occur with both tooth brushes. The lesions reach into the submucosa with the toothed type brush. Influence on the epithelium in the sense of normalising keratinisation after tooth brush massage could not be confirmed.

The study was designed to test the efficacy of a PVP-iodine antiseptic agent on potentially pathogenic oral bacteria. A 0.5% concentration of the test compound was sufficient to inhibit the growth of 7 out of 8 tested strains. Only bacteroides gingivalis continued to grow during exposure to a 0.5 and 1% concentration of the test compound. Quantitative suspension experiments demonstrated that the onset of action occurred within five minutes. Quantitative suspension experiments with protein loading resulted in a lower efficacy of the tested agent. Results indicate that the tested compound may be recommended as an oral disinfectant.

In 15 adult patients with severely advanced periodontal disease unrelated to localized juvenile periodontitis high numbers of A. actinomycetemcomitans (A. a.) were identified in samples of subgingival plaque (median log CFU 5.13). In order to correlate clinical conditions with bacteriological findings, in every patient 2 deep periodontal pockets were treated with a 3-phase regimen of minocycline administration, mechanical, and surgical periodontal therapy. A. a. was eliminated by minocycline alone in 2 cases. Minocycline in combination with subgingival scaling resulted in 6 patients in A. a. negative samples. Following termination of minocycline therapy, frequently increasing numbers of A. a. were observed. Patients showed significant gain in clinical attachment or reduction of probing pocket depth during different phases of therapy, but only if A. a. was suppressed close to or below the lower limit of detection (5 CFU/ml). Considerable problems with elimination of A.a. may be connected with frequently observed recurrent periodontal disease in these patients.

In 20 patients the plaque-removing properties of two toothbrushes were tested which work on the principle of an electric swing toothbrush. Brush A was of space-tufted type, brush B of multi-tufted type. The test ran for 14 days for each toothbrush. The study showed that the multi-tufted brush achieved a 30 to 50% better plaque reduction, measured on all tooth surfaces. When considering individual tooth surfaces it was shown that approximal surfaces were less well cleaned than the facial or oral surfaces. After a fortnight the cleaning power of both brushes was reduced. In spite of better plaque reduction by the multi-tufted type of brush the hand tooth brush by instructed patients is to be preferred.

In patients with symmetric recessions in their canine and premolar regions, one side was supplied with an epithelium-containing and the other with an epithelium-free graft from the hard palate. Both sides were studied and compared. After six months, the size of the connective tissue transplants was reduced by 50% (that of the epithelium transplants by 0%). Within half a year, the width of the attached gingiva had decreased by 36% in the case of connective tissue transplants (epithelium transplants by 15%) and the vertical graft width by 60% (epithelium transpltnas 17%). Our clinical and histological findings suggest that grafting of heterotopic connective tissue transplants is not equal to epithelium-containing transplants.

The effect of two toothpastes on plaque and gingiva is tested. This study allows the conclusion that higher portions of detergents in toothpastes are likely to breakup the intercellular structure of epithelium and thus provoke increased epithelial cell disquamation.

Thus, it was the object of this investigation to test the common plaque indices with regard to their usuability and to compare them with a newly developed approximal space plaque index (API).

The information about the vitality of the plaque is limited. Only motile bacteria can be distinguished as alive. Vital staining allows to differentiate between living nonmotile rods and dead, previously motile rods. With increasing severity of the periodontal destruction, the proportion of alive respectively motile rods and vibrions increases. The vital staining shows very clearly the relation between destruction and living rods.