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Objectives: To investigate the effect of an Objective Structured Clinical Examination (OSCE) on dental students’ learning strategies and competence to manage periodontal diseases in patients. The implemented OSCE was expected to be superior to the existing Written Exam in fostering the acquisition of clinical competencies in terms of study strategies that are more oriented towards clinical practice, longer study time, greater clinical proficiency, and more realistic self-assessment. Material and methods: After a clinical course in periodontology, 72 third year dental students were assessed summatively, either using a Written Exam or an OSCE (P-OSCE). The students were informed beforehand about the assessment formats. The self-assessed clinical competence, study time and strategies (i.e. practice with a manikin, peers and patient case) were evaluated by means of a questionnaire. After a comprehensive dental care course, all 72 students were assessed by an overall end-of-year OSCE, in which three periodontal stations were included ‘measuring pockets’, ‘educating patients’ and ‘tracing an X-ray with bone-loss’. The competence of the previous Written Exam group and the P-OSCE group was investigated by determining the mean scores and pass-fail scores of three periodontal test-stations as well as the total score of the end-of-year OSCE. The degree of realistic self-assessment was studied by correlating the self-assessed competencies as evaluated by means of the questionnaire with the total score of the end-of-year OSCE. Results: Self-assessed clinical competence, study time and study strategies showed no differences between the P-OSCE and the Written Exam-group. The clinical competence determined in the test-station ‘measuring pockets’ in the end of year overall OSCE was higher for the P-OSCE group ( P = 0.05) when compared with the Written Exam group; the two groups performed equally well in the test station ‘educating patients’, whereas the performance in ‘tracing an X-ray with bone-loss’ was better in the Written Exam group. This group also had a higher total score in the end-of-year OSCE ( P = 0.05). The degree of realistic self-assessment was higher in the P-OSCE group than in the Written Exam group: in the P-OSCE group the self-assessed clinical competencies correlated significantly with the total score of the overall end-of-year OSCE ( P ≤ 0.05). Conclusions: No effects of the implementation of an OSCE in undergraduate periodontal education were observed in study strategies, but the implementation of an OSCE in undergraduate periodontal education appears to stimulate learning, resulting in greater achievement of specific clinical competence and a greater level of realistic self-assessment. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to test in periodontal maintenance patients whether the systems for pressure control that have been commercially developed contribute to more reproducible probing depth measurements as compared with a manual probe. Material and Methods: In 12 patients duplicate measurements were made at day 0 and 1 week later. In each patient four teeth with the deepest pockets were measured at six sites. In total 288 sites were available for comparisons. The Florida Probe® (FP) (159 N/cm2), the Jonker Probe® (JP) (153 N/cm2), the Brodontic® probe (BP) (255 N/cm2) and the manual probe (MP) were used in a randomized scheme. Results: Mean probing measurements showed for the FP and the JP lower recordings than for the BP and manual probe. The FP, the BP and the MP showed no differences between the duplicate measurements, except for the JP where the second measurement was deeper. Correlation coefficients between measurements at day 0 and 1 week show for the BP and the MP are 0.90 and 0.89, respectively, while for the FP and the JP they are 0.76 and 0.75, respectively. Conclusion: The BP and the MP appear to be reliable tools for reproducible pocket depth measurements in periodontal maintenance patients. [ABSTRACT FROM AUTHOR]

Objective: To compare two sonic toothbrushes in relation to the reversal of experimental gingivitis. Materials and Methods: Subjects refrained from brushing mandibular teeth for 21 days. During a 4-week treatment phase, the right or left side of the mouth was brushed with either the Sonic Complete (SC) or Sonicare Elite (SE) toothbrush as randomly allocated. Plaque and gingivitis were assessed on day 0, after 21 days of no oral hygiene and after 1, 2 and 4 weeks of brushing twice daily. Results: Thirty-four subjects provided evaluable data. The experimentally induced gingivitis (EIG) resulted in higher bleeding and plaque scores compared with day 0. The mean plaque scores at day 21 changed from 3.09 to 1.30 for the SC, and from 3.02 to 1.21 for the SE. At the end of the treatment period, there was no significant difference between the two brushes. The mean bleeding scores changed from 1.87 (day 21) to 0.97 for the SC, and from 1.83 to 0.92 for the SE. For the assessments at 1, 2 and 4 weeks post-EIG, both brushes showed a significant decrease in bleeding scores. There were no statistically significant differences between brushes. [ABSTRACT FROM AUTHOR]

Van Strydonck DAC, Timmerman MF, van der Velden U, van der Weijden GA: Plaque inhibition of two commercially available chlorhexidine mouthrinses. J Clin Periodontol 2005; 32: 305–309. doi: 10.1111/j.1600-051X.2005.00681.x.© Blackwell Munksgaard, 2005.Chlorhexidine (CHX) 0.2% solution is still“the leading oral antiseptic” for controlling gingivitis. Side effects, however, limit the acceptability to users and the long-term employment of a 0.2% CHX antiseptic in preventive dentistry. This stimulated the development of new formulations. The aim of the present study was to assess the effect on plaque inhibition and taste perception of two commercially available mouthrinses (0.12% CHX non-alcohol base with 0.05% cetyl pyridinium chloride (Cpc)versus0.2% CHX alcohol base).The study was designed as a single-blind, randomized two group parallel experiment, to compare two different commercially available mouthrinses, during a 3-day plaque accumulation model. Forty healthy volunteers were enrolled in the study and received a thorough dental prophylaxis at the beginning of the test period. Over a 72-h experimental non-brushing period, during which subjects abstained from all forms of mechanical oral hygiene, one group (test) used a 15 ml alcohol free 0.12% CHX (=18 mg) mouthrinse on a Cpc base (Perioaid®, CHX⊕Cpc), twice daily for 30 s. The other group (control) used a 10 ml 0.2% CHX (=20 mg) mouthrinse on an 11.8% ethanol alcohol base (Corsodyl®, CHX⊕Alc), twice daily for 60 s. After 72 h of plaque formation, the amount of plaque was evaluated. By the use of visual analogue scale, the subjects were asked for their appreciation of the taste of the mouthrinse they had used.The mean plaque index for the CHX⊕Cpc group was 0.97 and for the CHX⊕Alc group 0.78. After 72 h of non-brushing, there was no significant difference in plaque accumulation between the two groups. The answers to the questions (taste perception and after-taste) showed a statistically significant difference between the two groups. The mean visual analogue scale (VAS) scores for taste appreciation on a scale from very bad to very good taste (0–10) were 5.92 for the CHX⊕Cpc group and 4.10 for the CHX⊕Alc group (p=0.02). The mean visual analogue scale (VAS) scores for the after-taste on a scale from very short to very long (0–10) were 7.24 for the CHX⊕Cpc group and 5.38 for the CHX⊕Alc group.Within the limitations of the present study design, it can be concluded that rinsing with a 0.12% CHX mouthrinse on a non-alcohol base with 0.05% Cpc (Perio-Aid®) is not significantly different from rinsing with a 0.2% CHX mouthrinse on an alcohol base (Corsodyl®). It appears that the subjects appreciated the taste of the non-alcohol CHX solution better but the after-taste of the rinse remained longer in the mouth. [ABSTRACT FROM AUTHOR]

Versteeg PA, Timmerman MF, Piscaer M, Van der Velden U, Van der Weijden GA. Brushing with and without dentifrice on gingival abrasion. J Clin Periodontol 2005; 32: 158–162. doi: 10.1111/j.1600-051X.2005.00652.x.© Blackwell Munksgaard, 2005.This study was designed to evaluate two factors possibly influencing incidence of gingival abrasion during toothbrushing: (1) the abrasiveness of a dentifrice and (2) the possible influence of feedback of oral sensory perception.For this purpose, two separate, single blind, randomized clinical experiments were performed. The two groups of subjects were requested not to brush their teeth 48 h, prior to the experiments. After staining with disclosing solution gingival abrasion sites were recorded as small (⩽5 mm) and large (>5 mm), both before and after brushing. The dentifrice experiment was a split-mouth design, including 36 subjects, brushing their teeth in two randomly selected contra-lateral quadrants, either with or without dentifrice, whereas the remaining two quadrants were brushed, using the alternative choice. The sensory perception feedback experiment was a full-mouth design, including 43 subjects and two separate brushing exercises with use of dentifrice. The first brushing-exercise was performed by a dental hygienist, excluding the feedback of oral sensory perception of the brusher. After a 4 weeks period of familiarization to the manual toothbrush, subjects brushed themselves in the same random order as the hygienist, using a fresh brush, thus including oral sensory perception.In the dentifrice experiment, the increment of small abrasion sites was 5.86 for brushing with and 5.75 without dentifrice. There was no statistically significant difference between brushing with and without dentifrice. Both with and without dentifrice, more small abrasions were found vestibular, (3.78 and 4.22, respectively) as compared with lingual (2.22 and 1.42, respectively) (p=0.027,p<0.001). In the sensory perception feedback experiment, the increment in small gingival abrasion sites was larger for the subjects brushing themselves (8.86) as compared with the professional brushing (2.94,p<0.0001). Subjects caused more abrasion on the vestibular surfaces (6.28) as compared with the lingual (0.60,p=0.0001), where the professional did not show this difference (vestibular: 1.88, lingual: 1.30,p=0. 1388).No statistically significant difference in the incidence of gingival abrasion was found between brushing with dentifrice or without dentifrice. Neither did oral sensory perception seem to affect the incidence of gingival abrasion. [ABSTRACT FROM AUTHOR]

Paraskevas S, Danser MM, Timmerman MF, van der Velden U, van der Weijden GA: Amine fluoride/stannous fluoride and incidence of root caries in periodontal maintenance patients. A 2-year evaluation. J Clin Periodontol 2004; 31: 965–971. doi: 10.1111/j.1600-051X.2004.00593.x.© Blackwell Munksgaard, 2004.The purpose of the present study was to evaluate in a group of periodontal maintenance patients, the effect of using a dentifrice and mouthrinse containing amine fluoride (AmF) and stannous fluoride (SnF2) as compared with a dentifrice and mouthrinse both containing sodium fluoride (NaF) with regard to their root caries experience.In total, 80 patients who had been treated for moderate-to-severe periodontitis agreed to participate in this study. Subjects received supportive periodontal therapy at regular intervals of 3–4 months for at least a period of 1 year. The patients were randomly divided into two groups: (1) the test group used an AmF/SnF2 dentifrice and mouthrinse and (2) the control group used an NaF-containing dentifrice and mouthrinse. Root caries was recorded at four sites per tooth at baseline and 24 months.An increase in number of the exposed root surfaces was noted for both groups during the experimental period (p<0.05). The mean number of active caries lesions at baseline was 2.1 and 1.8 for the test group and control group, respectively. At 24 months, the corresponding values were 1.8 for the test and 2.2 for the control group. An increase of the mean number of restored surfaces was noted for the AmF/SnF2 group (from 7.3 to 13.4) and the control group (from 7.9 to 14.7) during the course of the study. This increase was found to be statistically significant for both groups in comparison with the baseline values (p⩽0.01). No statistically significant differences were noted between groups. Further analysis of the restored surfaces revealed that the major increase in number of the restorations was associated with restorations involving three to four root surfaces in the same tooth. Molars and premolars were the teeth receiving most new restorations.The present study did not detect a difference in terms of root caries development between the two groups. Root caries development is a common finding associated with surfaces developing recession in patients once treated for periodontal problems. [ABSTRACT FROM AUTHOR]

Dahan M, Timmerman MF, Van Winkelhoff AJ, Van der Velden U: The effect of periodontal treatment on the salivary bacterial load and early plaque formation. J Clin Periodontol 2004; 31: 972–977. doi: 10.1111/j.1600-051X.2004.00595x.© Blackwell Munksgaard 2004.The purpose of the present study was to investigate in periodontitis patients the relationship between the number of bacteria in the saliva and the amount of de novo plaque formation before and after treatment.At baseline, before any treatment was provided, patients rinsed with 10 ml sterile saline. After professional tooth cleaning the patients were instructed to abolish all tooth cleaning procedures for the subsequent 24 h. After this period, the rinsing procedure was repeated and the amount of de novo plaque was assessed. Three months after the initial periodontal therapy was completed the experiment was repeated. The microbiological evaluation of the rinsing samples was carried out by means of phase contrast microscopy and anaerobic culturing.After treatment the amount of de novo plaque was less compared to before treatment, 0.40 and 0.65 respectively. Both before and after treatment more de novo plaque was present at sites with inflammation than at healthy sites. In order to evaluate the contribution of the numbers of salivary bacteria to the amount of de novo plaque formation an analysis was carried out for healthy sites. This analysis included only healthy sites as determined before treatment and the same sites after treatment. The results showed a significant reduction in the de novo plaque formation after treatment (0.49 before and 0.22 after treatment). Phase contrast microscopic evaluation showed that the number of bacteria in the rinsing samples after treatment was less than before treatment. After treatment also a reduction was found in the prevalence ofPrevotella intermedia,Tannerella forsythensisandPeptostreptococcus microsin the rinsing samples.The present study confirms the observation in the literature that the periodontal condition is of major importance in the rate of de novo plaque formation. In addition, the results suggest that the number of bacteria in the saliva may play a role. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to examine, by clinical means and as patient perception of post-operative events, the effect of Emdogains (enamel matrix derivative (EMD)) on the healing of soft-tissue wounds following periodontal surgery in comparison to flap surgeries without application of EMD. Material and Methods: For this study, 22 subjects (nine female and 13 male) who were scheduled for periodontal flap surgery were selected. The mean age for all patients was 49.9 (SD 8.7) years (range, 32-67). Six women and five men were assigned to the test group and three women and eight men were assigned to the control group. All subjects were scheduled, after re-evaluation of the periodontal status 8 weeks after initial treatment, to undergo surgery of the soft tissues, because of existing of probing pocket depth (5mm or more), on at least three teeth. At random, 11 patients were assigned to control treatment and 11 patients were placed in the test group. All underwent one periodontal flap surgery for the purpose of this study. A modified Widman flap was performed. Patients in the test group received an application of EMD underneath the mucoperiostal flaps and onto the exposed root surfaces. Clinical measurements were taken at four different points in time, at the time of surgery, 1, 4 and 8 weeks after surgery. All subjects filled out a questionnaire every day for the first 7 days following surgery to evaluate post-operative complaints. Results: Of all parameters evaluated none showed a significant difference between the control and EMD groups, except for gingival swelling at the 1-week assessment, where the EMD group exhibited a higher swelling score. The questionnaire revealed that complaints of oozing of blood from the wound was twice more prevalent 1 day post-surgery in the control (n56) as in the EMD group (n53). Conclusion: This study shows that the early woundhealing of periodontal flapsurgeries in those sites treated with Emdogains is not different from control sites. [ABSTRACT FROM AUTHOR]

Van der Weijden GA, Timmerman MF, Versteeg P, Piscaer M, Van der Velden U: High and low brushing force in relation to efficacy and gingival abrasion. J Clin Periodontol 2004; 31: 620–624. doi: 10.1111/j.1600-051X.2004.00529.x.© Blackwell Munksgaard, 2004. Does a high brushing force induce more gingival abrasion than a low (regular) brushing force? Furthermore, what is the effect of a low or high force on the efficacy? Thirty-five non-dental students were selected. All received an appointment prior to which they abstained from oral hygiene for at least 48 h. At baseline the teeth and surrounding tissues were disclosed using Mira-2-Tone® disclosing solution. Next, the examiner (PAV) evaluated the number of sites with gingival abrasion and the amount of dental plaque (Quigley & Hein) at 6 surfaces of each tooth. In the absence of this examiner, the subject's teeth were brushed by a hygienist (MP) using the Braun/Oral-B®-D17 oscillating rotating toothbrush. Brushing was performed in two randomly selected contra-lateral quadrants for 60 s with either a low force (±1.5 N) or high force (±3.5 N) and in the opposing quadrants for 60 s with the alternative force. Visual feedback was given to control force. The brush was moved from the distal tooth to the central incisor perpendicular to the tooth surface with an angle of approximately 10–15° towards the gingival margin. Next, the number of sites with abrasion and the remaining plaque were assessed again. The overall baseline gingival abrasion scores were 3.1 and 3.2 sites for high and low force, respectively, and increased to 5.0 and 5.9 sites respectively after brushing. There was no significant difference with respect to incidence of abrasion. At baseline, 48 h. plaque levels were 2.2. The reduction in plaque scores with the low force was 60% and with the high force 56%. This difference was significant. With the oscillating rotating power toothbrush (Braun/Oral-B D17) the use of high force (±3.5 N) is less efficacious as compared to a regular low force (±1.5 N) while the incidence of gingival abrasion sites was comparable. (This study was sponsored by Gillette.) [ABSTRACT FROM AUTHOR]

Paraskevas S, Danser MM, Timmerman MF, Van der Velden U, Van der Weijden GA: Effect of a combination of amine/stannous fluoride dentifrice and mouthrinse in periodontal maintenance patients. J Clin Periodontol 2004; 31: 177–183. © Blackwell Munksgaard, 2004. The purpose of the present study was to evaluate the beneficial effect of using a dentifrice and mouthrinse containing amine fluoride (AmF) and stannous fluoride (SnF2) in a group of periodontal maintenance patients. Efficacy parameters were plaque, gingival inflammation, pocket depth and attachment loss. An additional parameter was development of stain. In total, 80 patients who had been treated for moderate-to-severe periodontitis agreed to participate in this study. Subjects received supportive periodontal therapy at regular intervals of 3–4 months for at least a period of 1 year. The patients were randomly divided into two groups: (1) the test group used an AmF/SnF2 dentifrice and mouthrinse and (2) the control group used a sodium fluoride (NaF)-containing dentifrice and mouthrinse. Clinical assessments were performed at baseline, 3, 6, 12, 18 and 24 months. The mean plaque index score after 3 months in the test group (0.24) was significantly lower than that in control group (0.34) ( p⩽0.05), a difference that was maintained throughout the remainder of the study. In terms of bleeding on probing, at no point in time were significant differences between test and control group found. No significant differences were noted between the two groups, nor were there any significant changes in comparison with baseline values with respect to pocket depth and attachment level. At baseline, the mean percentage of sites with no staining was 98% for both the test and control groups. At all further assessments, the staining in both groups was elevated as compared with baseline. Smoking did not affect the outcome of the study. The combined use of an AmF/SnF2 dentifrice and mouthrinse did not affect the parameters of inflammation (bleeding upon marginal probing and probing pocket depth), but it has shown to be more effective in terms of plaque reduction when compared with the use of an NaF dentifrice and mouthrinse in a group of periodontal patients placed under regular maintenance care. [ABSTRACT FROM AUTHOR]

Rowshani B, Timmerman MF, Van der Velden U: Plaque development in relation to the periodontal condition and bacterial load of the saliva. J Clin Periodontol 2004; 31: 214–218. © Blackwell Munksgaard, 2004. To investigate the influence of the oral bacterial load on plaque development in various groups of periodontitis patients and in healthy subjects. This study included subjects with a healthy periodontium, a healthy reduced periodontium after treatment, an inflamed reduced periodontium after treatment and untreated periodontitis. At the start of the study, subjects were instructed to rinse with 10 ml reduced transport fluid (RTF) for 10 s in order to evaluate the oral bacterial load. The microbiological evaluation included anaerobe culture and phase-contrast microscopy. Next, the amount of plaque and the clinical condition were evaluated. Thereafter, all supragingival plaque was removed and patients were instructed to refrain from all oral hygiene procedures for 19 h. Subsequently, the rinsing procedure and the evaluation of the amount of plaque were repeated. The amount of plaque that developed in 19 h was significantly higher in the untreated periodontitis group as compared with the two healthy groups. In case of an inflamed reduced periodontium, sites with deep pockets developed more plaque in 19 h than sites with shallow pockets. The number of bacteria present in the rinsing samples of the two inflamed groups was considerably higher than of the two periodontally healthy groups. A significant correlation was found between the bleeding index at intake and the plaque index at 19 h. No correlations were found between gingival recession and the bacterial counts at intake, and the plaque index at 19 h. The present findings support the concept that the periodontal condition is the dominating factor in relation to the rate of plaque formation. The number of bacteria present in the oral cavity as ascertained by means of a rinsing sample does not seem to play a role. [ABSTRACT FROM AUTHOR]

Van Strydonck DAC, Scalé S, Timmerman MF, van der Velden U, van der Weijden GA: Influence of an SLS-containing dentifrice on the anti-plaque efficacy of a chlorhexidine mouthrinse. J Clin Periodontol 2004; 31: 219–222.© Blackwell Munksgaard, 2004. Chlorhexidine (CHX) and sodium lauryl sulphate (SLS), the most widely used detergent in dentifrice, may counteract. Consequently, studies about this interaction suggested that care is required when combining both these compounds, even when they are introduced separately into the oral cavity. The purpose of the present study was to investigate the effect of toothbrushing with a SLS-containing dentifrice in one jaw, on the plaque inhibition of a CHX mouthrinse in the opposite jaw during a 4-day study period. The study was an examiner-blind, randomised two-cell, crossover design. It used a 4-day plaque accumulation model to compare two different oral hygiene regimens with a washout period of 17 days. Sixteen healthy volunteers were enrolled in the study and received a thorough dental prophylaxis at the beginning of each 4-day test period. One jaw (upper or lower) was randomly assigned as the “ study” jaw. The opposite jaw was assigned as the “ dentifrice” jaw and served only to introduce the effect of brushing with a dentifrice in the study model. Two oral hygiene regimens were evaluated. During one randomly assigned test period, the “ dentifrice” jaw was treated by toothbrushing with a 1.5% SLS-containing dentifrice and rinsed together with the “ study” jaw with 0.2% CHX, thus forming regimen 1. As a control during the other test period, both the “ dentifrice” jaw and “ study” jaw were only rinsed with 0.2% CHX, forming regimen 2. No other oral hygiene methods were allowed. After 4 days of undisturbed plaque accumulation, the amount of plaque was evaluated ( ). The “ study” jaw was used to study the effect of the two regimens on the level of plaque accumulation at the end of the 4-day period. The overall plaque index was 0.36 for regimen 1 and 0.34 for regimen 2. There was no significant difference in plaque accumulation between the two regimens. Within the limitations of the present study design, it can be concluded that ordinary brushing with a 1.5% SLS-containing dentifrice (Colgate Bi-Fluor), followed by rinsing with water does not appear to reduce the level of plaque inhibition offered by a post-brushing CHX rinse. [ABSTRACT FROM AUTHOR]

To explore aspects of cellular immune responses in the pathogenesis of periodontitis we analyzed phenotype and function of peripheral T cells. Two groups of subjects participated: one group consisted of 10 highly susceptible patients with severe periodontitis (mean age 29 years) and a control group consisted of 10 age, gender and race matched subjects with gingivitis. From all subjects peripheral blood was collected. The results showed that the numbers of CD3+, CD4+ and CD8+ T cells as well as the CD4/CD8 ratio, and the proliferative capacity of T cells, were not different between the two groups of subjects. Also, proportions of naive and memory T cells for both the CD4+ and CD8+ subpopulations were not different. Functional heterogeneity within the CD+4 and CD8+ T cell compartments was determined by intracellular analysis of interferon-γ (IFN-γ) and interleukin-4 (IL-4) prduction. On the basis of these latter anlyses among CD4+ and CD8+ cells, T helper (Th) 1 or Th2 function and T cytotoxic (Tc) 1 or Tc2 function, respectively, could be deduced. No significant differences in proportions of CD4+ and CD8+ T cells positive for intracellular IFN-γ or IL-4 were observed between periodontitis patients and gingivitis controls; however a higher level of intracellular IL-4 in CD8+ T cells was seen in periodontitis patients. This might indicate that there is a shift towards a Tc2 function within the CD8+ T cell subpopulation. The current explorative study suggests that further research into the role of CD8+ T cells in the pathogenesis of periodontitis is warranted. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to investigate the clinical differences between individuals highly susceptible and individuals insusceptible to periodontal breakdown. The susceptible group consisted of 7 patients with a diagnosis of juvenile periodontitis. The insusceptible group consisted of 7 individuals selected on the basis of age (52 years or older), presence of at least 18 teeth, no evidence of extractions due to periodontal breakdown, no loss of attachment, shallow pockets, gross amounts of plaque and no history of interdental cleaning. Results showed that the susceptible group had more bleeding, less plaque and deeper pockets than the insusceptible group. Since the 2 groups seem to behave differently with regard to bleeding upon probing and amount of plaque, bleeding, plaque ratios were calculated. Testing showed a highly significant difference between the 2 groups. The same results were obtained if only sites with shallow pockets were included in the analysis. On the basis of these results, it is hypothesized that a high value of the ratio between bleeding and plaque may act as a prognostic indicator for periodontal breakdown. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

At present, several risk factors for the Initiation and progression of periodontitis have been identified, in order to investigate the role of various potential clinical and microbiological risk factors and indicators, a longitudinal study was initiated in a young population deprived from regular dental care. The present communication describes the baseline cross-sectional data obtained in 1987 in terms of the clinical periodontal condition and prevalence of periodontal bacteria in the oral cavity. Alt inhabitants in the age range 15 25 years of a village with approximately 2000 inhabitants at a tea estate on Western Java. indonesia. were examined clinically and microbiologically. ln total. 255 adolescents, comprising 130 males and 125 females participated in the study. Samples for bacteriological examination were taken from the gingiva. the dorsum of the tongue. and the saliva. Plaque index, bleeding upon probing. pocket depth, and attachment loss (AL) were scored on the approximal surfaces from the vestibular aspect of all teeth as well as the mid-vestibular and mid-lingual aspects of the Ramfjord teeth. Calculus was scored only on the 4 surfaces of the kamfjord teeth. Following the clinical measurements, the deepest bleeding pocket with no clinical loss of attachment was sampled for microbiological examination. In addition, in 37 subjects a deep bleeding (&ges;4 mm) with at least 4 mm of attachment loss was sampled. Moderate periodontitis (max. AL 3.4 mm) was found in 26% of the population, advanced periodontitis (max. AL 3 4 mm) in 8%, whereas 66% of the population showed no or minor periodontitis (max. AL 0.2 mm. Actinobacillus actinomycetemcomitans was found in 57% of the population, Porphyromonas gingivalis in 87%. Prevotella intermedia and motile rods in all cases and spirochetes in 89%, P. gingivalis (66%). A. actinomycetemcomitans (37%) and spirochetes (63%) were of all the sampled sites of the oral cavity, most frequently detected in pockets without attachment loss. Motile rods were most prevalent on the tongue and in the saliva (92% and 89%, respectively). A high prevalence of the investigated periodontal bacteria was detected both in the pockets without and with attachment loss. No significant association between the clinical periodontal parameters and the prevalence of the microorganisms was observed at a patient level. At a site level, both P. gingivalis and spirochetes were more prevalent in sites with attachment loss. The actual role of these putative periodontal pathogens may he elucidated more extensively, when longitudinal data on the present population become available. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Presents a response by D.S. Barendregi, U. van der Yelden, J. Reiker and B.G. Loos to a letter to the editor about his article on periodontics discussed in previous issues of "Journal of Clinical Periodontology."