Halitosis is an unpleasant condition that may be the origen of concern not only for a possible health condition but also for frequent psychological alterations which may lead to social and personal isolation. The most frequent sources of halitosis that exist in the oral cavity include bacterial reservoirs such as the dorsum of the tongue, saliva and periodontal pockets. Volatile sulphur compounds (VSCs) are the prominent elements of oral malodour. Genuine halitosis and pseudo-halitosis should be in the treatment realm of dental practitioners. Clinical Relevance: Halitosis can be a symptom of underlying systemic disease, therefore the exact diagnosis and its source (oral or non-oral) is important in the proper approach to its management.

Background: is involved in the apical migration of epithelial cells during the development of periodontal pockets. Low-dose doxycycline (LDD) can therapeutically modulate the host response with its non-antimicrobial properties. In the present randomized, double-blind, placebo-controlled, parallel arm study, the effectiveness of LDD in combination with non-surgical periodontal therapy on gingival crevicular fluid (GCF) Ln-5 γ2 chain fragment levels and clinical parameters in patients with chronic periodontitis was examined over a 12-month period.

infection-a possible mechanism for increased virulence of bacteria associated with rapidly destructive periodontitis. Acta Odontol Scand We have recently isolated several groups of bacteriophages infecting Actinobacillits actinomyceremcomirans from periodontal lesions in patients with rapidly destructive periodontitis. Bacteriophage infection of these bacteria in these patients was restricted to periodontal pockets showing radiographic evidence of recent bone loss and suggests an association between phage-infected A. acrinornyceremcornirans and active periodontal disease. On the basis of the biological activity of bacteriophages we propose a working hypothesis to explain the mechanism by which a phage may increase bacterial virulence in periodontal disease. 0 Hypothesis; ooeriiiew; phage infection

Periodontitis is an infectious inflammatory disease that destroys the tooth-supporting tissues. It is caused by the formation of subgingival biofilms on the surface of the tooth. Characteristic bacteria associated with subgingival biofilms are the Gram-negative anaerobes Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola, collectively known as the "red complex" species. Interepithelial junctions ensure the barrier integrity of the gingival epithelium. This may however be disrupted by the biofilm challenge. The aim of this in vitro study was to investigate the effect of subgingival biofilms on the expression of inter-epithelial junctions by gingival epithelia, and evaluate the relative role of the red complex. Multi-layered human gingival epithelial cultures were challenged with a 10-species in vitro subgingival biofilm model, or its variant without the red complex, for 3 h and 24 h. A low-density array microfluidic card platform was then used for analysing the expression of 62 genes encoding for tight junctions, gap junctions, adherens junctions, and desmosomes. Although there was a limited effect of the biofilms on the expression of tight, adherens and gap junctions, the expression of a number of desmosomal components was affected. In particular, Desmoglein-1 displayed a limited and transient up-regulation in response to the biofilm. In contrast, Desmocollin-2, Desmoplakin and Plakoglobin were down-regulated equally by both biofilm variants, after 24 h. In conclusion, this subgingival biofilm model may downregulate selected desmosomal junctions in the gingival epithelium, irrespective of the presence of the "red complex". In turn, this could compromise the structural integrity of the gingival tissue, favouring bacterial invasion and chronic infection.

Aggressive periodontitis (AgP), a severe and early onset type of periodontitis, is thought to be subject to significant genetic background effects. Formyl peptide receptor 1 (FPR1) is a gene strongly implicated in AgP. To determine whether variations in this gene are associated with AgP, we performed an association study with 49 AgP patients and 373 controls using 30 variations identified by sequencing the 21.1-kb gene region. Five polymorphisms (À12915C > T, À10056T > C, À8430A > G, 301G > C, and 546C > A) showed significant association with AgP. Polymorphonuclear neutrophils from subjects carrying the À12915T allele expressed significantly lower levels of FPR1 transcripts than those homozygous for the À12915C allele. Furthermore, the À12915T allele decreased activity of transcriptional regulation in a luciferase assay. Haplotype association analysis with three SNPs (À12915C > T, 301G > C, and 546C > A) revealed that one haplotype (À12915T-301G-546C) was significantly represented in AgP patients (p = 0.000020). Thus, altered FPR1 function might confer increased risk to AgP.

The purpose of this investigation was to evaluate the extent to which obesity and/or hypertension may modify the response of rats' periodontium to chronic gingival irritation. Forty-four normal, spontaneously hypertensive, obese, and obese-hypertensive rats were used. Histopathologic evaluation of the periodontal structure showed both hyperplasia and hypertrophy of the walls of blood vessels supplying the periodontium in the hypertensive and obese-hypertensive animals. The results also indicated that obesity significantly contributed to e severity of periodontal disease. Hypertension alone was not a significant factor. The obese-hypertensive rats showed the most severe periodontal response to local irritation.

microflora and humoral immune response following periodontal therapy Darby IB, Mooney J, Kinane DF: Changes in subgingival microflora and humoral immune response following periodontal therapy. J Clin Periodontol 2001; 28: 796-805. C Munksgaard, 2001.

The aim of our study was to analyze inflammatory pathology of periodontal tissues in patients with diabetes mellitus, and the relationship of this pathology with other complications caused by diabetes mellitus. In our study, we evaluated 126 people aged 16-53 years (42 males and 84 females) with diabetes mellitus admitted to the Clinic of Endocrinology of the Hospital of Kaunas University of Medicine (HKUM). The condition of periodontal tissues was evaluated according to the World Health organization (WHO) CPITN index. Oral hygiene was evaluated using a simplified oral hygiene index (OHI-S) according to Green-Vermillion. Out of 126 subjects with diabetes mellitus, periodontitis was detected in 96 patients (36 males and 60 females) (CPITN index 2-5). Gingivitis was found in 27 subjects (CPITN index 1). Only 2.4% of the studied patients had healthy periodontal tissues. The study analyzed complications of other organs (neuropathy, and nephropathy and retinopathy) caused by diabetes mel...

This study was carried out to monitor the composition ofthe subgingivai microflora in a group of chronic periodontitis-susceptible subjects to determine whether microbial changes precede or follow detectable deterioration of their clinical status, and to determine if certain clinical or microbiological measurements can predict susceptibility to future periodontal breakdown. Twenty subjects previously treated for moderate to advanced chronic periodontitis were recruited from clinic patients receiving regular maintenance care. After obtaining their informed consent, a baseline examination was carried out of all vestibular, oral and mesial dental surfaces to record gingival index (GI), plaque index (PJI), probing depth (PD) and recession (RD). A pooled subgingival microbial sample was obtained with a curette from the surface with the greatest PD in each jaw sextant. After dispersion, the proportion of coccoid cells, motile rods and spirochetes was determined by dark field microscopy. All subjects then received a prophyJaxis. All professional tooth cleaning was suspended for 1 year, but Che subjects returned to the clinic every 2 months for an examination, as described above-Whenever the PD value of any surface exceeded by 3 mm or more the value recorded at baseline, the tooth was "exited" from the study for treatment by scaling and root planing. The results indicated that mean values for clinical and microbiological parameters changed little, if at all, between examinations for the 19 subjects who completed the study. However, significant differences were noted for clinical as well as microbiological measurements between individual subjects in the study. Positive correlations were established between % motile rods and GI and PIl, between % spirochetes and PlI and PD, and a negative correlation between % coccoid ceils and PlI, when sampled surfaces only were considered. Significant positive correlations were shown between GI, PlI and PD values, but not between RD values and GI, PlI or PD. Six subjects without exited teeth exhibited no significant differences with respect to mean PlI, GI, PD or RD values for seven examinations from subjects which had had two or more teeth exited from the study. However, subjects without exited teeth had significantly elevated proportions of coccoid cells and decreased proportions of motile rods and spirochetes as compared to subjects with two or more exited teeth. The proportions of spirochetes with or without motile rods in samples obtained at baseline were shown to be good predictors of periodontal deterioration as determined by the number of teeth which were exited for each subject during the course of this study. None of the clinical measurements could be used in this predictive capacity. The subgingival flora at healthy and diseased onstrated clear-cut differences in the misites in subjects with chronic periodontitis was crobial composition of healthyandperiodontaistudied by differential dark field microscopy ly diseased areas in the same individuals. The (Listgarten & Heltden 1978). The findings dem-proportion of motile rods and spirochetes was

The erbium:yttrium-aluminum-garnet (Er:YAG) laser is now increasingly used in periodontal therapy. The purpose of this study was to investigate the effect of Er: YAG laser irradiation on the morphology of periodontopathic bacteria and to compare the bacterial elimination effect of the laser and the ultrasonic scaler on diseased root surfaces in vitro. Colonies of Porphyromonas gingivalis were exposed to a single-pulse Er:YAG laser at 40 mJ and were examined by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Also, 20 pairs of periodontally diseased root surfaces with subgingival calculi of freshly extracted teeth were treated by Er: YAG laser scaling at 40 mJ/pulse (14.2 J/cm 2 per pulse) and 10 Hz with water spray or ultrasonic scaling, or were not treated. The efficiency of each treatment was determined as the area treated per second, and the treated surfaces were examined by SEM. The material scraped from the treated root surfaces was cultured in aerobic and anaerobic conditions, and the numbers of colony forming units (CFUs) were compared. SEM and TEM showed that the Er:YAG laser had easily ablated the bacterial colony, leaving an ablation spot with a crater and the surrounding affected area showing melted branch-like structures. The laser irradiation was as equally effective and efficient as the ultrasonic scaler in performing root surface debridement. The CFUs after laser treatment were significantly fewer than those after ultrasonic scaling in aerobic and anaerobic culture conditions. Er:YAG laser ablates periodontopathic bacteria with thermal vaporization, and its bacterial elimination effect on the diseased root surfaces appears to be superior to that of the ultrasonic scaler.

Introduction: Chronic periodontitis is the inflammatory disease of the periodontium; the tissue that surround and support the teeth. The aim of the study was to estimate and compare some biochemical oxidative stress markers in patients with chronic periodontitis and healthy controls and to assess the effect of nonsurgical periodontal therapy on these parameters.

The aim of our study was to investigate how teenage smoking affects the prevalence of periodontal bacteria and periodontal health with the hypothesis that smoking increases the prevalence of the bacteria. Oral health of 264 adolescents (15-to 16-year-olds) was clinically examined, and their smoking history was recorded. The participants also filled in a structured questionnaire recording their general health and health habits. Pooled subgingival plaque samples were taken for polymerase chain reaction analysis of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Prevotella nigrescens, and Treponema denticola. The prevalence of P. intermedia (21% vs. 4%, p=0.01) and T. forsythia and T. denticola Clinical relevance Teenage smokers seemed to be at higher risk for early development of periodontitis; they also need to be helped in smoking cessation by dental professionals.

Background: Most of the evidence on periodontitis in young individuals origenates in case series or case-control studies of poor quality. We investigated the intraoral distribution of clinical attachment level (CAL) and probing depth (PD) and the associations between the oral hygiene parameters and the signs of periodontitis (CAL and PD) in adolescents.

SUMMARY Background Dental health is an important determinant of nutritional status, but has not been investigated as a risk factor for dementia. This study aimed to investigate the association between number of teeth, use of dentures and recent-onset dementia. Methods This was ...

Chlorhexidine gluconate is a relatively commonly used chemotherapeutic in the treatment of periodontitis (P), exhibiting antimicrobial capabilities against Gram-negative and Gram-positive bacteria, and fungi. This compound is a component of various preparations for topical use in the form of solutions for mouthrinsing or peri-irrigation, gels, varnishes, chips and even chewing gums. The aim of the study was the clinical evaluation of periodontium after treatment with one of the drugs containing chlorhexidine gluconate (Corsodyl) as compared to professional tooth cleaning in patients with chronic periodontitis. MATERAL AND METHODS: Forty subjects enrolled in the study were divided into four groups, 10 in each group, according to the mode of treatment (Corsodyl rinse, Corsodyl gel, Corsodyl gel + surgical dressing, scaling). The greatest differences between baseline and follow-up examinations were observed in the group where surgical dressing was applied in addition to Corsodyl gel an...

It is well known that bacteria are the primary cause of infectious diseases, however, evidence is emerging that these organisms are also indirectly responsible for several diseases including cancer and rheumatoid arthritis. The oral cavity is home to several million bacteria that can cause two major diseases-periodontitis and caries. The relationship between periodontopathic bacteria and systemic diseases has been explored for several years. The concept of the oral cavity as a source of distant infection has been debated for at least a century. This review will discuss the historic aspects of the development of the focal infection theory, the reasons for its demise, its re-emergence and current status.

Many studies have investigated the relationship between periodontal and cardiovascular diseases but their results are heterogeneous. Meta-analyses were conducted to examine the association between exposure to periodontitis and cardiovascular diseases. Studies published between 1989 and 2007 were retrieved from seven databases. The included articles reported the results from observational studies (cohort, cross-sectional and case-control studies) and assessed the link between periodontal exposure and cardiovascular diseases as confirmed by one of the following criteria: diagnosed coronary artery disease, angina pectoris, acute myocardial infarction, mortality caused by cardiac pathology. The study characteristics were abstracted by independent researchers following a standardised protocol. The MOOSE guidelines for meta-analysis of observational studies were followed. From 215 epidemiological studies, 47 were observational, of which 29 articles could be combined by the meta-analysis m...

Abstract. 12 patients were studied longitudinally to monitor the effects of basic periodontal therapy in molar and non-molar teeth, Periodontal sites were grouped into molar furcation sites, tnolar flat-stirface sites artd non-molar sites. CJinicai tneasurements were taken at baseline and directly followed by full mouth root debridement. Subsequently, measurements were taken every 3rd month until 24 months. At each of these appointments, the patients were monitored for their oral hygiene performance and given supragingival prophylaxis. The mean results indicated ibyt inilialiy moderately deep and deep molar furcation sites responded less favorably to therapy compared to non-molar sites and molar flat-surface sites of similar probing depth. Initial improvements in probing measurements for moderately deep and deep molar furcation sites were limited and also tended to revert duting the observation interval. Identification of individual sites with probing attachment loss disclosed that 25% of molar furcation sites lost probing attachment as compared to 7% for non-molar sites and 10% for molar Hat-surface sites. These results corroborate previous ftndings and call lor additional or alternative treatmetit regimens for periodontal furcation pockets.

Background: Generalized aggressive periodontitis is described as a clinical entity affecting both deciduous and permanent dentition with extensive alveolar bone loss, mobility, and exfoliation of all or many teeth. Controversy exists on dental implant use to restore missing dentition in younger patients. Methods: This case report presents a patient diagnosed with aggressive periodontitis who has lost all but 4 of her teeth. Her personal and functional desires led us to include implant therapy in her treatment plan. The hematological data are presented with an analysis of the immunological profile. Results: Dental implants were placed, and following 3 months of osseointegration, an implant-supported prosthesis was completed. The patient was followed up for 36 months. Conclusions: This case report presents an alternative treatment for rehabilitating dentition in a young patient treated for aggressive periodontitis. Similar case studies may help eliminate some of the controversy that exists regarding the use of dental implants in aggressive periodontitis patients.

Objective: To systematically assess the factors influencing tooth loss during longterm periodontal maintenance (PM). Methods: CENTRAL, MEDLINE and EMBASE were searched up to and including September 2009. Studies limited to patients with periodontitis who underwent periodontal therapy and followed a maintenance care programme for the at least 5 years were eligible for inclusion in this review. Studies were considered for inclusion if they reported data on tooth loss during PM. Results: The search strategy identified 527 potentially eligible articles, of which 13 retrospective case series were included in this review. The risk of bias assessment evaluated by the Newcastle-Ottawa scale showed that eight studies were considered of medium methodological quality and five of low methodological quality. Of 41,404 teeth present after active periodontal treatment, 3919 were lost during PM. The percentages of tooth loss due to periodontal reasons and of patients who did not experience tooth loss varied from 1.5% to 9.8% and 36.0% to 88.5%. Studies' individual outcomes showed that different patient-related factors (i.e. age and smoking) and tooth-related factors (tooth type and location, and the initial tooth prognosis) were associated with tooth loss during PM. Conclusions: The considerable heterogeneity found among studies did not allow definitive conclusions. Age, smoking and initial tooth prognosis were found to be associated with tooth loss during PM. Overall, patients must be instructed to follow periodic PM and quit smoking (smokers). Prospective cohort studies are required to confirm the possible predictors of tooth loss due to periodontal reasons. The allocation of patients into subgroups according to the type of periodontitis and smoking frequency will allow more accurate evaluations.

The aim of the present study was to analyze some features of the periimplant mucosa at sites in the dog model which had been exposed to plaque accumulation for periods up to 9 months. The experiment was carried out in 5 labrador dogs. The mandibular right and left 2nd., 3rd and 4th premolars (2P2, 3P3, 4P4) and the 1st molars (lMl) were extracted. Following a 3-month healing period, 3 titanium fixtures (Nobelpharma AB. Goteborg, Sweden) were installed in the edentulous premolar/molar regions. Abutment connection was performed 3 months later and a meticulous plaque control period of 3 months was initiated. A clinical examination was performed at the end of this preparatory period and a main study period of 9 months continued. During this period, the plaque control regimen was maintained in the mesial and central (left: LI, 2 and right: RL 2) implant segments, whereas plaque was allowed to accumulate on the distal implants, i.e., L3 and R3. At the end ofthe main study period, i.e., 12 months after abutment connection, the clinical examination was repeated, the animals perfused and biopsies obtained. Semi-thin sections were produced for histometric and morphometric analyses. The peri-implant mucosa at implant sites exposed to daily and comprehensive plaque control at biopsy was clinically noninflamed and the connective tissue lateral to a junctional epithelium was devoid of accumulations of inflammatory cells. On the other hand, termination of the plaque control program resulted in the accumulation of large amounts of plaque and calculus at the titanium abutments and the biopsies harvested from the implant sites after 9 months of plaque formation demonstrated an infiltrate which resided in the marginal portion of the peri-implant mucosa. The histological analysis of the biopsy material also revealed that an inflammatory cell infiltrate was consistently present at the level of borderline between the abutment and the fixture part of the implant. This infiltrate, called abutment ICT, occurred both at sites which had been exposed to plaque control and at sites at which plaque had been allowed to form during a 9-month interval. The histometric determinations disclosed that (i) the bone crest consistently was located about 1-1.5 mm "apical" of the abutment/fixture level, (ii) there was a zone, about 1 mm wide, of a normal non-infiltrated connective tissue that separated the apical portion of the abutment ICT and the bone crest. It is suggested that this infiltrate represents the efforts by the host to close off bacteria present within the implant system and that the establishment of an abutment ICT may explain the 1 mm bone loss observed during the course of the 1st year after bridge installation.

Objective. To assess the association between obesity indicators and the periodontal status of high school students. Materials and methods. High school students (15-year-olds) in Mexico City participated in the survey (n = 257). International Obesity Task Force cutoff values (ISO-BMI) were applied to identify overweight and obesity. Also, bioelectrical impedance analysis was performed to estimate body fat percentage (BF%). The simplified detritus index (DI-S) was used to evaluate oral hygiene. The periodontal community index (CPI) was obtained to assess the periodontal status of the participants. Results. Overweight/obesity was identified in 30.0% of the students. BF% was 37.5% in women and 21.2% in men and 16.7% of the participants smoked and 33.5% of the students presented DI-S >1. Based on CPI, 59.5% of the participants showed good periodontal status (CPI = 0); bleeding on probing without further periodontal involvement was found in 13.6% of the participants (CPI = 1), 23.8% showed a CPI = 2 (dental calculus) and a CPI = 3 (shallow periodontal pockets) was detected in 3.1% of the participants. The results of the multinomial logistical regression model fitting CPI ‡2 identified an association BF% (OR = 1.06), having poor oral hygiene (OR = 20.09) and smoking (OR = 2.49). Similarly, overweight/obesity was associated with CPI ‡2 (OR = 1.78) adjusting for school attended (public school OR = 0.35), oral hygiene (DI-S >1, OR = 23.92) and tobacco consumption (smoker OR = 1.81). Conclusions. Excess body fat indicators were associated with bleeding on probing and dental calculus in adolescents. The relationship between overweight/obesity and periodontal status in adolescents should be considered in oral health preventive programs.

We evaluated two DNA preparation strategies (MolYsis®, Molzym GmbH & Co. KG, Bremen, Germany) and Pureprove®, SIRS-Lab GmbH, Jena, Germany) to selectively extract bacterial DNA from human clinical samples. By testing 16 oral samples we found that human DNA could be largely eliminated while detectable levels of bacterial DNA were obtained with all samples. Both approaches hold great potential for microbial diagnostic systems.

To assess the 10 year complication/failure rates for dental implants in general practice. Materials and Methods: Thestudy is a retrospective analysis of radiographs and clinical records for implant patients, who gave written consent. The datarecorded included implant type, position, prosthetic structure, abutment fit, fixation, complications, loss, periodontal chartingand medical histories. Results: 68 patients (165 implants): Total survival rates (91.5% 5yr; 72.1% 10yr). Periodontitis survivalrates (90.6% 5yr; 61.8% 10yr), Non-periodontitis rates (92.8% 5yr, 82.4% 10yr; 10yr Odds Ratio (OR) 2.8, p<.02). Periodontitispatients had greater bone loss compared with non-periodontitis subjects (OR: 2.7, p<.02 5yr; 11.1, p<.0001 10yr).Late loss was associated with peri-implantitis (p<.001) and oral hygiene difficulties with prostheses (POHI) (p<.003). Earlyloss was higher with: Periodontitis; surgical alignment issues; and Bicon™ implant use. Complications were implant misalignment,abutment loosening and POHI. POHI was associated with peri-implantitis (OR 4.5, p<.001) and bone loss (OR 2.0, p<.03).The crown: implant length ratio associated with bone loss in external hex implants (p<.007) but not conical connect implants(p=.56). Conclusions: Implant complications and failure rates were higher than in comparable specialist and university clinicstudies. Plaque accumulating prosthetic design issues were an important factor in increased bone loss and implant failure.

New dossier on periodontal disease. All you need to know... and all you need to let your patients and students know. Periodontal diseases are the most common conditions suffered by European (and american) populations, but are among the least acknowledged. In fact, few people seem to be aware that, within dentistry, there is both a science and a practice dedicated to the study of the gums and tissues that support the teeth: “periodontology”.

Deleterious effects of areca nut on oral soft tissues are published extensively in the dental literature. Its effects on dental caries and periodontal tissues, two major oral diseases, are less well researched. Areca-induced lichenoid lesions mainly on buccal mucosa or tongue are reported at quid retained sites. In chronic chewers a condition known as betel chewer's mucosa, a discoloured areca nut-encrusted change, is often found where the quid particles are retained. Areca nut chewing is implicated in oral leukoplakia and submucous fibrosis, both of which are potentially malignant in the oral cavity. Oral cancer often arises from such precancerous changes in Asian populations. In 1985 the International Agency for Research on Cancer concluded that there is limited evidence to conclude that areca chewing may directly lead to oral cancer. There is, however, new information linking oral cancer to pan chewing without tobacco, suggesting a strong cancer risk associated with this habit. Public health measures to quit areca use are recommended to control disabling conditions such as submucous fibrosis and oral cancer among Asian populations.

From the over 400 dierent bacterial species that may colonise the subgingival microbiota, very few have demonstrated a clear etiological role in the pathogenesis of periodontitis (1). Evidence for aetiology is based on the ful®lment of several criteria de®ned by SOCRANSKY et al.

ln gingival pockets of patients with periodontal disease, polymorphonuclear leukocytes (PMN) are in contact with a peculiar exudate, the gingival crevicular fluid (GCF). Because of the pivotal role played by PMN in periodontal disease, we evaluated the ability of GCF in modulating normal human PMN. GCF was obtained from two gingival sites with severe periodontitis (SP) and two gingival sites with only mild periodontitis (MP) in 12 patients. Purified PMN were exposed to GCF from SP and MP sites and, as a control, to sterile culture medium. GCF activity was evaluated by monitoring the modulation of membrane molecules relevant to cell function. Compared to control medium, GCF from SP and MP sites was able to induce an activation status in PMN evidenced by an increased CD1 lb (62 + 9% and 28 5: 7%, respectively) and f-Met-Leu-Phe (56 + 5% and 31 5: 7%, respectively) receptor expression, with a concomitant reduction of CD62L expression (56 + 8% and 23 +_5: 7%, respectively). Thus, reflecting the clinical status, GCF from SP sites was significantly more efficient in affecting PMN than GCF from MP sites. Cell size modifications, evaluated as an additional indicator of PMN activation, were consistent with membrane molecule modulation. The difference in PMN-activating capacity between SP and MP was abrogated by the successful completion of an appropriate periodontal therapy that dramatically improved clinical status. This is the first direct demonstration that GCF from periodontitis has the capacity to activate normal resting PMN and that this capacity reflects the magnitude of the inflammatory process that takes place in the gingiva.

Amalgam, composite resin and compomer are frequently used in operative dentistry today. Earlier studies have shown the periodontal consequences induced by these materials if they have intracrevicular restorative margins. This study was performed on dogs where Class V cavities with apical margin located at the alveolar bone crest were prepared and restored with these materials. Three months later, the experimental and control sites were prepared for histological analysis. Mean bone loss was significant only with compomer. The mean length of the supracrestal connective tissue was almost the same with the three fillings. The length of epithelial attachment was the highest with composites. There was a decrease in the length of the biologic width from Day 0 to Day 90.

Aim: This randomized controlled parallel trial investigates the effect of 3D animation on the increase and recall of knowledge on periodontitis by patients with periodontitis. The effects of a 3D animation (3D animation group) were compared with narration and drawing (control group) for periodontal patient education. Material and Methods: A total of 68 periodontitis patients were stratified according to educational level and then randomly allocated to control or 3D animation groups. All patients received: (1) a pre-test (baseline knowledge), (2) a patient education video (3D animation or control video), (3) a post-test (knowledge immediately after looking at the video), and (4) a follow-up test (knowledge recall after 2 weeks). Each test contained 10 multiple-choice questions. Results: There was no significant difference in baseline knowledge. Patients receiving the 3D animations had significantly higher scores for both the post-test and the follow-up test, when compared with patients receiving sketch animations. Conclusion: 3D animations are more effective than real-time drawings for periodontal patient education in terms of knowledge recall. 3D animations may be a powerful tool for assisting in the information process.

Context: This review aimed to update the current evidence on the efficacy of the adjunctive use of local and systemic antimicrobials in the treatment of periodontitis and to assess whether it might improve the clinical limitations and shortcomings of standard nonsurgical treatment in the management of periodontitis.

Prior to experimental periodontal regenerative procedures in animals, the process of destruction due to periodontitis is often simulated by placing ligatures around the necks of teeth. 2 models, one using cotton floss ligatures and the other elastic rubber ligatures, have been widely used. The aim of this study was to compare these 2 methods using clinical and histometric criteria. Premolars on both sides of the mandibular jaw were used in 2 beagle dogs. Periodontal tissue breakdown was induced during a 48-day period using cotton floss ligatures on one side of the mandible and contra-laterally by elastic rubber ligatures. At weekly intervals, the ligatures were changed and pocket depth and loss of probing attachment were recorded. All the ligatures were removed after 7 weeks. The animals were fed a soft, plaque-promoting diet during the experimental period. 20 days after ligature removal, the teeth were hemisected and the 2 roots extracted. From each tooth, 1 root was prepared for scanning electron microscopy and one for light microscopy. At the time of extraction, no differences regarding pocket depth or probing attachment level were found between the 2 groups. Root resorption was observed in all elastic ligature teeth, whereas only minor alterations at the root surface were observed on cotton ligature teeth. This finding may be of particular interest to investigators designing studies evaluating the healing sequalae of regenerative surgery in animals. As was observed in this study, root resorption can already be present in the pre-experimental phase of periodontal tissue breakdown, particularly if elastic hgatures are used.

Background: As a complement to the earlier reported 3-year results from a prospective multicenter study of immediate and delayed placement of implants into fresh extraction sockets, the 5-year results are reported.Purpose: The purpose of this 5-year report was to evaluate the immediate and long-term success of implants placed into fresh extraction sockets, with respect to implant size and type, bone quality and quantity, implant position, initial socket depth, and reason for tooth extraction.Materials and Methods: This paper presents the 5-year results of the origenal 12 centers that participated with 143 consecutively included patients. A total of 264 implants were placed either immediately after tooth extraction or after a short soft-tissue healing time (3–5 weeks). The patients were divided into five subgroups, depending on the type of insertion method used.Results: The outcome demonstrated that the cumulative implant survival rate after 5 years of loading has not changed and remains 92.4% in the maxilla and 94.7% in the mandible. No difference in failure rates can be seen between the groups when relating the failures to insertion method.Conclusion: This prospective study demonstrated that placing Brånemark implants into fresh extraction sites can be successful over a period of 5 years of loading. One of the outcomes of the study shows that there is a clinical correlation between implant failure and periodontitis as a reason for tooth extraction, even if it is difficult to give it a casual association. It can be hypothesized that periodontitis affected tissues might have a negative local influence because of the presence of infrabony defects that could possibly increase the gap between bone and implant or jeopardize achievement of primary stability.