The apically repositioned flap procedure, by definition, implies that the mucogingival junction (MGJ) is shifted into an apical location. That this actually would be the case has never been shown in long-term studies. The 13 subjects in the present study had during the years 1964-1965 received treatment of moderately advanced periodontal disease (probing pocket depths less than or equal to 5 mm) in the lower jaw. An apically repositioned flap (ARF) procedure was applied in the left or right half of the mandible and a gingivectomy (GE) was performed in the contralateral side. Starting in December 1981, the patients were recalled for clinical and radiographic determination of long-term results. The width of the band of keratinized gingiva was measured clinically and the distance from the MGJ to the lower border of the mandible (LBM) was measured from orthopantomograms. Slightly less keratinized gingiva was observed on the sides where GE had been used. There was no statistically significant difference in the orthopantomographic distance from the MGJ to the LBM between ARF and GE operations. The results indicate that the apically repositioned flap procedure does not result in a permanent apical shift of the MGJ.
A randomly selected sample of 1992 adults (995 men and 997 women) representing four equally sized age groups of 25-, 35-, 50-, and 65-years-old inhabitants of West Bothnia were studied for prevalence of symptoms and clinical signs of mandibular dysfunction. Of the sample 79% completed a questionnaire and a clinical examination. The chewing inability increased with age. Recurrent headaches (once a week or more often) were reported to occur in 11% to 15% of the four age groups, and the duration of headaches was generally more than 2 years. Tooth-clenching, which was the most frequent oral parafunction, was reported significantly more often in women, whereas attrition was more severe in men. The commonest clinical finding was temporomandibular joint clicking, which varied between 13% and 35% in the different age groups. Crepitation was observed more often in women and increased with age. The jaw muscles were more frequently tender to palpation in women and the elderly. The mean maximal mouth opening capacity varied between 55 mm and 44 mm, decreasing with age, and was for the whole sample significantly higher among men. Since signs and symptoms of craniomandibular disorders were common findings in all age groups, routine dental examination should always include functional evaluation of the stomatognathic system.
The amount of plaque accumulation was assessed in an intraindividual study comprising 10 individuals. During different 2-week periods, the test subjects used nylon floss (unwaxed, waxed and specially treated), silk floss (unwaxed and waxed), Superfloss or triangular toothpicks for interdental tooth cleaning. Only teeth in contact with neighboring ones and with open interdental spaces were included in the study. The plaque removal of the interdental aids used was registered by estimating the amount of plaque present at the end of each experimental period according to a Plaque Index (Silness & Löe 1964) modified for plaque registration on 10 surface units around each tooth. In general, dental floss had a higher plaque removing potential than triangular toothpicks, especially on lingual axial surfaces.
– Twenty‐four adults participated in an intraindividual crossover experimental study to compare the plaque removing ability of straight multitufted and V‐shaped brushes. Twelve of the participants had loss of periodontal tissue resulting in open but healthy interdental areas while the other 12 displayed no periodontal breakdown. In part 1 the participants were asked to brush their teeth using their own brushing technique and length over two 12‐day periods during which time they, at random, used one brush for the first and the other brush for the second period. In part 2 the participants were professionally brushed by two dental assistants using four brushing techniques (The Bass, The Roll, The Circular Scrub and The Horizontal Scrub) randomly assigned to the four quadrants of the mouth. Cleaning was performed once a day for two 5‐day periods, during which time the participants refrained from brushing and interdental cleaning. Initial toothbrush assignment was randomized. At the beginning of the study and each test period no plaque or gingival inflammation was visible. At the end of each period the accumulated plaque was registered. The results showed that there was no difference between the two brushes tested in the unsupervised part. The plaque removing ability when using either of the brushes varied between participants. When professionally used the straight multitufted and V‐shaped toothbrushes did not show any difference in plaque removal on buccal and lingual surfaces. Interproximally the V‐shaped toothbrush was better at plaque removal than the straight one. However, plaque still remained after brushing with the V‐shaped toothbrush, which indicates that toothbrushing always must be supplemented with interdental aids and that the shape of brushes as well as the techniques used are of little importance. Interproximal areas with tissue breakdown and loss of interdental papillae accumulated more plaque than those with no periodontal tissue breakdown.
– The plaque‐removing efficacy when using waxed dental floss and three interdental brushes was compared in an intraindividual clinical trial. Nine adult patients treated for periodontal disease, with a reduced but healthy periodontium and large interdental spaces were subjects in the study. Each subject tested the four interdental cleaning aids in random sequence over a 2‐wk period. The duration of the study was 8 wk. The results indicated that the use of interdental brushes is preferable to that of dental floss in cleaning interdental areas where the papilla is missing. No difference in achieved cleanliness was noted after use of the different interdental brushes tested. No gingival damage or damage to the hard tissue of the teeth was observed after use of interdental brushes or dental floss.
The aims of this investigation were: (i) to study a group of dry mouth Sjögren's syndrome (SS) patients comprising individuals with pathological and non-pathological amounts of rest saliva and (ii) to compare these two categories of SS patients with a sex- and age-matched control group with respect to their periodontal and dental status. Thirty-three dry mouth patients and 33 sex- and age-matched patients, referred to the same private dental clinic in southern Norway, were examined for rest and stimulated saliva, as well as their dental and periodontal status. All patients were referred to the local hospital for blood and urine examinations. The dry mouth SS patients were all of the secondary type. Volumes of rest and stimulated saliva were significantly lower in the low saliva SS group compared with the high saliva SS group; the values for immunoglobulin G (IgG) and IgA were similarly lower for the low saliva group, but not for IgM which was significantly higher. The two SS subgroups and their controls were compared for the volume of rest and stimulated saliva, which showed a statistically significant lower volumes for the low saliva SS group compared with the control group. None of the subgroups and their controls differed concerning filled or missing teeth, but the total SS group revealed significantly higher number of missing teeth. The periodontal and dental status did not show any statistically significant differences except for a few scattered higher periodontal level losses of attachment in the SS subgroups. The blood and urine analyses showed statistically significant higher values for sedimentation rate, white blood cell count and haemoglobin in the SS low saliva group compared with the control group while anti-streptolysin was lower. In the high saliva SS group only sedimentation rate and white cell count were higher compared with the control. The conclusions is SS patients do not have an increased risk for developing periodontitis.
An intraindividual study was performed on 23 (15 male and 8 female) patients suffering from periodontal disease, in order to investigate the plaque‐removing ability of denial floss and of round, triangular and rectangular toothpicks. Only teeth in contact with neighbouring teeth and with open interdental spaces were included in the study. The plaque‐removing ability of the interdental aids used was registered by estimating the amount of plaque at the end of each experimental period (14 days) according to a modified Plaque Index (Silness & Löe 1964) in which plaque was registered on ten surfaces around each tooth. The results show that round and rectangular toothpicks remove plaque only from the buccal part of the proximal surfaces, but that triangular toothpicks and dental floss are effective on both the buccal and lingual parts of the proximal and axial surfaces.
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