The feasibility and reliability of using a home screening test to detect gingival inflammation.

The purpose of this study was to evaluate the feasibility and reliability of using a home screening occult blood test to detect the presence of gingival inflammation. Fifty (50) healthy male and female subjects participated in this study. Pre- and post-stimulation saliva samples were obtained and tested for occult blood. Subjects brushed for one minute to stimulate gingival bleeding associated with inflammation. Saliva samples were obtained and tested for occult blood using a commercial screening kit. Following the screening test, a bleeding index (BOP) was determined and used as an indicator of gingival inflammation. Those with a BOP > 50% were assigned to the high group. Those with a BOP of 31 to 50% were assigned to the middle group, and those with a BOP of < or = 30% were assigned to the low group. Twelve subjects in the high group, 10 subjects in the mid group, and 2 subjects in the low group tested positive for occult blood following stimulation. A chi-square analysis showed an association between the screening test for occult blood and the groups (P = 0.0001). The test sensitivity was 75.9% and the specificity was 90.5%.

Physical characteristics of Ti-6A1-4V implants fabricated by electrodischarge compaction.

Physical characteristics of a Ti-6A1-4V implant were evaluated following fabrication using a new electrodischarge compaction technique. Ti-6A1-4V atomized powders were loaded into Pyrex tubes (3.3 mm ID) and subjected to a high-voltage, high-current-density pulse in air for a period of less than 300 microseconds. Single pulses (1.0, 1.5, 2.0 and 2.5 KJ/grampowder) were applied from a capacitor bank (240, 480 or 720 microF) to produce solid core implants with porous surface layers. Implants were evaluated microscopically for core size, neck size, pore size, grain structure, and incorporated oxide film. Hardness was also evaluated. Implants were compared with Ti-6A1-4V commercial powders. Core size increased and pore size decreased with increases in energy and capacitance. The cores were composed of equiaxed grains which were free of oxide at the grain boundary. Porous layers, consisting of particles connected in three dimensions by necks, were free of oxide films at the connecting interfaces. Neck size increased with increases in input energy and capacitance. Hardness readings of the core, necks, and porous particles resulted in readings higher than or similar to control materials. Electrodischarge compaction did not alter the physical characteristics during compaction.

Clinical and microbiological effects of a sanguinaria-containing mouthrinse and dentifrice with and without fluoride during 6 months of use.

The purpose of this study was to test the efficacy and safety of sanguinaria-containing regimens with and without fluoride using the American Dental Association guidelines for evaluating chemotherapeutic agents. The study was a 6-month, double-blind, 4-cell, placebo-controlled, parallel investigation involving 120 subjects. Following screening procedures, subjects were randomly assigned to 4 groups. Group 1 received a dentifrice containing 0.075% sanguinaria extract (SaE) and 2.0% zinc chloride (ZnCl2) in a dicalcium phosphate base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2. Group 2 received identical products without SaE or ZnCl2. Group 3 received a dentifrice containing 0.8% sodium monofluorophosphate, 0.075% SaE, and 0.05% ZnCl2 in a silica base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2. Group 4 products were identical to those of Group 3 but without SaE and ZnCl2. Supragingival plaque and gingival inflammation were scored at 0, 1, 2, 1.5, 3, 4.5, and 6 months; bleeding upon probing was measured at 1, 1.5, 3, and 6 months. Microbiological samples were taken from plaque, tongue, and cheek areas. The active products produced statistically significantly lower scores than the placebo agents for all indices (P less than .0001). Six-month plaque scores were 13.1% lower for Group 1 and 17.4% lower for Group 3 compared to placebo products. When the Plaque Severity Index was applied, the percentage reductions were 33% for Group 1 and 41% for Group 3 compared to placebos. Gingival inflammation scores were 16.7% lower for Group 1 and 18.1% lower for Group 3 at 6 months compared to placebo scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Sanguinaria toothpaste and oral rinse regimen clinical efficacy in short- and long-term trials.

Short- and long-term testing of sanguinaria toothpaste and oral rinse used individually have yielded both positive and negative results. This review evaluates the results of a number of clinical trials testing the regimen use of sanguinaria products for periods ranging from 14 days to six months. Review of these trials establishes the clinical efficacy of the two products in combination. The regimen approach produces consistently positive reductions in plaque, gingival inflammation and bleeding parameters for up to six months with no adverse hard tissue effects and only one reversible adverse soft tissue effect observed among the 260 subjects tested. In addition, no adverse microbiological shifts in the normal oral flora were observed.

Incidence of anterior ridge deformities in partially edentulous patients.

A random sample of 416 diagnostic casts was evaluated to determine the incidence and type of ridge deformities present in anterior ridges of partially edentulous patients. Loss of teeth resulted in 91% (31 of 34) of ridge deformities. The most prevalent defect was the class III or combination labiolingual and apicocoronal type of deformity.

A comparison of postoperative pain experience following periodontal surgery using two local anesthetic agents.

This controlled, double-blind, split-mouth study was designed to evaluate postoperative pain experience following periodontal surgery on 20 patients. Two commercially available local anesthetic agents, bupivacaine HCl and lidocaine HCl, were used. Periodontal surgeries were standardized to minimize differences in difficulty, extent and time. A patient questionnaire was used to collect data for the 24-hour observation period following periodontal surgery. During this period, pain perception was assessed by visual analogue scales. The results indicated that when bupivacaine was used, there was less postoperative pain, fewer postoperative analgesics taken and a longer period of "numbness" (anesthesia) as compared to lidocaine. The patients expressed a strong preference for bupivacaine over lidocaine.

Gingival sequela from a retained piece of dental floss.

A case was reported where a piece of dental floss broke and was retained in an interproximal area. The patient came to the clinic a few days later with a periodontal abscess. After the retained fragment of dental floss was removed, the abscess resolved. Therefore, a retained portion of dental floss should be immediately removed to prevent gingival irritation and tissue injury.

Developmental variations of tooth morphology and periodontal disease.

Some developmental variations of tooth morphology may influence the potential for periodontal disease by allowing accumulation of bacterial plaque and calcified deposits. Mechanical plaque control becomes difficult even for the conscientious patient. Periodontal disease may be hastened in these cases. The therapist must be aware of these variations and their significance in the etiology of isolated periodontal lesions. Recognition of these anomalies and early diagnosis may improve the prognosis of the involved tooth.

Rationale and methods for crown lengthening.

Surgical crown lengthening should not be attempted when tooth fractures extend into the middle third of the root. Excessive bone reduction on the fractured tooth and necessary blending of osseous contours over adjacent teeth may result in mobility or furcation involvement. In addition, the necessary osseous surgery may create precipitous changes in the bony architecture that will be bridged by soft tissues. This results in increased pocket depth and an unhealthy situation. If the tooth in question has a hopeless prognosis or the osseous surgical procedure would create a poor crown-root ratio, furcation involvement, mobility, or esthetic problems, crown lengthening should be avoided. In cases such as these, extraction may be indicated.