Effect of an instructional motivation program on oral health in Danish adolescents after 1 and 2 years.

A 2-year study of the isolated effect of an intensive motivation program in the oral health of 11--15-year-old schoolchildren was carried out in a Danish provincial town. The motivation program consisted of small-group sessions during which maximum effort was made to obtain active engagement from the children. After 1 year the experimental group was supplemented with two new groups of children who in addition to the motivation participated in a competition on dental hygiene. The effect of the motivational program on knowledge and behavior was evaluated. While the program seemed to result in a reinforcement of the already existing positive attitude, the cognitive level was only slightly improved and no change in behavior resulting in improved oral health was registered.

Effect of professional toothcleansing every third week on gingivitis and dental caries in children.

A previous paper reported on the 1-year effect on dental caries and gingivitis of biweekly professional toothcleansing. The purpose of this study was to evaluate the influence of a change from 2 to 3 weeks in the interval between the professional toothcleansings during the 2nd year. The DMFS increment during the 2nd year did not differe significantly between the experimental and control groups. The plaque and gingival indices, although increased during the 2nd year, were still significantly lower in children subjected to the 3-weekly cleansing than in children in the control group.

Effect of regular small group instruction per se on oral health status of Danish schoolchildren.

A 1-year study of the isolated effect of an intensive motivation program aimed at improving the oral health status of 11-13-year-old schoolchildren was conducted in a Danish provincial town where all children have access to a free and comprehensive school oral health program. The effect was negligible as measured by epidemiologic indices.

The effect of professional toothcleansing on gingivitis and dental caries in children after 1 year.

The purpose of this study was to determine the effects of professional mechanical toothcleansing on plaque, gingivitis, and dental caries in young children with a high caries experience. Seventy-eight children, 7 years of age, were stratified according to presence or absence of smooth surface lesions on the permanent teeth and subsequently randomly assigned to an experimental group and a control group. The experimental group was given a thorough mechanical toothcleansing every 2 weeks. After 12 months a statistically significant difference in plaque accumulation and a minor difference in level of gingival inflammation could be demonstrated between the two groups. The incidence of dental caries in permanent teeth present at both examinations was 70% lower in the experimental group. The effect on permanent teeth erupting during the study and on primary teeth present at both examinations was not statistically significant.

[Can attachment gain be achieved by means of orthodontic measures?]. / Kann die parodontale Verankerung von Zähnen durch kieferorthopädische Behandlung verbessert werden?

The influence of intrusive movement was analyzed in an animal experiment. The results indicate that the periodontal status previously observed might in fact be related to a clinically significant amount of new attachment. Since the intrusion is carried out in case of horizontal bone loss, this treatment is specially focusing on the situation which has the most doubtful prognosis by means of the current new attachment procedures. A possible explanation of the attachment gain demonstrated may be that the stretching of the periodontal ligament fibres at the marginal level generates a sort of natural filter reducing the down growth of the epithelium. Another possible explanation may be that the orthodontic stimulation increased the turnover in the periodontal ligament and thereby improved the chances of the periodontal ligament to repopulate the previous infected root surface. There is, on the basis of the results presented reason to believe that a combination of a prevented colonarization from gingival tissue and a stimulation of the periodontal ligament cells showed open new perspective in the treatment of heavily involved periodontal patients.

Intrusion of incisors in adult patients with marginal bone loss.

Elongated and spaced incisors are common problems in patients suffering from severe periodontal disease. Thirty patients characterized by marginal bone loss and deep overbite were treated by intrusion of incisors. Three different methods for intrusion were applied: (1) J hooks and extraoral high-pull headgear, (2) utility arches, (3) intrusion bent into a loop in a 0.17 x 0.25-inch wire, and (4) base arch as described by Burstone. The intrusion was evaluated from the displacement of the apex, incision, and the center of resistance of the most prominent or elongated central incisor. Change in the marginal bone level and the amount of root resorption were evaluated on standardized intraoral radiographs. The pockets were assessed by standardized probing and the clinical crown length was measured on study casts. The results showed that the true intrusion of the center of resistance varied from 0 to 3.5 mm and was most pronounced when intrusion was performed with a base arch. The clinical crown length was generally reduced by 0.5 to 1.0 mm. The marginal bone level approached the cementoenamel junction in all but six cases. All cases demonstrated root resorption varying from 1 to 3 mm. The total amount of alveolar support--that is, the calculated area of the alveolar wall--was unaltered or increased in 19 of the 30 cases. The dependency of the results on the oral hygiene, the force distribution, and the perioral function was evaluated in relation to the individual cases. It was obvious that intrusion was best performed when (1) forces were low (5 to 15 gm per tooth) with the line of action of the force passing through or close to the center of resistance, (2) the gingiva status was healthy, and (3) no interference with perioral function was present.

Application of chlorhexidine by oral irrigation systems.

Low concentrations of chlorhexidine (0.006%) were found to inhibit plaque formation when 750 ml was applied twice daily by oral irrigation systems. The procedure took 1-2 min and may be a convenient method of maintaining oral hygiene in patients in whom normal mechanical cleansing is difficult.

New attachment through periodontal treatment and orthodontic intrusion.

The present study was performed to investigate the tissue reaction related to orthodontic intrusion of teeth with a reduced periodontium and further to evaluate the influence of oral hygiene on this reaction. In each of five Macaca fascicularis monkeys, periodontal tissue breakdown was induced around the premolars and the upper incisors by placing orthodontic elastic ligatures around the teeth. The breakdown procedure was continued until a minimum of four pockets could be measured on probing. Following removal of the elastics, a flap operation was performed. The pocket epithelium and granulation tissue were excised. During the surgical procedure, a notch was placed just above the bone. The teeth were divided postoperatively into four groups according to treatment: group 1 = flap operation, no oral hygiene program; group 2 = flap operation plus oral hygiene program three times per week; group 3 = flap operation plus intrusion, no oral hygiene program; and group 4 = flap operation plus intrusion plus oral hygiene. Groups 3 and 4 were subdivided into two observation periods. A total of 60 teeth corresponding to 120 approximate surfaces were studied. The animals were killed with perfusion; histologic sections were produced and stained alternatively with hematoxylin and eosin, and van Gieson's solution. The histologic analysis showed that new cementum formation and new collagen attachment were observed following the surgical procedure if the oral hygiene was maintained, but also demonstrated that the intrusion improved the quantity of new attachment if carried out under healthy conditions. New attachment was a consistent finding in group 4, but varied from 0.7 to 2.3 mm. In case of intrusion without oral hygiene, the results varied from moderate new attachment to an aggravation of the periodontal bone loss. On the basis of the results presented here, the combination of periodontal treatment and orthodontic intrusion seems to be a method by which improvement of the periodontal condition can be obtained, provided that both the biomechanical force system and the oral hygiene are kept under control.

Plaque inhibition by guanidino propyl piperazine (CKO 569A).

The plaque inhibiting effect of the antibacterial substance, guanidino propyl piperazine (CKO 569A) has been analized in a clinical study of 10 adults. Plaque formation was enhanced by three daily rinses with 15% sucrose. Normal hygiene was performed. The effects of a twice daily mouthwash of 30 s duration with 0.2, 0.1 and 0.05% CKO 569A, 0.05% chlorhexidine and a placebo on plaque formation were compared through a registration of plaque scores. Each solution was tested over a period of 5 days. As a result of this study it could be concluded that in humans CKO 569A is an effective inhibitor of plaque, and that lingual plaque scores appear to be a good indicator of plaque inhibiting activity.

Experimental gingivitis in young and elderly individuals.

The development of experimental gingivitis was studied in young elderly humans during a 21-d period of oral hygiene abstention. The state of the gingiva was assessed by the Gingival Index and by measurements of the amount of gingival exudate on filter paper strips placed at the entrance of the gingival sulcus of the lower lateral incisors and cuspids. Soft deposits were assessed by the Plaque Index and by differential counts of microorganisms in gram stained smears od ento-gingival plaque. At the end of the plaque growth period, the patients were given a thorough dental prophylaxis. Gingival condition and plaque were assessed at regular intervals during a subsequent period of controlled oral hygiene. The development of gingivitis during the oral hygiene abstention period was more rapid and more severe in old than in young individuals. Plaque accumulation was greater in the older persons. A definite difference in plaque consistency was alos observed. However, microscopic counts of various types of microorganisms did not reveal any differences throughout the period of plaque accumulation. When active oral hygiene was reinstituted, the state of the gingiva rapidly returned to pre-experimental levels in both groups. The findings of this study indicate that with age ther is an altered host response to the microorganisms of the plaque.