[Long-term results of traditional periodontal therapy]. / Langetermijnresultaten van traditionele parodontale therapie.

OBJECTIVE: To evaluate the long-term results of traditional therapy consisting of initial preparation followed by mucogingival surgery including bone recontouring and regular maintenance treatments. DESIGN: 125 patients between 25 and 70 with a generalised periodontitis of the type adult and rapidly progressing periodontitis were selected. These patients were treated according to a fixed protocol by a periodontist and a dental hygienist. SETTING: The Practice for Periodontology in Groningen. METHODS: Patients were treated in a practice limited to periodontology. Before and 5 years after treatment the following data were assessed: plaque- and bleeding-score, probing pocket-depth, mobility and furcation involvement. Furthermore the reason for extraction was established. RESULTS: In general a great reduction in plaque- and bleeding-score and probing pocket-depth was much better in case of good oral hygiene. Within 5 years after treatment only 1.1% of the teeth were extracted. Furcations with through and through involvement in combination with deep residual pockets were mostly the reason for this. CONCLUSION: It is concluded that with traditional periodontal therapy following a strict protocol including regular maintenance treatments excellent treatment results can be achieved.

[Periodontal aftercare. Prudence after after traditional surgical therapy and after guided tissue regeneration]. / Parodontale nazorg. Beleid na traditionele chirurgische therapie en na geleide weefselregeneratie.

The system of maintenance determines the long term success of periodontal therapy. Guided tissue regeneration enables us to regenerate lost periodontal supporting tissues. Likewise a good maintenance system is very important. Since regeneration of periodontal tissue is a relatively slow process, the direct post-operative care differs somewhat from the traditional treatment. Prevention of infection and trauma is of the utmost importance.

Dental hygienists' influence on the patients' knowledge, motivation, self-care, and perception of change.

The purpose of this study was to assess the success of the dental hygienist in the dental health education of dental patients in general dental practice. Special emphasis was laid on health education in the field of periodontics. The answers on a questionnaire of 159 dental patients who visited a dental hygienist were compared with the answers of 302 dental patients who had never visited a dental hygienist. The comparison was done by means of t-test and regression analysis on specially developed scales with regard to knowledge, motivation, self-care, and perception of change. On all scales the dental patients who visited a dental hygienist scored better. This difference remained when social demographic variables and the dentist's influence were taken into account. This indicates that the dental hygienist is successful in the behavioral aspect of her work.

Attitudes of two groups of dentists towards dental hygienists.

The purpose of the study was to assess whether cooperation with a dental hygienist was based on pursuit of financial gain or on aspirations to improve patient care. To this end a questionnaire was sent to 972 dentists. 412 dentists replied, of whom 178 had patients treated by a dental hygienist. Questions were asked regarding practice profile, preventive orientation and dentists' opinion about the material and immaterial value of cooperation with a dental hygienist. Discriminant analysis showed that the main distinguishing factor between dentists who did and dentists who did not cooperate with dental hygienists was their opinion about the quality of the dental hygienists' work in relation to the non-financial costs for patients, insurance companies, and dentists. The difference in the dentists' opinions about the direct profitability of dental hygienists was not significant. The conclusion can be drawn that the orientation of Dutch dentists towards care for their patients plays a more important role in a dentist's decision to cooperate with a dental hygienist than is usually presumed.

Experimental gingivitis and frequency of tooth brushing in the beagle dog model. Clinical findings.

The aim of this experiment was to study clinical parameters when 3 different frequencies of tooth brushing were applied to sites of experimental gingivitis in beagle dogs. 12 beagle dogs, at the start of the experiment 2 years of age, were used. After a thorough cleaning, the maxillary left and right first, second and third premolars were brushed daily for a period of 8 weeks. Subsequently, for 4 weeks, all brushing was omitted in order to establish an experimental gingivitis. After this pre-experimental period, the dogs were distributed into 3 groups of 4 dogs each: one group was brushed 7 times a week, a second was brushed 3 times a week and the third group was brushed only once a week. Brushing was carried out for 24 weeks, only on the right sides of the upper jaws, the left upper jaws serving as controls. At regular intervals, plaque index, gingival index and probing depths were assessed. A brushing effect was calculated for each dog, to include information on all within-dog and between-dog variations. The present study demonstrated that only by brushing every day can clinically healthy gingivae be obtained in the beagle dog model with experimental gingivitis at baseline. The state of gingival health at baseline may be used to determined the frequency of brushing necessary to create or maintain healthy gingivae.

Gingival health and frequency of tooth brushing in the beagle dog model. Clinical findings.

The aim of this experiment was to study clinical parameters when 3 different frequencies of plaque removal were applied to healthy gingivae in the beagle dog model. The maxillary first, second and third premolars of 12 beagle dogs, at the start of the experiment 2 years of age, were, after a thorough cleaning, submitted to daily plaque removal during a pre-experimental period of 8 weeks. At the start of the experiment, the dogs were distributed into 3 groups of 4 dogs each: one group was brushed 7 times a week, a second group was brushed 3 times a week and another group was brushed only once a week. Brushing was executed over a period of 24 weeks, on the right sides of the upper jaws. The left upper jaws served as controls. At regular intervals, the plaque index, the gingival index and probing depths were assessed. A "brushing effect" was calculated for each dog, to include information on all within-dog and between dog variations. Comparison of brushing effects revealed that in this experimental model, plaque removal with a frequency of 3 times a week was sufficient to preserve gingival health, whereas tooth brushing once a week resulted in gingival inflammation. Therefore it can be concluded that 3 times a week is the critical brushing frequency in the beagle dog model with healthy gingiva at baseline.