Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Oct 2000.> Search Strategy (You Saved Citations 1-300 From Set 85): ----------------------------------------------------------------------------- 1 ("99351665" or "98132732" or "97321740" or "93139336").ui. 4 2 Reproducibility of results/ 53323 3 exp risk/ 227197 4 Models, statistical/ 9724 5 Prevalence/ 44755 6 Discriminant analysis/ 2577 7 Forecasting/ 28594 8 exp Cohort studies/ 367539 9 Evaluation studies/ 99787 10 Risk-taking/ 3751 11 exp Health behavior/ 26393 12 reproducib:.mp. 87122 13 risk:.mp. 414044 14 forecast:.mp. 30078 15 False negative reactions/ or False positive reactions/ 19370 16 (sensitivity or specificity).ti,ab. 279532 17 (predictive adj value$1).mp. 20072 18 (predictive adj validit:).mp. 880 19 (likelihood adj ratio:).mp. 1434 20 (false adj (negative$1 or positive$1)).ti,ab. 23142 21 (randomized controlled trial or controlled clinical 183793 trial).pt. 22 double blind method/ or single blind method/ 65359 23 practice guideline.pt. 4699 24 consensus development conference$.pt. 2783 25 random$.ti,ab. 193352 26 random allocation/ 40827 27 (single blind$3 or double blind$3 or triple blind$3).ti,ab. 56757 28 exp "sensitivity and specificity"/ 89544 29 or/15-28 670432 30 or/2-14 959966 31 exp Tooth demineralization/ 22628 32 demineralization.mp. 1620 33 caries.mp. 15295 34 caires.mp. 1 35 craies.mp. 0 36 careis.mp. 4 37 carise.mp. 0 38 (teeth adj3 cavit:).mp. 422 39 (tooth adj3 cavit:).mp. 217 40 (dental adj3 cavit:).mp. 276 41 (dentin adj3 cavit:).mp. 254 42 (enamel adj3 cavit:).mp. 182 43 (teeth adj3 decay:).mp. 374 44 (tooth adj3 decay:).mp. 321 45 (dental adj3 decay:).mp. 250 46 (dentin adj3 decay:).mp. 12 47 (enamel adj3 decay:).mp. 20 48 (active adj decay).mp. 9 49 (rampant adj3 decay:).mp. 14 50 (recurrent adj3 decay:).mp. 30 51 (white adj spot:).mp. 509 52 carious.mp. 2077 53 cariology.ti,ab. 56 54 (non-cavitated adj3 lesion:).mp. 15 55 (noncavitated adj3 lesion:).mp. 2 56 Tooth remineralization/ 478 57 (dental adj3 fissure:).mp. 99 58 (tooth adj3 fissure:).mp. 50 59 (teeth adj3 fissure:).mp. 98 60 caries-free.mp. 603 61 cariesfree.mp. 17 62 Cariogenic agents/ 728 63 precavit:.mp. 8 64 (filled adj3 teeth).mp. 510 65 (filled adj3 tooth).mp. 117 66 (oral adj fissure:).mp. 6 67 (tooth adj3 remineraliz:).mp. 28 68 (teeth adj3 remineraliz:).mp. 24 69 dft.mp. 413 70 dfs.mp. 1258 71 dmf:.mp. 6397 72 cariogeni:.mp. 1787 73 or/31-72 32256 74 73 and 30 5368 75 74 and 29 1059 76 75 or 1 1059 77 limit 76 to (human and english language and yr=1980-2000) 970 78 limit 77 to (preschool child < 2 to 5 years > or child < 6 459 to 12 years > or adolescence < 13 to 18 years >) 79 exp Tooth, deciduous/ 5992 80 Dentition, primary/ 369 81 Dentition, mixed/ 1066 82 ((primary or deciduous or mixed) adj5 (tooth or teeth or 5759 dent: or odont:)).mp. 83 or/79-82 9322 84 77 and 83 87 85 78 or 84 466 86 from 85 keep 1-300 300 *************************** <1> UI - 20265400 AU - Caffesse RG AU - De LaRosa M AU - Garza M AU - Munne-Travers A AU - Mondragon JC AU - Weltman R IN - The University of Texas-Houston, Health Science Center, 77030-3402, USA. TI - Citric acid demineralization and subepithelial connective tissue grafts. SO - Journal of Periodontology 2000 Apr;71(4):568-72 AB - BACKGROUND: The present study was designed to evaluate the effect, if any, of citric acid root demineralization in the outcome of subepithelial connective tissue grafts performed to cover localized gingival recessions. METHODS: Thirty-six patients participated, each providing one gingival recession; 19 received citric acid demineralization, while 17 did not. All were treated surgically with subepithelial connective tissue grafts and followed for 6 months. At baseline and 6 months, the following parameters were recorded: plaque index, gingival index, recession height, probing depth, recession width, and amount of keratinized tissue. Data were analyzed statistically to 1) evaluate the results achieved with each procedure individually over time and 2) compare the results obtained with the 2 procedures after 6 months. RESULTS: Results showed significant reductions in recession height after 6 months independently of whether citric acid was applied or not (2.79+/-0.79 versus 2.56+/-0.73). Similarly, recession width was significantly reduced (3.74+/-1.19 versus 3.50 +/-0.73), and the width of keratinized tissue was significantly increased (2.47+/-1.6 versus 2.3+/-1.2). No significant changes in probing depth were found (-0.16+/-0.06 versus -0.13+/-0.81). No significant differences were found when both techniques were compared in any one of the parameters analyzed (all P >0.30). CONCLUSIONS: It is concluded that: 1) the subepithelial connective tissue graft procedure provides a satisfactory solution in the treatment of localized gingival recessions, and 2) citric acid demineralization does not affect the clinical outcome of the surgical technique. <2> UI - 20345679 AU - Frencken JE AU - Sithole WD AU - Mwaenga R AU - Htoon HM AU - Simon E IN - j.frencken@dent.kun.nl TI - National oral health survey Zimbabwe 1995: dental caries situation. SO - International Dental Journal 1999 Feb;49(1):3-9 AB - Ten years after completion of the first national oral health survey, the second such survey was carried out in 1995. Application of a multi-stage sampling procedure resulted in 3,709 persons being examined according to the WHO oral health assessment form and criteria. The background variables studied were age, gender, type of location, socio-economic status. Comparison with results from major studies in other African nations are presented. It was concluded that the prevalence of dental caries in all age groups was high but that the severity was low. The prevalence of unmet treatment needs was very high with extraction as the predominant mode of treatment. The survey has shown that the vast majority of Zimbabweans are not receiving and/or are not seeking oral care. <3> UI - 20321835 AU - Munshi AK AU - Hegde AM AU - Munshi A IN - Department of Pedodontics and Preventive Dentistry, A.B. Shetty Memorial Institute of Dental Sciences, Karnataka. TI - Relationship between the existing caries status, plaque S. mutans and Cariostat caries activity test in children. SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1999 Sep;17(3):73-89 AB - An attempt was made in this study to find out the sensitivity and specificity of a caries activity test, CARIOSTAT and its relationship to the existing caries status and the plaque S. mutans level. The test proved to be highly sensitive and specific with significant relationship to the S.mutans count in the dental plaque. There also was a significant relationship between both the cultured microorganisms on MSB agar and the plaque in the Cariostat medium. <4> UI - 20316548 AU - Mjor IA AU - Gordan VV IN - Department of Operative Dentistry, UFCD, Gainesville, FL 32610-0415, USA. TI - A review of atraumatic restorative treatment (ART). SO - International Dental Journal 1999 Jun;49(3):127-31 AB - The purpose of this paper was to critically analyse the results obtained with the Atraumatic Restorative Treatment (ART) technique. The ART approach involves the excavation of cavitated carious lesions with hand instruments and restoration of the cavities and associated pits and fissures with a glass ionomer restorative material. The clinical trial outcomes involving ART include retention rates, cost effectiveness, operative sensitivity, and the effect of personnel with different educational backgrounds involved in this alternative operative treatment. Comparative studies involving permanent and deciduous teeth using amalgam and glass ionomer sealants have also been included in the same projects. Specially defined clinical criteria have been used to evaluate the results. ART offers an opportunity for restorative dental treatment under field conditions where no electricity is available. Three-year data have been published, but long term studies using relevant comparison alternatives are lacking. ART has so far been largely employed on populations with a low DMFT. The technique should also be applied to high risk patients with rampant caries before the maximal benefit of the treatment can be ascertained. <5> UI - 20305621 AU - Messer LB IN - School of Dental Science, University of Melbourne. TI - Assessing caries risk in children. [Review] [31 refs] SO - Australian Dental Journal 2000 Mar;45(1):10-6 AB - With the dramatic improvements in the oral health of children in Australia that have occurred over the past two decades, the option of, and the need for, targeted prevention of dental caries for those at high risk has become apparent. Since caries is of multifactorial aetiology, the clinical outcome varies depending on which factor, or combination of factors, is prominent in a particular individual; this may be related to both age and stage of life. Tests for caries risk can assist in prediction, but clinical signs and history are as important in assessing the main cause(s) of caries in an individual. In studies involving several factors, past caries experience (especially of the first permanent molar) continues to be the best predictor of future caries in children. Despite their ready availability, tests in the form of commercial kits are still expensive; no one test is an adequate predictor of caries risk, and the specificity and sensitivity of the tests are not reliably diagnostic for an individual. There is a need for regional longitudinal risk assessment studies in which potential risk factors are identified before the onset of caries in order to maximize predictive power and then validated against subsequent caries. Caries activity may not be able to be predicted in a population with low disease prevalence. Any risk assessment strategy must be followed by appropriate preventive interventions. [References: 31] <6> UI - 20247326 AU - Deery C AU - Fyffe HE AU - Nugent ZJ AU - Nuttall NM AU - Pitts NB IN - Dental Health Services Research Unit, Dental Hospital and School, University of Dundee, Park Place, Dundee, UK. c.h.deery@dundee.ac.uk TI - General dental practitioners diagnostic and treatment decisions related to fissure sealed surfaces. SO - Journal of Dentistry 2000 Jul;28(5):313-8 AB - OBJECTIVES: The purpose of this in-vitro study was to assess the validity and reproducibility of the diagnosis and treatment planned for occlusal surfaces prior to and following the placement of a clear sealant by a sample of general dental practitioners (GDPs). METHODS: 160 permanent posterior teeth were examined by 25 GDPs. The GDPs were not given any criteria and were therefore free to diagnose and plan care, as they felt appropriate. Each GDP conducted four examinations, two prior to and two after sealing. The teeth were serially sectioned to provide the validating criterion. RESULTS: After sealant placement, there was a statistically significant increase in specificity and decrease in sensitivity of both diagnostic and treatment decisions. The reproducibility expressed by the kappa-statistic was of the order of 0.5 prior to and after sealing with regard to diagnostic decisions. There was a general tendency to diagnose less disease after placement of a sealant (P<0. 001). There was also significantly less care (preventive or restorative) planned after sealant placement (P<0.001). CONCLUSIONS: The placement of a sealant resulted in the diagnosis of less disease and less restorative treatment. This may be appropriate as evidence exists to support the use of sealants as caries therapeutic agents. <7> UI - 20237500 AU - Petersson LG AU - Magnusson K AU - Andersson H AU - Almquist B AU - Twetman S IN - Department of Preventive and Paediatric Dentistry, Medical and Dental Health Centre, Lanssjukhuset, Sweden. lars.g.petersson@lthalland.se TI - Effect of quarterly treatments with a chlorhexidine and a fluoride varnish on approximal caries in caries-susceptible teenagers: a 3-year clinical study. SO - Caries Research 2000 Mar-Apr;34(2):140-3 AB - The aim of this study was to compare the effect of two different dental varnishes on approximal caries incidence in teenagers with proven caries susceptibility during a 3-year period. Two hundred 13- to 14-year-old subjects exhibiting at least two approximal enamel caries lesions were selected to take part in the study. One hundred and eighty subjects participated after informed consent and were randomly assigned to two equally sized groups. One group was treated with a fluoride varnish (FV, Fluor Protector) containing 0.1% F every 3rd month and the participants of the other group were treated in the same mode with a chlorhexidine varnish (CV, Cervitec((R))) containing 1% chlorhexidine and 1% thymol. In total, each subject was treated 12 times during the experimental period. Approximal caries including enamel lesions (DMFS(appr)) were recorded from four bitewing radiographs exposed at the start and end of the study. The mean (+/-SD) caries prevalence at baseline was 2.2+/-3.4 in the FV group and 2.5+/-4.0 in the CV group. After 3 years, the average approximal caries incidence was 2.7+/-3.1 and 3.1+/-3.5 in the FV and CV groups, respectively. The differences at baseline and after 3 years were not statistically significant. In conclusion, treatments every 3rd month with either a fluoride- or a chlorhexidine/thymol-containing varnish showed a promising effect with low approximal caries incidence and progression in teenagers with proven caries susceptibility. <8> UI - 20237498 AU - Li Y AU - Wang W AU - Caufield PW IN - Department of Oral Biology, School of Dentistry, University of Alabama at Birmingham, Ala., USA. yihongli@uab.edu TI - The fidelity of mutans streptococci transmission and caries status correlate with breast-feeding experience among Chinese families. SO - Caries Research 2000 Mar-Apr;34(2):123-32 AB - Our previous study reported that the fidelity of mutans streptococci (MS) transmission from mother to infant was gender- and race-specific within a Birmingham, Ala., population. We hypothesized that fidelity might be a function of postnatal nurturing practices. The purpose of the present study was to investigate those factors that could be correlated with MS transmission among Chinese children whose nurturing histories were known. Forty-eight families with 2- to 3-year-old children were selected from two kindergartens of Beijing, China. A questionnaire concerning the childhood nursing practice was obtained from the parents. Dental caries status was examined, and bacterial samples were collected for all participants twice at 6-month intervals. An average of six isolates of MS was picked at random from selective medium from each individual at each visit. Chromosomal DNA fingerprints were performed for all MS isolates to determine the genomic similarity within each family and among individuals. The results showed that 66% of the children at 2-3 years of age harbored MS, and 46% were caries-active. Of those children, 70% were breast-fed. Among the children whose chromosomal DNA fingerprint genotypes of MS matched that of their mothers, 88% were breast-fed compared with only 12% who were not breast-fed (p = 0.03). We also found that children who were breast-fed for more than 9 months were likely to harbor strains of MS common to their mothers (p = 0.04) and experience more dental caries (dmft = 4.4) at 3 years of age compared with children who were breast-fed less than 9 months (dmft = 1.4, p = 0.04). The data suggest that breast-feeding, especially prolonged breast-feeding, may correlate with the fidelity of transmission and that prolonged breast-feeding may contribute to a higher caries rate. <9> UI - 20261449 AU - Lattimore PJ AU - Thompson GM AU - Halford JC IN - Department of Psychology, University of Central Lancashire, Preston, England. p.j.lattimore@uclan.ac.uk TI - Developmental onset of eating-related color-naming interference: the role of restraint and eating psychopathology. SO - International Journal of Eating Disorders 2000 Jul;28(1):27-32 AB - OBJECTIVE: This study investigated the developmental onset of the Stroop interference effect for food and body shape words in 12- and 14-year-old females to determine whether dietary restraint and eating psychopathology influenced Stroop performance times. METHOD: A Stroop task containing neutral, food, and body shape-related words was administered to 152 schoolgirls. Participants completed the restraint scale of the Dutch Eating Behavior Questionnaire and the Drive for Thinness (DFT) subscale of the Eating Disorders Inventory. RESULTS: Significant color-naming impairments were observed for food-related words in 12- and 14-year-olds, in 14-year-old restrained eaters, and in 12-year-old unrestrained eaters. There were no significant differences between restrained and unrestrained eaters in either age group. Participants scoring high on the DFT subscale showed significant impairments for food-related words, but did not differ significantly from those scoring low on the DFT. There were no significant impairments in color-naming body shape-related words in any subgroups. DISCUSSION: This study did not confirm a different developmental onset for the food and body shape Stroop interference effect. Consideration of dietary restraint did add clarity to previously observed food-related interference effects in both age groups. The results for high- and low-DFT participants do not support the use of the eating-related Stroop tests as an early objective indicator of eating psychopathology. Copyright 2000 John Wiley & Sons, Inc. <10> UI - 20270569 AU - Ball ED AU - Wilson J AU - Phelps V AU - Neudorf S IN - Department of Medicine, University of California San Diego, La Jolla, CA 92093-0960, USA. TI - Autologous bone marrow transplantation for acute myeloid leukemia in remission or first relapse using monoclonal antibody-purged marrow: results of phase II studies with long-term follow-up. SO - Bone Marrow Transplantation 2000 Apr;25(8):823-9 AB - One hundred and thirty-eight patients with AML underwent ABMT with monoclonal antibody plus complement-purged marrow between August 1984 and March 1997. One hundred and ten patients were in CR (CR1: 23; CR2/3: 87) and 28 were in first relapse (R1) at ABMT. Preparative regimens included busulfan (16 mg/kg) and CY (120 mg/kg) (n = 93), CY (120 mg/kg over 2 days) with TBI (1200 cGy) (n = 35), and busulfan (16 mg/kg) plus etoposide (60 mg/kg) (n = 10). CR1 patients treated with CY/TBI (n = 7) had 3- and 5-year disease-free survival (DFS) rates of 71% and 57%. CR1 patients treated with BU/CY (n = 12), had 3- and 5-year DFS rates of 45%. Three and 5-year DFS for CR2/3 patients treated with CY/TBI (n = 26) was 23%. Three- and 5-year DFS for patients in CR2/3 treated with BU/CY (n = 55) was 31 and 28%. Three- and 5-year DFS for patients in R1 treated with BU/CY (n = 26) was 37%. In multivariate analysis, increased age was associated with greater risk of death and relapse. For CR2/3 patients, the length of CR1 was a significant predictor of DFS. ABMT performed in CR or R1 results in excellent 5-year DFS and OS. The contribution of purging may require a randomized trial comparing purged vs unpurged stem cell infusions. <11> UI - 20200896 AU - Llena-Puy MC AU - Montanana-Llorens C AU - Forner-Navarro L IN - Dental Pathology and Therapeutics Unit, Faculty of Medicine and Dentistry, University of Valencia, Spain. TI - Cariogenic oral flora and its relation to dental caries. SO - ASDC Journal of Dentistry for Children 2000 Jan-Feb;67(1):42-6, 9 AB - Many attempts have been made to establish the risk profile of dental caries; however, no diagnostic procedures are yet available to reliably predict such risk particularly among the pediatric and adolescent population. Age of subject, a history of caries affecting the primary dentition, the prevalence of Streptococcus mutans, pH values, salivary flow, and the frequency and amount of sugar consumption have been the factors most studied. A cross-sectional study is made of schoolchildren in the 12-13-year age-range to evaluate the relationship between dental caries and CFU/ml of S. mutans and Lactobacillus, salivary buffer capacity, and salivary flow. Likewise, an evaluation is made of the predictive value of the variables, bacterial count and salivary pH with respect to caries. A total of 167 children were subjected to oral examination to establish the DMFT and DMFS indices, followed by the collection of saliva for quantitating S. mutans, Lactobacillus, pH and salivary flow, by the Dentocult (SM)(LB) and Dentobuff systems (Vivadent). The data obtained were subjected to descriptive analysis, comparisons among variables were made by nonparametric testing with a confidence level of 95 percent. Test predictive value was studied in terms of sensitivity, specificity, positive and negative predictive values, and probability ratio. Statistically significant (p < 0.001) correlations were observed between the caries indices and bacterial counts. No significant association was recorded with the rest of the variables studied. Bacterial counts as well as salivary buffer capacities exhibited greater negative than positive predictive values, i.e., they were more effective in identifying healthy individuals than patients who required treatment. <12> UI - 20200895 AU - Marks LA AU - van Amerongen WE AU - Borgmeijer PJ AU - Groen HJ AU - Martens LC IN - Department of Cariology, Endodontology, Pedodontology at Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. TI - Ketac Molar Versus Dyract Class II restorations in primary molars: twelve month clinical results. SO - ASDC Journal of Dentistry for Children 2000 Jan-Feb;67(1):37-41, 8-9 AB - The aim of the present clinical study was an in vivo evaluation of an improved conventional glass ionomer cement Ketac Molar (ESPE), compared to a polyacid modified composite resin, Dyract (Dentsply/De Trey), used in primary molars. Fifty-three Ketac Molar and fifty-two Dyract restorations were placed in box-only preparations in primary molars. The application time for the chemically cured Ketac Molar, was longer compared to the light-cured Dyract. In comparing the materials, no differences were found, comparing both materials regarding secondary caries, marginal adaptation, wear and fracture toughness. One case of recurrent caries adjacent to a Ketac Molar restoration and two cases in the Dyract group were reported. Two Ketac Molar restorations and one Dyract showed bulk fracture at the time of evaluation. At the twelve-month evaluation, no difference between the investigated materials was registered, which indicates that Ketac Molar can be used as a proximal restoration in the primary dentition. It should be emphasized, however, that one-year data should not be extrapolated to indicate the long-term success of restorations. <13> UI - 20262473 AU - Reusens B AU - D'hoore W AU - Vreven J IN - University of Louvain, School of Dental Medicine and Stomatology, Department of Operative Dentistry, Brussels, Belgium. TI - In vivo comparison of a microfilled and a hybrid minifilled composite resin in Class III restorations: 2-year follow-up. SO - Clinical Oral Investigations 1999 Jun;99(2):62-9 AB - An in vivo comparison was made of two different types of restorative resins over a 2-year period: a microfilled resin (-1158262462Silux Plus, 3M-1158262462, USA) and a hybrid minifilled composite resin (-1158262461Herculite XRV, Kerr-1158262461, USA); 56 restorations were placed in 28 patients by one experienced dentist and examined by two independent evaluators using the United States Public Health Service (UPSHS) rating system for marginal adaptation, marginal discoloration, surface roughness, anatomic form and modified criteria for color match (direct and indirect evaluation). Modified criteria divided the classic A score into A1 for "not detectable" filling and A2 for "slightly discernible filling". Restorations were evaluated at baseline, 1 week, 6 months, 1 year and 2 years later. After 2 years, all materials were considered satisfactory for marginal adaptation, anatomic form and surface roughness (no "Charlie", or "Delta" ratings). No recurrent caries was observed. Clinical evaluation showed a significantly higher rate of marginal discoloration for the microfilled composite resin than the other resin. Hybrid composite resin materials may be expected to perform well as an anterior restorative material. Photographic ratings confirmed the clinical evaluation. The modified evaluation for color match demonstrated differences, which are not discernible with the USPHS system and showed, more rapidly, differences that appear later with the USPHS system. <14> UI - 20228676 AU - Vrbic V IN - Department of Cariology and Endodontics, Medical Faculty, University of Ljubljana, Slovenia. TI - Retention of a fluoride-containing sealant on primary and permanent teeth 3 years after placement. SO - Quintessence International 1999 Dec;30(12):825-8 AB - OBJECTIVE: The aim of this study, conducted in 132 randomly selected children, was to evaluate the retention of a fluoride-containing sealant on primary and permanent teeth. METHOD AND MATERIALS: In autumn 1995, a total of 195 primary molars in 36 children aged 4.5 years on average and 391 permanent premolars and molars in 96 children aged 10.5 years on average were sealed with Helioseal-F. The manufacturer's instructions were followed closely. The teeth were cleaned with a slurry of pumice and a rotating brush, isolated with cotton rolls, dried with air, etched for 60 seconds with an etching gel (37% phosphoric acid), rinsed with an air-water combination spray, and dried. Sealant was applied with a cannula and polymerized for 60 seconds. A saliva ejector was used throughout the procedure. Sealant retention was checked 3 years after placement. RESULTS: In the primary molars, full retention was found in 95.04%, partial retention in 3.12%, and loss of the sealant in 1.84% of the treated teeth. In the permanent molars, the corresponding rates were 95.81%, 2.83%, and 1.36%, respectively. CONCLUSION: Very good sealant retention was found 3 years after placement. The observed difference in retention between primary and permanent molars was not statistically significant. <15> UI - 20227031 AU - Soderling E AU - Isokangas P AU - Pienihakkinen K AU - Tenovuo J IN - Institute of Dentistry, University of Turku, Finland. eva.soderling@utu.fi TI - Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. SO - Journal of Dental Research 2000 Mar;79(3):882-7 AB - Xylitol is effective as a non-cariogenic sugar substitute. Habitual xylitol consumption appears to select for mutans streptococci (MS) with impaired adhesion properties, i.e., they shed easily to saliva from plaque. One hundred sixty-nine mother-child pairs participated in a two-year study exploring whether the mothers' xylitol consumption could be used to prevent mother-child transmission of mutans streptococci. All mothers showed high salivary levels of mutans streptococci during pregnancy. The mothers in the xylitol group (n = 106) were requested to chew xylitol-sweetened gum (65% w/w) at least 2 or 3 times a day, starting three months after delivery. In the two control groups, the mothers received either chlorhexidine (n = 30) or fluoride (n = 33) varnish treatments at 6, 12, and 18 months after delivery. The children did not chew gum or receive varnish treatments. MS were assessed from the mothers' saliva at half-year intervals and from the children's plaque at the one- and two-year examinations. The MS were cultured on Mitis salivarius agars containing bacitracin. The salivary MS levels of the mothers remained high and not significantly different among the three study groups throughout the study. At two years of age, 9.7% of the children in the xylitol, 28.6% in the chlorhexidine, and 48.5% in the fluoride varnish group showed a detectable level of MS. In conclusion, therefore, habitual xylitol consumption by mothers was associated with a statistically significant reduction of the probability of mother-child transmission of MS assessed at two years of age. The effect was superior to that obtained with either chlorhexidine or fluoride varnish treatments performed as single applications at six-month intervals. <16> UI - 20192958 AU - Hugoson A AU - Koch G AU - Hallonsten AL AU - Norderyd J AU - Aberg A IN - The Institute for Postgraduate Dental Education, Jonkoping, Sweden. TI - Caries prevalence and distribution in 3-20-year-olds in Jonkoping, Sweden, in 1973, 1978, 1983, and 1993. SO - Community Dentistry & Oral Epidemiology 2000 Apr;28(2):83-9 AB - Four cross-sectional studies were carried out in 1973, 1978, 1983, and 1993 to collect clinical and radiographic epidemiological data on the dental health status of the inhabitants of Jonkoping, Sweden. The aim of the present paper was to use these data to analyze trends in the development of caries among children and adolescents between 1973 and 1993. Approximately 500 randomly selected individuals evenly distributed among the age groups 3, 5, 10, 15, and 20 years participated in each study. The main results show that the numbers of caries-free individuals increased in all age groups. In 1993, the mean number of decayed and filled tooth surfaces in the primary (dfs) and the permanent (DFS) dentition in all age groups was less than half of that found in 1973. Most of this decrease took place during the first 5 years, i.e., between 1973 and 1978. Between 1978 and 1983, only minor changes were observed. There was a further reduction of approximately 30%-50% in dfs/DFS between 1983 and 1993 in 3-, 5-, 10-, and 20-year-olds. The frequency distributions of dfs/DFS for 5- and 15-year-olds revealed an increasing skewness over time: in 1993, a large majority of the children and adolescents had a low or moderate caries severity while only a small group had high scores of dfs/DFS. <17> UI - 20192961 AU - Holst D AU - Schuller AA IN - Institute of Community Dentistry, Blindern, Oslo, Norway. dholst@odont.uio.no TI - Oral health changes in an adult Norwegian population: a cohort analytical approach. SO - Community Dentistry & Oral Epidemiology 2000 Apr;28(2):102-11 AB - OBJECTIVES: The purpose of this analysis was to study temporal variation in oral health in an adult population. The cohort analysis comprised 1) estimation of longitudinal, cross-sectional, and time-lag differences in caries and treatment experience of the adult population in Trondelag from 1973 to 1983 and to 1994; 2) assessment of which of the effects of age, period and cohort was the most plausible explanation for the observed differences and 3) discussion of causal and other factors underlying the effects of age, period and cohort. METHODS: Cohort analysis was used to study changes in oral health over time. Study participants were selected by random sampling in 1973, 1983, and 1994 (n = 1959, n = 3195, n = 2341 respectively). The methods of data collection comprised standardised clinical measurements and a self-administered questionnaire. Cohort tables were established to analyse changes in DFT from 1973 to 1983 and DFT and DFS from 1983 to 1994. RESULTS: Four patterns of changes in oral health were identified from adolescence to older adulthood. They point in different directions which indicate that complex processes are present. There were two and three significant changes in the subsets of analysis. Assumptions and conditions that allow identification of separate cohort, period, and age effects appeared not to be present. The pattern of changes was consistent with main effects of both age, period, and cohort. The effects were discussed from the perspective of the chosen frame of explanatory factors. CONCLUSIONS: The changes in oral health between populations in 1973, 1983 and 1994 were the combined consequences of simultaneously occurring factors that account for both age, period and cohort effects. <18> UI - 20191322 AU - Burt BA AU - Keels MA AU - Heller KE IN - Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. bburt@umich.edu TI - The effects of a break in water fluoridation on the development of dental caries and fluorosis. SO - Journal of Dental Research 2000 Feb;79(2):761-9 AB - Durham, NC, fluoridated since 1962, had an 11-month cessation of fluoridation between September, 1990, and August, 1991. The purpose of this study was to assess the effects of this break on the development of caries and fluorosis in children. Study participants were continuously-resident children in Kindergarten through Grade 5 in Durham's elementary schools. There were 1696 children, 81.4% of those eligible, for whom a questionnaire was completed and clinical data recorded. Age cohorts were defined by a child's age at the time that fluoridation ceased. Caries was recorded in children in the Birth Cohort through Cohort 3, and fluorosis for children in Cohorts 1 through 5. Caries was assessed in the primary first and second molars according to the decayed-filled index; fluorosis on the labial surfaces of the upper permanent central and lateral incisors was assessed by the Thylstrup-Fejerskov (TF) index. Mother's education was associated with caries; higher education of the mother had an odds ratio of 0.53 (95% CI 0.40, 0.76) for caries in the child. No cohort effects could be discerned for caries. Overall prevalence of fluorosis was 44%. Prevalence in Cohorts 1, 2, 3, 4, and 5 was 39.8%, 32.3%, 33.0%, 62.3%, and 57.1%, respectively. These cohort differences remained statistically significant in regression analysis. It was concluded that while the break had little effect on caries, dental fluorosis is sensitive to even small changes in fluoride exposure from drinking water, and this sensitivity is greater at 1 to 3 years of age than at 4 or 5 years. <19> UI - 20205076 AU - Kowash MB AU - Pinfield A AU - Smith J AU - Curzon ME IN - Department of Paediatric Dentistry, Leeds Dental Institute, University of Leeds. TI - Effectiveness on oral health of a long-term health education programme for mothers with young children. SO - British Dental Journal 2000 Feb 26;188(4):201-5 AB - AIM: To determine the effect of dental health education (DHE) on caries incidence in infants, through regular home visits by trained DH Educators over a period of 3 years. METHOD: A randomly selected cohort of 228 children born between 1st January and 30th September 1995, in a low socioeconomic/high caries suburb of Leeds (UK) were divided into the following groups: A) DHE focused on diet; B) DHE focused on oral hygiene instruction (OHI) using fluoride toothpaste; and C) DHE by a combined diet and OHI message. DHE was given using an interview and counselling for at least 15 minutes at home every 3 months for the first 2 years and twice a year in the third year of the study. A fourth group D was given diet and OHI, at home, once a year only. All children and mothers were examined for caries and oral hygiene. A fifth group E (control) received no DHE and were never visited but examined at 3 years of age only. RESULTS: In the groups of children visited regularly only two developed caries and three had gingivitis (all in group A). In group E, however, 33% of children had caries and nine (16%) had gingivitis. The differences in caries levels and caries risk factors between study and control groups were statistically significant (P < 0.001). Mothers of the study groups also showed an improvement in their own levels of gingivitis, debris and calculus scores by the second and third examinations (P < 0.001). CONCLUSION: Regular home visits to mothers with infants, commencing at or soon after the time of the eruption of the first deciduous teeth, was shown to be effective in preventing the occurrence of nursing caries. <20> UI - 20182464 AU - Dini EL AU - Holt RD AU - Bedi R IN - Universidade Estadual Paulista, Araraquara, SP, Brazil. TI - Prevalence of caries and developmental defects of enamel in 9-10 year old children living in areas in Brazil with differing water fluoride histories. SO - British Dental Journal 2000 Feb 12;188(3):146-9 AB - AIMS: To assess the prevalences of caries, of developmental defects of enamel and their interrelationship in Brazilian 9-10-year-olds from areas of contrasting fluoridation histories. METHODS: Systematic random sampling procedures were used to select children from an area where water had been fluoridated in 1963 and from a second area where water had been fluoridated since 1998. Clinical examinations for caries were carried out using the DMFT index and WHO diagnostic criteria. Developmental defects of enamel on upper incisors were diagnosed using the DDE index. RESULTS: A difference of 40% in DMFT was observed, with a lower prevalence of disease in the area fluoridated since 1963. Diffuse opacities affected 14.3% of the children from the area fluoridated since 1963 compared with only 2.4% in the area fluoridated in 1998. Children living in the area fluoridated in 1963 who had diffuse defects had twice the chance of being free from caries compared with those living in the same area who had no defects or who had only demarcated or hypoplastic defects. CONCLUSIONS: This study confirms previous ones in showing the benefits of water fluoridation. Diffuse opacities of upper incisors affected relatively few subjects in either of the two areas. <21> UI - 20128565 AU - Helminen SE AU - Vehkalahti M AU - Lammi R AU - Ketomaki TM AU - Murtomaa H IN - Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Finland. TI - Dentists' decisions as to mode of preventive treatment in adolescents and young adults in Finland. SO - Community Dental Health 1999 Dec;16(4):250-5 AB - OBJECTIVE: To evaluate dentists' real-life decisions as to mode of preventive treatment in adolescents and young adults, in relation to these patients' oral-health status, and to the dentists' characteristics. DESIGN: A random sample of 206 adolescents and 239 young adults (mean ages 13 and 27 years) produced 411 (92%) individual oral health records providing data on actual clinical examinations and treatment courses carried out by 56 dentists in one administrative unit of the Finnish public oral health service during 1994-1996. OUTCOME MEASURES: Preventive measures were defined as active and passive, active including any kind of motivation or instructions given to a patient concerning home self-care, and passive prevention being topical application of fluoride. RESULTS: More adolescents had received both active and passive prevention than had young adults (active: 27% vs. 20%; passive: 85% vs. 70%). Of adolescents, 7% and of young adults 25% were given no preventive treatment. The mean number of active preventive measures per adolescent during the treatment course was 0.3 and of passive measures 1.0; for young adults 0.2 and 0.8, respectively. A subject's oral health status made no significant difference in active prevention given. Active measures were more frequently given to all patients by male dentists, 35% vs. 22% (P < 0.02), and passive measures by females, 82% vs. 52% (P < 0.001). The odds of active prevention for adolescents were 7.4 comparing male dentists to female; of passive 13.8 comparing female to male. CONCLUSIONS: Dentists should be motivated to make considered treatment decisions on preventive treatment. <22> UI - 20128562 AU - Hawley GM AU - Wainwright-Stringer Y AU - Craven R AU - Blinkhorn AS IN - Mancunian Community Health NHS Trust, Manchester, UK. TI - An investigation into the use of a dental hygienist in school screening. SO - Community Dental Health 1999 Dec;16(4):232-5 AB - OBJECTIVE: A pilot study to measure the validity of using a hygienist to carry out school screening. DESIGN: Following a standard training programme a dental hygienist (DH), recruited from general practice, a newly appointed dental officer (DO) and an epidemiologist (SDO), who acted as the standard, all screened the same group of school children on two occasions. SETTING: An inner city school with known high levels of disease. PARTICIPANTS: Ninety-eight 7- and 8-year-old children attending school. MAIN OUTCOME MEASURES: For each clinician the levels of referral, the reasons for referral and the repeatability were measured. RESULTS: The hygienist referred 26 children (27%) for further examination while the DO and the SDO both referred 61 (62%). The DO achieved the required standards of sensitivity and specificity when results were compared with the SDO but the hygienist did not. Intra-examiner reliability in all three clinicians was good. CONCLUSIONS: The standard training programme used to prepare dental officers to carry out school screening to an agreed standard was insufficient for this hygienist's needs. <23> UI - 20146493 AU - Hobdell MH AU - Lalloo R AU - Myburgh NG IN - University of Texas-Houston, Dental Branch 77030, USA. mhobdell@mail.db.uth.tmc.edu TI - The Human Development Index and Per Capita Gross National Product as predictors of dental caries prevalence in industrialized and industrializing countries. SO - Annals of the New York Academy of Sciences 1999;896:329-31 <24> UI - 20132676 AU - Gales MA AU - Nguyen TM IN - Department of Pharmacy Practice, School of Pharmacy, Southwestern Oklahoma State University, Weatherford, USA. TI - Sorbitol compared with xylitol in prevention of dental caries. [Review] [16 refs] SO - Annals of Pharmacotherapy 2000 Jan;34(1):98-100 AB - OBJECTIVE: To summarize published data on the comparative efficacy of sorbitol and xylitol for prevention of dental caries. DATA SOURCES: Published double-blind comparative trials, using sorbitol and xylitol products, identified by MEDLINE (January 1966-December 1998) and International Pharmaceutical Abstracts (January 1970-December 1998) searches. DATA SYNTHESIS: Clinical trials generally used sorbitol and xylitol gums, which patients chewed three to five times daily for 20-40 months. Xylitol was superior to sorbitol in two longer, secondary dentition trials (30-63% reductions), but not in two primary dentition trials. CONCLUSIONS: The data suggest that xylitol-containing gums may provide superior efficacy in reducing caries rates in high-risk populations. [References: 16] <25> UI - 99200727 AU - Bishay N AU - Petrikowski CG AU - Maxymiw WG AU - Lee L AU - Wood RE IN - Department of Dentistry, Princess Margaret Comprehensive Cancer Centre, University of Toronto, Ontario, Canada. TI - Optimum dental radiography in bone marrow transplant patients [see comments]. CM - Comment in: Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999 Oct;88(4):376-8 SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1999 Mar;87(3):375-9 AB - OBJECTIVE: The purpose of this study was to establish an optimum radiographic examination regimen for patients undergoing bone marrow transplantation. Two radiographic examinations were compared: the panoramic radiograph and the full mouth series of radiographs. STUDY DESIGN: A prospective analysis of 65 consecutive patients undergoing bone marrow transplantation was undertaken. All patients were examined through use of both panoramic and full mouth series intraoral radiographs, including bitewings. Significant findings were recorded and compared by means of paired t test analysis for parametric data, such as caries, periapical inflammation and subgingival calculus, and by means of McNemar's test for nonparametric data, such as the presence or absence of severe periodontal disease. RESULTS: Acquired findings, such as caries, periodontal disease, and clinically significant faulty restorations, were detected more frequently from the full mouth series (P < .05). There was no significant difference in the detection of periapical pathosis. In 8 of 65 patients, clinically significant information, such as evidence of impacted wisdom teeth, neoplasms, and multiple myeloma, was better detected from the panoramic radiographs. CONCLUSIONS: The results suggest a combination of both modalities as the optimum means of radiologic survey in this "high-risk" patient population. <26> UI - 20113836 AU - Bader JD AU - Shugars DA AU - White BA AU - Rindal DB IN - Sheps Center for Health Services Research, University of North Carolina, Chapel Hill 27599-7590, USA. jim:bader@unc.edu TI - Evaluation of audit-based performance measures for dental care plans. SO - Journal of Public Health Dentistry 1999 Summer;59(3):150-7 AB - OBJECTIVES: Although a set of clinical performance measures, i.e., a report card for dental plans, has been designed for use with administrative data, most plans do not have administrative data systems containing the data needed to calculate the measures. Therefore, we evaluated the use of a set of proxy clinical performance measures calculated from data obtained through chart audits. METHODS: Chart audits were conducted in seven dental programs--three public health clinics, two dental health maintenance organizations (DHMO), and two preferred provider organizations (PPO). In all instances audits were completed by clinical staff who had been trained using telephone consultation and a self-instructional audit manual. The performance measures were calculated for the seven programs, audit reliability was assessed in four programs, and for one program the audit-based proxy measures were compared to the measures calculated using administrative data. RESULTS: The audit-based measures were sensitive to known differences in program performance. The chart audit procedures yielded reasonably reliable data. However, missing data in patient charts rendered the calculation of some measures problematic--namely, caries and periodontal disease assessment and experience. Agreement between administrative and audit-based measures was good for most, but not all, measures in one program. CONCLUSIONS: The audit-based proxy measures represent a complex but feasible approach to the calculation of performance measures for those programs lacking robust administrative data systems. However, until charts contain more complete diagnostic information (i.e., periodontal charting and diagnostic codes or reason-for-treatment codes), accurate determination of these aspects of clinical performance will be difficult. <27> UI - 20113835 AU - Bader JD AU - Shugars DA AU - White BA AU - Rindal DB IN - Sheps Center for Health Services Research, University of North Carolina, Chapel Hill 27599-7590, USA. jim:bader@unc.edu TI - Development of effectiveness of care and use of services measures for dental care plans. SO - Journal of Public Health Dentistry 1999 Summer;59(3):142-9 AB - OBJECTIVES: Standardized measures to assess clinical aspects of the performance of managed dental care plans are not available. This project sought to develop and evaluate measures for effectiveness of care and use of services that could be calculated using a plan's administrative data. METHODS: Two panels of stake holders representing dental plans, purchasers, and dental providers participated in a modified Delphi process to refine initial sets of effectiveness of care and use of services measures modeled after HEDIS measures for medical care. The refined measures were then pilot tested in two dental health maintenance organizations. RESULTS: The development process resulted in specification of seven effectiveness of care measures assessing disease activity classification, and prevention and outcomes for caries, periodontal disease, and tooth loss. Six use of services measures focusing on prophylaxes, third molar surgery, preventive, restorative, prosthetic, surgical, and endodontic care also were specified. Pilot testing of the measures indicated reasonable reliability and sensitivity, but also demonstrated the need for supervision or auditing of the process. CONCLUSIONS: These standardized measures for dental care plan performance are available for immediate use. However, because the measures depend on diagnostic information (periodontal probing data and diagnoses associated with restorative treatments) in the administrative data set, their adoption will require changes in most plans' data systems and data collection policies. <28> UI - 20099333 AU - Lygidakis NA AU - Oulis KI IN - Pediatric Dentistry Centre IKA, Community Health System, Athens, Greece. TI - A comparison of Fluroshield with Delton fissure sealant: four year results. SO - Pediatric Dentistry 1999 Nov-Dec;21(7):429-31 AB - PURPOSE: The purpose of this study was to evaluate the retention rate and the caries increment differences between a light cured, F releasing filled fissure sealant and a non-F nonfilled one. METHODS: The two different fissure sealants (Fluoroshield, Delton) were placed on all 4 caries-free first permanent molars of 112 children aged 7-8 years, under a half-mouth experimental design. All the children were seen in 6 month intervals where a preventive program, including regular topical fluoride application was applied. The sealants were not reapplied if they had been lost between examinations. RESULTS: After 48 months 162 teeth in the F sealant group and 162 in the conventional sealant group were evaluated. Regarding sealant retention, 124 teeth (77%) in the first group and 144 (89%) in the second were fully sealed, and 23 (14%) compared to 9 (6%) were partly sealed (P = 0.01). Regarding caries development, 14 teeth (9%) had developed caries in the first group and 19 (10%) in the second (P > 0.1). CONCLUSION: In a regular biannual preventing program including topical gel application, F-releasing filled sealant (Fluroshield) appears to have a declined full retention rate, after four years, when compared with a non-F nonfilled one (Delton). However, total sealant loss and caries increment was similar in both groups. <29> UI - 20105829 AU - Flinck A AU - Kallestal C AU - Holm AK AU - Allebeck P AU - Wall S IN - Department of Epidemiology and Public Health, Umea University, Sweden. TI - Distribution of caries in 12-year-old children in Sweden. Social and oral health-related behavioural patterns. SO - Community Dental Health 1999 Sep;16(3):160-5 AB - OBJECTIVE: To describe the distribution of caries in 12-year-old children in Sweden according to socio-demographic and oral health related behaviour. PARTICIPANTS: The study group consisted of 3,373 12-year-old children residing in catchments of 26 different public dental health clinics in Sweden, geographically well represented. METHOD: The clinical examination for dental caries was performed by 28 calibrated dentists. A questionnaire on lifestyle was distributed to the children with questions on ethnicity, socio-economic level and oral health as well as overall health attitudes. RESULTS: The proportion of 12-year-old children with no experience of dentine caries was 47% and 35% were completely free from all caries. Intraoral distribution of caries showed most lesions on the first molar mesial surface, with 80% enamel and 20% dentine caries. Almost all children brushed their teeth twice a day and a third of the children had an extra intake of fluoride. Decayed surfaces including enamel caries (DeS) was chosen as a measure of ongoing caries and used when dividing children into three caries groups; caries free (50%), 1-3 lesions (40%) and the high caries group (10%) with more than 3 lesions. These groups showed distribution differences. More non-Swedish children, children from workers' homes, and children who brushed their teeth less than twice a day were found in the high caries group. More children from workers' homes living in big cities and snacking more than once a week were also found in the high caries group. This could not be shown for other social groups. Also children who had an extra intake of fluoride were classified in the high caries group. <30> UI - 20105813 AU - Jones C AU - Woods K AU - Whittle G AU - Worthington H AU - Taylor G IN - North West Dental Public Health Resource Centre, Wesham Park Hospital, UK. TI - Sugar, drinks, deprivation and dental caries in 14-year-old children in the north west of England in 1995. SO - Community Dental Health 1999 Jun;16(2):68-71 AB - OBJECTIVES: To examine associations between dental caries and reported drink consumption. DESIGN: A cross-sectional caries prevalence study including reported drink consumption. SETTING: Secondary schools across the former North Western Region of England. SUBJECTS: A random sample of 6,014, 14-year-old children. RESULTS: The mean DMFT of the sample was 2.74. The reported mean weekly consumption of cans of carbonated drinks was 5.66, with a range of zero to 42. There was a significant gender difference in drink consumption and a significant correlation between the reported weekly consumption of cans of carbonated drinks and DMFT. Logistic regression analysis showed tea drinkers had a significantly lower DMFT than coffee drinkers and that this effect was independent of the addition of sugar and the number of cans of drink consumed. Reported use of sugar-free carbonated drinks was not associated with better dental health. CONCLUSIONS: Reported consumption of sugared drinks and carbonated drinks was associated with significantly higher levels of dental caries. Drinking tea was associated with lower levels of caries. Sugar-free drinks were not associated with better dental health. <31> UI - 20069256 AU - Deery C AU - Care R AU - Chesters R AU - Huntington E AU - Stelmachonoka S AU - Gudkina Y IN - Dental Health Services Research Unit, University of Dundee, UK. c.h.deery@dundee.ac.uk TI - Prevalence of dental caries in Latvian 11- to 15-year-Old children and the enhanced diagnostic yield of temporary tooth separation, FOTI and electronic caries measurement. SO - Caries Research 2000 Jan-Feb;34(1):2-7 AB - The aim of this study was to test the feasibility of employing clinical visual examination at the D(1) (enamel and dentine caries) diagnostic threshold, fibre-optic transillumination (FOTI), elective temporary tooth separation (ETTS) and electronic caries measurement (ECM) in the environment of an epidemiological study or clinical trial. It also aimed to compare the diagnostic yield of these diagnostic aides and methods. The sample consisted of 182 Latvian children, mean age 13.3 years (range = 10.6-15.7). For 12-year-old subjects the mean D(3)MFS was 10.58 (SD 6.05) and the mean D(1)MFS was 19.97 (SD 10.47). The additional diagnostic yield from FOTI examination of approximal sites was 40.0% at the D(1) threshold. The additional apparent yield for ETTS was 52.8% at the D(1) threshold. ETTS detected 38.3% more carious surfaces than FOTI at the D(1) threshold. Conversely 57 surfaces thought to be carious on FOTI examination were judged sound following ETTS. Although the ECM appeared practical to use, it broke early in the trial and the results obtained prior to breakdown appeared inaccurate. In conclusion, all diagnostic methods were feasible under the conditions of an epidemiological study or clinical trial. <32> UI - 20098171 AU - Fyffe HE AU - Deery C AU - Nugent ZJ AU - Nuttall NM AU - Pitts NB IN - Dental Health Services Research Unit, Dental Hospital and School, Dundee, Scotland, UK. h.e.fyffe@dundee.ac.uk TI - Effect of diagnostic threshold on the validity and reliability of epidemiological caries diagnosis using the Dundee Selectable Threshold Method for caries diagnosis (DSTM). SO - Community Dentistry & Oral Epidemiology 2000 Feb;28(1):42-51 AB - OBJECTIVES: To develop a method for recording dental caries at the D1 (enamel and dentine) diagnostic threshold (without loss of D3 information) and assess its reliability, 'benchmark' validity and potential effects on reported caries prevalence and needs assessment. METHODS: Multi-examiner training, calibration and validation trial. Two groups of 10 dental examiners were trained to diagnose dental caries at the D1 (enamel and dentine) diagnostic threshold under the conditions of a caries prevalence survey, prior to a calibration trial being undertaken. RESULTS: Where 'experienced examiners' were trained to examine at the D1 (enamel and dentine) diagnostic threshold, under the conditions of a cross-sectional epidemiological survey, there was no significant deterioration in inter-examiner agreement on the assessment of teeth and a significant difference in one of two comparisons on the assessment of surfaces using the kappa statistic. Assessed against a benchmark examiner, there was no significant loss of sensitivity at the D1 diagnostic threshold compared with the D3 threshold and, although there was a significant loss of specificity at the D1 threshold, all specificity values could be considered to be high. CONCLUSIONS: Modifying the diagnostic criteria typically used in surveys of caries prevalence (to allow assessment of the levels of enamel caries which could benefit from preventive care as well as dentinal caries requiring restorative care) in adolescents does not adversely affect the reliability or benchmark validity of experienced examiners to a significant degree. <33> UI - 20098169 AU - Hausen H AU - Karkkainen S AU - Seppa L IN - Institute of Dentistry, University of Oulu, Finland. hannu.hausen@oulu.fi TI - Application of the high-risk strategy to control dental caries. SO - Community Dentistry & Oral Epidemiology 2000 Feb;28(1):26-34 AB - OBJECTIVE: The aim of this prospective study was to determine whether a child population with low overall caries frequency benefits when prevention is targeted to high-risk individuals. METHODS: Data from clinical examinations and salivary tests were used to assess caries risk in 12-year-olds (n=1465). Children who were regarded as being at high risk of developing caries were randomized into two groups. Half (HRI group) were offered intensive prevention (counseling, F-varnish applications, F-lozenges, sealants, chlorhexidine), and the other half (HRB group) were provided the same basic prevention given to low-risk children (counseling, one F-varnish application/year). A random sample of the low-risk children (LRB) was followed up for the same 3-year period as the high-risk children. The number of children completing the study was 216 in the LRB group, 199 in the HRI group and 174 in the HRB group. RESULTS: The mean (SD) 3-year DMFS increment was 2.0 (2.4), 4.4 (4.7) and 5.1 (5.0) in the LRB, HRI and HRB groups, respectively. Comparison between the LRB and HRB groups revealed that risk assessment was fairly successful in terms of mean DMFS increment. However, 63% of the children in the LRB group developed at least one new lesion (max. 12). CONCLUSIONS: The negligible difference between the HRI and HRB groups implies that intensifying prevention produced practically no additional benefit. By offering all children only basic prevention, virtually the same preventive effect could have been obtained with substantially less effort and lower costs. <34> UI - 99283433 AU - Mass E AU - Eli I AU - Lev-Dor-Samovici B AU - Weiss EI IN - Department of Pediatric Dentistry, Tel Aviv University, Israel. TI - Continuous effect of pit and fissure sealing on S. mutans presence in situ [see comments]. CM - Comment in: Pediatr Dent 1999 Jul-Aug;21(4):230 SO - Pediatric Dentistry 1999 May-Jun;21(3):164-8 AB - PURPOSE: The effect of sealants on S. mutans presence in situ was investigated. METHODS: Four intact, fully erupted first permanent molars in each of 74 children, aged 6-8 years were required for inclusion in the study. Baseline examination included deft and plaque index. S. mutans presence on occlusal surfaces of the molars was evaluated, using a microbial replica method. Immediately after sealing the first permanent molars on one side, S. mutans presence in situ was re-evaluated, as well as three and six months thereafter. Three months after the initiation of the study, S. mutans presence was evaluated on the molars of the unsealed side, which were consequently sealed and re-evaluated immediately, and three months later. RESULTS: Positive correlation was found between deft scores, plaque indices and microbial replica values, at baseline. Sealing caused a significant reduction in S. mutans levels on the treated occlusal surfaces, in vivo (P < 0.001), which lasted, in most cases, up to six months. CONCLUSIONS: The data suggest that sealants enable a prolonged reduction of S. mutans presence in situ, indicating an additional prevention effect, by reducing one source of dissemination. <35> UI - 20039828 AU - Lin YT AU - Tsai CL IN - Department of Dentistry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan. TI - Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan. SO - Cleft Palate-Craniofacial Journal 1999 Nov;36(6):522-6 AB - OBJECTIVE: The purposes of this study were to investigate the caries prevalence in cleft lip, cleft palate, or both in children under the age of 2 years and to evaluate parental attitudes toward bottle-feeding, dental care, and their relationship to baby bottle tooth decay (BBTD) in Taiwan. DESIGN: Randomized and prospective study. SETTING: Institutional setting. PATIENTS AND METHODS: One hundred twenty-three 2-year-old children (68 boys and 55 girls) with cleft lip, cleft palate, or both were selected for this study. A questionnaire that asked questions about knowledge of oral health, knowledge and beliefs about BBTD, children's feeding habits, children's dental care, and parenting attitudes toward children with clefts was completed by the parents or caretakers. Children were divided into bottle-feeding and non-bottle-feeding groups according to the questionnaire responses of parents or caretakers. Each child was examined with a dental mirror and explorer under focused flashlight using defs index to determine the presence of BBTD. RESULTS: Thirty-nine percent (48) subjects reported a bottle-feeding habit; the overall prevalence of BBTD was 15.4%. The habit of bottle-feeding was significantly related to BBTD (p = .019). The defs score for children who were bottle-fed was significantly higher than children who were not bottle-fed (p = .045). Parents or caretakers of both bottle-feeding and non-bottle-feeding children showed no significant differences in their attitudes toward bottle-feeding and feeding habits (p > .05). However, parents of non-bottle-fed children had significantly better dental care than parents of bottle-fed children in brushing frequency (p < .001) and brushing before bed (p < .001). CONCLUSIONS: Children with clefts who took a bottle to bed showed an increased risk of developing BBTD. The parents or caretakers of bottle-fed children also showed a lack of motivation to perform regular preventive dental home care for their children. This suggests that oral health promotion programs should begin in infancy for children with clefts and their parents. <36> UI - 20075337 AU - Wenderoth CJ AU - Weinstein M AU - Borislow AJ IN - Albert Einstein Medical Center, The Maxwell S. Fogel Department of Dental Medicine, Division of Orthodontics, Philadelphia, PA 19141-3098, USA. TI - Effectiveness of a fluoride-releasing sealant in reducing decalcification during orthodontic treatment. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1999 Dec;116(6):629-34 AB - Decalcification and caries during orthodontic treatment still remains a problem. A method to protect the susceptible area beneath and adjacent to bonded attachments, independent of patient compliance, would be extremely beneficial. A clinical trial was performed using a dual-cured lightly filled BIS-GMA fluoride-releasing sealant. The barrier effect of this material on white spot formation, gingival irritation, and plaque accumulation during fixed orthodontic therapy was examined. Twenty patients with a total of 225 metal brackets placed on anterior teeth participated in this study. Brackets were placed in both arches in a conventional manner with a chemically cured, unfilled bonding resin; 112 teeth (every other tooth) received the barrier material after bracket placement, while the remaining 113 teeth served as controls. Intraoral photographic slides were taken before and after treatment and were evaluated blindly by 7 observers for white spot formation. Gingival and plaque indexes were recorded initially and consecutively every 6 months. Observation time ranged from 5 to 18 months. The results of this prospective clinical study indicated that there was no significant difference (P >.05) between the decalcification rates of the treatment or control groups. Likewise there was no added benefit with respect to plaque accumulation or gingival irritation. <37> UI - 20067062 AU - Anusavice KJ IN - Department of Dental Biomaterials, University of Florida, Gainesville 32610-0446, USA. kanusavice@dental.ufl.edu TI - Does ART have a place in preservative dentistry?. [Review] [17 refs] SO - Community Dentistry & Oral Epidemiology 1999 Dec;27(6):442-8 AB - The ART technique consists of hand excavating carious tissue and placing a highly viscous glass ionomer cement as a restoration material and as a sealant. Although the results of several studies are promising, the retention rates of these restorations for primary teeth are not impressive. Materials and methods that yield greater success rates are needed to improve long-term caries management outcomes. In principle, ART should yield outcomes similar to those associated with preservative dentistry, including the potential for minimal surgical intervention, conservation of sound tooth structure, avoidance of pain and need for local anesthetic injections, reduced risk for subsequent endodontics and tooth extraction, and increased survival time of the affected teeth. The ideal direct-filling ART material would be biocompatible and tooth colored; "forgiving" in its handling properties; insensitive to moisture or desiccation; hardenable without special equipment; able to form stable bonds to enamel and dentin; able to seal marginal gaps against bacteria; capable of releasing fluoride or remineralization and antibacterial agents when demineralization is most likely; and resistant to chemical attack. The highly viscous glass ionomer materials currently used for ART meet several of this criteria, though they may be deficient in their ability to seal marginal gaps against bacteria and in their sensitivity to desiccation. Furthermore, although they release fluoride over the lifetime of the restoration, this fluoride release alone may not prevent caries progression in all cases. It is necessary for cases of high caries risk to use chlorhexidine in conjunction with fluoride to achieve caries arrest and remineralization of adjacent areas of the affected teeth. Thus, while the ART technique offers some benefits in restoring function and reducing the rate of caries progression, it is unlikely that current materials will be able to arrest caries progression completely in high-risk persons. [References: 17] <38> UI - 20067056 AU - Thibodeau EA AU - O'Sullivan DM IN - Department of Behavioral Sciences, University of Connecticut School of Dental Medicine, Farmington 06030-3910, USA. thibodeau@nso.uchc.edu TI - Salivary mutans streptococci and caries development in the primary and mixed dentitions of children. SO - Community Dentistry & Oral Epidemiology 1999 Dec;27(6):406-12 AB - OBJECTIVES: For more than 25 years, both cross-sectional and longitudinal studies of dental caries have focused on the role of salivary mutans streptococci (SMS) as a predictor of caries risk. This study examined the relationship between SMS and longitudinal caries development in the primary and mixed dentitions. METHODS: Eighty-five children, initial mean age 3.8 years, were examined for dental caries at baseline and once annually for 6 years. Children's SMS were sampled with a tongue blade, which was impressed onto plates containing a medium selective for SMS. After incubation, colony forming units of SMS were determined semi-quantitatively and categorized as low, moderate or high. RESULTS: Children classified as high caries risk at baseline had significantly greater (P<0.05) dmfs scores for all teeth, and in the primary molars, than children classified as moderate or low caries risk at every age but 9 (P<0.10). Children classified as high risk at age 3 had the greatest DMFS increment through age 8. Based on annual examinations, there was a trend towards increasing mean dmfs/DMFS scores among children classified as high risk in every year. CONCLUSIONS: The current study is among the first to report on the ability of annual measurements of SMS to identify long-term caries risk in both the primary and the mixed dentitions. Despite limitations in predicting caries risk using microbiological methods, this longitudinal study supports the overall benefits of this type of testing. <39> UI - 20057414 AU - Jalevik B AU - Sjostrom O AU - Noren JG IN - Specialist Clinic for Pedodontics, Molndal, Sweden. TI - Evaluation of three years of dental care of adolescents in the Public Dental Service in west Sweden. SO - Swedish Dental Journal 1999;23(4):141-8 AB - 107 individuals, randomly selected from the County of Goteborg and Bohuslan, all born in 1970 were followed regarding the dental care received 1987-1989. The records of each individual from the actual time were collected and information on diagnosis and treatment measures was gathered. Radiographs from the actual time were studied by one of the authors. Sixty-two per cent of the adolescents had been examined and treated all 3 years. Six percent had not been seen at all. The sample was divided into three groups depending on the patient's DFSa value at the examination the first year. This classification appeared to correlate well with caries development in the following years. One-fourth of the sample was responsible for the major part of the non-attendance and late cancellations. The dental health of these subjects was below average, and non-attendance seemed to be a further risk factor. The preventive measures undertaken during the study appeared to correlate poorly with the actual situation of the patient and the presence or absence of potential risk factors. <40> UI - 99391682 AU - Machiulskiene V AU - Nyvad B AU - Baelum V IN - Department of Therapeutic Stomatology, Faculty of Stomatology, Kaunas Medical University, Kaunas, Lithuania. vita@kma.lt TI - A comparison of clinical and radiographic caries diagnoses in posterior teeth of 12-year-old Lithuanian children. SO - Caries Research 1999 Sep-Oct;33(5):340-8 AB - Bite-wing radiography has been recommended for use in adolescents as clinical examinations alone may lead to underestimation of carious lesions in approximal and occlusal surfaces. The aim of this study was to describe the relationship between clinical and radiographic caries diagnoses among 12-year-old Lithuanians using a new clinical scoring system which differentiates between cavitated and non-cavitated caries lesions. Eight hundred and seventy-two children were examined clinically and two standardized posterior bite-wing radiographs were taken of each participant. Bite-wing radiography contributed significantly to the total number of lesions diagnosed only at the dentin level in approximal surfaces. Clinical examination performed better than radiographic examination at the non-cavitated/enamel level, particularly on occlusal surfaces. Less than 2% of the clinically sound surfaces were diagnosed with dentin lesions/fillings radiographically. When using the cavitated level of clinical diagnosis, the frequency of 'hidden' caries lesions increased from 1.9 to 2.9% in approximal surfaces, and from 1.7 to 5. 2% in occlusal surfaces. The intra-examiner reliability data for the clinical and radiographic recordings supported the conclusion of an additional diagnostic value of bite-wings only for approximal surfaces. The findings demonstrate that the diagnostic yield of bite-wing radiography is higher for approximal than for occlusal surfaces. The efficacy of bite-wings depends on the refinement of the clinical caries diagnostic criteria. 'Hidden' caries does not seem to be a major problem when the clinical caries diagnostic criteria include non-cavitated diagnoses. <41> UI - 99391688 AU - Marks LA AU - Weerheijm KL AU - van Amerongen WE AU - Groen HJ AU - Martens LC IN - Cariology, Endodontology, Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands. Luc.Marks@rug.ac.be TI - Dyract versus Tytin Class II restorations in primary molars: 36 months evaluation. SO - Caries Research 1999 Sep-Oct;33(5):387-92 AB - Due to the changed treatment approach of proximal caries and the amalgam controversy, clinicians are in search for new materials. The aim of the present study was to compare amalgam with an adhesive material in deciduous molars in a clinical, split-mouth design study. At baseline 30 polyacid modified composite (Dyract) and 30 amalgam (Tytin) restorations were placed in primary molars, of which 24 and 17 could be evaluated after 24 and 36 months, respectively. Modified USPHS criteria were used for clinical evaluation every 6 months. Annual bite-wing radiographs were taken for evaluation of recurrent caries and cervical gap formation. In the present study, for Dyract as well as for Tytin restorations, low rates of recurrent caries were found, while Dyract restorations showed a better marginal adaptation and surface texture compared to Tytin restorations. In the Dyract group more radiolucencies were found at baseline. In both groups no patient complaint or pain was reported related to the radiolucencies. After 3 years the colour of Dyract was not comparable to the original. For Dyract no excessive wear was noticed compared to enamel. During the study one Dyract (recurrent caries: 18 months) and two Tytin (pulpal aetiology: 6 months, recurrent caries: 36 months) restorations had to be replaced. Even though the restorations were placed in caries risk children, at the 36 months' evaluation of this clinical study, the results indicate that Dyract can be an alternative for Tytin in the primary dentition. <42> UI - 99368222 AU - Delain M AU - Cartron G AU - Bout M AU - Benboubker L AU - Linassier C AU - Lamagnere JP AU - Colombat P IN - Department of Hematology/Oncology, Bretonneau Hospital, Tours, France. TI - Intensive therapy with autologous stem cell transplantation as first-line therapy in poor-risk Hodgkin's disease and analysis of predictive factors of outcome. SO - Leukemia & Lymphoma 1999 Jul;34(3-4):305-13 AB - The value of high-dose therapy with autologous stem cell transplantation as first-line therapy in poor prognosis Hodgkin's disease is controversial and we report the results of evaluation of twenty-six patients who were selected for this procedure from February 1989 to July 1994. They were all patients with stage IV at diagnosis with at least two other unfavourable characteristics, i.e. B symptoms, mediastinal mass greater than 0.45 of the thoracic diameter, two or more extranodal sites, bone marrow involvement, inguinal node involvement, serum lactic dehydrogenase greater than 400 IU/L, or low hematocrit. At the time of transplantation, 19 patients were in complete remission and 10 were in partial remission > or = 50%. Procedure-related mortality in the first 90 days post-graft was 7% overall. Of the 24 evaluable patients, 22 (92%) were assessed as complete responders, and 2 (8%) had progression of disease at 6 months. The actuarial overall survival (OS), disease-free survival (DFS) and event-free survival (EFS) at 5 years were 69%, 79% and 58%, respectively. The Cox proportional hazards model was used to assess prognostic factors. In univariate analysis only one prognostic factor was found to be significantly associated with improved DFS, i.e. low serum lactic dehydrogenase (LDH) (DFS at 5 years: 92% if LDH < 400 IU/L vs 44% if LDH 400 IU/L, P = 0.007). DFS rates between first complete remission and first partial remission groups were not significantly different (DFS at 5 years: 87% vs 66%, p = 0.15). These first results are encouraging but randomized studies are needed. <43> UI - 99360011 AU - Holst A AU - Braune K AU - Kjellberg-Larsson M IN - Public Dental Service, County of Blekinge, Sweden. TI - Occurrence and distribution of caries in 6-year-old children in Blekinge, Sweden. SO - Swedish Dental Journal 1999;23(2-3):71-6 AB - Community dentistry in Blekinge aims at age-specific levels of dental health. For 6-year-old children the goal is that > 65 percent will have dmft = 0 in the year 2000. At present there is no study on dental health in 6-year-olds in Blekinge. The aims of the present study are to establish baseline epidemiological data on dental caries in the county of Blekinge, expressed as dentin lesions and enamel lesions, to analyse these data and to formulate program oriented planning of dental care for pre-school children to achieve the dental health goal for the year 2000. The material comprised a random sample of 213 children. The sample was drawn from the population register for children living in the county of Blekinge. A clinical investigation was performed by one of the authors and was completed with bite-wing radiographs whenever the proximal surface could not be inspected clinically. In addition the parents were asked questions about tooth-brushing and use of fluoride tablets. Fifty-six percent of the children had filled lesions and manifest lesions (dfs), 65 percent had enamel caries lesions (dsi) and 42 percent had manifest lesions (ds). Fifty-three percent had dmft > 0. The finding of initial lesions in 65 percent of the children indicates that caries prevalence is greatly underestimated. Together with poor oral hygiene, this means an increase in the risk of caries progression. The pattern of dental health was very skewed among the children; 23 percent had between 5 and fourteen decayed or filled teeth and 11 percent had from 5 to 23 manifest lesions. Clinics in Blekinge have had different strategies for preventive dental care. In 1997, however, all the public dental service clinics in Blekinge, adopted a uniform program for child dental care, focusing on primary prevention and risk assessment for each individual. <44> UI - 99351666 AU - Emilson CG AU - Gisselsson H AU - Birkhed D IN - Department of Cardiology, Faculty of Odontology, Goteborg University, Sweden. emilson@odontologi.gu.se TI - Recolonisation pattern of mutans streptococci after suppression by three different modes of chlorhexidine gel application. SO - European Journal of Oral Sciences 1999 Jun;107(3):170-5 AB - Clinical studies have shown conflicting results for the reduction of approximal caries when chlorhexidine gel has been applied either in trays or by flossing. To investigate whether these modes of treatment affect the colonization of mutans streptococci (MS) differently, we quantified MS in saliva and on various tooth surfaces before and after a single chlorhexidine gel application. Twenty-one schoolchildren (15-16 yr old), with high numbers of salivary MS, were randomised into three groups. The subjects were treated with a 1% chlorhexidine gel applied either by: 1) interdental flossing; 2) individually designed mouth trays; or 3) a combination of polishing and flossing. Analysis of saliva and of dental plaque from 12 sites over an 8-wk period showed a greater reduction of both salivary MS counts and total number of colonised sites in the tray group than in the flossing group. The effect on MS in the polishing-flossing group approached that obtained in the tray group. In the interdental areas, more sites had no detectable MS (score 0) after tray treatment than after flossing, whereas the reduction of heavily colonised sites (scores 3+/-4) was higher in the flossing group. The reappearance of sites with score 3+/-4 after the gel treatment was more rapid in the flossing group than in the other two groups. In conclusion, the results showed a transient reduction of MS colonisation by all three methods, and that the application of the chlorhexidine gel both in mouth trays or as a combination of polishing and flossing was more effective in reducing the MS population than flossing alone. <45> UI - 99351665 AU - Splieth C AU - Bernhardt O IN - Department of Operative Dentistry, Periodontology and Pediatric Dentistry, Ernst Moritz Arndt University, Greifswald, Germany. splieth@rz.uni-greifswald.de TI - Prediction of caries development for molar fissures with semiquantitative mutans streptococci test. SO - European Journal of Oral Sciences 1999 Jun;107(3):164-9 AB - Risk-specific caries prevention requires validated and simple parameters for a caries risk assessment. The aim of the study was to evaluate the validity of a site-specific chair-side mutans streptococci (MS) test for the prediction of caries incidence in fissures. In 230 6- to 7-yr-old children, occlusal plaque samples of teeth 16 and 36 were cultured with Dentocult SM tests at 37 degrees C for 24 hr. Caries (DMFS), initial caries, sealants, and a plaque index (QHI) were recorded and oral hygiene habits were assessed. Not erupted, carious, filled and sealed teeth were excluded from the analysis (n = 154). After 2 yr, the status of the fissures was re-examined, and a fluoride history was recorded with a questionnaire filled out by the children's parents. Sealed teeth were excluded again (n = 54). With a classification of MS score 0 or 1 as low and MS score 2 or 3 as high caries risk, 92% agreement was reached by two independently working examiners. The MS scores and caries incidence correlated significantly. Seventy-eight % of the caries progression in fissures was prognosed correctly. Sensitivity was 50%, specificity 82%, positive predictive value 29%, and negative predictive value 92%. Children with caries progression tended to have lower fluoride scores. Low MS scores were most likely to be associated with low caries incidence, while high mutans streptococci scores seem to be partially compensated by other parameters. <46> UI - 99407371 AU - Smales RJ AU - Wong KC IN - Faculty of Dentistry, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong. rjsmales@schmuck.mad.adelaide.edu.au TI - 2-year clinical performance of a resin-modified glass ionomer sealant. SO - American Journal of Dentistry 1999 Apr;12(2):59-61 AB - PURPOSE: To compare the 2-year clinical performance of an experimental resin-modified glass ionomer cement sealant (K-512 = Fuji III LC) with that of a light-cured resin-based sealant (Delton Opaque) in young adults: MATERIALS AND METHODS: 14 subjects with 47 K-512 and 41 Delton sealants were recalled at 2 years for clinical examination, photographs after enamel etching, impressions and radiographs. RESULTS: K-512 showed 0% complete retention, 62% partial retention, and 38% nil retention. The corresponding percentages for Delton were 32%, 58% and 10%, respectively. There was one instance of fissure caries for K-512 and three for Delton. Sealants deemed to need retreatments because of retention failures were 62% for K-512 and 34% for Delton. The K-512 sealants continued to darken over the study, many becoming slightly darker than the sealed teeth. <47> UI - 99354539 AU - Toumba KJ AU - Duggal MS IN - Division of Child Dental Health, Leeds Dental Institute. TI - Effect on plaque pH of fruit drinks with reduced carbohydrate content. SO - British Dental Journal 1999 Jun 26;186(12):626-9 AB - OBJECTIVES: To assess the acidogenic response in dental plaque after challenge with four fruit drinks, including two blackcurrant drinks newly formulated, with low levels of carbohydrate. METHODS: 24 adult volunteers rinsed, in randomised order, with each of two new formulations of a blackcurrant drink (7% juice with 0.49% and 10% juice with 0.65% carbohydrate concentration respectively), an apple and blackcurrant drink with no added sugar (0.8%), and a mixed citrus fruit drink with a higher carbohydrate concentration (4.5% w/v). Solutions of 10% sucrose and 10% sorbitol were used as controls. Plaque pH was assessed, in vivo, before and after the acidogenic challenge using the plaque-harvesting technique. RESULTS: Results showed that the minimum plaque pH after the subjects rinsed with the new blackcurrant drinks was higher as compared with all the other test products and significantly so compared with the mixed citrus drink (P = 0.0001). It was also found that with the 7% blackcurrant juice drink none of the subjects and with 10% blackcurrant juice drink only one subject recorded a pH drop below the pH of 5.7. Ten minutes after consumption, both the new formulation blackcurrant drinks produced significantly higher plaque pH than the mixed citrus drink. In addition, overall change in the hydrogen ion concentration over the study period (sigma delta cH) was significantly less with both new blackcurrant drinks compared with the mixed citrus drink. CONCLUSIONS: It was concluded that the two new formulations with low levels of carbohydrate had a low acidogenic potential and did not depress the plaque pH below the critical level and their consumption could not be considered to pose a significant risk for enamel demineralisation. <48> UI - 99331518 AU - Astrom AN AU - Awadia AK AU - Bjorvatn K IN - Department of Odontology-Community Dentistry, University of Bergen, Norway. anne.nordrehaug@cih.uib.no TI - Perceptions of susceptibility to oral health hazards: a study of women in different cultures. SO - Community Dentistry & Oral Epidemiology 1999 Aug;27(4):268-74 AB - People typically attribute lower health risks to themselves than to others, a phenomenon called unrealistic optimism. OBJECTIVES: The purpose of this study was to investigate how women's perceived susceptibility to tooth decay is related to information from various sources, trust in these sources and personal experience with risk factors. Comparative risk judgments for oral health hazards were also investigated. METHODS: Two samples of women were included. In 1997, a random sample of adults (n = 1190) aged 25 years, from three counties of western Norway, were invited to complete postal questionnaires at home. A total of 735 adults (62%) responded, of whom 374 (51%) were women. During July 1997, a convenient sample of 140 women, aged 15-40 years, participated in a structured interview at a Maternal Child Health clinic in Arusha town, Tanzania. RESULTS: Among the Tanzanian women, information from health workers and media, trust in these sources, symptoms of tooth decay and intake of sugared foods were significantly related to perceived risk for tooth decay. Pearson's correlation coefficients varied from r = 0.47, P < 0.001 (trust in health workers) to r = 0.20, P < 0.05 (intake of sugared foods). In both groups of women all mean ratings of comparative risk differed significantly (P < 0.001) from the midpoint of the scales (marked same risk as others), as tested by one sample t-test (test value = 0). The range of t-values was from t = -12.7 (dental fluorosis) to t = -18.2 (tooth decay) and from t = -4.9 (gum disease) to t = -8.3 (loss of teeth) among the Tanzanian and Norwegian women, respectively. CONCLUSIONS: When judging their susceptibility for tooth decay, Tanzanian women seem to consider both information from health workers and their personal risk experience. Optimism in comparative risk judgments for oral health hazards was evident among both the Tanzanian and the Norwegian women investigated. These findings are discussed in the context of implications for oral health education. <49> UI - 99333025 AU - Stephen KW TI - Use of fluoride [letter; comment]. CM - Comment on: Lancet 1999 May 1;353(9163):1462 SO - Lancet 1999 Jul 3;354(9172):74-5 <50> UI - 99312085 AU - Stephen KW AU - Macpherson LM AU - Gorzo I AU - Gilmour WH IN - Dental Public Health Unit, University of Glasgow Dental School, Scotland, UK. k.stephen@dental.gla.ac.uk TI - Effect of fluoridated salt intake in infancy: a blind caries and fluorosis study in 8th grade Hungarian pupils. SO - Community Dentistry & Oral Epidemiology 1999 Jun;27(3):210-5 AB - Salt fluoridation is effective at inhibiting caries, but fluorosis prevalence data are deficient. OBJECTIVES: The purpose was to undertake a blind study of caries and tooth mottling in 8th grade school pupils from south-east Hungary who had resided (test) or not resided (control), until November 1985, in a 350 ppm F-/kg domestic salt-fluoridated area during their early years of life. METHODS: In Szeged, blind clinical caries and anterior tooth mottling scoring (+10% repeats) of 49 previously salt-fluoridated (mean age 14.14 years) and 59 non-salt-fluoridated subjects (mean age 14.08 years) were undertaken by one examiner, in June 1997. In addition, radiographic and photographic recordings were taken. In Glasgow, four dental and two lay staff scored the projected 35 mm colour transparencies (+10% repeats) of each pupil's six upper anterior teeth, for tooth mottling. All clinical, radiographic and photographic data were then analysed. RESULTS: Mean DMFS scores were 9.18 (SD=10.72) for test users and 4.51 (SD=6.24) for control users (P<0.01) and, based on repeat observations, clinical reliability=0.99; X-ray reliability=0.95. Clinically, three test children had fluorosis of 10 teeth, with eight teeth in two controls. Photographic scoring by the clinical examiner gave a 97.2% clinical match, while photographic agreements for all four dentist pairs were 92.5%-97.2%, with lay observers' agreements at 89.8%. For both groups, 10% repeats produced 98.5% agreements. In a sole test case "fluorosis" photographic unanimity was obtained, and non-unanimous "possible fluorosis" was recorded by two to four panel members for only three other test and two control subjects. CONCLUSIONS: No evidence was found that significant anterior tooth fluorosis resulted in subjects exposed previously to 350 ppm F-/kg domestic salt from birth to 2.3-4.8 years of age. However, no caries benefit was demonstrated after the 11.5-year salt fluoridation gap. Caries differences seemed social class-related, city-based controls having less disease than rural test subjects, in spite of an identical F- tablet regimen in all schools from 1987, until subjects were 10 years old. These data emphasise (a) the superiority of sustained community-delivered fluoridation and (b) the need to maintain constant fluoride delivery to tooth surfaces, certainly well beyond 10 years of age. <51> UI - 99225382 AU - Ericson D AU - Zimmerman M AU - Raber H AU - Gotrick B AU - Bornstein R AU - Thorell J IN - Department of Cariology, Lund University, Malmo, Sweden. Dan.Ericson@odcariol.lu.se TI - Clinical evaluation of efficacy and safety of a new method for chemo-mechanical removal of caries. A multi-centre study. SO - Caries Research 1999 May-Jun;33(3):171-7 AB - The aim of the study was to evaluate the clinical efficacy and safety of a new method (Carisolvtrade mark) for chemo-mechanical removal of caries. At four centres, 137 consecutive patients (64 females and 73 males aged 3-85 years, mean 35) entered a prospective, controlled, randomised open study. One primary caries lesion with distinct dentine involvement was selected per patient. A total of 116 lesions in permanent and 21 in deciduous teeth were selected. Caries was removed with traditional drilling or the new method. Gel was applied onto the carious dentine and the softened caries gently removed with specially designed hand instruments. New gel was applied and the procedure was repeated until no more debris could be removed and the surface was hard as judged by clinical criteria (probing and visual inspection). An independent examiner judged the cavity being caries-free or not, using clinical criteria. One hundred and thirteen patients were randomised for gel treatment and 24 for drilling. Three patients selected for drilling did not complete the treatment. Total caries removal was achieved in 106 cases with gel and in 19 with drilling. The reasons for incomplete caries removal were step-by-step excavation in 5 cases, unsuccessful caries removal in 1 case for each treatment, while 2 cases refused inspection. Mean (+/- SD) time for caries removal was 10.4 (+/-6.1) min with the gel method and 4.4 (+/-2.2) min with drilling. Mean volume of gel used was 0.4 (+/-0.2) ml. Eighty-two of 107 patients perceived that the new method caused less discomfort compared to drilling. Dentine caries was effectively removed using the Carisolv method without any adverse reactions. <52> UI - 99330253 AU - van Dijken JW AU - Kieri C AU - Carlen M IN - Institution of Oral Biology, Dental School, Umea University, Sweden. TI - Longevity of extensive class II open-sandwich restorations with a resin-modified glass-ionomer cement. SO - Journal of Dental Research 1999 Jul;78(7):1319-25 AB - Several new techniques have been introduced for use in the esthetic restoration of posterior cavities to substitute for the presumed toxicity of amalgam. Composite-laminated glass-ionomer cement restorations, the sandwich technique, have been recommended for caries-risk patients. Clinical evaluation of the use of conventional glass-ionomer cements in the open-sandwich restoration has shown a high failure rate. The aim of this study was to evaluate the durability and cariostatic effect of a modified open-sandwich restoration utilizing a resin-modified glass-ionomer cement (RMGIC) in large cavities. The materials consisted of 274 mostly extensive Class II Vitremer/Z100 restorations performed by four dentists in 168 adults. Six experimental groups were investigated. In four groups a thick and in two groups a thin layer of cement was placed. Cavity conditioning before application of the RMGIC self-etching primer was done in 3 groups with polyacrylic acid and in one group with maleic acid; in two groups, only water rinsing was performed. The restorations were evaluated at baseline and after 6, 12, 24, and 36 months according to modified USPHS criteria (van Dijken, 1986). After 3 years, 239 restorations were evaluated. Twelve (5%) were estimated as non-acceptable. Two were replaced, and seven were repaired with resin composite. Tooth fractures were observed in 2.5%. Slight erosion of the RMGIC part was seen in 4%, and in one case operative treatment was indicated. Post-operative sensitivity was reported for 9 teeth. Forty-three percent of the patients were considered as caries-risk patients. Only one restoration showed secondary caries. The three-year results indicated that the modified open-sandwich restoration is an appropriate alternative to amalgam including extensive restorations. <53> UI - 99283434 AU - Achong RA AU - Briskie DM AU - Hildebrandt GH AU - Feigal RJ AU - Loesche WJ IN - Department of Pediatric Dentistry, Mott Children's Health Center, Flint, Michigan, USA. TI - Effect of chlorhexidine varnish mouthguards on the levels of selected oral microorganisms in pediatric patients. SO - Pediatric Dentistry 1999 May-Jun;21(3):169-75 AB - PURPOSE: The effect of a chlorhexidine varnish delivery system on the levels of selected oral microorganisms was evaluated in caries active pediatric patients, ages 4 to 12 years old. METHODS: Forty-six patients were enrolled into the study when they had multiple carious surfaces and salivary mutans streptococci (MS) levels higher than 10(4) colony forming units (CFUs) per milliliter. This study incorporated a double-blind design and patients were randomly assigned to either the chlorhexidine treatment group or the placebo group. Complete-arch, vacuum-adapted mouthguards (0.02 in. polypropylene coping material) were custom fabricated and coated internally with either a 3.0% chlorhexidine varnish or a placebo varnish. Two pretreatment paraffin-stimulated saliva samples were obtained for culturing prior to varnish treatment. Saliva samples were also obtained immediately after treatment and once a month for up to three months after wearing the mouthguard appliances. Dental restorations were placed at most of these saliva collection visits. Mouthguards were reportedly worn for an average of 9.7 hours per night for approximately seven nights by 40 subjects (87%). RESULTS: After two months, and after three months, there was a significant reduction in MS levels immediately after the chlorhexidine varnish treatment. Total anaerobic and total facultative bacteria levels were not significantly affected. CONCLUSION: One week of nightly use of the chlorhexidine varnish mouthguard system is effective at reducing the number of MS in caries-active pediatric patients in the mixed and primary dentition for at least three months. <54> UI - 99243306 AU - Zimmer S AU - Robke FJ AU - Roulet JF IN - Charite, Humboldt-University Berlin, School of Dentistry, Dept. of Operative and Preventive Dentistry, Germany. stefan.zimmer@t-online.de TI - Caries prevention with fluoride varnish in a socially deprived community. SO - Community Dentistry & Oral Epidemiology 1999 Apr;27(2):103-8 AB - It has been suggested that specific preventive programs be developed for children with high caries risk. One possibility is to consider whole classes in socially deprived schools as caries-risk groups and perform an intensified preventive program for the entire class. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of such a program which includes the application of a fluoride varnish (Duraphat). METHODS: The application of the varnish was offered three to four times a year in a community with low socio-economic status and a generally high caries level. Two hundred and sixty-nine children in six primary schools of Linden/Limmer, a district in Hannover, Germany, were allocated to a test or a control group. The test group received the fluoride varnish for 4 years whereas the control group received no professional fluoride application. DMFT was recorded at the beginning of the study and after 4 years. RESULTS: At the end of the study, children who had received a minimum of two fluoride applications per year showed a significantly lower caries increment in comparison with the control group (0.88 DMFT vs 1.39 DMFT, P < 0.05). CONCLUSIONS: It can be concluded that a minimum of two applications of the fluoride varnish Duraphat per year may be an effective measure in preventing caries in socially deprived children with high caries activity. <55> UI - 99243312 AU - Kallestal C AU - Wang NJ AU - Petersen PE AU - Arnadottir IB IN - Department of Epidemiology and Public Health, Umea University, Sweden. carina.kallestal@epiph.umu.se TI - Caries-preventive methods used for children and adolescents in Denmark, Iceland, Norway and Sweden. SO - Community Dentistry & Oral Epidemiology 1999 Apr;27(2):144-51 AB - Denmark, Iceland, Norway, and Sweden have all had a similar decline in dental caries during the last 20 years, although the decline has come later in Iceland. The purpose of this study was to compare the caries-preventive methods used for children and adolescents in these four countries. Questionnaires were sent to random samples of dentists, dental hygienists, and dental nurses working with children during 1995 and 1996. The results showed that the use of preventive methods was generally consistent between the countries. Nevertheless there were differences between the countries concerning the choice of preventive strategy for risk patients and also in how prevention was implemented. Danish dental care providers chose oral hygiene education as the priority, which they put into practice. Apart from fluoride varnish for some patients, most of them did not use or recommend fluoride except fluoride toothpaste. The Norwegian and Icelandic dental care providers chose both oral hygiene education and the use of fluoride as priorities, while most Swedish dental care providers preferred to provide dietary advice and oral hygiene education, and additional fluoride for risk patients. The differences could not be explained by other variables than nationality, implying that there are differences between the dental cultures in the four countries. The informational basis of decisions on preventive strategies varied between the different dental professionals in each country as well as between the countries, indicating that national professional cultures are being shaped differently. Despite the differences in choice of preventive methods, the dental health of children varies little across the frontiers. This raises the question of the significance of the choice of preventive methods to the decline of dental caries and points towards an urgent need to develop evidence-based preventive strategies. <56> UI - 99256535 AU - Gordan VV AU - Mjor IA AU - Hucke RD AU - Smith GE IN - Department of Operative Dentistry, University of Florida, College of Dentistry, Health Science Center, Gainesville 32610-0415, USA. TI - Effect of different liner treatments on postoperative sensitivity of amalgam restorations. SO - Quintessence International 1999 Jan;30(1):55-9 AB - OBJECTIVE: The purpose of this clinical study was to assess the sensitivity experienced and reported by patients following treatment of primary carious lesions with Class I or Class II amalgam restorations. METHOD AND MATERIALS: Only previously untreated teeth were selected. The cavity preparations were treated according to one of four regimens: group 1 = no liner; group 2 = two coats of a copal varnish; group 3 = a dentin adhesive resin liner; group 4 = a resin-modified glass-ionomer liner. Patients were contacted on days 2 and 7 postoperatively and questioned regarding the presence or absence of sensitivity. If sensitivity was experienced, they were asked which stimuli created the sensitivity, the length of time it lasted, and its intensity on a subjective scale. If sensitivity was experienced on day 7, patients were also contacted on days 14, 30, and 90 to assess the degree of sensitivity. Nineteen teeth were included in each of the four groups. RESULTS: By days 2 and 7, no significant difference existed among groups; by day 14, 22% of restorations in group 2 and 17% of those in group 3 were sensitive, while teeth in groups 1 and 4 exhibited no sensitivity reactions. CONCLUSION: Use of a resin-modified glass-ionomer liner or no dentin treatment resulted in short-term sensitivity in fewer than one third of the teeth. Almost one third of the teeth restored with a dentin adhesive resin liner or copal varnish exhibited initial sensitivity, which lasted up to 30 days in a few teeth. <57> UI - 99213081 AU - Seow WK AU - Amaratunge A AU - Sim R AU - Wan A IN - Pediatric Dentistry, University of Queensland. TI - Prevalence of caries in urban Australian aborigines aged 1-3.5 years. SO - Pediatric Dentistry 1999 Mar-Apr;21(2):91-6 AB - PURPOSE: This study investigated the prevalence and etiological factors associated with caries in a group of young Australian aboriginal children from 1 to 3.5 years of age. METHODS: One hundred and forty-seven healthy infants, aged from 1 to 3.5 years, attending a community health center in Brisbane, a nonfluoridated state capital city, were randomly selected for the study. RESULTS: The caries prevalence was 39% by subjects and 32% by the total number of teeth present. The mean number of decayed, filled teeth (dtf) was 2.5 +/- 0.4, which is more than twice the figure for 3-year-old children in Australia. Furthermore, the filled (f) component represented only 1% of the total dft, suggesting very low treatment levels. Increased caries experience of the infants was strongly associated with high dental plaque scores, high levels of Streptococcus mutans infection, and sleep-time consumption of milk containing added sugar. CONCLUSION: The results suggest that urban Australian aboriginal infants are at high risk for caries, and that preventive strategies are urgently required. <58> UI - 99202247 AU - Tsurusawa M AU - Katano N AU - Yamamoto Y AU - Hirota T AU - Koizumi S AU - Watanabe A AU - Takeda T AU - Hatae Y AU - Yatabe M AU - Mimaya J AU - Gushiken T AU - Nishi K AU - Anami K AU - Kikuta A AU - Kanegane H AU - Asami K AU - Nishikawa K AU - Sekine I AU - Kawano Y AU - Iwai A AU - Furuyama T AU - Ijichi O AU - Miyake M AU - Mugishima H AU - Fujimoto T AU - et al IN - Department of Pediatrics, Aichi Medical University, Japan. tsuru@aichi-med-u.ac.jp TI - Improvement in CNS protective treatment in non-high-risk childhood acute lymphoblastic leukemia: report from the Japanese Children's Cancer and Leukemia Study Group. SO - Medical & Pediatric Oncology 1999 Apr;32(4):259-6 AB - BACKGROUND: Prevention of central nervous system (CNS) leukemia by early introduction of therapy to this sanctuary site is an essential component of modern treatment strategy for acute lymphoblastic leukemia (ALL). However, the optimal form of preventive CNS therapy remains debatable. PROCEDURE: To address this issue, we evaluated the efficacy of CNS preventive therapy for 572 children with ALL who achieved complete remission in the Children's Cancer and Leukemia Study Group (CCLSG) ALL874 (1987-1990) and ALL911 (1991-1993) studies. They received risk-directed therapy based on age and leukocyte count. In the ALL 874 study, the non-high-risk (low-risk [LR] + intermediate risk [IR]) patients were randomly assigned to the conventional cranial irradiation (CRT) regimen (L874A and I874A) and the high-dose methotrexate (HDMTX) regimen without CRT (L874B and I874B). The former patients received 18-Gy CRT plus 3 doses of intrathecal (i.t.) MTX and the latter patients received 3 courses of HDMTX at 2 g/m2 plus 13 doses of ITMTX (L874B) or 4 courses of HDMTX at 4.5 g/m2 plus 1 dose of ITMTX (I874B). RESULTS: The 7-year probabilities (+/- SE) of CNS relapse-free survival were 97.3% +/- 2.6% (L874A, n = 41) vs. 90.3% +/- 5.3% (L874B, n = 39) (P = 0.25) in the LR patients, and 100% (I874A, n = 55) vs. 78.5% +/- 6.5% (I874B, n = 54) (P = 0.002) in the IR patients. The corresponding disease-free survival (DFS) rates were 79.4% +/- 6.5% vs. 74.4% +/- 7.3% (P = 0.62) in the LR group and 63.3% +/- 6.8% vs. 58.3% +/- 7.2% (P = 0.66) in the IR group. Thus, the HDMTX regimen could not provide better protection of CNS relapse as compared with the CRT regimen, although their overall efficacy was not significantly different. In the ALL 911 study, intensive systemic chemotherapy with extended i,t, injections of MTX plus cytarabine achieved a high CNS relapse-free survival (98% +/- 1.9% at 7 years) and a favorable DFS (85.5% +/- 5% at 7 years) in the IR patients. The patients in the high-risk (HR) group in both ALL874 and ALL911 studies received the 18-Gy or 24-Gy CRT with intensive systemic chemotherapy. Their 7-year probabilities of CNS relapse-free survival ranged from 88% to 95%, among which the T-ALL patients had a risk of CNS leukemia, which was 3-4 times higher compared with B-precursor ALL patients. CONCLUSIONS: These results indicate that long-term intrathecal CNS prophylaxis as well as appropriate systemic therapy for the non-high-risk patients can provide protection against CNS relapse equivalent to that provided by cranial irradiation. <59> UI - 99144785 AU - Millett DT AU - Nunn JH AU - Welbury RR AU - Gordon PH IN - Unit of Orthodontics, Glasgow Dental Hospital and School, UK. TI - Decalcification in relation to brackets bonded with glass ionomer cement or a resin adhesive. SO - Angle Orthodontist 1999 Feb;69(1):65-70 AB - Forty randomly selected patients had brackets bonded on one side of the of the maxillary labial segment with glass ionomer cement. Teeth on the opposite side were bonded with a resin adhesive. Teeth were assessed for decalcification pretreatment, at debond, and at review using a standardized photographic technique and a modified DDE index. The mean number of teeth affected by decalcification and the mean extent of decalcification per tooth increased during the treatment period, but from debond to review both of these measurements decreased for teeth bonded with either material (p)<0.01, t-test). Decalcification appears to become less severe posttreatment, but does not appear to be significantly affected during 12 to 18 months of orthodontic treatment by bonding with glass ionomer cement. Dietary and other environmental factors, including fluoride preparations, may be of greater importance in the prevention of decalcification during fixed appliance therapy. <60> UI - 99148770 AU - Plantier-Colcher I AU - Dupriez B AU - Simon M AU - Detourmignies L AU - Jouet JP AU - Fenaux P AU - Bauters F AU - Morel P IN - Service des Maladies du Sang, Hopital Huriez, Centre Hospitalier Regional et Universitaire de Lille, France. TI - The VIM3-AraC regimen followed by autologous stem cell transplantation in refractory or relapsing aggressive non-Hodgkin's lymphoma. A prospective study of 71 consecutive cases. SO - Leukemia 1999 Feb;13(2):282-8 AB - We evaluated with an intent-to-treat analysis the response rate, the disease-free survival (DFS), and the overall survival after a multidrug salvage regimen (VIM3ARAC), followed by stem-cell transplantation (SCT) in case of response, in patients with aggressive non-Hodgkin's lymphoma (NHL) who progressed on or after the first-line therapy. Seventy-one patients (refractory: 15; relapse 'on therapy': 36; and relapse 'off therapy': 20) received two courses of VIM3ARAC (teniposide, ifosfamide, mitoxantrone, mitoguazone, high-dose methotrexate, high-dose cytarabine, prednisolone). SCT was performed only in patients with minimal disease after the second course. The response rate was 72%. It was not influenced by response to first-line therapy. Forty-eight patients (68%), including 32 complete responders, fulfilled response criteria for SCT. Thirty-six patients underwent SCT (allogeneic: 3; autologous: 33). The 4-year DFS rate of the 48 responding patients was 39%. The actuarial survival at 4 years was 34% for all patients. Relapse off therapy and a performance status <2 at relapse were the only two independent favorable prognostic factors for survival. In conclusion, VIM3AraC is associated with a high response rate in relapsing and refractory aggressive NHL. Up to half of the patients could receive SCT. This chemotherapy, followed by SCT could durably salvage 34% of these patients. <61> UI - 99051260 AU - Caplan DJ AU - Slade GD AU - Biesbrock AR AU - Bartizek RD AU - McClanahan SF AU - Beck JD IN - Department of Dental Ecology, University of North Carolina and Chapel Hill, N.C. 27599-7450, USA; The Procter & Gamble Company, Mason, Ohio, USA. dan:caplan@unc.edu TI - A comparison of increment and incidence density analyses in evaluating the anticaries effects of two dentifrices. SO - Caries Research 1999;33(1):16-22 AB - This study aimed to determine whether incidence density (ID) calculations of caries incidence rates would provide a more sensitive means of detecting caries-preventive effects than would traditional techniques. A secondary analysis was conducted using data from a 1981 study in which three dentifrices were compared in a double-blind randomized clinical trial. Subjects were examined at baseline and 1, 2 and 3 years after baseline. Three-year DMFS increments were calculated for 1,754 subjects attending the baseline and 3-year examinations. Caries ID rates then were calculated for 2, 661 subjects who had at least two examinations, using each surface's net increment (-1, 0 or +1) as the numerator and the surface's time at risk as the denominator. Despite theoretical advantages, the ID method did not alter the conclusions drawn using DMFS increments, apparently because (a) subjects lost to follow-up were similar to those completing the study, and (b) loss to follow-up was similar among treatment groups. <62> UI - 99419825 AU - Ansell SM AU - Kurtin PJ AU - Stenson M AU - Habermann TM AU - Greipp PR AU - Therneau TM AU - Witzig TE IN - Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. TI - Evaluation of the proliferative index as a prognostic factor in diffuse large cell lymphoma: correlation with the International Index. SO - Leukemia & Lymphoma 1999 Aug;34(5-6):529-37 AB - The reasons for differences in outcome between groups of patients with diffuse large cell lymphoma (DLCL) defined by clinical prognostic factors are largely unknown. Measures of cell proliferation may offer a biological explanation for these differences. This study tested the hypothesis that these survival differences between the groups defined by established prognostic factors were due to the proliferative index. The bromodeoxyuridine labeling index (LI), a measure of the S-phase fraction, was prospectively determined on fresh tumor specimens obtained at initial diagnosis in 80 patients with DLCL seen between 1986-1993 at a single institution. Patients were grouped using prognostic factors that were significant in a univariate analysis as well as the International Index (IPI). The LI in each of these groups was compared to determine whether the differences in outcome between the groups could be explained by differences in the LI. The median LI for all patients was 5.1% (range: 0.1-25%). When the predictive effect of the LI on response and survival was analyzed, the LI did not correlate with complete response or disease-free survival (DFS). There was a trend, however, for patients with a lower LI to have a poorer overall survival (p=0.06). When the patients were analyzed using the International Index (IPI), the mean LI for patients in the low-risk, low-intermediate, high-intermediate and high risk groups was 7.1%, 10.0%, 6.4% and 6.6% respectively (p=0.41). When analyzed separately, there was no significant difference in the LI for any of the patient groups defined by significant prognostic factors. The only difference in the LI was that the median LI in patients with T-cell DLCL was significantly lower than the LI in patients with B-cell DLCL (p=0.001) and these patients had an inferior complete response rate (p=0.001), dis