bluuebunny/crossref_metadata_2025 huggingface dataset:
Host Responses in Patients With Generalized Refractory Periodontitis
Authors: Hernichel‐Gorbach Edith , Kornman Kenneth S. , Holt Stanley C. , Nichols Frank , Meador Harold , Kung John T. , Thomas Charles A.
Published: March 2012

Although patients with refractory periodontitis have been widely reported, no clear biologic profile of these patients has been noted. The purpose of the present study was to evaluate host responsiveness of a well‐defined group of refractory periodontitis patients by determining the effect of a lipopolysaccharide (LPS) challenge on monocyte surface receptor density and on the release of inflammatory mediators. Venous blood was obtained from 7 refractory periodontitis, 8 stable periodontal maintenance, and 8 gingivitis patients with no evidence of periodontitis. Mononuclear cells were cultured in either control media or media treated with Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), or Salmonella typhimurium (S. typh) LPS. At 0 and 24 hours supernatants were assayed for prostaglandin‐E2 (PGE2) and interleukin‐1β (Il‐1β) release by ELISA. Using flow cytometry the density of specific monocyte surface receptors were assayed with Mo3e and LeuM3 monoclonal antibodies (mAb); T‐cell CD4/CD8 ratios were assayed with OKT‐3, OKT‐4, and OKT‐8 mAb. After 24 hours incubation with Pg or S. typh LPS, the upregulation of the Mo3e receptor was significantly decreased for refractory periodontitis patients (P < 0.05) when compared to gingivitis and to stable maintenance patients. In refractory periodontitis patients the T‐cell CD4/CD8 ratio was decreased. Upon stimulation with Pg or S. typh LPS, monocytes from stable maintenance and refractory periodontitis patients released more Il‐1β (P < 0.05) and PGE2 (P = 0.13 and 0.15) than monocytes from gingivitis subjects. The current data suggest that, as assessed by the inflammatory mediator release of Il‐1β and PGE2, monocytes from both stable maintenance and refractory periodontitis patients may have the potential for a more vigorous inflammatory response to a given bacterial challenge, when compared to monocytes from individuals without a previous history of periodontitis. However, only refractory periodontitis patients had a decreased CD4/CD8 ratio and decreased Mo3e expression, representing some alteration in the mononuclear cell‐cytokine system, that distinguished them from patients who responded predictably to treatment. J Periodontol 1994;65:8–16.
Osteosarcoma Presenting as Supracrestal Bone Formation
Authors: Kabani Sadru P. , Pollack Ralph P.
Published: March 2012

We report an unusual case of maxillary osteosarcoma presenting as supracrestal bone formation in a 41‐year‐old woman. This case is of interest from the point of view of radiographic appearance of supracrestal bone formation with widened periodontal ligaments and the buccal and palatal swelling of the tissues. Moreover, to the best of our knowledge, the histopathologic evidence of cementai resorption has not been reported earlier. J Periodontol 1994;65:93–96.
Molecular Basis of Leukocyte Adhesion Molecules in Early‐Onset Periodontitis Patients With Decreased CD11/CD18 Expression on Leukocytes
Authors: Katsuragi Kyoko , Takashiba Shogo , Kurihara Hidemi , Murayama Yoji
Published: March 2012

We analyzed the cell‐cell adherence related to CD11/CD18 and CD18 mRNA in individuals with decreased CD11/CD18 expression on their neutrophil surface. Epstein Barr virus‐transformed B cell lines were developed from one localized juvenile periodontitis (LJP) patient with decreased CD11/CD18 in the peripheral blood neutrophils and without systemic diseases; two siblings with generalized prepubertal periodontitis (GPP) caused by leukocyte adhesion deficiency (LAD); another LJP patient; one localized prepubertal periodontitis. (LPP) patient; and two healthy subjects. Adhesion of leukocytes to each other was measured as cluster formation by aggregation assay. The length and the amount of CD18 mRNA expressed in the cell lines were analyzed by Northern blotting using the 32P‐labeled CD18 cDNA. The coding region of the mRNA was analyzed by the reverse transcription‐polymerase chain reaction method. Base‐mismatches between CD18 mRNA and the 32P‐labeled RNA probe synthesized from CD18 cDNA were analyzed by RNase protection assay. In the adherence assay, cells from the LJP patients with decreased CD11/CD18 formed more clusters of smaller size and fewer cells than those of the other subjects. The cells from GPP and LAD patients did not aggregate and did not form clusters either in the absence or presence of PMA. There were no differences in the length and the amount of mRNA between the LJP patients and the other subjects, while GPP‐LAD patients expressed a small amount of long mRNA. The whole coding region (2,313 base pairs) of all subjects was amplified except for the GPPLAD patients, and the 5′‐region (1,119 base pairs) was amplified from all subjects. Basemismatches were detected on the coding region from 965 to 1,450 nucleotides of CD18 mRNA in GPP‐LAD patients. No mismatch was detected on other regions of CD18 mRNA in any subject. These results suggest that the LJP patient with an anomaly of qualitative aggregation related to CD11/CD18 is not related to sequence abnormalities of CD18 mRNA suggesting other mechanisms. In contrast, the adherence defect in two GPP‐LAD patients was related to heterogeneous molecular mutations on CD18. J Periodontol 1994;65:949–957.
Short‐Term Healing of Autogenous and Allogeneic Bone Grafts After Sinus Augmentation: A Report of 2 Cases
Authors: Nishibori Masakazu , Betts Norman J. , Salama Henry , Listgarten Max A.
Published: March 2012

Sinus augmentation to facilitate the placement of cylindrical endosseous implants in the posterior maxilla has become more commonplace, and many different materials have been used for the sinus graft. The results of two sinus augmentation procedures, one grafted with demineralized freeze‐dried bone (DFDB) and the other with autogenous iliac bone, are presented. Bone cores were obtained with a trephine drill from the grafted regions at the time of implant placement. Eight implants were placed into the grafted areas in each subject. The sample from the sinus grafted with autogenous bone was obtained 8 months postoperatively and the bone core from the sinus grafted with DFDB was taken 16 months postoperatively. The bone specimens were subsequently examined under light microscopy. The autogenous specimens demonstrated new bone formation with increased quantity and improved quality when compared to the specimens obtained from the sites grafted with allogeneic bone. All 8 implants placed into the autogenous grafts were clinically osseointegrated at stage 2. At 16‐months postsurgery, the bone core taken from the site grafted with DFDB demonstrated poor bone quality and still contained remnants of the graft material in the region approximating the sinus membrane. Two of the 8 implants placed into the allogeneic grafts failed at stage 2. These findings suggest that autogenous sinus grafts produce bone of adequate quantity and quality for implant placement, whereas DFDB sinus grafts are not completely remodeled by the host and may produce bone of insufficient quality and quantity for predictable implant placement. J Periodontol 1994;65:958–966.
Clinical and Microbiological Effects of Controlled‐Release Locally Delivered Minocycline in Periodontitis
Authors: Jones Archie A. , Kornman Kenneth S. , Newbold Dewey A. , Manwell Mary A.
Published: March 2012

The clinical efficacy of Minocycline in a subgingival local delivery system was evaluated alone (M) or as an adjunct to scaling and root planing (M+SRP), in comparison to scaling and root planing (SRP) or to no subgingival treatment (NoTx) in adult periodontitis. Fifty‐one adult patients with ≥7 mm periodontal pockets demonstrating the presence by culture of Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), or Actinobacillus actinomycetemcomitans (Aa) were randomized into one of the above 4 treatment groups. All sites ≥5 mm in the most diseased quadrant in each patient received the therapy. Other quadrants were not treated. All patients received standardized oral hygiene instructions at the beginning of the study. At 0, 1, 3, and 6 months following therapy the 7 mm experimental sites were evaluated for selected periodontal pathogens by DNA probe analysis. At these same time points, the plaque index, gingival index, and bleeding on probing were evaluated as well as probing depth and relative clinical attachment level which were assessed by means of an automated probe. Probing depth reduction with M+SRP was significantly greater than all other groups at one month and significantly greater than NoTx and SRP at 3 months. There were no differences in probing depth reduction among groups at 6 months. At 6 months the gain in clinical attachment level was significantly greater for SRP than for either the NoTx or M groups. The prevalence of Pg decreased significantly in the M and M+SRP groups at one month. The prevalence of Pi decreased significantly from baseline at one month in the M group. No other significant microbiological differences between groups were noted. In terms of clinical probing depth, subgingival minocycline as an adjunct to SRP may produce significant clinical benefits over SRP alone in patients with adult periodontitis. This benefit may be related to a decrease in prevalence of Pg. J Periodontol 1994; 65:1058–1066.
Association of the Severity of Periodontal Disease With Organ Complications in Type 1 Diabetic Patients
Authors: Karjalainen Kaisa M. , Knuuttila Matti L. E. , von Dickhoff Kai J.
Published: March 2012

This study examined the relationship between the severity of periodontal disease and organ complications in long‐term Type 1 or insulin‐dependent diabetes mellitus patients, taking account of the severity and concomitant existence of these complications. The population studied consisted of 26 Type 1 diabetics 26 to 34 years old, who had had diabetes for at least 10 years. Severity of periodontal disease was shown to increase with severity of organ complications. Patients with advanced complications had significantly more bleeding on probing, pockets ≥ 4 mm deep, and more attachment loss than patients with incipient complications or no complications. Stepwise multiple regression analysis showed that the existence of advanced complications was the only diabetesrelated factor predicting pockets ≥ 4 mm deep. Subgingival calculus, sex, and smoking were other significant variables. Retinopathy was the organ complication most suited to comparison, since it is usually the first to appear and can easily be classified from nonexistent to severe. Differences in severity of periodontal disease were less obvious if metabolic balance alone was considered than between subgroups formed on the basis of the existence of advanced complications. Severity of periodontal disease and the existence of complications were more closely related to long‐term glucose balance than single, most recent HbA1 values. Prevalence of pockets at sites with subgingival calculus increased with severity of complications. Indicators of dental‐health behavior, including amount of plaque, subgingival calculus, home‐care practices, and regularity of visits to the dentist, were worse in subjects with poor control and complications. Our results suggest that attention needs to be paid to Type 1 diabetes of long‐standing disease with poor long‐term glucose control, particularly those with organ complications. J Periodontol 1994; 65:1067–1072.
Smoking as an Additional Risk for Tooth Loss
Authors: Holm Gunnar
Published: March 2012

Epidemiological studies have shown that loss of teeth is associated with increasing age. This was explained as the result of the action of microorganisms which, as components of dental plaque, destroyed the tooth by causing caries or periodontitis. Routine prevention programs therefore concentrated on removal of plaque, resulting in good oral hygiene. Despite good oral hygiene some individuals developed periodontitis. Studies have indicated that smoking may be a risk factor for this disease. This study was undertaken to determine whether or not smoking is also a risk factor for tooth loss. A total of 273 individuals were followed for 10 years, during which 93 individuals lost a total of 260 teeth. Younger individuals and especially males smoking more than 15 cigarettes a day were found to have the highest relative risk of losing teeth (4.55 and 3.18 respectively). In the younger age groups the proportional attributable risk was also highest; 78% for smokers smoking more than 15 cigarettes a day. The combination of a high plaque score and smoking was, together with age, the strongest predictor of tooth loss. The findings of this study suggest that smokers, especially those in the age group < 50 years, are a high risk group for tooth loss. J Periodontol 1994; 65:996–1001.
In Vitro Studies on Laser Scaling of Subgingival Calculus With an Erbium:YAG Laser
Authors: Aoki Akira , Ando Yoshinori , Watanabe Hisashi , Ishikawa Isao
Published: March 2012

The effectiveness of a newly‐developed Er:YAG laser with a fiber delivery system to remove subgingival calculus was examined in vitro. Fifty‐three (53) periodontallyinvolved human extracted teeth with a band of subgingival calculus were used. Two experiments were conducted: in experiment 1, laser scaling was performed with water irrigation on a straight line and on a broad area, against the subgingival calculus at the energy levels of 10 to 120 mJ/pulse (3.5 to 42.4 J/cm2/pulse) and the pulse repetition rate of 10 pps. The morphological changes of the laser‐scaled site were observed by SEM, and the efficiency of laser scaling was determined. In experiment 2, laser scaling was performed with and without water irrigation at 30 mJ/pulse and 10 pps. The morphological changes, the efficiencies, and temperature changes with and without water irrigation were compared. The pulsed Er:YAG laser used with water irrigation was able to remove the subgingival calculus from the tooth root effectively at the energy level of about 30 mJ/pulse (energy density: 10.6 J/cm2/pulse) and 10 pps, under in vitro conditions. Ablation of the tooth substance on laser scaling was generally observed within the cementum. There was little increase in temperature on the root surface during laser scaling. This study suggests the potential for the clinical application of the Er:YAG laser in subgingival scaling. J Periodontol 1994; 65:1097–1106.
Discussion: Animal Models in Reconstructive Therapy
Authors: Selvig Knut A.
Published: March 2012

Experimentation in animal models has created a basis for highly improved therapeutic procedures in reconstructive periodontal surgery. This symposium has discussed several animal models currently used; additional models have been described in recent literature. The presentations by Drs. Caton, Wikesjö, and Lynch illustrated the need for further discussion of some of the problems inherent in animal experimentation, including: standardization of periodontal defect configuration; adequate recording of preoperative attachment level; minimizing the effect of biological variability; use of surgically‐created versus naturally‐developed periodontal lesions; choice of observation period; and regenerative potential of the model chosen. J Periodontol 1994; 65:1169–1172.
Dentine Hypersensitivity: A Clinical Trial to Compare 2 Strontium Densensitizing Toothpastes With a Conventional Fluoride Toothpaste
Authors: Pearce Nicola X. , Addy M. , Newcombe R.G.
Published: March 2012

A considerable number of varied agents are apparently effective in the treatment of dentine hypersensitivity. In particular, the literature supports the efficacy of fluoride and strontium containing formulations. Despite this, comparisons between strontium products are relatively few in number and surprisingly there are almost no evaluations of these products against “bench mark,” conventional commercial fluoride toothpastes. This study was a double‐blind parallel group comparison of two strontium‐based desensitizing toothpaste products and a conventional fluoride product in the treatment of dentine hypersensitivity. A total of 119 patients completed the 12‐week study and from them, sensitivity gradings were obtained at baseline, 1, 4, 8, and 12 weeks. Sensitivity was scored in response to cold air, a thermal probe at 0°C, and scratching with a dental probe. Patients also graded their overall sensitivity at each visit, using a visual analogue scale and the effects of treatment on completion. Plaque and gingivitis indices were recorded at each visit. There was an overall and progressive reduction in all sensitivity parameters in the 3 groups with no significant differences between the treatments. Plaque and gingivitis scores were already relatively low in this patient group at baseline but improved further as the study continued. The improvements, however, were comparable in the 3 groups. Under the conditions of this clinical trial the 2 desensitizing toothpastes showed similar reductions, but no greater than that observed in the conventional fluoride toothpaste. There is perhaps the need for further evaluations of desensitizing formulations using conventional fluoride products as controls rather than minus active or placebo formulations. J Periodontol 1994;65:113–119.
The Influence of Surface‐Free Energy on Supra‐ and Subgingival Plaque Microbiology. An In Vivo Study on Implants
Authors: Quirynen Marc , Van Der Mei Hennie C. , Bollen Curd M. L. , Van Den Bossche Luc H. , Doornbusch Gésinda I. , van Steenberghe Daniel , Busscher Henk J.
Published: March 2012

The influence of surface free energy on supra‐ and subgingival plaque microbiology was examined in 9 patients with functional fixed prostheses supported by endosseous titanium implants. Two abutments (trans‐mucosal part of the 2 stage implant) were replaced by either a new titanium abutment or a fluor‐ethylene‐propylene (FEP) coated abutment per subject. After 3 months of habitual oral hygiene, plaque samples were taken. Supragingival plaque was examined by means of differential phase‐contrast microscopy, whereas for the subgingivial plaque additional analyses (DNA probes analysis, culturing) were performed. The subgingival samples were taken by paper‐points and by scraping of the subgingival abutment surface. Differential phase‐contrast microscopy showed a significant difference in plaque composition, especially when supragingival plaque was considered (P = 0.05). FEP coated abutments frequently harbored more coccoid microorganisms, whereas spirochetes or motile organisms were only detected around titanium abutments. Subgingivally, the number of colony forming units (CFU) in paper‐points was comparable for both types of abutments. If the to‐the‐abutmentadhering plaque was considered, the number of CFU was 5 times higher on the titanium abutments than on the FEP coated abutments. However, this difference did not reach a statistical level of significance (P = 0.38). The DNA probe analysis of the subgingival plaque collected with paper‐points showed a slightly higher frequency and concentration of perio‐pathogens around the titanium abutments. However, the inter‐substratum differences were smaller than the inter‐subject differences. The latter seemed to be related to patient's dental status. These results indicate that lowering the surface‐free energy of intra‐oral hard surfaces results in a reduction in bacterial colonization and in a retardation in its maturation in the supragingival area. For the subgingival area, the influence of this surface characteristic is not as obvious. J Periodontol 1994; 65:162–167.
HLA A9 and B15 Are Associated With the Generalized Form, But Not the Localized Form, of Early‐Onset Periodontal Diseases
Authors: Shapira Lior , Eizenberg Shlomit , Sela Michael N. , Soskolne Aubrey , Brautbar Haim
Published: March 2012

HLA proteins are genetically determined, and account in part for individual immune response. Several studies have been performed seeking an association between HLA antigens and various forms of periodontitis with no conclusive results. The aim of the present study was to determine the frequency of HLA antigens of patients suffering from the localized (LJP) and the generalized (SGP) forms of early‐onset periodontitis (EOP). Twenty‐six EOP patients from the same ethnic group were studied in comparison to 113 race‐matched controls. The EOP group included 11 LJP and 15 SGP patients. HLA‐A9 and B15 antigens were found to be significantly elevated in the patient group. These differences were found to be due to the high frequency of A9 and B15 antigens in the SGP patients, with the LJP patient group showing no significant difference from the control group. The results are in agreement with previous studies in which A9 and B15 were found to be associated with EOP. However, previous studies did not differentiate between the localized and the generalized form of EOP. These results support the hypothesis that the generalized and the localized forms of EOP are under different genetic control. J Periodontol 1994;65:219–223.
Effectiveness of Adjunctive Irrigation in Early Periodontitis: Multi‐Center Evaluation
Authors: Newman Michael G. , Cattabriga Marcello , Etienne Daniel , Flemmig Thomas , Sanz Mariano , Kornman Kenneth S. , Doherty Frances , Moore Debra J. , Ross Candy
Published: March 2012

The purpose of this study was to determine the effect of daily water irrigation versus regular oral hygiene alone on gingival and periodontal health in periodontitis patients receiving supportive periodontal treatment. The study also sought to determine if there are enhanced benefits from using an antiplaque zinc sulfate rinse as an irrigant. One hundred fifty‐five patients who have had periodontitis and had been treated either surgically or non‐surgically completed the 6‐month multi‐center multi‐national study. Patients with at least two 5 mm sites demonstrating bleeding on probing were assigned to 3 equal groups by balanced randomization. In all centers Group A (n = 57) performed regular oral hygiene only, and Group B (n = 58) irrigated with 500 ml water once daily after regular oral hygiene. Group C (n = 40) patients irrigated with a total of 500 ml once daily; following irrigation with 300 ml water, the patients then irrigated with an additional 200 ml with a zinc sulfate solution. The irrigants were diluted to provide the manufacturer's recommended daily dosage. The supragingival irrigation was performed with a commercially available oral irrigator. Bacterial measurements at baseline, 3 months, and 6 months were taken to determine the effect of irrigation on the target organisms and will be reported elsewhere. Gingival index: irrigation with water (Group B) was significantly better than normal oral hygiene (Group A) and irrigation with zinc sulfate (Group C) (P < 0.05) in reducing gingival inflammation. Bleeding on probing: significant reductions in bleeding on probing occurred for water (Group B) compared to normal oral hygiene (Group A) (P < 0.01). Among the patients with greater baseline bleeding (> 30% sites), irrigation with water (Group B) was significantly better than normal oral hygiene (Group A) in reducing bleeding on probing and gingival inflammation (P < 0.01); and water irrigation was significantly better than zinc sulfate irrigation (P < 0.05) for reducing gingival inflammation. Probing depth: irrigation with water (Group B) demonstrated clinically small, but statistically significant, reduction (P < 0.05) in probing depth compared to Group A and Group C. Plaque index: there were no significant differences observed. This study demonstrates that adjunctive supragingival irrigation with water can provide meaningful clinical outcomes for patients with periodontitis who are being treated in the maintenance phase of periodontal therapy. J Periodontol 1994; 65:224–229.
Influence of Tooth Instrumentation Roughness on Subgingival Microbial Colonization
Authors: Leknes Knut N. , Lie Tryggve , Wikesjö Ulf M.E. , Bogle Gary C. , Selvig Knut A.
Published: March 2012

This study evaluated microbial colonization of periodontal pockets subjected to root instrumentation with a curet or a rotating diamond. Ten maxillary and 10 mandibular subgingival pockets were established in the canines of 5 beagle dogs. The subgingival root surface areas were debrided by a sharp curet or a flame‐shaped, fine‐grained, rotating diamond point. The dogs were fed a plaque‐inducing diet for 70 days. Specimens from both instrumentation groups were then harvested and prepared for stereomicroscopic and scanning electron microscopic evaluation. Grading of the extent of subgingival colonization was performed in coded specimens directly on the fluorescent screen of the scanning electron microscope in a grid‐counting system. Error of the method was assessed by duplicate counts. The subgingival root surface areas were divided into 3 zones: cervical, middle, and apical, and statistical differences between these zones as well as between the 2 instrumentation groups were calculated. The results revealed that curettreated surfaces were smoother and promoted less subgingival colonization than diamondtreated surfaces. The difference in amount of bacterial colonization between the 2 groups was statistically significant (P <0.05) in all zones. Bacterial colonization decreased in apical direction in both instrumentation groups. For the diamond‐treated specimens, this decrease was significant (P <0.05) between each of the 3 zones. In the curet‐treated specimens, the decrease was significant only between the cervical and the apical zone (P <0.05). The present study has demonstrated that subgingival instrumentation roughness significantly influences the subgingival microbial colonization. J Periodontol 1994; 65:303–308.
Flow‐Cytometric Identification and Detection of Porphyromonas gingivalis by a LPS Specific Monoclonal Antibody
Authors: Kamiya Ichiro , Okuda Kazuhiro , Hara Kohji
Published: March 2012

The purpose of this study was to identify Porphyromonas gingivalis (P. gingivalis) by flow cytometry (FCM) using a monoclonal antibody (MAb) OMR‐Bg1E directed to P. gingivalis‐specific lipopolysaccharide (LPS). The P. gingivalis strains ATCC 33277, 381, ES075, W50, and A7A1 were selected for the study. Fusobacterium nucleatum (F. nucleatum), Prevotella intermedia (P. intermedia), Campylobacter rectus (C. rectus), Streptococcus sanguis (S. sanguis) and Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans) served as controls. A suspension of 107 bacteria/ml of each bacteria was prepared and then reacted with a P. gingivalis specific MAb OMR‐Bg1E and fluorescein isothiocyanate (FITC) labeled second antibody. These samples were analyzed by FCM. Bacterial specific binding aggregate on data was separated out by the forward and side‐angle‐scatter characteristics, while non‐specific binding (NSB) was eliminated by excluding the region with mouse IgG‐positive and second antibody‐positive area. FCM detected a mean range of 56.2% to 97.2% P. gingivalis strains. There was a 5.1% non‐specific binding using FCM to non‐P. gingivalis strains. When the P. gingivalis concentration was adjusted to 102, 104, and 106 bacteria/ml, a detection rate of 35.7%, 48.1%, and 91.4%, was respectively observed. The lower sensitivity of the flow cytometric assay was 102 bacteria/ml. When P. gingivalis was added to P. intermedia suspension at 1, 20, 40, 60, and 80%, the MAb‐positive fraction yielded by FCM displayed a coefficient of determination of 0.967 with the actual percentage of P. gingivalis and could be regressed to a linear function. The same P. gingivalis strain was then added to P. gingivalis‐fite native plaque samples at a final concentration of 0, 1, 5, 10, 15, 20, 40, 60, and 80%. The detection rate by flow cytometric analysis showed a significant correlation (P < 0.0001) with the actual percentage of P. gingivalis in the spiked plaque sample and the coefficient of determination to a linear regression curve was as high as 0.983. In competition experiments incubating MAb with LPS purified from P. gingivalis, subsequent reaction of MAb with the P. gingivalis whole cell was reduced. This study demonstrates the reliability of FCM analysis of P. gingivalis by the use of the MAb OMR‐Bg1E. Flow‐cytometric identification using P. gingivalis or other bacteria‐specific MAbs could offer a means for rapid screening and semi‐quantitation of periodontopathic bacteria in mixed cultures or plaque samples. J Periodontol 1994; 65:309–315.
The Effect of a Light‐Cured Periodontal Dressing Material on HeLa Cells and Fibroblasts In Vitro
Authors: Gilbert A. D. , Lloyd C. H. , Scrimgeour S. N.
Published: March 2012

The effect which a visible light‐curing periodontal dressing material based upon a urethane dimethacrylate resin has upon HeLa cells and fibroblasts in its uncured and fully cured states has been studied in vitro. Fully‐cured material has no effect on either cell type. Uncured material produces a surrounding zone of growth inhibition and cell death on direct contact. Inhibition is caused by the release into the medium of substances toxic to cells. However, this growth inhibition is overcome in time (5 days). It is suggested that partly‐cured material containing residual free monomer in contact with a healing gingival site could impede rapid repair. Nuclear magnetic resonance microimaging has shown that in places where there is a greater depth of material (e.g., interproximal regions) this underlying material may be partly cured. Increasing the exposure to the curing light will prevent (or minimize) the presence of partly‐cured material; the fully‐cured material being compatible with the cells. J Periodontol 1994; 65:324–329.
Technetium 99m‐MDP Scintigraphy of Patients Undergoing Implant Prosthetic Procedures: A Follow‐Up Study
Authors: Meidan Zeev , Weisman Shmuel , Baron Joseph , Binderman Itzhak
Published: March 2012

The clinical evaluation of peri‐implant tissue is mainly based on x‐rays. In recent years, radioisotope scintigraphy using Tc‐99m‐MDP (technetium‐99m‐methylene diphosphonate) proved to be a useful and reliable clinical method for measuring increased metabolic activity at specific sites of the skeletal tissue. Twenty‐six (26) patients (26 to 75 years) who were diagnosed for implant prosthetic treatment modality were randomly chosen to participate in this study. Each patient was injected with 20 mCi of Tc‐99m‐MDP was scanned 2 hours later by gamma‐camera for isotope uptake levels in the jaws. Each patient was scanned 1 to 4 times, starting 2 weeks after implant surgery and up to the 40th week postsurgery. Blade and screw type implants using the non‐submerged, one‐stage technique were placed. Therefore, the prosthetic reconstruction was initiated 2 weeks after implant surgery. In order to compare the different scans we formulated a relative “bone scan index” (BSI). The results of 62 scans were plotted as BSI against time after implant surgery. A mathematical regression analysis of the BSI was also performed. At the initial stage of 2 to 3 weeks after surgery the BSI is high and then gradually declines. While BSI of the implants in the mandible reaches baseline levels after 12 weeks, the BSI in the maxilla reaches baseline only after 20 weeks. On the other hand, there was no difference in BSI with regard to blade or screw type implant. Here we were able to demonstrate that the process is independent of implant modality and depends on the specific metabolic properties of the jaw. The BSI curves are used now in our clinic to diagnose peri‐implant tissue on the basis of normal or increased metabolic activity which is a dynamic measurement unlike the x‐ray. J Periodontol 1994; 65:330–335.
Clinical, Bacteriological, and Immunological Examinations and the Treatment Process of Two Papillon‐Lefèvre Syndrome Patients
Authors: Ishikawa Isao , Umeda Makoto , Laosrisin Narongsak
Published: March 2012

papillon‐lefèvre syndrome (pls) is a rare disease associated with the early onset of periodontal breakdown in deciduous and permanent dentition. The etiology of the destruction has not been completely clarified. Two female patients (ages 4 and 7 years) with severe destruction of the periodontal structures were examined. Except for palmar and plantar hyperkeratosis, dermatologie examination revealed no other medical disorders. On immunological analysis, measurement of serum antibody titers to 7 periodontopathic bacteria‐ including Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans was performed by enzyme‐linked immunosorbent assay (ELISA). Further immunblot analysis of A. actinomycetemcomitans and microbial culture of samples collected from deep periodontal pockets and mouthrinse solution were performed. The serum of the two patients showed high IgG titer against A. actinomycetemcomitans. Immunoblot results of the two patients against sonicated extract of A. actinomycetemcomitans Y4 strain exhibited a similar pattern. The band pattern differed from that observed in other forms of early onset periodontitis patients or periodontally healthy subjects. Moreover, A. actinomycetemcomitans colonies were cultured in high percentages from the pocket samples. Antibiotic therapy was instituted in addition to conventional periodontal therapy. In the younger patient, all deciduous teeth were extracted as part of the treatment and A. actinomycetemcomitans was no longer detected. All four permanent first molars and 8 permanent incisors subsequently erupted with healthy periodontium. However, the older patient did not improve after periodontal and antibiotic (minocycline and erythromycin) treatments and A. actinomycetemcomitans was consistently detected. Ofloxacin medication finally eliminated A. actinomycetemcomitans from the periodontal pockets. This antibiotic was also associated with reduced gingival inflammation and probing depth. Further destruction of the periodontium has not been detected for 3 years. The serum IgG titers against A. actinomycetemcomitans decreased in both patients. It is suggested that A. actinomycetemcomitans is a major pathogen closely related to periodontal tissue destruction in PLS patients. J Periodontol 1994; 65:364–371.
A Comparison of the Effect of Epidermal Growth Factor, Platelet‐Derived Growth Factor, and Fibroblast Growth Factor on Rat Periodontal Ligament Fibroblast‐Like Cells' DNA Synthesis and Morphology
Authors: Blom Søren , Holmstrup Palle , Dabelsteen Erik
Published: March 2012

An enhanced formation of bone, dentin, and collagen fibers in periodontal wounds after application of polypeptide growth factors has recently been reported. However, the complex environment in vivo makes it impossible to determine the specific effects of growth factors on various cells involved in the wound‐healing process. We have therefore investigated the mitogenic and morphogenic effects of recombinant epidermal growth factor (rEGF), natural platelet‐derived growth factor (nPDGF), and natural fibroblast growth factor (nFGF) on periodontal ligament fibroblast‐like cells. A cell line was established from rat PDL tissue. The cell line was characterized according to morphology, growth pattern, cytoskeletal proteins, and growth kinetics. The mitogenic effect of growth factors was assessed by incorporation of [3H]thymidine in the cellular DNA for 4 hours. Differences between groups of observations were assessed by the Student t‐test. The morphogenic effects of growth factors were described with respect to growth pattern, cell orientation, and cell and nucleus form after a random photographic recording. The fibroblast‐like cell type and the non‐transformed phenotype of the cell line have been identified by the presence of parameters considered to be characteristic of a normal fibroblast‐like cell line. The morphogenic analysis of both experimental and control cultures showed a monolayer of adherent cells with spindle or stellate morphology, a random alignment and round or elongated nuclei. Incorporation of [3H]‐thymidine was increased in a dose‐dependent manner by all growth factors. Maximal effect on the DNA synthesis was: rEGF, 131%; nPDGF, 274%; and nFGF, 182%. The results show that growth factors in high concentrations have no dramatic effects on the morphology of PDL fibroblast‐like cells. However, variation in the mitogenic potency of the growth factors should be considered when these growth factors are used in periodontal treatments in the future. J Periodontol 1994; 65:373–378.
Interleukin‐1β Concentration of Gingival Crevicular Fluid
Authors: Preiss Dagmar S. , Meyle Joerg
Published: March 2012

The concentration of interleukin‐1β is elevated in inflamed gingival tissue. Therefore a method for the measurement of interleukin‐1β (Il‐1β) in gingival crevicular fluid (GCF) using a commercially available Il‐1β ELISA was developed. GCF was collected with periopaper strips and 4 protocols of sampling using filter paper strips were tested; the method with a recovery rate of 111.9% (SD: ± 14.5%) was chosen for subsequent analysis of all samples. Il‐1β concentration in GCF of periodontitis patients and a healthy control group was determined. Patients (n = 19, mean age: 29.3 years) had not been treated. The healthy control group (n = 14, mean age: 22.8 years) showed, after a hygiene regimen of 2 weeks, no clinical signs of gingival/periodontal inflammation. Probing depth, clinical attachment level, bleeding upon probing, and a modified plaque index were recorded. Il‐1β could be detected in all GCF samples. The concentration ranged between 22.8 ng/ml and 150 ng/ml in the healthy control group and between 85.8 ng/ml and 882.2 ng/ml in the periodontitis patients. No sex‐related differences were noted. According to our present results the determination of GCF Il‐1β concentration is possible using commercially available test kits if the principle of sample preparation is adapted to the specific requirements of GCF analysis. J Periodontol 1994; 65:423–428.
The Effect of Platelet‐Derived Growth Factor on the Cellular Response of the Periodontium: An Autoradiographic Study on Dogs
Authors: Wang Hom‐Lay , Pappert Thomas D. , Castelli Walter A. , Chiego Daniel J. , Shyr Yu , Smith Billy A.
Published: March 2012

Platelet‐derived growth factor (PDGF) is a polypeptide growth factor considered to have a role in the proliferation and migration of fibroblasts at a wound healing site. The aim of this investigation was to determine if PDGF, when applied to root surfaces, would stimulate the proliferation of fibroblasts and further enhance regeneration. Six mongrel dogs with healthy periodontia were selected for this study. Using a closed wound surgical model, standardized 4 × 4 mm fenestration defects were created into dentin on the mid‐facial of the mesial and distal roots of 4 mandibular posterior teeth in each quadrant. Each defect received either: 1) saline solution (C); 2) expanded polytetrafluoroethylene (ePTFE) membrane; 3) PDGF; or 4) ePTFE + PDGF. 3H‐thymidine was administered 1 hour prior to animal sacrifice at 1, 3, and 7 days postsurgery. Each time period included 2 dogs with each dog undergoing the four different treatments. Slides were prepared for autoradiography. 3H‐thymidine‐labeled cells were counted and results were statistically analyzed using the Bonferroni (Dunn) t test on the SAS program. Results indicated PDGF enhanced fibroblast proliferation when compared to the groups without PDGF. Significant differences (P < 0.05) were noted at day 1 and 7 when PDGF and PDGF + GT were compared to C and GT groups. No significant differences were observed in labeled fibroblasts between the C and GT groups at any time period. These findings suggest that PDGF enhances fibroblast proliferation in early periodontal wound healing, whether used alone or in combination with the ePTFE membrane. J Periodontol 1994;65:429–436.
The Connective Tissue With Partial Thickness Double Pedicle Graft: The Results of 100 Consecutively‐Treated Defects
Authors: Harris Randall J.
Published: March 2012

Obtaining predictable root coverage has been a goal of periodontal therapy for some time. The connective tissue with partial thickness double pedicle graft has been shown to produce predictable esthetic root coverage. The purpose of this study was to examine the results of the surgical technique on 100 consecutively treated defects. The procedure produced a mean root coverage of 97.7%. Root coverage of 100% was obtained 89% of the time. With this technique, esthetic root coverage can be accomplished in a predictable manner. Additionally, it was the intent of this study to examine whether or not certain factors could be associated with root coverage results. Factors that could be associated with root coverage success or lack of success included: size of the pedicle, previous free gingival graft, and plaque control during the postoperative period. Factors that did not appear to be related to root coverage included: history of smoking (heavy or light), defect width, defect depth, history of snuff use, history of orthodontics, tooth type treated, number of defects treated, age, preoperative bleeding on probing, preoperative plaque present, esthetic concerns of the patient, and surgical experience of the operator. Additionally, attached gingiva levels were not a factor if the areas had not been treated with a free gingival graft. J Periodontol 1994; 65:448–461.
Methods of Assessing Risk for Periodontitis and Developing Multifactorial Models
Authors: Beck James D.
Published: March 2012

In assessing risk for disease, periodontitis can be thought to be more like some of our common medical conditions: certain people are at higher risk than others, and efforts at prevention and intervention involve a combination of personal behaviors and professional practices. This paper presents some principles of designing risk assessment studies. In addition, the choices that must be made in deciding what is high risk and the type of model to be constructed are presented along with implications of each alternative. Terms such as risk indicators, risk factors, risk predictors, risk models, and prediction models are presented and discussed. To illustrate some of the issues, findings from the Piedmont 65+ Dental Study (a longitudinal study of oral health in older adults) indicate that: 1) indicators of risk developed from cross‐sectional studies quite often are not confirmed as risk factors in longitudinal studies and longitudinal data implicate additional factors; 2) oral risk factors were important in explaining disease progression, but other categories of risk factors also played an explanatory role; 3) the risk models were able to predict who would experience attachment loss at some time during the 3‐year period with a high degree of accuracy, but there was only moderate success at predicting who would not experience attachment loss; 4) including risk predictors in the models did improve the ability of one model to predict attachment loss, but the risk predictor masked the presence of an important risk factor; and 5) it is highly likely that adding measures of host defense mechanism to the study could result in improved models. J Periodontol 1994;65:468–478.
Genetic and Heritable Risk Factors in Periodontal Disease
Authors: Michalowicz Bryan S.
Published: March 2012

The purpose of this paper is to review current knowledge of genetic risk factors for the periodontal diseases and to present updated and additional data from the Minnesota Twin Periodontal Study. Family studies suggest that susceptibility to the early onset forms of disease, particularly prepubertal and juvenile periodontitis, is, at least in part, influenced by host genotype. Inherited phagocytic cell deficiencies appear to confer risk for prepubertal periodontitis. The prevalence and distribution of juvenile periodontitis in affected families are most consistent with an autosomal recessive mode of inheritance. However, considerable etiologic as well as genetic heterogeneity within these clinically‐defined diseases is evident. Whether or not genetic factors influence the more common adult chronic periodontitis is less clear. Although results from family studies suggest that environmental factors appear to be the major determinants of variance in adult periodontitis, data from our twin studies indicate that both genetic and environmental factors influence disease. Furthermore, comparisons between reared‐together and reared‐apart adult monozygous twins indicate that early family environment has no appreciable influence on probing depth and attachment loss measures in adults. J Periodontol 1994;65:479–488.
Neutrophil Defects as Risk Factors for Periodontal Diseases
Authors: Hart Thomas C. , Shapira Lior , Van Dyke Thomas E.
Published: March 2012

There are several hypotheses proposed for the etiologic mechanisms causing periodontal diseases. These include a paradigm in which all individuals are equally susceptible to one or several pathogenic bacteria; a second paradigm that holds that all bacteria are equally virulent and that host susceptibility determines onset of disease; or a combination of the above. In this review, we analyze the role of neutrophil dysfunction as a risk factor for the onset of periodontitis. Both intrinsic or genetically inherited abnormalities of neutrophils and acquired neutrophil abnormalities are considered. While a large body of data implicates neutrophil dysfunction, either intrinsic or acquired (bacterially or extrinsically induced), as a significant risk factor for the periodontal diseases, clear, prospective, longitudinal epidemiologic studies to evaluate this association remain to be performed. J Periodontol 1994; 65:521–529.
Tobacco Use as a Risk Factor
Authors: Bergström Jan , Preber Hans
Published: March 2012

Tobacco, particularly tobacco smoking, has a substantial influence on periodontal health and disease. It is associated with an increased disease rate in terms of periodontal bone loss, periodontal attachment loss, as well as periodontal pocket formation. In addition, it exerts a masking effect on gingival symptoms of inflammation. Risk assessment based on an increasing body of investigations over the past few years suggests that the tobacco attributable risk is considerable, estimated odds ratios being of the order 2.5 to 6.0 or even greater. Although the mechanisms by which tobacco exerts its influence are obscure, information available to date does not support the view that its action simply relates to other environmental factors such as the dental plaque or some specific microflora. It seems more likely that it primarily has a systemic influence affecting host response or susceptibility. The chief novelty of the present report is that current data suggest that, although the overall disease prevalence is decreasing, the proportion of periodontal disease attributed to tobacco is stable or even increasing. This seems to be analogous to what has been observed for other smoking‐associated chronic diseases. This, in turn, indicates that periodontal disease behaves like several other chronic diseases and, further, that tobacco should be considered a major risk factor for chronic periodontal disease. J Periodontol 1994;65:545–550.
Utilization of Dental Services as a Risk Factor for Periodontitis
Authors: Brown L.J. , Garcia R.
Published: March 2012

The relation between utilization of dental services from community dentists and the extent and severity of alveolar bone loss is reported for a panel of men followed for over 6 years. Oral health data were collected by the Department of Veterans Affairs, Dental Longitudinal Study, which began in 1969 and still continues. Participants have received regular oral examinations approximately every 3 years. A variety of oral health conditions were assessed, including plaque, calculus, gingival inflammation, probing depth, tooth mobility, clinical attachment level, and alveolar bone loss. Utilization data were abstracted from the dental records of dental offices that participants attended from 1979 through 1988. Multivariate modeling as well as comparisons of high utilizers and non‐utilizers indicate that utilization of routine diagnostic and preventive services was not predictive of the extent and severity of periodontitis. J Periodontol 1994; 65:551–563.