bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiments with P2P Botnet Detection
Authors: Rivière Lionel , Dietrich Sven
Published: March 2012

Botnets, which are used to perform various malicious activities, have become a major threat in recent years. Spamming, phishing, stealing sensitive information, conducting distributed denial of service (DDoS) attacks, scanning to find more hosts to compromise using malware are the goals of many botnets, sometimes of low-profile botnets such as the Nugache botnet [1] which used a peer-to-peer (P2P) structure. Some botnets hide their network activities for many months (and maybe years) before being noticed. Networks might contain more deceptive or dormant bots which haven´t been exposed yet. Here we apply an a posteriori detection approach based on mutual contacts peers exchange in a network, called the dye-pumping algorithm [2]. After briefly recalling typical botnet operations, we will talk further about the dye-pumping algorithm (DPA) mechanism and implementation, its input data structures, and then give a short analysis of the results of our experiment.
The aging myostatin null phenotype: reduced adiposity, cardiac hypertrophy, enhanced cardiac stress response, and sexual dimorphism
Authors: Jackson Melissa F , Luong Dung , Vang Dor Dor , Garikipati Dilip K , Stanton James B , Nelson O Lynne , Rodgers Buel D
Published: March 2012

The natural aging process results in the physiological decline of multiple tissues and organ systems. Changes commonly occur with middle age and include decreased skeletal muscle mass, bone mineral density, cardiac output, and insulin sensitivity, and increased adiposity, all of which can contribute to the onset of sarcopenia, osteoporosis, heart failure, or type 2 diabetes. Recent studies suggest that myostatin may influence many of these systems. We therefore sought to determine whether they are affected by aging, especially in ‘middle-aged’Mstn−/−mice (12–20 months old (m.o.)). Although body weights were similar in wild-type (WT) andMstn−/−mice, lean fat-free mass and skeletal muscles composed of predominantly type I, II, and mixed fibers were significantly heavier inMstn−/−mice. These differences were accompanied by lower total adiposity, especially in female mice, white and brown fat pad weights, and adipocyte size. Hearts were heavier inMstn−/−mice across a large age range (3–24 m.o.) and exhibited signs of dilated cardiomyopathy at rest, which include lower strain measurements compared with WT myocardium. However,Mstn−/−mice responded better to isoproterenol stress tests with greater increases in fractional shortening and ejection fraction—differences that were again more apparent in females and which are consistent with physiological cardiac hypertrophy. Spleens and kidneys were also smaller, although histologically normal, inMstn−/−mice. These data together suggest that attenuating myostatin could potentially prevent or possibly treat pathological conditions that develop with age. Additional studies are nevertheless needed to definitively assess potential risks to cardiac function.
Role of Copy Number Variants in Structural Birth Defects
Authors: Southard Abigail E. , Edelmann Lisa J. , Gelb Bruce D.
Published: March 2012

BACKGROUND AND OBJECTIVE:

Human genomes include copy number variants (CNVs), defined as regions with DNA gains or losses. Pathologic CNVs, which are larger and often occur de novo, are increasingly associated with disease. Given advances in genetic testing, namely microarray-based comparative genomic hybridization and single nucleotide polymorphism arrays, previously unidentified genotypic aberrations can now be correlated with phenotypic anomalies. The objective of this study was to conduct a nonsystematic literature review to document the role of CNVs as they relate to isolated structural anomalies of the craniofacial, respiratory, renal, and cardiac systems.

METHODS:

All full-length articles in the PubMed database through May 2011 that discussed CNVs and isolated structural defects of the craniofacial, respiratory, renal, and cardiac systems were considered. Search terms queried include CNV, copy number variation, array comparative genomic hybridization, birth defects, craniofacial defects, respiratory defects, renal defects, and congenital heart disease. Reports published in languages other than English and articles regarding CNVs and neurocognitive deficits were not considered.

RESULTS:

Evidence supports that putatively pathogenic CNVs occur at an increased frequency in patients with isolated structural birth defects and implicate specific regions of the genome. Through CNV detection, advances have been made in identifying genes and specific loci that underlie isolated birth defects.

CONCLUSIONS:

Although limited studies have been published, the promising evidence reviewed here warrants the continued investigation of CNVs in children with isolated structural birth defects. Patient care and genetic counseling stand to improve through a better understanding of CNVs and their effect on disease phenotype.
Triage Nurse Initiation of Corticosteroids in Pediatric Asthma Is Associated With Improved Emergency Department Efficiency
Authors: Zemek Roger , Plint Amy , Osmond Martin H. , Kovesi Tom , Correll Rhonda , Perri Nicholas , Barrowman Nick
Published: March 2012

OBJECTIVE:

To assess the effectiveness of nurse-initiated administration of oral corticosteroids before physician assessment in moderate to severe acute asthma exacerbations in the pediatric ED.

METHODS:

A time-series controlled trial evaluated nurse initiation of treatment with steroids before physician assessment in children with Pediatric Respiratory Assessment Measure score ≥4. One-to-one periods (physician-initiated and nurse-initiated) were analyzed from September 2009 through May 2010. In both phases, triage nurses initiated bronchodilator therapy before physician assessment, per Pediatric Respiratory Assessment Measure score. We reviewed charts of 644 consecutive children aged 2 to 17 years for the following outcomes: admission rate; times to clinical improvement, steroid receipt, mild status, and discharge; and rate of return ED visit and subsequent admission.

RESULTS:

Nurse-initiated phase children improved earlier compared to physician-initiated phase (median difference: 24 minutes; 95% confidence interval [CI]: 1–50; P = .04). Admission was less likely if children received steroids at triage (odds ratio = 0.56; 95% CI: 0.36–0.87). Efficiency gains were made in time to steroid receipt (median difference: 44 minutes; 95% CI: 39–50; P < .001), time to mild status (median difference: 51 minutes; 95% CI: 17–84; P = .04), and time to discharge (median difference: 44 minutes; 95% CI: 17–68; P = .02). No differences were found in return visit rate or subsequent admission.

CONCLUSIONS:

Triage nurse initiation of oral corticosteroid before physician assessment was associated with reduced times to clinical improvement and discharge, and reduced admission rates in children presenting with moderate to severe acute asthma exacerbations.
Tight Glycemic Control With Insulin in Hyperglycemic Preterm Babies: A Randomized Controlled Trial
Authors: Alsweiler Jane M. , Harding Jane E. , Bloomfield Frank H.
Published: March 2012

OBJECTIVE:

The optimal treatment of neonatal hyperglycemia is unclear. The aim of this trial was to determine whether tight glycemic control with insulin improves growth in hyperglycemic preterm infants, without increasing the incidence of hypoglycemia.

METHODS:

Randomized, controlled, nonblinded trial of 88 infants born at <30 weeks’ gestation or <1500 g who developed hyperglycemia (2 consecutive blood glucose concentrations (BGC) >8.5 mmol/L, 4 hours apart) and were randomly assigned to tight glycemic control with insulin (target BGC 4–6 mmol/L, “tight” group) or standard practice (restrictive guidelines for starting insulin, target BGC 8–10 mmol/L, “control” group). The primary outcome was linear growth rate to 36 weeks’ postmenstrual age.

RESULTS:

Eighty-eight infants were randomly assigned (tight group n = 43; control group n = 45). Infants in the tight group had a lesser lower leg growth rate (P < .05), but greater head circumference growth (P < .0005) and greater weight gain (P < .001) to 36 weeks’ postmenstrual age than control infants. Tight group infants had lower daily BGC (median [interquartile range] 5.7 [4.8–6.7] vs 6.5 [5.1–8.2] mmol/L, P < .001) and greater incidence of hypoglycemia (BGC <2.6 mmol/L) (25/43 vs 12/45, P < .01) than controls. There were no significant differences in nutritional intake, or in the incidences of mortality or morbidity.

CONCLUSIONS:

Tight glycemic control with insulin in hyperglycemic preterm infants increases weight gain and head growth, but at the expense of reduced linear growth and increased risk of hypoglycemia. The balance of risks and benefits of insulin treatment in hyperglycemic preterm neonates remains uncertain.
The potential use of cannabidiol in the therapy of metabolic syndrome
Authors: Kleiner Dénes , Ditrói Kálmán
Published: March 2012

Cannabidiol, a cannabinoid and serotonin receptor antagonist, may alleviate hyperphagia without the side effects of rimonabant (for example depression and reduced insulin sensitivity). Similar to the peroxisome proliferator-activated receptor-gamma agonists, it may also help the differentation of adipocytes. Cannabidiol has an immunomodulant effect as well that helps lessen the progression of atherosclerosis induced by high glucose level. It may also be effective in fighting ischaemic diseases, the most harmful complications of metabolic syndrome. However, it can only be administered as an adjuvant therapy because of its low binding potency, and its inhibiting effect of cytochrome P450 enzymes should also be considered. Nevertheless,,it may be beneficially used in adjuvent therapy because of its weak side-effect profile. Orv. Hetil., 2012, 153, 499–504.
Advances in the prevention, diagnosis and therapy of vascular diseases
Authors: Szabó Katalin Judit , Ádány Róza , Balla József , Balogh Zoltán , Boda Zoltán , Édes István , Fekete István , Káplár Miklós , Mátyus János , Oláh László , Olvasztó Sándor , Paragh György , Páll Dénes , Pfliegler György , Vajda Gusztáv , Zeher Margit , Csiba László
Published: March 2012

Atherosclerosis is a systemic disease affecting the coronary, carotid, intracerebral, renal and peripherial arteries. The early morphological and functional impairments could be detected in the second or third decades of life and their progression depend on the number and severity of risk factors and individual susceptility. Although the vascular risk factors (smoking, overweight, age, unhealthy diet, lack of physical exercise, hypertension, diabetes mellitus, chronic kidney disease and dyslipidemia) are the same and common in the different vascular diseases, the present clinical routine artificially classifies the diagnosis and therapy of different vascular diseases into different subfields of medicine with the negative impact of possible polypragmasia. Recently, worldwide health surveys (e.g. REACH registry) have proven the usefulness of a holistic approach in the diagnosis and therapy of multiorgan-affected vascular patients. This review summarizes the multidisciplinary advances and future perspective of vascular diseases. Orv. Hetil., 2012, 153, 483–498.
Comment to paper “Penetration depth and tip radius dependence on the correction factor in nanoindentation measurements” by J.M. Meza et al. [J. Mater. Res. 23(3), 725 (2008)]
Authors: Durst Karsten , Rehman Hamad ur , Merle Benoit
Published: March 2012

[Meza et al. J. Mater. Res.23(3), 725 (2008)] recently claimed that the correction factor beta for the Sneddon equation, used for the evaluation of nanoindentation load-displacement data, is strongly depth- and tip-shape-dependent. Meza et al. used finite element (FE) analysis to simulate the contact between conical or spheroconical indenters, and an elastic material. They calculated the beta factor by comparing the simulated contact stiffness with Sneddon’s prediction for conical indenters. Their analysis is misleading, and it is shown here that by applying the general Sneddon equation, taking into account the true contact area, an almost constant and depth-independent beta factor is obtained for conical, spherical and spheroconical indenter geometries.
Strength properties of self-compacting mortar mixed with GGBFS
Authors: Lim Siong Kang , Ling Tung Chai , Hussin Mohd Warid
Published: March 2012

Self-compacting cement grout (SCCG) is an economical and effective material used for repairing structural cracks. However, in terms of raw material cost, SCCG is higher than for conventional concrete due to the high cement volumes at relatively low water–binder ratios to achieve satisfactory combinations of high fluidity and stability. It is expected that ground-granulated blast furnace slag (GGBFS) can be used as an alternative material to replace a high volume of cement in preparing self-compacting repair mortar (SCRM). In this study, the effects of GGBFS content on both fresh and hardened properties of SCRM were investigated. The influence of different curing conditions on long-term compressive strength was also studied. In addition, the microstructure of some mixes at the age of 6 months was also observed by using scanning electron microscopy. The results show that the workability and final bleeding value of fresh SCRM decreased with the increase in GGBFS content. At early ages, the compressive strength rate of SCRM incorporating GGBFS was lower but it increased with time and became more pronounced at 30 to 50% replacement level. Thus, the maximum limit of GGBFS replacement is suggested to be controlled at 50% to make the most excellent development in long-term compressive strength. As for curing conditions, specimens stored in water showed higher gain in long-term strength than those samples exposed to air and natural weather weathering conditions.
Flexural fatigue strength of hybrid fibrous concrete beams
Authors: Singh Surinder P. , Singh Amrit P. , Bajaj Vineet
Published: March 2012

The paper presents a study on the flexural fatigue strength of hybrid fibre-reinforced concrete (HyFRC) containing different proportions of steel and polypropylene fibres. An experimental programme was conducted to obtain the fatigue lives of HyFRC specimens at different stress levels in which approximately 113 flexural fatigue tests were conducted. Approximately 60 complimentary static flexural tests were executed for reference purpose. The specimen incorporated different proportions of steel fibres and polypropylene fibres in the ratio of 25–75%, 50–50% and 75–25% by volume. The total fibre content was kept at 1·0% by volume. The test data was used to estimate the coefficients of the fatigue equations representing S–N diagrams. The fatigue test data has also been employed to determine a relationship between fatigue stress level S, fatigue life N and probability of failure Pf, and to generate a family of S–N–Pf curves for HyFRC. The experimental coefficients of the fatigue equation were also obtained from the fatigue test data to represent the S–N–Pf curves analytically.
Cervical Cemental Tears in Older Patients With Adult Periodontitis. Case Reports
Authors: Ishikawa Isao , Oda Shigeru , Hayashi Joichiro , Arakawa Shinichi
Published: March 2012

This communication reports 5 cases of cervical and 1 apical cemental tears. The diagnosis of the cervical tears was made by a characteristic feature which presented radiographically as a prickle‐like body. The fragment of cementum could be detached by root planing or during periodontal surgery and uneventful healing was obtained following these procedures. The process of aging in addition to continuous occlusal strain may lead to this phenomenon. Cervical cemental tear may be one of the contributing factors in the progress of adult periodontitis. J Periodontol 1996;67:15–20.
Reduction of Aerosols Produced by Ultrasonic Sealers
Authors: Harrel Stephen K. , Barnes James B. , Rivera‐Hidalgo Francisco
Published: March 2012

There is concern with decreased air quality and potential aerosol contamination in the dental operatory. This problem has been addressed by the Centers for Disease Control and Prevention, which recommends that all sources of blood‐contaminated splatter and aerosols be minimized. One of the major sources of potential aerosol contamination in the dental setting is the ultrasonic sealer. This study looks at the use of a high volume evacuator attachment for the ultrasonic sealer handpiece. Artificial teeth were mock‐scaled for 1 minute with and without the evacuator attachment. The mock scaling was performed within a plastic enclosure that had a 1 cm grid laid out on 4 sides. Scaling was performed 10 times each by 2 operators. An erythrosin solution was used for the ultrasonic sealer coolant with a coolant volume of 17.5 ml/min. The number of squares containing a red erythrosin spot were counted and considered to represent aerosol contamination. The high volume evacuator attachment produced a 93% reduction in the number of contaminated squares (chi squared significant at P < 0.05). There was no increase in heat transfer to a tooth analogue when the high volume evacuator attachment was used with the ultrasonic sealer as compared to the sealer without the evacuator attachment. It is felt that the high volume evacuator attachment is capable of significantly reducing the amount of aerosol contamination produced within the test system without increased heat transfer to the tooth. J Periodontol 1996;67:28–32.
Spatial Resolution and Angular Alignment Tolerance in Radiometric Analysis of Alveolar Bone Change
Authors: Shrout Michael K. , Weaver John , Potter Brad J. , Hildebolt Charles F.
Published: March 2012

This pilot study was undertaken to determine the effect of x‐ray beam alignment and spatial resolution on quantification of alveolar bone using radiometric techniques. Six (6) dry mandibles were radiographed at 70 kVp, 10 mA, 0.6 seconds using D‐speed film, with a bone chip (2.64, 4.10, or 6.07 mg) present or absent at 7 x‐ray beam alignments (0°, 2° horizontal, 2° vertical, 4° horizontal, 4° vertical, 6° horizontal, 6° vertical). This resulted in 28 radiographs per mandible. Radiographs were digitized using 50‐ and 200‐μm pixel spatial resolution. Image gray levels were standardized using a simple look‐up table shift. Regions of interest (ROIs) were positioned on the alveolar bone where the bone chips had been placed. Cumulative percent histograms (CPH) were calculated for those ROIs. Regression analysis was used to evaluate the relationships between CPH changes and bone chip size as x‐ray beam angulation and spatial resolution was varied. The resulting R2 values for angulation ranges of 0° to 1.4°, 1.5° to 2.4°, and 2.5° to 5.5° were: 0.983, 0.941, 0.891 for 50‐μm pixel images and 0.869, 0.909, and 0.774 for 200‐μm pixel images. We conclude that 50‐μm pixel spatial resolution is apparently superior to 200‐μm pixel images if radiometric data is to be evaluated. With 50‐μm pixel spatial resolution, alignment variations up to 5° may be acceptable in clinical studies, depending on the magnitude of bone change that is to be detected. J Periodontol 1996;67:41–45.
Repair of a Defect Following the Removal of a Maxillary Adenomatoid Odontogenic Tumor Using Guided Tissue Regeneration. A Case Report
Authors: Vitkus Robert , Meltzer Jeffrey A.
Published: March 2012

Adenomatoid odontogenic tumors (AOT) make up 3% of odontogenic tumors. This tumor, most commonly found in the maxillary arch, mimics a follicular cyst associated with an impacted tooth. This, is a case report of an AOT found in a 14‐year‐old female undergoing active orthodontic therapy. The surgical removal of the lesion resulted in the exposure of a large bony cavity surrounding the maxillary left canine. Placement of freeze‐dried bone and coverage with an expanded polytetrafluoroethylene membrane resulted in rapid and complete healing of the lesion and restoration of osseous support. J Periodontol 1996;67:46–50.
Early‐Onset Periodontitis Associated With Weary‐Kindler Syndrome: A Case Report
Authors: Wiebe Colin B. , Silver John G. , Larjava Hannu S.
Published: March 2012

Weary‐kindler syndrome is a rare and poorly understood genetic disorder that has manifestations of both epidermolysis bullosa and poikiloderma congenitale. There are approximately 70 cases documented in the past 40 years but no cases appear in the dental literature, although dental findings have been discussed superficially in dermatological and pediatrie publications. This case reports on the periodontal findings and treatment for a 16‐year‐old female diagnosed with the syndrome. Early exfoliation of deciduous teeth, severe periodontal bone loss around many permanent teeth, and fragile bleeding gingiva were key features. Microbiological testing revealed an absence of Actinobacillus actinomycetemcomitans and low levels of other commonly accepted periodontal pathogens. Tests for inflammation, including AST and elastase, were positive prior to therapy and greatly decreased after mechanical root instrumentation. A beneficial effect of non‐surgical periodontal therapy was observed in the short‐term follow‐up. J Periodontol 1996;67:1004–1010.
Clinical and Histologic Observations of Sites Implanted With Intraoral Autologous Bone Grafts or Allografts. 15 Human Case Reports
Authors: Becker William , Urist Marshall , Becker Burton E. , Jackson William , Party David Andrew , Bartold Mark , Vincenzzi Gianpaolo , De Georges Dino , Niederwanger Markus
Published: March 2012

The cases reported in this paper were treated at 7 different clinical centers and present clinical and histologic observations from 15 patients and 21 human biopsies. The biopsies were taken from extraction sockets or dental implant sites which were grafted with either autologous intra‐oral bone (6 sites), demineralized freeze‐dried bone (DFDBA) (7 sites), or mineralized freeze‐dried bone (MFDBA) (7 sites), or a combination of autologous bone, DFDBA and a barrier membrane (1 site). Six sites were grafted with DFDBA and augmented with expanded polytetrafluoroethylene (ePTFE) barrier membranes. Biopsies for histological evaluation were taken 4 to 13 months after implantation. A bone scoring system of 0 to 4 was used to evaluate the sections for dead implanted particles or the presence of vital bone. A bone score of 3 indicated the presence of dead implant material, blood vessels, islands of cartilage, osteoblasts, and new bone formation. A score of 4 indicated total replacement of the implanted material by the host bone. The average bone score for sites which received autologous bone was 2.33; for DFDBA sites, 0.98; and MFDBA was 0.18. The over‐riding histologic characteristic of sites implanted with DFDBA or MFDBA was retention of non‐vital graft particles within fibrous connective tissue. Biopsies taken adjacent to the host bed demonstrated incorporation of the allografts (osteoconduction). Sites grafted with autologous bone chips also demonstrated non‐vital bone chips surrounded by vital host bone (osteoconduction). Sites which received barrier membranes did not appear to improve or impair bone healing of the augmented sites. Autologous bone chips harvested from within the oral cavity as well as allografts may serve as biologic fillers, but do not apparently contribute to osteoinduction. Autologous bone will eventually be resorbed and replaced by the host. DFDBA and MFDBA are resorbed very slowly and apparently do not contribute to osteoinduction. Allografts apparently are not resorbed by osteoclasts and therefore their continued use around dental implants is questioned. J Periodontol 1996;67:1025–1033.
Compliance With Supportive Periodontal Therapy and Its Relation to the Bleeding Index
Authors: Novaes Arthur B. , de Lima Fernando Reno , Novaes Arthur B.
Published: March 2012

This is a retrospective study of 418 patients who received active periodontal treatment between the years of 1984 and 1990. The patients were instructed to return for supportive periodontal treatment (SPT) at 3 to 6‐month intervals. The objective of this study was to evaluate patient compliance with periodic recall visits, and to study the relationship of bleeding upon probing in those who returned regularly. The patients were divided into 3 groups: patients who returned periodically for supportive treatment, patients who interrupted the proposed maintenance treatment, and patients who never returned after active periodontal treatment. Analysis was made for each group to correlate the degree of compliance with gender, disease classification, and type of treatment received. To analyze bleeding upon probing, 2 groups of patients were selected: a test group with 39 patients who had attended at least 10 recall visits and participated in the study for more than 40 months, and a control group of 21 patients who interrupted the SPT for at least 12 months. The results showed that 26% of the treated patients returned for SPT and, of those, 40% returned irregularly. There was a statistical significant difference in compliance in relation to disease classification and the type of treatment received, but no correlation was found between compliance and gender. There was a statistically significant difference in compliance between the test group and the control group in relation to the variation of the bleeding index. J Periodontol 1996;67:976–980.
Porous Polysulfone Coated With Platelet‐Derived Growth Factor‐BB Stimulates Proliferation of Human Periodontal Ligament Fibroblasts
Authors: Mailhot Jason M. , Sharawy Mohamed M. , Galal Mohamed , Oldham Arlene M. , Russell Cari M.
Published: March 2012

The purpose of this study was to investigate if the treatment of porous polysulfone (PPSF) with various concentrations of platelet‐derived growth factor‐BB (PDGF‐BB) would stimulate the proliferation of the adherent human periodontal ligament fibroblasts (HPDLF) in culture. Sterilized PPSF cylinders were immersed in an Eagle's minimum essential medium supplemented with 0.5% fetal bovine serum and 1% penicillin/streptomycin‐containing either 0, 10, 20, or 50 ng/ml of PDGF‐BB for 24 hours. After 24 hours, the PPSF cylinders were removed and allowed to dry then placed in culture plates for each time point. Pooled HPDLF (8 × 104) and 3H‐thymidine in medium were pipetted into each well to cover the treated and control PPSF cylinders and plates were then incubated. At 1, 4, and 10 days the PPSF cylinders were removed and macromolecular precipitation was performed. Incorporation of 3H‐thymidine was measured and a 2‐way ANOVA with repeated measures was performed. In addition, determination of binding and release was performed using I125‐PDGF‐BB treated PPSF at 0, 2, 12, and 24 hours, and at 4 and 10 days. Results showed that the effects on HPDLF were significant for dose (P = 0.0012; F = 5.74) and time (P = 0.0001; F = 40.83). At 4 days, the percent increases above the control for the doses 10, 20, and 50 ng/ml were 192%, 310%, and 162% respectively. In conclusion, our findings suggest that treating PPSF with PDGF‐BB results in a significant increase in the proliferation of HPDLF cells adherent to PPSF. J Periodontol 1996;67:981–985.
PCR Reaction and Dot‐Blot Hybridization to Monitor the Distribution of Oral Pathogens Within Plaque Samples of Periodontally Healthy Individuals
Authors: Conrads Georg , Mutters Reinier , Fischer Jutta , Brauner Astrid , Lütticken Rudolf , Lampert Friedrich
Published: March 2012

The purpose of this study was to determine the distribution of the putative periodontal pathogens Prevotella intermedia, Prevotella nigrescens, the three oral Capnocytophaga species (C. ochracea, C. sputigena, C. gingivalis), as well as Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in plaque samples of periodontally healthy individuals. We chose a newly developed 16S rDNA directed Polymerase chain reaction (PCR) and a previously described dot‐blot hybridization assay to detect, differentiate, and quantify these bacteria directly in clinical samples. The subjects of these investigations were 66 sulcus fluid samples from 17 children (ages 3 to 5) attending a kindergarten, 48 sulcus fluid samples from 12 children (ages 9 and 10) from a primary school, and 25 subgingival plaque samples isolated from 6 different periodontally healthy dental students (ages 24 to 27). We were able to demonstrate the presence of P. nigrescens in 54 (kindergarten: 5; primary school: 33; students: 16) samples by PCR and quantified it by dot‐blot hybridization. In addition, we found C. ochracea in 12 (kindergarten: 2; primary school: 10) samples by PCR reaction only. The other tested bacterial species were absent by the methods used. Furthermore we confirmed the specificity of our P. nigrescens‐PCR in selected samples by enzyme electrophoresis. J Periodontol 1996;67:994–1003.
Cigarette Smoking Increases the Risk for Subgingival Infection With Periodontal Pathogens
Authors: Zambon J.J. , Grossi S.G. , Machtei E.E. , Ho A.W. , Dunford R. , Genco R.J.
Published: March 2012

Cigarette smoking has been found to increase the risk for periodontitis. The present study examined the association between cigarette smoking and subgingival infection with periodontal pathogens to determine if smokers are more likely to be infected with certain periodontal pathogens than non‐smokers. Self‐reported data on 1,426 subjects, aged 25 to 74, from the Erie County Study were obtained including data on 798 subjects who were current or former smokers. Mean clinical attachment loss was used to estimate the severity of periodontal destruction. Subgingival infection with target periodontal pathogens was determined by indirect immunofluorescence microscopy. Smokers harbored significantly higher levels and were at significantly greater risk of infection with Bacteroides forsythus than non‐smokers. Adjusting for disease severity, the risk of subgingival infection with B. forsythus in current smokers was 2.3 times that of former smokers or non‐smokers. The relative risk of B. forsythus infection also increased 1.18 times for every category of smoking as the amount of smoking measured in packyears increased from very light to heavy. Adjusting for disease severity, Porphyromonas gingivalis was also more likely to subgingivally infect smokers than non‐smokers; however, there was not a significantly higher relative risk for infection with this bacterium. The data from this study indicate that cigarette smoking increases the likelihood of subgingival infection with certain periodontal pathogens. This may partly explain the increased risk for periodontitis seen in smokers. J Periodontol 1996;67:1050–1054.
Medications as Risk Factors for Periodontal Disease
Authors: Ciando Sebastian G.
Published: March 2012

As the United States population ages, people will be taking more medications which may benefit their general health but not necessarily their periodontal health. The effects of medications have been grouped into six categories as follows: behavioral alteration of oral hygiene methods, alteration of plaque composition, effect on gingival tissues, effect on alveolar bone, effect on gingival crevicular fluid, and effect on salivary flow. Although most medications discussed in this paper increase the risk for periodontal disease, a few may actually decrease the risk. These include the effect of Phenytoin on alveolar bone, the antibacterial effect of antibiotics, the anticollagenolytic effects of tetracyclines, and the effect of non‐steroidal anti‐inflammatory drugs on decreasing alveolar bone resorption. J Periodontol 1996;67:1055–1059.
The Role of Osteopenia in Oral Bone Loss and Periodontal Disease
Authors: Wactawski‐Wende Jean , Grossi Sara G. , Trevisan Maurizio , Genco Robert J. , Tezal Miné , Dunford Robert G. , Ho Alex W. , Hausmann Ernest , Hreshchyshyn Myroslaw M.
Published: March 2012

Osteoporosis and periodontitis are diseases which affect a large number of women and men, with incidence increasing with advancing age. Osteopenia is a reduction in bone mass due to an imbalance between bone resorption and formation, favoring resorption, resulting in demineralization and leading to osteoporosis. Osteoporosis is a disease characterized by low bone mass and fragility and a consequent increase in fracture risk. Periodontitis is characterized by inflammation of the supporting tissues of the teeth, resulting in resorption of the alveolar bone as well as loss of the soft tissue attachment to the tooth and is a major cause of tooth loss and edentulousness in adults. The relationship of osteopenia to oral bone loss and periodontal disease has been addressed in a limited number of studies. A review of current knowledge regarding this relationship is presented. Interpretation of the literature is complicated by the variety of methods used to assess osteopenia, oral bone mass, and periodontitis, as well as varying definitions of outcomes of interest. Results of a previously unpublished study are presented which suggest that severity of osteopenia is related to loss of alveolar crestal height and tooth loss in post‐menopausal women. The literature on the relationship among these disorders is limited and points to the need for additional studies which thoroughly evaluate the influence of potential confounding factors to further define the relationship between low bone mineral density and periodontal disease in larger populations. Clearer understanding of this relationship may aid health care providers in their efforts to detect and prevent osteoporosis and periodontal disease. Increased dialogue among medical and dental professionals will be increasingly important in achieving and maintaining patients' optimal health. J Periodontol 1996;67:1076–1084.
Full‐ Versus Partial‐Mouth Disinfection in the Treatment of Periodontal Infections. Long‐Term Clinical Observations of a Pilot Study
Authors: Vandekerckhove Betty N. A. , Bollen Curd M.L. , Dekeyser Chris , Darius Paul , Quirynen Marc
Published: March 2012

A classical treatment for chronic adult periodontitis consists of four to six consecutive sessions of scaling and root planing at a 1‐ to 2‐week interval. Such a so‐called “quadrant or sextant therapy” might result in a reinfection of a previously disinfected area by bacteria from an untreated region. The purpose of this study was to investigate, over an 8‐month period, the clinical benefits of full‐mouth disinfection within a 24‐hour period in the control of chronic periodontitis. Ten adult patients with advanced chronic periodontitis were randomly assigned to a test and a control group. The control group received the standard scheme of initial periodontal therapy, consisting of scaling and root planing per quadrant at 2‐week intervals. In the full‐mouth disinfection group, scaling and root planing of the four quadrants was performed within 24 hours and immediately followed by a thorough supra‐ and subgingival chlorhexidine application to limit any transfer of bacteria. The latter involved tongue brushing with a 1% chlorhexidine gel for 60 seconds, mouthrinsing with a 0.2% chlorhexidine solution twice for 60 seconds, repeated subgingival irrigation of all pockets with a 1% chlorhexidine gel (3 times within 10 minutes), and mouthrinsing twice daily with a 0.2% chlorhexidine solution during 2 weeks. In addition, both groups received thorough oral hygiene instructions. The plaque index, gingival index, probing depth, gingival recession, and bleeding on probing were recorded prior to professional cleaning and at 1, 2, 4, and 8 months afterwards. Although the test group scored higher plaque indices than the control group, especially at months 2 and 4, the gingival index and bleeding tendency showed similar improvements with time. However, when the gingival/plaque ratio was considered, the latter was lower in the test group at all follow‐up visits. For pockets ≥ 7 mm, full‐mouth disinfection showed a significantly (P = 0.01) higher reduction in probing depth at each follow‐up visit with, at month 8, a reduction of 4 mm (from 8 mm to 4 mm), in comparison to 3 mm (from 8 mm to 5 mm) for the classical therapy. The increase in gingival recession in the fullmouth disinfection group remained below 0.7 mm, while in the control group it reached 1.9 mm after 8 months. This resulted in a gain of clinical attachment level of 3.7 mm for the test group versus 1.9 mm for the control group. A radiographical examination also indicated a superior improvement for the test group when compared to the control group. This pilot study suggests that a full‐mouth disinfection in one day results in an improved clinical outcome in chronic periodontitis as compared to searings per quadrant at 2‐week intervals over several weeks. J Periodontol 1996;67:1251‐1259.
The Effect of Lipopolysaccharide on Growth Factor‐Induced Mitogenesis in Human Gingival Fibroblasts
Authors: Hill Steven J. , Ebersole Jeffrey L.
Published: March 2012

Quiescent and non‐quiescent human gingival fibroblasts (HGF) were incubated for 24 hours with Actinobacillus actinomycetemcomitans lipopolysaccharide (LPS) and/or growth factors (interleukin‐1β [IL‐1β], insulin, epidermal growth factor [EGF], platelet‐derived growth factor [PDGF], fibroblast growth factor [FGF], and transforming growth factor‐β [TGF‐β]) to examine the ability of LPS to modify HGF proliferation in response to these autocrine and paracrine growth factors. A. actinomycetemcomitans LPS at high concentrations (≥ 9 μg/well) generally resulted in a reduction in DNA synthesis in quiescent and non‐quiescent fibroblasts; however, LPS at low concentrations (< 9 μg/well) showed a minimal enhancement of DNA synthesis (40 to 60%) in quiescent and non‐quiescent cells. HGF co‐incubated with mitogenic agents and LPS (9 μg/well) exhibited suppression of growth factor‐induced 3H‐Tdr uptake compared to growth factor‐stimulated controls. In contrast, 3H‐Tdr uptake was slightly elevated with addition of LPS at low concentrations (0.09 μg/well). These trends were seen with all growth factors tested. Non‐quiescent cells, in general, were more responsive to the growth factors and LPS/growth factor combinations when compared to the quiescent HGF. HGF were further tested for the ability of LPS to alter growth factor responsiveness by pretreating the cells with LPS prior to incubation of the growth factor, as well as, subsequent addition of LPS to growth factor‐pretreated cells. Similar patterns were observed as above, except IL‐1μ‐pretreated quiescent and nonquiescent HGF followed by LPS addition demonstrated a marked elevation in proliferation when compared to IL‐1μ stimulated controls. These findings suggest that LPS may potentially modulate the proliferative rate of connective tissue undergoing inflammatory or growth factor‐induced reparative processes in periodontal lesions. J Periodontol 1996;67:1274–1280.
Effect of Smokeless Tobacco Extract on Human Gingival Keratinocyte Levels of Prostaglandin E2 and Interleukin‐1
Authors: Johnson Georgia K. , Poore Thomas K. , Payne Jeffrey B. , Organ Connie C.
Published: March 2012

Gingival recession and white mucosal lesions frequently occur at sites of smokeless tobacco (ST) placement. The etiology of these alterations is presumably related to the irritating effects of tobacco components. The purpose of this study was to examine the effect of an aqueous ST extract (STE) on gingival keratinocyte production of prostaglandin E2 (PGE2) and interleukin‐1 (IL‐1), mediators involved in periodontal destruction and keratinocyte proliferation. Keratinocyte cultures were established from healthy tissues discarded from 8 subjects undergoing crown lengthening procedures. Cells (passage 2‐3) were seeded at 2.5 × 104 cells/well into 48 well tissue culture plates and maintained in serum‐free media at 37°C. On day 4 or 5, the wells were divided into 4 groups receiving either 10%, 5%, 2.5%, or 0% STE for time periods ranging from 30 to 240 minutes. PGE2 levels (pg/104 cells), as measured by enzyme immunoassay, were significantly (P < 0.05) increased in the 10% (215.66 ± 34.58) and 5% STE (151.82 ± 27.97) treated cultures compared to untreated cells (46.16 ± 9.58). IL‐lα and IL‐lβ proteins were elevated (P < 0.05) in cell lysates (299.45 ± 38.69 and 28.45 ± 5.18, respectively) from 5% STE exposed cultures compared to control wells. At 10% STE, secreted IL‐lα was decreased (P < 0.05) relative to 2.5% STE. This may reflect a toxic effect, as 10% STE significantly (P < 0.05) depressed cell numbers and viability. Lower tobacco concentrations did not affect cell numbers or viability, but significantly (P < 0.05) increased PGE2 and IL‐1 levels. Tobaccoinduced synthesis of these mediators may play a role in the development of tobaccorelated oral disease. J Periodontol 1996;67:116–124.
A Comparison of 2 Analgesic Regimens for the Control of Postoperative Periodontal Discomfort
Authors: Tucker Patricia W. , Smith John R. , Adams Donald F.
Published: March 2012

A single blind study of 24 patients compared the postoperative periodontal pain relief and adverse effects associated with a pretreatment regimen with etodolac, a nonsteroidal anti‐inflammatory drug (NSAID), to a typical pro re nada (prn) regimen with a combination of acetaminophen with hydrocodone. Patients selected required one or more periodontal osseous surgeries that were judged to involve relatively similar degrees of surgical manipulation. Patients in the etodolac group received two 300 mg capsules 30 minutes prior to surgery and then redosed themselves prn. Patients who received the combination drug were not premedicated and followed a prn regimen. The subjects used a verbal analogue scale to report levels of pain hourly for the first 8 hours (starting 30 minutes prior to surgery) and also indicated any side effects experienced during the first week after surgery. Specific parameters monitored were the mean sum of hourly pain scores, mean hourly pain scores, time to first medication, number of postoperative doses, and adverse effects. Of the parameters studied, the only one that showed a statistically significant difference was the time to first medication. The time span from 30 minutes prior to the beginning of surgery to the first postsurgical dose was greater for etodolac than for the combination drug. However, the total number of medications taken under both regimens was similar. The side effects were minimal for both of the drugs studied. It was concluded that the analgesic regimens tested under clinical practice conditions were comparable in providing analgesia with minimum side effects in uncomplicated periodontal osseous surgery. Studies with larger numbers of patients are needed to definitively address whether these regimens are truly equivalent. J Periodontol 1996;67:125–129.
Repopulation of Periodontal Pockets by Microbial Pathogens in the Absence of Supportive Therapy
Authors: Shiloah Jacob , Patters Mark R.
Published: March 2012

This clinical study evaluated the reinfection incidence by Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) in periodontal pockets following scaling and root planing (SRP) and intrapocket irrigation with antimicrobial agents in a patient population who did not receive supportive maintenance therapy. The number of target organisms was determined utilizing DNA probes. Forty‐one (41) inflamed pockets ≥ 5 mm with attachment loss and containing at least one target species were selected in 6 adult patients. Following a baseline clinical and bacterial examination, all patients received thorough SRP. In addition, 1 to 2 teeth in each patient were randomly assigned to each of the following 4 treatment modalities: 1) control group, no irrigation; 2) saline group, irrigation with 2 cc of 0.85% saline; 3) tetracycline group, irrigation with 2 cc of aqueous tetracycline HCl, 50 mg/ml (5%); and 4) Chlorhexidine group, irrigation with 2 cc, respectively. All selected sites were non‐adjacent. No additional therapy was rendered during the entire 1‐year observation period. Clinical parameters and microbial analyses were recorded again at 1 week, and 1, 3, 6, 9, and 12 months post‐treatment. The effect of antimicrobial irrigation on the reinfection rate of sites by Aa, Pg, and Pi was compared with that of the control groups (1 and 2) by ANOVA. No statistically significant differences were observed among the irrigation treatment groups with regard to any of the clinical or bacterial parameters studied. Therefore, the 4 treatment groups were combined into a single group whereby the rate of bacterial repopulation following extensive scaling and root planing could be ascertained. The infection incidence of sites at baseline (of total sites), 1 week and 12 months (of sites originally infected at baseline) was 14/41, 3/14, and 7/14 for Aa; 33/41, 6/33, and 12/33 for Pg; and 37/41, 3/37, and 12/37 for Pi, respectively. Thus, half or fewer of the originally infected sites became reinfected at 12 months despite lack of maintenance therapy. The results suggest that 1) a single episode of pocket irrigation with antimicrobial agents following thorough scaling and root planing did not affect the rate of repopulation of periodontal pockets by the tested pathogens; 2) thorough scaling and root planing has a lasting suppressive effect on selected periodontal pathogens for the majority of sites in patients with adult periodontitis; 3) pre‐operative probing depth, the amount of gingival fluid flow and the composition of the subgingival microflora may serve as predictors for reinfection in the absence of maintenance care; and 4) reinfection of the treated sites by Aa, Pg, and/or Pi may constitute a risk factor that diminishes the effect of therapy in the absence of supportive maintenance care. J Periodontol 1996;67:130–139.
Vertical Ridge Augmentation Using a Resorbable Membrane: A Case Report
Authors: Piattelli M. , Scarano A. , Piattelli A.
Published: March 2012

The vertical dimension may be very important clinically where anatomic structures may limit the bone height available for implant insertion. Moreover, lack of bone tissue may result in exposure of implant threads, soft tissue recession, less‐than‐optimal implant stability, and esthetic problems in the prosthetic reconstruction. Attempts have been made to increase the bone height with the placement of autografts and allografts on top of the ridge, but long‐term results have been unsatisfactory. Recently an increase of bone in a vertical direction has been obtained in rats, rabbits, and man using expanded polytetrafluoroethylene (ePTFE) membranes. The authors present a case in which an increase of the vertical dimension of the alveolar ridge was obtained using a resorbable freeze‐dried dura mater membrane in association with demineralized freeze‐dried bone. After a 6‐month uneventful healing period the space under the membrane was filled by a tissue with the macroscopic features of bone, and the two implants were almost covered by the newly‐formed tissue. An histological examination of a retrieved sample of the newly formed tissue demonstrated the presence of mature bone. It can be concluded that a localized vertical increase of the alveolar ridge may be obtained with the use of a resorbable freeze‐dried dura mater membrane. J Periodontol 1996;67:158–161.
Verruciform Xanthoma. Case Report and Literature Review
Authors: Huang Jehn‐Shyun , Tseng Chuen‐Chyi , Jin Ying‐Tai , Huang Chi‐Chou , Wong Tong‐Yiu V. , Chen Hung‐An , Chen Hong‐Rong , Yen‐Ping Kuo Mark , Kuo Ying‐Shiung
Published: March 2012

Verruciform xanthoma is a relatively uncommon lesion. Half of the reported cases occurred in the gingiva or alveolar ridge. In most cases, the clinical impressions are papilloma or verrucous carcinoma, which demonstrates the importance of the clinical and pathological recognition of this lesion. The cause of pathogenesis is still unknown since the first report in 1971. There are some cases reported in conjunction with leukoplakia, carcinoma in situ, pemphigus, and discoid lupus erythematosus (DLE), which merits close evaluation of this disease. This article reports two cases of verruciform xanthoma and reviews the evidence of its pathogenesis from the available literature. J Periodontol 1996;67:162–165.