bluuebunny/crossref_metadata_2025 huggingface dataset:
Periodontal Diseases in the U.S. In 1981: Prevalence, Severity, Extent, and Role in Tooth Mortality
Authors: Brown L. J. , Oliver R. C. , Löe H.
Published: March 2012

Prevalence, severity, and extent of periodontal diseases as well as the role of periodontal diseases in tooth mortality are described for persons 19 years and older in the U.S. in 1981. The data were collected with a household probability sample of non‐institutionalized persons living in the contiguous 48 states. Plaque and calculus scores were collected for six index teeth. All permanent teeth present and capable of being assessed were scored for gingivitis; pocket depths were measured on the mesial of each tooth with a periodontal probe. Examinations were conducted by trained dentists calibrated on specific criteria. Only 15% of persons in the U.S. in 1981 were free from any sign of periodontal diseases. Periodontitis (pockets ≥ 4 mm) affected approximately 36% of the population. Advanced Periodontitis (pockets ≥ 6 mm) was present in 8% of the population and was usually found on only one or two teeth when present. End‐stage periodontal destruction requiring extraction of teeth was found in only 4% of all persons while less than 20% of all missing teeth were listed as missing due to periodontal disease.
The Use of 0.2% Chlorhexidine Spray as an Adjunct to Oral Hygiene and Gingival Health in Physically and Mentally Handicapped Adults
Authors: Kalaga A. , Addy M. , Hunter B.
Published: March 2012

Chlorhexidine has been used as an aid to or replacement for oral hygiene measures in special needs groups such as the handicapped. Previous studies have indicated that spray delivery of Chlorhexidine is both effective and acceptable. This study evaluated twice daily use of a 0.2% Chlorhexidine spray as an adjunct to toothbrushing in a group of physically and mentally handicapped adults attending a day training center. The study was a doubleblind, placebo controlled, cross‐over design involving two 31 days regimens separated by 30 days. Plaque, bleeding on probing, and pocketing were measured at the beginning and end of each regimen. There were clinically and statistically significantly lower plaque and bleeding scores at the end of the Chlorhexidine compared to the placebo period. Pocketing was also significantly less after Chlorhexidine, although in clinical terms the difference was small. The apparent acceptability and effectiveness of the regimen suggests that small doses of Chlorhexidine delivered by sprays may be of considerable value as an aid to oral hygiene in handicapped individuals.
Effect on Periodontal Status of Rotary Electric Toothbrushes vs. Manual Toothbrushes During Periodontal Maintenance
Authors: Murray P. A. , Boyd R. L. , Robertson P. B.
Published: March 2012

We compared the use of a rotary electric toothbrush with conventional toothbrushing for their effectiveness in modulating the subgingival microbiota. Forty subjects who had received periodontal treatment for moderate to advanced Periodontitis and were on 3month periodontal maintenance were divided into two equal groups matched for age and sex. One group used only the rotary tooth cleaner and the other group used conventional toothbrushing, dental floss, and toothpicks for 12 months. Subgingival plaque samples (two sites per patient) were taken from 10 subjects per group at baseline, 6 months, and 12 months and analyzed for percentage of obligate anaerobes and colony‐forming units of black‐pigmented Bacteroides, Fusobacterium, Actinomyces, Streptococcus, and Veillonella spp. The percentage of spirochetes and motile rods was determined by darkfield microscopy. Results showed that levels of obligate anaerobes, Fusobacterium, and Actinomyces and percentage of spirochetes and motile rods decreased significantly (P < 0.05), while levels of Streptococcus spp. increased (P < 0.05) for both groups. However, there was no significant difference between the two groups, indicating that the rotary tooth cleaner and conventional toothbrushing are equally effective in controlling gingivitis and fostering a less pathogenic microflora.
A Scanning Electron Micrographical Study of Root Surfaces and Subgingival Bacteria After Hand and Ultrasonic Instrumentation
Authors: Garnick Jerry J. , Dent J.
Published: March 2012

The effects of hand and ultrasonic instrumentation on root surface topography and subgingival plaque were studied. One approximal subgingival root surface on each of two single rooted teeth of six patients was root planed. The opposing proximal surfaces were not treated and served as controls. On each patient, the two test surfaces were randomly treated by hand or ultrasonic instrumentation (Cavitron) until clinically smooth. The teeth were extracted, divided into mesial and distal sides, and processed for scanning electron microscopy (SEM). The observations were restricted to an area 2 mm by 3 mm just coronal to the plaque‐free zone. The root surfaces were scanned by SEM, both at low (× 100) and at higher magnifications (× 5000). At low power, a photomontage was produced of the surface area of the test teeth.

At low magnifications (× 100, × 500), the topography resulting from hand instrumentation appeared smooth with parallel scratches compared to scaly but flat surfaces with occasional deep gouges with the ultrasonic method. At high magnifications (× 5000), tooth surfaces were similar in topography when instrumented by either hand or ultrasonic methods. Root surfaces were covered in some areas by a fibrillar‐like membrane that resembled fibrin. Individual bacteria were found on the surfaces of this material. On other areas not covered by this membrane, bacterial plaque was only observed when tooth surfaces had not been contacted by either hand or ultrasonic instrumentation.
Connective Tissue‐Associated Proteins in Crevicular Fluid:
Authors: Bowers Mary R. , Fisher Larry W. , Termine John D. , Somerman Martha J.
Published: March 2012

Tests for periodontal disease that are able to detect both ongoing and future loss of clinical attachment would be valuable assets in determining the diagnosis and treatment of periodontal diseases. We hypothesized that connective tissue‐associated proteins could be detected in crevicular fluid and would reflect the biochemical activity of the periodontium in health and disease. To test this hypothesis, crevicular fluid samples obtained from patients with various states of periodontal disease were analyzed for the presence of several connective tissue‐associated proteins using a dot blot assay. Two such proteins, osteonectin and Npropeptide alpha I type I collagen, were detected in crevicular fluid samples of patients with periodontal disease. Furthermore, the amount of these proteins detected in crevicular fluid appeared to increase with increased probing depth at the sampled site. These studies indicate that measurements of connective tissue‐associated proteins in crevicular fluid may prove to be a valuable tool for diagnosing periodontal diseases.
Neovascularization of Surface Demineralized Dentin
Authors: Tweden Katherine S. , Spadone Donald P. , Terranova Victor P.
Published: March 2012

Uneventful healing of the wound site created by periodontal reconstructive surgery is crucial for the long term survival of the dentition. Wound healing has been shown to be initiated and mediated by matrix components and polypeptide growth factors. Neovascularization (or angiogenesis) is one of the most important events in the healing process of a wound site. Any increase in the degree and/or rate of neovascularization could result in more rapid or complete healing. Previously, we have shown that basic fibroblast growth factor (bFGF) selectively enhances periodontal ligament cell migration and proliferation. In addition, we have shown that FGF stimulates human umbilical vein endothelial cell migration and proliferation. In this study we examined whether human umbilical vein endothelial cells could be influenced to form capillary‐like structures in a type I collagen stroma and on dentin surfaces in response to fibroblast growth factor (FGF). We observed tubule‐like structures formed from a monolayer of endothelial cells within a type I collagen sponge in response to a gradient of FGF. Furthermore, we observed tubule‐like structures formed from self‐association of individual endothelial cells on partially demineralized dentin surfaces in response to FGF. Proliferation of human endothelial cells on dentin was dose dependent and maximally stimulated at a concentration of 10 ng/ml FGF. These data indicate that FGF can induce endothelial cell migration, proliferation and tubule formation on dentin.
Actinobacillus actinomycetemcomitans Serotypes and Leukotoxicity in Korean Localized Juvenile Periodontitis
Authors: Chung Hyun‐Ju , Chung Chong‐Pyoung , Son Seong‐Heui , Nisengard Russell J.
Published: March 2012

actinobacillus actinomycetemcomitans is thought to play an important role in the pathogenesis of localized juvenile Periodontitis (LJP). Preliminary data suggested that the serotype distribution of A. actinomycetemcomitans in Korea and the United States differ. This study evaluated A. actinomycetemcomitans prevalence, serotype distribution, and leukotoxicity in Korean LJP patients by culture, enzyme‐linked immunosorbent assay, indirect immunofluorescence, and lactate dehydrogenase release from polymorphonuclear leukocytes exposed to A. actinomycetemcomitans. A. actinomycetemcomitans occurred in 75% of LJP lesions and 6% of normal sites with approximately equal distribution of serotype a, b, and c. Single serotypes were isolated from nine patients while three patients harbored two serotypes either in the same or different disease sites. A. actinomycetemcomitans leukotoxicity occurred in 22% isolates with a 69% prevalence. Individual sites harbored both leukotoxic and non‐leukotoxic strains with no serotype association. The distribution of serotypes and leukotoxic strains of A. actinomycetemcomitans in Korean LJP patients differed from those reported in the United States. This suggests that serotype b may not be more important in the pathogenesis of LJP. (J Periodontol 1989:60:506–511.)
Total Calculus Removal: An Attainable Objective?
Authors: Kepic Thomas J. , O'Leary Timothy J. , Kafrawy Abdel H.
Published: March 2012

The primary purpose of this study was to determine if two sessions of scaling and root planing, one using a “closed” approach and the other using an “open” approach, would remove all calculus from teeth with severe periodontal disease. Fourteen teeth (8 single‐rooted, 6 multi‐rooted) were treated by closed scaling and root planing with an ultrasonic instrument, and 17 others (10 single‐rooted, 7 multi‐rooted) were treated with hand instruments. After a healing period of 4 to 8 weeks, anesthesia was secured, periodontal flaps were raised, and the teeth were treated a second time using the same instrumentation as before. The teeth were then extracted and prepared for light microscopic evaluation. Twelve of the 14 teeth treated by ultrasonics and 12 of the 17 treated by hand instruments retained calculus. The two types of instruments had similar scores in the treatment of proximal root surfaces, furcal walls, and furcal summits. Hand instrumentation appeared to be more effective than ultrasonics in removing cementum from proximal surfaces, although this is not based on a formal statistical comparison of the two methods. Neither instrument was effective in removing cementum from the furcal walls or summits. Five randomly selected blocks containing remaining root structure were deparaffinized and prepared for scanning electron microscopy. One hand‐instrumented specimen, which had not shown calculus with light microscopy, displayed calculus at the SEM level. All five specimens displayed residual calculus at either the light microscope, the SEM level, or both. The results of this study indicate that complete removal of calculus from a periodontally diseased root surface is rare. J Periodontol 1990;61:16–20.
In Vitro Release of Doxycycline From Bioabsorbable Materials and Acrylic Strips
Authors: Larsen Tove
Published: March 2012

Treatment of marginal periodontitis may include use of local antibiotics. In the present in vitro study the bioabsorbable materials Surgicel, Tissell, and CollaCote and acrylic strips were examined for release of doxycyeline into liquids and residual antibacterial activity of the materials. Pieces of material were incubated in 1 ml of water or human serum which was exchanged every day for 9 days. The concentration of doxycyeline in the liquids was measured spectrophotometrically while the residual antibacterial activity of the materials was determined microbiologically. Surgicel constantly showed very high concentrations and level of residual activity. The acrylic strip and CollaCote decreased to low levels of both concentration and residual activity in a few days. Tissell was intermediate with a continuous decrease in concentration but rather high level of residual activity throughout the study. In serum the acrylic strip was partly dissolved and Surgicel was totally dissolved after 2 days. Left undisturbed in serum Surgicel was not dissolved for 2 weeks. These results indicate that Surgicel and Tissel may be capable of prolonged release of doxycyeline in vivo. J Periodontol 1990;61:30–34.
Effect of Benign Familial Neutropenia on the Periodontium of Yemenite Jews
Authors: Stabholz A. , Soskolne V. , Machtei E. , Or R. , Soskolne W.A.
Published: March 2012

The purpose of this study was to compare the periodontal status of Yemenite Jews with and without benign familial neutropenia (BFN). Thirtyfour volunteers were examined at baseline and after 3 years. Plaque index (P1I), bleeding index (BI) probing depth (PD), and attachment levels (AL) were recorded. Differential blood counts were done on at least three occasions during the study. Volunteers with at least one count of <2000 neutrophils were considered neutropenic. The majority of patients received oral hygiene instructions and scaling at the initial visit. During the study there was a significant drop in P1I (P<0.01) and BI (P<0.05). At baseline the BFN and non‐BFN volunteers had similar P1I, but the BI was significantly greater in the BFN group. At follow‐up, there was a significantly greater number of teeth with pockets ≥ 6 mm in the BFN group (P<0.05). These results indicate that volunteers with BFN, a phenomenon that has not previously been associated with any pathology, are more susceptible to gingival inflammation and attachment loss than unaffected volunteers and that they respond more favorably to an improvement in oral hygiene. J Periodontol 1990;61:51–54.
Myospherulosis. Report of a Case
Authors: Wallace M.L. , Neville B.W.
Published: March 2012

A case of myospherulosis, a condition first reported in 1969, is reported following the extraction of mandibular third molars and subsequent placement of Terra‐Cortril and Gelfoam into the extraction sites. The lesions were discovered during a periodontal surgical procedure and to the best of our knowledge this is the first such report in the periodontal literature. J Periodontol 1990;61:55–57.
Ectopic Gingival Sebaceous Glands Presenting as Localized Periodontitis
Authors: Cohen Robert E. , Aguirre Alfredo , Drinnan Alan J. , Neiders Mirdza E. , Mastroianni Anthony J.
Published: March 2012

The development of ectopic gingival sebaceous glands is a very unusual condition which is histologically similar to Fordyce's granules when they occur within the buccal or labial mucosa. In this report, we present a rare case of ordinarily innocuous, ectopic gingival sebaceous glands, which presented clinically and radiographically as localized advanced periodontitis. Histological and immunocytochemical evaluation of tissue removed from the periodontal lesion following excisional biopsy supported the diagnosis of an ectopic gingival sebaceous defect. This case illustrates the necessity of considering less frequently occurring entities in the differential diagnosis of localized lesions which appear to be periodontal in origin. J Periodontol 1990;61:58–60
Antibodies Directed to the Chemotactic Factor Receptor Detect Differences Between Chemotactically Normal and Defective Neutrophils From LJP Patients
Authors: DeNardin Ernesto , DeLuca Chester , Levine Michael J. , Genco Robert J.
Published: March 2012

Localized juvenile periodontitis (ljp) is a progressively destructive infection of the supporting tissues of the teeth, primarily affecting adolescents. In this disease, patients' polymorphonuclear leukocytes (PMN) exhibit decreased Chemotaxis (CTX) and decreased binding of the chemotactic peptide N‐formyl‐l‐methionyl‐l‐leucyl‐l‐phenyl‐alanine (FMLP) to specific receptors on the PMN surface. Since the FMLP receptor is involved in the activation of the PMN, and its subsequent response to chemotactic stimuli, a decrease in the chemotactic peptide receptor, as seen in LJP patients, is suspected to be a predisposing factor for this disease. To define differences in the FMLP receptor between CTX defective LJP patients and CTX normal donors, a battery of monoclonal antibodies reactive against the FMLP receptor was prepared. The FMLP receptor was affinity‐purified, and was found to be comprised of two components, one of 68 kDa, and the other of 94 kDa. Only the 68 kDa component specifically bound a radioiodinated FMLP analogue in a photoaffinity experiment. Seven monoclonal antibodies were selected on the basis of their reactivity with the 68 kDa receptor component, and of these, 5 showed reduced binding against PMN from CTX defective LJP donors when compared to their reactivity against PMN from CTX normal subjects. Two of the 7 anti‐68 kDa antibodies reacted with PMN from both sets of subjects at a comparable extent. Furthermore, the presence of 20 nmol of FMLP inhibited the binding of 5 of the anti‐receptor antibodies to whole PMN, including one that showed no difference in binding between CTX normal and defective PMN, and 4 of the 5 that did show such difference. These results show that a difference in the binding of antibodies to the FMLP receptor complex exists between neutrophils from chemotactically depressed LJP patients as compared to normal controls. These differences in binding may be due to qualitative differences in the receptor or may represent reduced expression of receptor components on the surface of LJP neutrophils. These results add further support to the concept that alterations in the surface of PMN from LJP patients are associated with reduced Chemotaxis. J Periodontol 1990;61:609‐617.
Periodontal Disease Morbidity Quantification. I. Optimal Selection of Teeth for Periodontal Bone Loss Surveys
Authors: Shrout Michael K. , Hildebolt Charles F. , Vannier Michael W. , Province Michael , Vahey Edward P.
Published: March 2012

The assessment of alveolar bone loss with bite‐wing radiographs is attractive because bite wings are relatively convenient, inexpensive, and available. The choice of teeth used influences the validity of global bone loss assessments based on partial mouth measurements. The objective of this study was to validate periodontal bone loss indices based on a few teeth. The mandibular posterior teeth were considered as a basis for abbreviated indices. The optimum number of teeth included was evaluated, and the utility of abbreviated indices was determined experimentally. The teeth from 75 skulls were measured from the cemento‐enamel junction (CEJ) to the alveolar bone at six locations per tooth. The subsets of teeth which best represent the average whole mouth bone loss were found with all‐possible‐subsets regression analysis. Bone loss data from 179 prehistoric skulls were used to test the validity of selected teeth indices. Bone loss measurements from the mandibular posterior areas were representative of full‐mouth bone loss measurements. Mandibular second premolars plus any other mandibular posterior teeth were the optimal combination of tooth for an abbreviated index. This subset is suitable for use with bite‐wing radiographs. J Periodontol 1990; 61:618‐622.
Peripheral Ameloblastoma of the Gingiva. A Case Report
Authors: Mintz Sheldon , Anavi Yakir , Sabes William R.
Published: March 2012

Reports of gingival peripheral ameloblastoma are extremely rare and have been sporadic. This paper reports a pertinent case of a 40‐year‐old woman who for 2 years had a progressively enlarging asymptomatic firm mass in the buccal gingival region of the lower premolars. Cupping of the underlying bone was radiographically demonstrated. The lesion was excised surgically together with extraction of the first premolar, and no evidence of recurrence was seen 5 years later. The clinical, radiological, and histopathological characteristics of gingival peripheral ameloblastoma were analyzed in the 33 previously reported cases. The differential diagnosis and treatment of this case report are discussed. J Periodontol 1990; 61:649‐652.
Control of Gingivitis and Calculus by a Dentifrice Containing a Zinc Salt and Triclosan
Authors: Stephen K. W. , Saxton C.A. , Jones C.L. , Ritchie J.A. , Morrison T.
Published: March 2012

The effect of unsupervised brushing with a dentifrice containing two antiplaque agents, 0.5% zinc citrate and 0.2% triclosan, on gingival health, plaque, supragingival calculus, and the oral flora was compared to brushing with a non‐active control dentifrice. Volunteers were given oral hygiene instruction and their teeth were professionally cleaned. They then used a placebo dentifrice for a pre‐experimental phase of 1 month, before being stratified into two groups on the basis of their initial plaque, gingival bleeding, and calculus levels, sex, and age. Over the following 6 months, one group used the control while the other used the test dentifrice. Plaque levels, gingival bleeding, and calculus were assessed at baseline and at 3 and 6 months. Supragingival plaque was sampled for microbiological analysis at the initial examination, at 3 and 6 months (conclusion of study period) and 3 months after the study. Representative oral bacteria and the development of bacterial resistance to triclosan were monitored. Results showed that plaque was reduced and gingival health significantly improved during the 1‐month preexperimental period. During the experimental period, this improvement was not maintained by the control group as gingival bleeding and calculus increased. In contrast, gingival bleeding and calculus levels of the test group were maintained significantly below those of the placebo group. Plaque levels were lower in the test group after 3 and 6 months, but the groups were not significantly (P = 0.05) different. No shifts in oral flora or development of bacterial resistance to triclosan were detected. J Periodontol 1990; 61:674–679.
Guided Tissue Regeneration Following Treatment of Recession‐Type Defects in the Monkey
Authors: Gottlow Jan , Karring Thorkild , Nyman Sture
Published: March 2012

Recent studies have demonstrated extensive amounts of new attachment formation following reconstructive surgery based on the biological principle of guided tissue regeneration (GTR). The aim of the present investigation was to evaluate the effect of using a polytetrafluorethylene (PTFE) membrane in GTR‐treatment of recession‐type defects and to examine the interrelationship between the PTFE membrane and surrounding periodontal tissues. Full‐thickness flaps were raised around 24 maxillary premolar and molar teeth in 6 monkeys. The buccal alveolar bone was surgically removed to a level corresponding to the apical third of the roots. The exposed root surfaces were scaled and planed. In 12 teeth, PTFE membranes were adjusted to cover the exposed root surfaces from a level 1 to 2 mm apical to the CEJ, to a level 3 to 4 mm apical to the alveolar crest. The coronal border of the membranes was tightly adapted to the root surfaces by sling sutures. Twelve teeth served as control teeth without placement of membranes. The flaps were placed with the margin coronal to the CEJ and sutured. The animals were sacrificed after 3 months of healing and all experimental teeth were subjected to histological analysis. The membranes were found to be incorporated with the surrounding connective tissue, and the apical extension of the junctional epithelium terminated at the coronal border of the membranes. The amount of new attachment formation was on the average 74.3% of the defect height in the test teeth, which corresponded to 100% of the membrane covered root portion. Newly formed connective tissue attachment in the controls amounted to an average of 36.9% of the defect height. The amount of bone regeneration was similar at test and control teeth. The results of the present investigation showed that subgingivally placed membranes of the type used in the present study may predictably promote the formation of a new connective tissue attachment in recession‐type defects. J Periodontol 1990; 61:680–685.
Periodontal Repair in Dogs: Effect of Wound Stabilization on Healing
Authors: Wikesj Ulf M. E. , Nilvéus Rolf
Published: March 2012

This study evaluated a biodegradable polylactic acid matrix as a wound stabilizing implant in reconstructive periodontal surgery. Supra‐alveolar circumferential periodontal defects, 5 to 6 mm large, were surgically created around the mandibular premolars in 7 beagle dogs. The root surfaces in left and right jaw quadrants were treated with either heparin or saline. In this model, root surface treatment with heparin compromises periodontal repair and results in a long junctional epithelium and a reduced connective tissue repair to the root surface, whereas saline treatment results in almost complete connective tissue repair. Following heparin or saline treatment a polylactic acid implant was placed on 1 premolar in each quadrant. After 4 weeks of wound healing, the dogs were sacrificed and tissue blocks prepared for histometric analysis. Postoperatively, the implant became exposed and infected in 3 dogs and had to be removed. Therefore, the results reflect the 4 dogs in which healing progressed uneventfully. Connective tissue repair to the root surface in teeth treated with heparin averaged 82% of the defect height. Mean connective tissue repair in teeth treated with heparin and the implant was significantly greater and comprised approximately 99% of the defect height (P < 0.05). Teeth treated with saline either with or without the implant also healed with almost complete connective tissue repair. The results support the importance of wound stabilization in periodontal wound healing. Development of biodegradable implant systems aimed at stabilizing and supporting the healing wound seems a desirable direction for future research in regenerative periodontal procedures. J Periodontol 1990; 61:719–724.
Clinical Evaluation of a Biodegradable Collagen Membrane in Guided Tissue Regeneration
Authors: Chung Kong Mun , Salkin Leslie M. , Stein Marc D. , Freedman Arnold L.
Published: March 2012

A bio‐resorbable Type I collagen membrane was investigated as a barrier for guided tissue regeneration. Ten human subjects with at least one pair of contralateral periodontal lesions with probing pocket depths of ≥ 5mm and radiographic evidence of ≥ 40% bone loss were included. Each patient underwent contralateral surgical flap procedures. A collagen barrier was adapted to the tooth in the experimental defect and the flap replaced and sutured. The controls consisted of the same procedure without the placement of the barrier. Standardized measurements of change in probing attachment levels and fill of intrabony defects were obtained at the time of surgery and 1 year later at the time of surgical re‐entry. The differences in change of probing attachment levels and amount of bone fill between individual test and control sites were compared utilizing the student's t‐test for paired samples. The mean probing attachment gain in the test sites was 0.56 ± 0.57 mm, and there was a mean probing attachment loss of 0.71 ± 0.91 mm in the control sites (P < 0.01). The gain of bone in test lesions was 1.16 ± 0.95 mm, while no gain was observed in the control lesions (P < 0.01). The results of this study demonstrated that sites treated with a collagen barrier comprised of cross‐linked bovine Type I collagen exhibited significantly better healing as compared to control sites over the 1year period of the study. J Periodontol; 1990; 61:732–736.
A Veterans Administration Cooperative Study of Biphasic Calcium Phosphate Ceramic in Periodontal Osseous Defects
Authors: Nery E.B. , Lee K.K. , Czajkowski S. , Dooner J.J. , Duggan M. , Ellinger R.F. , Henkin J.M. , Hines R. , Miller M. , Olson J.W. , Rafferty M. , Sullivan T. , Walters P. , Welch D. , Williams A.
Published: March 2012

One hundred thirty‐seven v.a. patients were randomized to one of three treatment groups to evaluate the efficacy of biphasic calcium phosphate (BCP) ceramic in the treatment of periodontal osseous defects. This material was tested against both autogenous bone implant and open flap curettage procedures. Baseline probing attachment level, Navy plaque index, and gingival index were recorded for all patients. These parameters were monitored for 3 years. At the end of this period, 101 patients had completed the study. Although the plaque and gingival indices steadily increased with time, there were no statistically significant differences among the treatment groups. Patients in the ceramic group had a gain in attachment level of 1.0 mm; those in the curettage group, 0.9 mm; and 0.4 mm for those in the bone implant group. Although the BCP patients had a greater gain, the difference was not statistically significant. In this veteran population, not only did BCP patients fail to outperform those in the control groups, all three treatment groups were similarly ineffective. J Periodontol 1990; 61:737–744.
A Family Study of a Mother and Daughter with Increased Susceptibility to Early‐Onset Periodontitis: Microbiological, Immunological, Host Defensive, and Genetic Analyses
Authors: Nishimura Fusanori , Nagai Atsushi , Kurimoto Keiji , Isoshima Osama , Takashiba Shogo , Kobayashi Mitsuharu , Akutsu Isao , Kurihara Hidemi , Nomura Yoshio , Murayama Yoji , Ohta Hiroyuki , Kato Keijiro
Published: March 2012

Microbiological, immunological, host‐defensive, and genetic analyses were performed on a mother and daughter, both of whom had early‐onset periodontitis (rapidly progressive periodontitis in the mother; localized juvenile periodontitis in the daughter). Microscopic examination revealed a greatly elevated percentage of rod‐form bacteria in both subjects. Fusobacterium sp. and Porphyromonas gingivalis (formerly Bacteroides gingivalis) were the predominant microorganisms cultured. The humoral immune responses to F. nucleatum, P. gingivalis, and Actinobacillus actinomycetemcomitans were much higher in both subjects than those to any other periodontal bacteria examined. Functional and phenotypic analysis of the peripheral lymphocytes showed no significant abnormalities. However, investigation of neutrophil function showed that the mother had depressed neutrophil Chemotaxis and Superoxide production. The daughter had depression not only of Chemotaxis and Superoxide production, but also of neutrophil phagocytosis. Serological typing of HLA antigens revealed the same Class II HLA profile in both subjects. It was concluded that both subjects very probably had an identical condition and that these patients provided a unique model for improving our understanding of the host factors involved in periodontal disease. J Periodontol 1990; 61:755–765.
The Apical Location of Calculus Within the Intrabony Defect
Authors: Richardson A. Charles , Chadroff Brian , Bowers Gerald M.
Published: March 2012

Although several studies have concluded that calculus removal becomes more difficult as pocket depth increases, few have examined the clinical location of calculus within the intrabony defect. This study evaluated the relationship between apical calculus position and the depth and morphology of the intrabony defect. As part of an on‐going study of new attachment procedures in humans, 260 intrabony defects were surgically entered in 39 patients. Using magnifying loops and fiber optics in all defects, the most apical level of calculus was grooved to serve as both a clinical and histologic reference point. Clinical measurements made prior to root debridement included the alveolar crest to base of calculus, and the base of calculus to base of defect. The type of defect was classified by the number of remaining osseous walls. Calculus has not been found apical to the groove in any histologic section. The mean distance measured clinically between the base of the calculus and the base of the defect was found to increase with the depth of the defect. This relationship did not vary with either tooth type or number of remaining osseous walls in the defect. Data analysis of this group of patients (N = 39) showed a positive correlation (r =.83) between increasing depth of intrabony defect and the distance of the most apical calculus from the defect base. J Periodontol 1990;61:118– 122.
Patient Preference for Waxed or Unwaxed Dental Floss
Authors: Beaumont Robert H.
Published: March 2012

The purpose of this study was to discover patient preference for waxed or unwaxed dental floss, and to learn more about individual flossing habits. One hundred patients randomly presenting for routine dental examinations volunteered to sample a brand of similar‐appearing waxed and unwaxed dental floss. After flossing an anterior and a posterior contact area with both types, the patients indicated whether they preferred the waxed or unwaxed floss. The patients also answered questions concerning their flossing habits. Waxed floss was found to be preferred after sampling by 79% and unwaxed by 21%. An additional 50 patients sampled a different brand of waxed and unwaxed floss in a similar manner. In this group 78% preferred the waxed and 22% the unwaxed type. A final group of 50 patients compared mint flavored waxed floss with plain waxed floss of the same brand. In this group 56% preferred the mint flavored waxed floss, 24% the plain waxed floss, and 20% had no preference. A combined total of only 29.5% of the patients claimed to floss daily, 53.5% floss irregularly but at least once a week, while 17% do not floss even once a week. Waxed floss was purchased for home use by a combined patient total of 57.5%, unwaxed by 32%, and neither type by 10.5%. An unsubstantiated belief in the superiority of unwaxed floss has persisted to the present time. Since both waxed and unwaxed floss have now been shown to be of similar clinical effectiveness, it may be prudent for dental professionals to recommend the often preferred and purchased waxed floss for more patients than unwaxed after evaluating individual needs and preferences. The recommendation of preferred waxed floss may help promote optimal patient compliance and improve the percentage of patients flossing daily. J Periodontol 1990;61:123–125.
Lateral Periodontal Cyst Review of the Literature and Report of a Case
Authors: Angelopoulou Eleni , Angelopoulos Angelos P.
Published: March 2012

The lateral periodontal cyst is a rare odontogenic cyst of developmental origin. It occurs on the lateral periodontal region of a vital tooth and has specific histologic features. In this paper a case of a lateral periodontal cyst is presented and cases previously reported in the literature are reviewed. The present case concerns a 50‐year old woman who presented for an asymptomatic gingival swelling of the left canine mandibular region of 2 month's duration. X‐ray examination showed a well circumscribed radiolucency with a radiopaque margin lying between the roots of the lateral incisor and canine. The associated teeth were vital. Enucleation of the lesion was performed. The histologic examination of the specimen showed a cyst lined by thin non‐keratinized epithelium with focal thickenings containing clear cells. J Periodontol 1990;61:126–131.
Multiple Myeloma of the Periodontium. A Case Report
Authors: Petit Jean‐Claude , Ripamonti Ugo
Published: March 2012

Multiple periodontal lesions were the presenting features leading to a diagnosis of multiple myeloma in a 38‐year‐old male. Ulceration and bleeding from a rapidly growing retromolar myelomatous mass, multiple foci of alveolar bone destruction and cortical expansion together with multifocal skeletal destruction were the hallmarks of the neoplastic process. Radiotherapy and chemotherapy brought a substantial, but temporary, remission with improvement of the periodontal condition. A sudden exacerbation of the disease reactivated the previous lesions, new ones developed, and the patient died 22 months after the diagnosis was made. J Periodontol 1990;61:132–137.
Prolonged Systemic Administration of Cyclosporin A Affects Gingival Epithelium
Authors: Pisanty S. , Rahamim E. , Ben‐Ezra D. , Shoshan S.
Published: March 2012

Gingival biopsies were obtained from 12 patients suffering from Behcet's disease who were treated with Cyclosporin A (CsA) for up to 20 months. Preparations were made for examination with both light and scanning electron microscopy (SEM). Along with known changes in the gingival epithelial structure observed following CsA treatment, we also found unusual clusters of needle‐like crystallites embedded in the epithelium, mostly at the base of the acanthotic projections. Toluidin blue staining revealed increased numbers of both intact and degranulated mast cells in the attached epithelium. It is concluded that CsA affects the gingival epithelium and that the clinically observed enlargement of gingival tissue following prolonged treatment with CsA is due primarily to CsA‐epithelial interaction. J Periodontol 1990; 61:138–141.
Molecular Genetic Analysis of Actinobacillus actinomycetemcomitans Epidemiology
Authors: Zambon Joseph J. , Sunday Gregory J. , Smutko John S.
Published: March 2012

Research over the past decade has identified many of the microorganisms involved in the etiology of human periodontitis such as Actinobacillus actinomycetemcomitans. Efforts are now directed toward defining these species' role in the pathogenic process. Since microbial colonization of host tissues is a key first step in developing a bacterial infection, determining the source of the periodontal pathogens and their route of transmission is likely to be crucial in formulating preventive strategies. Recently, a technique from molecular biology, restriction endonuclease analysis, has been used to track bacterial infections. In the present study, this method was used to investigate the epidemiology of A. actinomycetemcomitans infection. One hundred twenty‐four human subgingival plaque isolates of A. actinomycetemcomitans were examined including bacterial strains from the United States, Korea, and Norway as well as 15 strains from cynomolgus (Macaca fasicularis) and spider monkeys {Macaca iris) and 4 reference strains. The genomic DNA from each strain was purified, digested with each of 16 restriction endonucleases, and the DNA digests were resolved by electrophoresis. The resulting patterns of DNA fragments were compared and also correlated with the A. actinomycetemcomitans serotype determined using serotype‐specific antisera in immunofluorescence. Human isolates of A. actinomycetemcomitans even from disparate geographic sources showed little diversity by restriction endonuclease analysis. Three major restriction patterns were found. Restriction pattern I was common to all 20 of the serotype a isolates, restriction pattern II was associated with 58% of the 73 serotype b isolates examined, while restriction pattern III was associated with the remaining serotype b strains and with all 15 of the serotype c strains. All A. actinomycetemcomitans isolates from a single site, or from several sites in the same patient, or from a single patient over time showed the same restriction pattern suggesting a clonai infection by this microorganism. By contrast, strains of A. actinomycetemcomitans isolated from non‐human primates revealed numerous and distinct restriction endonuclease patterns none of which resembled human strains. These results are consistent with the idea that human oral infection by A. actinomycetemcomitans is clonal in any one patient and that human oral infection is associated with a limited number of possible genotypes. Restriction endonuclease analysis of genomic DNA from A actinomycetemcomitans and other periodontal pathogens provides a powerful tool for analyzing the microbial ecology of subgingival plaque as well as determining the mode of transmission and acquisition for individual species. J Periodontol 1990;61:75–80.
Biphasic Calcium Phosphate Ceramic Combined With Fibrillar Collagen With and Without Citric Acid Conditioning in the Treatment of Periodontal Osseous Defects
Authors: Nery E.B. , Eslami A. , Van Swol R.L.
Published: March 2012

The purpose of this study is to determine whether the combination of biphasic calcium phosphate ceramic (BCP) and collagen and citric acid root conditioning would promote accelerated new attachment of periodontal tissue to the root surface in dogs. Intrabony defects were surgically produced for each animal and were made chronic for 16 weeks. These defects were assigned to two study treatment and one control group: ceramiccollagen without citric acid (CO‐CE); ceramic‐collagen with citric acid (CO‐CE‐CA); and control (surgical debridement and root planing only). Results showed that all groups gained new attachment level as demonstrated both clinically and histometrically. The treatment groups showed a significant mean gain greater than the control (P<.005), but no significant difference was found between treatment groups. Small areas of ankylosis was also found in both treatments but there was no evidence of active root resorption. It is concluded that the use of combined BCP and fibrillar collagen is beneficial in promoting new attachment of periodontal tissues to the root surface in dogs. Although citric acid root conditioning did as well or better than ceramic and collagen alone, its benefits are still speculative and need further experimentation. J Periodontol 1990; 61:166– 172.
Neutrophil Surface Protein Markers as Indicators of Defective Chemotaxis in LJP
Authors: Van Dyke T. E. , Warbington M. , Gardner M. , Offenbacher S.
Published: March 2012

Abnormalities of neutrophil function have been highly correlated with severe, early onset periodontal diseases. Nonetheless, the identification of these patients and diagnosis of specific disease states, such as LJP or prepubertal periodontitis, are difficult and costly. In this report, the identification and quantification of neutrophil cell surface markers specific to LJP patients with neutrophil Chemotaxis defects are described. GP110 and FMLP receptors were quantified by flow cytometry on neutrophils from LJP patients with neutrophil Chemotaxis defects, LJP patients without Chemotaxis defects, other patients with primary neutrophil Chemotaxis defects, and controls. Results suggest that reduction of GP110 and FMLP receptor on neutrophils is specific for LJP patients who exhibit neutrophil Chemotaxis abnormalities. J Periodontol 1990;61:180–184.
Occurrence of Periodontitis in an Urban Adolescent Population
Authors: Perry Dorothy A. , Newman Michael G.
Published: March 2012

The presence of periodontitis in 307 black, Hispanic, and Asian students age 12 to 15 years was evaluated by calibrated examiners in a Los Angeles inner city junior high school. The periodontal status of maxillary and mandibular incisors and permanent first molars was evaluated using the Plaque Index, probing depth, attachment loss, bleeding on probing, tooth mobility, presence of calculus, and caries. Thirty‐nine (12.7%) of 307 students had 5 mm or deeper probing depths and associated attachment loss of at least 2 mm and were considered to have periodontitis (PD). The PD group had significantly more bleeding, calculus, and missing teeth than the non‐PD group, but both groups had moderate to severe plaque accumulation. The distribution and severity of disease increased with age. Deeper probing depths were associated with the molar teeth and six (15.4%) of the 39 subjects in the PD group had furcation involvement. Clinical screening alone was not sufficient to determine if the periodontitis seen was localized juvenile periodontitis; however, the program detected a high occurrence of periodontitis in this population group. J Periodontol 1990;61:185–188.
Stimulation of Lymphocytes in Vitro by Bacteroides intermedius and Bacteroides (Porphyromonas) gingivalis Sonicates
Authors: Raber‐Durlacher J.E. , Zeijlemaker W.P. , Meinesz A.A.P. , Abraham‐Inpijn L.
Published: March 2012

The present study was designed to assess whether the in vitro stimulation of lymphocytes by sonicates of Bacteroides intermedius and Bacteroides (Porphyromonas) gingivalis is antigen specific or non‐specific. In addition, the role of T and B lymphocytes in these responses was assessed. Peripheral blood lymphocytes obtained from healthy volunteers were cultured in the presence of these bacterial preparations and the proliferative response was measured. In similar experiments the response of umbilical cord blood lymphocytes did not exceed background values. In limiting dilution experiments only 1:4000, 1:6800, and 1:8200 of the lymphocytes initially reacted to B. intermedius, which strongly argues for the antigen‐specificity of the response. Purified T cells, in the presence of monocytes, proliferated when stimulated with B. intermedius and B. gingivalis. As for B cell stimulation, the bacterial extracts were capable of inducing IgM production, which appeared to be T cell dependent. These findings support the notion that B. intermedius and B. gingivalis induce specific T cell activation; secondarily, a T cell dependent, polyclonal B cell activation may occur. J Periodontol 1990; 61:217– 223.
Human Clinical and Histologic Responses to the Placement of HTR Polymer Particles in 11 Intrabony Lesions
Authors: Stahl S.S. , Frown S.J. , Tarnow D.
Published: March 2012

Eleven intrabony periodontal lesions in five volunteer patients received surgical debridement followed by site implantation of a porous paniculate polymeric composite (HTR polymer). These patients were observed over time periods varying from 4 weeks to 26 weeks. At the end of the individual observation periods, treated sites were surgically removed in block for histologic analysis. Clinical observations indicated a reduction in pocket depth following treatment which consisted of both gingival recession and gain in clinical closure. No untoward effects were observed clinically in any treated patient during the observation periods. Histologic responses varied from gain in closure by epithelial adhesion to new attachment of varying magnitude. Such varied responses were seen within the same patient and between patients. Graft particles were present at sites from 4 weeks to 26 weeks after implantation and were surrounded by connective tissue capsules. At the periphery of some particles, limited bone formation was present. The alveolar bed was remodeling, at times surrounding specific particles. In our sample, HTR polymer, therefore, appeared to be a well tolerated synthetic graft material when implanted in human intrabony lesions. J Periodontol 1990;61:269‐274.