bluuebunny/crossref_metadata_2025 huggingface dataset:
Defective Neutrophil Function in an Insulin‐Dependent Diabetes Mellitus Patient. A Case Report
Authors: Cutler Christopher W. , Eke Paul , Arnold Roland R. , Van Dyke Thomas E.
Published: March 2012

The objective of this study was to evaluate the polymorphonuclear leukocyte (PMN) function in a poorly controlled adult insulin‐dependent diabetic patient (IDDM) with severe recurrent periodontitis, while describing the microbiological and clinical findings. Chemotaxis, Superoxide production, and phagocytosis and killing of Porphyromonas (Bacteroides) gingivalis by the IDDM PMN were evaluated 1 week before treatment relative to a healthy, matched control. These analyses revealed a significant (P <.05) depression in the number of IDDM PMNs migrating along an FMLP gradient (Boyden chamber assay). In addition, a significant (P <.05) enhancement of IDDM PMN superoxide production in response to opsonized zymosan (cytochrome C reduction) was observed. Phagocytosis and killing (fluorochrome phagocytosis assay) by IDDM PMN of two P. gingivalis strains was also impaired significantly (P <.05). The subgingival microflora contained significant levels of P. gingivalis, Actinobacillus actinomycetemcomitans, Eikenella corrodens, and Peptostreptococcus micros. Periodontal treatment consisted of extraction of hopeless teeth, scaling and root planing and 3 weeks of Augmentin therapy. The antibiotic therapy resulted in unrecoverable numbers of the putative pathogens and a reduction in both gingival inflammation and disease progression. The IDDM healing response to previous surgical treatment and extractions was poor, presumably due to a marked thrombocytopenia (91 × 103 platelets/mm3). / Periodontol 1991; 62:394–401.
Psoriasis‐Associated Periodontitis: A Case Report
Authors: Yamada J. , Amar S. , Petrungaro P.
Published: March 2012

Psoriasis with oral manifestations is rarely seen. It has been reported in the past either as an oral manifestation of this skin disease or lichen planus accompanying psoriasis. Very few periodontal lesions associated with dermatologic psoriasis have been reported in the literature. This report describes a case of psoriasis in which exacerbation of the cutaneous disease was accompanied by gingival epithelial changes and periodontal bursts, together with a report on the light microscopy of biopsies from periodontal lesions. J Periodontol 1992; 63:854–857.
The “Plaque‐Free Zone” in Health and Disease: A Scanning Electron Microscope Study
Authors: Friedman Marlize T. , Barber Pauline M. , Mordan Nicola J. , Newman Hubert N.
Published: March 2012

A “plaque‐free” zone has been described on the enamel surface of healthy extracted teeth. This study examined this zone on chronic adult periodontitis‐affected teeth (CAPT). Ten healthy controls and 16 CAPT were collected immediately after extraction, fixed, dehydrated, critical point dried, coated, and viewed by scanning electron microscopy (SEM). The “plaque‐free” zone was observed in both groups as an area with few bacteria between the apical plaque border and the coronal limit of an epithelial layer on the root surface, extending to the residual periodontal ligament. On the healthy specimens, the apical plaque border consisted mainly of cocci and short rods, while on the CAPT specimens spirochetes predominated. Isolated or small groups of microorganisms were always present in the “plaque‐free” zone and at its apical limit, close to or in contact with junctional epithelial cells. This zone is therefore not completely free of plaque, as suggested. It was concluded that a tissue complex, analogous to that in health on enamel, persists on the root surfaces of CAPT throughout the disease process. It comprises a discrete plaque border, a dental cuticle with sparse organisms, and an epithelium analogous to junctional epithelium. Its main function would appear to be to prevent bulk access of plaque to the surrounding tissues, including direct contact of bacteria with underlying ligament. J Periodontology 1992; 63:890–896.
Field Testing As Clinical Trial Methodology in Periodontics
Authors: Kornman Kenneth S. , Newman Michael G. , Holtzman Samuel , Matheson James E.
Published: March 2012

In the early 1950s the randomized control trial (RCT) was introduced and became widely accepted as the definitive proof of efficacy of a specific medical treatment. In fact, the acceptance and application of this methodology were instrumental in converting medicine from an unpredictable art to a science. At present no other methodologies exist that allow the evaluation of therapeutic efficacy with confidence comparable to that achieved with randomized controlled trials. In recent years researchers have applied new experimental designs and data analysis techniques to clinical trials conducted in a field trial environment to facilitate the understanding of proper use of new therapeutic agents and procedures. Since many of the new methodologies are still evolving or have only recently been introduced, this review considers some of the major trends and developments, as well as experiences of the authors, in field trial methodology. This manuscript addresses the following questions: 1) Are there current clinical trial needs that are not met by RCT? 2) If so, what considerations are necessary for new approaches to have scientific usefulness? and 3) What are the strengths and weaknesses of the field trial's setting relative to an institutional environment? J Periodontol 1992; 63:1064– 1071.
Measurement of Attachment Level in Clinical Trials: Probing Methods
Authors: Pihlstrom Bruce L.
Published: March 2012

Measurement of clinical attachment level has become a standard for judging clinical response in periodontal therapy. A number of probing methods and instruments have been developed in an attempt to address limitations in obtaining this measurement. First generation instruments include conventional periodontal probes; second generation probes utilize controlled forces; and third generation probes incorporate automated measurement, controlled forces, and computerized data capture. Various types of Stents have been used and repeated measurement techniques have been proposed to reduce examiner error. Controlled force probes appear to have their greatest advantage in increasing inter‐examiner repeatability. The use of measurement Stents increases inter‐ and intra‐examiner reliability. However, use of such Stents may be limited to small sample studies of limited duration. Third generation instruments offer advantages in terms of automated measurement and data capture, increased resolution, and a more continuous measurement scale, but do not necessarily result in increased intra‐or inter‐examiner reliability. Examiner training and calibration are essential for any measurement instrument. Decisions for or against use of a particular instrument must be made on the basis of the needs of each clinical trial. At the present time, no commercially available instrument resolves all of the inherent limitations of clinical measurement of attachment level. J Periodontol 1992; 63:1072–1077.
Cigarette Smoking in a Periodontal Practice
Authors: Haber Jerome , Kent Ralph L.
Published: March 2012

This case‐control study compares the prevalence of cigarette smoking among patients in a periodontal practice (cases) with that of patients in referring general dental practices (controls). Smoking histories of patients (age ≥25 years) in a periodontal practice and five general dental practices were obtained by questionnaire. From the general practices, only patients reporting negative histories for Periodontitis were studied. Periodontal status of the periodontal practice patients was based on bone loss from full mouth radiographic surveys and gingival pocket depths. Patients were stratified by age (25 to 40, 41 to 55, and >55 years) and sex. The combined frequency of current or former cigarette smoking reported by 196 periodontal practice patients with moderate or advanced Periodontitis (M‐A perio group) was higher than that reported by 209 general dental practice patients (gen prac group) in all age and sex catagories. The age and sex adjusted summary odds ratio for a positive smoking history among M‐A perio subjects relative to gen prac subjects was 2.6 (P <0.001). Separate corresponding odds ratios (age and sex adjusted) for current smoking versus never smoking in the two groups were 3.3 (P <0.001) and for former smoking versus never smoking 2.1 (P <0.004). Among current smokers, patients in the M‐A perio group reported heavy smoking (> 10 cigarettes/day) relatively more often than control subjects (adjusted R.O. = 5.7; P <0.001). In the M‐A perio group the frequency of current smoking increased with disease severity. These associations add to the accumulating evidence suggesting that both current and former smokers are at increased risk for Periodontitis, and that cigarette smoking is a major risk factor for Periodontitis. J Periodontol 1992;63:100‐106.
Evaluation of Oral Bacteria as Risk Indicators for Periodontitis in Older Adults
Authors: Beck James D. , Koch Gary G. , Zambon Joseph J. , Genco Robert J. , Tudor Gail E.
Published: March 2012

The prevalence of people and sites with attachment loss, pocket depth, Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Porphyromonas gingivalis are described for a random sample of 366 black and 297 white community‐dwelling adults, aged 65 or over, residing in five counties in North Carolina. In addition, relationships between sites harboring these microorganisms and loss of attachment (LA) and pocket depth (PD) are presented in a manner that considers the lack of independence of sites within each person. Pocket depths and recession were measured on all teeth by trained examiners during household visits. Immunofluorescent assays for A. actinomycetemcomitans, P. intermedia, and P. gingivalis were conducted on subgingival plaque samples obtained from the mesiobuccal aspect of the four first molar teeth using paper points. The prevalences of A. actinomycetemcomitans, P. intermedia, and P. gingivalis were greater in blacks than in whites. The most striking difference was seen for P. gingivalis, which was found in 38.8% of blacks and 9.4% of whites. Similar relationships were found when the percent of sites with these organisms were assessed. Blacks with P. gingivalis or P. intermedia had a higher prevalence of sites with LA ≥7 mm as compared to blacks not infected with P. gingivalis or P. intermedia. The same was true for whites. Similar relationships between P. gingivalis or P. intermedia and PD ≥6 mm were found for both blacks and whites. However, the greater prevalence for blacks than whites for LA ≥7 mm or PD ≥6 mm when both were infected with P. gingivalis or P. intermedia were suggestive trends rather than significant. Finally, a logistic regression model for LA ≥7 mm showed that race was no longer a significant explanatory variable when P. gingivalis, P. intermedia, last visit to the dentist being more than 3 years ago, and tobacco use were already in the model. It is clear that destructive periodontal disease is the result of a complex relationship among subgingival microflora and non‐bacterial factors. The interaction between the microbial flora and these other factors present a fruitful area of investigation in order to fully understand the complexity of periodontal disease in adults. J Periodontol 1992; 63:93‐99.
Comparison of a 0.12% Chlorhexidine Mouthrinse and an Essential Oil Mouthrinse on Oral Health in Institutionalized, Mentally Handicapped Adults: One‐Year Results
Authors: McKenzie William T. , Forgas Lorraine , Vernino Arthur R. , Parker Donald , Limestall J.D.
Published: March 2012

The purpose of this study was to compare the efficacy of a 0.12% Chlorhexidine mouthrinse and an essential oil mouthrinse on plaque accumulation and gingivitis in mentally handicapped adults over a one‐year period. Twenty‐seven institutionalized mentally handicapped adults participated. Gingival index (GI), plaque index (PI), and probing depths (PD) were recorded and an ultrasonic scaling was performed (Baseline 1). GI, PI, and PD were again recorded after 2 weeks (Baseline 2). Patients were then assigned to either the Chlorhexidine or essential oil mouthrinse group. The patients rinsed twice daily under supervision with their assigned mouthrinse while maintaining their attempts at daily brushing. GI and PI were recorded at monthly intervals for 12 months, while the PD was recorded only at Baseline 1 and 2 and at 12 months. A paired t‐test was used to compare differences between the parameters at Baseline 1 and Baseline 2. A 2factor repeated measure ANOVA was performed on each parameter after the Baseline 2 evaluation. A statistically significant decrease in the probing depth occurred as a result of ultrasonic scaling; however, no significant changes in the PI or GI occurred. Both mouthrinses produced a significant improvement in the GI after one month. Despite the improvement, the GI was still indicative of disease. Over the 12 months no further significant improvement in the GI occurred. A statistically significant improvement in the PI occurred in the Chlorhexidine group at month 1, but returned to Baseline 2 levels over the 12 months. No improvement in the PI occurred in the essential oil group. The probing depths remained the same over the 12 months. No clinically significant improvements in the gingival condition of these mentally handicapped adults occurred as a result of rinsing with either mouthrinse. J Periodontol 1992; 63:187–193.
Clinical Criteria for the Definition of “Established Periodontitis”
Authors: Machtet Eli E. , Christersson Lars A. , Grossi Sara G. , Dunford Robert , Zambon Joseph J. , Genco Robert J.
Published: March 2012

The objective of the present study was to define criteria for the diagnosis of “established periodontitis.” This term will define subjects who have demonstrated clinical attachment loss, and as such can be considered to have periodontitis. Using these criteria, healthy and established periodontitis subjects were compared with respect to gender, race, and age. Five hundred and eight subjects including 248 females and 260 males between the ages of 25 to 73 (mean 44.6 years), were examined in this study. The clinical examination included: plaque assessment index (PAI); gingival assessment index (GAI); probing pocket depth (PPD); and clinical attachment level (CAL). The mean and frequency distribution of these parameters were analyzed by age and gender. CAL (mean 2.12 mm) showed constant and significant increases with age, ranging from a mean of 1.63 mm in subjects 25 to 34 years of age to a mean of 2.65 mm in subjects 65 to 74 years of age. Males exhibited higher mean values than females for all the measured parameters, which were statistically significant for PAI, PPD, and CAL. The frequency distribution of subjects with PPD and CAL beyond certain threshold levels showed an exponential decline and was correlated to both the severity of the most involved site as well as the number of sites beyond threshold levels. The clinical entity of “established periodontitis” is suggested based on the presence of CAL ≥ 6 mm in 2 or more teeth and one or more sites with PPD ≥ 5 mm. In the present study, 30.5% of the subjects fell into this category. African‐Americans, who constituted 5.7% of the subjects, comprised almost 10% of the established periodontitis group. Likewise, males who comprised 51.1% of the subjects constituted over 60% of the established periodontitis group. The aged (65 to 74 years) made up 8.8% of the subjects, but nearly 14% of the established periodontitis group. These higher proportions of the aged, male, and African‐American individuals in the established periodontitis group would suggest that they are at higher risk for this disease. This clinical characterization of established periodontitis may be useful in focusing on the subset of the population which may be at greater risk for periodontal breakdown. J Periodontol 1992; 63:20Z–215
Topographical Characteristics of Root Trunk Length Related to Guided Tissue Regeneration
Authors: Jackson Lu Hsein‐Kun
Published: March 2012

Thirty‐seven molars with 94 furcations were selected for a topographical study of root trunks to clarify the possible factors which may affect the clinical application of guided tissue regeneration technique. A pre‐determined plane was marked on the root trunk of each tooth 1 or 2 mm below the cemento‐enamel junction (CEJ). The plane followed the presumed position of the occlusal border of the Teflon membrane. Cross sectioning of the root was then performed following the plane, and the width of the gap between the membrane and root surface was measured with the aid of a stereomicroscope. The results revealed, within the limited samples of this study, 94% of the furcations possessed variant depth of developmental concavities on the root trunks. These superficial irregularities at the entrances of furcations may prevent complete adaptation of the coronal microstructure of the Teflon membrance along their root surfaces. The width of the gaps between root surfaces and membranes ranged from 0.000 mm to 2.250 mm for all tooth samples. The study implied that the subgingival application of guided tissue membranes 1 to 2 mm below CEJ cannot ensure complete adaptation of furcation defects with their coronal microstructures in the majority of molars. J Periodontol 1992; 63:215‐219.
The Apical Border Plaque in Chronic Adult Periodontitis. An Ultrastructural Study. I. Morphology, Structure, and Cell Content
Authors: Vrahopoulos Theofilos P. , Barber Pauline M. , Newman Hubert N.
Published: March 2012

This study concerns the apical border (AB) plaque in relation to chronic adult Periodontitis (AP). Fifty‐six teeth from 24 patients with AP were examined by transmission electron microscopy (TEM). The AB was not discrete with islands of bacteria in the so‐called plaque‐free zone (PFZ). Coronal to the AB, the established plaque commonly consisted of three to four layers of Gram‐positive and Gram‐negative cocci, rods, filaments, and spirochetes and a superficial layer, mainly of spirochetes, but including filaments, “test tube brush,” and “corn‐cob” formations. The most apical apparently intact organisms in the PFZ were in bacterial islands or in isolation and were predominantly Gram‐negative cocci and rods, with occasional other morphotypes. The most apical microorganisms were invariably ghost cells. A cuticle of varying thickness and structure was present at the plaque/tooth interface. It was concluded that there was a limited range of intact bacterial morphotypes in the apical border plaque in chronic periodontitis. J Periodontol 1992; 63:243–252.
The Effects of Chlorhexidine Digluconate on Human Fibroblasts In Vitro
Authors: Pucher Jeffery J. , Daniel C.
Published: March 2012

The drug Chlorhexidine has been widely utilized as a wound antiseptic and oral antimicrobial rinse. There have been numerous reports on its safety as an oral rinse, but its effects on wound healing have been contradictory. The present study utilized human fibroblasts derived from skin and oral tissues to test the effects of chlorhexidine on viability, growth, collagen gel contractions, and total protein synthesis. Cells were exposed for an hour to 0.005% and 0.002% chlorhexidine and for 30 seconds to 0.12% chlorhexidine. Our results indicate that a 0.002% concentration of the drug shows minimal cytotoxicity, but is able to suppress cell division almost completely. Collagen gel contraction, as a model of wound contraction, was also severely affected by all of the concentrations of chlorhexidine used. Total protein synthesis was suppressed by chlorhexidine in collagen gel culture. The data support the hypothesis that chlorhexidine is highly cytotoxic to cells in vitro, but various cell functions such as proliferation, collagen gel contraction, and protein synthesis are affected to different degrees by the drug. J Periodontol 1993; 62:526–532.
Early Effects of Periodontal Therapy on the Detection Frequency of Four Putative Periodontal Pathogens in Adults
Authors: Ali Raouf Wahab , Lie Tryggve , Skaug Nils
Published: March 2012

This study aimed to examine early posttreatment changes in the periodontal microflora. Paper point sampling and conventional bacterial cultivation were used to monitor the effects of surgical and non‐surgical periodontal therapy on the detection frequency of Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, and Capnocytophaga species in deep periodontal pockets. Ten patients, 5 men and 5 women (mean age 44 years), with advanced periodontal disease were selected from the dental school patient population for the study. A total of 245 teeth in 10 defined areas of the dentition were treated by oral hygiene instruction followed by scaling and root planing alone (121 sites) or with surgical interventions (124 sites). Ninety sites, 47 surgical and 43 non‐surgical, with initial pocket depth ≥ 6 mm were sampled at baseline and 3 months after completion of therapy. Treatment by both procedures resulted in significant clinical improvements as assessed by all clinical parameters used. Baseline results may indicate that the level of P. gingivalis was reduced in the presence of P. intermedia, while A. actinomycetemcomitans seemed to be reduced in the presence of P. gingivalis and/or P. intermedia. Three months after therapy, the detection frequency of P. gingivalis was significantly reduced (P <0.05) in surgical and non‐surgical sites while the reduction for P. intermedia was significant only for surgical sites (P <0.05). P. intermedia was eliminated from 2/3 of the non‐surgical sites that had been positive at baseline, but this reduction did not reach a significant level, and the relative proportion of this organism increased significantly (P <0.05) in the sites positive after therapy. A. actinomycetemcomitans could not be detected in any of the sampled sites 3 months after therapy. Capnocytophaga species were significantly reduced to the same extent (P <0.05) following both treatment modalities. J Periodontol 1992; 63:540–547.
Guided Tissue Regeneration in the Treatment of Human Facial Recession. A 12‐Case Report
Authors: Tinti Carlo , Vincenzi Gianpaolo , Coltellini Pierpaolo , Prato Giampaolo Pini , Clauser Carlo
Published: March 2012

A guided tissue regeneration procedure was used to treat human buccal recessions, 3 to 7 mm deep, in 12 patients. No procedure for increasing the width of keratinized tissue was performed prior to treatment. A thick bipedicled flap was raised with a semilunar incision in the alveolar mucosa and a marginal incision was extended to the adjacent papilla. The root surface was made concave by curets and burs to create space for regeneration. The membrane was fixed to the cemento‐enamel junction and covered by the flap which consisted of the residual gingiva and of alveolar mucosa. The membranes were removed 4 weeks after placement. The patients were recalled 6 months after the reentry procedure. The average reduction in recession was 2.50 mm (P <0.01) and the average attachment gain was 2.84 (P <0.01). Pocket depth was slightly reduced (0.33 mm), although the degree of reduction was not of statistical significance. The width of keratinized tissue increased slightly (0.83 mm). These results demonstrate the possibility of treating human buccal recessions by means of a guided tissue regeneration procedure, with predictable recession reduction and attachment gain. A minimal amount of keratinized tissue was needed. J Periodontol 1992; 63:554–560.
Recurrent Peripheral Odontogenic Fibroma of the Attached Gingiva: A Case Report
Authors: Michaelides Paul L.
Published: March 2012

Peripheral odontogenic fibroma is an uncommon, benign, unencapsulated, exophytic gingival mass of fibrous connective tissue covered with a surface epithelium. Odontogenic epithelium and mineralized material may be found in the mass. A case is reported of a lesion that recurred in the attached gingiva following initial excision. Differential diagnosis of exophytic gingival lesions and post‐operative management are also discussed. J Periodontol 1992; 63:645–647.
Retained “Hopeless” Teeth: Lack of Effect Periodontally‐Treated Teeth Have on the Proximal Periodontium of Adjacent Teeth 8‐Years Later
Authors: Wojcik Michael S. , DeVore Cheryl H. , Beck F. Michael , Horton John E.
Published: March 2012

We previously reported the lack of effect periodontally‐treated teeth prognosed “hopeless” and retained for 3.4±1.5 years have on the proximal periodontium of adjacent teeth. We now report our findings for the same group of subjects following 8.4±0.7 years of “hopeless” tooth retention. Of the 17 “hopeless” and adjacent teeth originally measured in 17 subjects, 14 of the subjects were still available for re‐evaluation. Measures used to assess the periodontium of proximal surfaces of adjacent teeth included pocket depths (PD), radiographic alveolar bone level (R‐BL), and periodontal ligament space width (W‐PL). Treatment for the subjects consisted of surgical therapy (N = 15) and scaling and root planing (N = 2). Of the 14 subjects re‐examined, 2 were eliminated due to loss of adjacent tooth reference points and 2 due to extraction of the “hopeless” tooth (N = 10). Differences in measurements (i.e., nonadjacent to “hopeless” tooth value minus adjacent to “hopeless” tooth value) were analyzed using a repeated measures ANOVA. There were no significant differences for PD (P = 0.20), R‐BL (P = 0.29), or W‐PL (P = 0.16). These data confirm our original findings that retained periodontally “hopeless” teeth do not significantly affect the proximal periodontium of adjacent teeth following therapy. J Periodontol 1992; 63:663–666.
A Histomorphologic Study of the Effects of Periodontal Inflammation on the Maxillary Sinus Mucosa
Authors: Moskow Bernard S.
Published: March 2012

Twenty blocks of human jaws obtained at autopsy and containing maxillary molar teeth with the contiguous maxillary sinus intact were prepared utilizing conventional histopathologic techniques and were studied by light microscopy. The purpose of this investigation was to confirm earlier clinical reports suggesting a close association between human Periodontitis and maxillary sinus thickening and to morphologically document the nature of the sinus changes. Seventeen of 20 jaw specimens demonstrated moderate to advanced periodontal destruction with pervasive extension of the inflammatory infiltrate through the alveolar process beyond the apices of the teeth and extending to the region of the antrum. Of the 20 histologic specimens, 10 showed extensive thickening of the sinus membrane, 9 had moderate hyperplastic changes, and only 1 specimen demonstrated a normal appearing sinus. Pathologic changes in the sinus membrane included inflammatory cell infiltration, edema, fibrosis of the tunica propria, mucous‐serous gland proliferation, interstitial pseudo‐cyst formation, polyp formation, hyalinization of the connective tissue lining, thrombosis of blood vessels, and metaplastic and degenerative changes in the epithelial lining. This study, based on histopathologic changes, suggests an apparent direct relationship between moderate and severe Periodontitis of the maxillary molar teeth and pathologic changes resulting in thickening of the maxillary sinus mucosa. J Periodontol 1992; 63:674–681.
Biochemical and Clinical Factors Influencing Oral Malodor in Periodontal Patients
Authors: Yaegaki Ken , Sanada Kazuo
Published: March 2012

The amounts of volatile sulfur compounds (VSC) and methyl mercaptan/hydrogen sulfide ratio in mouth air from patients with periodontal involvement were 8 times greater than those of control subjects. Our studies demonstrated that, in patients with periodontal disease: 1) the concentration of disulfide, which is converted to VSC, increased in proportion to the total pocket depth; 2) 60% of the VSC was produced from the tongue surface; 3) the amount of tongue coating was 4 times greater than in control subjects; and 4) VSC production and the methyl mercaptan/hydrogen sulfide ratio of the tongue coating were increased. 2‐Ketobutyrate, which is a byproduct of the metabolism of methionine to methyl mercaptan, was higher in the saliva of patients with periodontal disease. This implies that metabolism of methionine to methyl mercaptan increases in the oral cavity of patients with periodontal pockets. Since free L‐methionine, rather than protein, is the main source for methyl mercaptan, we estimated the methionine supply from the gingival fluid into the oral cavity of patients with periodontal involvement. The results showed that the ratio of methionine to whole free amino acids was significantly higher than that of cysteine. Our studies suggest that not only microorganisms, but also the tongue coating and gingival fluid are factors which enhance VSC production in patients with periodontal disease. J Periodontol 1992; 63:783–789.
A Histomorphometric Study on The Healing of Class III Furcations Utilizing Bone Labelling in Beagle Dogs
Authors: White Cecil , Hancock E. Brady , Garetto Lawrence P. , Kafrawy Abdel A.
Published: March 2012

The dynamics of bone turnover in the furcations of teeth treated with expanded polytetrafluoroethylene (ePTFE) membranes were evaluated using multiple fluorochrome labels in 6 male beagle dogs. Loss of attachment involving the furcation area was induced in the second, third, and fourth premolar teeth using silk ligatures. The resulting defects were treated with the use of mucoperiosteal flaps for access, debridement of the defects, and placement of ePTFE membranes covering the furcations of the second and fourth premolare (experimental teeth) while the third premolar received only debridement without membrane placement (control tooth). Five fluorochrome labels were administered intravenously at timed intervals to act as markers of the osseous response. Membranes were removed at 4 weeks and all animals were terminated at 12 weeks post‐membrane placement. One side of the mandible was decalcified, sectioned at 7 μm, and stained with either hematoxylin and eosin or Gomori's tri‐chrome. The opposite side provided non‐decalcified tissue processed as 100 μm ground sections. Using fluorescent light and point‐hit evaluation, tissue in the coronal half of each specimen was classified as either labelled bone, unlabelled bone, or resorption space. In addition, microradiographs were prepared of each ground section and specimens classified as either woven bone, old lamellar bone, or new lamellar bone. No significant differences in attachment levels, or level of junctional epithelium, were observed in decalified sections although greater remodeling activity was noted in the experimental specimens. Comparison of ground sections revealed significant differences (P < 0.05) in all categories with both methods of evaluation. Experimental specimens exhibited greater remodeling activity, bone apposition, and percentage of woven bone formation. These results suggest that light microscopy may underestimate the overall osseous response and that membrane placement significantly alters bone turnover in treated furcation sites. J Periodontol 1994;65:84–92.
Effect of Treatment on Some Periodontopathogens and Their Antibody Levels in Periodontal Abscesses
Authors: Hafström Caroline A. , Wikström Maude B. , Renvert Stefan M. , Dahlén Gunnar G.
Published: March 2012

Twenty patients suffering from abscess of periodontal origin were treated and followed clinically and microbiologically for 6 months. Microbiological examination was performed by culture technique. One deep and one shallow periodontal pocket in the same patient were examined concomitantly. Serum was collected and analyzed for specific antibody level using ELISA methodology. Treatment included supragingival scaling, drainage, and irrigation of the periodontal pocket with 0.85% sodium chloride and systemic tetracycline administration, 1 g per day for 2 weeks. At baseline, 90% of the abscesses harbored Porphyromonas gingivalis and/or Prevotella intermedia. After 6 months, abscess sites demonstrated a reduced probing depth, less bleeding on probing, and gain of attachment. Abscess sites showed no P. gingivalis and the proportion of P. intermedia was significantly reduced 6 months after treatment. In deep periodontal pockets a similar pattern was seen. Shallow pockets demonstrated few clinical signs of inflammation and the number of bacteria was generally low. Campylobacter rectus, Capnocytophaga spp, and Fusobacterium nucleatum were frequently seen in low numbers in most sites during the study period, while Actinobacillus actinomycetemcomitans was detected only in a few sites. The IgG levels in patient sera against antigens of homologous bacterial strains remained fairly constant for 6 months. The result of the present study indicates that P. gingivalis and P. intermedia are involved in periodontal abscess formation. Also, treatment where drainage is combined with tetracycline administration promotes healing and reattachment. J Periodontol 1994; 65:1022–1028.
Osteoporosis: A Risk Factor in Periodontal Disease
Authors: von Wowern Nina , Klausen Bjarne , Kollerup Gina
Published: March 2012

Osteoporosis is suspected as a risk factor in periodontal disease, but previous studies have failed to establish a relationship. Possible explanations for this could be lack of precise methods for assessment of osteoporosis in the jaws and confounding of the result by other factors such as age, gender, or smoking. In the present study 12 female patients with osteoporotic fractures (Group O) and 14 normal women (Group N) were examined clinically for plaque (VPI), gingival bleeding (GBI), and loss of attachment on the 6 Ramfjord index teeth. Bone mineral content (BMC) of the mandible and forearm was determined by dual photon scanning. Results were presented as arithmetic means ± standard error, and differences between groups were tested by 2‐sample t‐test. The two groups were comparable with respect to age (O: 68.3 ± 1.8 years, N: 68.1 ± 1.5 years), menopausal age (O: 47.5 ± 1.8 years, N: 47.2 ± 1.3 years), and smoking habits (O: 4 smokers, N: 3 smokers). The osteoporotic women had significantly lower BMC values than controls in the mandible (O: 0.63 ± 0.04 in U/cm2; N: 0.78 ± 0.02 in U/cm2, P <0.01) and forearm (O: 1.05± 0.05 in U/cm; N: 1.28 ± 0.05 in U/cm, P <0.01). No significant differences were found with respect to plaque (O: 46.67 ± 10.00%, N: 36.67 ± 6.67%) and gingival bleeding (O: 46.67 ± 11.67%, N: 43.33 ± 10.00%), whereas significantly greater loss of attachment was seen in osteoporotic women (O: 3.65 ± 0.18 mm, N: 2.86±0.19 mm, P <0.01). These results suggest that severe osteoporosis which significantly reduces the bone mineral content of the jaws may be associated with less favorable attachment level in case of periodontal disease. J Periodontol 1994;65:1134–1138.
Longitudinal Evaluation of Elastase as a Marker for the Progression of Periodontitis
Authors: Armitage Gary C. , Jeffcoat Marjorie K. , Chadwick David E. , Taggart Edward J. , Numabe Yukihiro , Landis J. Richard , Weaver Susan L. , Sharp Tonya J.
Published: March 2012

To determine whether elastase levels in gingival crevicular fluid (GCF) could serve as a marker for the progression of periodontitis, we monitored GCF elastase and periodontal status in selected sites in 32 periodontally healthy volunteers and 31 periodontitis patients at intervals over a 6‐month period. Clinical measurements included plaque index, gingival index, bleeding on probing, suppuration, probing depth, clinical attachment level, and relative attachment level measured with an automated disk probe. GCF elastase, detected by reaction with a fluorescent substrate, was assessed visually against fluorescence standards and quantitatively with a fluorometer. Bone loss was detected by subtraction radiography of standardized vertical bite‐wing radiographs at baseline and 6 months. Mean visual elastase scores (VES) and quantitative elastase measurements were significantly higher (P < 0.001) in sites from periodontitis patients than in sites from healthy volunteers. When bone loss was used as the criterion for disease progression, significantly higher (P < 0.001) visual and quantitative GCF elastase levels were found at progressing sites than in nonprogressing sites in the periodontitis patients. The odds ratios (OR) for the event of developing bone loss with positive 4‐minute and 8‐minute VES tests were 4.2 (P < 0.001) and 7.4 (P < 0.001), respectively. When corrected for the tendency of progressing sites to be clustered within a subpopulation of patients, the OR for developing bone loss with the 4‐minute and 8‐minute VES tests were 3.1 (P < 0.007) and 4.9 (P < 0.001), respectively. These data indicate that sites with high levels of elastase are at significantly greater risk for progressive bone loss as assessed by digital subtraction radiography. J Periodontol 1994;65:120–128.
Immunohistochemical Analysis of Tissues Regenerated From Within Periodontal Defects Treated With Expanded Polytetrafluoroethylene Membranes
Authors: Pritlove‐Carson Sandra , Palmer Richard M. , Floyd Peter D. , Morgan Peter M.
Published: March 2012

Immunocytochemical analysis was carried out on samples of 5‐, 6‐, and 9‐week old regenerated soft tissue taken from healing periodontal defects treated by guided tissue regeneration using expanded polytetrafluorethylene (ePTFE) membranes. A panel of monoclonal and polyconal antibodies to cytokeratins, vimentin, and collagen was used to label cells and collagen types I, III, and IV. Epithelium was identified in 7 of the 9 samples examined, in addition to mesenchymal cells staining positively for vimentin and co‐distribution of collagen types I, III, and IV in all samples. Clinical observations indicated that exposure of the ePTFE membranes during healing was a frequent occurrence, and the presence and quantity of epithelium found within the healing defect beneath the membrane may be related to the extent to which this occurs. J Periodontol 1994;65:134–138.
Assessment of Interleukin‐6 in the Pathogenesis of Periodontal Disease
Authors: Takahashi Keiso , Takashiba Shogo , Nagai Atsushi , Takigawa Masayuki , Myoukai Fumio , Kurihara Hidemi , Murayama Yoji
Published: March 2012

This study was performed to investigate the aspects of interleukin‐6 (IL‐6) production in both the gingival tissue and the peripheral blood of patients with periodontal disease and of periodontally healthy subjects. In addition, IL‐6 expression in human gingival tissues was studied by reverse transcription‐polymerase chain reaction analysis and by immunoperoxidase staining with anti‐IL‐6 monoclonal antibody. The levels of IL‐6 in the culture supernatants from peripheral blood mononuclear cells (PBMC) stimulated with lipopolysaccharide and in serum were examined by bioassay. We detected IL‐6 mRNA expression in all inflamed gingival tissues (17/17) examined and in 2/4 in healthy gingival tissues. IL‐6 protein was detected mainly in endothelial cells, fibroblasts, and macrophages but not in the area containing T or B cells in the inflamed gingival tissues, and was not detected at all in healthy gingival tissues. There was no significant difference between the subjects with periodontal disease and those with healthy gingival tissues either in serum IL‐6 levels or in the amount of IL‐6 produced by PBMC. These results suggest that non‐lymphoid cells in inflamed gingival tissue may contribute to the pathogenesis of periodontal disease via IL‐6 production, and that the IL‐6 produced in gingival tissue may not reflect the IL‐6 levels in peripheral blood. J Periodontol 1994;65:147–153.
Adherence of Oral Microorganisms to Guided Tissue Membranes: An In Vitro Study
Authors: Wang Hom‐Lay , Yuan Kuo , Burgett Frederick , Shyr Yu , Syed Salam
Published: March 2012

Microorganisms can adhere and colonize on an exposed guided tissue regeneration (GTR) membrane thus developing a nidus of infection. The purpose of this study was to compare early bacterial adhesion to three different GTR membranes. Expanded polytetrafluoroethylene, polyglactin 910, and collagen were used as the test membranes. In part I of this study 15 different oral microbes were used to compare their relative ability to adhere to the membranes. Six of the most strongly adherent bacteria (Actinomyces viscosus, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Streptococcus mutans, Fusobacterium nucleatum, and Selenomonas sputigena) were selected for part II of this study. The membranes were placed in tubes containing broth cultures containing identical concentrations (1 × 108 cells/ml) of these bacteria at 37°C. Membranes were placed in tubes of media without bacteria as controls. At 4, 6, 12, and 24 hours, the bacterial cultures were decanted and the membranes in the tubes were agitated gently in reduced transfer fluid (RTF) 4 times to remove non‐adherent bacteria. Each tube was then sonicated for 30 seconds in 10 ml RTF to detach adherent bacteria. The detached adherent bacteria were counted using a Petroff‐Hausser chamber. Data were analyzed by using the SAS program. Analysis of variance was used to test for differences between multiple means. Results showed S. mutans had the strongest adherence at all time points except for P. gingivalis which exhibited the strongest attachment to the collagen membrane at 4 and 6 hours. Selenomonas sputigena had the lowest adherence capability to all test membranes. Polyglactin 910 had significantly (P <0.05) lower S. mutans adherence than either the ePTFE or the collagen membrane at 4 and 6 hours. The collagen membrane had significantly higher values of S. mutans adherence at 12 and 24 hours when compared to the other two membranes. No significant differences on A. actinomycetemcomitans, A. viscosus, F. nucleatum, and Selenomonas sputigena were observed when different membranes were compared. This pilot study indicated that certain bacteria adhere to GTR membranes and that S. mutans and P. gingivalis have the strongest adherence affinity of those microbes tested. J Periodontol 1994;65:211–218.
Bacteria as Risk Markers for Periodontitis
Authors: Wolff Larry , Dahlén Gunnar , Aeppli Dorothee
Published: March 2012

Specific microbial species have been closely associated with periodontitis. Through longitudinal studies, some of these microbial species have been implicated in the etiology of progressive periodontal disease. Although putative periodontal pathogens are often isolated from individuals with severe periodontitis, they also frequently inhabit the subgingival environment and are not always associated with advanced disease. In this respect, it is becoming increasingly apparent that there is no single etiology of the various periodontal diseases. Destructive periodontal diseases are the result of environmental, host, and bacterial factors. Microorganisms, however, are essential components of any model for progressive periodontitis. This paper selectively reviews bacteria as risk markers for periodontitis. Attention focuses on bacteria in conjunction with behavioral patterns (oral hygiene habits and smoking) and host response (gingival crevicular fluid substances) as risk markers for periodontitis. Prospective studies implicating specific bacteria in progressive periodontitis are addressed and a bacterial risk assessment model for progressive periodontitis is discussed with respect to the interplay between bacterial, environmental, and host markers. J Periodontol 1994; 64:498–510.
Evidence for Autosomal Dominant Inheritance and Race‐Specific Heterogeneity in Early‐Onset Periodontitis
Authors: Marazita Mary L. , Burmeister John A. , Gunsolley John C. , Koertge Thomas E. , Lake Kim , Schenkein Harvey A.
Published: March 2012

Early‐onset periodontitis (EOP) refers to a group of severe periodontal diseases with age of onset near puberty that are characterized by rapid destruction of the tissues supporting the teeth in othewise healthy individuals. Mixed model segregation analyses of 100 families, ascertained through 104 probands with EOP, were carried out to test major locus and multifactorial hypotheses for the etiology of EOP. Heterogeneity tests were used to compare the parameter estimates and conclusions obtained in Black families from those from non‐Black families. The data in these families confirmed that the oftenreported female preponderance of EOP appears to be an ascertainment bias. The segregation analysis results were consistent with an autosomal major locus being sufficient to explain the family patterns of EOP in the entire dataset, and also in both the Black and non‐Black subsets. A dominant mode of transmission was most likely, with penetrance of about 70%. Although the etiologic conclusions were the same for Black and non‐Black families, there was significant heterogeneity in parameter estimates. In particular the Black allele frequency was 0.016 versus the non‐Black frequency of 0.001. J Periodontol 1994;65:623–630.
Periodontal Disease Among New England Elders
Authors: Fox Christopher H. , Jette Alan M. , McGuire Sheila M. , Feldman Henry A. , Douglass Chester W.
Published: March 2012

Much of the existing oral epidemiologic literature is limited by having inadequate numbers of the oldest‐old in their sample, having used rudimentary periodontal measures, or not having examined probability samples of community‐dwelling elders. The New England Elders Dental Study (NEEDS) is the first study that documents the periodontal disease status of a probability sample of 554 adults aged 70 to 96 living within an entire U.S. Public Health Service region. The NEEDS study revealed substantially higher estimates of periodontal destruction among older adults than previous national studies would suggest. These results are consistent with several papers in the literature that suggest that periodontal disease rates are on the increase in older adults. In the coming decades dentistry should be prepared to meet the increasing need and demand for periodontal services in the growing older population. J Periodontol 1994;65:676–684.
A Study of a Pre‐Brushing Mouthrinse as an Adjunct to Oral Hygiene
Authors: Hunter Lyndsey , Addy Martin , Moran John , Kohut Bruce , Hovliaras Christine A. , Newcombe Robert G.
Published: March 2012

A previous clinical screening study demonstrated that a cetylpyridinium chloride (CPC) essential oil mouthrinse inhibited plaque regrowth to a significantly greater extent than a negative control or a triclosan/copolymer rinse when used without toothbrushing. The purpose of this study was to evaluate the same ingredient combination as a prebrushing rinse over a 6‐week period. The study employed a 4 group parallel design with a minimum of 50 subjects per group. Subjects with a minimum baseline plaque index of 1.95 were recruited. The formulations employed were two variations of a CPC/essential oil rinse, a triclosan/copolymer product, and a hydroalcohol negative control. Subjects were rendered plaque free at baseline and then rinsed twice daily before toothbrushing with their allocated product. Plaque was scored at 6 days and 6 weeks. Plaque scores were reduced at 6 days compared to baseline but there were no significant differences between any of the groups. At 6 weeks, plaque scores were significantly lower in both CPC/essential oil groups compared to control. Although both CPC/essential oil groups showed plaque scores which were lower than the triclosan group, in only one of the groups was the difference significant. The triclosan product was not significantly different from control. The results support the previous findings that a CPC/essential oil rinse could be a useful adjunct to oral hygiene when used prior to normal toothbrushing. J Periodontol 1994; 65:762–765.