bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Chlorhexidine on the Structure and Permeability of Hamster Cheek Pouch Mucosa
Authors: Harvey Brien V. , Squier C. A. , Hall B. K.
Published: March 2012

This study examined the effects of Chlorhexidine (CHD) on the clinical appearance, morphology, and in vitro permeability of hamster cheek pouch mucosa. The cheek pouches were treated daily for 3 weeks with topical applications of saline, 0.2% CHD, or 2.0% CHD. Treatment with 2.0% CHD resulted in the formation of discrete white lesions in every animal in the group, whereas no changes were identified in any animal treated with 0.2% CHD or saline. Upon microscopic examination it was determined that treatment with 2.0% CHD resulted in a statistically significant (P < 0.01) increase in epithelial thickness, when compared to the other groups, and the lesions were found to consist of hyperplastic areas of epithelium with associated inflammatory cell accumulations. Daily treatments with 2.0% CHD, 0.2% CHD or saline had no effect on the very low permeability of cheek pouch mucosa to 14C‐CHD. However, treatment with 2.0% CHD resulted in decreased permeability to 3H20 (P < 0.05) when compared to the other groups. Treatment with 2.0% CHD also resulted in a thickened permeability barrier (P < 0.01), as determined using a tracer, horseradish peroxidase. It is concluded that topical applications of 0.2% CHD have no detectable effect on cheek‐pouch mucosa while applications of 2.0% CHD result in hyperplasia and a decrease in mucosal permeability. Our results suggest that CHD should be used with caution clinically and at a concentration of 0.2% or less.
Endodontic Complications Following Periodontal and Prosthetic Treatment of Patients With Advanced Periodontal Disease
Authors: Bergenholtz Gunnar , Nyman Sture
Published: March 2012

A retrospective analysis was carried out to determine the frequency and onset of endodontic complications occurring in 52 patients treated for advanced periodontal disease. Comparisons were made between teeth which, following periodontal treatment, were used as abutments in fixed prosthetic reconstructions and nonabutment teeth. The study included 672 teeth with initially vital pulps (255 abutment teeth and 417 nonabutment teeth). The observation period varied from 4 to 13 years with a mean of 8.7 years. Pulpal necrosis including periapical lesions developed with a significantly higher frequency in abutment teeth than in nonabutment teeth (15% vs. 3%). The majority of these lesions did not appear until several years following the completion of active treatment. Conceivable reasons for the development of pulpal necrosis in teeth subjected to combined periodontal and prosthetic treatment are discussed.
The Influence of Trauma From Occlusion on the Bacterial Repopulation of Periodontal Pockets in Dogs
Authors: Kaufman Howard , Carranza Fermin A. , Endres Barbara , Newman Michael G. , Murphy Neal
Published: March 2012

Pockets were surgically created in the two upper external incisors of four beagle dogs, and a copper band adapted to prevent reattachment. After 4 weeks the copper bands were removed, the teeth scaled and root‐planed and crowns placed on both experimental teeth in such a way that one of them was forced bucally when the teeth occluded. An orthodontic appliance anchored in bands cemented to the cuspid teeth brought the tooth back to its original position when disclusion occurred. Experimental time was 12 weeks. Clinical indices and bacterial samples for darkfield examination were taken at baseline and weekly thereafter. The dogs were fed a diet that favored plaque accumulation and no oral hygiene was performed. Surgically created pockets initially became populated by cocci (65%‐75%) and small amounts of motile bacteria (12%‐15%) including 3% to 4% spirochetes. In 4 weeks the percentage of cocci declined steadily (42%‐45%) and motile bacteria increased to 37% to 43% with spirochetes representing 24% to 27%. After scaling and root planing, the number of cocci increased again and motile bacteria declined although the baseline values were not reached. This decline persisted for 2 weeks after scaling. Repopulation of the pocket in traumatized and nontraumatized teeth followed the same initial pattern, taking again 5 weeks to return to prescaling levels. No difference was found between traumatized and nontraumatized teeth. Clinical measurements, however, revealed a statistically greater loss of attachment in traumatized teeth as compared with nontraumatized teeth.
The Laterally Positioned Odontogenic Keratocyst: A Case Report
Authors: Neville Brad W. , Mishkin David J. , Traynham Ryland T.
Published: March 2012

An odontogenic keratocyst which was in a lateral periodontal location is reported. The histology of the odontogenic keratocyst is compared with that of the lateral periodontal cyst. The importance of correctly diagnosing the odontogenic keratocyst is stressed, especially in view of its high recurrence rate and its possible association with the basal cell nevus syndrome.
The Prevalence and Distribution of Intrabony Defects in Dry Mandibles
Authors: Tal Haim
Published: March 2012

One hundred mandibles of South African Negroes were examined for the presence of intrabony defects, and the distance between the cemento‐enamel junction and alveolar bone crest was measured along the buccal and lingual surface of roots associated with interdental craters.

Two‐hundred thirty‐one intrabony defects were detected (4.1% of the possible occurrences). There were 51 craters, 19 of which were associated with the distal surfaces of the second molars. Most craters (84.3%) had higher lingual than buccal walls. Seventy‐one defects (35.8%) were one‐walled pockets, 98 defects (49.6%) were two‐walled pockets and 30 (15%) were three‐walled pockets. Twenty‐eight one‐walled pockets (39.4%) formed hemisepta against interproximal root surfaces. Mesial surfaces of canines were the most commonly involved with hemisepta.

There was an increase in the frequency of intrabony pockets from the anterior to the posterior zones of the mandibles. Interproximal root surfaces were by far more commonly associated with defects than buccal or lingual surfaces.
Periodontal Response After Tooth Movement Into Intrabony Defects
Authors: Polson Alan , Caton Jack , Polson Anne P. , Nyman Sture , Novak John , Reed Brian
Published: March 2012

The present study was undertaken since conflicting evidence exists regarding the effect of such tooth movement on levels of connective tissue attachment. Localized intrabony pockets were produced around isolated incisors in four rhesus monkeys. The root surfaces were planed to the level of the bone at the base of the angular bony defects. An oral hygiene regime was begun and continued for the remainder of the study. The experimental teeth were moved orthodontically into, and through, the original area of the intrabony defect. Two months after cessation of active tooth movement, block specimens were removed for histologic analysis. Control specimens comprised those teeth with induced periodontal defects, but without tooth movement. In specimens not subjected to tooth movement, angular bony defects were present and epithelium lined the root surface to the apical extent of instrumentation. The alveolar bone adjacent to the orthodontically moved teeth no longer had angular defect morphology. On the pressure side, epithelium lined the root surface, was interposed between root surface and bone and terminated at the apical limit of root instrumentation. On the tension side, the crest of the bone was located apical to the level of root planing, and epithelium lined the instrumented portion of the root surface. It was concluded that orthodontic tooth movement into intrabony periodontal defects was without effect upon the levels of connective tissue attachment.
Relative Resistance of Long Junctional Epithelial Adhesions and Connective Tissue Attachments to Plaque‐Induced Inflammation
Authors: Beaumont Robert H. , O'Leary Timothy J. , Kafrawy Abdel H.
Published: March 2012

This study compared the resistance to periodontal disease of the long junctional epithelial adhesion and the naturally occurring dentogingival junction. Two groups were used, each containing three young male beagle dogs with all permanent teeth erupted. Periodontitis was induced around maxillary and mandibular premolars in the experimental dogs over a 42‐day period, using subgingival ligatures and a soft diet. Fourteen days after ligature removal, flaps were reflected, granulation tissue was removed and the roots were planed to the alveolar crest. Reference grooves were placed in the root surfaces at the level of the alveolar bone, the flaps were positioned over the alveolar crests, and sutures were placed. A 60‐day period permitted healing with formation of long junctional epithelial adhesions. During this 116‐day period control dogs were maintained in gingival health by daily brushing and by prophylaxis every 14 days. Both groups had a high level of health (GI scores of 0) at the beginning of the 20‐day combined disease phase. Inflammation was induced in both groups by subgingival ligature placement and a plaque‐promoting diet. Right and left sides of both groups represented separate time intervals within the 20‐day period. Block sections were secured at time of killing and the tissues were prepared for light and fluorescent microscopic evaluation.

Mean GI scores and mean probing depths increased similarly in both groups. Tagge index scores of gingival inflammation were higher at the longer time periods in the experimental animals. However, they displayed an intact long junctional epithelial adhesion throughout the study, while control animals frequently showed ulceration of the sulcular epithelium. Neither group showed significant changes in location of the apical cells of the attachment epithelium. Crestal osteoblastic activity, confirmed with Procion labeling, predominated in the experimental animals, while osteoclastic activity predominated in the control. Under the conditions of this study, there appeared to be no appreciable difference in resistance to disease between a long junctional epithelial adhesion and a true connective tissue attachment.
The Lateral Periodontal Cyst: A Report of 37 Cases
Authors: Cohen David Andrew , Neville Brad W. , Damm Douglas D. , White Dean K.
Published: March 2012

The lateral periodontal cyst is a developmental cyst of odontogenic origin which is located along the lateral aspect of a tooth root. Thirty‐seven previously unreported lateral periodontal cysts (LPCs) are presented. Clinical, roentgenographic and histologic features of the LPC are reviewed. Further, the importance of distinguishing the developmental LPC from laterally positioned inflammatory cysts of pulpal or periodontal disease origin and laterally occurring odontogenic keratocysts is stressed.
Alloplastic Implants of Tricalcium Phosphate Ceramic in Human Periodontal Osseous Defects
Authors: Snyder Alvin J. , Levin Marvin P. , Cutright Duane E.
Published: March 2012

Initial pilot studies using tricalcium phosphate ceramic placed into human periodontal osseous defects demonstrated osseous repair. Therefore, further evaluation of this material was undertaken on 17 carefully selected patients with 1‐wall, 2‐wall, crestal and furcation defects using standardized preoperative and postoperative radiographs, clinical measurements and clinical photographs. Inverse bevel, full‐thickness flaps were raised, the areas debrided, root surfaces planed with ultrasonic and hand instrumentation, osseous penetrations made with curet point and the flaps sutured after the defects were filled. Eighteenmonth reentry surgical procedures were performed on 10 of the 17 patients, with a resultant average of 2.8 mm of new bone. Controls were not used in this study since a protocol describing a sham procedure with other than 3‐wall osseous defects was not acceptable in 1973 to the Clinical Human Use Committee.

Although the tricalcium phosphate ceramic material was not found to be totally predictable in this study, it may nevertheless become a useful graft material because of its potential for osseous repair in combination with its availability, host acceptability, ease of manipulation and storage advantages.
The Effect of Surface Adsorption and Staining Reactions on the Antimicrobial Properties of Some Cationic Antiseptic Mouthwashes
Authors: Moran J. , Addy M.
Published: March 2012

The phenomenon of surface adsorption appears fundamental to the antiplaque activity of the cationic antiseptics. Moreover, reaction with chromogenic material is relevant to the local side effect of staining. The pupose of this investigation was to determine how such local reactions affect the antibacterial activity of some of these antiseptics. The minimum inhibitory concentration (MIC) of commercial mouthrinses containing alexidine, cetyl pyridinium chloride, Chlorhexidine gluconate and hexetidine against Oxford staphylococcus (NCTC 6571) and Escherichia coli (NCTC 10418) was established by tube dilution. The effect on the MIC values against O. staphylococcus of adding polymethylmethacrylate polymer or against E coli of adding a standard tea solution was then measured. The zones of inhibition around acrylic blocks soaked in the respective antiseptics, with and without postexposure washings, were measured. The effects on zone width of placing the antisepticsoaked blocks in tea were recorded. The MIC values of alexidine, cetyl pyridinium chloride and Chlorhexidine gluconate, but not hexetidine, were all increased by adding polymethylmethacrylate to cultures. Tea added to the culture increased the MIC values against E. coli for alexidine, Chlorhexidine and hexetidine, but not for cetyl pyridinium chloride. Zones of inhibition around antiseptic‐treated blocks were reduced by washing and, in the case of hexetidine, completely abolished. Tea‐soaking further reduced the zones of inhibition for alexidine and Chlorhexidine, but not cetyl pyridinium chloride. It was concluded that surface adsorption and/or reaction with chromogenic material reduces the antibacterial activity of the cationic antiseptics. Hexetidine in the mouthrinse employed appeared to possess little or no adsorption potential to acrylic.
B‐Lymphocyte Blastogenesis in Response to Periodontitis‐Associated Bacteria: Kinetics and Proportion of Total Response
Authors: Donaldson Stephen L. , Ranney Richard R. , Tew John G.
Published: March 2012

A role for activated b‐lymphocytes in mediating the initiation and/or progression of periodontal diseases has been proposed in previous work. The present study was conducted to: (1) assess the proportion of total lymphocyte blastogenic response to selected oral bacteria which is composed of T‐cell and B‐cell activation, respectively, and (2) to determine whether different kinetic patterns exist for the T‐cell vs. the B‐cell responses to these bacteria. Using lymphocyte rosetting and culturing techniques, rosette‐positive and rosette‐negative lymphocyte preparations were examined for blastogenic responsiveness following stimulation with a variety of both Gram‐positive and Gram‐negative periodontitis‐associated bacteria. Results of these studies indicated that both peripheral blood lymphocytes (PBL) from healthy adults and cord blood lymphocytes (CBL) from placental afterbirths responded to these bacteria with similar kinetic patterns. The net PBL blastogenic response appeared to consist of an early B‐cell response, which peaked at Days 2 or 3 of culture, followed by a later T‐cell response, which peaked at Days 5 to 6 of culture. The B‐cell response appeared to be T‐cell‐dependent in that B‐cells cultured alone showed minimal thymidine uptake over the entire 6‐day period, but the addition of irradiated T‐cells to these B‐cell cultures resulted in a greatly enhanced B‐cell response.
Absence of Periodontitis in a Population of Insulin‐Dependent Diabetes Mellitus (IDDM) Patients
Authors: Barnett Michael L. , Baker Richard L. , Yancey John M. , MacMillan Duncan R. , Kotoyan Marcos
Published: March 2012

The prevalence of periodontitis was studied in a population of insulin‐dependent diabetes mellitus (IDDM) patients, aged 10–18, with a variety of disease durations and levels of control. The sample included a number of patients with poorly controlled IDDM of long duration. None of the patients had radiographic signs of periodontitis. When considered in conjunction with previously reported studies, the findings suggest that populations of IDDM patients may differ in susceptibility to the periodontal diseases; thus, generalizations concerning prevalence based on only a few studies may be inappropriate.
Clinical Evaluation of the Prophy‐Jet® as an Instrument for Routine Removal of Tooth Stain and Plaque
Authors: Weaks L. M. , Lescher N. B. , Barnes C. M. , Holroyd S. V.
Published: March 2012

The prophy‐jet® was evaluated for its effectiveness in removing plaque and stain from teeth and on its effects on the marginal gingiva. Using a randomized split‐mouth design, half the mouth was treated with the Prophy‐Jet and the contralateral side with a rubber cup and prophylaxis paste. The results indicated that the Prophy‐Jet removes tooth plaque and stain as well as the rubber cup and prophylaxis paste method, and does so in less time. It was also found that there was some immediate soft tissue trauma following both treatment modalities, with a mean Trauma Index score of 0.23 ≠ 0.16 for the rubber cup and prophylaxis paste and 0.75 ≠ 0.37 for the Prophy‐Jet. Within 6 days, the trauma index scores were not significantly different. Similar results were found for marginal gingival redness and bleeding on probing. The Prophy‐Jet is an excellent alternative instrument for removal of tooth stain and dental plaque.
Arachidonic Acid Metabolism in Inflamed Gingiva and its Inhibition by Anti‐Inflammatory Drugs
Authors: ElAttar Tawfik M. A. , Lin Hsien S. , Tira Daniel E.
Published: March 2012

Prostaglandin (pg) synthetase inhibitors are tissue‐selective. Therefore, the action of four nonsteroidal anti‐inflammatory drugs (NSAID) was tested against PG synthesis from 14C‐arachidonic acid by gingival homogenate. Suprofen and tolmetin sodium did not significantly inhibit PGs at any of the three concentration levels used (10−7, 10−5, 10−3 m), whereas flurbiprofen and zomepirac sodium did significantly inhibit PG formation at millimolar concentration. The results, coupled with our previous study on indomethacin, Piroxicam and Ibuprofen open the way for future tests of NSAIDs in treatment of gingival inflammation and periodontal disease.
Inhibition of Oral Contraceptive Effectiveness by Concurrent Antibiotic Administration
Authors: Barnett Michael L.
Published: March 2012

The use of antibiotics in periodontal therapy has received increasing attention in recent years. Although generally safe, certain antibiotics, including tetracycline and ampicillin, have been shown to interact indirectly with oral contraceptives, with a resultant decrease in oral contraceptive efficacy. This paper reviews the nature of antibiotic‐oral contraceptive interactions, as well as the precautions that have been suggested for patients taking oral contraceptives for whom certain antibiotics have been prescribed.
Periodontal Diagnosis: Current Status and Future Needs
Authors: Polson Alan M. , Goodson J. Max
Published: March 2012

The literature relating to current methods of periodontal diagnosis is reviewed. There exists a future need for objective diagnostic techniques which reflect the dynamics of periodontal disease activity.
The Incidence and Severity of Complications and Pain following Periodontal Surgery
Authors: Curtis James W. , McLain James B. , Hutchinson Rowland A.
Published: March 2012

This study examines the incidence and severity of postoperative complications and pain in 304 consecutive periodontal surgical cases. Comparisons were made between plastic soft tissue surgery, osseous surgery and pure mucogingival procedures. Multivariable analysis was used to ascertain significant associations of numerous factors to complications and pain. Postoperative complications were rated as moderate or severe in only 5.5% of the cases. Although the total postoperative complications were minimal, regression analysis revealed osseous surgery to be three times more likely than pure mucogingival surgery to cause complications of bleeding, infection, swelling or adverse tissue changes. Minimal or no postoperative pain was reported by 51.3% of the patients. Pure mucogingival surgery was significantly related to pain and was 3.5 times more likely to cause pain than osseous surgery and 6 times more likely than plastic soft tissue surgery. The duration of surgery was statistically significant for both complications and pain. The overall results of the study indicate the risks of undergoing periodontal surgery, in terms of postoperative complications and pain, are minimal.
Clinical and Laboratory Studies of a Family with a High Prevalence of Juvenile Periodontitis
Authors: Page Roy C. , Vandesteen G. Edward , Ebersole Jeffrey L. , Williams Betsy L. , Dixon Irwin L. , Altman Leonard C.
Published: March 2012

The form of periodontitis with onset at puberty and affecting predominantly the first molars and incisors is called juvenile periodontitis (JP). The disease has been the object of intense study because from its analysis may come insights into understanding other, more common, forms of periodontitis. We recently had the opportunity to study an unusual family in which both parents developed JP in their teens. We did clinical examinations, measured leukocyte Chemotaxis, analyzed the pocket microflora, looked for serum antibodies against a large panel of putative periodontal pathogens and correlated the results. The couple had two affected and two unaffected children. One of the unaffected children was not available for study. Neutrophil Chemotaxis was abnormal in both parents and in the two affected children, but not in the unaffected child. Actinobacillus actinomycetemcomitans accounted for 17.5% of the pocket flora isolated from one affected child and 2.5% of that from the unaffected child, but was not detected in the remaining family members. Antibodies specific for A. actinomycetemcomitans, Hemophilus aphrophilus and Eikenella corrodens were present in the serum of both affected children and for Capnocytophaga sputigena and C. ochracea in the father, but no antibodies directed against any of the species studied were found in the mother and the unaffected child. The distribution of disease in this family was more compatible with an X‐linked dominant than with an autosomal recessive mode of inheritance. The correlations among presence or absence of disease, abnormal neutrophil Chemotaxis and presence of serum antibodies reacting with A. actinomycetemcomitans were excellent. However, the pattern of serum antibodies observed did not reflect the composition of the pocket flora, and antibodies against putative periodontal pathogens not detected in the pocket flora were also found, indicating that JP has a more complex microbial etiology than has been previously suspected.
Surgical Removal of the Fully Impacted Mandibular Third Molar: The Influence of Flap Design and Alveolar Bone Height on the Periodontal Status of the Second Molar
Authors: Chin Quee Trevor A. , Gosselin Denis , Millar E. P. , Stamm John W.
Published: March 2012

This study was carried out because a great deal of uncertainty exists as to the effect of the surgical removal of the fully impacted third molar on the periodontal status of the second molar. The objectives were to determine (a) the effect of surgical removal of the third molar on the periodontal status of the second molar; (b) the influence of flap design on these results; (c) the influence of the initial height of the alveolar bone on the distal of the second molar on subsequent changes in attachment level. The study included 30 patients with bilateral mandibular impactions. A split‐mouth experimental design was used, with one side of the mandible being randomly allocated to one of two flap design groups. Plaque level, gingival inflammation, probing depth and attachment level measurements around the second molar were taken at baseline and then at monthly intervals for a period of 6 months. Alveolar bone height was measured from panoramic radiographs. Six months postsurgically, both flap design groups exhibited a statistically significant loss of attachment level on the distal surface of the second molar with no difference between the two flap groups. The initial height of the alveolar bone on the distal of the second molar had no influence on the loss of attachment.

It was concluded that (a) the surgical removal of the fully impacted mandibular third molar led to the loss of attachment on the distal of the second molar; (b) flap design had no influence on the degree of attachment loss; (c) the initial height of the alveolar bone on the distal of the second molar had no influence on the loss of attachment.
Comparative Analysis of Biopsy Specimens from Gingiva and Alveolar Mucosa
Authors: Stablein Michael J. , Silverglade Lee B.
Published: March 2012

A total of 834 consecutive biopsy specimens from the gingiva and 448 from the alveolar mucosa were examined to see if differences in structure and function are reflected in categories and frequency of diagnoses. In both regions, inflammatory/reactive hyperplasia accounted for about 85% of the lesions and neoplasia for most of the remainder. Pyogenic granuloma was the most common lesion in the gingiva (23.6%) and fibrous hyperplasia in the alveolar mucosa (23.2%).

The ratio of benign to malignant neoplasms was greater in the gingiva (10:1) than in the alveolar mucosa (almost 1:1). Benign tumors of the gingiva and malignant tumors of the alveolar mucosa occurred more often in males than one would expect from their proportion in the survey (keeping in mind that the numbers in alveolar mucosa were small).

Lesions in these two regions were similar, but differed greatly in their frequency and in sex and age distribution.
Localization of Fibronectin in Gingival Connective Tissue of the Beagle Dog: Immunofluorescent Light Microscopic Findings
Authors: Cho Moon‐II , Lee Yu Lin , Garant Philias R.
Published: March 2012

Affinity purified antibodies to plasma fibronectin were used to localize fibronectin in the connective tissues of inflamed and noninflamed beagle gingiva. In noninfiltrated gingival connective tissue, fibronectin was demonstrated in the basement membrane beneath gingival epithelium and around blood vessels as a uniform and intensely stained band about 3 to 10 μm thick. Fibronectin was also distributed throughout the connective tissue in association with collagen fibrils as a more diffuse, less intensely stained pattern.

The inflamed gingiva included in this study was characterized by proliferation of epithelial pegs, heavy infiltration of plasma cells and loss of collagen within the subepithelial connective tissue. In these sites, fibronectin was present as an intensely stained band around blood vessels and at the crest of connective tissue papillae nearest the sulcular space. The fibronectin in the basement membrane beneath the epithelium appeared diminished and less uniformly distributed. A delicate network of fibronectin was present around plasma cells and the remaining collagen fibers.
Development of a Biochemical Profile for Gingival Crevicular Fluid: Methodological Considerations and Evaluation of Collagen‐Degrading and Ground Substance‐Degrading Enzyme Activity during Experimental Gingivitis
Authors: Lamster Ira B. , Hartley Linda J. , Vogel Richard I.
Published: March 2012

The potential application of gingival crevicular fluid (GCF) analysis to periodontal diagnosis has been examined for more than 25 years. Unfortunately, the information available has not provided the clinician with a more sensitive means of diagnosing periodontal disease or an effective means of monitoring periodontal therapy. A careful review of the literature on GCF, however, suggests that discrepancies occur in the method of GCF collection, the use of GCF for analysis from pooled or isolated crevicular locations, the method of analyzing the samples and the way in which the data is reported. Studies in our laboratory have suggested a technique for GCF analysis that collects GCF from individual crevices with a filter paper strip inserted for a standard time, determines the volume of GCF collected with a calibrated electronic meter and elutes the material into a larger volume of diluent. This approach allows for detection of site‐to‐site and patient‐to‐patient differences in GCF volume while providing sufficient samples to analyze GCF for multiple constituents. We have used this approach to evaluate GCF for vertebrate forms of the enzymes collagenase (latent and active forms), β‐glucuronidase and arylsulfatase during the development of experimental gingivitis in man. Interproximal and midradicular areas were studied. Our results indicate that during the 4 weeks of the gingivitis, the absolute amount of active collagenase in GCF increased 550% at the interproximal sites and 190% in the midradicular sites, and the per cent of active collagenase increased from 15 to 71% at the interproximal sites, and from 16 to 36% at the midradicular sites. In contrast, the increase in ground substance‐degrading enzyme activity during the experimental gingivitis was proportionally less. The increase in β‐glucuronidase activity in GCF was 180% for the interproximal sites and 40% for the midradicular sites, and the increase in arylsulfatase activity in GCF was 240% for the interproximal sites and 20% for the midradicular sites. These data suggest that the degree of collagen degradation in the periodontium may be modulated by a relative lack of ground substance‐degrading enzyme activity in the gingival environment. In addition, this study supports the use of our sampling and processing approach for GCF analysis.
Local Antibody Responses in Periodontal Diseases
Authors: Ebersole J. L. , Taubman M. A. , Smith D. J.
Published: March 2012

The relationship between local and systemic host antibody responses, colonization of subgingival plaque by periodontal disease‐associated microorganisms and the progression of periodontal disease was assessed in 61 patients. Serum antibody levels to a battery of oral microorganisms were determined by an enzyme‐linked immunosorbent assay (ELISA), and an organism to which each patient exhibited a significantly elevated IgG response was chosen for further study. To detect the presence of the specific microorganism, plaque samples were obtained and examined using a seroELISA. Static crevicular fluid (SCF) samples were also obtained from all teeth and analyzed for IgG antibody to the homologous organism. A modification of the standard ELISA using biotin and avidin allowed a 5‐ to 10‐fold increase in sensitivity for detection of IgG antibody in serum and SCF. Comparison of the distribution of elevated SCF antibody and the presence of the corresponding microorganism in each patient showed that the proportion of agreement was 54 to 78% in the samples. Schematic representation of the temporal relationship between the organism, the host response and disease activity were prepared to explain the results obtained in investigations of these parameters and to provide a testable hypothetical framework for future studies.
In Vivo Assay of Crevicular Leukocyte Migration: Its Development and Potential Applications
Authors: Iacono V. J. , Singh S. , Golub L. M. , Ramamurthy N. S. , Kaslick R.
Published: March 2012

Defects in neutrophil or polymorphonuclear leukocyte (PMNL) Chemotaxis have been observed in a number of clinical conditions, including Down's syndrome and insulindependent diabetes mellitus (IDDM), which tend to be associated with severe forms of periodontal disease. In addition, impaired PMNL Chemotaxis is frequently detected in individuals with localized juvenile periodontitis (LJP). The ability to monitor PMNL function in vivo at the gingival sulcus should therefore be useful as a diagnostic test. In this regard, we developed a technique which measures the response of PMNLs to a chemotactic agent, e.g., casein and N‐formylmethionylleucylphenylalanine (N‐FMLP) placed directly into gingival crevices. The development of the technique and its relationship to in vitro assays of Chemotaxis are discussed, and data obtained from tests of the assay on control and streptozotocin‐induced diabetic rats and human subjects with various periodontal diseases and IDDM are presented. As compared with healthy subjects and control animals, atypical (double peak) and reduced crevicular PMNL response patterns were observed during oral and systemic diseases. This suggests that the in vivo assay with appropriate modifications can be used diagnostically to assess PMNL migratory dysfunction and to identify individuals who may be susceptible to severe forms of periodontal disease.
Antibiotic Susceptibilities of Periodontal Bacteria: In Vitro Susceptibilities to Eight Antimicrobial Agents
Authors: Walker Clay B. , Pappas Janet D. , Tyler Kathy Z. , Cohen Samuel , Gordon Jeffrey M.
Published: March 2012

In vitro susceptibilities of 369 to 966 bacterial isolates from periodontal lesions to eight antibiotics were determined by agar dilution technique as a means of determining which antimicrobial agents were inhibitory for bacteria frequently associated with destructive periodontal diseases. Although most bacteria were relatively susceptible to the penicillins, greater activity was generally noted with amoxicillin than with either penicillin or ampicillin with the exception of Selenomonas sputigena and Peptostreptococcus. Antibacterial activities obtained with minocycline were significantly higher than with tetracycline for Actinobacillus actinomycetemcomitans and Streptococcus but comparable for most other taxa. Clindamycin and metronidazole both demonstrated excellent activity against the anaerobic Gram‐negative rods but were less effective against some of the capnophilic and facultative organisms. Eikenella corrodens was exceptionally resistant to both of these drugs; and A. actinomycetemcomitans was generally resistant to Clindamycin but relatively susceptible to metronidazole. Erythromycin was considerably less active than the other antibiotics against the majority of the periodontal bacteria. No single antibiotic, at concentrations equivalent to those achieved in body fluids, was uniformly effective in inhibiting all bacteria currently implicated or suspected as etiologic agents of periodontal diseases.
Tetracyclines Inhibit Tissue Collagenases: Effects of Ingested Low‐Dose and Local Delivery Systems
Authors: Golub L. M. , Goodson J. M. , Lee H. M. , Vidal A. M. , McNamara T. F. , Ramamurthy N. S.
Published: March 2012

In a series of experiments, Golub et al. demonstrated that tetracyclines, but not other antibiotics, can inhibit mammalian collagenases and proposed that this property could be useful in treating diseases, such as periodontal disease (but also included certain medical conditions, e.g., corneal ulcers) characterized by excessive collagen degradation {JPeriodont Res 1983, 1984 and 1985; Experientia 1984; Cornea 1984). One effect was the dramatic reduction of tissue collagenase activity within the gingival crevicular fluid (GCF) of periodontal pockets after administering a standard regimen of a tetracycline (e.g., 200 mg minocycline or 1000 mg tetracycline/day). The preliminary studies described below determined the effect of (1) low‐dose (LD; 40–80 mg/day) orally administered minocycline on GCF collagenase activity and on the subgingival microflora (Exp. I), and (2) tetracyclineloaded monolithic fibers (TF) on collagenase activity in vitro (Exp. II). In Exp. I, GCF collagenase activity was reduced by 45 to 80% 2 weeks after initiating LD minocycline therapy, an effect that lasted for at least several weeks after stopping drug treatment. No consistent change in the relative proportions of G(+), G(‐) and motile subgingival microorganisms was detected as a result of LD treatment suggesting that the reduction in GCF collagenase activity was a direct inhibition of the enzyme by the drug. In Exp. II, 3‐ and 6mm lengths of TF in vitro established tetracycline concentrations in 250 μl of 132 μg/ml, from 3‐mm lengths, and 265 μg/ml, from 6‐mm lengths, after an 18‐hour incubation. Although these concentrations were slightly lower than those established in the GCF of individual TF‐treated periodontal pockets in vivo (Goodson et al. 1983, J Periodontol), the released tetracycline from 3‐ and 6‐mm TFs inhibited rat polymorphonuclear leukocyte collagenase activity in vitro by 21 % and 45%, respectively (bacterial collagenase activity was also inhibited in vitro). These results indicate that TF placed into individual periodontal pockets could maintain a level of tetracycline in GCF that would effectively inhibit tissue (and perhaps also bacterial) collagenases at the lesion site.
Root Planing with Interdental Papilla Reflection and Fiber Optic Illumination
Authors: Reinhardt Richard A. , Johnson Georgia K. , Tussing Gerald J.
Published: March 2012

The complete removal of accretions during closed scaling and root planing in moderatedeep pockets is difficult, presumably due to inadequate mechanical and visual access. The purpose of this study was to evaluate the effect of minimal papilla reflection and illumination with a prototype fiber optic unit on root planing efficiency. Nonmolar teeth with moderatedeep interproximal pockets (>3 mm) in four patients scheduled to receive immediate complete dentures were randomly divided into groups for treatment: Group I—interproximal root planing augmented by papilla reflection and fiber optic illumination (n = 26 surfaces); Group II—interproximal root planing with papilla reflection only (n = 24); Group III—untreated controls (n = 23). Immediately after treatment, the experimental teeth were extracted, stained with toluidine blue and interproximal areas were evaluated for remaining accretions with a microscope‐digitizing pad‐computer system. Significantly less (P < 0.01) root surface was covered by deposits in Group I than Group II (0.57 ± 0.29% vs. 2.42 ± 0.63%), and both treatment groups had fewer (P < 0.0005) accretions than untreated controls (57.72 ± 3.40%). These results suggest that root planing with papilla reflection produces an interproximal surface with few remaining deposits, and fiber optic illumination and transillumination further enhance this effect.
Freeze‐Dried Bone Allografts Combined with Tetracycline in the Treatment of Juvenile Periodontitis
Authors: Mabry Thomas W. , Yukna Raymond A. , Sepe Walter W.
Published: March 2012

Sixteen patients diagnosed as having juvenile periodontitis were randomly placed into one of two treatment groups. Group I received local and systemic tetracycline (TTC), while Group II received no antibiotics. Osseous defects were grafted with allogeneic freeze‐dried bone (FDBA) mixed with TTC powder (Group la) or FDBA alone (Group IIa). Contralateral defects were debrided only in both Groups (Ib and IIb). Direct reentry evaluation of 104 measurement sites demonstrated significantly greater bone fill (mean = 2.8 mm) and resolution of osseous defects (mean = 72.7%) in the TTC/FDBA‐treated group (la) as compared to the TTC plus debridement only (Ib) or no TTC‐treated groups (Ha and IIb). The results of this study indicate that of the modes of treatment investigated, the combination of local and systemic tetracycline coupled with freeze‐dried bone allografts was the treatment of choice for defects associated with juvenile periodontitis.
Focal Epithelial Hyperplasia (Heck's Disease)
Authors: Hallmon William W. , Waldrop Thomas C. , Houston Glen D.
Published: March 2012

The occurrence of focal epithelial hyperplasia (Heck's Disease) in a 12‐year‐old MexicanAmerican female is presented. Focal epithelial hyperplasia is a relatively unusual and benign disorder characterized generally by multiple asymptomatic nodules, occurring most commonly in younger segments of indigenous populations and ethnic groups. The clinical behavior, histologic appearance and possible etiologic factors of focal epithelial hyperplasia are discussed.
Clinical Studies of One Family Manifesting Rapidly Progressive, Juvenile and Prepubertal Periodontitis
Authors: Spektor Michael D. , Vandesteen G. Edward , Page Roy C.
Published: March 2012

We report clinical, radiographic and historical data on a large family with an unusually high prevalence of periodontitis. The proband, a 20‐year‐old black male, had the classic features of juvenile periodontitis (JP). His father was periodontally normal, while his mother had lost all her teeth at age 27 because of rapidly progressive periodontitis (RP). In addition to the 13 living children the couple had had 2 miscarriages. Of the children, one had RP, five had JP and two had prepubertal periodontitis (PP). Both maternal grandparents of the proband had become edentulous at an early age, presumably because of early‐onset periodontitis. Four of 10 siblings of the proband's mother had early‐onset periodontitis. In contrast, the paternal grandparents did not have early‐onset periodontitis nor was periodontitis unusually prevalent in the siblings of the proband's father. The pedigree for this family is consistent with, but does not prove, an X‐linked dominant pattern of genetic transmission. The natural history of early‐onset periodontitis and the relationship among PP, JP and RP are not understood. The fact that the mother of the proband had RP and she had offspring with RP, JP and PP indicates a close relationship among these diseases and argues in favor of a common underlying mechanism. JP was not preceded by PP in the proband nor his affected 21‐year‐old brother, but one sister had PP, and at age 15 manifested JP. In her case, the alveolar bone around the deciduous molars had been destroyed, but it regenerated as the permanent premolare erupted. The idea that JR has its onset during the circumpubertal period is supported by the fact that seven of the postpubertal family members had periodontitis, while only two of six prepubertal children manifested the disease. In addition, radiographs of the proband revealed that the alveolar bone around his first permanent molars was normal at age 11½ but bone resorption was clearly apparent by age 12. On the other hand, onset around a given tooth can occur at times far removed from puberty. The members of this family also manifested a high caries rate, and in some cases the first permanent molars had been lost, making diagnosis difficult. Our observations illustrate some of the pitfalls and problems in assigning diagnoses in family studies of this type.
Carrageenan‐Induced Inflammation and Its Effects on Mitotic Activity and Keratinization of Gingival Epithelium
Authors: Caffesse Raul G. , Nasjleti Carlos E. , Kowalski Charles J.
Published: March 2012

This study was undertaken in order to: (1) evaluate the cell population in carrageenaninduced inflammation and (2) investigate the extent to which this inflammation modified mitotic activity, and keratinization of the sulcular epithelium induced by daily prophylaxes in monkeys. Normal‐keratinized oral gingival epithelium was also evaluated for these processes in the same gingival specimens. Each of three adult Rhesus monkeys received a thorough prophylaxis 1 week prior to the experiment. Over the 10‐week experimental period, each monkey received daily rubber cup prophylaxes. In addition, during the last 10 days, daily gingival injections of a 1% carrageenan saline solution and normal saline solution were given. One hour prior to sacrifice, each monkey received an intravenous injection of tritiated thymidine, 1 μCi/gram of body weight. After sacrifice and tissue processing, the histologic sections were evaluated. It was found that the carrageenan solution injected into gingival tissues produced an acute inflammatory response consisting of polymorphonuclear leukocytes PMNs (61.3%), lymphocytes (5.2%), monocytes/macrophages (23.5%), plasma cells (2.0%) and unidentified cells (3.8%). An Inflammatory Index and a Mitotic Activity Index were determined, and keratin length and widths were measured. Data were analyzed statistically using analysis of variance. Pairwise comparisons were also made using Scheffe's method of multiple comparisons. The study showed that: (1) carrageenan solutions injected into gingival tissues elicited an acute inflammation; (2) acute inflammation present in gingival connective tissue stimulated an increase in mitotic activity in subjacent gingival epithelium; (3) acute inflammation within gingival tissues did not modify the inducedkeratinized sulcular epithelium, or the normally‐keratinized oral gingival epithelium; and (4) acute inflammation may not necessarily affect tissue keratinization, if bacterial plaque is removed daily.
Relation Between Control of Diabetes and Gingival Bleeding
Authors: Ervasti Tellervo , Knuuttila Matti , Pohjamo Leena , Haukipuro Kyösti
Published: March 2012

The periodontal health status of 50 adult diabetics and 53 healthy controls was examined. The diabetic group was further divided into three subgroups according to the control of diabetes. Comparison between the entire diabetic group and the control group did not reveal any differences in either the amount of etiologic factors or in the degree of gingival changes. On the other hand when the subgroups of diabetic patients were examined, those with poorly controlled diabetes suffered significantly more from gingival bleeding than those with good or moderate control. The difference in the amount of gingival bleeding between diabetics with poor control and the control group was also statistically significant. The amount of etiologic factors, however, was similar in all the studied diabetic subgroups indicating an independent significance of the degree of control of diabetes. No correlation was found between duration, complications and medication of diabetes and gingival bleeding. The reason for increased bleeding in poorly controlled diabetics could be either inflammation or vascular changes in the gingiva.
Improved Technique for Localized Ridge Augmentation: A Report of 21 Cases
Authors: Allen Edward P. , Gainza Craig S. , Farthing Gregory G. , Newbold Dewey A.
Published: March 2012

Topographical aberrations in a residual edentulous ridge often prevent establishment of a satisfactory pontic/ridge relationship. An improved technique is described for predictable augmentation of localized alveolar‐ridge deficiencies. Results are reported from 21 cases involving 26 sites. All 14 sites using fibrous connective tissue grafts demonstrated shrinkage, although an improvement in residual ridge contour was obtained. Hydroxylapatite implant material was placed in 12 sites with shrinkage seen in only two sites. Advantages, requirements for success and technical considerations of the improved technique are discussed.
Dentinal Sensation and Hypersensitivity: A Review of Mechanisms and Treatment Alternatives
Authors: Berman Louis H.
Published: March 2012

Dentinal hypersensitivity has long been a dilemma of both dentists and patients. With teeth being maintained longer, there has been an increased demand placed upon the dentist to manage the sensitivity of cervically exposed dentin. There has been much written on this subject. The purpose of this review is to summarize the current concepts thought to be responsible in dentinal sensation, and to review and critique the various treatment modalities for dentinal hypersensitivity.