bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Hand Versus Ultrasonic Instrumentation in Open Flap Root Planing
Authors: Hunter Ronald K. , O'Leary Timothy J. , Kafrawy Abdul H.
Published: March 2012

The primary purpose of the study was to determine if, with an open flap approach, ultrasonic or hand instrumentation could remove all calculus from previously untreated teeth with moderate to severe loss of attachment. To be included in the study, teeth had to have at least 5 mm of attachment loss, be scheduled for extraction and be graded 2 or 3 on the Calculus Index of the Periodontal Disease Index system. Under local anesthesia, fullthickness, envelope‐type flaps were elevated apical to the crest of bone to allow access to the root surfaces which were then treated with hand or ultrasonic instrumentation until the roots felt hard and smooth to a Hartzell explorer. The teeth were then removed, rinsed, and lightly scrubbed to remove debris and a No. 14 wheel bur was used to place a groove along the coronal extent of the connective tissue attachment. A stereomicroscope at magnification × 4.6 was used to quantitate the percentage of residual calculus on 25 teeth treated by each method. Overall, hand‐scaled root surfaces demonstrated less residual calculus (5.78%) than ultrasonically treated surfaces (6.17%). Twenty teeth treated by each method were then prepared for histologic evaluation and evaluated under the light microscope at magnification × 100 for residual calculus and relative smoothness. Residual calculus was found on four ultrasonically and 12 hand‐treated teeth and was almost evenly distributed between anterior and posterior teeth for both methods. The finding of considerably less calculus on histologic than on stereomicroscopic examination may have been due to the loosening of deposits by instrumentation, especially ultrasonic vibration, and their subsequent release during histologic preparation.

Among the hand‐scaled teeth, of 244 surfaces evaluated 138 (56.6%) were considered smooth, and 106 (43.4%) were graded rough. Among the ultrasonically scaled teeth, of 256 surfaces evaluated, 48 (18.8%) were smooth and 208 (81.2%) were rough.
Periosteal Ossifying Fibroma of the Palate
Authors: Saito Ichiro , Ide Fumio , Inoue Masahito , Teratani Kazuhiro , Satoh Masanori , Kiuchi Kazuhiko , Umemura Shinichiro
Published: March 2012

An unusual case of the ossifying fibroma of a 54‐year‐old woman is reported. Clinically the lesion appeared as an exophytic mass on the hard palate and apparently originated outside of bone. Histologically the resected tumor is well encapsulated and made up of a richly cellular fibroblastic stroma containing foci of mature bone with a predominantly lamellar structure. While the possibility exists that the lesion is reactive, it appears to be a true neoplastic growth and a purely soft tissue process arising from the periosteum of the palate. Thus, we proposed the term periosteal ossifying fibroma for this distinct lesion in order to distinguish it from the common peripheral ossifying fibroma.
Cyclosporine Therapy: Its Significance to the Periodontist
Authors: Daley T. D. , Wysocki G. P.
Published: March 2012

Cyclosporine is a relatively new immunosuppressive agent which has been used successfully to prevent organ transplant rejection, to treat type‐I diabetes mellitus as well as several other autoimmune disorders. It is anticipated that the therapeutic use of cyclosporine will progressively increase in the future to include the treatment of numerous other disorders. As its clinical use broadens, more health professionals will need to become familiar with the beneficial effects as well as some of the undesirable side‐effects of cyclosporine therapy. Two side‐effects of the drug which are of interest to the periodontist are gingival hyperplasia and transient perioral hyperaesthesia. It is anticipated that the dental profession, particularly periodontists, will be called upon to help prevent, control or treat these side effects. The purpose of this paper is to familiarize the periodontist with cyclosporine and to discuss its anticipated impact on the practice of periodontics.
The Toothbrush and Gingival Traumatic Injury
Authors: Smukler Hyman , Landsberg Jacob
Published: March 2012

This paper explores, by means of clinical observation, toothbrush misuse and its relationship to gingival recession/clefting. The morphology of the lesions created is correlated with the vigor, duration, frequency and direction of the toothbrush abuse. In addition, histologic observations of biopsied tissue from different types of clefts and recessions are used as a basis for discussion of the possible pathogenesis of this type of lesion.
The Healing of Atraumatic and Traumatic Incisions in the Gingivae of Monkeys
Authors: Wirthlin M. R. , Hancock E. B. , Gaugler R. W.
Published: March 2012

Standard wounds of simple incision and trauma were made in the gingivae of monkeys. The healing from the 1st to the 21st day was described clinically, his'tologically, physically and biochemically. There were no major clinical differences, but both atraumatic and traumatic wounds have reactions in the periodontium to be considered in postoperative care.
Prepubertal Periodontitis Affecting the Deciduous and Permanent Dentition in a Patient With Cyclic Neutropenia: A Case Report and Discussion
Authors: Prichard John F. , Ferguson David M. , Windmiller Joan , Hurt William C.
Published: March 2012

Neutropenia is a transient or chronic blood disorder characterized by a decrease in the number of circulating polymorphonuclear leukocytes (PMNs). Neutrophils are a major cellular defense against infection, and depletion of these cells is potentially fatal. Stomatitis and gingivitis frequently are seen in patients with neutropenia. Therefore, the diagnosis of severe oral pathoses of obscure origin must include a differential white blood cell count. The importance of the dentist's role is dramatically illustrated in the rare case reported here, since the oral condition was the reason for this patient's definitive blood work‐up. The report illustrates the importance of the laboratory assessment in dental patients with unusual periodontal destruction or other inexplicable oral changes.
Effects of Gold Salts on Experimental Periodontitis: I. Histometric Evaluation of Periodontal Destruction
Authors: Novak M. John , Polson Alan M. , Freeman Eric
Published: March 2012

Systemic administration of gold salts for treatment of arthritis is thought to limit tissue destruction through alteration of inflammatory cell function. The present study ascertained if gold salts could modify the tissue destruction associated with an experimental marginal periodontitis. Therapeutic levels of serum gold salts were established in four squirrel monkeys (experimental) by intramuscular injection of Myochrisine (gold sodium thiomalate 25 mg/ml) at 5 mg/kg/body weight at 4‐day intervals for 12 days. Marginal periodontitis was then induced around mandibular bicuspids by tying plaque retentive ligatures at the gingival margins. Periodontitis was induced around corresponding teeth in four control animals which had not received gold salts. Serum levels of gold salts were maintained in experimental animals, and all animals were killed 2 weeks after induction of periodontitis. Progression of periodontitis was evaluated histometrically on step‐serial sections, and the results analyzed statistically. Specimens from gold‐receiving animals had significantly smaller areas of infiltrated supracrestal connective tissue, and less loss of connective tissue attachment and coronal alveolar bone. Quantitation of total plaque around the ligatures showed no differences; however, there was less plaque located apical to the ligatures in gold‐receiving specimens. Although the study design did not permit identification of the relative importance of cellular or microbial factors, it was concluded that administration of systemic gold salts was associated with significantly less periodontal destruction.
Pocket Epithelium Removal via Crestal and Subcrestal Scalloped Internal Bevel Incisions
Authors: Liten Joyce M. , O'Leary Timothy J. , Kafrawy Abdel H.
Published: March 2012

This study assessed the extent of pocket epithelium removal by crestal and subcrestal scalloped inverse bevel incisions during mucoperiosteal flap surgery. Fifty‐six gingival biopsies were obtained from 52 participants, who had extractions of periodontally involved teeth. Sulcular incisions which severed the epithelial attachment served as controls. Experimental scalloped internal bevel incisions were made: (1) at the gingival crest extending apical to the osseous crest (crestal incision) and (2) 1 to 2 mm apical to the gingival margin extending apical to the osseous crest (subcrestal incision). In the two procedures the initial incisions were followed by sulcular incisions to sever the epithelial attachment. After both crestal and subcrestal incisions full thickness flaps were reflected, pocket contents were removed, and flaps were replaced against the teeth. Gingival biopsies were then obtained from control and experimental sites followed by extraction of teeth.

All specimens were processed, embedded in paraffin, sectioned, stained with hematoxylin and eosin and examined for residual pocket epithelium.

Control incisions eliminated pocket epithelium in two of 20 specimens. Crestal incisions eliminated pocket epithelium in 11 of 25 areas, while subcrestal incisions eliminated pocket epithelium in 13 of 25 areas. All 10 papillary areas treated by crestal incisions and 8 of the 10 papillary areas treated by subcrestal incisions displayed residual pocket epithelium. Neither crestal nor subcrestal scalloped internal bevel incisions consistently eliminated all pocket epithelium.
Human Lymphocyte Antigen Haplotype and Resistance to Periodontitis
Authors: Goteiner David , Goldman Marc J.
Published: March 2012

Certain human lymphocyte antigen (HLA) haplotypes have been correlated with the presence of certain diseases. To date no significant relationship between periodontitis and HLA haplotype has been demonstrated. The purpose of this study was to determine the frequency of HLA‐A, HLA‐B and HLA‐C haplotypes in patients resistant to chronic periodontitis and to determine if there is any association between specific HLA genes and periodontal health. Twenty‐five healthy individuals who demonstrated a high resistance to periodontal disease (mean age 49.9 years) were matched to 25 subjects with chronic periodontitis and to a periodontally undiagnosed population of 22,000 individuals. Peripheral blood was taken and HLA specificity was determined by the microlymphocytotoxicity test. The results indicated a statistically significant increase in the occurrence of HLA‐B5 (P = 0.0059) and a trend in the occurrence of HLA‐A28 (P= 0.0565) in those patients resistant to periodontal disease when compared to the matched controls. When compared to the large random control group, a significant correlation was observed for HLA‐A28 (P < 0.01) in blacks and HLA‐B5 (P < 0.01) in whites. It is possible that the HLA‐A28 and the HLA‐B5 individual may have the ability to resist the progression of chronic periodontitis.
A Histometric Evaluation of the Effect of Citric Acid Preparation Upon Healing of Coronally Positioned Flaps in Nonhuman Primates
Authors: Woodyard S. G. , Snyder A. J. , Henley G. , O'Neal R. B.
Published: March 2012

Facial recession defects were created on maxillary canine teeth of six Macaca irus monkeys and left untreated and exposed to oral fluids for 6 to 12 weeks. Notches were placed in the exposed root surfaces at the level of the free gingival margins. Following root planing with the addition of topical citric acid application on experimental surfaces, pedicle flaps were coronally positioned over the previously exposed roots. After euthanasia, block sections representing postsurgical time periods of 0, 3, 7, 14, 21, 28 and 42 days were secured and tissues were processed for histologic evaluation. All citric acid‐treated surfaces exhibited new connective tissue attachment of pedicle flaps to previously exposed areas by 14 days with transmission electron micrographs confirming beginning cementum deposition. In contrast, controls demonstrated epithelial migration to, or apical to, reference notches. Although the total number of samples available for statistical comparison was small, a two‐tailed t test for correlated samples showed citric acid application did not result in enhanced clinical root coverage, but did result in significantly greater amounts of new connective tissue attachment (P < 0.05, df = 3). Pedicle flap healing against teeth with devital pulps was identical to that seen in teeth with vital pulps, while citric acid application to root‐planed surfaces of vital teeth had no observable effect upon pulpal tissues.
Treatment of Juvenile Periodontitis Patients by Control of Infection and Inflammation: Four Case Reports
Authors: Jaffin Robert A. , Greenstein Gary , Berman Charles L.
Published: March 2012

Four patients, ages 14–17, who demonstrated characteristics of juvenile periodontitis, underwent antibiotic and surgical therapy to control microbial etiologic factors. No occlusal equilibration or bone grafting techniques were employed. Subsequent to treatment, all four patients demonstrated decreased pocket depths and mobility on teeth associated with vertical osseous defects. Osseous repair was evident on postoperative radiographs. Reentry procedures, on one patient, confirmed that osseous repair had occurred in 2‐ to 3‐wall, 3‐wall, hemi‐circumferential and furcal defects. If infection and inflammation are controlled, it appears that the potential for osseous repair in juvenile periodontitis patients is greater than has been thought.
The Effectiveness of Regenerating Versus Mature Marrow in Physiologic Autogenous Transplants
Authors: Amler Melvin H.
Published: March 2012

Differences in rates of bone healing in animals and in human extraction wounds suggest that marrow tissue is more likely to form bone when transplanted at the onset of its most active regenerative period rather than at its maturity. To test this hypothesis, small segments of polyvinyl sponge were implanted into experimentally produced femur cavities in Sprague‐Dawley rats, to provide matrices for regenerating cellular structure in the grafting procedures. Bone resulted in 16 of 22 cases (72.7%) in which regenerating marrow was transferred to the anterior eye chamber, compared with 4 of 23 cases (17.4%) in which mature marrow was used (P = 0.0002). No bone resulted when washed, polyvinyl sponge samples were implanted as controls in 6 cases. These findings indicate that with existing techniques it is probably more effective to transplant regenerating marrow than mature marrow.
Serum and Salivary IgG and IgA Response to Initial Preparation Therapy
Authors: Reiff Richard L.
Published: March 2012

The purpose of this study was to determine and compare IgG and IgA concentration in both serum and unstimulated whole saliva obtained prior to any therapy and following initial preparation therapy (IPT) in 15 healthy adult dentulous patients, five each of periodontal disease Classes I, II and III. During the first visit before therapy, 10 ml of whole blood and 5 ml of saliva were obtained. Serum protein electrophoresis was conducted to rule out immunoglobulinopathies. Radial cell immunodiffusion endpoint technique was employed on serum and saliva to determine IgG and IgA in mg/dl. Following IPT, achievement of plaque control and 3 weeks after any dental instrumentation, 10 ml of blood and 5 ml of saliva were obtained from each patient and IgG and IgA in mg/dl were determined. The following are trends that were observed: greater decrease in IgG and IgA in serum and saliva following IPT in Class I periodontal patients than in other classes; saliva was a better indicator of local humoral response than serum for this group of patients; the less severe the periodontal involvement, more consistent was the reduction in IgG and IgA following IPT, especially for saliva; IPT elicited a decreased IgG and IgA concentration when local antigenic stimuli were reduced by both patient and dentist.
Revascularization Following the Lateral Sliding Flap Procedure
Authors: Caffesse Raul G. , Kon Simao , Castelli Walter A. , Nasjleti Carlos E.
Published: March 2012

Two young adult rhesus monkeys, with an average weight of 12 pounds were used. Anesthesia with Nembutal(r) 30 mg/kg of body weight was given to perform the surgeries. Artificial defects were created by raising a flap and removing about 5×7 mm of the buccal alveolar plate and suturing the flaps exposing the alveolar crest. These defects were left untreated for 2 months. Then, mucogingival lateral sliding flaps were performed to cover the recessions. Postoperative periods of 1, 9, 14, 21, 28 and 35 days were obtained when the animals were killed. A combined solution of Pelikan carbon black and 10% buffered formalin was perfused through the exposed and cannulated external carotid arteries to evaluate revascularization. After killing, blocks, including the operated teeth and the surrounding tissues, were fixed in 10% formalin and then partially decalcified in EDTA. Two blocks per time interval were obtained. One of the blocks was processed for regular histology, and sectioned bucco‐lingually. In these sections it was found that the new attachment to the root was mediated by a combination of connective tissue attachment and a long junctional epithelium. The other blocks were cut cross‐sectionally at about 1‐mm thickness. Sections were selected from three different areas: (a) at the most coronal part of the laterally displaced flap, (b) at the middle of the localized defect and (c) at the bottom of the defect. They were cleared following the Spalteholtz method. Initially, at 1‐day postoperatively, a network of perfused vessels was seen marginally and the flap was well adapted to the tooth surface and the tissue bed, with a thin blood clot interposed. Healing progressed uneventfully and by 28 days the surgically treated area depicted a completely reestablished vascularization, which grew from the displaced flap, surrounding periodontal membrane and tissues. Similar results, but with faster healing, were observed in areas (b) and (c).
Etidocaine HCl Local Anesthetic for Periodontal Flap Surgery
Authors: Hlava Gwen L. , Reinhardt Richard A. , Kalkwarf Kenneth L.
Published: March 2012

Long acting local anhsthltics have been used successfully during third molar extractions and endodontic procedures. They were shown to provide longer duration of anesthesia and contribute to less postoperative pain. This study evaluated the effectiveness of one long acting local anesthetic agent (etidocaine) for periodontal flap procedures. A double‐blind, split mouth design treated 17 matched contralateral pairs of posterior sextants. One region was treated following administration of 1.5% etidocaine HCl with 1:200,000 epinephrine. The matched control region was treated following administration of 2% lidocaine with 1:100,000 epinephrine. The results indicate that, while etidocaine provided a longer duration of anesthesia (P < 0.005), no difference was noted in the number of pain pills patients took or the period of time over which they took them. Inadequate hemostasis was a recurrent problem with etidocaine anesthesia. The use of 1.5% etidocaine HCl with 1:200,000, epinephrine offers no significant advantages over traditional anesthetic solutions.
Variations in Subgingival Microflora From Healthy and Intervention Sites Using Probing Depth and Bacteriologic Identification Criteria
Authors: Greenwell Henry , Bissada Nabil F.
Published: March 2012

This investigation studied the changes in probing depths and subgingival microbial flora of clinically healthy and diseased sites before and after scaling and root planing.

Thirty‐six sites in 18 individuals were studied in two groups of patients, Group I (9 patients) had received no periodontal surgery, while group II had received surgery within the previous 4 years. Neither group had had professional prophylaxis or scaling and root planing within the previous 6 months. Group I had an average probing depth of ≥5 mm and group II had an average of ≤4 mm. Scaling and root planing was performed on both groups at the beginning of the experiment and all patients were instructed in oral hygiene. Plaque and gingival indices, gingival fluid measurements, probing depths and dark field microscopic examination of subgingival plaque were evaluated immediately before scaling and root planing (baseline) and then once every 2 weeks for 2 months.

For descriptive analysis of the data, all sites in both groups were classified according to probing depth or bacteriologic criteria. Sites with either ≥85% nonmotile bacteria or ≤4 mm probing depth were presumed “healthy” and others were considered “diseased.”

Results following scaling and root planing showed that: (1) microflora from diseased sites tended to return to baseline after 4 to 8 weeks, (2) sites that were presumed healthy according to bacteriologic criteria exhibited no change in the flora and (3) there was an increase in the proportion of nonmotile bacteria in sites with probing depths of ≤4 mm.

These data support the concept of site‐specific variation in the subgingival microflora of patients susceptible to periodontitis.
Particle Size of Periodontal Bone Grafting Materials
Authors: Zaner David J. , Yukna Raymond A.
Published: March 2012

Samples of autogenous bone obtained by high speed burs, low speed burs, hand chisels and bone blending; freeze‐dried bone purchased from a tissue bank and alloplastic materials, such as Calcitite®, Durapatite, Periograf® and Synthograft® used as donor material for periodontal bone grafting procedures, were evaluated histometrically. Particle sizes ranged from a mean of 210 × 105 μ for bone blend to 1559 × 783 μ for hand‐chisel samples. Except for those two materials, all of the others were in the 300 to 500 micron (0.3–0.5 mm) range that seems to be preferred for use in periodontal defects.
The Effects of Two Sharpening Methods on the Strength of a Periodontal Scaling Instrument
Authors: Murray Gary H. , Lubow Richard M. , Mayhew Robert B. , Summitt James B. , Usseglio Robert J.
Published: March 2012

Several different techniques exist for sharpening periodontal sealers each of which will yield a relatively sharp instrument; however, some techniques may decrease the strength of the instrument more rapidly than others. The purpose of this study was to evaluate the effect of two different sharpening techniques on the strength of a periodontal sealer. Sixty McCall No. 13‐14 sealers (SCI‐DENT) were divided into groups of ten. Each group was reduced in size from 0 to 50% of a standard original size in increments of 10% by reducing the face of the instrument using an RX Honing Machine. A second set of 60 sealers was treated in a similar fashion by reducing the lateral surfaces of the instrument. Original angles and blade clearances were maintained on all instruments. Strength was measured by applying a force at a positive rake angle of 15° in an Instron Testing Machine with a head speed of 50 cm/min. There were no significant differences in strength from grinding on the face vs. the lateral surfaces of the sealer in contrast to the observations of other investigators. Moreover, a 10 to 20% reduction can be accomplished before a significant drop in strength is observed by sharpening either the side or face of the instrument.
Lack of Significance of Increased Tooth Mobility in Experimental Periodontitis
Authors: Ericsson Ingvar , Lindhe Jan
Published: March 2012

This experiment was carried out in order to study the rate of progression of experimentally produced periodontal tissue breakdown in teeth which prior to the placement of cotton floss ligatures either had a normal or a permanently increased tooth mobility. Six beagle dogs were used. Trauma from occlusion of the jiggling type was produced on test teeth using a model previously described. Four months later experimental periodontal tissue breakdown was induced around both control and test teeth by placing cotton floss ligatures around the necks of the teeth. The ligatures which were exchanged once every 4 weeks during a 4month period were replaced at the level of the gingival margin. Tooth mobility measurements and radiographic examinations were performed on Days 0, 30, 60. 90, 120, 160, 240 and 300. One dog was killed on Day 120 and the remaining 5 dogs on Day 300. Biopsies of the test and control teeth were fixed in formalin, decalcified, embedded in paraffin and mesiodistal sections cut with the microtome set at 4 μm. The results demonstrated that the degree of periodontal breakdown, initiated and maintained by ligature placement and plaque accumulation, was similar around teeth with a wide periodontal ligament space and in teeth with a normal width of the periodontium. In other words, progression of the plaque‐associated lesions appeared to be unrelated to the width of the periodontal ligament space, i.e., to the degree of horizontal tooth mobility.
Immunologic Profile of Juvenile Periodontitis: I. Lymphocyte Blastogenesis and the Autologous Mixed Lymphocyte Response
Authors: Suzuki Jon B. , Park Sarah K. , Falkler William A.
Published: March 2012

Studies of blastogenesis of lymphocytes in culture from juvenile periodontitis (JP) patients have been inconclusive. Experiments demonstrating differences in lymphocyte blastogenesis to preparations of putative periodontopathogens in JP and Phytohaemagglutinin (PHA) were performed. Variables in the blastogenesis assay system recently reported were controlled which included using a range of cell and activator concentrations, incubation times of 3, 5 and 7 days, conical‐bottomed microtest wells and chemical inhibitors during labeling of DNA which permits accurate assessment of lymphocyte blastogenesis. Using these modified culture conditions, stimulated lymphocytes of localized (LJP) and generalized (GJP) forms of JP patients did not differ significantly from stimulated lymphocytes of healthy subjects in counts incorporated, stimulation index, incubation time, cell concentration or activator dose required for maximal blastogenesis to bacterial preparations of Actinobacillus actinomycetemcomitans (Y‐4), Bacteroides gingivalis, Capnocytophaga ochraceus, Fusobacterium nucleatum, Streptococcus sanguis and Treponema denticola. Unstimulated lymphocyte cultures reflecting the autologous mixed lymphocyte response (AMLR) were increased for LJP compared to healthy subjects although not statistically significant. Unstimulated lymphocyte cultures of GJP were decreased compared to healthy subjects and LJP (P < 0.05). These observations indicate that GJP patients may have abnormalities in T‐ and B‐lymphocyte regulatory mechanisms.
The Relationship Between Periodontitis and the Maxillary Sinus
Authors: Lane James J. , O'Neal Robert B.
Published: March 2012

This article presents a short review of the literature describing the relationship of periodontal disease and the maxillary sinus. This is followed by two case reports which demonstrate a close physical relationship between molar roots and the sinus and suggest that a sinusitis may develop from the extension of periodontal disease into the maxillary sinus. Further investigation of this hypothesis is necessary.
Parotid Saliva Agglutinins for Sheep Erythrocytes as a Measure of Ongoing Inflammation in Periodontal Disease
Authors: Suber John F. , Boackle Robert J. , Javed Tariq , Vesely Jana
Published: March 2012

The level of parotid saliva agglutinins to sheep erythrocytes (PSAE) may be directly related to the severity of ongoing inflammation. PSAE were titrated in a population of 19 individuals with no clinical evidence of gingivitis or periodontitis. In these normal individuals PSAE were detected at an average salivary dilution of 1:8. However, 31 patients receiving treatment for periodontitis had PSAE at an average dilution of 1:26. Furthermore, the parotid saliva of those periodontal patients had significantly higher IgA and protein concentrations than the healthy group. The salivary flow rate and the IgA to protein ratio were similar in both groups. The elevated titer of PSAE may be due in part to heterogenic stimulation of B cells in periodontal tissues and therefore may be related to the rate of the ongoing inflammatory disease process.
Human Neutrophil Migration under Agarose to Bacteria Associated with the Development of Gingivitis
Authors: Lareau Donald E. , Herzberg Mark C. , Nelson Robert D.
Published: March 2012

In clinically healthy gingiva and increasingly with the development of inflammation, neutrophils are found in the gingival tissues and sulcus. This study evaluated the relative ability of bacteria associated with gingival health and developing inflammation to stimulate this increase in neutrophil accumulation. Dialyzed bacterial sonic extracts (BE) in buffer and pooled human serum (PHS) from pure cultures of Streptococcus sanguis, Actinomyces viscosus, A naeslundii, Bacteroides intermedius, Fusobacterium sp and Veillonella sp were tested for stimulation of human neutrophil migration under agarose. In addition, fractions of 5 sanguis culture fluids (CFs) from Sephadex G‐10 chromatography were evaluated. All BE solutions were incubated for 1 hour at 37°C and heat‐inactivated prior to testing. All BEs in buffer attracted neutrophils, with the greatest responses seen to S sanguis and B intermedius followed by A viscosus. Migration to all BEs in PHS was greater than in buffer, suggesting that all BEs are capable of generating serum chemoattractants. A viscosus BE activated serum attractants to the greatest degree. CFs of S sanguis, A viscosus, and to a lesser degree, Fusobacterium sp, also attracted neutrophils. Evidence from [3H]FMLP competitive ligand‐binding assays indicated that S sanguis CFs contained low molecular weight (<700) chemoattractants, which were probably formylmethionyl oligopeptide‐like materials. Of the bacteria associated with health, S sanguis and A viscosus appeared at least as able to generate chemoattractants during growth or with exposure to serum as bacteria associated with gingivitis. This observation suggests that these “healthy” bacteria, which are found in greater numbers with developing inflammation, may mediate increased neutrophil transmigration in early disease.
Biosynthesis of Prostaglandins in Gingiva of Patients with Chronic Periodontitis
Authors: Mendieta Carlos F. , Reeve Charles M. , Romero J. Carlos
Published: March 2012

This study was undertaken to determine the ability of inflamed and normal gingival tissues to synthesize Prostaglandins (PGs) from the precursor arachidonic acid. Thirteen samples of inflamed human gingival tissue and six samples of normal human gingival tissue were studied. The inflammation was characterized histologically. After incubation of the tissue with [14C]arachidonate, PG metabolites were separated by thin‐layer chromatography and identified by comparison with co‐chromatographed standards. Inflamed gingival tissue synthesized significantly larger amounts, compared to normal tissue, of 6‐keto‐PGF1α (P < 0.05), thromboxane B2 (P < 0.01), PGD2 (P < 0.05), and PGA2 (P < 0.001). Some unidentified metabolites, possibly lipoxygenase products, were detected in significantly (P < 0.001) larger amounts in inflamed than in normal tissue.
Identification of Langerhans Cells in Human Gingival Epithelium
Authors: DiFranco Charles F. , Toto Patrick D. , Rowden Geoffrey , Gargiulo Anthony W. , Keene Joseph J. , Connelly Eileen
Published: March 2012

The purpose of this study was (1) to qualitatively compare three recent techniques of Langerhans cell detection in oral epithelium and (2) to quantitatively compare Langerhans cells in clinically normal and clinically inflamed human gingival biopsies.

Eleven subjects were selected who displayed chronic periodontitis and moderate gingival inflammation. A quadrant associated with clinically inflamed tissues was not treated, while the remaining teeth were scaled and root‐planed. Two gingival biopsies were taken: clinically normal, treated tissue; and clinically inflamed, untreated tissue. Langerhans cells were stained using HLA‐DR, S‐100 and OKT6. They were quantitated using a standardized grid for OKT6‐stained sections only. Approximately 5 times as many Langerhans cells were identified in the biopsy specimens of clinically inflamed human gingiva as in clinically normal gingiva of the same patient. Of the methods studied, OKT6 was qualitatively determined to be the best for visualization of these cells. An immunologic role in the host response to chronic periodontal disease is postulated for Langerhans cells.
Determination of the Presence of Root‐Bound Endotoxin Using the Local Shwartzman Phenomenon (LSP)
Authors: Ito Koichi , Hindman Robert E. , O'Leary Timothy J. , Kafrawy Abdel H.
Published: March 2012

The purpose of these studies was to determine, by attempting to elicit the local Shwartzman phenomenon (LSP), if the material extracted from periodontally involved root surfaces is actually endotoxin or only an endotoxin‐like substance.

A total of 719 periodontally involved teeth and 201 unerupted third molars yielded pooled samples of root surface grindings which were treated with the endotoxin extraction technique of Westphal and Jann. The resultant extracts were reconstituted with sterile, isotonic, nonpyrogenic saline or pyrogen‐free water.

In the first study each of the reconstituted extracts was injected into the right palatal gingiva of New Zealand white rabbits which had demonstrated the ability to elicit an LSP. Commercial Salmonella enteritidis endotoxin was injected into the left (control) palatal gingiva. This was followed 18 hours later by a provoking injection of 200 to 300 μg S enteritidis endotoxin in a marginal ear vein. In the second study, reconstituted extracts were injected into the right side of the abdomen of New Zealand white rabbits. The left (control) side received varying amounts of S enteritidis endotoxin. Twelve hours later each animal received a provoking injection of 400 μg of S enteritidis endotoxin in a marginal ear vein. In both studies the animals were examined 6 hours later for visual signs of an LSP. After sacrifice, the tissues were prepared and histologic sections evaluated by two examiners who were unaware of how the specimens had been treated.

The results indicated that a heat‐stable, phenol‐water extractable and highly irritating substance could be obtained from periodontally involved root surfaces. However, it is questionable if the substance extracted was actually endotoxin. If a true endotoxin, it was present only in extremely small amounts.
Inhibitory Effect of Periodontally Diseased Root Extracts on the Growth of Human Gingival Fibroblasts
Authors: Olson Richard H. , Adams Donald F. , Layman Don L.
Published: March 2012

Cementum shavings obtained from periodontally diseased and nondiseased areas of 100 removed, single‐rooted teeth were extracted with either pyrogen‐free water (PFW) for 5 minutes, 1 m citric acid for 5 minutes or 45% phenol‐PFW for 90 minutes at 65°C. The extracts were membrane‐filtered, dialyzed exhaustively versus PFW, lyophilized, weighed and then dissolved in complete growth medium. The phenol‐water or citric acid extracts of cementum shavings from periodontally diseased roots were positive for endotoxin by the limulus lysate assay (LLA). Pyrogen‐free water extracts of diseased or phenol‐water extracts of nondiseased cementum shavings were negative, or only slightly positive, respectively, for endotoxin by LLA. Media containing the various extracts were added to logarithmically growing cultures of human gingival fibroblasts (HGF). Separate cultures of HGF were exposed to Escherichia coli endotoxin at concentrations of 50, 100, 250 and 500 μg/ml to determine the growth‐inhibitory effects of a known endotoxin. Cell growth was analyzed by measuring the incorporation of tritiated thymidine into cells. Suppression of HGF growth from 30 to 49% by E. coli endotoxin was concentration‐dependent and linear over the concentration range of endotoxin tested. Pyrogen‐free water extracts of diseased (endotoxin negative) or phenol‐water extracts of nondiseased cementum shavings (slightly endotoxin positive) did not effect HGF growth. However, citric acid or phenol‐water extracts of diseased cementum shavings (highly endotoxin positive) significantly suppressed HGF growth 58% and 61%, respectively. These results indicate that citric acid is effective in removing cytotoxic substances, presumably endotoxin, from cementum shavings and suggest that citric acid treatment is effective clinically in detoxifying periodontally diseased root surfaces.
Phagocytic Cells in Periodontal Defense: Periodontal Status of Patients with Chronic Granulomatous Disease of Childhood
Authors: Cohen Myron S. , Leong Patricia A. , Simpson David M.
Published: March 2012

Both qualitative and quantitative neutrophil abnormalities have been associated with severe forms of periodontitis. Defects in chemotaxis, phagocytosis and bacterial killing have been reported among both peripheral blood and gingival neutrophils harvested from patients with juvenile and rapidly progressive periodontitis.

Chronic granulomatous disease of childhood (CGD) is a rare, inherited disorder associated with the occurrence of severe, life‐threatening, suppurative infections of skin, liver, lymph nodes and other organs. Neutrophils and monocytes from individuals with CGD lack enzymes necessary for the production of oxygen reduction/products such as H2O2 and superoxide anion, and therefore are unable to kill many species of bacteria and fungi. However, no detailed study of the periodontium of these patients has been undertaken. Accordingly, five patients whose ages ranged from 17 to 32 years were included in this study. An additional (sixth) patient was included based on complete dental records. Neutrophils from all patients demonstrated defective O2 metabolism, and all patients had histories of chronic recurrent abscesses consistent with CGD. All patients were receiving antibiotic prophylaxis.

Several patients had ulcerative lesions of the oral cavity of unknown etiology. Examination of the periodontium revealed that three patients had gingivitis, one had localized early periodontitis, and one had generalized early‐to‐moderate periodontitis. The severity of periodontal disease was consistent with patient age and local etiologic factors. No patients had evidence of juvenile, severe or rapidly‐progressing disease in spite of their leukocyte defects. These findings suggest the following possibilities: (1) nonoxidative mechanisms of bacterial killing by PMNs are sufficient to protect against periodontal pathogens, (2) organisms of the periodontium make H2O2 in concentrations sufficient to contribute to the function of CGD neutrophils, (3) antibiotic prophylaxis prevents acquisition and/or multiplication of pathogenic oral flora associated with periodontitis and (4) oxidative mechanisms of neutrophils are important in promoting the tissue damage associated with some forms of periodontitis. These observations offer clues to the pathophysiology of periodontitis.
The Presence of Bacteria within the Oral Epithelium in Periodontal Disease: I. A Scanning and Transmission Electron Microscopic Study
Authors: Saglie F. R. , Carranza F. A. , Newman M. G.
Published: March 2012

The presence of bacteria within the gingival oral epithelium and adjacent connective tissue in cases of periodontitis and localized juvenile periodontitis have been described using scanning and transmission electron microscopy. The following bacterial morphotypes were identified: cocci, short rods, filaments and few spirochetes in periodontitis and mainly coccobacillary‐shaped bacteria in localized juvenile periodontitis. Also Mycoplasma‐like structures were identified in the localized juvenile periodontitis cases. Tunnel‐like formations at different depths of the oral epithelium contained higher numbers of bacteria than those seen on the adjacent oral surface. Identification of specific bacteria in the oral epithelium may have important pathogenic and therapeutic implications.
Practice Styles in Periodontics II
Authors: Born David O. , Nevins Myron
Published: March 2012

In 1980 the American Academy of Periodontology published the results of its first major survey of practice characteristics in the Journal of Periodontology.1 That first study arose from membership concerns about the lack of knowledge about career patterns of periodontists and, more specifically, about employment opportunities for graduating periodontists. Three years later, the Committee on Practice Styles and Opportunities in Periodontics was appointed to replicate the earlier study in order to provide information on recent changes in the practice of periodontics. This decision is commendable since few dental specialty organizations collect data from their membership which can be systematically compared to data from an earlier study.

The Academy's Committee contacted David O. Born, PhD, a dental manpower specialist at the University of Minnesota and a technical advisor on the earlier study, for assistance in conducting a replication in 1984. Based on feedback on the first survey and on comments and suggestions from committee members, a revised questionnaire was developed. This questionnaire was, for the most part, a replication of the earlier survey instrument, although several problematic items were deleted or modified and new items, reflecting more recent concerns, were added.

The revised questionnaire was distributed in the Spring of 1984 through two mailings to 2937 Active members and 798 Affiliate members. After unusable and undeliverable questionnaires were deleted from the returns, an effective response rate of 55% (N = 2082) was obtained.

This report is based on the information supplied by those 2082 members. In the tables and text which follow, the figures reported at the national level refer to “Private practice” periodontists responding to the survey; Academy members who are a part of the Federal services (e.g., Military, Veterans' Administration, Indian Health Service, etc.) are tabulated separately as “District 8” data. While several members from foreign countries responded to the survey, their data have not been included since the information was too dispersed to permit conclusions to be drawn.
Reliability of Standardized Narrow Strips in the Periotron®
Authors: Asikainen Sirkka , Etemadzadeh Hossein , Ainamo Jukka
Published: March 2012

In clinical practice the authors have found the 2‐mm wide Periopaper® slightly too large for insertion into the gingival crevice. This study investigated the reliability of Periotron® readings for quantitation of gingival fluid when using filter paper strips which are narrower than the Periopaper®. The round‐ended strips were cut to a standard size 1 mm wide and 15 mm long using a conchotome. A microsyringe was used to deposit 0.1 μl of four different fluids (distilled water, undiluted horse serum, diluted horse (1:2) and human (1:2) sera) onto Periopaper® and the narrow S–690 strips. The moistened end of each strip was placed between the jaws of both the Periotron® 600 and the Periotron® 6000, and the maximum digital reading was recorded in two series of 20 measurements for each of the four fluids and two strips, giving a total of 640 assessments. A comparison between the two series confirmed the excellent reproducibility of Periotron® readings. The comparison between strips revealed from 10% (Periotron® 600) to 20% (Periotron® 6000) lower readings for the S‐690 than for the Periopaper® strips for all fluids. The SD of the readings for both the S‐690 and the Periopaper® strip was low enough to make the difference between strips statistically significant. The slightly lower readings obtained with the narrow S‐690 strip were found as reliable as those recorded when using Periopaper®.
Management of Arthrogryposis Multiplex Congenita
Authors: Sakamoto F. O. , Claman L. , Klabunde M. , Perry T. , Horton J. E.
Published: March 2012

Arthrogryposis multiplex congenita is a rare disorder of skeletal muscle development which is characterized by deforming contractures of the joints, but seldom affects the temporomandibular joint. This report reviews the condition and reports the findings and periodontal management of a patient referred with arthrogryposis multiplex congenita which required treatment for severe dilantin gingival hyperplasia.
The Inductive Properties of Human Dentin and Cementum
Authors: Morris Melvin L.
Published: March 2012

Studies of the inductive properties of human dentin and cementum have yielded differing results. Comparisons are difficult to draw because of variations in time, donor tissue, host immunologic status, implant site, decalcifying agents and degree of decalcification. Analysis of the many experiments intimates that the answers may lie in the use of citric acid and/or the degree of decalcification. The direction of future investigations is suggested.
Usefulness of Subtraction Radiography in the Evaluation of Periodontal Therapy
Authors: Hausmann E. , Christersson L. , Dunford R. , Wikesjo U. , Phyo J. , Genco R. J.
Published: March 2012

Subtraction radiography, a sensitive and accurate technique for identifying alveolar crestal change from standardized pairs of radiographs, is useful in monitoring periodontal therapy. One half of the radiographs were found to be appropriate for subtraction analysis using present technology for taking standardized radiographs. The criterion for usability was identical interpretation of subtraction images made in duplicate from a pair of radiographs. A set of radiographs was analyzed by subtraction radiography as well as by measurement of alveolar bone‐crest height. Subtraction radiography was found to be more sensitive in detecting change. Whereas 53% pairs of radiographs showed a change on subtraction radiography, only 14% showed a change in crest height. Comparison of change by subtraction radiography and probing attachment level showed an overall correlation. Since these two measures assess different aspects of the periodontium, perfect correlation was not expected.
Nuclear Medicine: An Indicator of “Active” Alveolar Bone Loss in Beagle Dogs Treated with a Nonsteroidal Anti‐inflammatory Drug
Authors: Jeffcoat M. K. , Williams R. C. , Kaplan M. L. , Goldhaber P.
Published: March 2012

Nuclear medicine was used to assess the activity of alveolar bone loss in beagle dogs treated with the nonsteroidal anti‐inflammatory drug flurbiprofen. Radiographic measurements of the rate of bone loss were taken during a 6‐month “pretreatment” period and a 9month treatment period. During the treatment period six dogs received a placebo, and six dogs received orally 0.02 mg/kg flurbiprofen daily for 9 months. In addition, each dog received periodontal surgery in one half of the mouth at the end of the pretreatment period. The rate of alveolar bone loss was significantly decreased in the treatment period in the flurbiprofen‐treated dogs (P < 0.001). Measurements of boneseeking radiopharmaceutical uptake were taken 3 months after the initiation of therapy. The single measurement of uptake was compared to the rate of bone loss determined from repeated radiographs taken during the 9‐month treatment period. Bone‐seeking radiopharmaceutical uptake was an accurate indicator of “active” bone loss in 83.5% of the teeth studied.
Current Concepts of the Pathogenesis of Periodontal Disease: Microbiology Emphasis
Authors: Newman Michael G.
Published: March 2012

A summary of the major highlights of periodontal pathogenesis research with particular emphasis on periodontal microbiology is presented. Bacteriologic specificity, periodontal disease activity, anatomical plaque research, bacterial recolonization and the concept of bacterial succession are discussed. Periodontal immunology, gingival fluid, histopathology as well as clinical research are briefly mentioned as they interrelate with periodontal microbiology.