bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcium Concentrations in Dental Plaque of Patients with Juvenile and Adult Periodontitis
Authors: Sewȯn Liisi A. , Söderling Eva
Published: March 2012

Calcium concentrations in plaque of patients with juvenile (JP) and adult (AP) periodontitis were compared. These calcium concentrations in JP patients were significantly (P < 0.01) lower than in AP patients. Because JP patients are not intense calculus‐formers, the finding that they have low calcium concentrations in plaque agrees with the authors' previous suggestion that calculus formation is a marker of high calcium concentrations in plaque.

JP patients have good caries resistance in general, as was the case in this study. The finding that they have low calcium concentrations in plaque conflicts with the view that caries‐resistant dentitions are usually associated with high concentrations of calcium in plaque.
Viadent®, Ethanol, and pH Effects upon Gingival Epithelial‐like Cells, in Vitro
Authors: Barczynski John L. , Fletcher Ronald D. , Segal Alan H. , Conway James C.
Published: March 2012

Interest has recently been directed towards the use of antiplaque mouthrinses. Most published material concerns the antimicrobial effects of these agents rather than their effects upon oral tissue. This study was conducted to evaluate the effect of a sanguinarine‐containing mouthrinse called Viadent® upon epithelial‐like gingival cells. The cells were grown for 24 hours in supplemented Earle's medium, with and without different Viadent® dilutions. Cell counts were made with a hematocytometer. It was found that 50% of the cells were inhibited at 1.2% Viadent®. In similar studies, it was found that 70% ethanol and two pH buffers were less toxic than Viadent®. Exposure of preformed cell monolayers to Viadent® also showed significant inhibition. The relative toxicity of different antiplaque agents may be compared using such cells as a model system. In conclusion, it was observed that Viadent® significantly affected gingival cell growth in vitro, that viable cell numbers were greatly reduced by short time exposure, and that the toxic effect of Viadent® could only partially be accounted for by ethanol content and/or pH.
Effects of Octenidine on Dental Plaque and Gingivitis in Monkeys
Authors: Shern Roald J. , Little Wayne A. , Kennedy John B. , Mirth Dale B.
Published: March 2012

This investigation monitored the effects of daily oral rinses with octenidine on plaque and gingivitis in five monkeys. Formulations containing 0.5% or 1.0% octenidine or the rinse vehicle placebo were provided daily for 2 weeks. Each week the dentition of each monkey was examined, photographed, and sampled for plaque. All responses exhibited a numerical decrease in mean scores following treatments with each concentration of octenidine, whereas the placebo treatment exerted negligible effects. Decreases in plaque mass were observed after 2 weeks of treatment with 1% octenidine (58%) or 0.5% octenidine (55%) compared with the corresponding baseline values. Similar trends were noted in the extent and thickness of supragingival plaque and its ability to decrease the pH of a sucrose solution. Octenidine treatments reduced the proportions of motile forms in samples of subgingival plaque and also restricted its ability to produce H2S. Slight numerical decreases were seen in the Gingival Index and flow rate of the crevicular fluid. These consistent protective trends suggest that octenidine decreases the pathogenic potential of established plaque.
Cell Populations Associated with Conversion from Bleeding to Nonbleeding Gingiva
Authors: Caton Jack , Thilo Bernard , Polson Alan , Espeland Mark
Published: March 2012

The purpose of this study was to observe changes in cell populations of the interdental gingival tissue, which accompanied the conversion of a bleeding to a nonbleeding state induced by scaling and improved oral hygiene. Fifteen bleeding and 18 stopped‐bleeding interproximal gingival biopsies were obtained from 33 patients and processed for light microscopic evaluation. The morphometric analysis of eight connective tissue components revealed that the percentage volume density of all inflammatory cells decreased, and the percentage of fibroblasts and collagen increased, when the gingiva changed from a bleeding to a nonbleeding state. Furthermore, the inflammatory cell infiltrate in bleeding and stoppedbleeding specimens was dominated by mononuclear cells of the lymphocyte/macrophage/ monocyte group, while plasma cells and polymorphonuclear leukocytes comprised only a small fraction of the inflammatory cells present. Significant repair of gingival connective tissue had occurred in the stopped‐bleeding specimens.
Retained “Hopeless” Teeth
Authors: DeVore Cheryl H. , Beck Frank M. , Horton John E.
Published: March 2012

The retention of teeth diagnosed as periodontally “hopeless” may accelerate the destruction of the adjacent proximal periodontium. Studies determining the influence these teeth have on the health status of adjacent teeth appear nonexistent. It was the intent of this retrospective study to assess the status of the periodontium in adjacent teeth proximal to the periodontium of “hopeless” teeth.

We evaluated 17 teeth, each being mesially adjacent to one “hopeless” tooth, in 17 subjects treated for periodontal disease. In each case, the “hopeless” and the adjacent teeth received the same treatment. Probing depths (P–D), radiographie alveolar bone level (R–BL) and the width of the periodontal ligament space (W–PL) were measured for both the adjacent interproximal and the nonadjacent interproximal surface for each hopeless tooth. At both pretherapy and posttherapy, there were no significant differences for any of the variables (P– D, R–BL and W–PL) for the adjacent interproximal surfaces with the nonadjacent interproximal surfaces. However, there was a significant reduction in the mean probing depth for the adjacent interproximal surfaces, pretherapy to posttherapy. No other significant changes were found in any of the other variables for either the adjacent or nonadjacent interproximal surfaces.

These data suggest that teeth considered periodontally “hopeless” and retained have no effect on the proximal periodontium of adjacent teeth prior to and following therapy.
Development of Gingiva Following Surgical Exposure of a Facially Positioned Unerupted Incisor
Authors: Lundberg Margareta , Wennström Jan L.
Published: March 2012

A case with a facially positioned, unerupted maxillary incisor is presented as an illustration of the potential of the periodontal tissues to establish a zone of gingiva following surgical intervention. Despite the fact that the tooth had an erupting position entirely within the area of the alveolar mucosa, a zone of keratinized gingiva developed following surgical exposure of the crown of the tooth. This healing potential should be considered when selecting the treatment for facially positioned, unerupted teeth.
Histological Study of the Hydroxyapatite‐Collagen Complex Implants in Periodontal Osseous Defects in Dogs
Authors: Minabe M. , Sugaya A. , Satou H. , Tamura T. , Ogawa Y. , Hori T. , Watanabe Y.
Published: March 2012

This study was performed to determine whether the process of wound healing, following periodontal surgery, could be improved through the combined use of collagen and grafting of hydroxyapatite (HAP) particles.

Twenty‐four proximal defects were made in the mandibular fourth premolars and second molars of six adult mongrel dogs. Steel wires and resin were put into the defect to enhance plaque formation. At eight weeks, the wires and resin were removed. At ten weeks, HAP or HAP‐collagen complex was implanted during reconstructive surgery, along the root surface treated with acid conditioning. Dogs that received no implant following a flap operation served as controls. In these three groups of animals, differences in the extent and features of healing were histopathologically examined two months later. Animals implanted with a HAP‐collagen complex showed a larger amount of new cementum formation when compared with HAP‐implanted or control animals. In addition, in animals from the HAPcomplex group, the interdigitation between the root surface and the gingival connective tissue fibers tended to be reinforced resulting in suppressed epithelial downgrowth. However, neither bone formation nor the reformation of the periodontium was promoted in the HAPcollagen complex group.

These results suggest that implantation of an HAP‐collagen complex promotes cementogenesis of the demineralized root surface and can establish a stronger interdigitation between the root surface and the gingival connective tissue fibers.
Systematic Errors in Estimating Prevalence and Severity of Periodontal Disease
Authors: Kingman A. , Morrison E. , Löe H. , Smith J.
Published: March 2012

Partial‐mouth scores are often used in epidemiologie studies to estimate the prevalence and severity of periodontal disease. Such estimates systematically underestimate the prevalence of disease, but the bias can be in either direction for disease severity. Three large data sets containing full‐mouth examinations (mesiobuccal, midbuccal, distobuccal, and midlingual (MBDL) sites per tooth) for either attachment loss or probing pocket depths were used to investigate the magnitudes of systemic error that occur by employing four specific partialmouth scores (M, MB, MBD, and MBDL sites per tooth), which are based on the random half‐mouth technique. For prevalence of disease the sensitivity of a partial score was a function of the disease level in the population. All four partial scores were sensitive enough to adequately portray true prevalence using the 2‐mm demarcation value, the MBD and MBDL scores might still be considered adequate for the 4‐mm value, but none of these partial scores were adequate for the 7‐mm value. For disease severity the MBDL score produced unbiased estimates, the others were biased. The relative biases for the MB and MBD scores were all under 10% (in absolute value), but the M score produced severe relative biases, 24% for probing pocket depths and ‐12% for attachment loss.
The Effects of Exclusion of Epithelium From Healing Periodontal Pockets
Authors: McHugh William D.
Published: March 2012

Epithelium was excluded experimentally from artificially induced periodontal pockets by cutting off the crowns of vital teeth and covering the roots with mucoperiosteal flaps. This procedure was carried out on 58 teeth in eight rhesus monkeys and specimens recovered at from five to 36 weeks postoperatively.

Thirty‐eight (66%) of the teeth remained completely covered by soft tissue for the duration of the experiment. Up to 4.4 mm (mean = 0.9 mm) of new attachment with cementum and attached collagen fibers was found on both the sides of the roots and the cut ends, but root resorption and downgrowth of epithelium over root surfaces were about equally common. Thus, even when epithelium is excluded from healing periodontal pockets, reattachment with new cementum and attached collagen fibers is not consistently achieved, even after periods of 36 weeks. Root resorption and ankylosis are major complications. Although most new attachment appears to result from cells originating in the periodontal ligament, it can also arise from cells from the gingival connective tissue.
Evaluation of Furcation Region Response to Periodontal Therapy
Authors: Kalkwarf Kenneth L. , Kaldahl Wayne B. , Patil Kashinath D.
Published: March 2012

Five hundred fifty‐eight molars were treated with one of four types of periodontal therapy: coronal scaling (CS); root planing (RP); modified Widman surgery (MW); or flap with osseous resectional surgery (FO). This report presents the probing depth and probing attachment changes in the furcation region following therapy and two years of maintenance follow‐up. All types of therapy were effective in reducing probing depths. FO was the most effective in reducing probing depth followed by MW, RP, and CS. Reduction in probing depth was primarily due to gingival recession. FO resulted in a loss of probing attachment in both a vertical and horizontal direction following therapy. Following two years of maintenance care, sites treated with FO continued to exhibit a mean net loss of vertical probing attachment. A mean net loss of horizontal probing attachment was present after two years of maintenance care, regardless of the treatment modality employed. Many more sites were initially removed during osseous resectional surgery to achieve treatment criteria than were initially removed from the other groups. FO treated teeth demonstrated a lesser percentage of furcation sites demonstrating clinically significant breakdown during the two years of maintenance care.
Human Gingival Langerhans Cells as Accessory Cells in Mitogen Induced T Cell Responses
Authors: Newcomb G. M. , Powell R. N.
Published: March 2012

Peripheral blood and gingival tissue was collected from patients undergoing surgery for the treatment of periodontal disease. Both unfractionated peripheral blood mononuclear cells and a T cell‐enriched, monocyte‐depleted lymphocyte population were isolated from the blood samples while a gingival epithelial cell suspension was prepared from the oral aspect of the gingival tissue. The blood cells (1 X 105) were then co‐cultured with the gingival epithelial cells (1 x 105 and 1 x 104) in 200 μl aliquots in microtitre trays for three days to see if the epithelial cells could act as accessory cells in the lymphocyte response to the mitogen, phytohaemagglutinin (PHA). Lymphocyte proliferation was assessed by measuring the uptake of [6‐3H] thymidine during the last 18 hours of culture.

Removal of monocytes from peripheral blood mononuclear cells led to a significant, but not total, reduction in the proliferative response to PHA. When gingival epithelial cells were added to the T cells they restored their response to PHA in a dose dependent fashion. As Langerhans cells were the only potentially immunocompetent cells seen in the epithelial cell suspensions, it is concluded that these cells are acting as accessory cells in the T cell response to PHA.
Penetration and Uptake of Colloidal Gold‐Labeled Concanavalin A in The Junctional Epithelium of The Rat
Authors: Takata Takashi , Nikai Hiromasa , Ijuhin Naokuni , Ito Hiroshi
Published: March 2012

A complex of colloidal gold and concanavalin A (CG‐Con A) with various biological properties and high ultrastructural resolution was applied into the sulcus of rat molar gingiva and traced with an electron microscope for three hours to examine the cytological changes occurring in the cells of the junctional epithelium (JE) during penetration of extrinsic irritants, and to determine the roles of JE cells in such a circumstance. While the penetration of CG‐Con A was impeded on the surface of keratinized oral gingival/sulcular epithelium, CG‐Con A penetrated swiftly through JE into the connective tissue. In the process of penetration, CG‐Con A was taken up by lysosomal and vacuolar structures of JE cells in which degenerative changes were often provoked. Degeneration of JE cells was seen selectively in the second and/or third cell layers from the innermost cell layer of JE. It was assumed that JE cells by their phagocytic activity might participate in the first line of defense against extrinsic irritants. On the other hand, the phagocytic activity of JE cells seems also to be involved in tissue destruction, if the amount and/or toxicity of irritants exceed the dissimilating capacity of JE cells.
The Effect of Polishing Pastes on Composite Resin Surfaces
Authors: Serio Francis G. , Strassler Howard E. , Litkowski Leonard J. , Moffitt William C. , Krupa Catherine M.
Published: March 2012

Clinically, composite resins can be polished to a smooth surface at the time of placement using a variety of polishing methods. Subsequently maintaining the finish on recalls needs to be evaluated. The purpose of this investigation was to compare surface textures of a small particle composite resin (average particle size 5 microns) after polishing with prophylaxis and polishing pastes. Each specimen of the small particle composite resin, PrismaFil, was finished and polished to a smooth surface with Soflex discs. This was the control polish. The specimens were then polished with a rotating rubber prophylaxis cup with seven different prophylaxis and polishing pastes. All the samples were then prepared for scanning electron microscopy (SEM) evaluation and photographed at 750x to compare the effects of polishing on the surfaces of composite resins. SEM photographs were also made of a sample polished with Soflex discs (SF) and with a dry rubber cup (RC).

The seven prophylaxis and polishing pastes were Command Ultrafine Lustre Paste (CULP), Coral Phosphate Prophylaxis Paste (CPPP), NuPro fine (NPF), NuPro medium (NPM), Prophydent (PD), Rembrandt Polishing Paste (RPLP) and Rembrandt Prophylaxis Paste (RPXP). The SEM photographs were rated by independent evaluators according to surface roughness from the smoothest to roughest surfaces. The results of the evaluator ratings determined that the composite resin surface gets rougher with the use of any polishing paste. The smoothest to roughest surface by groupings were: (SF)‐(RPLP)‐(CULP, RC)(RPXP)‐(NPF, CPPP, PD)‐(NPM).
Abnormal Lymphocyte Profiles and Leukotriene B4 Status in a Patient with Crohn's Disease and Severe Periodontitis
Authors: Engel L. David , Pasquinelli Kirk L. , Leone Salvatore A. , Moncla Bernard J. , Nielson Kathleen D. , Rabinovitch Peter S.
Published: March 2012

This case report describes clinical and laboratory findings for a 60‐year‐old woman with recently diagnosed Crohn's disease and severe generalized Periodontitis. Comparison of dental radiographs taken in 1975, in 1983, and at the time of our evaluation in 1986 revealed dramatic progression of alveolar bone loss over that period. Standard laboratory blood tests did not reveal any remarkable significant leukocyte abnormalities, but flow cytometric analysis of lymphocytes revealed a paucity of B cells stained with anti‐light chain antibodies, and an increased proportion of T lymphocytes which were dully‐stained with anti‐CD5 monoclonal antibody. B cell function as determined by in vitro proliferative responsiveness to anti‐IgM antibody was only about 50% of that observed with cells from two healthy normal subjects. Serum leukotriene B4 (LTB4) was elevated to 150% of normal values, in spite of the fact that the patient was taking a systemic anti‐inflammatory drug which is known to reduce LTB4 levels. The microbial flora was highly mixed and included several putative periodontopathic bacteria. Therapy consisted of oral hygiene instruction, scaling and root planing, mucoperiosteal‐flap curettage, extracoronal splinting, and selective extraction of three teeth. The periodontal status improved markedly with therapy. Possible relationships between the patient's immunological status, her Crohn's disease, and the severe periodontal breakdown are discussed.
Primary Gingival Enlargement as a Diagnostic Indicator in Acute Myelomonocytic Leukemia
Authors: Hou Guey‐Lin , Tsai Chi‐Cheng
Published: March 2012

A 25‐year‐old Chinese female, five months pregnant, came to our dental clinic with a chief complaint of slight gingival inflammation. A diagnosis of pregnancy gingivitis was made. One week later, there was a sudden onset of extremely generalized gingival enlargement and very high WBC count (144,000/cmm) was noted. Physical, laboratory, and microscopic examination led to the diagnosis of acute myelomonocytic leukemia.

The observations of good oral hygiene and clinical course suggested that leukemic cell infiltration was the major cause of sudden onset of gingival enlargement. This article emphasizes the importance of primary gingival enlargement in the initial diagnosis of leukemia.
Factors Associated with Occurrence and Reversibility of Connective Tissue Attachment Loss
Authors: Zappa U. E. , Poison A. M.
Published: March 2012

Marginal Periodontitis appears to be site‐specific, demonstrates rapid bursts of connective tissue attachment destruction, and may, at times, repair spontaneously. The present study was undertaken to investigate associations between bacterial populations and periodontal destruction parameters within the first 14 days after induction of experimental Periodontitis in animals receiving metronidazole. Metronidazole was administered orally to four squirrel monkeys for 17 days at a daily dose of 100 mg/kg body weight. After three days (baseline), marginal Periodontitis was induced by tying silk ligatures at the gingival margins of maxillary and mandibular bicuspids and molars. Subgingival bacterial samples were taken and periodontal destruction evaluated at baseline, and 3, 7 and 14 days after ligature placement. Dark‐field microscopy was used to quantitate motile forms, spirochetes, straight and curved rods, filaments, cocci and fusiforms. Levels of connective tissue attachment, crestal alveolar bone and the volume of bone were assessed histometrically. Bacterial and histometric parameters were analyzed using analysis of variance. The results indicated that subgingival plaque, prior to induction of Periodontitis, consisted primarily of cocci. At three days after ligature placement, cocci were significantly decreased, while straight rods became the predominant bacterial group for the remainder of the study. Spirochetes and motile forms were virtually absent at all time points. Histometric analyses showed significant loss of connective tissue attachment at three and seven days, which was reversed and repaired at 14 days. Factors relating to initiation, potentiation, and reversibility of connective tissue attachment loss are discussed.
Ultrastructural Examination of Human Periodontal Pockets Following the Use of an Oral Irrigation Device in Vivo
Authors: Cobb Charles M. , Rodgers Richard L. , Killoy William J.
Published: March 2012

To date, there are no ultrastructural studies that have examined untreated chronic periodontal pockets immediately following dental debridement with an oral irrigation device. This study used both scanning electron microscopic and transmission electron microscopic methodology to examine previously untreated human periodontal pockets after their exposure to a pulsating oral irrigation with saline solution. A comparison of 16 untreated controls with 16 test specimens revealed qualitative differences in microbial morphotypes at various pocket depths. Control specimens at all pocket depths examined (0‐6 mm), exhibited a mixed microbial flora consisting of cocci, short rods, and filamentous organisms. Specifically at 3‐ to 4‐mm and 5‐ to 6‐mm levels in control specimens, spirochetes, fusiforms, and branching organisms were obvious. In contrast, test specimens exhibited a few cocci and short rods at 0‐ to 2‐mm and 3‐ to 4‐mm levels and a mixed flora at the 5‐ to 6‐mm level. There was no observable difference between control and test specimens concerning epithelial topography, cavitations, microulcerations, spatial relationships, and individual cell appearance. Both control and test specimens exhibited a mild spirochete invasion of the epithelial strata. Collectively these observations suggest that pulsating oral irrigation effects a qualitative change on subgingival plaque and is not injurious to the soft tissues.
Periodontal Disease in Sickle Cell Disease Subjects
Authors: Crawford John M.
Published: March 2012

Various systemic diseases and conditions have been associated with an increase in periodontal disease severity.1–4 These studies indicate that host‐response mechanisms influence the initiation and/or progression of inflammatory periodontal diseases. Diseases that have been associated with an increased severity of periodontal disease include various neutrophil abnormalities,1 Down's syndrome,2 diabetes,4 and recently, the acquired immunodeficiency syndrome.5,6 Sickle cell disease is strongly associated with a predisposition to various infections; therefore, the objective of this study was to determine whether sickle cell disease is also associated with an increase in the severity of periodontal disease. A total of 78 patients with sickle cell anemia (SS), hemoglobin SC disease (SC) or S Thalassemia were evaluated blind and compared with an appropriate control population using clinical and radiographic indices of periodontal disease severity. The results clearly indicate that, in this population of patients, sickle cell disease is not associated with increased levels of gingivitis or periodontitis.
The Effect of Retained Subgingival Calculus on Healing after Flap Surgery
Authors: Fujikawa Kenji , O'Leary Timothy J. , Kafrawy Abdel H.
Published: March 2012

This study investigated the effects of retained subgingival calculus on healing of the periodontium at ten, 30 and 120 days. Eight beagle dogs between eight and ten years old with naturally occurring periodontal disease were used. One dog that died before any procedures were done provided information on the extent of gingival inflammation prior to surgery. Quadrants from seven dogs meeting the criteria for inclusion were selected, and each quadrant was randomly designated as either an instrumented or noninstrumented, surgical site. The gingival index for the selected sites was recorded along with clinical probing measurements. Instrumented sites were treated by reflection of a facial mucoperiosteal flap followed by thorough root planing. Non instrumented sites were treated by a facial mucoperiosteal flap alone. All flaps were returned to their preoperative position and secured with interrupted sutures. No antibiotics were given. Meticulous daily plaque control was begun the day after surgery and continued until sacrifice. There was a statistically significant reduction in gingival index scores for the 30‐ and 120‐day instrumented sites and for the 120‐day noninstrumented sites. Mean probing depths for the instrumented group showed a significant reduction at 30 and 120 days and for the noninstrumented group at 120 days after surgery. Forty percent of the noninstrumented roots and 10% of the instrumented roots displayed subgingival calculus. At all evaluation periods and in both instrumented and noninstrumented roots, inflammation was more intense when calculus was present; the difference was significant at ten days with the instrumented and at ten and 30 days with the noninstrumented specimens. The intensity of inflammation decreased over time and at 120 days was minimal in the presence of calculus.
Refractory Periodontitis: Mixed Infection with Bacteroides gingivalis and Other Unusual Bacteroides Species : A Case Report
Authors: Van Dyke T. E. , Offenbacher S. , Place D. , Dowell V. R. , Jones J.
Published: March 2012

Host immune response and the predominant subgingival microflora were evaluated in a 47‐year‐old male exhibiting severe, recurrent Periodontitis. The patient's neutrophils were chemotactically elevated but other functions were within normal limits. Significantly, Bacteroides gingivalis and Bacteroides zoogleoformans constituted 80% of the cultivable microflora and total cell count in subgingival plaque. The remainder of the cultivable microbiota was comprised of Fusobacterium nucleatum and Haemophilus aprophillis. The present study provides additional evidence for an association between B. gingivalis and severe, recurrent periodontal disease.
The Mechanism of Pocket Formation
Authors: Takata Takashi , Donath Karl
Published: March 2012

Two hundred eighteen human teeth with surrounding periodontal tissues in different stages of phathogenesis were studied under light microscopy using the “sawing and grinding” technique. This was done without decalcification and with special emphasis on the dentogingival junction area so as to study the mechanism of pocket formation. Thirty early, 133 established, and 214 advanced lesions were included. No initial lesion was seen. Pocket formation, provoked by microbacterial plaque, seemed to be initiated by the degenerative changes in the second or third cell layers from the innermost cells in the most coronal part of the junctional epithelium facing the microbial plaque. Consequently, an intraepithelial cleavage was formed followed by the degeneration and desquamation of the cells lining the split. This resulted in a deep crevice and gingival pocket formation in both early and established lesions. In advanced lesions, the deep pocket epithelium was exposed for such a long distance adjacent to the plaque and calculus, that the epithelium could be directly affected by toxic bacterial products and mechanical irritation of calculus. Finally, the epithelium became very thin and ulcerated, and a typical periodontal pocket was formed. The disruption of the epithelial barrier along with the concomitant penetration of bacteria and/or their toxic products were considered to be the most significant factors related to the conversion of an established lesion to an aggressive lesion.
Upper Anterior Tooth Mobility
Authors: Khoo Kim Kuang , Watts Trevor L. P.
Published: March 2012

The relationship between buccolingual tooth mobility (TM) and other clinical parameters was studied in 124 upper anterior teeth in 21 patients with untreated Periodontitis. Periapical long‐cone radiographs were available for 74 teeth in the same population. TM was measured with Miihlemann's macroperiodontometer. Probing depths, attachment levels and bleeding were measured with a constant force probe. Bone levels were estimated from radiographs. Presence of occlusal contact was noted in the intercuspal position and excursive movements of the mandible.

Attachment levels showed the highest correlation with TM, and radiographically estimated bone support was the next highest. Results varied according to tooth type: the attachment level of the lateral incisors showed the highest correlation with TM, while probing depths and proximal bone support showed lower associations with TM in all cases. In this population, no association was detected between the presence of occlusal contact and TM, or between inflammation and TM. Multiple and partial correlation analysis indicated that probing attachment level was the most important correlate of tooth mobility.
Six‐Month Effects of a Sanguinarine Dentifrice on Plaque and Gingivitis
Authors: Mauriello Sally M. , Bader James D.
Published: March 2012

A six‐month, double‐blind clinical trial was conducted to determine the effectiveness of a sanguinarine‐containing dentifrice in reducing plaque and gingival inflammation. One hundred twenty adult volunteers were randomly assigned to a control or experimental group. The test dentifrice contained 750 mcg/g of sanguinaria extract. A dentifrice of similar composition without sanguinarine was used as the placebo. Plaque and gingival inflammation scores were recorded for four surfaces on each of 12 index teeth at baseline, one‐, three, and six‐months. Matched pair t‐test analyses showed no significant differences between experimental and control groups for mean six‐month changes in plaque and gingival inflammation scores in analyses using all 48 sites per subject or in analyses of only the 24 interproximal sites. No long‐term reduction was demonstrated in plaque or gingival inflammation with the use of a sanguinarine‐containing dentifrice.
The in Vitro Effects of Amine Fluorides on Plaque Bacteria
Authors: Kay H. M. , Wilson M.
Published: March 2012

Forty strains of bacteria which may be isolated from subgingival plaque were tested for their in vitro susceptibility to several amine fluorides and a commercial formulation (Elmex® gel) containing these compounds. The amine fluorides were active against a wide range of plaque bacteria with gram‐positive strains tending to be more sensitive than gram‐negatives. The minimum inhibitory concentrations ranged from 45 to 1440 μg/ml with approximately half of the strains being inhibited at a concentration of 130 μg/ml of amine fluoride. The Elmex gel had a bactericidal effect on all of the strains tested and exhibited a rapid killing action at high dilutions. These in vitro findings suggest that amine fluorides may be useful in the treatment or prophylaxis of plaque‐related diseases.
Tooth Loss in 1535 Treated Periodontal Patients
Authors: Nabers Claude L. , Stalker William H. , Esparza Dolores , Naylor Beverly , Canales Sylvia
Published: March 2012

Of 1535 treated recall patients surveyed over an average time of 12.9 years since treatment was completed, 1371 had lost no teeth from periodontal disease. The total number of teeth lost was 444, with the average tooth loss for the 1535 patients being 0.29. In the three full arch splinted cases, the loss rate was 14.67 teeth per patient. Patients treated without any excisional or flap surgical procedures made up 26.5% of those surveyed, whereas 73.5% had required various surgical procedures. No attempt was made to compare different pocket therapy procedures.

Although many patients developed recurrent periodontal problems during recall, only 15.9% of the 1535 patients required surgical retreatment. Teeth that were originally given a doubtful prognosis often were responsible for recurrent problems and sometimes required extraction.
Bilateral Subpontic Osseous Hyperplasia
Authors: Takeda Yasunori , Itagaki Mitsunobu , Ishibashi Kanji
Published: March 2012

A case of osseous hyperplasia under the pontics of fixed partial dentures in right and left mandibular first molar regions is presented. Radiographs showed hemispherical radioopacities on the alveolar ridges. Histologie examination revealed the lesions were composed of a dense mass of mature bone with well‐developed lamellae and haversian systems, viable osteocytes in lacunae and a few marrow spaces filled with loose fibrous connective tissue. The review of the literature showed osseous hyperplasia under the pontic of a fixed partial denture has been seen only in the mandibular molar or premolar regions, but no conclusion about its etiology was made.
Giant Cell Fibroma
Authors: Swan Richard H.
Published: March 2012

The giant cell fibroma should be of special interest to the periodontist as its primary site of occurrence is on the gingival tissue. A case report of a large giant cell fibroma is followed by a review of this interesting oral tumor, including the controversy surrounding its classification as a separate entity.
Tetracycline Therapy in Patients with Early Juvenile Periodontitis
Authors: Novak M. John , Polson Alan M. , Adair Steven M.
Published: March 2012

Tetracycline therapy, when used in conjunction with surgery or root planing, has been shown to be effective in controlling the progression of juvenile Periodontitis. However, the ability of tetracycline alone to control the disease has not been assessed. The present study evaluated the effects of tetracycline therapy, with supragingival plaque control, on clinical attachment levels and radiographie bone height in patients with clinical and radiographie evidence of juvenile Periodontitis. The four patients (mean age 15.2 ± 0.3 yrs) each demonstrated loss of attachment of ≥2 mm at one or more probing sites and had accompanying radiographie evidence of early localized bone loss. Following an initial clinical evaluation consisting of pocket depths, attachment levels and standardized radiographs, the patients received systemic tetracycline therapy (1 gm/day for three to six weeks) and oral hygiene instruction. At the completion of antibiotic therapy, patients received a supragingival professional prophylaxis every two weeks for three months, whereupon the initial evaluation was repeated. On comparing the initial and three‐month clinical and radiographic data, there were significant decreases in clinical and radiographic measurements.

For a total of 85 affected probing sites around 26 teeth, 79% decreased in pocket depth by ≥2 mm (with no sites increasing in pocket depth) and 69% gained clinical attachment (with only one site losing attachment of 1 mm). Radiographic measurements revealed an increase in both the height and area of coronal alveolar bone. The findings indicated that six weeks of systemic tetracycline therapy combined with supragingival plaque control was effective in the initial control of early juvenile Periodontitis.
Partial Regeneration of Periodontal Tissues Using Collagen Barriers
Authors: Pitaru S. , Tal H. , Soldinger M. , Grosskopf A. , Noff M.
Published: March 2012

The capacity of collagen membranes to support guided regeneration of periodontal tissues in the dog was assessed. The mesiolabial, labial and distolabial aspects of the mesial root of the second and third mandibular premolar were surgically exposed in three beagle dogs. Collagen membranes, 0.5 to 0.7 mm thick, prepared from a purified solution of ratType I collagen were interposed between the gingival flap and the exposed root surfaces of the right premolars. The left premolare were sham‐operated without the use of collagen membranes. Animals were killed one month after surgery. Tissue blocks, including the surgical sites, were removed and prepared for histological and histometric examination.

Long epithelial attachment was the modality of healing in the control sites. The apical level of the junctional epithelium was located either at, or close to, the apical level of the defect. The experimental sites exhibited a combination of three healing modalities: (1) partial regeneration of periodontal tissues (new bone, periodontal ligament and cementum) occurred in the apical half of the defect, (2) long epithelial attachment developed in the coronal quarter of the defect and (3) connective tissue adhesion developed between the two. Pocket depth was similar in both the control and experimental sites. Collagen membranes could not be identified at the time of examination.

The results indicate that: (1) collagen membranes have the capacity to support regeneration of periodontal tissues and (2) collagen membranes are either incorporated within the healing tissues or degraded by these during the healing process. These findings suggest that collagen membranes may be of value in reconstructive periodontal therapy.
Antigenicity of Freeze‐Dried Cortical Bone Allograft in Human Periodontal Osseous Defects
Authors: Quattlebaunr J. Bryan , Mellonig James T. , Hensel Nancy F.
Published: March 2012

The purpose of this investigation was to determine whether donor‐specific anti‐HLA antibodies could be detected against freeze‐dried cortical bone allograft (FDBA) placed in human periodontal osseous defects. Twenty patients with multiple periodontal bony defects amenable to treatment in two allografting procedures were enrolled. No patient had preexisting anti‐HLA antibodies. FDBA used for all allografting procedures was obtained from one donor of known HLA antigens, and all patients were tissue‐typed. Serum samples were taken two weeks after the first allograft (primary challenge), two weeks after the second allograft (secondary challenge) and at three months. Serum samples were assayed for the presence of anti‐HLA antibodies using an Amos modified microcytotoxicity assay.

At no time could any donor‐specific anti‐HLA antibodies be detected in any patient. All allografts were judged clinically successful, with no adverse tissue reactions to the donor material. FDBA may be regarded as a graft material lacking clinically significant antigenicity.
Hand Versus Ultrasonic Instrumentation in the Removal of Endotoxins from Root Surfaces in Vitro
Authors: Checchi Luigi , Pelliccioni Gian Andrea
Published: March 2012

The goal of this study was to determine whether ultrasonic scalers are as effective as curettes in providing fibroblast attachment to the scaled root surfaces. Extracted, periodontally involved teeth were cut along the sagittal plane; then one half of the root was curetted, the other half ultrasonically scaled. In addition, monkey kidney fibroblasts were suspended in a petri dish containing root fragments of the tooth halves. At the same time, control dishes without fragments were mounted. All dishes were treated with radioisotopic techniques. There was no significant difference in fibroblast growth between periodontally involved root surfaces treated using curettes or ultrasonic scalers. Both treatments caused the roots to lose their toxicity. The limitations of ultrasonic scalers in terms of shape, size and awkward handling need to be considered when choosing the approach that best suits each case.
A Rationale for Monitoring the Periodontal Microbiota after Periodontal Treatment
Authors: Listgarten M. A.
Published: March 2012

Strict control of dental plaque accumulation remains the cornerstone of successful maintenance of the treated patient. However, some recurrences of Periodontitis appear to take place despite good oral hygiene habits. A proportion of these are likely due to qualitative features of the periodontal microbiota rather than merely increased mass. Microscopic as well as cultural monitoring of qualitative features of the periodontal microbiota may be helpful in detecting critical changes. This review presents some of the research findings that provide a rationale for microbiological monitoring. Some of the advantages as well as difficulties encountered with these procedures are discussed.
Change in Attachment Level
Authors: Gunsolley J. C. , Best A. M.
Published: March 2012

Attachment level or pocket depth measurements are used to detect change in periodontal attachment. However, measurement error limits their usefulness for this purpose.

The aims of this study are twofold. The first aim was to test the assumption, used in previous reports of measurement error, that attachment level measurements are normally distributed. The second aim was to estimate error rates encountered when assessing periodontal attachment level change with attachment level or pocket depth measurements.

Two simulation methods are compared in their ability to reproduce the distribution of differences in replicated measurements. A simulation method based on a normal distribution was not able to reproduce the actual distribution of differences between replicate measurements. In contrast simulations based on resampling recreated the distribution of differences in replicated attachment level measurements. Due to the inability of simulations based on the normal distribution to reproduce the distribution of differences in replicated measurements, simulations based on the resampling procedure were used to estimate error rates.

Determining change in attachment level or pocket depth by either single or paired measurements resulted in low Type I error rates for both single and paired measurements. For single measurements of attachment level, the Type I error rate was 0.0074 for a 3‐mm change. Paired measurements of attachment level had a Type I error rate of 0.0014 for a 3mm change. However, false‐positive rates were found to be much higher. For single measurements of attachment level, the false‐positive rate was 0.32 for a 3‐mm change. Taking two measurements at each time point reduced the proportion of false‐positives by a factor of two: to 0.15 for 3‐mm changes. Similar values were obtained for pocket depth measurements.

This study demonstrates that a large proportion of perceived change in attachment level or pocket depth can be attributed to false positives.
Enzyme Activity in Crevicular Fluid for Detection and Prediction of Clinical Attachment Loss in Patients with Chronic Adult Periodontitis
Authors: Lamster Ira B. , Oshrain Richard L. , Harper D. Scott , Celenti Romanita S. , Hovliaras Christine A. , Gordon Jeffrey M.
Published: March 2012

Previous reports have described a method by which multiple constituents can be analyzed from a sample of gingival crevicular fluid (GCF) collected with a precut filter paper strip. In this study the relationship of changes in GCF levels of the vertebrate (lysosomal) enzymes β‐glucuronidase (BG) and arylsulfatase (AS) and the cytoplasmic enzyme lactate dehydrogenase (LDH) was evaluated longitudinally in reference to loss of clinical attachment in patients with existing chronic adult Periodontitis. Thirty‐six patients were followed for six months. Clinical attachment loss was recorded as the change between the baseline and three month examinations, and the three‐ and six‐month examinations. GCF analysis was performed at baseline and three months. Three groups of patients were identified based on disease progression. Group I patients (N = 5) displayed a generalized form of disease activity. In these patients we observed clinical attachment loss of at least 2.0 mm at a minimum of three unrelated sites. Group II patients (N = 4) displayed a localized form of disease activity. In these patients clinical attachment loss of at least 2.5 mm occurred at one site, or two anatomically related sites. Group III patients (N = 27) did not display clinical attachment loss as defined here. Enzyme analysis was evaluated as a whole mouth score (the per cent of samples from a patient in which enzyme activity was at least twice the population mean) and at individual samples. Group I patients could be identified by elevated whole mouth scores for BG, while Group II patients could not be identified by whole mouth scores for any of the enzymes. The region of clinical attachment loss in Group II patients could be identified by individual GCF samples that demonstrated BG activity that was at least 4 times the population mean at baseline, and remained elevated at three months. In contrast, AS and LDH did not provide a statistically significant measure of localized clinical attachment loss in Group II patients. Using this two‐tiered criteria, calculation of sensitivity (89%), specificity (89%) and k (0.72) for the relationship of BG activity in GCF to detection and prediction of clinical attachment loss indicated that analysis of this enzyme, GCF, has diagnostic value. BG is considered a marker for primary granule release from polymorphonuclear leukocytes (PMN). Therefore, clinical attachment loss in patients with existing adult Periodontitis appears to be related to an exuberant PMN response in the crevicular environment.
Clinical Evaluation of the Use of Citric Acid and Autologous Fibronectin in Periodontal Surgery
Authors: Caffesse R. G. , Kerry G. J. , Chaves E. S. , McLean T. N. , Morrison E. C. , Lopatin D. E. , Caffesse E. R. , Stults D. L.
Published: March 2012

This study evaluated the effects of citric acid demineralization and autologous fibronectin application in association with a modified Widman flap in the treatment of Periodontitis. The study population comprised 29 patients under treatment for moderate to advanced Periodontitis who reached the one‐year posttherapy evaluation. After thorough scaling and root planing, a split mouth design was used in which two quadrants were treated by modified Widman flap alone, and the other two randomly assigned quadrants were treated by modified Widman flap combined with citric acid demineralization and autologous fibronectin application. Fibronectin, which had previously been isolated from the patient's own plasma, was applied with a tuberculin syringe on the citric acid demineralized root surfaces and the inner aspect of the flap. After suturing provided good flap adaptation, additional fibronectin was again applied under the flap and external pressure was applied. Patients were clinically evaluated at baseline and at one year. Statistical evaluation of the data using paired t test and Chi‐square analysis indicated that both approaches, modified Widman flap alone or in combination with citric acid and fibronectin, significantly reduced probing pocket depth and increased clinical attachment. However, the changes achieved with citric acid and fibronectin were statistically greater than those obtained with the flap alone. Furthermore, the number of sites gaining 2 mm or more of clinical attachment were significantly increased. The results suggest that the use of citric acid and fibronectin holds promise in promoting reattachment after periodontal therapy.