bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Recombinant Human Bone Morphogenetic Protein‐4 with Carriers in Rat Calvarial Defects
Authors: Ahn Seong‐Hee , Kim Chang‐Sung , Suk Hun‐Joo , Lee Yong‐Jun , Choi Seong‐Ho , Chai Jung‐Kiu , Kim Chong‐Kwan , Han Soo‐Boo , Cho Kyoo‐Sung
Published: February 2005

Background: Bone morphogenetic proteins (BMPs) are being evaluated as candidates for periodontal and bone regenerative therapy. However, the research on recombinant human bone morphogenetic protein‐4 (rhBMP‐4) has been insufficient to evaluate its capacity to enhance bone formation and its carrier system. The purpose of this study was to evaluate the bone regenerative effect of rhBMP‐4 delivered with an absorbable collagen sponge (ACS) or β‐tricalcium phosphate (β‐TCP). We also compared the potential of β‐TCP to that of ACS as a carrier system for rhBMP‐4.

Methods: Eight‐mm calvarial critical‐sized defects were created in 100 male Sprague‐Dawley rats. The animals were divided into 5 groups of 20 animals each. The defects were treated with rhBMP‐4/ACS (rhBMP‐4 at 0.05 mg/ml), rhBMP‐4/β‐TCP (rhBMP‐4 at 0.05 mg/ml), ACS alone, β‐TCP alone, or left untreated for surgical control. The rats were sacrificed at 2 or 8 weeks postsurgery, and the results were evaluated radiodensitometrically, histologically, and histomorphometrically.

Results: The results of radiodensitometric analysis were as follows: the rhBMP‐4/ACS and the rhBMP‐4/β‐TCP groups were more radiopaque than other groups at both 2 and 8 weeks (P <0.01). The histologic observations were as follows: in the rhBMP‐4/ACS and the rhBMP‐4/β‐TCP groups, new bone was evident at the defect sites at 2 weeks and 8 weeks. The results of histomorphometric analysis were as follows: the rhBMP‐4/ACS and the rhBMP‐4/β‐TCP groups had more bone (%) than other groups at both 2 and 8 weeks (P <0.01).

Conclusions: Surgical implantation of rhBMP‐4/ACS may be used to support bone regeneration in the rat calvarial criticalsized defect, and rhBMP‐4/β‐TCP may be able to regenerate bone in the rat calvarial critical‐sized defect without complication. In addition, both ACS and β‐TCP may be considered as available carriers for rhBMP‐4. J Periodontol 2003;74:787‐797.
Detection of Tannerella forsythensis (Bacteroides forsythus) and Porphyromonas gingivalis by Polymerase Chain Reaction in Subjects with Different Periodontal Status
Authors: Klein Marlise I. , Gonçalves Reginaldo B.
Published: February 2005

Background: The aim of this study was to determine the prevalence of Tannerella forsythensis (formerly Bacteroides forsythus) and Porphyromonas gingivalis in subgingival plaque samples by using polymerase chain reaction (PCR), and to assess the relationship of these bacteria with different categories of periodontal disease and health.

Methods: Subjects were distributed into 3 groups according to their periodontal diagnosis: group 1, periodontally healthy (N = 10); group 2, periodontitis with probing depth ≤5 mm (N = 10); group 3, periodontitis with probing depth ≥5 mm (N = 10). The subjects in groups 2 and 3 had healthy and diseased periodontal sites. Subgingival plaque samples were obtained using paper points inserted into periodontal pockets (diseased sites) and into healthy gingival sulci (healthy sites) of the same subject.

Results: The distribution of bacteria differed in healthy and diseased sites. T. forsythensis (B. forsythus) was not detected in any sample from healthy sites in any group but was detected in 70% and 100% of diseased sites in groups 2 and 3, respectively. P. gingivalis was detected in only one sample from a healthy site (group 2), and in the diseased sites, its prevalence was 40% (group 2) and 90% (group 3). In addition, T. forsythensis (B. forsythus) and P. gingivalis were both detected in 30% and 90% of the diseased sites in groups 2 and 3, respectively.

Conclusion: These results indicate a possible association between periodontal disease and the presence of T. forsythensis (B. forsythus) and/or P. gingivalis. J Periodontol 2003;74:798‐802.
Crown Lengthening in Mandibular Molars:A 5‐Year Retrospective Radiographic Analysis
Authors: Dibart Serge , Capri Diego , Kachouh Ibrahim , Van Dyke Thomas , Nunn Martha E.
Published: February 2005

Background: Crown lengthening procedures are a significant part of the periodontist's armamentarium. In order to recreate the clinical space lost to caries or trauma necessary for prosthetic restoration, osseous surgery is often required. If the procedure is not carefully planned, it may result in furcation involvement of multirooted teeth.

Methods: Twenty‐six subjects with 26 mandibular molar teeth requiring crown lengthening procedures prior to prosthetic crown placement were evaluated. Nineteen subjects with 24 prosthetic crowns on lower molars which had not undergone crown lengthening were included as control teeth. Bite‐wing radiographs prior to surgery (for the test group) or placement of the crown (control group) and 5 years after completion of the prosthesis were compared and analyzed.

Results: Of the 26 test teeth, 10 teeth (38.5%) were found to have radiographic evidence of furcation involvement, whereas none of the control teeth developed furcation invasions.

Conclusion: A critical distance from the furcation (CDF) of 4 mm was established as a landmark under which, if surgery was performed on mandibular molars, chances of furcation involvement in the future were very high. J Periodontol 2003;74: 815‐821.
Mandibular Bone Remodeling Under a Choline‐Deficient Diet: A Histomorphometric Study in Rats
Authors: Gorustovich Alejandro A. , Espósito María A. , Guglielmotti María B. , Giglio Máximo J.
Published: February 2005

Background: A deficiency of lipotropic factors in the rat induces renal, hepatic, and/or hematic damage. The aim of the present study was to evaluate the effect of a choline‐deficient diet and refeeding on mandibular bone remodeling.

Methods: Fifty Wistar rats were divided into 5 groups: group 1 (G1): control diet for 15 days; group 2 (G2): choline‐deficient diet for 15 days; group 3 (G3): control diet for 30 days; group 4 (G4): choline‐deficient diet for 30 days; and group 5 (G5): choline‐deficient diet for 15 days and control diet for 15 days. All animals were sacrificed by ether overdose. The mandibles were resected, radiographed, decalcified, processed, and embedded in paraffin. Bucco‐lingually oriented sections were obtained at the level of the interradicular bone of the medial roots of the left first molar, and stained with hematoxylin and eosin (H & E). Bone tissue density and bone remodeling were determined histomorphometrically. Body weight, food intake, hematocrit, and hemoglobinemia were also recorded.

Results: Microscopic observation revealed that osteogenesis was lower in rats fed a choline‐deficient diet, at both 15 and 30 days, and that this decrease did not revert with a control diet. Histomorphometric evaluation showed 37% and 27% reduction in bone tissue density at 15 and 30 days, respectively, and a 30% decrease in bone formation at 30 days, compared to controls.

Conclusion: In this experimental model, a choline‐deficient diet led to altered bone remodeling as observed by a marked reduction in osteogenesis. J Periodontol 2003;74:831‐837.
Adhesion of Porphyromonas gingivalis. Serotypes to Pocket Epithelium
Authors: Dierickx Kurt , Pauwels Martine , Laine Marja L. , Van Eldere Johan , Cassiman Jean‐Jacques , Van Winkelhoff Arie J. , Van Steenberghe Daniel , Quirynen Marc
Published: February 2005

Background:Porphyromonas gingivalis., a key pathogen in periodontitis, is able to adhere to and invade the pocket epithelium. Different capsular antigens of P. gingivalis have been identi fied (K‐serotyping). These P. gingivalis capsular types show differences in adhesion capacity to human cell lines or to cells cultured on a feeder layer or stromal equivalent.

Methods: The adhesion capacity of different P. gingivalis serotypes (6 capsular types and non‐encapsulated strains) was compared on in vitro cultured epithelial monolayers from periodontal pockets of patients with periodontitis. The degree of adherence of P. gingivalis was evaluated by both culture and fluorescence microscopy.

Results: Non‐encapsulated strains adhered significantly more than their capsulated variants. Capsule type 4 (K‐4) adhered slightly better than the remaining K‐types.

Conclusion: This study indicates that the presence and type of capsule have a significant influence on the initial adhesion of P. gingivalis to human periodontal pocket epithelial cells. J Periodontol 2003;74:844‐848.
Enhanced Bone Augmentation by Controlled Release of Recombinant Human Bone Morphogenetic Protein‐2 from Bioabsorbable Membranes
Authors: Lee Yong‐Moo , Nam Sung‐Heon , Seol Yang‐Jo , Kim Tae‐Il , Lee Seung‐Jin , Ku Young , Rhyu In‐Chul , Chung Chong‐Pyoung , Han Soo‐Boo , Choi Sang‐Mook
Published: February 2005

Background: The present study was undertaken to determine the effect of recombinant human bone morphogenetic protein‐ (rhBMP‐2)‐loaded biodegradable membranes on bone augmentation in a rabbit calvarial model.

Methods: Five µg of rhBMP‐2 was loaded into a stiff hemispherical dome membrane made of poly(L‐lactide) and tricalcium phosphate (PLLA/TCP). The release kinetics of rhBMP‐2 from the membrane were determined in vitro using a human BMP‐2 immunoassay. Twelve rhBMP‐2‐loaded dome membranes (test group) and 12 control dome membranes (control group) were placed on the partial‐thickness calvarial defects of 24 rabbits. The animals were sacrificed at 4 and 8 weeks, and undecalcified ground sections were prepared. Newly formed bone area and height were measured histomorphometrically and calculated by percentage ratio to the total submembranous space area and height below the dome.

Results: In vitro release results demonstrated that rhBMP‐2 was released consistently over a 4‐week period following a high initial burst release on the first day. At both 4 and 8 weeks, histomorphometric analysis revealed that the test group showed signi ficantly higher newly formed bone heights and areas than the control group (P <0.01). In the control group, new bone height was 36.3% of the dome height and the new bone area reached 8.2% of the submembranous space area at 8 weeks, while the test group reached 87.3% and 35.4%, respectively.

Conclusion: These results suggest that the use of rhBMP‐ 2‐loaded PLLA/TCP membranes can result in additional bone augmentation, which is due to the osteoinductive properties of rhBMP‐2 released from the membrane during healing. J Periodontol 2003;74:865‐872.
Hereditary Gingival Fibromatosis and Expression of Ki‐67 Antigen: A Case Report
Authors: Saygun Işil , Özdemir Atilla , Günhan Ömer , Aydintug͠ Yavuz Sinan , Karsliog͠lu Yildirim
Published: February 2005

Background: Hereditary gingival fibromatosis (HGF) is a fibrotic enlargement of the gingiva. The mechanism that leads to the accumulation of abnormal amounts of gingival tissue in HGF is still unknown. The aim of this report was to present the clinical and histopathologic characteristics of a patient with gingival fibromatosis and to evaluate the proliferation of HGF fibroblasts.

Methods: We examined the proliferation rate of fibroblasts in this case by using Ki‐67 immunohistochemical staining and compared the rate to fibroblasts of non‐fibromatosis gingival tissues from 5 healthy patients serving as controls.

Results: There were no Ki‐67‐positive cells in the lesional tissue, and the control gingiva revealed no immunostaining. The number of Ki‐67 antigen‐positive epithelial cell nuclei was observed to be low in the basal cell layers of hyperplastic gingival epithelia, similar to the control group.

Conclusions: In the present case, there was no increase in the proliferation rate of lesional fibroblasts observed by Ki‐67 immunohistochemical staining as a proliferation marker; only the epithelium was stained. It seems likely that the underlying mechanism of HGF may be an increase in the biosynthesis of collagen and glycosaminoglycans rather than cell proliferation. J Periodontol 2003;74:873‐878.
Two Cases of Linear IgA Disease with Clinical Manifestations Limited to the Gingiva
Authors: Valle A. Eguia Del , Martínez‐Sahuquillo A. , Padrón J.R. Armas , Urizar J.M. Aguirre
Published: February 2005

Linear IgA disease (LAD) is a chronic, subepithelial blistering disease that is associated with the presence of linear deposits of IgA along the basement membrane zone. Etiopathogenic aspects of LAD are only partially known. LAD is clinically characterized by vesiculobullous skin and mucous lesions. Although more than half of LAD patients present oral mucosal lesions, there are only a few cases reported of oral lesions as the only manifestation of LAD. This study presents 2 of these uncommon cases. J Periodontol 2003;74:879‐882.
Ameloblastoma of the Mandible: A Case Report
Authors: Levin Marvin P. , Kratochvil F. James , Nolan Joseph
Published: February 2005

This report describes the case of a 60‐year‐old male who presented with a radiolucent lesion between his mandibular right premolars. The original radiographic diagnosis was a lateral periodontal cyst, but surgery produced biopsy material that proved to be an ameloblastoma. A discussion on developing a differential diagnosis is presented. J Periodontol 2003;74: 883‐886.
Use of Orthodontic Treatment as an Aid to Third Molar Extraction: A Method for Prevention of Mandibular Nerve Injury and Improved Periodontal Status
Authors: Hirsch A. , Shteiman S. , Boyan B.D. , Schwartz Z.
Published: February 2005

Background: Impaction of mandibular third molars predisposes to pathological conditions including periodontal disease. Extraction of these teeth also may lead to damage to the nerve and to periodontal involvement of the second molars. This report describes a series of cases in which the third molars were orthodontically induced to erupt to prevent the sequelae associated with extraction.

Methods: Impacted mandibular third molars in 18 patients were surgically exposed following placement of an orthodontic appliance. Depending on the individual case, 1 of 3 approaches was used: attachment of a bracket, placement of a post in the root canal, or placement of an orthodontic wire through a bucco‐lingual canal. After suturing the mucoperiosteal flap, the orthodontic appliance was activated. After the tooth erupted, it was removed and periodontal parameters were measured on the second molar.

Results: No damage to the inferior alveolar nerve was found. Probing depths on the second molar were reduced from 7.9 ± 1.6 mm on the buccal and 7.4 ± 1.0 mm on the lingual to 1.8 ± 0.7 mm and 1.9 ± 0.7 mm, respectively. There was an average gain of 5.0 mm in attachment. Keratinized tissue increased from 2.9 ± 0.7 to 3.8 ± 0.6 mm.

Conclusions: The interdisiplinary use of periodontics and orthodontics results in non‐surgical removal of impacted mandibular third molars without damage to the inferior alveolar nerve and iatrogenic periodontal sequelae to the second molars. J Periodontol 2003;74:887‐892.
The Subepithelial Connective Tissue Graft with a Vestibular Releasing Incision
Authors: Butler Bobby L.
Published: February 2005

Initially, the rationale for mucogingival surgery was for function and health. In the past few years, esthetic results from augmentation procedures have become a goal. The subepithelial connective graft is technique to achieve root coverage. Anatomically is a procedure that cannot be utilized in every case. A difficult situation is the shallow vestibule with no keratinized gingiva and a strong frenulum attachment. The subepithelial connective tissue graft with vestibular release as described here can achieve esthetic root coverage despite a shallow vestibule. J Periodontol 2003;74:893‐898.
Radiologic and Histomorphometric Evaluation of Maxillary Sinus Grafting with Alloplastic Graft Materials
Authors: Ozyuvaci H. , Bilgiç B. , Firatli E.
Published: February 2005

Background: Sinus lifting procedures are widely used to obtain adequate bony support for implant placement at the atrophic maxillae. The aim of this study was to compare various sinus lifting and grafting techniques and materials.

Methods: Nine maxillae were treated with delayed and 46 maxillae with immediate implant placement techniques. A total of 104 implants were inserted. Panoramic radiographs were obtained prior to, after, and 6 to 8 months after surgery. Computed tomographies were also taken before and after surgery. The height of new bone was compared. Biopsy specimens were obtained during delayed implant placement and analyzed histomorphologically.

Results: There were no statistically significant differences between the panoramic radiographs for delayed and immediately placed implants, or between the graft materials. We observed correlations between the panoramic radiographs and computerized tomographies.

Conclusion: Both delayed and immediate placement of implants can be used safely for sinus lifting. There were no statistically significant differences between the various graft materials. J Periodontol 2003;74:909‐915.
Meta‐Analysis of Local Tetracycline in Treating Chronic Periodontitis
Authors: Pavia Maria , Nobile Carmelo G.A. , Angelillo Italo F.
Published: February 2005

Background: Meta‐analysis was used to assess the clinical efficacy of local delivery of tetracycline alone or as an adjunct to conventional mechanical therapy in patients with chronic periodontitis.

Methods: Studies were identified in MEDLINE and others sources. Meta‐analyses were performed on the basis of probing depth (PD) at baseline, type of antimicrobial used, and experimental and control regimens (i.e., tetracycline plus scaling and root planing [SRP] versus SRP, tetracycline versus SRP, and tetracycline versus placebo, or no treatment). The effect of local tetracycline was evaluated for follow‐up times of 4, 8, 12, 16, 24, and 36 weeks. Sensitivity analysis was performed according to antimicrobial delivery mode (irrigation, fibers, strips). A random effects model was used.

Results: The literature search identified 29 studies that met our inclusion criteria and were entered into the meta‐analysis. A significant mean reduction in PD for the combined tetracycline and SRP was observed regardless of initial probing depth and independently to the duration of follow‐up. Tetracycline alone did not perform better than SRP, whereas they performed significantly better than placebo. Differences in improvement of attachment level (AL) were substantially similar to those encountered for PD.

Conclusions: Our results documented that local delivery of tetracycline improves the clinical outcomes of traditional treatment and should be considered particularly as an adjunct to SRP. Considerations regarding the adverse effects of widespread use of tetracycline should be taken into account when choosing a therapeutic strategy of chronic periodontitis. J Periodontol 2003;74:916‐932.
In Vitro Assessment of the Plaque‐Removing Ability of Hydrodynamic Shear Forces Produced Beyond the Bristles by 2 Electric Toothbrushes
Authors: Hope Christopher K. , Petrie Aviva , Wilson Michael
Published: February 2005

Background: The aim of this study was to compare the effi‐cacy of interproximal plaque removal by the hydrodynamic shear forces produced by 2 electric toothbrushes (toothbrush A, Sonicare Plus and toothbrush B, Braun Oral B) using laboratory‐grown plaque biofilms in an anatomically correct in vitro brushing model.

Methods: In vitro oral biofilms were grown in a constantdepth film fermenter on hydroxyapatite (HA) discs. Brushing experiments were conducted in a specially constructed machine designed to simulate the brushing of interproximal plaque between mandibular molar teeth; the bristles of the toothbrush did not make contact with the biofilm at any time. The load force between the brushes and teeth were in accordance with typical use and an exposure time of 5 seconds was used throughout. The efficacy of brushing was assessed by enumeration of the percentage of viable bacteria removed from the HA discs. These experiments were conducted with the electronic effect of the toothbrushes either activated or inactivated.

Results: Activation of toothbrush A significantly (P = 0.004) increased the median percentage of bacteria removed from 0.47% to 48.45%. Likewise, activation of toothbrush B significantly (P = 0.015) increased the median percentage of bacteria removed from 2.85% to 15.86%. The median percentage of plaque bacteria removed by the active toothbrush A was significantly (P = 0.009) greater than that removed by toothbrush B in this model system.

Conclusion: These data imply that toothbrush A would be more effective than toothbrush B at removing interproximal dental plaque in vivo. J Periodontol 2003;74:1017‐1022.
Combined Local Application of Tetracycline and Bisphosphonate Reduces Alveolar Bone Resorption in Rats
Authors: Yaffe A. , Herman A. , Bahar H. , Binderman I.
Published: February 2005

Background: Recent animal studies have shown that a combination of chemically‐modiﬁed tetracyclines together with bisphosphonates, when delivered systemically, are synergistically effective in suppressing periodontal bone loss. In the present study, we explored the combined efﬁcacy of local delivery of alendronate and tetracyclines in reducing alveolar bone loss.

Methods: Eighty‐six (86) male Wistar rats were used in these experiments. The ﬂap was elevated using a special periosteal elevator, on both sides of the mandible, as described previously. A gelfoam pellet containing the drugs was applied between the alveolar bone and the mucoperiosteal flap, according to the experimental protocol. The rats were divided into 5 treatment groups: 1) alendronate; 2) doxycycline hyclate 10% (DOXY); 3) tetracycline hydrochloride 1% (TET); 4) alendronate + DOXY; and 5) alendronate + TET. In the operated control sites (C), saline was applied. The rats were sacriﬁced 21 days following the ﬂap procedure. Sections of the mandibles (1.5 mm), in a buccal‐ lingual direction, underwent microradiography and were analyzed for bone loss.

Results: DOXY alone was most effective in reducing bone loss. Alendronate was also effective in reducing bone loss as shown in previous reports. TET did not reduce bone loss signiﬁcantly when used alone. In combination with alendronate TET was synergistically effective. The combined local treatment of alendronate + DOXY showed no additive effect.

Conclusions: In the present study, we found that tetracyclines can be most effective in reducing alveolar bone loss when applied locally. The combined local treatment of alendronate and tetracycline may have a synergistic effect. J Periodontol 2003;74:1038‐1042.
A Preliminary Study on Oxygen Saturation Levels of Patients During Periodontal Surgery with and without Oral Conscious Sedation Using Diazepam
Authors: Aeschliman Steven D. , Blue Mark S. , Williams Karen B. , Cobb Charles M. , MacNeill Simon R.
Published: February 2005

Background: Stress and anxiety alter respiratory rate and thereby alter oxygen saturation in the blood. Management of psychological stress in the dental office may help maintain blood gas homeostasis. One method of stress management is through the use of preoperative oral sedation.

Methods: The study population consisted of 13 patients scheduled to receive two quadrants of periodontal surgery at two different appointments. A randomized split‐mouth crossover design was used with one quadrant of surgery involving preoperative oral sedation (diazepam) and local anesthetic, and the second using local anesthetic only. Oxygen saturation was monitored by pulse oximetry, which recorded the number of times saturation dropped below 95% in a given time period. Data were recorded at 5 time periods: 1) baseline; 2) from time of anesthetic administration to 20 minutes into surgery; 3) 21 to 40 minutes; 4) 41 to 60 minutes; and 5) 61 to 80 minutes into the surgery. Data were analyzed by a two‐factor repeated measures ANOVA. The two within‐group factors were treatment group and time.

Results: Results indicated no significant interaction between time and treatment (P>05). However, data for groups over time suggested a trend supporting an interaction. The η2 value of 0.124 suggested a moderate effect favoring the diazepam treatment. No significant difference was noted for the main effect of treatment and time. However, the η2 value of 0.24 for treatment effect (diazepam versus no diazepam) suggested a meaningful difference between groups. Similarly the η2 value of 0.135 for time suggested a moderate effect over time within‐subjects.

Conclusions: This study indicates that diazepam given orally in adult dosages does not cause significant respiratory depression, and is generally safe for those healthy patients who may require slight to mild sedation during periodontal surgery. J Periodontol 2003;74:1056‐1059.
Localized Aggressive Periodontitis in Primary Dentition: A Case Report
Authors: Suzuki Junji , Okada Mitsugi , Wang Yurong , Nii Noriko , Miura Kazuo , Kozai Katsuyuki
Published: February 2005

Background:A 5‐year‐old Japanese boy presented with persistent gingival inflammation and severe mobility of the right lower primary incisors. Due to severe alveolar bone loss and a deep periodontal pocket (5 mm), the incisors were extracted at the second visit.

Methods:Clinical, radiographic, histological, and microbiological examinations were carried out. Then, the polymerase chain reaction (PCR) technique was employed to detect specific periodontal pathogens. The chemotactic activity of polymorphonuclear neutrophils was also measured.

Results: Tannerella, Capnocytophaga, Fusobacterium, and Eikenella sp. were recovered from the subgingival microﬂora around the right lower incisors, while A. actinomycetemcomitans, Tannerella forsythensis (formerly Bacteroides forsythus), Prevotella nigrescens, Campylobacter rectus, and Capnocytophaga gingivalis were detected using the PCR method. Further chemotaxis assay revealed that neutrophil function was depressed compared with that of healthy controls.

Conclusions: Although inflammation remained around the right primary second molars, the bone loss was controlled by periodic professional mechanical teeth cleaning (PMTC), subgingival irrigation, and local antibiotic application. The probing depths of all teeth, including permanent incisors and molars, were within 2.5 mm. J Periodontol 2003;74:1060‐1066.
Guided Tissue Regeneration in Human Class II Furcation Defects Using a Diphenylphosphorylazide‐Cross‐Linked Collagen Membrane: A Consecutive Case Series
Authors: Zahedi Charles S. , Miremadi S. Asghar , Brunel Gérard , Rompen Eric , Bernard Jean‐Pierre , Benque Edmond
Published: February 2005

Background: Several bioabsorbable collagen membranes are either currently available or under investigation for use in guided tissue regeneration (GTR) procedures. The aim of this 12‐month reentry study was to evaluate a diphenylphosphorylazide (DPPA)‐cross‐linked bovine type I collagen membrane in the healing of mandibular Class II furcation defects. The DPPA technique prevents the inclusion of foreign cytotoxic cross‐linking substances in the reticulated molecules, thus providing a more biocompatible product.

Methods: Forty non‐smoking periodontally compromised adult subjects volunteered for this study, and one defect was randomly selected in each patient. At baseline, plaque index (PI), gingival index GI), probing depth (PD), gingival margin location GML), clinical attachment level (CAL), and width of the attached gingiva (AG) were measured. Intrasurgical hard tissue measurements consisted of the vertical open probing attachment level (V‐OPAL) and horizontal open probing attachment level (H‐OPAL), as well as furcation entrance width (FW) and height (FH) and subclassification of defects according to vertical bone loss. All soft tissue measurements were repeated 12 months after membrane placement using conservative flap reentry surgeries; hard tissue parameters were also assessed at this time.

Results: DPPA‐cross‐linked collagen membranes demonstrated good handling characteristics, and no postoperative adverse tissue reactions or clinically detectable localized allergic responses were observed. GI and PI remained low during the entire study period. When the one year reentry values were compared to the baseline measurements, a significant reduction in PD (1.9 ± 1.4), FW (2.1 ± 1.7), FH (2.9 ± 1.6), and gain in CAL (1.7 ± 1.5), V‐OPAL (2.1 ± 1.9), and H‐OPAL (4.7 ± 1.4) were observed (P ≤0.05). However, there were no significant differences in GML or AG. Hard tissue improvements resulted in the complete closure of 30% (12) of the defects, and transformation of 67.5% (27) of the defects to Class I, while one defect remained a Class II (2.5%).

Conclusions: Based on this 12‐month clinical reentry study, a DPPA‐cross‐linked collagen membrane could be beneficial in GTR treatment of Class II mandibular furcation involvements, both in terms of soft and hard tissue improvements. J Periodontol 2003;74:1071‐1079.
Changes in Alveolar Bone Height and Width Following Post‐Extraction Ridge Augmentation Using a Fixed Bioabsorbable Membrane and Demineralized Freeze‐Dried Bone Osteoinductive Graft
Authors: Zubillaga Gabriel , Von Hagen Stanley , Simon Barry I. , Deasy Michael J.
Published: February 2005

Background: It has been shown that the amount of healed bone following guided bone regeneration (GBR) with demineralized freeze‐dried bone allograft (DFDBA) and a bioabsorbable membrane is significantly less than the initial quantity. A study was designed to determine if the amount of GBR would be affected by using an osteoinductive DFDBA and bioabsorbable membrane and membrane stabilization.

Methods: Eleven extraction sites (10 patients) were treated with DFDBA and bioabsorbable membrane before placing endosseous implants. Standardized alveolar height and width measurements were taken after extraction, GBR, and 4 months postoperatively, at predetermined measurement points (sites midpoint and 3 mm mesial and distal from the midpoint) and classified as augmented (<1 mm increase of GBR height or width) or grafted (>1 mm increase). Five membranes were stabilized.

Results: Three mm from the crest, augmented points exhibited a complete loss of augmented width. There was also some loss of pre‐GBR bone width (ranging from 4.7% to 20%) at augmented and grafted points. Five mm from the crest, augmented points lost 83.3% to 92.3% of augmented width and grafted points lost 12.9% to 18% of pre‐GBR width. Loss of augmented height ranged from 93.5% to 100%. Augmented (except distal) and grafted measurement points lost 2.1% to 12% of pre‐GBR height. Comparing tacked and non‐tacked sites, the former manifested less loss of augmented bone width, the latter augmented bone height.

Conclusions: Results indicate a complete loss of augmented width 3 mm from the crest and almost complete loss in height and width 5 mm from the crest. Membrane stabilization appeared beneficial. J Periodontol 2003;74:965‐975.
Influence of Cyclosporin A Therapy on Bone Healing Around Titanium Implants: A Histometric and Biomechanic Study in Rabbits
Authors: Sakakura Celso E. , Margonar Rogério , Holzhausen Marinella , Nociti Francisco H. , Alba Rodolfo Candia , Marcantonio Elcio
Published: February 2005

Background: Immunosuppressive agents may induce severe changes on bone metabolism. The purpose of the present study was to evaluate the influence of the administration of cyclosporin A (CsA) on the bone tissue around titanium implants.

Methods: Eighteen New Zealand rabbits were randomly divided into 2 groups of 9 each. The test group (CsA) received daily subcutaneous injection of CsA (10 mg/kg body weight) and the control group (CTL) received saline solution by the same administration route. Three days after therapy began, 2 implants (7.0 mm long and 3.75 mm in diameter) were inserted bilaterally at the region of the tibial methaphysis. After 4, 8, and 12 weeks the animals were sacrificed and biomechanical tests and histometrical procedures, consisting of the determination of the percentages of bone‐implant contact and bone area within the limits of the implant threads, were performed.

Results: Intergroup analysis showed that the removal torque and the percentage of bone contact with the implant surface for CsA group were significantly lower than those of the CTL group at 12 weeks (28.5 and 39.2 N cm, P = 0.01; 7.76% and 18.52%, P = 0.02, respectively).

Conclusion: The data from the present study suggest that long‐term administration of cyclosporin A may negatively influence bone healing around dental implants. J Periodontol 2003;74:976‐981.
Human Periodontal Ligament Cell Responses to Recombinant Human Bone Morphogenetic Protein‐2 with and without Bone Allografts
Authors: Markopoulou C.E. , Vrotsos I.A. , Vavouraki H.N. , Dereka X.E. , Mantzavinos Z.S.
Published: February 2005

Background: Recombinant human bone morphogenetic protein‐2 (rhBMP‐2) has been found to promote the osteoblastic differentiation of human periodontal ligament cells. Its effect depends on the delivery system used. In this study we examined the effect of rhBMP‐2 on the proliferation and osteoblastic differentiation of human periodontal ligament cells cultured alone or with 3 different bone allografts.

Methods: The rhBMP‐2 effect on cell proliferation and osteoblastic differentiation was examined by measuring [3H] thymidine incorporation and ALPase activity, respectively, on human periodontal ligament (hPDL) cells. Two human demineralized freeze‐dried allografts of cortical (DFDBAco) and cancellous (DFBDAca) bone origin and 1 non‐demineralized freeze‐dried allograft (FDBA) of cancellous bone origin, derived from different tissue banks, were used to evaluate the rhBMP‐ 2 effect on cell osteoblastic differentiation. The measurements were taken on various days.

Results: rhBMP‐2 decreased hPDL cell proliferation. rhBMP‐ 2 acted on the third day of the process of cell differentiation, had a specific time of action, achieved its peak effect on the fourth and fifth days, and then did not provoke any further effects. The 3 bone allografts were efficiently combined with rhBMP‐2. The combination of rhBMP‐2 and DFDBAco showed the effect with the longest duration. rhBMP‐2, on day 4, made the inactive bone allograft more active while, on the other days, its effect was dependent on the allograft alone.

Conclusions: rhBMP‐2 promotes the osteoblastic differentiation of human periodontal ligament cells and decreases cell proliferation. In this study rhBMP‐2 in the presence of the bone allografts tested resulted in hPDL cell differentiation. J Periodontol 2003;74:982‐989.
Comparison of Porous and Non‐Porous Teflon Membranes Plus a Xenograft in the Treatment of Vertical Osseous Defects: A Clinical Reentry Study
Authors: Walters Stephen P. , Greenwell Henry , Hill Margaret , Drisko Connie , Pickman Kim , Scheetz James P.
Published: February 2005

Background: The primary aim of this 9‐month randomized, controlled, blinded, clinical reentry study was to compare the regenerative effects of a nonporous polytetrafluoroethylene (NP) periodontal membrane to a porous expanded polytetrafluoroethylene (P) periodontal membrane in the treatment of vertical osseous defects.

Methods: Twenty‐four patients, 11 males and 13 females, age 24 to 74 (mean 50.5 ± 13.1) provided one site with an intraosseous defect ≥4 mm and were divided equally and randomly into two groups. Following debridement both groups were grafted with a bovine‐derived xenograft coated with a synthetic cell‐binding peptide; then the test group received an NP membrane and the control group received a P membrane. All defects were reentered after 9 months. Measurements were performed by a masked examiner.

Results: There were no statistically significant differences (P >0.05) between NP and P groups for any open or closed probing measurement at any time. Similar open initial defect depth for the NP group and P groups (4.8 versus 5.0 mm) demonstrated identical 9‐month defect fill of 2.8 mm (57%) for both groups. A difference in crestal resorption for the NP compared to the P group (0.4 versus 0.8 mm) accounted for the difference in mean percent defect resolution, which was 67% for NP compared to 72% for the P group. Overall, nine (75%) of the NP group defects and eight (67%) of the P group defects showed more than 50% defect fill.

Conclusion: Treatment of vertical osseous defects with nonporous or porous polytetrafluoroethylene membranes in combination with a xenograft resulted in statistically signidficant improvement in open and closed probing measurements, with no significant difference between treatment groups. J Periodontol 2003;74:1161‐1168.
Role of Insulin‐Like Growth Factor‐1 Signaling in Dental Fibroblast Apoptosis
Authors: Han Xiaozhe , Amar Salomon
Published: February 2005

Background: Studies have shown that periodontal ligament fibroblasts (PDLF) and gingival fibroblasts (GF) respond differently to growth factors in the repair and regeneration of periodontal tissues. The goal of this study was to determine the effects of insulin‐like growth factor‐1 (IGF‐1) signaling on cell apoptosis in PDLF compared to GF.

Methods: The levels of apoptosis were compared between cultured PDLF and GF by DNA fragmentation assay and trypan blue exclusion assay, either in the presence or absence of IGF‐1. The transcript level of upstream signaling molecules, such as IGF binding protein‐5 (IGFBP‐5), IGF‐1 receptor (IGF‐1R), and phosphoinositide 3‐kinase (PI3K), was studied using reverse transcription‐ polymerase chain reaction (RT‐PCR). Furthermore, the role of IGFBP‐5 in IGF‐1 signaling was verified by annexin‐V staining using ﬂow cytometric analysis.

Results: IGF‐1 significantly inhibited the level of DNA fragmentation and decreased trypan blue‐positive cells in PDLF compared to GF during serum deprivation. The mRNA expression of IGFBP‐5, IGF‐1R, and PI3K was constitutively upregulated in PDLF compared to GF. In the presence of exogenous IGFBP‐5, the annexin‐V–positive cells were significantly decreased in GF after IGF‐1 stimulation.

Conclusions: The present study provides evidence that IGF‐1 reduces apoptosis in cultured PDLF compared to GF. Upregulation of IGF‐1R and PI3K in PDLF further suggests the activation of IGF signaling in PDLF. In addition, the anti‐apoptotic effect of IGF‐1 may be facilitated by the upregulation of IGFBP‐5 in PDLF. J Periodontol 2003;74:1176‐1182.
Association Between Interleukin‐1 Genotype and Periodontal Disease in a Diabetic Population
Authors: Guzman Sergio , Karima Mamdouh , Wang Hwa‐Ying , Van Dyke Thomas E.
Published: February 2005

Background: Recently, it has become evident that for many common chronic diseases, modifying factors amplify disease mechanisms to make the clinical condition more severe. The aims of this report were 1) to investigate the prevalence of periodontitis in a diabetic population, 2) to evaluate the association of periodontitis with metabolic control, and 3) to evaluate periodontitis in diabetics with different interleukin (IL)‐1 genotypes.

Methods: One hundred diabetic patients were screened. Type and duration of diabetes, level of control (glycosylated hemoglobin), and demographic data were recorded. Periodontal disease was defined as two or more teeth with clinical attachment loss (CAL) ≥5 mm. Poorly controlled diabetes was defined as glycosylated hemoglobin values >8%. Finger‐stick blood samples were collected and analyzed for genotyping of IL‐1A (+4845), IL‐1B (+3954), IL‐1B (–511), and IL‐1RN (+2018) polymorphisms.

Results: Among the diabetic patients in the study, 66% showed periodontal destruction, and 43% of those could be characterized as severe. The prevalence of severe attachment loss increased with decreasing control of diabetes. Only the IL‐1B (–511) genotype was found to be associated with periodontal disease in the African American patients (P <0.05). The frequency of allele 1 was 0.77 in periodontitis affected versus 0.33 in healthy African American diabetics. A borderline significant association between IL‐1B (+3954) and periodontal disease also was noted in Caribbean periodontal patients (P = 0.06); however, the allele 2 frequency in this population was only 10%.

Conclusions: These data confirm the high prevalence and severity of periodontitis in the diabetic population, and support the association between poor glycemic control and periodontal disease. The low prevalence of some of the IL‐1 gene polymorphisms in the ethnic groups included in this study limits the validity of conclusions on genotype associations with clinical findings, but there was a trend suggesting that allele 1 at IL‐1B (–511) and IL‐1B (+3954) was overrepresented among diabetics with periodontal disease. J Periodontol 2003;74:1183‐1190.
Effects of Enamel Matrix Derivative on Porphyromonas gingivalis
Authors: Newman Seth A. , Coscia Salvatore A. , Jotwani Ravi , Iacono Vincent J. , Cutler Christopher W.
Published: February 2005

Background: Enamel matrix derivative (EMD) is used during periodontal surgery for the regeneration of periodontal tissue. It consists of the amelogenin fraction of porcine enamel matrix (AMEL) suspended in a vehicle of propylene glycol alginate (PGA). EMD‐treated sites appear to heal with less inﬂammation. It has been suggested that antimicrobial properties of EMD might account for improved healing in vivo. The objectives of this study were: 1) to determine the antibacterial effects of EMD on the periodontal pathogen Porphyromonas gingivalis and 2) to establish the component(s) of EMD that are responsible for this effect.

Methods: The antimicrobial effects were determined in vitro using the broth dilution assay. P. gingivalis at a starting inoculum of 109 colony forming units/ml was treated with EMD, AMEL, and PGA in Hank's balanced salt solution (HBSS) for 1, 3, and 24 hours. The CFU/ml of P. gingivalis recovered on enriched Brucella blood agar was determined at 6 and 10 days.

Results: EMD (containing AMEL and PGA) or PGA alone eliminated recoverable CFUs of P. gingivalis. Interestingly, AMEL in HBSS increased recoverable CFUs from 8.62 log CFU/ml to 8.93 log CFU/ml. Further analysis of the dose response at concentrations of 0.3, 3, and 30 mg/ml of AMEL in HBSS revealed that only 30 mg/ml (clinical concentration) increased CFUs of P. gingivalis relative to baseline (from 8.8 log CFU/ml to 9.2 log CFU/ml in 3 hours). Additionally, AMEL was compared to a protein control bovine serum albumin (BSA) to determine whether this effect was unique to AMEL. A marked increase in recoverable CFUs occurred with the AMEL (increasing from 8.8 log CFU/ml to 9.47 log CFU/ml), but not with BSA.

Conclusions: EMD possesses antimicrobial properties that can be attributed to the propylene glycol alginate vehicle. The amelogenin fraction of porcine enamel matrix in enamel matrix derivative (i.e., AMEL) is not antibacterial for P. gingivalis and was shown to increase recoverable CFUs.J Periodontol 2003; 74:1191‐1195.
Comparative Clinical Study of Connective Tissue Graft and Two Types of Bioabsorbable Barriers in the Treatment of Localized Gingival Recessions
Authors: Çetiner Deniz , Parlar Ateş , Baloş Köksal , Alpar Reha
Published: February 2005

Background: Localized buccal recessions occur in more than 60% of individuals; therefore, there is a need for predictable root coverage techniques. The objective of the present study was to evaluate the clinical effectiveness of the guided tissue regeneration (GTR) procedure versus connective tissue graft (CTG) in the treatment of localized gingival recessions over a 12‐month postoperative period.

Methods: Thirty bilateral matched pairs of localized buccal recessions in 22 patients were treated with CTG and GTR in this study. For the GTR procedure, two types of bioabsorbable barriers, polylactide/polyglycolide acid (PLGA) and solvent dehydrated duramater allograft (SDDA) membranes, were used and CTG was obtained from the palatal mucosa. The selected pairs of teeth were randomly assigned to one of three groups (10 pairs per group): group 1, PLGA (10 recessions) or CTG (10 recessions); group 2, SDDA (10 recessions) or CTG (10 recessions); or group 3, PLGA (10 recessions) or SDDA (10 recessions). Statistical analysis evaluated both intra‐ and intergroup measurements. The height of gingival recession (GR), width of keratinized tissue (KT), clinical attachment level (CAL), and probing depth (PD) were assessed at baseline and at 6, 9, and 12 months following surgery.

Results: The amount of root coverage was 74.3%, 69.6%, and 86.3% with PLGA, SDDA, and CTG, respectively. The gain in KT was significant in the CTG group (P <0.05). No significant differences were observed among the three groups with respect to PD and CAL.

Conclusions: Results of this study indicate that all techniques led to an improvement of all clinical parameters except PD from baseline. However, CTG increased KT considerably compared to GTR. The final esthetic results were similar for the two membranes and connective tissue graft. J Periodontol 2003;74: 1196‐1205.
Effect of Hydroxamic Acid‐Based Matrix Metalloproteinase Inhibitors on Human Gingival Cells and Porphyromonas gingivalis
Authors: Yoshioka Masami , Yokoyama Nozomi , Masuda Kaname , Honna Tomoaki , Hinode Daisuke , Nakamura Ryo , Rouabhia Mahmoud , Mayrand Denis , Grenier Daniel
Published: February 2005

Background: Matrix metalloproteinases (MMPs) are considered to play key roles in tissue destruction during periodontitis. In this study, we evaluated the cytotoxicity of hydroxamic acid‐based MMP inhibitors (ONO‐4817, ONO‐MI1‐514, and ONO‐MI1‐570), and their inhibitory effects on MMP‐2 and ‐9 activities and growth of Porphyromonas gingivalis.

Methods: Human gingival fibroblasts (HGF) and human gingival epithelial cells (HGE) were incubated with test inhibitors prior to investigating cell viability, cell proliferation, and mRNA expression for MMP‐2 and ‐9. Gelatin zymography and a colorimetric MMP assay were performed to study the inhibitory effects on MMP‐2 and ‐9 activities derived from HGF and HGE, respectively. The effect of MMP inhibitors on keratinocyte migration and P. gingivalis growth was also tested.

Results: Cell viability was not affected by any of the inhibitors at a final concentration of 50 µM, nor was cell proliferation at 20 µM. All inhibitors clearly inhibited MMP‐2 produced by HGF and MMP‐9 produced by HGE in a dose‐dependent manner. No change was found in mRNA expression of MMPs by gingival cells treated with the inhibitors. ONO‐4817 and ONO‐MI1‐514 inhibited keratinocyte migration. ONO‐4817 showed a slightly inhibitory effect on the growth of P. gingivalis.

Conclusion: Data obtained in this study support the potential use of the three MMP inhibitors for the prevention and treatment of periodontal disease. J Periodontol 2003;74:1219‐1224.
A Case of Zimmermann‐Laband Syndrome with Supernumerary Teeth
Authors: Holzhausen Marinella , Gonçalves Daniela , Corrêa Fernanda de Oliveira Bello , Spolidorio Luís Carlos , Rodrigues Valter Curi , Orrico Silvana Regina Perez
Published: February 2005

Background: Zimmermann‐Laband syndrome is a rare autosomal dominant disorder that is characterized by gingival fibromatosis, ear, nose, bone, and nail defects, and hepatosplenomegaly.

Methods: This case report describes the clinical presentation and periodontal findings in a 13‐year old female patient with previously undiagnosed Zimmermann‐Laband syndrome.

Results: Clinical and radiographic findings and genetic counseling confirmed the diagnosis of Zimmermann‐Laband syndrome. The most striking oral findings were the presence of gingival enlargement involving both the maxillary and mandibular arches, anterior open bite, non‐erupted teeth, and two supernumerary teeth. Periodontal treatment consisted of gingivectomy in four quadrants. Histopathologic evaluation of excised tissue supported the diagnosis of gingival fibromatosis. The patient was referred for appropriate orthodontic treatment and genetic counseling, and has been closely followed for the earliest signs of hepatosplenomegaly.

Conclusions: Dental practitioners should be alert for developmental abnormalities that may occur in patients with gingival fibromatosis as this may indicate the presence of a rare disorder like Zimmermann‐ Laband syndrome. A comprehensive medical history and physical systemic evaluation are essential for correct diagnosis and treatment of these cases. J Periodontol 2003;74:1225‐1230.