bluuebunny/crossref_metadata_2025 huggingface dataset:
Cyclooxygenase‐2‐Dependent Prostaglandin Production by Peripheral Blood Monocytes Stimulated With Lipopolysaccharides Isolated From Periodontopathogenic Bacteria
Authors: Noguchi Kazuyuki , Yanai Masayuki , Shitashige Miki , Nishihara Tatsuji , Ishikawa Isao
Published: February 2005

Background: Prostaglandin E2 (PGE2) plays important roles in the pathogenesis of periodontal disease. Recent studies have revealed the existence of 2 isozymes of cyclooxygenase (COX), called COX‐1 and COX‐2. The purpose of the present study was to investigate the contribution of COX‐1 and COX‐2 to PGE2 production by human peripheral blood monocytes that are stimulated with lipopolysaccharides (LPS) from periodontopathogenic bacteria.

Methods: LPS were isolated from Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans) and Porphyromonas gingivalis (P. gingivalis) by the phenol‐water method. Peripheral blood monocytes were stimulated with LPS for the indicated periods, and the levels of PGE2 or interleukin (IL)‐1β in the culture media were measured by enzyme‐linked immunosorbent assay. Expression of COX‐1 and ‐2 proteins was studied by immunocytochemical staining, and COX‐2 mRNA expression was examined by Northern blot analysis.

Results: Peripheral blood monocytes stimulated with A. actinomycetemcomitans‐ or P. gingivalis‐LPS produced PGE2 in a time‐ and dose‐dependent manner. Indomethacin, a non‐selective COX‐1/COX‐2 inhibitor, and NS‐398, a specific COX‐2 inhibitor, completely inhibited PGE2 production. Immunocytochemical staining of COX‐1 and COX‐2 proteins showed that expression of COX‐2 protein was increased in monocytes that were stimulated with A. actinomycetemcomitans‐ or P. gingivalis‐LPS, compared with that in unstimulated monocytes, whereas expression of COX‐1 protein was not altered. Northern blot analysis showed that monocytes stimulated with A. actinomycetemcomitans‐ or P. gingivalis‐LPS expressed COX‐2 mRNA, while COX‐2 mRNA was not detectable in unstimulated cells. Treatment of A. actinomycetemcomitans‐LPS‐stimulated monocytes with NS‐398 induced a significant increase of IL‐1β production to the same extent as treatment with indomethacin.

Conclusions: These results suggest that COX‐2 is induced in monocytes stimulated with LPS derived from A. actinomycetemcomitans and P. gingivalis and that the COX‐2 is primarily responsible for PGE2 production. COX‐2 may be pivotal in PGE2 production in periodontal lesions and may be involved in inflammatory responses. J Periodontol 2000;71:1575‐1582.
Amine Fluoride/Stannous Fluoride and Chlorhexidine Mouthwashes as Adjuncts to Surgical Periodontal Therapy: A Comparative Study
Authors: Horwitz Jacob , Machtei Eli E. , Peled Micha , Laufer Dov
Published: February 2005

Background: Postsurgical mouthwashes are routinely used in clinical studies and also in daily clinical practice. Chlorhexidine gluconate (CHX) has long been the gold standard for supragingival chemical plaque control regimens. Amine fluoride/stannous fluoride (AmF/SnF2) formulations have also been extensively studied and shown to have an antibacterial effect and be useful as antiplaque agents. The antibacterial effect of AmF/SnF2 and its minimal extrinsic tooth staining make it a possible alternative to CHX as an adjunct to periodontal surgical therapy. The aim of this double‐blind, controlled clinical trial was to evaluate and compare the combined effect of an AmF/SnF2 or a CHX mouthwash and surgical periodontal therapy on periodontal parameters.

Methods: Thirty‐two patients with at least 3 pockets ≥5 mm in the same quadrant were selected for this study, following a hygienic phase of therapy. They were randomized into 2 treatment groups: surgical flap debridement and a postsurgical CHX mouthwash or surgical flap debridement and an AmF/SnF2 postsurgical mouthwash, performed twice daily for 3 weeks. Clinical measurements were taken at baseline and 3 and 12 weeks postsurgery.

Results: Both treatment modalities resulted in significant improvements in probing depth and clinical attachment level. There was no significant difference between groups in any of the recorded parameters. Staining index at week 3 in the CHX group was significantly higher than in the AmF/SnF2 group (P <0.05). However these differences leveled down at 12 weeks.

Conclusions: Our results support the alternative use of an AmF/SnF2 mouthwash in plaque control management of patients following flap debridement surgery. J Periodontol 2000;71:1601‐1606.
Osteotome Sinus Floor Elevation and Simultaneous, Non‐Submerged Implant Placement: Case Report and Literature Review
Authors: Ioannidou Effie , Dean John W.
Published: February 2005

The osteotome sinus floor elevation is a conservative technique for sinus elevation and immediate implant placement. The purpose of this report is to present a case using the sinus floor elevation technique for placement of a non‐submerged implant with 12 months follow‐up after permanent restoration and to review the literature regarding sinus floor elevation. The osteotome sinus floor elevation technique may be used successfully for the placement of nonsubmerged implants. It allows for shorter post‐treatment waiting times and provides a less invasive approach compared to 1‐ or 2‐step antrostomy procedures. J Periodontol 2000;71:1613‐1619.
Reduction of Severe Gingival Overgrowth in a Kidney Transplant Patient by Replacing Cyclosporin A With Tacrolimus
Authors: Hernández Gonzalo , Arriba Lorenzo , Lucas Miguel , de Andrés Amado
Published: February 2005

Side effects of certain drugs such as cyclosporin A (CsA) and phenytoin may induce gingival overgrowth which in some instances become unacceptable to the patient because esthetic, functional, and other effects. Use of these drugs is related to important medical situations, such as organ transplantation and control and withdrawal of the drugs is contraindicated. Tacrolimus is an immunosupressant used to prevent graft rejection in organ transplant patients and has been shown to cause fewer oral side effects than CsA. This report deals with a case of probable synergism between the use of CsA and phenytoin which caused an intense gingival overgrowth in kidney transplant patient. A treatment protocol including very thorough oral hygiene, scaling and root planing, clorhexidine digluconate rinses (0.12%), and substituting CsA with tacrolimus is described. Response to treatment after 6 months of tacrolimus use was excellent with almost complete reversion of the gingival enlargement. One‐year follow‐up demonstrated a stable gingival situation. The successful substitution of CsA with tacrolimus provides great expectations for the management of CsA‐related gingival enlargement. J Periodontol 2000;71:1630‐1636.
The Use of a Bioabsorbable Barrier for Regenerative Management of Marginal Tissue Recession. I. Report of 100 Consecutively Treated Teeth
Authors: Boltchi Farhad E. , Allen Edward P. , Hallmon William W.
Published: February 2005

Background: Periodontal plastic surgical procedures aimed at coverage of exposed root surfaces have evolved into routine treatment modalities. The present study was designed to assess the effectiveness and the predictability of a bioabsorbable barrier in the treatment of human recession defects utilizing a single‐step surgical procedure.

Methods: One hundred consecutive single and multiple adjacent Miller Class I, II, and III buccal recession defects in 41 patients were treated with a combination of a bioabsorbable barrier and coronally advanced flap technique. Clinical parameters were recorded immediately prior to surgery, at 3 months, and after a minimum of 6 months.

Results: A highly significant reduction in recession depth from a mean value of 3.2 ± 0.9 mm preoperatively to 0.3 ± 0.5 mm postoperatively, corresponding to a mean root coverage of 92.7% ± 14.1%, was obtained. Complete (100%) root coverage was obtained in 75% of the sites. Factors adversely affecting root coverage were membrane exposure postoperatively and preoperative recession depth ≥4 mm. In addition, inferior results were achieved at mandibular incisor and maxillary molar sites. Factors having no effect on root coverage included maxillary versus mandibular sites and single versus multiple adjacent sites.

Conclusions: The use of guided tissue regeneration in periodontal plastic surgery is highly predictable, and highly esthetic root coverage can be gained without requiring a second surgical procedure or a second surgical site and is, therefore, an attractive alternative to conventional grafting techniques. J Periodontol 2000;71:1641‐1653.
Alveolar Ridge and Sinus Augmentation Utilizing Platelet‐Rich Plasma in Combination With Freeze‐Dried Bone Allograft: Case Series
Authors: Kassolis James D. , Rosen Paul S. , Reynolds Mark A.
Published: February 2005

Background: Alveolar bone regeneration is frequently necessary prior to placement of implants. Efforts to improve wound healing have focused on factors that may enhance bone formation following guided bone regeneration (GBR) techniques alone or in combination with bone replacement graft materials. Recent reports suggest that platelet‐rich plasma (PRP), presumably high in levels of peptide growth factors, may enhance the formation of new bone when used in combination with autogenous graft material.

Methods: In this report, the clinical and radiographic results are presented on 15 consecutively treated patients using autologous PRP in combination with freeze‐dried bone allograft (FDBA) for sinus elevation and/or ridge augmentation. FDBA and PRP (0.5 g/2cc PRP) were mixed and placed as a composite graft material. A gel formed by mixing autologous thrombin‐rich plasma with PRP (1:4 ratio) was used to cover the graft material. Core biopsies of grafted areas were obtained in several patients as part of implant site preparation and were evaluated histologically to determine site maturation.

Results: Of 36 implant fixtures, 32 (89%) were considered clinically successful demonstrating complete bone coverage of the implant, no mobility, and a normal radiographic appearance at the time of re‐entry and 12 months post‐implant exposure. Four implants were removed due to mobility at the time of surgical exposure. Histologic evaluation of biopsy specimens revealed numerous areas of osteoid and bone formation around FDBA particles, with no evidence of inflammatory cell infiltrate.

Conclusions: These clinical and histological findings suggest that ridge augmentation and sinus grafting with FDBA in combination with PRP provide a viable therapeutic alternative for implant placements. Future studies are necessary to determine whether PRP enhances new bone formation or maturation with bone replacement allografts. J Periodontol 2000;71:1654‐1661.
Peripheral Occluding Effects of Non‐Absorbable Membranes on Ingrowth of Cultured Gingival Connective Tissue Cells
Authors: Fukuda Takeshi , Ezawa Tsunehiro , Tanaka Koji , Ito Koichi
Published: February 2005

Background: The success of periodontal regenerative procedures, i.e., using regenerative cells to repopulate wounds, is enhanced by using barrier materials, such as expanded polytetrafluoroethylene (ePTFE) membranes, to provide a barrier to the proliferation of epithelial cells and gingival connective tissue cells at the healing site. However, several animal and clinical studies have demonstrated the difficulties of avoiding thin connective tissue ingrowth under the ePTFE membrane used for bone regeneration procedures. We investigated the peripheral occluding effects of ePTFE membranes on ingrowth of cultured gingival connective tissue cells in vitro.

Methods: The ePTFE membrane was divided into 4 pieces, fixed, and immobilized on a culture dish. Human connective tissue cells from clinically healthy gingiva were isolated and cultured. Low passages (2 through 3) of these cells, 5 × 105, were seeded and cultured in each dish. At weeks 1, 2, and 4, the ingrowth cells under the membranes were stained with Giemsa and photographed. The percentage of cell ingrowth as an area measurement and the cell ingrowth score as a linear measurement were determined using computer‐assisted interactive image processing.

Results: There were no measurable spaces between the membranes and the dishes at ×40 magnification using the stereomicroscope. However, the percentage of cell ingrowth under the membrane gradually increased from 1 to 4 weeks, reaching approximately 70% by week 4. There was a statistically significant difference between the 1‐ and 4‐week percentage of cell ingrowth (P <0.05). The cell ingrowth score also increased gradually, and cells invaded the center from all peripheral borders. There was a statistically significant difference for the lower right and left margins of the membrane between the 1‐week and 4‐week cell ingrowth scores. Furthermore, there was a statistically significant difference for the 4‐week cell ingrowth score between the upper and lower margins (P <0.05).

Conclusion: The use of ePTFE membranes placed over the culture dish plate cannot prevent ingrowth of cultured gingival connective tissue cells in vitro. J Periodontol 2000;71:1680‐1686.
Coronally Advanced Flap for the Treatment of Buccal Gingival Recessions With and Without Enamel Matrix Derivative. A Split‐Mouth Study
Authors: Modica Fabio , Pizzo Massimo Del , Roccuzzo Mario , Romagnoli Roberto
Published: February 2005

Background: The coronally advanced flap (CAF) is a predictable method for achieving root coverage in buccal gingival recessions. The use of enamel matrix derivative (EMD) has already been tested in treating intrabony defects. No clinical comparative study has been published evaluating the CAF in combination with EMD in treating buccal gingival recessions.

Methods: This split‐mouth study was performed to assess the efficacy of EMD to improve the results of a root coverage procedure. Fourteen pairs of Miller Class I and II bilateral comparable defects were selected in 12 patients. In each patient, one site was randomly assigned to the test group and the contralateral site to the control group. The treatment consisted of a CAF procedure with (test) or without (control) EMD. Gingival recession (REC), clinical attachment level (CAL), probing depth (PD), and extension of keratinized tissue (KT) were recorded at baseline and 6 months postsurgery.

Results: The average initial REC was 3.71 mm (SD ± 1.68) for the test group, and 3.50 mm (SD ± 1.56) for the control group. The 2 groups were statistically homogeneous. The mean root coverage was 3.36 mm (SD ± 1.55), corresponding to a value of 91.2% for the test group, and 2.71 mm (SD ± 1.20), equal to 80.9% for the control group. The differences between the 2 groups were not statistically significant. The mean CAL gain was 3.57 mm (SD ± 1.55) for the test group and 2.79 mm (SD ± 1.19) for the control group. No changes of PD and KT were found.

Conclusions: This study suggests that EMD does not seem to significantly improve the clinical outcomes of gingival recession treated by means of CAF, even though the test group showed slightly better results in terms of root coverage and CAL. Further studies with a larger number of teeth and higher statistical power are needed to support this conclusion. J Periodontol 2000;71:1693‐1698.
Clinical Evaluation of Wound Healing Following Multiple Exposures to Enamel Matrix Protein Derivative in the Treatment of Intrabony Periodontal Defects
Authors: Heard Richard H. , Mellonig James T. , Brunsvold Michael A. , Lasho David J. , Meffert Roland M. , Cochran David L.
Published: February 2005

Background: Multiple exposures to enamel matrix protein derivative (EMD) during periodontal therapy have been shown to be safe for the patient. The purpose of this study was to clinically determine if an altered course of wound healing would occur after multiple exposures to EMD in the treatment of intrabony defects. A secondary aim was to assess the efficacy of EMD in probing depth reduction and clinical attachment level gain.

Methods: Thirty‐two systemically healthy patients (18 females, 14 males, 33 to 69 years old) who were being treated for moderate to advanced periodontal disease were selected for the study. Surgical procedures involving 2 sites were separated by at least 8 weeks, and wound healing comparisons were made between the first and second procedure. Patients were given a diary card the day of surgery, which consisted of questions concerning the presence and severity of headaches, root hypersensitivity, tooth pain, swelling, and itching. Patients were also examined at postoperative visits to clinically assess wound healing and discuss responses to the questionnaire. Soft tissue measurements were taken the day of surgery and 6 months postoperatively to ascertain probing depth reduction (PD) and gains in clinical attachment levels (CAL).

Results: The results revealed no clinically detectable reaction that could not be attributed to normal postoperative sequelae. There were no differences in reported symptoms between patient gender, first and second procedures, or intrabony and non‐intrabony defects. Smokers were found to have a statistically significantly higher incidence of severe symptoms in root hypersensitivity, tooth pain, and swelling compared to non‐smokers (n = 21). The mean probing depth reduction was 3.8 ±1.5 mm (2 to 9 mm), while the mean clinical attachment level gain was 2.8 ±1.7 mm (0 to 8 mm).

Conclusions: The findings of this study demonstrate that EMD is a clinically safe product to use in the treatment of periodontal defects and that multiple uses do not have a negative impact on periodontal wound healing. In addition, a statistically significant gain in clinical attachment and reduction in probing depth were demonstrated. J Periodontol 2000;71:1715‐1721.
Cyclosporin A Upregulates Phospholipase C β1 in Fibroblasts From Gingival Overgrowth
Authors: Breschi Lorenzo , Montebugnoli Lucio , Bernardi Federico
Published: February 2005

Background: In an attempt to evaluate the influence of cyclosporin A (CsA) on fibroblast metabolism, the phospholipase C β1 (PLC β1) nuclear expression was evaluated in fibroblasts from heart transplantation patients treated with CsA who exhibited gingival overgrowth (GO) and from controls.

Methods: PLC β1 was assessed by immunoblotting and immunocytochemistry means.

Results: Findings did not show any difference in terms of PLC β1 expression between the 2 groups when fibroblasts were incubated in media without CsA, while the addition of CsA highly stimulated the fibroblasts from CsA‐treated patients compared to controls. The abnormal fibroblastic response in CsA‐treated patients was detected both in cells from enlarged gingival sites and in cells from clinically healthy gingival sites.

Conclusions: These results do not explain whether the exaggerated reactivity to in vitro CsA is the consequence of a genetically transmitted susceptibility to CsA that identifies those subjects at risk for developing GO, or whether it is a secondary effect of the long‐term in vivo exposure to CsA. However, the present data underline the lack of any close relationship between enhanced fibroblast activity and clinical signs of GO and support the hypothesis that some other factors, together with CsA, are involved in the pathogenesis of CsA‐induced GO. J Periodontol 2000;71:1722‐1728.
Relationship Between Interleukin‐6 Levels in Gingival Crevicular Fluid and Periodontal Status in Patients With Rheumatoid Arthritis and Adult Periodontitis
Authors: Bozkurt Fatma Yeşim , Berker Ezel , Akkuş Selami , Bulut Şule
Published: February 2005

Background: The aim of this study was to determine and compare interleukin‐6 (IL‐6) levels in gingival crevicular fluid (GCF) and clinical periodontal findings in patients with rheumatoid arthritis (RA) and adult periodontitis (AP).

Methods: A total of 45 patients divided into 3 groups (15 patients with RA and AP, 15 patients with AP, and 15 periodontally healthy subjects) were included in this study. Plaque index (PI), gingival index (GI), sulcus bleeding index (SBI), probing depth (PD), and attachment level (AL) values for each patient were recorded. Enzyme‐linked immunosorbent assay for quantitative detection of IL‐6 in each GCF sample was employed.

Results: No significant difference could be detected between the RA and AP groups in the mean clinical parameter data except PI. Although the mean GCF IL‐6 level in the RA group was the highest, no significant difference could be found among the groups. There was only a strong negative correlation between GCF IL‐6 levels and GI scores in the RA group.

Conclusions: In the patients with RA, despite increased local tissue destruction potential due to autoimmunity and higher PI levels than in the AP patients, our findings suggest that medication including corticosteroid and non‐steroidal anti‐inflammatory drugs may decrease gingival inflammation, but the synthesis and degradation of IL‐6 in gingival tissue of RA patients may be different. To our knowledge, this study is the first report determining GCF IL‐6 levels in RA patients. J Periodontol 2000;71:1756‐1760.
Oxygen Sufficiency in the Gingiva of Smokers and Non‐Smokers With Periodontal Disease
Authors: Hanioka Takashi , Tanaka Muneo , Ojima Miki , Takaya Keiko , Matsumori Yukiko , Shizukuishi Satoshi
Published: February 2005

Background: Epidemiological studies have demonstrated deteriorating effects of smoking on periodontal tissue. The aims of this study were to compare oxygen saturation of hemoglobin in the gingiva (GSo2) of smokers and non‐smokers and to evaluate the chronic effect of smoking on gingival oxygen sufficiency.

Methods: GSo2 was determined using tissue reflectance spectrophotometry in 110 papillary gingival sites of 62 smokers and 100 sites of 60 non‐smokers.

Results: No significant difference was found in GSo2 between smokers and non‐smokers. In the model of ANOVA with covariates, age (P = 0.0048) and probing depth (P = 0.0012) had significant effects on GSo2. No significant effect was found in either smoking status (P = 0.3557) or the modified gingival index (MGI) (P = 0.3824). The interaction effect between smoking status and the MGI was highly significant (P = 0.0003) indicating that the effect of smoking status on the GSo2 should be compared at each level of the MGI score. GSo2 in healthy gingiva was significantly lower in smokers than non‐smokers (P = 0.0014), while smokers showed higher GSo2 than non‐smokers in moderately inflamed gingiva (P = 0.0356). The GSo2 in inflamed gingiva was significantly decreased compared with healthy gingiva in non‐smokers (P = 0.0044), while smokers showed no significant difference between healthy and inflamed gingiva (P = 0.2772 to 0.8665). GSo2 in smokers was consistently and significantly lower than that of healthy gingiva of non‐smokers (P = 0.0391 to 0.0004).

Conclusions: Smokers exhibit possibly lower function of oxygen sufficiency in healthy gingiva and reduced ability to adapt the function in inflamed gingiva than non‐smokers. This suggests that smokers have functional impairments in the gingival microcirculation. J Periodontol 2000;71:1846‐1851.
Cigar, Pipe, and Cigarette Smoking as Risk Factors for Periodontal Disease and Tooth Loss
Authors: Albandar Jasim M. , Streckfus Charles F. , Adesanya Margo R. , Winn Deborah M.
Published: February 2005

Background: Our purpose was to test the hypotheses that cigar and pipe smoking have significant associations with periodontal disease and cigar, pipe, and cigarette smoking is associated with tooth loss. We also investigated whether a history of smoking habits cessation may affect the risk of periodontal disease and tooth loss.

Methods: A group of 705 individuals (21 to 92 years‐old) who were among volunteer participants in the ongoing Baltimore Longitudinal Study of Aging were examined clinically to assess their periodontal status and tooth loss. A structured interview was used to assess the participants' smoking behaviors with regard to cigarettes, cigar, and pipe smoking status. For a given tobacco product, current smokers were defined as individuals who at the time of examination continued to smoke daily. Former heavy smokers were defined as individuals who have smoked daily for 10 or more years and who had quit smoking. Non‐smokers included individuals with a previous history of smoking for less than 10 years or no history of smoking.

Results: Cigarette and cigar/pipe smokers had a higher prevalence of moderate and severe periodontitis and higher prevalence and extent of attachment loss and gingival recession than non‐smokers, suggesting poorer periodontal health in smokers. In addition, smokers had less gingival bleeding and higher number of missing teeth than non‐smokers. Current cigarette smokers had the highest prevalence of moderate and severe periodontitis (25.7%) compared to former cigarette smokers (20.2%), and non‐smokers (13.1%). The estimated prevalence of moderate and severe periodontitis in current or former cigar/pipe smokers was 17.6%. A similar pattern was seen for other periodontal measurements including the percentages of teeth with ≥5 mm attachment loss and probing depth, ≥3 mm gingival recession, and dental calculus. Current, former, and non‐ cigarette smokers had 5.1, 3.9, and 2.8 missing teeth, respectively. Cigar/pipe smokers had on average 4 missing teeth. Multiple regression analysis also showed that current tobacco smokers may have increased risks of having moderate and severe periodontitis than former smokers. However, smoking behaviors explained only small percentages (<5%) of the variances in the multivariate models.

Conclusion: The results suggest that cigar and pipe smoking may have similar adverse effects on periodontal health and tooth loss as cigarette smoking. Smoking cessation efforts should be considered as a means of improving periodontal health and reducing tooth loss in heavy smokers of cigarettes, cigars, and pipes with periodontal disease. J Periodontol 2000;71:1874‐1881.
Platelet‐Derived Growth Factor Enhancement of a Mineral‐Collagen Bone Substitute
Authors: Stephan Eugena B. , Renjen Rahul , Lynch Samuel E. , Dziak Rosemary
Published: February 2005

Background: Anorganic bovine bone‐collagen matrix is commercially available for bone regeneration procedures. Platelet‐derived growth factor‐BB (PDGF‐BB) has been demonstrated to stimulate bone formation in vivo and in vitro. It was the aim of these studies to examine 1) the interaction of this mineral‐collagen matrix with PDGF‐BB and 2) determine if the adsorption of PDGF‐BB to the mineral‐collagen matrix stimulates osteoblastic cell proliferation above that of the untreated matrix.

Methods: Measurement of PDGF‐BB adsorption and release was accomplished using 125I radiolabeled growth factor. The PDGF‐BB was incubated with the anorganic bovine bone‐collagen matrix and the amount which adsorbed was determined. In the release studies, radiolabeled PDGF‐BB was adsorbed to the matrix material, then the samples were incubated in buffer for various time periods. The amount of PDGF‐BB retained on the matrix was measured and the percent of growth factor released calculated. The biological activity was tested in an in vitro assay with primary culture neonatal rat osteoblastic cells. Osteoblastic cells were cultured on bone mineral‐collagen matrix with known amounts of adsorbed PDGF‐BB. Proliferation of the cells was assessed by 3H‐thymidine incorporation and cell attachment measured by prelabeling cells with 3H‐leucine.

Results: PDGF‐BB adsorbed to the mineralized‐collagen matrix material in a rapid, concentration‐dependent fashion. The growth factor was slowly released from the matrix such that approximately 30% of the adsorbed protein was liberated over 10 days. PDGF‐BB treated mineralized‐collagen matrix displayed significantly (P <0.05, ANOVA) enhanced proliferation of cultured osteoblastic cells compared to the mineralized‐collagen matrix alone.

Conclusions: These results suggest that PDGF‐BB is rapidly adsorbed then slowly released from the anorganic bovine bone‐collagen matrix. PDGF‐BB adsorbed to this material is able to stimulate proliferation of the attached osteoblastic cells. These data suggest that it may be clinically feasible to adsorb PDGF to this bone‐collagen matrix and that this combination of bone growth factor and mineralcollagen matrix has the potential for clinical applications. J Periodontol 2000;71:1887‐1892.
Mucogingival Interceptive Surgery of Buccally‐Erupted Premolars in Patients Scheduled for Orthodontic Treatment. II. Surgically Treated Versus Nonsurgically Treated Cases
Authors: Pini Prato Giovanpaolo , Baccetti Tiziano , Giorgetti Roberto , Agudio Giancarlo , Cortellini Pierpaolo
Published: February 2005

Background: The aim of this 2‐year longitudinal study was to compare the width of keratinized gingiva after orthodontic therapy for buccally erupting premolars that had been pretreated by extraction of deciduous teeth alone versus interceptive mucogingival surgery.

Methods: In 8 patients (aged 9 to 12 years) who presented with bilateral buccal eruption of homologous teeth (premolars), one side was randomly treated with extraction of the deciduous molar and mucogingival surgery (test site), while the other side was treated only by extraction of the deciduous molar (control site). All of the subjects underwent orthodontic treatment with fixed appliances.

Results: At the baseline visit prior to any treatment, there was no significant difference between the mean amount of keratinized gingiva at test sites (3.06 mm) and control sites (2.93 mm). Two years later, upon completion of orthodontic treatment, there was a significant difference between test (2.93 mm) and control (1.37 mm) sites in the mean width of keratinized tissue. In the control (untreated) group, 2 sites exhibited 1 mm of gingival recession after orthodontic treatment.

Conclusions: Mucogingival interceptive surgery is an effective technique to maintain keratinized tissue in correspondence with buccally‐erupted teeth. J Periodontol 2000;71:182‐187.
Coronally Advanced Flap Procedure for Root Coverage. Flap With Tension Versus Flap Without Tension: A Randomized Controlled Clinical Study
Authors: Pini Prato Giovanpaolo , Pagliaro Umberto , Baldi Carlo , Nieri Michele , Saletta Daniele , Cairo Francesco , Cortellini Pierpaolo
Published: February 2005

Background: This clinical controlled study was designed to measure the tension of coronally advanced flaps (CAF) performed to treat shallow gingival recessions and to compare the recession reduction (Rec Red) achieved in a test group (flaps with tension) and in a control group (flaps without tension) 3 months after surgery.

Methods: Eleven patients, aged 22 to 41 years, with high levels of oral hygiene (full mouth plaque score <20%) were selected for the study. Each patient showed 2 bilateral Miller Class I maxillary or mandibular gingival recessions located on homologous teeth. A total of 22 recessions were treated. The recession depth at the right site was similar to that at the left site (difference ≤1 mm). For each patient, the 2 recessions underwent CAF procedure in the same surgical session. Before suturing, the residual tension (FTens) of both right and left flaps was measured with a dynamometer. Then, one site was randomly assigned to the test group and the contralateral site to the control group. In the test site the flap was sutured. In the control site the flap was further relaxed, the tension was measured again, and the flap was sutured.

Results: In the test group (with tension) the initial mean recession depth was 2.82 ± 0.64 mm and mean FTens was 6.5 g, while in the control group (without tension) the initial mean recession depth was 2.68 ± 0.81 mm and mean FTens was 0.4 g. Three months later, the test group showed a mean recession reduction of 2.18 ± 0.60 mm, a mean percent root coverage of 78 ± 15%, and complete root coverage was achieved on 2 teeth (18%). In the control group the mean recession reduction was 2.32 ± 0.81 mm and mean percent root coverage was 87 ± 13%. Complete root coverage was obtained on 5 teeth (45%). The difference of recession reduction between the test and control group was not statistically significant (P = 0.3911). In the test group, linear regression analysis showed a statistically significant association between recession reduction and both recession depth at baseline (P = 0.0001) and mean of the 3 tensions recorded on the test side (MFTens) (P = 0.0009).

Conclusions: This study shows that minimal flap tension does not influence recession reduction after 3 months when shallow recessions are treated by means of CAF. In the test group (with tension), the statistical analysis suggests that the higher the flap tension, the lower the recession reduction. J Periodontol 2000;71:188‐201.
A Comparative Scanning Electron Microscopic Study on the Characteristics of Demineralized Dentin Root Surface Using Different Tetracycline HCl Concentrations and Application Times
Authors: Isik A. Gülden , Tarim Berna , Hafez Abeer A. , Yalçin Funda Sağlam , Onan Utku , Cox Charles F.
Published: February 2005

Background: The use of demineralizing agents has been reported to enhance the degree of connective tissue attachment to denuded roots. Of the agents used, tetracycline HCl has received the most attention.

Methods: The purpose of this study was to evaluate and compare the SEM surface morphology of human root dentin following various concentrations and application times of tetracycline HCl. The surface characteristics were compared and the width of dentin tubule orifices were measured and analyzed. Twelve human teeth were collected and stored in distilled water after soft tissue removal using hand instruments. The apical third of each root was removed and remaining mid‐root region was sectioned longitudinally through the root canal following removal of its cementum with a fine diamond bur. A total of 48 dentin specimens were randomly divided into 8 groups for conditioning at different tetracycline HCl concentrations, at 0, 10, 25, 50, 75, 100, 125, and 150 mg/ml. Application times for each group were 1, 3, and 5 minutes. Immediately following treatment procedures, the specimens were rinsed, fixed in GTAPBF, dehydrated, and prepared for SEM. Each specimen was examined at 2 magnification values, representative fields photographed, and data tested by one‐way ANOVA and paired t test statistical analysis.

Results: Our results indicate that the use of tetracycline HCl solution between 50 mg/ml and 150 mg/ml showed a statistically significant opening of dentin tubules. All tetracycline HCl groups at 1, 3, and 5 minutes show smear layer removal from the dentin surface.

Conclusions: Dentin demineralization is not time dependent at all concentrations of tetracycline HCI. J Periodontol 2000;71:219‐225.
Guided Tissue Regeneration With a Bioabsorbable Polylactic Acid Membrane in Gingival Recessions. A Histometric Study in Dogs
Authors: Casati Marcio Z. , Sallum Enilson A. , Caffesse Raul G. , Nociti Francisco H. , Sallum Antonio Wilson , da Silva Pereira Sergio L.
Published: February 2005

Background: The goal of this investigation was to histologically and histometrically evaluate the healing process of gingival recessions treated by guided tissue regeneration with bioabsorbable polylactic acid membranes (GTR group) and to compare it to that obtained with coronally positioned flaps (CPF group).

Methods: Gingival recessions were surgically created on the buccal aspect of the upper cuspids of 5 mongrel dogs. The defects (5×7 mm) were exposed to plaque accumulation for 3 months. The contralateral defects were then randomly assigned to each group. After 3 months of healing, the dogs were sacrificed and the blocks were processed. The histometric parameters evaluated included length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, and defect coverage.

Results: The extension of the epithelium was 1.9 ± 0.8 mm for the GTR‐group and 3.0 ± 0.9 mm for the CPF‐group (P = 0.16). The connective tissue adaptation was 0.1 ± 0.1 and 0.8 ± 0.5 mm in the GTR group and CPF group, respectively (P = 0.051). The new cementum was 3.8 ± 1.5 mm and 2.4 ± 0.3 mm in the GTR group and CPF group, respectively (P = 0.16). Bone formation was 1.1 ± 0.5 mm in the GTR group and 1.4 ± 0.2 mm in the CPF group (P = 0.53). Histologically, the defect coverage observed was similar, 90.5% and 91.9% for the GTR group and the CPF group, respectively. No statistical differences in any of the parameters could be detected.

Conclusions: Within the limits of this study, it can be concluded that both procedures resulted in a favorable healing response with no significant difference between the treatments. J Periodontol 2000;71:238‐248.
Periodontopathic Bacteria in Children With Down Syndrome
Authors: Amano Atsuo , Kishima Tetsuhiko , Kimura Shigenobu , Takiguchi Miyako , Ooshima Takashi , Hamada Shigeyuki , Morisaki Ichijiro
Published: February 2005

Background: It is widely known that individuals with Down syndrome (DS) often develop severe early‐onset periodontal diseases. In this study, we examined the prevalence of periodontopathic bacteria in DS children to determine if specific pathogens are acquired in their childhood.

Methods: The subjects were 60 DS children (2 to 13 years old, 5 in each age bracket) and 60 age‐matched controls. Ten pathogens, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Treponema denticola, Prevotella intermedia, P. nigrescens, Capnocytophaga ochracea, C. sputigena, Campyrobacter rectus, and Eikenella corrodens were surveyed in subgingival plaque samples using a polymerase chain reaction. Periodontal status was evaluated by probing depth, bleeding on probing, and gingival index.

Results: No significant difference in periodontal status was observed between the DS and control groups, however, all of the pathogens were detected with greater frequency in the DS children. B. forsythus, T. denticola, P. nigrescens, and C. rectus were significantly prevalent throughout all age brackets of the DS children (P <0.01 or 0.05). The occurrence of P. gingivalis was also significant in the DS subjects over 5 years old. A cluster analysis of the microbial profiles of the DS subjects showed that gingivitis severity was associated with increased varieties of the harboring pathogens and the distribution of P. gingivalis.

Conclusions: These results suggest that various periodontopathogens can colonize in the very early childhood of DS patients and maturation of subgingival components, including P. gingivalis, plays an important role in the initiation of gingival inflammation. J Periodontol 2000;71:249‐255.
The Effect of Chlorhexidine Mouthrinses on Early Bacterial Colonization of Guided Tissue Regeneration Membranes. An In Vivo Study
Authors: Zucchelli G. , Pollini F. , Clauser C. , De Sanctis M.
Published: February 2005

Background: Different membrane materials accumulate varying amounts of bacteria when exposed in the oral cavity, due to their textural and structural surface characteristics. The aim of the study was to evaluate the effect of chlorhexidine mouthrinses on the in vivo early bacterial colonization of 3 different guided tissue regeneration membrane materials.

Methods: Rectangular‐shaped strips cut from 3 periodontal membranes (expanded polytetrafluoroethylene, polyglactin 910, and polylactic acid) were glued to removable devices adapted to the 2 upper quadrants in 8 dental students. In each student 1 quadrant was randomly selected as test side while the other served as control side. The experiment was divided in 2 phases: in the first phase plaque accumulation was followed for 4 hours while the second accumuation was followed for 24 hours. During the 4‐hour experiment, students rinsed the test device twice (immediately following device application and after 2 hours) with 0.12% chlorhexidine solution. The control device was rinsed with saline. In the second phase, students rinsed the test device with chlorhexidine and the control devices with saline 3 times (after device application and at 8 and 16 hours). Both the 4‐hour and the 24‐hour specimens were processed for scanning electron microscopy analysis. Fifty‐four fields (at 200× magnification) were randomly selected and analyzed on each strip. Magnification was increased to determine the presence and morphotype of bacteria. The presence or absence of bacteria was assessed in a binomial fashion: the field was bacteria‐positive when bacteria constituted the deposits covering the membrane surface. The microscopic field was negative (bacterianegative) when no bacteria were observed. Bacteria‐positive fields showing rods and filaments as prevalent morphotypes were recorded as rod‐positive fields.

Results: The results of data analysis suggest that bacterial contamination of membrane materials is significantly reduced by treatment with chlorhexidine. They also suggest that other variables affect plaque accumulation as well; i.e., the time allowed (4 versus 24 hours) and the different membrane materials. The interaction between these 2 variables is also highly significant, thereby indicating a different rate of plaque accumulation on different materials, irrespective of the treatment with chlorhexidine.

Conclusions: It was concluded that chlorhexidine mouthrinses may be effective in reducing and delaying the early bacterial accumulation on membrane materials although they are not able to fully prevent it. Membrane surface characteristics seem to be a more critical factor than the use of chlorhexidine, in influencing bacterial adhesion and colonization of barrier materials. J Periodontol 2000;71:263‐271.
Liposarcoma Involving the Periodontal Tissues. A Case Report
Authors: Piattelli A. , Di Alberti L. , Favia G.F.
Published: February 2005

Liposarcomas constitute 15 to 20% of all soft tissue tumors. They are extremely rare in the head and neck and in the oral cavity. A 30‐year‐old patient was seen for a soft, painless mass in the right palate. Through panoramic radiography it was possible to observe a radiolucent area with sharp margins in the right upper quadrant. The lesion, after an incisional biopsy, was diagnosed as a “myxoid liposarcoma.” The patient underwent a wide excision of the lesion with bone laminectomy and he is well at a 4‐year follow‐up. The differential diagnosis included salivary gland tumors and palatal abscess. J Periodontol 2000:71:322‐324.
Periosteal Osteosarcoma of the Jaws: Report of 2 Cases
Authors: Piattelli A. , Favia G.F.
Published: February 2005

Osteosarcoma (OS) occurs most often in the long bones. OS of the jaws has clinical and biologic aspects different from those of the long bones. They tend to occur at an older mean age, pain and swelling are more typical, and prognosis is more favorable. Nearly all OS shows a very prominent central intramedullary bone component. Only rarely are juxtacortical (peripheral) OS located in the jaws. There are 2 main types of juxtacortical OS, periosteal and parosteal. We present 2 cases of OS of the jaws where the clinical, radiologic, and histologic findings pointed to a diagnosis of periosteal OS. Both patients presented, in fact, with lesions located superficially on the bone surface with no marrow involvement. Both tumors were characterized by the presence of a moderately differentiated chondroblastic tumor with foci of osteoid and bone formation. Periosteal OS should be differentiated microscopically from periosteal chondrosarcoma, intramedullary OS with periosteal extension, highgrade surface OS, and parosteal OS. The clinical differential diagnosis was done, in these cases, for epulis, gingival tumors, peripheral odontogenic fibroma, peripheral ossifying fibroma, pyogenic granuloma, peripheral giant cell granuloma, and mesenchymal malignant tumors. J Periodontol 2000;71:325‐329.
A Histochemical Investigation of the Bone Formation Process by Guided Bone Regeneration in Rat Jaws. Effect of PTFE Membrane Application Periods on Newly Formed Bone
Authors: Ohnishi Hideo , Fujii Noritaka , Futami Takayuki , Taguchi Naoyuki , Kusakari Haruka , Maeda Takeyasu
Published: February 2005

Background: Guided bone regeneration (GBR) has been widely utilized for the promotion of bone augmentation in bone loss areas. However, little information has been available regarding chronological changes in newly formed bone and alterations in the nature of newly formed bone after removal of a barrier membrane. The present study attempted to establish a GBR model for rat maxillae. We also examined the effects of membrane application periods on newly formed bone and its remodeling process after removal of the membrane in this experimental model.

Methods: Thirty‐five Wistar rats were divided into 2 groups: a membrane application group and a membrane removal group. The chronological changes of newly formed bone were evaluated histologically and statistically.

Results: At 2 weeks after the GBR procedure, bony cavities had completely filled the newly formed bone in the experimental side. In the control side, corticalization on the surface of the newly formed bone proceeded with a decrease in the bone marrow cavity, whereas the bone marrow space had enlarged by 12 weeks post‐surgery in the experimental side. In the membrane removal group, the osteoblasts appeared on newly formed bone at 1 week after membrane removal. Comparatively thick compact bone had formed on the surface of the newly formed bone at 4 weeks after membrane removal, and corticalization proceeded later.

Conclusions: The long‐term application of a barrier membrane induces the enlargement of the bone marrow spaces. We suggest that PTFE membrane removal in adequate time promotes the corticalization and maturation of the newly formed bone by the GBR technique. J Periodontol 2000;71:341‐352.
The Relationship Between Gingivitis and Colonization by Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in Children
Authors: Morinushi Takanobu , Lopatin Dennis E. , Van Poperin Neal , Ueda Yasuhiro
Published: February 2005

Background: Porphyromonas gingivalis and actinomycetemcomitans are closely associated with the onset and severity of adult periodontal disease. However, little is known regarding the colonization by, and host antibody response to, these microorganisms in children.

Methods: Plaque and sera were obtained from 40 healthy children, 2 to 18 years old. Gingival health was assessed by the periodontal disease index (PDI), papillary bleeding score (BS) and the modified total papillary margin attachment index (M‐PMA). P. gingivalis and A. actinomycetemcomitans in plaque samples were detected by slot immunoblotting (SIB). Serum antibody levels against these microorganisms were evaluated using ELISA.

Results: More than 60% of the children had detectable levels of P. gingivalis in their plaque. Those having detectable levels had more gingival inflammation than those having none; however, these differences were significant only in children over the age of 12 years (PDI, BS). In contrast, while 75% of the children had detectable A. actinomycetemcomitans, there were significant differences in gingival inflammation associated with colonization in children from 3 to 7 years of age (PDI) and over 12 years of age (M‐PMA). Serum antibody levels to P. gingivalis were inversely correlated with gingival inflammation in all age groups, while A. actinomycetemcomitans titers were positively correlated with gingival inflammation only in the children over 12 years. No significant relationship between the presence of either A. actinomycetemcomitans or P. gingivalis and antibodies to them was found.

Conclusions: Our findings show that P. gingivalis and A. actinomycetemcomitans are readily detected as early as 3 years of age and that their presence is associated with the onset and severity of gingivitis. J Periodontol 2000;71:403‐409.