bluuebunny/crossref_metadata_2025 huggingface dataset:
Familial Occurrence of Juvenile Periodontitis With Varied Treatment of One of the Siblings With Five‐Year Follow‐up: Case Reports
Authors: Hoffman Irwin D.
Published: March 2012

A 13‐year‐old female with varying degrees of vertical bone loss at the mesial surfaces of three first molars was treated by plaque control instruction, root planing and curettage of all sites and autologous tooth transplant into an extraction site, an autogenous iliac marrow graft at the second site, and passive eruption and osteoplasty at the third site. Two siblings had evidence of juvenile periodontitis and the mother had isolated bone defects involving some molars. Radiographic records were obtained of one of the male siblings at age 9 years and 10 months and 7 years and 10 months later, as well as of the mother. The male sibling had no evidence of bone loss at 9 years and 8 months, but advanced lesions were present at age 17 years and 8 months. Patterns of bone loss and teeth and tooth surfaces affected were different among the three family members studied. After 5 years, the three treated sites had normal sulcular depths. Bone regeneration was prominent at the marrow transplant site and tooth transplant site. Treatment was successful from a regenerative and stability point of view over a 5‐year period.
The Effects of Citric Acid on Attachment of Laterally Positioned Flaps,
Authors: Common John , McFall Walter T.
Published: March 2012

Citric acid demineralization of root surfaces to enhance new attachment clinically appears to be successful, but histologic evidence of new attachment in humans is lacking. Two recession‐like defects were surgically created on the facial aspect of mandibular incisors scheduled for extraction in five patients. Each patient had differing degrees of periodontal disease, but the control and experimental teeth of each were similarly involved. The roots were thoroughly planed and an apical reference notch was inscribed just coronal to crestal bone. One tooth served as the control, while the experimental tooth was treated with citric acid (pH 1) for two minutes. Two full‐thickness laterally positioned flaps were done to cover the roots. After healing periods of 1, 2, 4, 12, and 20 weeks, the teeth were removed by block section for histologic evaluation. The type of attachment differed on the teeth with longer healing periods. The control teeth exhibited a long epithelial attachment with no evidence of cementogenesis, whereas the experimental teeth had a connective tissue attachment to newly formed cementum coronal to the reference notch. These observations provide evidence that demineralization of root surfaces may promote increased or accelerated connective tissue attachment of laterally positioned flaps.
Tetracycline and Its Derivatives Strongly Bind to and Are Released From the Tooth Surface in Active Form
Authors: Baker P. J. , Evans R. T. , Coburn R. A. , Genco R. J.
Published: March 2012

Several antibiotics were found to adsorb to saliva‐coated enamel and to inhibit in vitro plaque formation by pure cultures of oral bacteria: Actinomyces viscosus, Actinomyces naeslundii and Streptococcus mutans. Tetracycline, minocycline and oxytetracycline adsorbed to the greatest degree, showing 100‐fold higher adsorption than spiramycin, the test antibiotic with least adsorption. Inhibition of in vitro plaque formation was found to require both drug substantivity (capacity for adsorption) and antimicrobial activity. Inhibition of plaque formation in the in vitro assay employed correlated well with clinical efficacy.
Scanning Electron Microscopic Evaluation of Several Resharpening Techniques
Authors: DeNucci Donald J. , Mader Carson L.
Published: March 2012

The scanning electron microscope (sem) was used to evaluate the cutting edges of curettes as they came from the manufacturer, after they had been made dull and after they were resharpened by several standard resharpening techniques and one experimental technique. Micrographs were taken of the cutting edges with the SEM at a standard magnification. The quality of the cutting edges was blindly evaluated by five independent examiners who unanimously agreed that the experimental resharpening technique produced the highest quality edge. The experimental resharpening technique used a Whittler Instrument Sharpener on the face of the blade followed by a rotating, abrasive impregnated, felt wheel on the lateral surface of the blade.
Subgingival Metronidazole in Acrylic Resin Vs. Chlorhexidine Irrigation in the Control of Chronic Periodontitis
Authors: Yeung F. I. S. , Newman H. N. , Addy M.
Published: March 2012

After initial scaling, root planing and cleaning of subcontact areas, chronic periodontitis patients received oral hygiene instruction consisting of Bass toothbrushing using a sodium fluoride toothpaste, but without stress on interdental cleaning. They were then assigned to two groups, one of which self‐administered 0.2% chlorhexidine solution subgingivally, once daily for 4 weeks, while the other was subjected to subgingival application of acrylic resin strips containing 40% metronidazole once weekly for 4 weeks. Plaque Index, Sulcus Bleeding Index, probeable pocket depth and gingival shrinkage were assessed for this treatment period and for a further 8 weeks. Highly significant improvements compared with baseline values were achieved and maintained to the end of the study. There were no significant differences between the groups at any time, except for Sulcus Bleeding Index which at Days 56 and 84 showed metronidazole to be superior. It was concluded that the regimens selected were equally effective in improving periodontal health over a 3‐month period.
Effectiveness of Routine Periodontal Treatment With and Without Adjunctive Metronidazole Therapy in a Sample of Mentally Retarded Adolescents
Authors: Clark D. Christopher , Shenker Stephanie , Stulginski Phillip , Schwartz Stephane
Published: March 2012

A sample of mentally retarded adolescents with moderate periodontal disease was given conventional treatment with and without adjunctive metronidazole therapy following consent of guardians. Antibiotics or placebo tablets were taken 1 week following prophylaxis in a double blind clinical trial. Six months after the baseline examinations, there were no significant differences between the treatment and control groups in the mean attachment level or the proportions of microorganisms in subgingival pockets.
Acute Necrotizing Ulcerative Gingivitis: A Transmission Electron Microscope Study
Authors: Courtois Gilbert J. , Cobb Charles M. , Killoy William J.
Published: March 2012

The purpose of this study was to provide additional evidence that in the lesions of acute necrotizing ulcerative gingivitis (ANUG), spirochetes and other microorganisms are capable of invading the nonnecrotic lamina propria of affected gingivae. Biopsies from eight patients with pathognomonic signs of ANUG were obtained under local anesthesia and processed for light and transmission electron microscopy. The results indicated that spirochetes and other bacteria are capable of penetrating the viable connective tissues of the lamina propria. The four zones of the ANUG lesion as first described by Listgarten were observed without difficulty. The maximum depth of bacterial infiltration into the lamina propria ranged from 155 to 400 microns from the nearest epithelial basal lamina. The histologic picture of the ANUG lesion did not always conform to the acute clinical manifestations.
Puberty Gingivitis in Insulin‐dependent Diabetic Children: I. Cross‐sectional Observations
Authors: Gusberti F. A. , Syed S. A. , Bacon G. , Grossman N. , Loesche W. J.
Published: March 2012

This cross‐sectional study examined the gingivitis occurring at puberty in a population of insulin‐dependent juvenile diabetics. Seventy‐seven children between the ages of 6 and 15 years were examined for gingivitis levels, stages of pubertal maturation and blood levels of glucose and glycosylated hemoglobin. Bacterial plaque was sampled from one or more approximal tooth surfaces of every subject and cultured under anaerobic and aerobic conditions on nonselective and selective media. The total cultivable flora and percentage of certain presumptive periodontopathic bacteria were determined. Before puberty, children with “high” levels of glycosylated hemoglobin also had higher gingivitis levels than children with “normal” metabolic control of diabetes. During puberty, the level of gingivitis increased independently from both fasting blood glucose levels and per cent glycosylated hemoglobin. The microbiota of marginal plaque was predominantly composed of facultatively anaerobic bacteria. The percentages of Capnocytophaga sp and Actinomyces naeslundii were statistically higher at the onset of puberty, suggesting that a specific bacterial shift in the microbial composition of marginal plaque occurs in response to host changes in juvenile diabetic children at this age period.
Psoriasis: Palatal Manifestations and Physiologic Considerations
Authors: Eastman John Russell , Goldblatt Lawrence I.
Published: March 2012

The histologic and clinical criteria for psoriasis involving the palate are discussed. A review of the literature shows the present case to be the fifth well‐documented one in the literature. A possible explanation for the rarity of clinical manifestations in the oral cavity is presented.
The Healing of Hamster Oral Mucosal Wounds Covered by Porcine Grafts: A Histologic Study
Authors: Turnbull Robert S. , Stross Ernest E.
Published: March 2012

The purpose of this study was to ascertain whether porcine skin grafts are incorporated by the host or act as temporary dressings which are sloughed and to determine the host reaction in terms of inflammatory response. A split‐thickness 5‐mm square recipient bed was prepared in the cheek pouches of 20 hamsters. Previously frozen, irradiated porcine skin was sutured onto each bed. Animals were killed at 3, 7, 10, 14 and 28 days. Results indicated that at 3 days the graft showed signs of necrosis and host epithelium was migrating under it. Some acute inflammation was evident. By 7 days all 7 grafts had sloughed and epithelialization was complete. The graft bed was maturing collagenous tissue with a mild infiltrate of chronic inflammatory cells. At 10 days healing was almost complete. In all instances the graft appeared to have been sloughed between the 3rd and 7th day and there was no evidence of a massive inflammatory response, foreign body reaction, host incorporation or graft vascularization. These results suggest that porcine skin could be used as a “biologic dressing” in periodontal mucogingival surgery involving grafting.
Effect of Liquid Protein Diet on Collagen Metabolism of the Gingiva of Young Rats
Authors: Evans Gerald H. , Yukna Raymond A. , Nakamoto Tetsuo
Published: March 2012

The effects of liquid protein diet (LPD) on gingival collagen metabolism were evaluated in young rats. Experimental animals received a LPD, while pair‐fed and ad libitum groups received a 20% casein diet. Prior to sacrifice at days 23, 35 and 48 post‐partum, animals from each group were injected with C14‐proline. Gingival tissues from the palate were excised and analyzed for collagen content and collagen synthesis. Results of body‐weight changes at day 48 showed a 20% decrease in the LPD group, while pair‐fed and ad libitum groups increased 47% and 267%, respectively. Collagen content per gram of gingiva was not significantly different among the three groups. Gingival collagen synthesis, however, did show significant differences among the three groups. It was concluded that while LPD effects on the overall body condition were profound, LPD exerts minimal effect on gingival collagen metabolism in young rats.
A Periodontal Attachment Mechanism Without Alveolar Bone: Case Report
Authors: Novak M. J. , Polson A. M. , Caton J. , Freeman E. , Meitner S.
Published: March 2012

A 22‐year‐old black male was referred for periodontal therapy because of radiographic evidence of advanced bone loss associated with the posterior teeth. Clinical examination revealed gingivitis, normal sulcus depths, and minimal loss of clinical attachment. Complete blood counts, serum chemistry, and neutrophil function were within normal limits. Histological, histochemical and ultrastructural analysis of an extracted tooth revealed no loss of attachment; large areas of the cementum were collagen‐poor and, ultrastructurally, resembled afibrillar cementum. It is proposed that the periodontal attachment mechanism present in this case was associated with a localized failure in normal periodontal development.
Healing Responses of Human Intraosseous Lesions Following the Use of Debridement, Grafting and Citric Acid Root Treatment: I. Clinical and Histologic Observations Six Months Postsurgery
Authors: Froum S. J. , Kushner L. , Stahl S. S.
Published: March 2012

Three block sections of treated human intraosseous lesions within one individual are presented. These lesions were debrided, filled with autogenous grafts and at two sites the root was treated with citric acid. The treated sites were lightly root planed once a month and the blocks were removed 6 months after surgery. In addition, the root accretions within two lesions were notched with a bur prior to root planing in order to positively identify the position of these root accretions in the histologic sections. Clinically, the lesions closed by marginal shrinkage and limited pocket closure. Histologically, regeneration of new cementum, osteogenesis at bone and graft spicule seams and reformation of functionally oriented ligament fibers were present at sites within lesions where accretions had covered the root. Such a healing phenomenon was observed close to the base of the lesions and seemed to be related to this spatial configuration rather than to the notching of the root itself. No specific increased healing responses could be attributed to citric acid root treatment. Thus, “regeneration” of new attachment is possible within human intraosseous lesions even at root sites previously covered by accretions. However, such responses seem to be limited to areas near the base of the intraosseous lesion.
Ultrastructural Study of Cultured Human Gingival Fibroblasts Exposed to Endotoxin
Authors: DeRenzis Frank A. , Chen Sow‐Yeh
Published: March 2012

Our current concept of periodontal disease is that some mediators found in the gingival sulcus are able to penetrate the epithelial barrier and produce tissue destruction in the periodontium. Endotoxin, one such mediator, recently has been the subject of considerable study. The purpose of this investigation was to substantiate the role of endotoxin in the pathogenesis of periodontal disease by ascertaining its action on cellular and subcellular components. In order to accomplish this, cultured human gingival fibroblasts were exposed to media containing either 300 μg/ml or 500 μg/ml of endotoxin and untreated medium for a period of 24 hours. Cells were harvested and prepared for electron microscopy by conventional methods. Electron microscopic examination revealed alterations in mitochondria, Golgi apparatus, lysosomal‐like bodies, cytofilaments and plasma membrane. Relationship of these alterations to pathologic processes is discussed.
A Longitudinal Study of Periodontal Disease in Patients With Reduced Immunocapacity
Authors: Oshrain Herbert I. , Telsey Bernard , Mandel Irwin D.
Published: March 2012

The periodontal status of renal transplant patients on immunosuppressant drug therapy was compared with that of an age matched normal group over a period of 2 to 4½ years. Gingival Index, Plaque Index, and Periodontal Destruction Index were used as measures of comparison. Over this period of time the Gingival Index of the immunosuppressed patients increased significantly when compared to the normals. There was a significant increase in the mean Plaque Index for both groups during the study period. The increase was greater in the immunosuppressed group. However, the difference in the Plaque Index for the two groups was not significant. There was little change in the Periodontal Destruction Index in both groups over time. The results of this study indicate that there is little difference in the rate of periodontal destruction between patients taking immunosuppressant drugs and normal patients. These findings, taken in conjunction with other recent reports, would seem to indicate that T cells play a minor role in the etiology of periodontal disease.
A Method to Measure Pain Associated With Hypersensitive Dentin
Authors: Thrash Wm. James , Dorman Homer L. , Smith Fred D.
Published: March 2012

Pain associated with dental hypersensitivity has been difficult to assess. An electronic threshold measure was developed to increase the degree of objectivity in a subject's response to a cold thermal stimulus. The apparatus consisted of a miniature thermistor connected to a medical multichannel recorder with a hand‐held event recorder. The thermistor was placed adjacent to the hypersensitive area for an accurate temperature measure of the point at which the subject first reported pain. Room temperature air was gently blown on the hypersensitive area, dropping the surface temperature evenly from intraoral temperature to room temperature. Results indicated that this method of assessment provided consistent and reproducible data. The apparatus can detect changes in sensitivity and offers an objective approach to sensitivity studies.
Peripheral Ameloblastoma: A Case Report
Authors: Ide Fumio , Saito Ichiro , Umemura Shinichiro
Published: March 2012

A case of peripheral ameloblastoma in a 32‐year‐old male is presented. Clinically the lesion appeared as a mass on the left mandibular lingual gingiva with no evidence of bone involvement. Histologic examination of the lesion revealed the presence of scattered islands of ameloblastoma within the connective tissue.
Suppression of Penicillin‐Resistant Oral Actinobacillus actinomycetemcomitans With Tetracycline: Considerations in Endocarditis Prophylaxis
Authors: Slots Jørgen , Rosling Bengt G. , Genco Robert J.
Published: March 2012

Actinobacillus actinomycetemcomitans is an oral bacterium which is being encountered with increasing frequency in infective endocarditis. This organism occurs in high numbers in periodontitis lesions of patients with localized juvenile periodontitis (periodontosis). It is present infrequently, and only in low numbers in most other individuals. Its common resistance to penicillin, erythromycin and vancomycin represents a clinical problem in patients at risk of developing endocarditis after dental treatment. However, the high activity of tetracyclines against A. actinomycetemcomiians may be useful in prophylactic endocarditis considerations by allowing a suppression of the organism prior to the institution of recommended prophylactic protocols. In this study, we determined the effect of systemic tetracycline‐HCl therapy (1 gm/day) on the oral A. actinomycetemcomitans population in five localized juvenile periodontitis patients who were heavily infected with the organism. A. aciinomycetemcomitans could not be detected in samples of subgingival and supragingival dental plaque and cheek mucosal surfaces following 14 days of administration of systemic tetracycline. The organism was still undetectable 3 weeks after therapy but it reappeared at a few oral sites at week 8 post‐treatment. On the basis of this data, it is proposed that the prophylactic endocarditis therapy of patients with high numbers of penicillin‐resistant A. actinomycetemcomitans include a two‐stage approach: first, the systemic administration of tetracycline for 14 days, and second, institution of a conventional prophylactic protocol during the time of dental treatment.
A Scanning Electron Microscope Study of the Effects of Various Agents on Instrumented Periodontally Involved Root Surfaces
Authors: Lasho David J. , O'Leary Timothy J. , Kafrawy Abdel H.
Published: March 2012

This study evaluated the effects of chemical and biologic agents on periodontally diseased root surfaces which had been scaled or root planed. The proximal surfaces of 25 teeth were scaled to remove all visible calculus, and the proximal surfaces of another 25 teeth were vigorously root planed to remove all cementum and to achieve a hard, smooth, glass‐like surface. Five scaled and five root planed specimens were randomly selected for light microscopic examination to determine the amount of cementum removed. Cementum remained on all scaled surfaces but root planing had removed most of the more coronal cementum. Each of the 40 remaining teeth (20 scaled and 20 root planed) was longitudinally sectioned to obtain an experimental and control specimen. Four scaled and four root planed sections were randomly selected as experimental specimens for a test of each of the following five agents: (1) saturated citric acid for three minutes; (2) 15% EDTA for 5 minutes; (3) sodium hypochlorite for 5 minutes, followed by a 30‐second application of 5% citric acid; (4) sodium hypochlorite alone for 5 minutes; and (5) 2% sodium deoxycholate (NAD) for 1 minute, followed by a 1minute rinse in distilled water, and then a 1‐minute application of 5% Cohn's fraction IV1. The control for each experimental specimen was treated with saline. All samples were prepared for SEM and examined at 3,000 ×. Areas of particular interest were also examined at 12,000 ×. The chemical treatments exposed only individual collagen fibers or irregular fiber bundles on the scaled surfaces. Saturated citric acid, EDTA, and sodium hypochlorite with citric acid neutralization removed debris and exposed openings in the root surfaces. Sodium hypochlorite alone and NaD/Cohn's fraction IV1 were less effective in removing surface debris and had an effect similar to that seen in the saline controls. Application to root planed specimens of saturated citric acid, EDTA, and sodium hypochlorite followed by 30 seconds of citric acid neutralization resulted in surfaces virtually free of debris and with numerous collagen fibers exposed on the surface. EDTA appeared to cause a morphologic change in the collagen fibers. Sodium hypochlorite alone, sodium deoxycholate followed by Cohn's fraction IV1, and physiologic saline were relatively ineffective in surface debridement.
Total Cementum Removal: A Realistic Objective?
Authors: O'Leary Timothy J. , Kafrawy Abdel H.
Published: March 2012

The purpose of the study was to determine if total cementum removal from periodontally involved root surfaces was a clinically realistic objective. The experimental specimens were 36 periodontally involved teeth, extracted because of advanced periodontal disease. Eighteen teeth were from patients under age 36 while the other 18 were from patients over 36. All teeth had at least 6 mm of attachment loss on the proximal surface tested and showed no evidence of forceps damage. After removing all visible calculus, equal numbers of each tooth type in each age group were given 50 planing strokes with either a Jacquette scaler, a Gracey curet. or an Indiana University curet. Following the planing procedure the specimens were fixed, decalcified, and 7 μ thick sections prepared and stained with hematoxylin and eosin. Two teeth were excluded from the evaluation due to poor orientation. In none of the remaining 34 teeth was cementum totally removed over the entire proximal test surface. There was no apparent difference between the instruments in the amount of residual cementum found. Larger amounts of residual cementum were seen in more apical areas in both age groups.
Bacterial Antibody Titers in Ligature‐Induced Periodontitis in Beagle Dogs
Authors: Chung Chong Pyoung , Nisengard Russell , Slots Jørgen , Ciancio Sebastian
Published: March 2012

serum antibodies to indigenous bacteria in ten beagle dogs were examined over a 7‐month period during the development of ligature‐induced periodontitis. Gram‐negative strains comprised approximately 75% of the cultivable periodontitis microflora with a predominance of black‐pigmented Bacteroides species. A total of 44 bacterial strains representing the predominant cultivable subgingival beagle dog microflora was selected for antibody determination. The IgG and, in some cases, IgM serum antibody titers to these organisms were determined by indirect immunofluorescence. The antibody titers to most test strains remained unchanged during the experimental period. Gram‐negative bacteria generally exhibited lower titers than the Gram‐positive bacteria. Especially low titers were found for the black‐pigmented Bacteroides. Four dogs that developed the most severe periodontitis showed about 2‐fold higher IgG titers to some Gram‐negative anaerobic rods in the pre‐ligation period than dogs that developed a more moderate periodontitis. These data suggested a possible diagnostic value of such antibody determinations. However, the overall finding of the present study was that serum antibody titers to key periodontopathic organisms remained low throughout the experiment. This result may suggest that the rapid periodontal destruction in ligature‐induced periodontitis is due in part to an inadequate antibody response against the infecting microorganisms and their pathogenic products.
Effect of Various Root Surface Treatments on the Viability and Attachment of Human Gingival Fibroblasts
Authors: Cogen Ronald B. , Garrison David C. , Weatherford Thomas W.
Published: March 2012

Periodontally involved extracted human teeth were either untreated or were treated with root planing, citric acid, or root planing followed by citric acid. Following incubation of the roots, in the presence of normal human gingival fibroblasts for varying periods of time, cells were assayed for viability by radioactive label (51Cr). In addition, the ability to promote attachment and growth of gingival fibroblasts, by root treatment as above, was observed. The results of multiple experiments in each category indicated strongly that none of the roots, regardless of treatment or nontreatment, had any significant adverse affect on the viability of the cells. However, only root‐planed roots, whether or not citric acid was used, promoted cell attachment and growth.
Healing Responses of Human Intraosseous Lesions Following the Use of Debridement, Grafting and Citric Acid Root Treatment: II. Clinical and Histologic Observations: One Year Postsurgery
Authors: Stahl S. Sigmund , Froum S. J. , Kushner L.
Published: March 2012

This report details histologic healing responses at intrabony sites within two patients about 1 year after surgery. Treatment consisted of open flat debridement of the lesions. At specific sites, augmenting procedures such as autogenous grafts, allografts, synthetic grafts and citric acid root treatment were utilized. In addition, notches were made through calculus prior to root planing at specific root surfaces. These notches were placed at varying distances from the base of the lesion. Patients were followed postsurgically with frequent maintenance visits. Block sections were removed at the end of the experimental period. Clinical reduction in pocket depth was noted at all treated sites. This reduction consisted of limited pocket closure, marginal gingival recession and repocketing. Histologically, all specimens showed evidence of repair. The most mature repair appeared at sites treated with debridement and autogenous grafts. “Regeneration” of lost periodontal attachment was demonstrated by evidence of cementogenesis, osteogenesis and the presence of functionally oriented ligaments. However, the coronal regeneration appeared spatially limited. Allografts showed a similar, but less mature healing response. Synthetic graft material acted essentially as a “filler” within the defect. Citric acid root treatment did not demonstrate clear evidence of augmentation of the repair process. Of particular note in these human specimens was further histologic demonstration that “regeneration” potential apparently can only take place in close proximity to histologically viable periodontal ligament cells which may act as “donor sites” for coronal “regeneration” of lost periodontal attachment. This histologic response was observed regardless of treatment modalities used.
Salivary ABO Antibodies and Periodontal Disease
Authors: Hardman Patrick K. , Hardman Jill T.
Published: March 2012

The purpose of this study was to determine and to compare the titers of salivary anti‐A and anti‐B antibodies in two groups of patients with periodontal disease as measured by Russell's Periodontal Index (PI). Forty volunteer subjects, who were new patients assigned to a screening clinic, were selected for the study based on the following criteria: (1) blood group, (2) medical history, (3) age and (4) periodontal condition. One group of patients (N = 20) had a PI of less than 2.0 and the other group of patients (N = 20) had a PI of greater than 4.0. Following screening, a 10‐ml sample of unstimulated whole saliva was collected, centrifuged and frozen. Within 30 days the saliva was thawed, titrated and tested for presence of anti‐A and anti‐B. Saliva agglutinin titers were determined using a variation of previous testing techniques. Statistically significant differences between the two groups were not obtained in the titers of salivary anti‐A (U = 192.5; P > 0.1) or the titers of salivary anti‐B (U = 162.8; P > 0.1). All 40 group O patients were found to have anti‐A and anti‐B in their saliva.
Effect of Inflammation on Periodontal Attachment Levels in Miniature Swine With Mucogingival Defects
Authors: Kalkwarf Kenneth L. , Krejci Robert F.
Published: March 2012

Previous authors have postulated that a dense band of keratinized, attached gingiva prevents the spread of inflammation from the gingival margin to the subjacent attachment apparatus. Chronically inflamed mucogingival defects were created over the vestibular surface of 12 central incisors in miniature swine. The untreated contralateral incisors were identified as paired controls. Placement of horizontal reference notches on the tooth surfaces was followed by measurement of Probing Depth (PD) and Probing Attachment Level (PAL) on the vestibular aspect of each experimental and control tooth. No plaque removal was accomplished at any time during the study. One year following the attainment of baseline data, all measurements were repeated. Results show an increase in PD and a loss of PAL in both experimental and control regions. No difference in increase of PD or loss of PAL between the groups could be discerned.
Cementogenesis and Soft Tissue Attachment After Citric Acid Treatment in a Human: An Electron Microscopic Study
Authors: Frank R. M. , Fiore‐Donno G. , Cimasoni G.
Published: March 2012

The four maxillary incisors and two maxillary premolars of a 25‐year‐old male patient were used to study epithelial and connective tissue attachment 67 days and 164 days after flap surgery and cutting of an horizontal intradentinal groove near the buccal cervical region. Three teeth were topically conditioned for 3 minutes with citric acid pH = 1. The three other teeth were used as controls. The histologic examination was carried out in doubleblind conditions; the examiners did not know which specimens were acid treated until the end of the study. Two of the three cases treated with citric acid showed improved healing conditions, when compared to the controls; a more coronal position of the epithelial attachment in the dentin nick as well as a relatively important gain in connective tissue attachment. Two types of connective tissue attachment were observed. The first consisted of an attachment to dentin, without cementum formation and was characterized by a mineralization of decalcified dentin collagen spliced with collagen, newly secreted by fibroblasts. The second type involved cementum formation. Topical citric acid treatment, however, can not be considered as a completely reliable clinical procedure since in one experimental case the type of attachment observed was not better than that seen in the control.
Effect of Factors Other Than Pathologic Status on Responsiveness of Peripheral Blood Mononuclear Cells from Patients With Chronic Periodontitis
Authors: Suzuki Jon B. , Sims Tom J. , Page Roy C.
Published: March 2012

Studies were designed to assess factors other than pathologic status of the cell donor which affect the blastogenic responsiveness in vitro of peripheral blood mononuclear cells (PBMs) from normal donors and patients with periodontitis. Cultures were established and activated using phytohemagglutinin‐P (PHA) or homogenates of Actinomyces viscosus (AVIS), a gram‐positive plaque microorganism, and Fusobacterium nucleatum (FUSO), a gram‐negative plaque microorganism. Activation was assessed by measuring the incorporation of labeled precursor into DNA. The effects of incubation time, vessel shape, cell concentration, prostaglandin E2 and indomethacin on blastogenic responsiveness were studied.

Blastogenic responsiveness became maximal after 5 to 8 days' activation with the bacterial substances, and after 3 days' activation with PHA. Radioactivity incorporated by cultures in microtest wells with flat, round and conical bottoms was 5.9, 7.8 and 10.6 × 103 cpm, respectively. Cultures of cells from all of the patients and normal subjects were activated by PHA, AVIS and FUSO, and cell concentration was a major determinant of the magnitude of the blastogenic response. Responsiveness of cultures from all patients and control subjects activated with AVIS and FUSO was inhibited significantly by Prostaglandin E‐2 (PGE2) at a concentration of 10 μm. Inhibition was generally 50% or greater. Indomethacin, an inhibitor of prostaglandin production, at a concentration of 0.5 μg/ml significantly enhanced responsiveness of AVIS‐ and FUSO‐activated cultures from control donors and patients, indicating that prostaglandins are produced endogenously, and that they affect cell responsiveness. The effect of PGE2 and indomethacin on PHA‐activated cultures was more variable and, where present, of a lesser magnitude than that observed for cultures activated with bacterial homogenates. In most cultures the effects were not statistically significant. Our data show that in studies of lymphocyte activation, the incubation time, culture‐vessel shape, cell concentration and presence of endogenous inhibitors need to be taken into account.
The Potential Attachment Area of the Maxillary First Molar
Authors: Hermann Donald W. , Gher Marlin E. , Dunlap Robert M. , Pelleu George B.
Published: March 2012

The assumption that the palatal (PAL) root of maxillary molars has significantly greater attachment area than either the mesiobuccal (MB) or the distobuccal (DB) root was tested by documenting the root surface area of the individual roots and root trunks of 20 extracted maxillary first molars. Each molar was cross sectioned every millimeter, and the circumference of each root and root trunk section was measured with a calibrated opisometer. Mean circumferential measurements from each 1‐mm section were summed to give the surface area for each root and root trunk. The DB root had significantly less surface area than either the MB or PAL root or the root trunk. There was no significant difference between the surface areas of the MB and PAL roots. The surface area of the root trunk, which was significantly greater than that of any of the three individual roots, averaged 32% of the total root surface area of the maxillary first molar.
A Method for the Geometric and Densitometric Standardization of Intraoral Radiographs
Authors: Duckworth J. E. , Judy P. F. , Goodson J. M. , Socransky S. S.
Published: March 2012

The interpretation of dental radiographs for the diagnosis of periodontal disease conditions poses several difficulties. These include the inability to adequately reproduce the projection geometry and optical density of the exposures. In order to improve the ability to extract accurate quantitative information from a radiographic survey of periodontal status, a method was developed which provided for consistent reproduction of both geometric and densitometric exposure parameters. This technique employed vertical bitewing projections in holders customized to individual segments of the dentition. a copper stepwedge was designed to provide densitometric standardization, and wire markers were included to permit measurement of angular variation. In a series of 53 paired radiographs, measurement of alveolar crest heights was found to be reproducible within approximately 0.1 mm. This method provided a full mouth radiographic survey using seven films, each complete with internal standards suitable for computer‐based image processing.
The Effect of Metronidazole on Human Periodontal Disease: A Clinical and Bacteriological Study
Authors: Lekovic V. , Kenney E. B. , Carranza F. A. , Endres B.
Published: March 2012

Fifteen female subjects undergoing treatment for nonspecific vaginitis with metronidazole 250 mg q.i.d. for 7 days were studied. Clinical and microbiological evaluations were carried out initially and at 2 and 4 weeks. The following parameters were measured in two quadrants: plaque index, sulcular bleeding index, pocket depth, attachment level and amount of gingival fluid. Dark field microscopy was used to quantitate the plaque constituents. One quadrant was subjected to root planing at the initial visit; the other quadrant received no therapy. No oral hygiene instructions were given. All the clinical parameters were significantly reduced in all areas. Gingival fluid, sulcular bleeding index and pocket depth showed greater improvement in the root‐planed quadrant compared to the nonroot‐planed quadrant. Dark field microscopy showed decreases in fusiforms, curved rods and spirochetes in all areas with a concomitant increase in cocci. The root‐planed quadrant showed no significant differences in microbiological aspects when compared to the nonplaned quadrant. Clinically, metronidazole therapy resulted in improvement of periodontal status with some additional but small enhancement due to root planing. Microbiologically, metronidazole dramatically changed the quality of plaque with no supplemental effect when root planing was added.
Bacterial IgG and IgM Antibody Titers in Acute Necrotizing Ulcerative Gingivitis
Authors: Chung Chong Pyoung , Nisengard Russell J. , Slots Jørgen , Genco Robert J.
Published: March 2012

IgG and IgM antibody titers to eight bacterial isolates were measured by indirect immunofluorescence and ELISA in sera from acute necrotizing ulcerative gingivitis (ANUG) patients during the acute phase, from ANUG patients during the convalescent phase, from patients with gingivitis and from subjects with normal gingiva. Subjects were matched with respect to age and sex. Compared to the gingivitis and healthy groups, the ANUG groups exhibited significantly higher IgG and IgM titers to intermediate‐sized spirochetes and higher IgG titers to Bacteroides melaninogenicus subsp intermedius. The findings support recent studies showing that these organisms are major bacterial components in ANUG lesions. They also suggest that these bacteria proliferate above‐normal levels several weeks or months prior to the clinical onset of ANUG.
In Vivo Crevicular Leucocyte Response in Humans to a Chemotactic Challenge: Effects of Periodontal Diseases
Authors: Singh S. , Golub L. M. , Iacono V. J. , Ramamurthy N. S. , Kaslick R.
Published: March 2012

An in vivo assay was recently developed to monitor the crevicular leucocyte response to chemotactic agents, e.g., casein and N‐formyl peptides. This method was used to monitor humans with little or no gingival disease (C group), gingivitis (G group), chronic periodontitis (CP group) and localized juvenile periodontitis (LJP group). Casein (0.2 μ1, 2 mg/ml) was placed into an isolated gingival crevice of each subject with a calibrated wire loop and the time recorded (t = 0). Leucocytes were counted in crevicular washes (10 μl) 15 minutes later and every 5 minutes thereafter up to t = 50 minutes. This protocol was repeated for the crevice of an adjacent tooth except that the crevicular fluid flow response to the chemotactic challenge was monitored. The C, G and CP subjects showed a similar pattern of response to the chemoattractant with a single “peak” of leucocytes at approximately t = 25 minutes. However, the peak cell count was much greater in the G and CP groups than in the C group. LJPs showed an abnormal pattern with two leucocyte peaks, one at approximately 25 minutes and the other at 45 minutes. Both peaks tended to be higher than the single peak seen in Cs but were significantly lower than that in Gs or CPs, even at similar levels of inflammation. In addition, the peak leucocyte response (to casein) in LJPs did not increase with increasing leucocyte counts in the unchallenged (resting) crevice, whereas a positive relationship was seen in the other groups of subjects. These data suggest that this new assay may provide important diagnostic information on in vivo neutrophil migration in the gingival crevice and on susceptibility to periodontal disease.
Relationships Between Bitewing and Periapical Radiographs in Assessing Crestal Alveolar Bone Levels
Authors: Reed Brian E. , Polson Alan M.
Published: March 2012

Bitewing (bw) and periapical (pa) radiographic techniques are used in clinical and epidemiologic studies to assess crestal alveolar bone levels. Since there appeared to be no basis for choosing one technique over the other, the present study investigated relationships between these techniques by assessing alveolar crest location at the same site. BW and PA radiographs were available from posterior quadrants of 210 subjects. Individual radiographs were projected at a magnification × 5.9 using a Leitz Prado‐Universal projector. The distance from the cemento‐enamel junction to the alveolar crest (CEJ‐CR) was measured for each proximal surface from the distal of the cuspid to the distal of the second molar. Data were arranged according to the proximal surface examined, and BW and PA measurements were compared using paired t tests. In addition, the degree of congruence of the two sets (BW/PA) of CEJ‐CR measurements was evaluated through computation of the Pearson Correlation. The data showed significant differences between mean BW and PA measurements for 50% of the tooth surfaces, and this trend was consistent through maxillary and mandibular quadrants, and mesial and distal surfaces. In situations of a significant difference, the BW measurement was greater than the PA 94% of the time. The correlations between the two types of measurements showed low reliability. It was concluded that BW and PA techniques provided significantly different values in assessing crestal alveolar bone levels, and data generated by these techniques should not be used interchangeably on an individual or group basis.
Long‐Term Effect of Orthodontic Treatment on Crestal Alveolar Bone Levels
Authors: Polson Alan M. , Reed Brian E.
Published: March 2012

It was the purpose of the present study to evaluate crestal alveolar bone levels in individuals (Study group, n = 104) who had completed orthodontic treatment at least 10 years previously and compare the findings with adults who had untreated malocclusions (Control group, n = 76). Crestal alveolar bone levels were determined on both bitewing and periapical radiographs by direct measurement from the cemento‐enamel junction to the alveolar crest. Data from the individual tooth surface measurements were subjected to analyses of variance partitioned on group (Study vs Control), radiographic method, tooth type, dental arch and surface location. There was no significant difference between crestal alveolar bone levels between the study and control group. A Group/Tooth/Surface interaction occurred for the distal surface of molars. The alveolar crest level was significantly less in the orthodontically treated group. Examination of the numerical data suggested that the measured dimension was low relative to normal values, and this effect may have been related to tooth intrusion during orthodontic treatment. It was concluded that orthodontic treatment during adolescence had no detrimental long‐term effect upon crestal alveolar bone levels.
Bacterial Invasion of Periodontal Tissues in Advanced Periodontitis in Humans
Authors: Manor A. , Lebendiger M. , Shifter A. , Tovel H.
Published: March 2012

Bacterial invasion of the pocket epithelium and underlying connective tissue was found in seven cases of advanced human periodontitis. Four cases showed invasion of the epithelium as well as the connective tissue while in the other three cases bacterial invasion was limited to the pocket epithelium. The microorganisms observed included cocci, rods, filaments, fusiforms and spirochetes and these were morphologically similar to those observed in the apical zone of the subgingival plaque. Most bacteria showed typical Gram‐negative cell walls. Bacteria were seen in enlarged epithelial intercellular spaces and among debris of disintegrated epithelial cells. In the connective tissue the bacteria were seen among remnants of collagen fibers and degenerated fibroblasts. Identification of the invading microorganisms may assist in understanding the pathogenesis of chronic periodontitis.
Gingival Lesions in Leukemia: A Classification
Authors: Barrett Anthony P.
Published: March 2012

A classification of gingival lesions that may be encountered in the patient with acute leukemia during remission induction chemotherapy and following bone marrow transplantation is presented. The classification distinguishes between lesions resulting directly from the disease and treatment, and those resulting indirectly from the depression of normal bone marrow and lymphoid tissues.
Scanning Electron Microscopic Studies of Root Dentin Surfaces Treated with Citric Acid, Elastase, Hyaluronidase, Pronase and Collagenase
Authors: Willey Ruth , Steinberg Arnold D.
Published: March 2012

The effect of topical application of various enzymes to citric acid‐demineralized root surface dentin was evaluated using the scanning electron microscope. All of the enzyme treatments appeared to expose more collagen than demineralization alone. Collagenase application appeared to clear all ground substance from the collagen fibrils and may have hydrolyzed some of the fibrils themselves. The other enzymes appeared to clear partially the intercollagenous ground substance.
Relationship Between the Interproximal Distance of Roots and the Prevalence of Intrabony Pockets
Authors: Tal Haim
Published: March 2012

The interproximal distance between adjacent root surfaces and the presence of intrabony pockets (IBP) facing these surfaces, was measured and recorded during 114 gingival flap procedures in 81 patients. Measurements were carried out in 344 interproximal areas and 117 IBP were detected at these sites. The correlation between the interproximal distance and the presence of IBP was positive and statistically significant (r = 0.81; P < 0.001). The frequency of IBP increased with increasing interdental distance (slope (s) = 5.723). When interdental distances between 2.1 and 4.5 mm were analyzed separately, the correlation and slope were high (r = 0.96; P < 0.01; s = 19.87). No significant correlation (r = −0.36; P > 0.4) existed when interproximal distances greater than 4.6 mm were analyzed separately. Intrabony pockets were frequently associated with interproximal distances greater than 2.6 mm (20–57.1%). They were less common (5–20%) when the interproximal distances were less than 2.6 mm. Two IBP in the same interdental areas were present only when these areas were greater than 3.1 mm. Based upon the present data, it seems that the frequency of IBP increased as the distance between adjacent teeth increased. However, when this distance was 4.6 mm or more, no further increase in the percentage frequency of IBP was noted.