bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of a Biodegradable Chlorhexidine Chip in the Treatment of Adult Periodontitis: Clinical and Radiographic Findings
Authors: Jeffcoat Marjorie K. , Palcanis Kent G. , Weatherford Thomas W. , Reese Marion , Geurs Nico C. , Flashner Moshe
Published: February 2005

Background: Previous multi‐center trials demonstrated the efficacy of a biodegradable chlorhexidine‐gelatin chip (CHX) in reducing probing depth in patients with periodontitis. The present study utilized a subset of subjects from the parent study to determine if the CHX chip was effective in maintaining alveolar bone over a 9‐month period.

Methods: Forty‐five subjects with at least four 5 to 8 mm pockets, stratified by smoking status, were enrolled in this double‐blind controlled, placebo‐controlled trial. Control groups received either placebo chip plus scaling and root planing (SRP) or SRP alone. Test group subjects received active CHX chip or SRP alone (to maintain the blind). Standardized radiographs were taken for quantitative digital subtraction radiography at baseline and 9 months.

Results: At 9 months, 15% of SRP treated subjects experienced loss of bone in 1 or more sites, no subject treated with active chip plus SRP lost bone (P <0.01). At 9 months, significant differences in the change in probing depth and clinical attachment levels favoring the active chip over SRP alone or SRP plus CHX chip were also observed (P <0.05).

Conclusions: These data indicate that the CHX chip, when used as an adjunct to scaling and root planing, significantly reduces loss of alveolar bone. J Periodontol 2000;71:256‐262.
Normal Osteoconduction and Repair in and Around Submerged Highly Bisphosphonate‐Complexed Hydroxyapatite Implants in Rat Tibiae
Authors: Denissen Harry , Martinetti Roberta , van Lingen Arthur , van den Hooff Arnold
Published: February 2005

Background: Ceramic hydroxyapatite implants have been used in dentistry for their unique compatibility with alveolar bone. Recently it was reported that bisphosphonates may be beneficial in preventing alveolar bone destruction associated with natural and experimental periodontal disease. Furthermore, bisphosphonate does prevent resorption of alveolar bone following mucoperiosteal flap surgery. We undertook a preliminary study evaluating the effects of highly bisphosphonatecomplexed hydroxyapatite implants on osteoconduction and repair in rat tibiae.

Methods: Porous hydroxyapatite implants were pre‐incubated in 10−2M bisphosphonate solutions at pH 3.49 and pH 7.32. The implants had a diameter of 2.1 mm and a height of 2 mm and adsorbed 115 µg bisphosphonate in vitro. Bisphosphonate/hydroxyapatite implants and plain hydroxyapatite implants were inserted in opposite tibial metaphyses of 35 rats. The measurement errors for the mineral density (MD) of the implants and the proximal trabecular mineral bone density (TD) were estimated by peripheral computed tomography and the bone mineral density (BMD) measurement error by dual x‐ray absorptiometry.

Results: The measurement errors for the MD of the implants and the TD by peripheral computed tomography were 0.81% and 1.96%, respectively ex vivo. The BMD measurement error estimated by dual x‐ray absorptiometry was 0.51% ex vivo. TD and BMD for bisphosphonate/hydroxyapatite implants were insignificantly higher compared to plain hydroxyapatite implants. Bisphosphonate/hydroxyapatite pre‐incubated at pH 7.32 were found to be nondegradable implants, while bisphosphonate/hydroxyapatite (pH 3.49) implants were slowly degradable and lost a significant 5% of their density. Histologically, all bisphosphonate/hydroxyapatite implants appeared to be fully integrated and effective as bone replacement material in rat tibial bone. They exhibited vascularization and osteoconduction of tibial bone growth along and inside their porous structure.

Conclusions: Our study suggests that normal osteoconduction and repair occurred in and around the highly bisphosphonate‐complexed hydroxyapatite implants in rat tibiae. J Periodontol 2000;71:272‐278.
Tissue Response to Titanium Implants in the Rat Maxilla: Ultrastructural and Histochemical Observations of the Bone‐Titanium Interface
Authors: Futami Takayuki , Fujii Noritaka , Ohnishi Hideo , Taguchi Naoyuki , Kusakari Haruka , Ohshima Hayato , Maeda Takeyasu
Published: February 2005

Background: The detailed mechanism of osseointegration, the most appropriate implant‐bone interface, remains unclear in jaw tissues at the ultrastructural level in contrast to the many reports using long bones. The present study reports on tissue response to titanium‐implantation on an animal model using rat maxilla.

Methods: Animals were sacrificed at 1 to 28 days postimplantation and prepared tissue specimens, freed from implants by a cryofracture technique, were processed for transmission electron microscopy and histochemistry for tartrate resistant acid phosphatase activity (TRAPase).

Results: Different patterns in bone formation were recognized between lateral and base areas of implant cavities. In the lateral area with narrow gaps, bone deposition took place from the pre‐existing bone towards the implant after active bone resorption by osteoclasts reactive to TRAPase. However, no distinct bone formation appeared in the lateral area where the implant had been installed close to the osteotomy margin. On the other hand, new bone formation was found at the base area without any apparent bone resorption. Interestingly, mononuclear cells reactive to TRAPase, presumably preosteoclasts, frequently occurred near preosteoblasts. Osseointegration around the implants was obtained in this model by 28 days post‐implantation except for the lateral area with complete contact with implants, where the thin layer remained in contact with the implant surface.

Conclusions: These findings indicate that ossification proceeds at different modes around the titanium implant in rat maxilla, depending on the nature of the recipient bones and the dimension of the gap between the implant and osteotomy margin. J Periodontol 2000;71:287‐298.
Comparison of Four Methods of Assessing Root Surface Debridement
Authors: Chan Yoong K. , Needleman Ian G. , Clifford Lester R.
Published: February 2005

Background: While there is great interest in measuring the effi‐cacy of root surface debridement, there is little consensus on how this might be best achieved. The aim of this study was therefore to compare four different methods of assessing root surface debridement in their ability to discriminate between ultrasonically instrumented root surfaces and non‐instrumented control surfaces.

Methods: Single‐session subgingival root debridement was performed by an experienced operator on 30 teeth prior to their extraction. Following extraction, efficacy of root surface debridement was measured by percentage of remaining calculus, instrument efficiency, modified instrument efficiency, and percentage apical plaque border. In addition, the effect of probing depth landmark (apical plaque border versus connective tissue attachment) on outcomes was assessed.

Results: The results indicated that percentage apical plaque border demonstrated highly statistically significant differences between instrumented and control surfaces (P = 0.02). No other assessment method was able to discriminate between instrumented and non‐instrumented surfaces, and this may be a function of the low amount of root surface calculus in the experimental sample. In addition, choice of probing depth landmark had a notable effect on the outcomes for instrument efficiency and modified instrument efficiency. Ninety‐five percent limits agreement of interexaminer reproducibility were found to be much higher than intra‐examiner measurement for all four methods of assessment.

Conclusions: Percentage apical plaque border appeared to be potentially more useful than other methods for assessing the efficacy of debridement of periodontally involved root surfaces, particularly for measuring instrument penetrability. J Periodontol 2000;71:385‐393.
The Bone Regenerative Effect of Platelet‐Derived Growth Factor‐BB Delivered With a Chitosan/Tricalcium Phosphate Sponge Carrier
Authors: Lee Yong‐Moo , Park Yoon‐Jeong , Lee Seung‐Jin , Ku Young , Han Soo‐Boo , Klokkevold Perry R. , Chung Chong‐Pyoung
Published: February 2005

Background: In order to achieve optimal effects, growth factors including platelet‐derived growth factor (PDGF) should be delivered with a biodegradable carrier that will release therapeutic concentrations over a sufficient length of time. The purpose of this study was to evaluate the bone regenerative effect of PDGF‐BB delivered with a chitosan/tricalcium phosphate (TCP) sponge carrier in a rat calvarial defect model.

Methods: The PDGF‐BB–loaded chitosan/TCP sponge carrier was fabricated by freeze‐drying a mixture of chitosan solution and TCP powder and soaking in a PDGF‐BB solution. The release kinetics of PDGF‐BB loaded onto the sponge were measured in vitro with 125I‐labeled PDGF‐BB. Chitosan/TCP sponges with and without PDGF‐BB were implanted into 8 mm calvarial defects in rats. Rats were sacrificed at 2 and 4 weeks following implantation, and histologic and histomorphometrical examinations were performed.c

Results: In vitro evaluation demonstrated that an effective therapeutic concentration of PDGF‐BB following a high initial burst release was maintained throughout the examination period. In the histologic examination, the chitosan/TCP sponge carrier promoted osseous healing of the rat calvarial defects as compared to controls. The addition of PDGF‐BB to the carrier further enhanced bone regeneration. Evidence of the degraded sponge matrix was observed mingled within the newly formed bone without connective tissue encapsulation.

Conclusions: The results of this study support the use of chitosan/TCP sponges as a delivery system for growth factors and demonstrate that PDGF‐BB loaded onto chitosan/TCP sponge carriers has an osteogenic effect on bone regeneration in vivo. J Periodontol 2000;71:418‐424.
Effect of Smoking on Periodontal Health in Molar Teeth
Authors: Kerdvongbundit Varunee , Wikesjö Ulf M.E.
Published: February 2005

Background: It is generally accepted that the primary cause of periodontitis is bacterial infection of long duration. In addition, there are several risk factors that may increase the probability and severity of periodontitis. For example, an increased breakdown of alveolar bone has been observed in smokers compared to never‐smokers. The objective of this study was to investigate the association between cigarette smoking and periodontal health, in particular, furcation involvement in molar teeth.

Methods: One hundred twenty (120) adult regular dental patients, presenting with at least 20 teeth each, third molars excluded, were evaluated. Sixty of the subjects consumed an average (± SD) of 16.8 ± 3.8 cigarettes daily and had smoked for 21.4 ± 5.7 years. The remaining subjects presented a negative history of smoking. Periodontal conditions for the molar teeth were recorded at the first and second mandibular molar buccal furcation area.

Results: Oral hygiene standards and dental care habits did not differ notably between smokers and never‐smokers. Smokers exhibited significantly fewer molar teeth than never‐smokers (2.2 ± 1.1 versus 3.0 ± 0.8; P <0.01). Also, smokers exhibited significantly advanced gingival recession, probing depth, clinical attachment loss, furcation involvement, and tooth mobility compared to never‐smokers (P <0.01).

Conclusions: The results of this study suggest that long‐term cigarette smoking significantly worsens periodontal health including degree and incidence of furcation involvement in molar teeth. J Periodontol 2000;71:433‐437.
Actinobacillus actinomycetemcomitans in Destructive Periodontal Disease. Three‐Year Follow‐Up Results
Authors: Buchmann Rainer , Müller Rüdiger F. , Heinecke Achim , Lange Dieter E.
Published: February 2005

Background: Convincing data exist that A. actinomycetemcomitans is an etiologic agent of periodontal disease. The purpose of this longitudinal study was to evaluate A. actinomycetemcomitans as a diagnostic indicator for periodontal disease in treated and periodontally maintained patients.

Methods: Following comprehensive mechanical/surgical and supportive amoxicillin plus metronidazole therapy in 13 subjects with A. actinomycetemcomitans‐associated destructive periodontal disease, we monitored subgingival A. actinomycetemcomitans at 4 individual sites in each patient up to 3 years post‐therapy. The periodontal status was determined, and A. actinomycetemcomitans levels were quantitatively enumerated on TSBV agar in CFU/ml. Six patients with a persistence of subgingival A. actinomycetemcomitans at each reexamination within 3 years post‐therapy were selected to be at risk for minor periodontal treatment outcomes and further recurrence of periodontal disease (test group). Seven subjects with a complete suppression of A. actinomycetemcomitans at each post‐therapy visit served as controls.

Results: The periodontal parameters decreased from overall values of 6.39 mm (probing depth, PD) and 7.64 mm (clinical attachment level, CAL) at the outset to 3.81 mm (PD) and 5.62 mm (CAL) 2 years post‐therapy (Friedman, P ≤0.05). At the 3‐year reexamination, the PD/CAL scores increased to 4.03/5.78 mm. Among the 6 individuals (46%) with persistence of subgingival A. actinomycetemcomitans at the final 3‐year visit (test group), periodontal status yielded increased levels of 4.45 mm (PD) and 6.60 mm (CAL). The control subjects (n = 7) revealed lower values of 3.67 mm (PD) and 5.09 mm (CAL). However, on a patient level, during the 3‐year observational trial, the periodontal status of the 13 individuals was not statistically affected by subgingival infection with A. actinomycetemcomitans.

Conclusions: Although in advanced periodontal disease, comprehensive mechanical and antimicrobial treatment is an appropriate regimen for sustained improvement of periodontal health, long‐term control of subgingival infection with A. actinomycetemcomitans could not be achieved. In the maintenance care of destructive periodontitis, the persistence of A. actinomycetemcomitans is not a diagnostic parameter for periodontal disease. J Periodontol 2000;71:444‐453.
The Importance of Data Presentation Regarding Gingival Crevicular Fluid Myeloperoxidase and Elastase‐Like Activity in Periodontal Disease and Health Status
Authors: Yamalik Nermin , Çağlayan Feriha , Kilinç Kamer , Kilinç Asuman , Tümer Celal
Published: February 2005

Background: The enzymatic profile of gingival crevicular fluid (GCF) is being analyzed with increasing interest, but related studies lack a general consensus on most methodological points, including the appropriate mode of data presentation.

Methods: GCF myeloperoxidase (MPO) and elastase‐like activity (ELA) levels were spectrophotometrically determined on a total of 60 subjects who were divided into three equal subgroups as early‐onset periodontitis (EOP), adult periodontitis (AP), and healthy. GCF enzyme levels were calculated and evaluated both as total enzyme activity and enzyme concentration. The correlations between these GCF enzymes and clinical periodontal status were also analyzed.

Results: With both modes of data presentation, the results regarding MPO activity were consistent. When presented either as total MPO activity or MPO concentration, the periodontally healthy group showed significantly lower MPO activity than the two patient groups (P <0.05). However, two modes of data presentation did not match when GCF ELA was concerned. When data were reported as total ELA, the healthy group exhibited lower enzyme activity (0.02 ± 0.001 U) than EOP (0.04 ± 0.01 U) and AP (0.06 ± 0.02 U) groups; but when reported as concentration, the highest ELA levels were seen in the healthy group (221 ± 31.53 nmol/min/ml), followed by AP (98.63 ± 23.03 nmol/min/ml) and EOP (70.49 ± 12.02 nmol/min/ml) (P <0.05). A strong‐positive and significant correlation existed between GCF MPO and ELA. Correlations with clinical parameters were mostly observed with total activities.

Conclusions: The findings of the present study confirm the relationship between GCF ELA and MPO activity and periodontal disease and also support the functional relativity between the two enzymes. Furthermore, based on these findings, it can be suggested that data presentation by use of total activity seems to be more sensitive in both the reflection of the actual enzymatic profile of GCF and also the existing clinical periodontal status. For each GCF component, the validity of different modes of data presentation should be considered. J Periodontol 2000; 71:460‐467.
Experimental Stress Suppresses Recruitment of Macrophages But Enhanced Their P. gingivalis LPSStimulated Secretion of Nitric Oxide
Authors: Shapira Lior , Frolov Igor , Halabi Amal , Ben‐Nathan David
Published: February 2005

Background: Epidemiological studies have suggested that stress can alter the onset and progression of periodontal disease. However, the mechanisms involved are not clear. The present study was designed to examine whether the functional response of mouse macrophages stimulated by Porphyromonas gingivalis lipopolysaccharide (LPS) is affected by experimental stress, and to investigate the role of corticosterone (CS) in the stress‐related effects.

Methods: Two models of stress were used: emotional (isolation) and physical (cold). We measured thioglycollate‐induced macrophage recruitment in vivo, and LPS‐induced nitric oxide (NO) secretion by the macrophages in vitro. Two groups of mice were exposed to the stress conditions: isolation or cold. A third group was injected daily with CS, and a fourth group was used as a control (no stress). After 3 days of stress conditions, thioglycollate was injected into the peritoneal cavity. Four days later, peritoneal macrophages were isolated, counted, and cultured. The secretion of NO by the cultured cells was evaluated with and without P. gingivalis LPS stimulation.

Results: The number of cells in the peritoneal lavage of stressed mice was significantly reduced in comparison to macrophages isolated from non‐stressed animals. The number of macrophages from CS‐treated mice did not differ from controls. NO secretion from unstimulated macrophages did not differ between the stressed and control groups. Stimulation of the macrophages with P. gingivalis LPS significantly enhanced NO secretion by macrophages from the control and stressed animals, but not by the CStreated group. NO levels secreted by P. gingivalis‐stimulated cells from the two stressed groups were significantly higher than the levels secreted by controls, and the isolation group released significantly higher levels than the cold group. Stimulation of the macrophages with P. gingivalis LPS and interferon (IFN)‐γ resulted in enhanced NO secretion in the 4 groups compared to LPS alone, with no significant differences between the groups.

Conclusions: The results suggest that experimental stress modulates the response of macrophages to inflammatory stimulants, and that CS is not the sole mediator involved. The presence of IFN‐γ in the culture may mask the functional differences induced by stress. The stress‐induced upregulation of NO secretion might be involved in the accelerated periodontal destruction in stressed subjects. J Periodontol 2000;71:476‐481.
Ridge Augmentation Following Implantation of Recombinant Human Bone Morphogenetic Protein‐2 in the Dog
Authors: Barboza Eliane Porto , Duarte Maria Eugênia Leite , Geolás Luiz , Sorensen Rachel G. , Riedel Gerard E. , Wikesjö Ulf M.E.
Published: February 2005

Background: Recombinant human bone morphogenetic protein‐2 (rhBMP‐2) in an absorbable collagen sponge (ACS) carrier induces bone for reconstruction of skeletal defects. The rhBMP‐2/ACS implant is prepared by administering a rhBMP‐2 solution to dry ACS. Once prepared, rhBMP‐2/ACS forms a moldable, cohesive, and adhesive implant. However, rhBMP‐2/ACS does not have sufficient structural strength to withstand soft tissue compression at specific anatomic sites. To more fully understand the mechanisms that affect bone induction by rhBMP‐2/ACS in the presence of soft tissue compression, it would be useful to have a preclinical model that appropriately simulates such circumstances in patients. This pilot study evaluated one such potential model.

Methods: Bilateral, Class III alveolar defects were surgically produced in 4 adult mongrel dogs following extraction of the mandibular fourth premolars and reduction of the alveolar ridge. After an 8‐week healing interval, mucoperiosteal flaps were elevated and rhBMP‐2/ACS or rhBMP‐2/ACS combined with hydroxyapatite (HA) was implanted into contralateral defects. The animals were euthanized at 12 weeks post‐augmentation and block biopsies processed for histologic evaluation.

Results: Limited augmentation followed implantation of rhBMP‐2/ACS (0.7 ± 0.6 mm). In contrast, sites receiving rhBMP‐2/ACS/HA exhibited clinically relevant ridge augmentation (5.5 ± 1.6 mm). Defects implanted with rhBMP‐2/ACS exhibited dense trabeculation within the corpus of the reduced alveolar process. The cortices appeared intact without evidence of expansion into the defect area. Three defects receiving rhBMP‐2/ACS/HA exhibited sparse bone trabeculae amidst HA particles, fibrovascular tissue, and marrow. Commonly, the HA particles were encapsulated by fibrous tissue. Some particles were observed in contact with bone.

Conclusions: The results suggests that rhBMP‐2/ACS has limited effect alone in this augmentation model of Class III alveolar ridge defects. Inclusion of HA into the rhBMP‐2 construct results in clinically relevant augmentation, however, the quality of bone is compromised. J Periodontol 2000;71:488‐496.
Radiographic and Digital Imaging in Periodontal Practice
Authors: Hausmann Ernest
Published: February 2005

This review defines terms such as accuracy, validity, and reliability, which are used to describe the quality of methods for taking x‐rays and for analyzing digital images. Values for these parameters are described for techniques of taking standardized x‐rays such as ear‐rod fixation and fixation by use of teeth with a dental impression. In addition, values are given for linear measurements on digitized images and for quantitative image subtraction. Differences are addressed between quantitative subtraction with a reference ramp and relative subtraction using the computer‐assisted densitometric image analysis (CADIA) system. The relationship between radiographic bone height and clinical attachment level is also discussed. Finally, present and future use in the periodontal office of linear radiographic measurements on digital images and digital subtraction is discussed. J Periodontol 2000;71:497‐503.
Therapy for a Patient With Oligodontia: Case Report
Authors: Wagenberg Barry D. , Spitzer Donald A.
Published: February 2005

Oligodontia, the congenital absence of numerous teeth, presents many problems for both patient and therapist. Chief among these is the sequence and timing of orthodontic therapy, implant placement, and restorative dentistry. The absence of teeth can pose not only functional but psychosocial problems for young people. This report details a young woman who was diagnosed with oligodontia at age 9, treated using a multidisciplinary approach, and followed for 12 years. J Periodontol 2000;71:510‐516.
Treatment With Subantimicrobial Dose Doxycycline Improves the Efficacy of Scaling and Root Planing in Patients With Adult Periodontitis
Authors: Caton Jack G. , Ciancio Sebastian G. , Blieden Timothy M. , Bradshaw Mark , Crout Richard J. , Hefti Arthur F. , Massaro Joseph M. , Polson Alan M. , Thomas John , Walker Clay
Published: February 2005

Background: In a previous study, subantimicrobial dose doxycycline (SDD) significantly improved clinical parameters associated with periodontal health in patients with adult periodontitis (AP) when used as an adjunct to a maintenance schedule of supragingival scaling and dental prophylaxis. In this double‐blind, placebo‐controlled, parallel‐group, multicenter study, the efficacy and safety of SDD were evaluated in conjunction with scaling and root planing (SRP) in patients with AP.

Methods: Patients (n = 190) received SRP at the baseline visit and were randomized to receive either SDD 20 mg bid or placebo bid for 9 months. Efficacy parameters included the per‐patient mean changes in clinical attachment level (CAL) and probing depth (PD) from baseline, the per‐patient percentages of tooth sites with attachment loss (AL) ≥2 mm and ≥3 mm from baseline, and the per‐patient percentage of tooth sites with bleeding on probing. Prior to analysis, tooth sites were stratified by the degree of disease severity evident at baseline

Results: In tooth sites with mild to moderate disease and severe disease (n = 183, intent‐to‐treat population), improvements in CAL and PD were significantly greater with adjunctive SDD than with adjunctive placebo at 3, 6, and 9 months (all P <0.05). In tooth sites with severe disease, the per‐patient percentage of sites with AL ≥2 mm from baseline to month 9 was significantly lower with adjunctive SDD than with adjunctive placebo (P <0.05). Improvements in clinical outcomes occurred without detrimental shifts in the normal periodontal flora or the acquisition of doxycycline resistance or multiantibiotic resistance. SDD was well tolerated, with a low incidence of discontinuations due to adverse events.

Conclusions: The adjunctive use of SDD with SRP is more effective than SRP alone and may represent a new approach in the long‐term management of AP. J Periodontol 2000;71:521‐532.
Effect of a Ceramic and a Non‐Ceramic Hydroxyapatite on Cell Growth and Procollagen Synthesis of Cultured Human Gingival Fibroblasts
Authors: Ruano Rogério , Jaeger Ruy G. , Jaeger Márcia M.M.
Published: February 2005

Background: Ceramic hydroxyapatites and non‐ceramic hydroxyapatites have been used extensively as alloplastic materials for bone reconstruction. However, different forms of hydroxyapatite induce different types of tissue response.

Methods: Human gingival fibroblasts (FMM1 cells) were used to analyze ceramic and non‐ceramic hydroxyapatite biocompatibility. The cells were grown on surfaces covered either by collagen (control group), collagen plus ceramic hydroxyapatite, or collagen plus non‐ceramic hydroxyapatite. Scanning electron microscopy, growth and cell viability curves, and procollagen immunoprecipitation were obtained. For the growth and viability curves, 104 cells were seeded on 60 mm dishes. Cells from each group were counted, in triplicate, at 1, 3, 4, 5, and 6 days after seeding using the Trypan blue dye exclusion assay.

Results: The cells grew in close contact with both types of hydroxyapatite particles. No differences were found in the amount of procollagen synthesis among any experimental group. The cultures treated with ceramic hydroxyapatite had a growth delay for the first 5 days. There was no difference in cell viability between the control group and the non‐ceramic hydroxyapatite group. However, cultures treated with ceramic hydroxyapatite showed significantly lower viability percentages than the other groups.

Conclusions: Hydroxyapatite supports cell growth and fibroblast metabolism including collagen production, and hence is biocompatible. Cell viability and structural studies showed that non‐ceramic hydroxyapatite has relevant physical and biological properties as an implant material. J Periodontol 2000;71:540‐545.
The Prevalence of Pathogenic Periodontal Microflora in Healthy Young Adult Smokers
Authors: Shiloah Jacob , Patters Mark R. , Waring Margaret B.
Published: February 2005

Background: Smoking is a major risk factor in periodontitis, although the mechanisms of its effects are not well understood. The overall goal of this clinical study was to determine if smoking enhances the colonization of the oral cavity by pathogenic bacteria in a periodontitis‐free population. The prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus, Eikenella corrodens, Bacteroides forsythus, and Treponema denticola was investigated in 25 smokers and 25 non‐smokers by using DNA probes.

Methods: The subjects were 21 to 35 years of age with a healthy periodontium or slight gingivitis and were systemically healthy. The test group included subjects who had a minimum of a 1.5 pack‐year history of smoking, while the control subjects never smoked. Subgingival plaque samples were taken by paper point following the assessment of multiple clinical parameters.

Results: This investigation showed: 1) no statistically significant differences were noted in any clinical parameter measured between the groups; 2) of the 8 subjects who were infected by at least 1 tested pathogen, seven were smokers (P = 0.02); 3) infected smokers had a 15.7 ± 3.5 pack‐year history and smoked a mean of 27 ± 5 cigarettes/day versus 4.4 ± 0.8 pack years and 15 ± 1 cigarettes/day for the non‐infected smokers (P = 0.0001 and P = 0.004); and 4) smokers were 18 times more likely to exhibit the presence of pathogens than non‐smokers.

Conclusions: These data indicate that the prevalence of colonization of the sulcus by pathogenic bacterial species in periodontitis‐free individuals is related to the quantity and duration of cigarette smoking. J Periodontol 2000;71:562‐567.
Expression of Molecules Involved in Antigen Presentation and T Cell Activation (HLA‐DR, CD80, CD86, CD44 and CD54) by Cultured Human Osteoblasts
Authors: Reyes‐Botella C. , Montes M.J. , Vallecillo‐Capilla M.F. , Olivares E.G. , Ruiz C.
Published: February 2005

Background: Osteoblasts express the CD44 antigen and HLA class II antigens, molecules which, together with other costimulatory molecules such as CD80, CD86, and CD54, are involved in antigen presentation and T cell activation. The aim of this study was to investigate the expression of these molecules in human osteoblasts.

Methods: Human osteoblastic cells obtained from samples of normal bone obtained during mandibular osteotomy were isolated, maintained in culture, and characterized. The identity of the cells was confirmed by their alkaline phosphatase activity and their capacity to produce osteocalcin. Flow cytometry was used to examine the expression HLA‐DR, CD80, CD86, CD44, and CD54 molecules involved in immune activities.

Results: We detected the expression of CD10, CD44, and HLA‐DR antigens, molecules involved in antigen presentation in cultured osteoblastic cells. Although the cells were negative for CD45, the leukocyte common antigen and CD14 (an antigen detected on macrophages), they expressed CD54, CD80, and CD86 antigens, which are also involved in the mechanisms of antigen presentation to and activation of T cells.

Conclusions: Our results suggest that osteoblastic cells or a subpopulation of these cells may have immune functions in bone. Further studies in which immune functions are assessed will be needed to test this hypothesis. J Periodontol 2000;71:614‐617.
Analysis of Human Gingival Tissue and Gingival Crevicular Fluid β‐Glucuronidase Activity in Specific Periodontal Diseases
Authors: Layik Meral , Yamalik Nermin , Çaglayan Feriha , Kilinç Kamer , Etikan Ilker , Eratalay Kenan
Published: February 2005

Background: β‐glucuronidase (βG) is one of the enzymes involved in the destruction of non‐collagenous components of the extracellular matrix. It is also considered an indicator or predictor of periodontal disease activity. The present study was conducted to determine the presence and the levels of βG activity in gingival tissue and gingival crevicular fluid (GCF) in periodontal disease and health status. The validity of 2 expressions of data, total βG activity versus βG concentration, and the correlations between clinical periodontal status and βG profile was also evaluated.

Methods: βG activities in gingival tissues and GCF samples from 57 individuals, divided into 3 equal groups of adult periodontitis (AP), early‐onset periodontitis (EOP), and periodontally healthy subjects were spectrophotometrically examined.

Results: Both patient groups had higher βG levels in both gingiva and GCF than controls. Significant differences were observed among all groups when total GCF βG activities were examined (P <0.05). However, the difference between AP and controls was not significant when concentration values were compared (P >0.05). The highest GCF βG activity, with both expressions, was detected in EOP group. No absolute correlations between clinical parameters and βG activity were observed, except for random correlations in the patient groups with mean total βG activities. Also GCF/gingiva βG levels and the 2 expressions did not show absolute correlations.

Conclusions: The findings of the present study confirm the relationship between βG activity and periodontal diseases. The differences in data concerning GCF total βG activity and βG concentration may suggest that they are not matching measures. Data presentation seems to be an important factor in GCF/enzyme profile studies. J Periodontol 2000;71:618‐624.
Bone Probing Measurement as a Reliable Evaluation of the Bone Level in Periodontal Defects
Authors: Kim Hyun‐Young , Yi Seung‐Won , Choi Seong‐Ho , Kim Chong‐Kwan
Published: February 2005

Background: Evaluation of periodontal regeneration is usually made by clinical measurements despite their limitations in determining the precise nature of the healing response. In the present study, the possibility of using bone probing measurements under local anesthesia to determine bone level changes without a re‐entry procedure was investigated.

Methods: Thirty‐eight (38) first molars in 28 patients with chronic periodontitis who were scheduled to have periodontal surgery were included in this study. A custom‐made acrylic resin stent was used for proper orientation of the probe for the bone probing depth measurement as well as probing depth measurements and surgical and radiographic bone level evaluations. The mesial, distal, and middle sites in the buccal aspect of each tooth were used. The sites were divided into 2 groups according to probing depth: those with a probing depth < 4 mm and those with a probing depth ≥ 4 mm.

Results: The probing depth was not significant in the difference between actual bone level (SBL) and bone probing depth (BP) (P >0.05). The greatest correlation to SBL was found with BP (γ = 0.92), followed by radiographic bone level (RBL) (γ = 0.69). The morphology of the defects had no significant effect on the difference between SBL and other measurements, while tooth surface and probing depth had significant effects on the difference between RBL and SBL.

Conclusions: The results of this study suggest that, regardless of probing depth, probing surface, and the presence of intrabony defects, there is a minimal difference between the BP and SBL. Determining the bone probing depth measurement is a kind of reliable method to estimate the regenerated bone level following periodontal treatment. J Periodontol 2000;71:729‐735.
Histologic Evaluation of Periodontal Healing in Humans Following Regenerative Therapy With Enamel Matrix Derivative. A 10‐Case Series
Authors: Yukna Raymond A. , Mellonig James T.
Published: February 2005

Background: Enamel matrix derivative (EMD) has been developed as a stimulus of periodontal regeneration. Human histology following its use has not been evaluated on pathologically altered root surfaces.

Methods: Ten intrabony defects in 8 patients were evaluated at 2 centers. Teeth with advanced adult periodontitis that were treatment planned for extraction were treated with sulcular incisions; full‐thickness flap reflection; debridement of granulomatous tissue from the defect; placement of a notch in the root at the apical extent of calculus; mechanical root planing; conditioning with citric acid; application of EMD; wound closure with sutures; and placement of a periodontal dressing. Biweekly to monthly recalls were made until removal of small block section biopsies at about 6 months. The biopsies were fixed, decalcified, step‐serial sectioned at 6µ to 8µ, and stained with hematoxylin and eosin or Masson's trichrome.

Results: Histologic evaluation of the region coronal to the base of the calculus notch showed evidence of regeneration (new cementum, new bone, and new periodontal ligament) in 3 specimens, new attachment (connective tissue attachment/adhesion only) in 3 specimens, and a long junctional epithelium in 4 specimens. No evidence of root resorption, ankylosis, or untoward inflammation was seen.

Conclusions: The results of this study fulfill the proof of principle that use of EMD can result in periodontal regeneration on previously diseased root surfaces in humans, but on an inconsistent basis. J Periodontol 2000;71:752‐759.
Regeneration of Class III Furcation Defects With Basic Fibroblast Growth Factor (b‐FGF) Associated With GTR. A Descriptive and Histometric Study in Dogs
Authors: Rossa Carlos , Marcantonio Elcio , Cirelli Joni A. , Marcantonio Rosemary A.C. , Spolidorio Luis C. , Fogo José C.
Published: February 2005

Background: The poor predictability of periodontal regenerative treatment of Class III furcation defects stimulates the study of alternatives to improve its results, such as the use of polypeptide growth factors. The objective of this study was to evaluate, both histologically and histometrically, the effects of topical application of basic fibroblast growth factor (b‐FGF) associated with guided tissue regeneration (GTR) in the treatment of Class III defects surgically induced in dogs.

Methods: All second and fourth premolars of 5 mongrel dogs were used and randomly assigned to one of three treatment groups: group 1 (control), treated with scaling and root planing, tetracycline hydrochloride (125 mg/ml) conditioning, and GTR with a collagen membrane; group 2, same treatment as group 1 plus 0.5 mg of b‐FGF; group 3, same treatment as group 1 plus 1.0 mg of b‐FGF. After a 90‐day healing period, routine histologic processing and staining with hematoxylin and eosin and Masson trichrome were performed.

Results: The descriptive analysis indicated better regenerative results in both groups treated with b‐FGF while the histometric data, analyzed by means of analysis of variance (ANOVA), showed greater filling of the defects in group 2 in comparison to the defects in groups 3 and 1, respectively, which was represented by a smaller area of plaque‐occupied space (P = 0.004) as well as a greater amount of newly formed cementum (P = 0.002).

Conclusions: These results indicate that b‐FGF, especially in smaller doses, may enhance the regenerative results in Class III furcation lesions, leading to greater filling of these defects with both mineralized and non‐mineralized tissues. J Periodontol 2000; 71:775‐784.
Pluronic Polyol Effects on Human Gingival Fibroblast Attachment and Growth
Authors: Hokett Steven D. , Cuenin Michael F. , O'Neal Robert B. , Brennan William A. , Strong Scott L. , Runner Royce R. , McPherson James C. , Van Dyke Thomas E.
Published: February 2005

Background: Enhanced speed of human gingival fibroblast (HGF) spreading and attachment, as affected by ionic bonding interactions, may facilitate cell orientation and subsequent collagen synthesis to promote early wound healing. The purpose of this study was to determine the in vitro effects of pluronic polyols, a family of widely used surfactants currently used as drug carriers for antibiotic, anti‐inflammatory, and anti‐neoplastic agents, on the attachment and growth of human gingival fibroblasts (HGF) to dentin and plastic surfaces using established tissue culture techniques.

Methods: Plastic culture wells containing Eagle's minimal essential media (EMEM) with 10% fetal calf serum and Pluronic F‐68 or F‐127 in concentrations from 1.2 × 10−2 to 1.2 × 10−10 M were incubated with HGF and run in replicates of ten. Attached cells were quantified by measuring the optical density of methylene blue‐stained cells. Additional experiments were conducted using human dentin sections as a substrate and Pluronic F‐68 or F‐127 at a concentration of 1.2 × 10−8 M. In these experiments, HGF were stained with acridine orange and quantified per unit area of dentin by fluorescence microscopy.

Results: Attachment and growth of HGF to both plastic and dentin were significantly increased over serum controls by very low concentrations of Pluronic F‐68 and F‐127 by 30 minutes, with attachment reaching a plateau at 2 hours.

Conclusions: Pluronic polyols, a family of widely used surfactants, in very low dosages may be beneficial in early postsurgical wound healing by facilitating early attachment and enhancing the growth rate of human gingival fibroblasts. J Periodontol 2000;71:803‐809.
Effects of Diode and Nd:YAG Laser Irradiation on Titanium Discs: A Scanning Electron Microscope Examination
Authors: Romanos George E. , Everts Hayo , Nentwig Georg H.
Published: February 2005

Background: Dental lasers have been recommended for uncovering submerged implants as well as decontaminating implant surfaces when treating peri‐implantitis. The aim of this study was to show the possible alterations in titanium disc surfaces using an Nd:YAG or a diode laser.

Methods: Three different titanium discs were used (sandblasted, titanium plasma‐sprayed [TPS], and hydroxyapatite [HA] coated) to determine the effects of laser irradiation on these surfaces using a scanning electron microscope (SEM). The discs were either irradiated with a pulsed Nd:YAG laser with a contact handpiece and power settings of 2.0, 4.0, and 6.0W or with a diode laser at 5.0, 10.0, and 15.0W power settings and continuous wave (cw) in the contact handpiece. Irradiated areas were compared with control titanium sites which were not lased. The specimens were prepared for SEM examination after the disc irradiation.

Results: The SEM examination demonstrated extensive melting in all of the Nd:YAG laser irradiated areas. Damage was seen in all TPS‐ and HA‐coated discs even at the lowest power setting. Loss of porosity, coating microfractures, and a relatively smooth surface were observed. In contrast, the diode laser did not cause any damage or modify the disc surface. Regardless of the power setting, there was no visible difference between lased and non‐lased surfaces after cw irradiation with the diode laser.

Conclusions: From these findings, it was concluded that the diode laser (980 nm) does not damage titanium surfaces, which should be of value when uncovering submerged implants and treating peri‐implantitis. J Periodontol 2000;71:810‐815.
Features of Severe Periodontal Disease in a Teenager With Chédiak‐Higashi Syndrome
Authors: Delcourt‐Debruyne Elisabeth M.C. , Boutigny Hervé R.A. , Hildebrand Hartmut F.
Published: February 2005

Background: Chédiak‐Higashi syndrome (C‐HS) is a rare congenital disease characterized by defective neutrophil function with abnormal lysosomal inclusions, neutropenia, and reduced chemotaxis. The complete syndrome includes oculocutaneous albinism with photophobia, neurologic features, recurrent infections, and enterocolitis.

Methods: A 14‐year‐old male C‐HS patient was referred to us because of serious periodontal destruction with acute inflamed gingiva and ulcers. Clinical and biological investigations were performed, leading to the diagnosis of C‐HS.

Results: Laboratory findings included neutropenia and hypergammaglobulinemia. Peripheral blood smears showed giant granules in neutrophils, eosinophils, and granulocytes. Bone marrow smears showed giant inclusions in leukocyte precursor cells. These granules and inclusions were characteristic of Chédiak‐Higashi syndrome. Oral radiographic status showed extensive loss of alveolar bone leading, in most cases, to tooth exfoliation. Bacteria often associated with periodontitis were detected in subgingival plaque samples, including Fusobacterium nucleatum, Campylobacter rectus, Prevotella melaninogenica, Peptostreptococcus anaerobius, and Clostridium sp. Biopsies of periodontal tissues for light and electronic microscopic examinations revealed massive bacterial invasion of the epithelial tissue, epithelial cells, and connective tissue. Ultrastructural observations of periodontal polymorphonuclear leukocytes showed defective granulation, with abnormal granules not discharging their lysosomal content against engulfed bacteria. Viable dividing bacteria were found in the cytoplasm.

Conclusions: In this case, early‐onset periodontitis seems to be the expression of C‐HS granulocyte deficiency. Periodontal treatment of these patients is often unsuccessful. This case report illustrates the importance of the dentist in initiating clinical and biological investigations in such early aggressive periodontitis in young patients. J Periodontol 2000;71:816‐824.
Immediate Loading of Implants in Partially and Fully Edentulous Jaws: A Series of 27 Case Reports
Authors: Jaffin Robert A. , Kumar Akshay , Berman Charles L.
Published: February 2005

Background: The concept of immediate loading of dental implants has been researched in animal and man. High predictability with titanium screw implants can be expected under certain circumstances. Delayed loading, which is empirically based, may offer roadblocks to success in the complex case. Micromotion under a denture, retention of compromised teeth, and the necessity for multiple implant surgeries complicate the situation. The present study was undertaken to demonstrate whether in partial and fully edentulous patients, titanium screw implants may be installed and loaded within 72 hours.

Methods: The study included 27 jaws (23 mandibles and 4 maxillas) in patients who refused to wear a denture or were told of the possibility of immediately loading their implants. Criteria similar to delayed loading was utilized. The patient had to have adequate volume and density for a minimum of 4 (10 mm) implants in the mandible and 6 in the maxilla, in addition to other requirements. After a thorough presurgical evaluation by the restorative dentist, a template and heat‐cured/metal‐reinforced provisional were fabricated. Following fixture installation, either the fixed provisional was placed or an impression was taken, and the provisional was seated within 72 hours. Once the temporary was placed, it remained until osseointegration was complete.

Results: Success rates similar to those in delayed loaded cases may be expected (95%). Fewer sandblasted/acid‐etched titanium screws were lost than machined titanium screws. All patients went on to completion of their original prosthetic prescription.

Conclusions: Patients who are partially or fully edentulous may predictably be restored with fixed implant prostheses immediately upon fixture placement if certain parameters are met. J Periodontol 2000;71:833‐838.
Long‐Term Follow‐up of Periodontitis in a Patient With Chédiak‐Higashi Syndrome. A Case Report
Authors: Shibutani Toshiaki , Gen Keika , Shibata Maki , Horiguchi Yumi , Kondo Naomi , Iwayama Yukio
Published: February 2005

Chédiak‐Higashi syndrome (CHS) is an extremely rare hereditary disease characterized by leukocyte dysfunction. We report on a 21‐year‐old woman who presented at the age 9 years with CHS and serious periodontal tissue destruction around erupted teeth. The patient had received systemic, radiographic, immunological, microbial, and clinical periodontal examinations since childhood. The chemotactic activity of neutrophils in the Boyden chamber assay was 22% of the control, and leukocyte bactericidal activity was one‐third of the control. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia were isolated from periodontal pockets. Periodontal treatment including oral hygiene was provided, followed by professional tooth cleaning from the age of 12 to 21 years. However, the mobility of teeth and the inflammation of periodontal tissue progressed. This CHS patient presented with periodontal disease of extremely early onset, which was resistant to periodontal treatment. J Periodontol 2000;71:1024‐1028.