bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelet Concentrates: Effects of Calcium and Thrombin on Endothelial Cell Proliferation and Growth Factor Release
Authors: Lacoste Eric , Martineau Isabelle , Gagnon Guy
Published: February 2005

Background: Clinical evidence suggests that platelet concentrate (PC) could have beneficial therapeutic effects on hard and soft tissue healing, due to the contents of growth factors (GFs) stored in the platelets. The objectives of this study were: 1) to determine the concentrations of platelet‐derived growth factor‐BB (PDGF‐BB), transforming growth factor‐β1 (TGF‐β1), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF) released from PCs and whole blood (WB), before and after the addition of various concentrations of calcium and thrombin, and 2) to assess the physiological importance of the released GFs on angiogenesis.

Methods: WB and PCs were harvested and prepared from three healthy volunteers. Enzyme‐linked immunosorbent assay tests, specific for PDGF‐BB, TGF‐β1, VEGF, and bFGF, were performed on WB and PC supernatants, collected before and 30 minutes after the addition of various concentrations of calcium and thrombin. The supernatants were also added to human umbilical vein endothelial cell (HUVEC) cultures in order to measure their effects on endothelial cell proliferation.

Results: Growth factor concentrations detected in PC supernatants were significantly greater (280% to 800% increase) than concentrations present in WB supernatants. Calcium and thrombin induced immediate GF release from PCs in a dose‐dependent fashion. Furthermore, PC supernatants led to greater HUVEC proliferation rates than WB supernatants. However, there was no correlation between the concentrations of specific GFs and HUVEC proliferation rates.

Conclusion: These results suggest that PCs could stimulate blood vessel formation. They also reinforce the relevance for using PCs in regenerative therapies. J Periodontol 2003;74:1498‐1507.
Granulocytic Sarcoma of Gingiva: An Unusual Case with Aleukemic Presentation
Authors: Antmen B. , Haytac M.C. , Sasmaz I. , Dogan M.C. , Ergin M. , Tanyeli A.
Published: February 2005

Background: Granulocytic sarcoma (GS) is an uncommon extramedullary tumor composed of dense aggregates of immature myeloid precursor cells, which is usually associated with acute or chronic myeloid leukemia. The tumor may also be a predecessor to acute myeloid leukemia (AML). It may be found in any location throughout the body; however, intraoral occurrence is extremely rare. This report describes a case of gingival granulocytic sarcoma that developed prior to AML in a 12‐year‐old female.

Methods and Results: The patient, who had a 3‐month history of gingival enlargement, was diagnosed as having granulocytic sarcoma based on clinical, radiological, and histological findings. Although the tumor regressed significantly after two induction chemotherapy courses, the patient subsequently died due to pneumococcal sepsis and pleurisy.

Conclusion: This case report affirms the importance of granulocytic sarcoma in the differential diagnosis of gingival enlargements, since the tumor may occur before bone marrow involvement by leukemic cells. J Periodontol 2003;74:1514‐1519.
A Simplified Classification and Repair System for Sinus Membrane Perforations
Authors: Fugazzotto Paul A. , Vlassis James
Published: February 2005

A classification and repair system is presented for the management of sinus membrane perforations, based upon membrane location and severity. The results of 19 consecutively treated cases are presented. All cases of sinus membrane perforation were appropriately managed, resulting in successful sinus augmentation therapy, implant placement, and restoration. All implants were functioning successfully at the time of statistical compilation. J Periodontol 2003;74:1534‐1541.
Performance of Double Acid‐Etched Surface External Hex Titanium Implants in Relation to One‐ and Two‐Stage Surgical Procedures
Authors: Ibañez Juan C. , Tahhan Marcelo J. , Zamar Juan A.
Published: February 2005

Background: The use of external hex titanium implants is widely accepted; however, in the past few years, they have been placed by using not only the traditional two‐stage surgical protocol, but also the one‐stage surgical protocol. The aim of the present study was to compare the success rates that can be obtained from two‐stage surgeries (conventional protocol) and one‐stage surgeries when double acid‐etched surface external hex titanium implants are used.

Methods: A total of 654 double acid‐etched surface external hex titanium implants were studied in 195 patients (109 females and 86 males) aged 18 to 79 (mean 49.20). These patients were followed‐up both clinically and radiographically for 3 years. Among these implants, 338 were inserted by means of two‐stage surgery and 316 were placed following the one‐stage surgery protocol.

Results: The success rate of the whole sample of double acid‐etched surface implants was 99.23%. The results showed a 99.05% success rate for one‐stage surgeries and 99.40% rate for two‐stage surgeries. Only three of the implants inserted by performing one‐stage surgery and two of the implants placed using two‐stage surgery failed before they were loaded. No implants were lost after the loading was completed. The bone level at 12 months was 0.58 mm for one‐stage‐placed implants and 0.54 mm for two‐stage‐placed implants. At 24 months the bone level was 0.77 mm and 0.68, respectively, and at 36 months 0.89 and 0.83.

Conclusion: The similar and high success rates obtained in one‐ and two‐stage surgeries using double acid‐etched surface external hex titanium implants demonstrate that it is possible to choose the most convenient surgical procedure for each particular case without increasing the risk of failure. J Periodontol 2003;74:1575‐1581.
Clinical Responses to Mechanical Periodontal Treatment in Chinese Chronic Periodontitis Patients with and without Actinobacillus actinomycetemcomitans
Authors: Tong Kenny S.K. , Zee Kwan‐Yat , Lee Dae‐Hyun , Corbet Esmonde F.
Published: February 2005

Background: The purpose of this study was to compare 12‐month clinical responses to mechanical periodontal treatment in Chinese chronic periodontitis patients at sites with and without Actinobacillus actinomycetemcomitans at baseline, and to investigate the ability of mechanical periodontal treatment to eliminate A. actinomycetemcomitans.

Methods: Nineteen patients and a total of 76 selected sites with a mean probing depth (PD) of ≥7 mm were studied. Whole mouth presence or absence of supragingival plaque (Pl%), bleeding on probing (BOP%), probing depth (PD), and probing attachment level (PAL) were recorded at six sites per tooth at baseline and after 3, 9, and 12 months. Baseline subgingival plaque samples were taken from the deepest PD site in each quadrant using sterile paper points and were cultured on TSBV plates for 5 days in a 5% CO2‐air incubator. All sites received mechanical periodontal treatment, which included oral hygiene instructions and supragingival and subgingival instrumentation with or without surgical access, with maintenance care being provided once every 3 months thereafter.

Results: At baseline, A. actinomycetemcomitans was isolated in 13 of the 19 subjects (68%) and in 29 out of the 76 sampled sites (38%). At the end of 12 months, in three of the initially A. actinomycetemcomitanspositive subjects, A. actinomycetemcomitans was not detected in the sampled sites, while one subject, in whom A. actinomycetemcomitans was not initially found at the sampled sites was A. actinomycetemcomitans‐positive at 12 months. Multi‐level variance component models showed there was no statistically significant difference in all clinical parameters between A. actinomycetemcomitans‐positive and ‐negative subjects (P >0.05). In the sampled sites of the initially A. actinomycetemcomitans‐positive subjects, the mean PD was reduced from 7.6 ± 1.6 mm to 3.2 ± 1.8 mm, the mean PAL gain was 1.4 ± 2.0 mm, and the mean recession was 3.0 ± 2.3 mm. The corresponding figures in the sampled sites of the initially A. actinomycetemcomitans‐negative subjects were 7.5 ± 1.6 mm to 2.7 ± 1.0 mm, 2.3 ± 2.6 mm and 2.4 ± 2.2 mm for mean PD changes, PAL gain, and mean recession, respectively.

Conclusions: Favorable clinical responses to mechanical periodontal therapy may occur in Chinese chronic periodontitis patients at sites infected with A. actinomycetemcomitans. The mere detection of subgignival A. actinomycetemcomitans does not necessarily imply poorer treatment outcomes in the control of chronic periodontitis. J Periodontol 2003;74:1582‐1588.
In Vivo Sensitivity of Human Root Dentin to Air Blast and Scratching
Authors: Camps Jean , Pashley David
Published: February 2005

Background: The present study evaluated the prevalence of radicular sensitivity to scratching as well as the effects of a common oxalate desensitizing agent on sensitivity to air blast and scratching.

Methods: Eighty‐seven patients self‐reporting dentin hypersensitivity, with at least two hypersensitive teeth, were included. Prior to any treatment, their sensitivity to air blast was recorded and rated as absent or present, and the force necessary to trigger pain when scratching was measured with a scratchometer in cN. For each patient one sensitive tooth was treated with an oxalate desensitizing agent and the other one with a placebo solution. The same measurements were carried out after treatment.

Results: Following treatment with a placebo solution, 70% of the teeth remained sensitive to air blast while only 38% of the desensitizing agent‐treated teeth remained sensitive to air blast (P <0.01). The mean force required to elicit pain prior to any treatment was 44 ±17 cN. This force statistically increased significantly after application of the placebo (53 ±17 cN) (P <0.05). After using the desensitizing agent, the force was even higher (95 ±24 cN) (P <0.01). Only 8% of the teeth treated with the desensitizing agent did not respond to treatment compared to 37% of the teeth treated with the placebo solution.

Conclusions: The placebo solution had a significant effect on sensitivity to air blast and to scratching (P <0.05). The oxalate desensitizing agent was more effective than the placebo solution at decreasing the sensitivity both to air blast and to scratching (P <0.01). The sensitivity to air blast seems to be overestimated because, after using the desensitizing agent, 38% of the teeth remained sensitive to air blast but only 8% remained sensitive to scratching. Pulpal inflammation may be involved in those teeth that did not respond to treatment. J Periodontol 2003;74:1589‐1594.
Factors Associated with Periodontal Diseases in a Dental Teaching Clinic Population in Northern Jordan
Authors: Khader Yousef S. , Rice Janet C. , Lefante John J.
Published: February 2005

Background: A cross‐sectional study of 603 subjects between 15 and 65 years of age (270 males and 333 females) from a dental teaching center serving a local population in northern Jordan was performed to identify the factors associated with probing depth (PD), clinical attachment level (CAL), gingival recession (GR), and number of missing teeth (MT).

Methods: All patients were interviewed orally and examined, using a structured questionnaire, by a single examiner. For each patient, the oral hygiene of six selected teeth and periodontal status of all teeth, excluding third molars, were assessed using plaque index (PI), PD, CAL, GR, and MT. Whole‐mouth averages of PD, CAL, and GR were calculated and used as the outcome variables.

Results: Increased age, plaque index, having diabetes, and smoking more than 15 pack‐years were significantly associated with increased PD, CAL, and GR. Brushing was significantly associated with decreased PD and MT, while brushing more than once per day was associated with increased GR. Use of dental floss and having hypertension were significantly associated with increased CAL and GR. Having peptic ulcers and having allergies were significantly associated with increased CAL only.

Conclusions: The findings suggest that increased age, high plaque index, having diabetes, and smoking more than 15 packyears are risk indicators of periodontal diseases as assessed by PD, CAL, and GR. Longitudinal, intervention, and etiology‐focused studies will establish whether these indicators are true risk factors. J Periodontol 2003;74:1610‐1617.
Effects of Chlorhexidine, Minocycline, and Metronidazole on Porphyromonas gingivalis Strain 381 in Biofilms
Authors: Noiri Yuichiro , Okami Yumiko , Narimatsu Masahiro , Takahashi Yusuke , Kawahara Takashi , Ebisu Shigeyuki
Published: February 2005

Background:Porphyromonas gingivalis is found in subgingival biofilm and is associated with periodontal disease. Bacteria in biofilms are able to resist higher antimicrobial concentrations than in suspension. Little is known about the susceptibility of P. gingivalis in biofilms to antimicrobial agents. The effects of chlorhexidine gluconate, minocycline hydrochloride, and metronidazole on P. gingivalis biofilms were examined in vitro.

Methods:P. gingivalis strain 381 biofilms were prepared on 32 hydroxyapatite disks. At 0, 24, 72, and 144 hours after perfusion of the three antimicrobial agents, two disks from each device were used to assess the antimicrobial effects by adenosine triphosphate (ATP) bioluminescence, and for morphological investigation by scanning electron microscopy (SEM).

Results: Close relationships were found between the results of the ATP analyses and the SEM observations in all groups examined. A significant decrease (P <0.001) in ATP content was found between the chlorhexidine‐treated and control groups. The extracellular matrix structure and P. gingivalis cells were altered in the presence of chlorhexidine. Minocycline hydrochloride also caused decrease (P <0.05) in the ATP content and morphological change on P. gingivalis biofilms. Metronidazole showed no significant efficacy against P. gingivalis biofilms.

Conclusion: Chlorhexidine gluconate was effective at reducing the viability of P. gingivalis 381 cells in biofilms, while minocycline hydrochloride and metronidazole exhibited weaker effects. J Periodontol 2003;74:1647‐1651.
Position Paper: Periodontal Diseases of Children and Adolescents
Authors:   Research, Science and Therapy Committee of the American Academy of Periodontology
Published: February 2005

This paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology and is intended for the information of the dental profession and the public. It represents a brief summary of the current state of knowledge about periodontal diseases in children and adolescents. J Periodontol 2003;74:1696‐1704.
Effect of Porphyromonas gingivalis Lipopolysaccharide, Tumor Necrosis Factor‐α, and Interleukin‐1β on calprotectin release in human monocytes
Authors: Suryono  , Kido Jun‐ichi , Hayashi Noriko , Kataoka Masatoshi , Nagata Toshihiko
Published: February 2005

Background: Calprotection is a major cytosolic protein of monocytes, granulocytes, and epithelial cells. It is known that calprotectin is released in inflammatory tissues and detected in gingival crevicular fluid (GCF) of periodontitis patients at high levels. The origin of calprotectin in GCF and its regulation in periodontal disease are unknown. In this study, we investigated the distribution of calprotectin in gingiva tissues with inflammation and the induction of calprotectin release from human monocytes by lipopolysaccharide of Porphyromonas gingivalis (P‐LPS), tumor necrosis factor‐α (TNF‐α), or interleukin ‐1β(IL‐1β)

Methods: Gingival tissues were obtained from a healthy donor and a periodontitis patient and calprotectin in gingival tissues was examined by immunohistochemical staining. Monocytes were isolated from the peripheral blood of healthy donors and cultured with P‐LPS, TNF‐α for 30 minutes to 4 hours. The content of calprotectin in the cell and medium fractions was determined by enzyme‐linked immunosorbent assay (ELISA)

Results: Calprotectin was markedly detected at the epithelial and adjacent connective tissue with many inflammatory cells in the gingival tissue from the periodontitis patient. P‐LPS increased calprotectin release from monocytes to the maximum level after 30 minutes of treatment and its level was elevated to about 2‐ to 3‐fold of the control level in a dose‐dependent manner (1 to 1,000 ng/ml). When the effect of TNF‐α and IL‐Iβ on calprotectin release was investigated, calprotectin release significantly increased to about 2.2‐ and 1.5‐fold that of the control level, respectively.

Conclusion: These results demonstrate that calprotectin release from monocytes is induced by P‐LPS, TNF‐α, and IL‐lβ, which in turn, cause and aggravate periodontal disease. J Periodontol 2003;74:1719‐1724.
Enamel Matrix Protines Bovine Porous Bone Mineral in the Treatment of Intrabony Defects: Comparative Controlled Clinical Trial
Authors: Zucchelli G. , Amore C. , Montebugnoli L. , De Sanctis M.
Published: February 2005

Background: Various clinical studies have demonstrated that applying commercially available enamel matrix proteins (EMP) on the instrumented root surface during access flap surgery promotes clinically significant gains of clinical attachment and bone in intrabony defects. The aim of the present controlled clinical trial was to evaluate the adjunctive effect of filling the intrabony lesion with bovine porous bone mineral (BPBM) to a simplified papilla preservation (SPP) flap and EMP surgical procedure.

Methods: Sixty deep interproximal intrabony lesions in 60‐patients with chronic periodontitis were treated‐with the SPP flap and EMP. In the 30 test defects, the intrabony component was filled with BPBM particles previously reconstituted with the EMP gel. A stringent infection control program was adopted for 1 year. The clinical and radiographical reevaluation was made 1 year after surgery.

Results: Both techniques resulted in clinically and statistically significant improvements between baseline and 1 year, in terms of clinical attachment level (CAL) gain, probing depth (PD) reduction, and radiographic bone fill; however, the BPBM test treatment showed statistically significantly greater CAL (5.8 ± 1.1 versus 4.9 ± 1.0) and radiographic bone (DEPTH) level gains (5.3 ± 1.1 versus 4.3 ± 1.5), and less increase in gingival recession (0.4 ± 0.6 versus 0.9 ± 0.5) than the control surgical procedure.

Conclusion: The present study data supported the hypothesis that the adjunctive use of BPBM in grafting intrabony defects has the ability to improve clinical and radiographical outcomes achievable with EMP alone. J Periodontal 2003;74:1725‐1735.
Reproducibility of Probing Depth Measurements Using a Constant‐Force Electronic Probe: Analysis of Inter‐ and Intraexaminer Variability
Authors: Araujo Marcelo W.B. , Benedek Kathleen M. , Benedek Janice R. , Grossi Sara G. , Dorn Joan , Wactawski‐Wende Jean , Genco Robert J. , Trevisan Maurizio
Published: February 2005

Background: Probing depth (PD) is a commonly used method to determine periodontal disease severity in both treating and evaluating disease progression. Agreement among examiners collecting data in scientific investigations is necessary to establish reliable criteria for determining levels of periodontal attachment loss. The objective of our study was to evaluate inter‐ and intraexaminer variability of PD measurements among study examiners using a constant force periodontal probe, and to compare the variability of tooth‐mean and quadrant‐mean.

Methods: Three examiners, who had been previously trained and calibrated, performed measurements on 20 volunteers. Intraand interexaminer variability of sites was determined by means of standard error of measurement (SE). Data analysis included determination of error for both quadrant mean and tooth mean.

Results: PD measurements for the quadrant‐mean were used to calculate the intraexaminer variability, resulting in a mean (SD) value for an SE of 0.40 mm (± 0.02). Interexaminer variability for quadrant mean was 0.16 mm (± 0.02). For tooth‐mean SE, the intraexaminer variability values were equal to 0.38 mm (± 0.07), and interexaminer variability equal to 0.24 mm (± 0.05).

Conclusions: All three examiners participating in our study were able to obtain reliable measurements for PD, using the constant force electronic probe. Reproducibility did not vary appreciably when using the whole quadrant mean compared to the tooth mean. These trained examiners were able to provide reproducible measures under 0.5 mm. J Periodontol 2003;74:1736‐1740.
Gene Expression of Extracellular Matrix Proteoglycans in Human Cyclosporin‐Induced Gingival Overgrowth
Authors: Gnoatto Nelson , Lotufo Roberto F.M. , Toffoletto Odaly , Marquezini Mônica V.
Published: February 2005

Background: Gingival overgrowth is one of the side effects associated with the systemic use of cyclosporin A (CsA). In vitro studies on the extracellular matrix of gingival tissues have demonstrated an altered composition, particularly an accumulation of proteoglycans and collagen. We investigated the gene expression of extracellular matrix proteoglycans in CsA‐induced gingival tissue alterations.

Methods: mRNA expression of the proteoglycans perlecan, decorin, biglycan, and versican was analyzed by reverse transcription polymerase chain reaction (RT‐PCR) in gingival samples obtained from 12 individuals, six with CsA‐induced gingival overgrowth (CsA group) and six with a normal gingiva (control group). The RT‐PCR products were subjected to 1% agarose gel electrophoresis containing ethidium bromide and analyzed qualitatively and semiquantitatively by densitometry. Density values were normalized by determining the expression of the housekeeping gene ß‐actin in the same sample. Groups were compared by the Student's t test.

Results: Perlecan expression showed a marked increase (54%) in the CsA group compared to the control group (P <0.01), while no significant differences were observed for the other proteoglycans.

Conclusion: CsA‐induced gingival overgrowth seems to be associated with increased expression of perlecan, a typical basement membrane proteoglycan, but not decorin, biglycan, or versican. J Periodontol 2003;74:1747‐1753.
Cyclooxygenase‐2 Inhibitors Decrease Interleukin‐1β–Stimulated Prostaglandin E2 and IL‐6 Production by Human Gingival Fibroblasts
Authors: Tipton David A. , Flynn Jon C. , Stein Sidney H. , Dabbous Mustafa Kh.
Published: February 2005

Background: Previous work showed that normal and aggressive periodontitis (AgP) gingival fibroblasts produce the boneresorbing cytokine IL‐6. PGE2 is important in regulating IL‐6 production. Non‐steroidal anti‐inflammatory drugs inhibit PG synthesis via COX‐1 and/or COX‐2 isoenzymes and may inhibit periodontal destruction. COX‐2 is induced after cellular activation (i.e., by inflammatory cytokines such as IL‐1β). Little is known about IL‐1β‐stimulated AgP fibroblast IL‐6 and PGE2 production and their regulation by COX inhibitors. The objective of this study was to determine the effects of COX‐2 inhibitors on amounts of PGE2 and IL‐6 made by IL‐1β‐stimulated gingival fibroblasts.

Methods: Gingival fibroblasts (2.5 × 104) from healthy or severe periodontitis patients were cultured in serum‐free medium, with or without IL‐1β (10–11M) for 24 hours, with or without the COX‐1/2 inhibitor indomethacin or the selective COX‐2 inhibitors NS‐398, celecoxib, or rofecoxib. PGE2 and IL‐6 in culture supernatants were determined by specific enzyme‐linked immunosorbent assay (ELISA)s.

Results: All of the COX inhibitors caused dose‐dependent decreases in IL‐1β‐stimulated PGE2, to a maximum of >90% in all cell lines (P ≤0.0001). The selective COX‐2 inhibitors, but not indomethacin, caused partial (generally up to approximately 60%), dose‐dependent decreases in IL‐1β‐stimulated IL‐6 in all cell lines (P ≤0.003). When exogenous PGE2 was added concurrently with COX‐2 inhibitors before addition of IL‐1β, IL‐6 production returned to levels at or approaching that produced by cells exposed only to IL‐1β (P ≤0.04).

Conclusion: The results suggest that COX‐2 inhibition may be useful in helping to control fibroblast production of IL‐6 in patients with severe periodontitis. J Periodontol 2003;74:1754‐1763.
Associations Between Systemic Status, Periodontal Status, Serum Cytokine Levels, and Delivery Outcomes in Pregnant Women with a Diagnosis of Threatened Premature Labor
Authors: Hasegawa Kozue , Furuichi Yasushi , Shimotsu Akihiro , Nakamura Masahiro , Yoshinaga Mitsuhiro , Kamitomo Masato , Hatae Masayuki , Maruyama Ikuro , Izumi Yuichi
Published: February 2005

Background: Threatened premature labor (TPL) often results in preterm birth (PB). The aim of the present study was to evaluate the associations of periodontal and general health conditions with TPL and PB in relation to serum cytokine levels and the composition of subgingival plaque.

Methods: Eighty‐eight women were enrolled in the study. Systemic conditions were assessed, and subgingival plaque samples obtained for bacterial analysis. Periodontal examinations included assessments of plaque, gingivitis, clinical attachment level, probing depth, and bleeding on probing. Serum cytokine levels also were analyzed. Gestational age at delivery was recorded, and the mothers were divided into a TPL or non‐TPL group, and into a non‐TPL‐TB (term birth), non‐TPL‐PB, TPL‐TB, or TPL‐PB group, accordingly.

Results: Forty subjects were classified as TPL and 18 as TPLPB. There were significant differences between the TPL and non‐ TPL subjects in several of the systemic and periodontal parameters and serum cytokine levels. Significant differences were observed between the TPL‐TB and TPL‐PB groups in the percentage of Tannerella forsythensis (Tf, formerly Bacteroides forsythus), and the serum interleukin (IL)‐8 and IL‐1β levels. Significant negative correlations between the gestational age at delivery and several periodontal parameters and serum IL‐8 and IL‐1β levels, and significant positive correlations between periodontal status and serum IL‐8 and IL‐1β levels, were observed.

Conclusions: The TPL women revealed worsened periodontal conditions and elevated serum IL‐8 and IL‐1β levels compared to the non‐TPL women. The elevated levels of serum IL‐8 and IL‐1β could have affected the maintenance of the proper uterinefetus relationship, resulting in premature uterine contractions. J Periodontol 2003;74:1764‐1770.
Anabolic Potential of Fibroblasts from Chronically Inflamed Gingivae Grown in a Hyperglycemic Culture Medium in the Presence or Absence of Insulin and Nicotine
Authors: Soory M. , Tilakaratne A.
Published: February 2005

Background: Impaired fibroblast function due to hyperglycemia shows reversal in response to insulin. The aim of this investigation was to use a hyperglycemic cell‐culture model to study the anabolic products of androgen metabolism in fibroblasts in response to insulin and nicotine.

Methods: Human gingival fibroblasts were derived from chronically inflamed gingivae of six nondiabetic periodontal patients with no history of smoking. Six cell lines were established in monolayer culture in 24 well multiwell plates, and duplicate incubations were performed with each cell line for all three experiments. Eagle's minimum essential medium was used in a range of individual experiments, with radiolabeled testosterone as substrate, in the presence or absence of (1) glucose (1 to 4,000 µg/ml); (2) insulin (1 to 100 µg/ml) independently; (3) an effective concentration of glucose (500 µg/ml) with serial concentrations of insulin (1 to 100 µg/ml); and (4) effective concentrations of nicotine (250 µg/ml), glucose, and their combinations in response to insulin (5 µg/ml). The controls contained no agents other than the radiolabeled substrate. At the end of a 24‐hour incubation period, the medium was solvent extracted with ethyl acetate, and androgen metabolites were separated by thinlayer chromatography and were quantified using a radioisotope scanner.

Results: The androgen substrate 14C‐testosterone was metabolized mainly to 5α‐dihydrotestosterone (DHT) and 4‐androstenedione. (1) Glucose at a concentration of 500 µg/ml reduced yields of DHT by 36% (n = 6; P <0.01). (2) Insulin caused a small but significant inhibition of DHT in normoglycemic cells. (3) Serial concentrations of insulin significantly counteracted the inhibitory effects of glucose on the yields of DHT (n = 6; P <0.01). (4) The independent inhibitory effects of nicotine and glucose on metabolic yields of DHT were marginally more pronounced in combination but significantly overcome in the presence of insulin.

Conclusion: Human gingival fibroblasts obtained from chronically inflamed tissue of nondiabetic patients demonstrated that the inhibitory effects of glucose and nicotine on androgen metabolism can be overcome by insulin, in varying degrees. J Periodontol 2003;74:1771‐1777.
Blood Test Values and Community Periodontal Index Scores in Medical Checkup Recipients
Authors: Takami Yuko , Nakagaki Haruo , Morita Ichizo , Tsuboi Shinji , Takami Shuji , Suzuki Noriko , Niwa Hisae , Ogura Yukio
Published: February 2005

Background: We examined the blood test values of people who received general medical checkups and their Community Periodontal Index (CPI) score.

Methods: A total of 7,452 persons (5,742 males and 1,710 females), who had general medical and dental checkups, were the subjects of the study. Many were people who worked for companies in and around Nagoya and their family members, ranging in age from 16 to 80 years. The blood test in our study consisted of 37 items used in general blood tests. Partial‐mouth recordings were used to measure CPI scores. The highest CPI score for each subject was used for analysis. Odds ratios and confidence interval values were obtained using the Mantel‐Haenszel method to analyze the results.

Results: CPI scores of 3 and 4 were related to the test values of high‐density‐lipoprotein cholesterol, serum iron, white blood cell count, fasting blood sugar, glycosylated hemoglobin A1, glycosylated hemoglobin A1c, and C‐reactive protein.

Conclusion: Blood test values tended to show correlations with CPI scores, more clearly seen in males than in females. J Periodontol 2003;74:1778‐1784.
Vertical Distance from the Crest of Bone to the Height of the Interproximal Papilla Between Adjacent Implants
Authors: Tarnow Dennis , Elian Nicolas , Fletcher Paul , Froum Stuart , Magner Ann , Cho Sang‐Choon , Salama Maurice , Salama Henry , Garber David A.
Published: February 2005

Background: As patient demand increases for more natural restorations in the esthetic zone, clinicians must have the highest level of skill and knowledge to maintain or reform the interdental papilla between teeth, between implants and teeth, and between adjacent implants. To date, there are no reports that have measured the distance from the contact point to the bony crest between implants. One reason for this may be the fact that, with two adjacent implants, the contact point of the crown can be established at any distance from the gingival margin according to the restorative dentist's specifications. Therefore, in this study, the height of the soft tissue to the crest of bone was measured between two adjacent implants independent of the location of the contact point. The purpose of this study was to determine the range and average height of tissue between two adjacent implants.

Methods: A total of 136 interimplant papillary heights were examined in 33 patients by eight different examiners in five private dental offices. After administration of appropriate local anesthesia, a standardized periodontal probe was placed vertically from the height of the papilla to the crest of bone. The measurements were rounded off to the nearest millimeter.

Results: The mean height of papillary tissue between two adjacent implants was 3.4 mm, with a range of 1 mm to 7 mm.

Conclusions: Clinicians should proceed with great caution when placing two implants adjacent to each other in the esthetic zone. In most cases, only 2, 3, or 4 mm of soft tissue height (average 3.4 mm) can be expected to form over the interimplant crest of bone. These results showed that modification of treatment plans may be necessary when esthetics are critical for success. J Periodontol 2003;74:1785‐1788.
Periodontal Health, Salivary Status, and Metabolic Control in Children with Type 1 Diabetes Mellitus
Authors: Aren Gamze , Sepet Elif , Özdemır Didem , Dınççağ Nevin , Güvener Bora , Firatli Erhan
Published: February 2005

Background: The aim of this study was to determine whether detectable periodontal destruction and alterations in the salivary status were present with duration of diabetes in children with type 1 insulin‐dependent diabetes mellitus (type 1 DM) as compared to healthy controls.

Methods: Sixteen newly diagnosed children with DM (group 1), 16 children with type 1 DM of long duration (group 2), and 16 healthy children (group 3) participated in the study. Periodontal health was assessed by plaque index, gingival index, bleeding on probing, and periodontal probing depths. The flow rate, pH, buffering capacity, and peroxidase activities of stimulated saliva were determined. The data were analyzed by Kruskall‐Wallis, Student t test, and Pearson's correlation analysis.

Results: The mean values for fasting blood glucose levels for the diabetic groups were significantly higher than for the controls. The mean values for salivary buffering capacities and salivary pH from the diabetic groups were significantly lower than for the controls. The plaque index values for the diabetic groups were significantly higher than for the controls. The mean gingival index value for group 1 was significantly lower than for group 2. The mean periodontal probing depths for group 1 were similar to those of the non‐DM controls, but the mean periodontal probing depths for group 2 were significantly greater than for both the non‐DM controls and group 1. Group 1 had significantly greater bleeding on probing scores than did the other groups (P <0.05).

Conclusion: The glycemic status of the diabetic subjects affects the periodontal probing depths, salivary pH, buffering capacity, and peroxidase activity. J Periodontol 2003;74:1789‐1795.
Distribution of Interleukin‐1β+3954 and IL‐1α–889 Genetic Variations in a Thai Population Group
Authors: Anusaksathien Orasa , Sukboon Angkana , Sitthiphong Piyawan , Teanpaisan Rawee
Published: February 2005

Background: The severe form of chronic periodontitis (CP) has been reported to be strongly associated with the presence of allele 2 of composite IL‐1β+3954 and IL‐1α–889 genetic polymorphisms (genotype positive). However, other studies have reported conflicting findings, not only on the association between the composite IL‐1 gene polymorphisms and CP, but also the link between IL‐1 gene polymorphisms and aggressive periodontitis (AgP). These might have resulted from differences in ethnic background and disease entities. The aim of this study was to determine the distribution of IL‐1β+3954 and IL‐1α–889 genetic polymorphisms in a group of Thai subjects based on their periodontal status, including CP, AgP, and healthy groups.

Methods: A total of 123 Thai subjects were clinically and radiographically assessed for their periodontal status. Blood samples were collected by fingerstick and adsorbed onto filter paper. The IL‐1β+3954 and IL‐1α–889 genotypes were performed by polymerase chain reaction, digested with restriction enzymes, and separated by gel electrophoresis.

Results: The distribution of allele 1 homozygous genotype was 97.6% and 84.6% for IL‐1β+3954 and IL‐1α–889, respectively. No allele 2 homozygous genotype was detected in either of these two gene loci. Only 1.6% (2 out of 123) of the subjects were genotype positive, which was too low to determine the association between the composite genotype of IL‐1β+3954 and IL‐1α–889 and severe forms of periodontal disease.

Conclusion: Genetic polymorphism of IL‐1 genes in these two loci may not be useful in predicting the severity of periodontal disease in the Thai ethnic group. J Periodontol 2003;74:1796‐1802.
Favorable Healing Following Space Creation in rhBMP‐2–Induced Periodontal Regeneration of Horizontal Circumferential Defects in Dogs with Experimental Periodontitis
Authors: Saito Emiko , Saito Akira , Kawanami Masamitsu
Published: February 2005

Background: Recombinant human bone morphogenetic protein‐2 (rhBMP‐2) is believed to be capable of inducing periodontal regeneration. However, the risk of aberrant healing events, such as root resorption and ankylosis, has been reported. We hypothesized that implantation of BMP‐containing carriers directly on the root planed surface may be the cause of unfavorable healing. The purpose of this study was to evaluate the influence of a 1 mm spacer membrane, which separated the rhBMP‐2 in polymer‐coated gelatin sponge (PGS) and the root surface, on periodontal regeneration of experimentally induced horizontal defects in dogs.

Methods: Horizontal circumferential periodontal defects were surgically created, and experimental periodontitis was induced in 72 maxillary and mandibular premolars of four male beagle dogs. The recipient sites of each quadrant received: 1) rhBMP‐2/PGS (B group) (rhBMP‐2 at 1.0 mg/ml, total implant volume/ site ∼ 7.2 µl) (n = 24); 2) rhBMP‐2/PGS with a spacer membrane (PB group) (n = 24); and 3) physiological saline (PS)/PGS as a control (P group) (n = 24). One quadrant was left untreated. Dogs were sacrificed at 12 weeks post‐surgery, and healing was evaluated histologically.

Results: Both groups treated with rhBMP‐2/PGS demonstrated enhanced new bone formation and connective tissue attachment with cementum regeneration when compared to the control group. Sites treated with rhBMP‐2/PGS showed a greater degree of bone formation than sites treated with rhBMP‐2/PGS and spacer membrane, although the latter sites showed no ankylosis.

Conclusions: Implantation of rhBMP‐2/PGS enhances bone formation and connective tissue attachment in horizontal circumferential defects. In addition, the use of a spacer membrane reduces the degree of bone formation, but minimizes ankylosis. J Periodontol 2003;74:1808‐1815.
Conversion from Cyclosporin A to Tacrolimus as a Non‐Surgical Alternative to Reduce Gingival Enlargement: A Preliminary Case Series
Authors: Hernández Gonzalo , Arriba Lorenzo , Cruz Frías María , de la Macorra José Carlos , de Vicente Juan Carlos , Jiménez Carlos , de Andrés Amado , Moreno Enrique
Published: February 2005

Background: Gingival enlargement (GE) is a frequent side effect that occurs in organ transplant recipients (OTR) after the administration of cyclosporin A (CsA). The availability of new drugs used to suppress graft rejection in OTR offers an opportunity to manage GE non‐surgically. This preliminary case series aimed to analyze the effect of CsA withdrawal and its substitution by another immunosuppressant in OTR with severe GE.

Methods: Four organ transplant recipients who had received a liver or renal allograft were recruited for this study. All OTR had developed clinically severe CsA‐induced GE. GE scores were assessed for each patient at baseline and at weeks 2, 4, 8, 12, 16, and 54 following conversion to tacrolimus. Scaling and root planing were initially performed and repeated monthly during the first 6 months. Careful polishing of the teeth was carried out once every 2 weeks until month 6 and then monthly until month 12. Hygiene instructions and reinforcement to optimize oral hygiene were maintained throughout the study.

Results: The four patients showed a rapid decrease in their gingival symptoms and in the size of the gingivae. This change was clinically evident 8 weeks after conversion to tacrolimus. One year later, all the patients experienced GE regression, although some anatomic irregularities persisted in the interdental papillae of one of the patients. No adverse effects from tacrolimus were observed during the study except in one patient who presented headaches.

Conclusion: It seems that CsA withdrawal and its conversion to tacrolimus in organ transplant recipients who develop severe gingival enlargement, together with an extensive plaque control program, provide an effective means to control/eliminate gingival hyperplasia, hyperplasia, with minimal risk of graft dysfunction. J Periodontol 2003;74:1816‐1823.
Root Coverage: Comparison of Coronally Positioned Flap With and Without Titanium‐Reinforced Barrier Membrane
Authors: Lins Lauro Henrique Souza , de Lima Antonio Fernando Martorelli , Sallum Antonio Wilson
Published: February 2005

Background: Various surgical procedures have been proposed as effective treatment methods for recession defects. The purpose of this study was to evaluate the clinical outcome of root coverage comparing the coronally positioned flap (CPF) with and without guided tissue regeneration (GTR) using a titaniumreinforced expanded polytetrafluoroethylene barrier in paired gingival recession defects.

Methods: Procedures were performed in 10 patients having bilateral buccal recession defects ≥2.0 mm on maxillary canines and first premolars. Mucoperiosteal flaps were raised and root surfaces were scaled, planed, and conditioned. Randomly assigned sites received either GTR + CPF or CPF treatment. Clinical parameters measured at baseline and at 6 months after the procedure included gingival recession depth (GRD), clinical attachment level (CAL), probing depth (PD), keratinized gingival width (KGW), and alveolar crest level (ACL).

Results: GRD decreased from 3.4 ± 0.6 mm to 1.9 ± 1.2 mm with GTR (45% root coverage) and from 3.3 ± 0.4 mm to 1.3 ± 0.7 mm with CPF (60% root coverage). The difference in GRD decrease between procedures was significant. CAL, KGW, and PD differences between procedures were not significant. ACL mean gain was significant (1.0 ± 0.6 mm in the GTR group and 0.2 ± 0.3 mm in the CPF group; P <0.05).

Conclusions: Both GTR and CPF procedures result in root coverage. The amount of root coverage obtained with CPF was greater than that observed with GTR, although GTR resulted in significantly greater ACL gain. J Periodontol 2003;74:168‐174.
Constitutionally Hyperreactive Neutrophils in Periodontitis
Authors: Fredriksson Margareta I. , Gustafsson Anders K. , Bergström Kurt G. , Åsman Björn E.
Published: February 2005

Background: Neutrophils constitute the first line of host defense, but their extracellular release of oxygen radicals and proteases may cause tissue destruction. Conflicting results have been reported on the neutrophilic production of oxygen radicals in periodontal patients. These may vary with different forms of periodontitis, the pathway of neutrophil activation studied, and the influence of smoking.

Methods: Venous blood was taken from 15 patients with severe chronic periodontitis, treated with scaling, with or without surgery. They were matched by age and gender to periodontally healthy controls; all participants were non‐smokers. Peripheral neutrophils from the participants were activated with IgGopsonized bacteria, complement‐opsonized zymosan, or phorbol myristate acetate (PMA). The total release of oxygen radicals was measured with luminol‐enhanced chemiluminescence (CL) and the extracellular release of oxygen radicals with isoluminol‐enhanced CL. Antibodies to endotoxin and the concentrations of interleukin (IL)‐8 and acute phase proteins in plasma were analyzed to see if these parameters were related to hyperreactivity of the neutrophils.

Results: Neutrophils from periodontal patients had significantly higher CL when activated via the FcγR pathway, measured as both total generation of oxygen radicals and extracellular generation. The neutrophil generation of oxygen radicals was also higher in patients when complement‐opsonized zymosan or PMA was used, but these differences were less pronounced. No significant differences in plasma proteins were found.

Conclusion: Our findings suggest that the increased CL from peripheral neutrophils in periodontitis may be related to a constitutionally greater responsiveness of the Fcγ‐receptor. J Periodontol 2003;74:219‐224.
Healing Is Delayed in Oral Compared to Dermal Excisional Wounds
Authors: Nooh Nasser , Graves Dana T.
Published: February 2005

Background: Oral wound healing is reported to occur more rapidly than dermal healing due, in part, to factors in saliva that facilitate the repair process. However, the oral environment also presents challenges to healing that include a large commensal flora and trauma from mastication.

Methods: Excisional punch biopsies (1.5 mm) were placed in the scalp and hard palate of mice to create similar wounds with an osseous floor and relatively thick connective tissue walls. Histomorphometric analysis of hematoxylin and eosin‐stained sections was performed at the widest part of each lesion.

Results: The rate of epithelial and connective tissue coverage and the amount of new connective tissue formed were delayed in the oral compared to dermal wounds. In addition, the number of polymorphonuclear leukocytes (PMNs) was significantly higher and more persistent in the oral wounds.

Conclusions: Under conditions where a considerable amount of new connective tissue synthesis is required, oral healing is slower than dermal repair. This may be due to a higher degree of inflammatory stimulation induced by conditions present in the oral environment. J Periodontol 2003;74:242‐246.
Bucco‐Lingual Bone Remodeling Around Implants Placed into Immediate Extraction Sockets: A Case Series
Authors: Covani Ugo , Cornelini Roberto , Barone Antonio
Published: February 2005

Background: Implants placed immediately after tooth extraction have shown high percentages of clinical success. Few studies in the scientific literature have observed the horizontal bone remodeling in the buccallingual direction after immediate placement of implants. The aim of this study was to analyze bone healing and coronal bone remodeling around 15 implants placed immediately after tooth removal without the use of guided bone regeneration (GBR) techniques.

Methods: Ten patients received a total of 15 implants placed immediately after removal of 15 single‐rooted teeth. All implants were placed within the alveolar confines, limiting, in most cases, small periimplant bone defects. After implant placement, the distance from the buccal to lingual bone plate was measured. No membranes or filling materials were used. Primary flap closure was performed in all cases.

Results: At second‐stage surgery, all peri‐implant defects were completely filled and the distance from buccal to lingual bone was measured again. The pattern of bone healing around the neck of immediate implants showed an absence of peri‐implant defects and a narrowing of bone crest width in a buccal‐lingual direction. The mean distance between buccal bone and lingual bone at the time of implant placement was 10.5 mm (±1.52) and, at second‐stage surgery, 6.8 mm (±1.33).

Conclusions: The coronal bone remodeling around immediate implants showed a healing pattern with new bone apposition around the neck of the implants and, at the same time, bone resorption with horizontal width reduction of the bone ridge. The small periimplant bone defects were completely healed without the use of GBR procedures. An absence of complications during the healing period was also observed, probably due to the absence of barrier membranes and grafting materials. J Periodontol 2003;74:268‐273.