bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of Demineralized Freeze‐Dried Bone and Autologous Bone to Induce Bone Formation in Human Extraction Sockets
Authors: Becker William , Becker Burton E. , Caffesse Raul
Published: March 2012

The purpose of this study was to test the bone‐forming capacity of demineralized freeze‐dried bone (DFDBA) and autologous bone grafts in extraction sockets. Seven paired sites were grafted with either DFDBA or autologous bone. The sites were reentered between 3 and 13 months for the purposes of obtaining biopsies of the grafted sites and to place endosseous implants. Biopsies from 6 of the 7 grafted sites were evaluated for new bone formation. DFDBA sites revealed the presence of dead particles of DFDBA with no evidence of bone formation on the surfaces of the implanted particles and no evidence of osteoclastic resorption of the bone particles. Biopsies from the 6 autologous sites revealed vascular channels with woven and lamellar bone. Some specimens had retained cortical, non‐vital bone chips. These bone chips were undergoing active osteoclastic resorption. The results of this study questions the use of DFDBA as a bone inductive graft material. J Periodontol 1994;65:1128–1133.
Periodontal Repair in Dogs: Supraalveolar Defect Models for Evaluation of Safety and Efficacy of Periodontal Reconstructive Therapy
Authors: Wikesjö Ulf M. E. , Kean Charles J.C. , Zimmerman Grenith J.
Published: March 2012

It is increasingly evident that controlled preclinical models with reproducible defect characteristics and biologic reaction are critical for evaluation of safety and efficacy of periodontal reconstructive protocols. Our investigations have characterized a supraalveolar periodontal defect in the mandibular premolar region in the beagle dog. This surgically‐created critical size defect heals with almost complete connective tissue attachment following immediate reconstructive surgery. When the defect is exposed to periodontitis‐simulating conditions prior to surgery the new connective tissue attachment is reduced. Bone and cementum regeneration is limited for both defect variations. Critical aspects relative to animal selection and management, surgical protocol, histologic and statistical analysis are discussed. This preclinical model has proven effective for evaluation of safety and efficacy of devices and biologics used adjunctive to periodontal reconstructive therapy. J Periodontol 1994; 65:1151–1157.
The Secretion of PGE2, IL‐1β, IL‐6, and TNFα by Adherent Mononuclear Cells From Early Onset Periodontitis Patients
Authors: Shapira Lior , Soskolne W. Aubrey , Sela M.N. , Offenbacher Steven , Barak V.
Published: March 2012

The secretion of prostaglandin E2 (PGE2), tumor necrosis factor alpha (TNFα), interleukin 1 beta (IL‐1β), and interleukin 6 (IL‐6) by adherent mononuclear cells (AMNC) from 28 patients with early‐onset periodontitis was studied. The early onset‐periodontitis patients consisted of 12 patients with localized juvenile periodontitis (LJP) and 16 patients with severe generalized periodontitis (SGP). The AMNC responses to different concentrations of lipopolysaccharide (LPS) (E. coli) were determined in these 28 patients and compared to 14 healthy controls. Mediator levels in the supernatant were measured using radioimmunoassays for PGE2, IL‐1β, and IL‐6 determination and an enzyme linked immunosorbent assay for TNFα levels. The mean age of the patients was 19.9 years for the LJP group, 30.4 years for SGP, and 28.0 years for the controls. The mean number of teeth per patient with attachment loss of >6 mm was 4.75 in the LJP patients and 17.3 in the SGP group. In the absence of LPS, LJP AMNC secreted significantly more PGE2 than unstimulated control or SGP AMNC, while similar baseline amounts of IL‐1β, IL‐6, and TNFα were secreted by AMNC from the 3 patient groups. LPS stimulation resulted in the dose‐dependent secretion of significantly higher levels of PGE2 by LJP AMNC compared to SGP AMNC which in turn secreted significantly more than controls. TNFα secretion by LJP monocytes was significantly greater than the SGP and the control groups while IL‐1β secretion by the SGP AMNC was depressed compared to the other two patient groups. No significant difference in IL‐6 secretion was noted among the 3 patient groups. These data suggest that the AMNC from the peripheral blood from each of the 3 patient groups differ considerably in their capacity to secrete inflammatory mediators. It is not clear as to whether these intergroup differences in systemic AMNC responsiveness represent an intrinsic or acquired difference in LPS responsiveness. J Periodontol 1994;65:139–146.
Clinical, Microbiological, and Histological Factors Which Influence the Success of Regenerative Periodontal Therapy
Authors: Machtei Eli E. , Cho Moon I. , Dunford Robert , Norderyd Johanna , Zambon Joseph J. , Genco Robert J.
Published: March 2012

The primary objectives of this double‐blind, controlled clinical trial were to assess factor(s) which affect the success of guided tissue regeneration (GTR) procedures in mandibular Class II buccal furcation defects. Thirty subjects, with mandibular Class II furcation defects, were randomly assigned to one of two treatment groups; patients in Group A received oral hygiene instructions with scaling and root planing, while subjects in Group B received similar treatment but without subgingival scaling and root planing at the affected site. After initial oral hygiene instructions and scaling and root planing, GTR surgery was performed using ePTFE barrier membranes. Membranes were retrieved at 6 weeks and subjected to histological examination. Twelve months after regenerative therapy, clinical measurements and re‐entry surgical measurements were repeated. Probing reduction (2.61 mm), horizontal probing attachment gain (2.59 mm), and vertical probing attachment gain (0.95 mm) were all significantly better compared to baseline. Likewise, significant improvements in furcation volume (8.0 μl) and in bone measurements were observed at re‐entry. There was no discernible difference between subjects for whom complete anti‐infective therapy was deferred to the time of the surgery (Group B) compared to subjects in whom complete anti‐infective therapy was performed as part of the hygienic phase of therapy (Group A). Pre‐operative pocket depth was directly correlated with the magnitude of attachment gain as well as the amount of new bone formation in the furcation area. Subjects who maintained good oral hygiene and who had minimal gingival inflammation throughout the study demonstrated consistently better regenerative response. The presence of connective tissue cells along the inner surface of the retrieved membranes also correlated with better healing. This suggests that the presence of connective tissue cells, as opposed to bacterial plaques or epithelial remnants, on the membranes is predictive of enhanced healing. Subjects who did not harbor Actinobacillus actinomycetemcomitans at the site of regenerative therapy showed a better clinical response with significantly greater bone regeneration than in A. actinomycetemcomitans infected subjects. Hence, monitoring for A. actinomycetemcomitans, and antimicrobial therapy for A actinomycetemcomitans‐infected sites is proposed as an adjunct to periodontal regeneration. In summary, shallow initial probing depth, poor oral hygiene, gingivitis, A. actinomycetemcomitans infection, and absence of connective tissue cells on retrieved membranes are associated with less favorable results for regenerative therapy. J Periodontol 1994;65:154–161.
Clinical Evaluation of Coralline Calcium Carbonate as a Bone Replacement Graft Material in Human Periodontal Osseous Defects
Authors: Yukna Raymond A.
Published: March 2012

A resorbable coralline calcium carbonate graft material (CalCarb) was compared to open flap debridement (DEBR) in human periodontal osseous defects. Following appropriate initial preparation procedures, flap surgery with defect and root debridement was performed in 20 patients. Alternating defects in each segment of surgery were treated with each procedure. Appropriate periodontal maintenance schedules were followed, and at 6 to 12 months a re‐entry flap surgery was performed for documentation and finalization of treatment. Forty defects which received CalCarb grafts demonstrated significantly better mean defect fill of 2.3 mm (67.7%) versus a mean defect fill of 0.7 mm (25.9%) (P <0.01) for 39 defects treated with DEBR. Other hard tissue findings showed similar clinically superior results with the use of CalCarb. Relative defect fill results showed 88% positive (50% to 100% defect fill) responses with CalCarb and only 13% positive responses with DEBR. There were 7 times more failures (minimal response) with DEBR than with CalCarb. Soft tissue findings showed no significant differences between treatments. These results are similar to those with other synthetic and natural bone replacement graft materials. However, the ease of handling of the CalCarb material, its resorbability, and its potential for improved bone regeneration may be of clinical advantage. J Periodontol 1994;65:177–185.
Autogenous Gingival Grafts as Epithelial Barriers for Immediate Implants: Case Reports
Authors: Evian Cyril I. , Cutler Susan
Published: March 2012

The purpose of this study was to evaluate the use of autogenous gingival grafts as barriers for endosseous implants placed directly into fresh extraction sockets. This study consisted of four patients who presented with hopeless teeth due to endodontic pathology, caries, or root resorption. In all cases, the teeth in question were extracted at the Stage 1 surgery. An endosseous root form implant was immediately placed into the extraction socket in each case. As a consequence of immediate placement, there was a lack of primary closure over the fixture and a large space was present between the fixture and the remaining alveolus. An autogenous gingival graft was sutured in place to cover the fixture and act as a physical barrier to epithelium, food debris, and possibly bacteria. At the Stage 2 surgery, all implants achieved complete osseointegration clinically and radiographically. The results at 16 to 24 months reveal continued success in all four cases. This report demonstrates the potential of autogenous gingival grafts in immediate implant placement. A clinical trial to fully assess the potential of this procedure is recommended. J Periodontol 1994;65:201–210.
Guided Tissue Regeneration With and Without Decalcified Freeze‐Dried Bone in Mandibular Class II Furcation Invasions
Authors: Wallace Stephen C. , Gellin Robert G. , Miller M. Clinton , Mishkin David J.
Published: March 2012

The purpose of this study was to compare periodontal soft and hard tissue repair using expanded polytetrafluoroethylene (ePTFE) membranes with and without decalcified freeze‐dried cortical bone allografts (DFDBA). Six patients with 17 mandibular Class II buccal molar furcal invasions received oral hygiene instructions followed by scaling and root planing. Baseline soft tissue measurements with periodontal probes were made to assess probing depths (PD), recession (REC), and probing attachment levels (PAL). After non‐surgical therapy, 10 teeth were randomly selected as test sites (ePTFE + DFDBA) and 7 as controls (ePTFE alone). Full‐thickness flaps were elevated, and open surgical measurements were made to determine alveolar crestal height (CEJ‐AC) and vertical (CEJ‐BDF) and horizontal (HPDF) defect depth. The ePTFE membranes were removed at 6 weeks. After 6 months, all sites were reentered and both soft tissue and open surgical measurements recorded. The following mean changes (mm) were found for ePTFE and ePTFE + DFDBA treated sites respectively: decreased PD = 1.5, 2.2; increased REC = 1.3, 1.3; loss(−)/gain PAL= −0.2, 0.8; decreased CEJ‐BDF = 3.8, 5.0; increased CEJ‐AC = 0.5, 0.4; and decreased HPDF = 2.3, 2.4. None of the changes were statistically significant. The addition of DFDBA to the GTR procedure did not significantly improve any of the mean soft tissue and open surgical measurements between control (ePTFE alone) and test (ePTFE + DFDBA) groups in mandibular Class II buccal furcations. Both treatment procedures resulted in significant decreases in PD, CEJ‐BDF, and HPDF and a significant increase in REC. There were no differences for PAL and CEJ‐AC within control and test groups seen with this sample. Larger randomized clinical trials are needed to more fully evaluate whether combined graft and GTR procedures offer an advantage over GTR alone. J Periodontol 1994;65:244–254.
Intrapulpal Temperatures During Pulsed Nd:YAG Laser Treatment of Dentin, In Vitro
Authors: White Joel M. , Fagan Mark C. , Goodis Harold E.
Published: March 2012

Lasers are being used for soft tissue removal, caries removal, and treatment of root surface sensitivity. One concern for laser safety is that the heat produced at the irradiated root surface may diffuse to the pulp causing irreversible pulpal damage. To test this heat diffusion, copper‐constantan thermocouples were inserted into the radicular pulp canals of extracted teeth. Simulating direct exposure which might occur during gingival excision, superficial caries removal, and modification of the dentin surface for treatment of root surface sensitivity, a 2 mm2 area of the external root surface was uniformly irradiated with a pulsed Nd:YAG laser using a 320 μm diameter fiber optic contact probe. Power was varied from 0.3 to 3.0 W with frequencies of 10 and 20 Hz. Temperature changes during cavity preparations using a high speed handpiece with air coolant were also recorded. Repeated measures ANOVA (P ≤0.05) indicated that intrapulpal temperatures increased as a function of power, frequency, and time. Intrapulpal temperatures decreased as remaining dentin thickness (0.2 to 2.0 mm) increased for each laser parameter. Irradiation of dentin using a Nd:YAG pulsed laser, within the treatment times, powers, and frequencies with adequate remaining dentin thickness, as outlined in this paper, should not cause devitalizing intrapulpal temperature rises. J Periodontol 1994;65:255–259.
Periodontal Therapy in Young Adults With Severe Generalized Periodontitis
Authors: Gunsolley J. C. , Zambon J.J. , Mellott C.A. , Brooh C.N. , Kaugars C. C.
Published: March 2012

This study evaluated the effect of periodontal therapy on clinical and microbiological parameters in 23 subjects with severe generalized early onset periodontitis. Therapy consisted of oral hygiene instruction and root planing and scaling, followed 3 months later by open flap debridement. Subjects were monitored for both clinical measures and levels of Actinobacillus actinomycetemcomitans and Porphyromas gingivalis as identified by indirect immunofluoresence. Clinical and microbiological evaluations were done at the start of the study, 3 months after the completion of root planing and scaling and 3 months after open flap debridement. Mean probing depth was reduced by both root planing and scaling and open flap debridement and the level of reduction demonstrated by both phases of therapy was similar to reductions found in studies that utilized subjects with chronic adult periodontitis. In contrast, reductions in attachment level due to the two phases of therapy, demonstrated in previous studies of subjects with adult periodontitis, were not found in the young adult subjects with severe periodontal disease utilized in this study. Levels of A. actinomycetemcomitans were not significantly affected by root planing and scaling, but were reduced by open flap debridement. P. gingivalis was virtually eliminated by root planing and scaling, demonstrating that the two bacterial types respond differently to periodontal therapy. These changes in microbiological parameters were similar to those found in studies of localized juvenile periodontitis subjects, where surgery or antibiotics have been shown to be necessary to reduce levels of A. actinomycetemcomitans. J Periodontol 1994; 65:268–273.
Maintenance Therapy in Young Adults With Severe Generalized Periodontitis
Authors: Gunsolley J.C. , Zambon J.J. , Mellott C.A. , Brooks C.N. , Kaugars C.C.
Published: March 2012

The purpose of this study was to evaluate one year of maintenance therapy in young adults with severe periodontitis (SP) who had previously received periodontal therapy consisting of root planing and scaling followed by open flap debridement. Subjects were evaluated with clinical and microbiological measurements at 3, 6, 9, and 12 months following the completion of active therapy. Subjects were included in the study if they completed a minimum of two evaluation appointments. Monitoring of these subjects during the maintenance phase was analyzed by three methods. First, changes in mean attachment level and mean probing depth were calculated at 3‐month intervals to determine if the subjects continued to lose or gain attachment and/or had periodontal pockets of increasing or decreasing depth. Second, the frequency of periodontal breakdown was determined and compared to breakdown rates of subjects in other patient populations. Third, future changes in attachment level were related to the presence or absence of two putative periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in subgingival plaque. Mean attachment level remained constant in 13 subjects who completed one year of maintenance therapy. However, mean probing depth increased at a yearly rate of 0.19 mm and in periodontally‐involved sites pocket depth increased at a yearly rate of 0.65 mm both of which were statistically significantly different from 0 (P<.05). The frequency of periodontal breakdown in this study was higher than reported in other similar studies of different periodontitis patient populations. The reminder of the data in the study was from 21 subjects who had completed at least two recall appointments. In these subjects sites infected with A. actinomycetemcomitans and P. gingivalis exhibited significantly greater probing depth than non‐infected sites. At 11 different sites in 6 subjects, P. gingivalis was detected in 16 samples and those sites had average additional attachment losses of 0.72 mm after 3 months. This additional attachment loss was significantly greater (P <.05) than that at sites having no detectable P. gingivalis, which experienced little or no additional loss in attachment level (average = 0.0007 mm). A. actinomycetemcomitans was detected in 35 samples from 29 different sites in 12 subjects; however, no additional attachment loss was found 3 months later. These results indicate that P. gingivalis, but not A. actinomycetemcomitans, may be predictive of future attachment loss in young adults with severe generalized periodontitis and that the frequency of periodontal breakdown may be higher in SP patients than that in other patient populations. Consequently, microbiological monitoring of patients for P. gingivalis and more frequent clinical monitoring of SP patients may be appropriate during maintenance therapy. J Periodontol 1994;65:274–279.
Identification and Semi‐Quantification of Estrogen and Progesterone Receptors in Peripheral Giant Cell Lesions of the Jaws
Authors: Whitaker S. Bryan , Bouquot Jerry E.
Published: March 2012

Cases of peripheral giant cell lesions of the jaws (PGCL) were evaluated for the detection of estrogen and progesterone receptor proteins (ERS/PRS) utilizing immunoperoxidase staining. Staining for ERS was strongly positive in three cases when examining the mononuclear cell population. Another two cases were weakly positive. In addition, an occasional ER+ multinucleated giant cell could be observed in three of the cases examined. PRS immunoreactivity was essentially negative in all cases. It is well known that the PGCL has a marked female predilection. This, coupled with the present findings, gives further evidence that some PGCL may be at least partially under hormonal influence. J Periodontol 1994;65:280–283.
Periodontal Repair in Dogs: Space Provision by Reinforced ePTFE Membranes Enhances Bone and Cementum Regeneration in Large Supraalveolar Defects
Authors: Sigurdsson Thorarinn J. , Hardwick Ross , Bogle Gary C. , Wikesjö Ulf M.E.
Published: March 2012

Regeneration of alveolar bone and cementum following reconstructive therapy with reinforced space providing expanded polytetrafluoroethylene (ePTFE) membranes was evaluated in supraalveolar mandibular premolar periodontal defects in five beagle dogs. The surgically‐created defects in contralateral jaw quadrants were randomly assigned to receive the dome‐shaped membrane or serve as surgical control. Flaps were positioned to completely submerge the teeth and sutured. The dogs were sacrificed 8 weeks after surgery and tissue blocks including teeth and surrounding structures processed for histology. Membrane treated defects in two animals became exposed and infected leaving intact quadrants in three dogs for histometric analysis. Parameters evaluated included defect height, height and area of regenerated alveolar bone, height of regenerated cementum, root resorption, and ankylosis. Mean defect height approximated 4.1 mm. Mean height (±s.d.) of regenerated alveolar bone amounted to 2.9±0.6 and 0.6±0.2 mm for membrane and control defects, respectively (P = 0.006). Corresponding values for bone area were 1.4±0.7 and 0.4±0.4 mm2 (P = 0.02). Cementum regeneration was observed in all teeth averaging (±s.d.) 1.6±0.3 mm for membrane treated and 0.1±0.1 mm for control defects (P = 0.01). Small amounts of root resorption were seen in all teeth with no significant difference between treatments. Ankylosis was noticed in three membrane treated and two control teeth. The present study provides a biologic rationale for space provision for enhanced bone and cementum regeneration in periodontal defects subject to reconstructive therapy. J Periodontol 1994;65:350–356.
Impaired Bactericidal Activity of PMN From Two Brothers With Necrotizing Ulcerative Gingivo‐Periodontitis
Authors: Cutler C.W. , Wasfy M. O. , Ghaffar K. , Hosni M. , Lloyd D.R.
Published: March 2012

The purpose of this study was to investigate the pathogenesis of necrotizing ulcerative gingivo‐periodontitis (ANUP) diagnosed in two brothers, age 9 (ANUP1) and 14 (ANUP2) from rural Egypt. Complete blood count, differential and blood chemistry were within normal limits for both brothers and they were not malnourished. The phagocytosis and killing function of their polymorphonuclear leukocuytes (PMN) towards four bacterial species were assessed using a fluorochrome microassay. The selection of bacterial species was based on preliminary microbiological results in early onset periodontitis in Egypt. Fluorochrome‐labeled Prevotella intermedia, Peptostreptococcus micros, Campylobacter rectus, and Porphyromonas gingivalis were pre‐opsonized with ANUP serum and added to PMN from both ANUP patients, as well as PMN from three sex‐matched and two sex‐and age‐matched healthy Egyptian control (CTL) subjects. We found significant depressions (P < 0.05) in PMN phagocytosis and killing of C. rectus and P. intermedia by ANUP1 and ANUP2, when compared to all CTL PMN. An assessment of the Gramnegative subgingival microflora present in both ANUP patients (in colony forming unit percent of total CFU recovered) (CFU %) revealed the presence of P. intermedia (ANUP1, 41.7 CFU %; ANUP2, 14.8 CFU %), Fusobacterium nucleatum (ANUP1, 3.6 CFU %.; ANUP2, 48.1 CFU %), and Veillonella spp. (ANUP1, 18.2 CFU %; ANUP2, 18.5 CFU %). Spirochetes were also observed in cytocentrifuged, Gram‐stained plaque from both ANUP patients. The predominant Gram‐positive bacterial species recovered from both NUG1 and NUG2 was Streptococcus morbillorum. J Periodontol 1994; 65:357–363.
Unique Intronic Variations of HLA‐DQβ Gene in Early‐Onset Periodontitis
Authors: Takashiba Shogo , Noji Sumihare , Nishimura Fusanori , Ohyama Hideki , Kurihara Hidemi , Nomura Yoshio , Taniguchi Shigehiko , Murayama Yoji
Published: March 2012

Human leukocyte antigen (HLA) class II β chain plays an important role in the recognition of foreign antigens in immune reactions. Different forms of immune reaction may be concerned with initiation and progression of infectious diseases such as periodontitis. In this study we examined the frequency of HLA class II serotype and the variation of HLA class II β gene in periodontitis patients. HLA serotypic frequencies in 70 Japanese patients with periodontitis and 26 individuals with periodontal health were examined. No HLA serotype specific to any type of periodontitis was observed. In order to detect differences among some HLA serotypes, restriction fragment length polymorphism (RFLP) analysis was undertaken with cDNA probes for HLA‐DRβ and HLA‐DQβ genes in 20 subjects (15 patients and 5 healthy individuals). Atypical BamHI and EcoRI restriction sites were found in the HLA‐DQβ gene from 3 patients with earlyonset periodontitis. In addition to these 20 subjects, an additional 80 subjects (40 patients and 40 healthy individuals) were screened for the atypical BamHI restriction site using the polymerase chain reaction method. It was detected in 7 patients with early‐onset periodontitis, 1 patient with adult periodontitis, and 3 healthy subjects. No clinical differences except age were found between patients with this gene variation and other patients. Interestingly, all 3 healthy subjects with this gene variation were from subjects whose family members developed early‐onset periodontitis with the gene variation. Atypical BamHI and EcoRI restriction sites and 41‐nt repeated sequence were found in the intron before the third exon of HLA‐DQB gene. These results suggest that these intronic gene variations may be useful as gene markers for a subpopulation of early‐onset periodontitis and might affect immune reactions such as antigen recognition. J Periodontol 1994;65:379–386.
Necrotizing Ulcerative Periodontitis: A Marker for Immune Deterioration and a Predictor for the Diagnosis of AIDS
Authors: Glick Michael , Muzyka Brian C. , Salkin Leslie M. , Lurie Deborah
Published: March 2012

a multitude of oral lesions have been described in individuals infected with the human immunodeficiency virus (HIV). Few studies have attempted to correlate specific oral findings with immune status and HIV disease progression in the population reflecting the demographic profile of this epidemic. A prospective study was conducted among 700 ambulatory HIV‐infected individuals seeking dental care between July 1, 1988 and June 30, 1992. Patients entered the study when they first applied for care and were followed at regular intervals unless death occurred before the conclusion of the study. The prevalence rate of necrotizing ulcerative periodontitis (NUP) was calculated for the entire population and specific to race, gender, and HIV transmission category. Survival analysis was used to estimate the cumulative probability of death within 24 months of a NUP diagnosis. The association between NUP diagnosis and CD4+ cell count below 200 cells/mm3 was also investigated, and it was found that HIV‐infected individuals presenting with a diagnosis of NUP were 20.8 times as likely to have a CD4+ cell count below 200 cells/mm3 compared to HIV‐infected individuals presenting without NUP. The prevalence of NUP was 6.3%. The lesion was significantly more common among men having sex with men (MSM), 8.4%, compared with non‐MSM males, 1.8%. No racial difference was noted. The mean CD4+ cell count for patients with NUP was 51.8 cells/mm3 (SD ± 71.2) while the median CD4+ cell count was 32.0 cells/mm3. The predictive value of a CD4 + cell count below 200 cells/mm3 in patients with this lesion was 95.1%. A cumulative probability of death within 24 months of a NUP diagnosis was 72.9%. The presence of NUP in HIV‐infected individuals is a predictable marker for immune deterioration and disease progression. Specific oral lesions such as NUP should be considered for inclusion within the AIDS surveillance definition. J Periodontol 1994; 65:393–397.
The Relative Efficacy of 0.1% and 0.2% Delmopinol Mouthrinses in Inhibiting the Development of Supragingival Dental Plaque and Gingivitis in Man
Authors: Abbott David M. , Gunsolley John C. , Koertge Thomas E. , Payne Elaine L.
Published: March 2012

Delmopinol, a 3‐alkyl substituted N‐hydroethyl morpholine, has shown potential as a mouthrinse for the management of dental plaque and treatment of gingivitis. Delmopinol has been shown to possess plaque inhibitory activity in several previous studies. The aims of this study were to: 1) compare the antiplaque, antigingivitis efficacy and safety of 0.1% and 0.2% delmopinol‐containing mouthrinses (DMP) in a 2‐week, randomized, parallel arm, vehicle controlled study; and 2) determine if a dose response antiplaque, antigingivitis effect could be found in this type of formulation. One hundred and thirty‐three male subjects were randomly assigned to one of three groups, 0.1% DMP, 0.2% DMP, or vehicle control mouthrinses. At baseline all subjects received a clinical examination consisting of an intraoral soft tissue, plaque (Turesky modification of Quigley‐Hein plaque index), and gingival index (modified gingival index) evaluations, and received a thorough oral prophylaxis. All subjects refrained from all forms of oral hygiene for the next 2 weeks, except for the use of the assigned mouthrinse. Subjects rinsed for 1 minute with their assigned mouthrinse twice daily under supervision for 2 weeks. Following 2 weeks of mouthrinse use, plaque and gingivitis scoring and soft tissue examinations were repeated. The results showed the mean plaque index at the 2‐week examination was statistically related to the baseline value (P < 0.0003, ANOVA) and the concentration of DMP (P < 0.0001, ANOVA). In contrast, the gingivitis index was not related to the concentration of DMP (P > 0.05, ANOVA). No adverse effects were noted or reported during this clinical trial. J Periodontol 1994;65:437–441.
Factitious Gingival Ulceration: A Presenting Sign of Munchausen's Syndrome?
Authors: Heasman Peter A. , MacLeod Iain , Smith David G.
Published: March 2012

This report describes the case of a 21‐year‐old female who presented with localized gingival ulceration that over a period of 4 weeks became generalized, affecting all the buccal gingiva as well as the lower lip. A detailed medical history suggested that the patient was generating the lesions herself. She was monitored for 6 months, during which time additional lesions developed on the scalp and face. Conventional therapy failed to resolve the lesions and the patient was ultimately referred for a psychiatric consultation in view of the similarity of this case with previously reported cases of factitious disease. J Periodontal 1994;65:442–447.
Comparative Metabolism of 3H‐Glucosamine by Fibroblast Populations Exposed to Cyclosporine
Authors: Zebrowski Edward J. , Pylypas Susan P. , Odlum Olva , Johnson Roger B.
Published: March 2012

Cyclosporine and nifedipine therapy produces gingival overgrowth in many patients. Neither the mechanism underlying this undesirable side effect nor the possibility of synergism between these drugs is known, although many renal transplant patients receive both drugs. This study compared the rates of 3H‐glucosamine utilization by three groups of fibroblasts: untreated gingival fibroblasts, fibroblasts from gingival overgrowth tissue of a patient receiving both cyclosporine and nifedipine, and normal gingival fibroblasts exposed to cyclosporine‐A in vitro. Significant differences in the rates of deposition of 3H‐glucosamine into the extracellular matrix by each group of gingival fibroblasts were demonstrated, suggesting that increased rates of deposition of proteoglycans into the gingival extracellular matrix by fibroblasts should be further investigated as a biologic mechanism for gingival overgrowth. J Periodontol 1994;65:565–567.
DNA Probe Analyses of the Survival of Selected Periodontal Pathogens Following Scaling, Root Planing, and Intra‐Pocket Irrigation
Authors: Shiloah Jacob , Patters Mark R.
Published: March 2012

This clinical study evaluated the survival rates of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in periodontal pockets following scaling and root planing and intra‐pocket irrigation with antimicrobial agents in patients with moderate and severe periodontitis. The number of target organisms was determined utilizing DNA probes. Adult periodontitis patients were selected on the basis that the subgingival flora contained at least one of the target organisms. Forty‐eight (48) inflamed pockets ≥ 5 mm in depth with probing attachment loss and containing at least one of the target species were then selected in 7 adult patients who harbored these bacteria. Following baseline clinical and bacterial examination, all patients received thorough scaling and root planing. In addition, 1 or 2 teeth in each patient which harbored the target flora at baseline were randomly assigned to each of the following 4 treatment modalities: 1) control group, no irrigation; 2) saline group, irrigation with 2 cc of physiologic saline; 3) tetracycline group, irrigation with 2 cc of aqueous tetracycline hydrochloride, 50 mg/ml (5%); and 4) Chlorhexidine group, irrigation with 2 cc 0.12% chlorhexidine. All selected sites (5 to 8 per patient) were nonadjacent teeth. Clinical parameters and microbial analysis were recorded again at one week, and one month postirrigation. The survival rate of the target microorganisms was determined and the effect of irrigation with antimicrobial agents on this microflora was compared with the control groups (1 and 2). This investigation, although conducted on a small group of patients, indicated that: 1) thorough scaling and root planing was very effective in reducing the target bacteria below the detectable level (< 6,000 cells/site) at the majority of sites and 2) the addition of antimicrobial irrigation did not significantly augment the results obtained from scaling and root planing alone. These results suggest that the effects of shortterm single professional subgingival irrigation with antimicrobial agents does not result in major adjunctive benefits in reduction of subgingival pathogens beyond that achieved by thorough scaling and root planing. Repeat applications, or slow release of topical antimicrobials, may be necessary to achieve adjunctive antimicrobial effects. Furthermore, studies with larger groups of subjects may be necessary to show differences between scaling and root planing and adjunctive professional subgingival irrigation. J Periodontol 1994; 65:568–575.
Comparison of DNA Probe and ELISA Microbial Analysis Methods and Their Association With Adult Periodontitis
Authors: Melvin W. Lee , Assad Daniel A. , Miller Glenn A. , Gher Marlin E. , Simonson Lloyd , York Andrew K.
Published: March 2012

The purposes of this study were two‐fold: to compare the DNA probe and enzyme linked immunosorbent assay (ELISA) microbial identification tests and correlate the levels of microorganisms with adult periodontitis. A single plaque sample was taken from each of 2 sites in 52 patients. Twelve of these patients were also sampled during and after treatment. The experimental site had clinical indicators of disease (bleeding on probing, probing and attachment loss of ≥ 6 mm) and the contralateral site (control) was clinically healthy. A total of 176 plaque samples were collected, divided, processed, and sent for both types of quantitative microbial analyses. All of these samples were used to compare the DNA probe and ELISA methods while only the initial 104 pretreatment sites were used to correlate microorganisms/method with clinical indicators of adult periodontitis. DNA probes were used to assay for A. actinomycetemcomitans, P. gingivalis, P. intermedia, E. corrodens, F. nucleatum, T. denticola, and C. rectus. An ELISA utilizing monoclonal antibodies was used to assay for P. gingivalis, E. corrodens, T. denticola, and C. rectus. Comparison of the two methods revealed that the ELISA test identified P. gingivalis and C. rectus significantly more often than the DNA probe method and that T. denticola was detected more frequently with the DNA probe. The sensitivities and specificities varied widely among organisms and by test. P. gingivalis, as identified by ELISA, had the highest degree of sensitivity and specificity (0.90 and 0.82 respectively) to clinical indicators of adult periodontitis. J Periodontol 1994;65:576–582.
A 12‐Month Study of the Efficacy of a Pre‐Brushing Rinse in Plaque Removal
Authors: O'Mullane Denis M. , Whelton Helen , Galvin Niamh , Phelan Judith , Gleeson Patrick
Published: March 2012

A 12‐month clinical trial was conducted to compare the effectiveness of a prebrushing rinse (PBR) in plaque removal with that of water. Four groups participated in the study; group 1 (test group) rinsed with PBR before brushing; group 2 rinsed with plain tap water; group 3 brushed only; and group 4 rinsed with sterile water (same color as the PBR). Pre‐brushing and post‐brushing plaque scores were recorded at baseline, 3 months, 6 months, 9 months (Ramjford surfaces) and 12 months for groups 1, 2, and 3 and at baseline, 3 months and 6 months for group 4. Pre‐brushing minus post‐brushing plaque scores (decrements) were significantly higher in the PBR group at baseline, and 6, 9, and 12 months. Using a single criterion (gingival bleeding index) there were no differences between the 4 groups at any of the 5 assessments, hence, the clinical significance of the higher plaque removal scores in the PBR group remains in doubt. J Periodontol 1994; 65:611–615.
Differential Effect of TGF‐β1 and PDGF on Proliferation of Periodontal Ligament Cells and Gingival Fibroblasts
Authors: Dennison David K. , Vallone Dominic R. , Pinero Gerald J. , Rittman Barry , Caffesse Raul G.
Published: March 2012

Regeneration of periodontal tissues requires orchestration of several cell types. Two cell types, gingival fibroblastic cells (gingival fibroblasts) and cells from the periodontal ligament (PDL cells), were studied to compare the effects of supplemental addition of TGF‐β1 and PDGF on proliferation. Cells obtained from healthy donors were cultured in 10% FBS supplemented with either 10 ng/ml TGF‐β1, 20 ng/ml PDGF, or both. Thymidine incorporation was measured after 24, 48, or 72 hours. Data from PDL (analyzed by ANOVA) showed the following relations: at 24 hours TGFβ1/PDGF = PDGF > TGF‐ β1 = control; at 48 hours TGFβ1/PDGF > TGF‐β1 > PDGF > control; at 72 hours TGFβ1/PDGF > TGF‐β1 > PDGF = control. Gingival fibroblast cultures showed the following relations: at 24 and 48 hours TGFβ1/PDGF = PDGF > TGF‐β1 = control; at 72 hours, TGFβ1/PDGF = PDGF > control with TGFβ1 not different from control or factor combinations. Both TGF‐β1 and TGF‐β1/PDGF showed a significantly greater increase in proliferation of PDL cells than in gingival fibroblasts at 48 and 72 hours (Student t test P < 0.05). In contrast, PDGF stimulated proliferation of gingival fibroblasts was significantly greater than PDL cells at 72 hours (P < 0.05). Thus, supplementation of complete cultures (containing 10% FBS) with TGF‐β1 alone or combined with PDGF stimulates proliferation of PDL cells to a significantly greater extent than proliferation of gingival fibroblasts. The data (together with the fact that TGF‐β1 inhibits epithelial cell migration) suggest that these growth factors may be valuable in promoting new connective tissue attachment in the periodontal wound. J Periodontol 1994;65:641–648.
Freeze‐Dried Dura Mater for Guided Tissue Regeneration in Post‐Extraction Dental Implants: A Clinical and Histologic Study
Authors: Fontana Enzo , Trisi Paolo , Piattelli Adriano
Published: March 2012

Soft membranes were used in 69 patients for bone regeneration around implants (blades and screws, submerged and non‐submerged) placed into extraction sockets. In about 10% of the patients a prosthetic restoration was completed immediately, while in the remaining patients the prostheses were connected after a healing period of 3 to 6 months; follow‐up ranged from 6 to 30 months. In 22 patients a re‐entry procedure was done to evaluate the membrane and in 4 patients a bone biopsy was taken from 3 to 6 months after the placement of the membrane. In all cases the peri‐implant tissues appeared clinically healthy and it was possible to see radiographically that the newly formed bone closely adapted to the implants. In most cases it was possible at 6 months re‐entry to see the membrane and detach it from the underlying tissues. There was a partial dehiscence of the membrane in only 4% of the cases. After 3 months the tissue under the membrane presented macroscopical features similar to mature bone, and bone biopsies in all cases showed a spongious lamellar bone with a high level of activity and a wide band of osteoid tissue. J Periodontol 1994;65:658–665.
Localization of Gingival Overgrowth in Heart Transplant Patients Undergoing Cyclosporin Therapy
Authors: Somacarrera M.L. , Hernández G. , Acero J. , Moskow B. S.
Published: March 2012

This research was aimed at determining and comparing the pattern of localization of both cyclosporin‐induced gingival overgrowth and associated periodontal variables in heart transplant patients. Thirty‐nine patients undergoing cyclosporin treatment were studied for 6 months following transplant surgery. Oral hygiene and gingivitis were evaluated using the Silness‐Löe and Löe‐Silness indices. Gingival overgrowth was measured using a periodontal probe to determine the height of the gingiva at six points per tooth. Statistical hypothesis testing was applied to calculate the significance of the results. Overgrowth average showed a steady and significant growth. The graphs depicting average overgrowth localization, “standard periodontograms,” showed remarkable symmetry, and a significantly anterior mandibular papillary distribution. No overgrowth was observed in edentulous areas. The localization of plaque and gingivitis followed a similar pattern; a highly significant correlation was found with the overgrowth localization pattern. It was concluded that the elimination of plaque is an important preventive measure for cyclosporin‐induced gingival overgrowth, and that tooth or periodontium related factors have a significant impact on its pathogenesis. J Periodontol 1994;65:666–670.
Elastase and α‐1‐Proteinase Inhibitor in Gingival Crevicular Fluid and Gingival Tissue in Adult and Juvenile Periodontitis
Authors: Ingman Tuula , Sorsa Timo , Kangaspunta Petri , Konttinen Yrjö T.
Published: March 2012

The presence and localization of PMN/neutrophil elastase and its endogenous inhibitor α1‐proteinase inhibitor (α1PI) were studied immunohistochemically in gingival tissue specimens collected from 9 adult periodontitis (AP) patients during flap surgery after the initial phase of periodontal therapy, and from 6 healthy controls with clinicallyhealthy periodontium upon surgical extraction of impacted third molars. In order to evaluate how periodontal tissue destructive events are reflected in gingival crevicular fluid (GCF), GCF samples were collected from the AP patients before any periodontal treatment and prior to flap surgery, from 5 localized juvenile periodontitis (LJP) patients, and from the controls. Elastase activity in the GCF was measured with the SAAVNA‐assay and the molecular forms and amount of α1PI by Western‐ and dot‐blotting. Immunohistochemical staining for PMN elastase was strongly positive in the connective tissue, but not in the epithelium, of the AP patients' gingival tissue specimens. In the healthy gingival tissue specimens only a few elastase‐positive cells were present. Both in AP and in control gingival specimens, α1PI was detected in the connective tissue and in the keratinized layer of the epithelium, however, its amount was markedly lower in the control specimens. Elevated levels of α1PI and PMN elastase were detected in the GCF of all periodontitis patients when compared to controls. Based on the present findings we conclude that: 1) PMN elastase activity is associated with periodontal inflammation in situ, and increased activities are detected in AP GCF, but not in LJP GCF, and 2) α1PI is present both in healthy and in inflamed periodontal tissues, but during periodontal inflammation its amount is increased, probably due to a compensatory extracellular matrix (ECM) ‐protective mechanisms of the host's defense system. J Periodontol 1994;65:702–709.
The Relationship Between First Presentation and Subsequent Observations in Heavy Calculus Formers
Authors: Blank Lawrence W. , Rule James T. , Colangelo Gary A. , Copelan Nancy S. , Perlich Malcolm A.
Published: March 2012

There are few studies that provide information on the natural history of calculus formation. The purpose of this study is to evaluate the relationship between pre‐scaling baseline calculus scores, the time since the last prophylaxis before baseline, and scores 8 weeks after scaling in a group of presumed heavy calculus formers. Scaling and polishing were completed on 203 subjects with Volpe‐Manhold Index (VMI) calculus scores of 7 or higher, and the date of the last prophylaxis was noted. All were re‐examined after 3 weeks. The group included 45.8% males and 54.2% females; the mean age was 41.74 (range = 24 to 72). Racial mix was 57.6% African‐American, 39.9% white, and 2.5% other. The mean baseline VMI score was 24.07 (SD = 15.38, range = 7‐97). The VMI scores were directly related (P = <.001) to the date of the last scaling and were highest in subjects whose last scaling was more than 2 years earlier (33.67) and least in subjects whose last scaling was less than 6 months previous (15.12). At 8 weeks the mean VMI score was 9.96 (SD = 7.30; range = 0‐41). The VMI scores at this time were inversely related (P = <.05) to the date of the last scaling before baseline and were lowest in subjects whose last scaling was more than 2 years earlier (9.07) and highest in subjects with the last scaling less than 6 months previous to baseline (13.07). This study concludes that subjects with initial whole mouth VMI scores of 7 and higher tend to maintain high levels of calculus 8 weeks after scaling. Also, subjects with recent scalings formed more calculus than those with greater time since last scaling. J Periodontol 1994;65:750–754.
Evaluation of Consecutively Placed Unloaded Root‐Form and Plate‐Form Implants in Adult Macaca mulatta Monkeys
Authors: Fritz Michael E. , Lemons Jack E. , Jeffcoat Marjorie , Braswell Laura D. , Reddy Michael
Published: March 2012

The present paper describes 18 consecutively‐treated non‐human primates (Macaca mulatta) as part of a balanced block design study of 36 animals to examine osseointegration in root‐ and plate‐form implants prepared by atraumatic preparation of bone. Clinical measurements around selected teeth and digital radiology were utilized to monitor periodontal disease and bone deposition around the unloaded implants. Once a month scaling procedures were utilized as a means of preventing further advance of periodontal disease. Results indicate that once‐monthly regimen of scaling and root planing can prevent attachment loss of natural teeth and will not interfere with the healing of either type of implant; once‐monthly scalings produce significant reduction in redness (P <.05) and reduced probing depths (P =.01). A second finding is that both root and blade implants show radiographie evidence of osseointegration in this primate model. The quantitative analysis demonstrates bone gain is not stabilized until 6 months after healing. The data may indicate that occlusal loading of mandibular implants at 3 months may be premature. J Periodontol 1994;65:788–795.