bluuebunny/crossref_metadata_2025 huggingface dataset:
Pocket Formation 3 Years after Comprehensive Periodontal Therapy
Authors: Halazonetis Thanos D. , Smulow Jerome B. , Donnenfeld O. Walter , Mejias Judith E.
Published: March 2012

The records of 50 adult patients were studied to determine the incidence of pocket formation 3 years following periodontal therapy. These patients were treated at the Postgraduate Periodontal Clinic of Tufts University School of Dental Medicine and were subsequently placed on a 3‐month maintenance schedule. A total of 1080 teeth with probing depths of 3 mm or less at the end of active therapy were examined. Before treatment 305 teeth (28.2%) had probing depths of 1 to 3 mm, 480 (44.4%) had depths of 4 to 5 mm and 295 (27.4%) had depths of 6 mm or more. Three years after active treatment 944 teeth (87.4%) had probing depths of 1 to 3 mm, 110 (10.2%) had 4 to 5 mm depths and 26 (2.4%) had depths of 6 mm or more. Pockets developed more frequently in maxillary than mandibular teeth, in molars more than in any other tooth type and in those teeth which before treatment had pockets of 6 mm or more. Pockets were less likely to develop in patients with good plaque control and in patients below the age of 40.
Evaluation of the Effect on Root Surfaces of Air Turbine Sealers and Ultrasonic Instrumentation
Authors: Lie T. , Leknes K. N.
Published: March 2012

Three air turbine scalers were compared to each other and to an ultrasonic instrument (CAVITRON®) on medium and maximum power setting. The amount of remaining calculus, roughness and loss of tooth substance were estimated by means of well‐defined index systems (RCI and RLTSI). The time required to clean the test surfaces—marked on proximal root surfaces of mandibular incisors—was also noted. Standardized scanning electron microscope (SEM) micrographs were independently “blind‐scored” by three examiners, and total mean scores were calculated.

The results revealed significant differences (P < 0.001) between the instruments with respect to the amount of remaining calculus. There were also significant differences (P < 0.05) between roughness and loss of tooth substance produced by CAVITRON® at maximum power setting and that produced by the other instruments. No differences were found with regard to the time required to clean the test surface (until visually clean).
Gingival and Bacterial Plaque Response to Instrumentation, Oral Hygiene Instruction and Nutritional Therapy
Authors: Jones Barry Webb , Scott Tony E. , Coleman James R. , Clark James W. , Morse P. Kenneth , Sobel Robert E.
Published: March 2012

Thirty‐three male subjects participated in a study to examine the effect of supplements of multiple vitamins and minerals, local therapy (periodontal instrumentation and oral hygiene instruction) and a combination of both on gingival inflammation and bacterial plaque formation. Subjects were given either multivitamin and mineral supplements or placebos on a double‐blind basis for 21 days. On Day 7, the mandibular incisors were instrumented, and each subject was instructed in brushing and flossing. Observations were taken at Days 0, 7 and 21. There was a significant (P = 0.004) effect from micronutrient supplementation at Day 7 on the gingival index but no significant effect on the plaque index. On Day 21 there was no statistical superiority noted for the supplemented group in respect to either the gingival or plaque index, although the gingival index approached significance (P = 0.062).
Cicatricial Pemphigoid: A Case of Onset at Age 5
Authors: Moy W. , Kumar V. , Friedman R. P. , Schaeffer M. L. , Beutner E. , Helm F.
Published: March 2012

Cicatricial pemphigoid is a chronic subepideimal bullous dermatosis which primarily involves the mucous membranes. It is a disease found almost exclusively among middleaged and elderly persons. This report describes a case of cicatricial pemphigoid with onset at age 5 and involving primarily the mucous membranes of the mouth and eyes. The patient cleared well on 40 mg of Prednisone and has been maintained on a regimen of 7.5 mg of Prednisone every other day.
Repigmentation of the Gingiva Following Surgical Injury
Authors: Perlmutter Samuel , Tal Haim
Published: March 2012

Oral melanin pigmentation is not uncommon in some races and ethnic groups. Repigmentation of depigmented oral mucosa has been described after chemical, thermal, surgical, pharmacologic or idiopathic factors. Information on the repigmentation of oral tissues after surgical procedures is extremely limited. This communication reports on gingival repigmentation over a 7 to 8 year period following removal of gingival tissues.

Pigmented keratinized gingiva was removed in two Jewish Yemanite adult males, who had moderate or heavily pigmented gingiva. After surgery, the exposed lamina propria was covered by a periodontal pack for 7 to 10 days. The tissues were then observed periodically for signs of repigmentation. Healing was uneventful and the surgically treated areas in both patients remained depigmented over the first 2 years. After 32 months, some pigmentation was found in one of the patients, and with the exception of two limited sites, the area was completely repigmented after 7 years. The surgically treated area in the second patient remained depigmented over an 8‐year follow‐up period.

These observations agree with previous reports that described gingival pigmentation as spontaneous and suggest that further controlled experimental studies be undertaken to explore the biologic basis for repigmentation.
The Effect of Different Treatment Modalities on Connective Tissue Attachment
Authors: Lai Hongmin , O'Leary Timothy J. , Kafrawy Abdel H.
Published: March 2012

This study compared the effect of four treatment modalities on connective tissue attachment. Ligature‐induced periodontitis was established around the mandibular premolare of five young beagle dogs over 8 weeks. Following a 2‐week period without ligatures, a reference dog was sacrificed to estimate the extent and nature of the disease. Three dogs received flap procedures in one mandibular posterior segment, and the six experimental roots were treated with citric acid (pH 1) for 3 minutes; the contralateral mandibular segments received flap procedures and the roots were treated with 4% Chlorhexidine gluconate in the Hibiclens® preparation for 3 minutes. One segment of the control dog received flap procedures, and the roots were treated with sterile normal saline; the contralateral segment received closed root planing. The experimental dogs were sacrificed 1, 2 and 3 months after treatment. The control dog was sacrificed 3 months postoperatively. One week before sacrifice each dog received a Procion dye injection.

At sacrifice the study segments of all four treated dogs were clinically healthy, with no observable differences between the different treatment modalities. Histologically, the 1‐ and 3‐month Chlorhexidine, the 3‐month saline and 3‐month root planed specimens had long junctional epithelial adhesions with little connective tissue attachment. The 2‐month Chlorhexidine and all citric acid‐treated sections showed appreciable amounts of new connective tissue attachment. Some 2‐month and 3‐month citric acid and 2‐month Chlorhexidine sections showed cementum over the apical portion of the long junctional epithelium. The frequency of occurrence and the length of cementum overlapping epithelium increased appreciably over time.

Chlorhexidine was less predictable than citric acid in enhancing connective tissue attachment. When compared with the size of the periodontally involved area in the reference dog, all new connective tissue attachment could have occurred on uninvolved surfaces denuded by the root planing or flap procedures. The finding of cementum overlying the junctional epithelium indicates that coronal migration of connective tissue attachment is possible.
The Effect of Amoxicillin on Destructive Periodontitis
Authors: van Oosten M. A. C. , Hug H. U. , Mikx F. H. M. , Renggli H. H.
Published: March 2012

In a 22‐year‐old female patient, advanced localized periodontal destruction was observed. The planned treatment consisted of oral hygiene instructions, professional plaque control, deep scaling and root planing and finally modified Widman flap surgery. One molar had to be extracted but was left untreated initially as a control. During the treatment period of 9 months and during 1 year thereafter, samples were taken of the subgingival plaque for darkfield microscopy. The unplanned use of amoxicillin by the patient for a middle ear infection resulted in a suppression below detection level of spirochetes at the investigated sites. At the nontreated control site, the absence of spirochetes was accompanied by a 3‐mm reduction of pocket depth and a 2‐mm gain in clinical probing attachment, while some formation of new alveolar bone was observed. At the treated sites, clinical improvement was observed. However, a distinction between the effect of the periodontal therapy and the nonscheduled use of amoxicillin could not be made at the treated sites. It is concluded that a single course of systemically administered amoxicillin changed the composition of the subgingival microflora over a long period of time (17 months) and had a beneficial effect upon the status of the periodontium.
Systemic Antibody Response of Clinically Characterized Patients with Antigens of Eubacterium brachy Initially and Following Periodontal Therapy
Authors: Vincent Jack W. , Falkler William A. , Suzuki Jon B.
Published: March 2012

Eubacterium brachy, a Gram‐positive anaerobic rod, has been implicated by cultural studies to be associated with the microflora of periodontal diseases. Serum samples from 184 clinically characterized patients were evaluated in a standardized enzyme‐linked immunosorbent assay (ELISA) for reactivity to E. brachy antigens. Sera from clinically healthy subjects (HS) served as controls. Sera from rapidly progressive periodontitis (RP) patients demonstrated significantly greater reactivity by ELISA than did HS when reactivity with E. brachy antigens was determined (P < 0.05). Juvenile periodontitis (JP) and adult periodontitis (AP) patients did not differ in reactivity by ELISA from HS (P > 0.05). Three to 4 years following successful periodontal therapy, reactivity was not significantly altered in any patient group (P > 0.05). The possible significance of these findings and the importance of an extracellular antigen of E. brachy in the immunopathology of periodontal diseases are discussed.
Relative Influence of Scaling and Root Planing and Occlusal Adjustment on Sulcular Fluid Flow
Authors: Hakkarainen Kristiina
Published: March 2012

The aim of the investigation was to clarify the effects of the resolving of inflammation on one hand and the removal of occlusal trauma on the other hand on the rate of sulcular fluid flow (SFF) from deep periodontal pockets. Forty‐seven adult patients having at least one tooth with an inflamed >5 mm periodontal pocket and elevated mobility associated with occlusal trauma were selected for the study. After oral hygiene instruction and supragingival scaling, the rate of sulcular fluid flow of the test teeth was recorded on Day 0. After the baseline recording, each patient was randomly assigned to either Group A or Group B. The test teeth of Group A were subjected to subgingival scaling and root planing under local anesthesia, and the test teeth of Group B were subjected to occlusal adjustment. On Day 14 sulcular fluid flow was recorded for both groups, after which Group A received occlusal adjustment and group B received scaling and root planing. On Day 28 the sulcular fluid flow recordings were repeated for both groups.

The mean flow rates of both Group A and Group B decreased significantly (P < 0.05) from Day 0 to Day 28. When the occlusal interference was eliminated 2 weeks after scaling and root planing (Group A), no additional decrease in sulcular fluid flow was observed. When the occlusal interference was eliminated before scaling and root planing (Group B), the reduction in sulcular fluid flow remained statistically insignificant through the first 2week observation period. For the incisors and canines, a significant (P < 0.05) reduction in SFF was measured after scaling and root planing of the occlusally adjusted teeth (Group B). It was concluded that occlusal interferences do not affect the quality of sulcular fluid flow.
An Unusual Cause of Bilateral Mental Neuropathy in an AIDS Patient
Authors: Milam Stephen B. , Rees Terry D. , Leiman Herbert I.
Published: March 2012

A case is reported of a patient with sudden onset, generalized toothache accompanied with a numb chin and lower lip. A thorough oral examination was negative. A complete medical evaluation revealed a positive HTLV‐III antibody titer and acute lymphoblastic leukemia (Burkitt's‐type). An unexplained trigeminal neuropathy should prompt the dentist to refer the patient for complete medical evaluation. A high index of suspicion of a malignant process should be maintained in all cases of unexplained numb lower lip and/or chin.
Immunohistochemical Study of Structural Proteins in Developing Junctional Epithelium
Authors: Massoth Donna L. , Dale Beverly A.
Published: March 2012

The objective of this study was to investigate structural proteins of ameloblasts, reduced enamel epithelium and junctional epithelium using antikeratin antibodies to determine if keratin expression changes as ameloblasts differentiate to cells of junctional epithelium. Block sections of fully erupted, partially erupted and unerupted molar and incisor teeth were removed at necropsy from monkeys age 2, 5, 6 and 7 years. Tissues were fixed in Carnoy's fixative, decalcified in Kristensen's solution for 4 to 8 weeks, embedded in paraffin and sectioned at 5 μ. Representative sections were stained with hematoxylin and eosin. Remaining sections were stained with antikeratin antibodies AE1, AE3, 34βE12, 35βH11 and anti40kD using the avidin‐biotin‐conjugated immunoperoxidase method. Results were analyzed qualitatively for presence or absence of staining products. Antibody 35βH11 reacted with ameloblasts and reduced enamel epithelium during the early maturation phase of tooth development but not with the reduced enamel epithelium of erupting teeth or with junctional epithelium. The anti‐40kD antibody stained ameloblasts and reduced enamel epithelium of unerupted teeth and teeth erupting through oral epithelium; however, junctional epithelium of partially erupted and fully erupted teeth were unstained. Antibodies AE1, AE3 and 34βE12 stained ameloblasts and all layers of reduced enamel epithelium and junctional epithelium in all stages of development. These results suggest a relationship between expression of structural proteins and changes during development and differentiation of ameloblasts to junctional epithelial cells.
Immunohistological Study with Peroxidase‐Antiperoxidase Staining in a Case of Generalized Prepubertal Periodontitis
Authors: Hara Yoshitaka , Aono Masao , Maeda Katsumasa , Akamine Akifumi , Furukawa Takeshi , Yoshimura Sachiko
Published: March 2012

A case of prepubertal periodontitis was observed and examined immunohistologically with peroxidase‐antiperoxidase staining. The patient was an 11‐year and 7‐month‐old Japanese girl, well‐developed and well‐nourished. Her parents were first cousins. Her chief complaint was the loosening and loss of the permanent teeth. There was a similar history of primary dentition. Her remaining permanent teeth were loosened with severe alveolar bone loss, but calculus deposit was minimal. Significantly, there was no palmar‐plantar hyperkeratosis. General examination showed normal data except for the increase of the immunoglobulin concentrations. In neutrophil function tests Chemotaxis was depressed, although phagocytosis, random migration and Superoxide production were within normal limits. Histologically, neutrophils were seen in the gingival tissue and other findings were also similar to those of adult periodontitis. In immunohistological examination, IgG‐bearing cells which mostly consisted of plasma cells predominated in the lesion. Considering the past history, the immunodeficiency and the absence of palmar‐plantar hyperkeratosis, the case was diagnosed as prepubertal periodontitis.
Healing Responses to Grafting of Combined Collagen: Decalcified Bone in Periodontal Defects in Dogs
Authors: Blumenthal N. , Sabet T. , Barrington E.
Published: March 2012

The feasibility of a new combined collagen gel‐autolysed antigen‐extracted allogeneic bone implant was tested. Its effect on gaining new attachment in surgically created defects in four dogs was evaluated over 24 weeks. As controls, sites receiving implants of the bone implant alone, nonimplanted and untreated defects were also evaluated. The collagen gel encouraged ingrowth of regenerative tissue‐fibroblasts in the early stages of wound healing while the allogeneic bone induced new bone formation. The graft materials were bicompatible, technically manageable and clinically effective. From the present preliminary study, it was evident that the combined autolysed antigen‐extracted allogeneic bone‐collagen gel implant may offer advantages over the present implant materials and techniques currently used in the treatment of periodontal intrabony defects.
A Study of Epithelial Odontogenic Residues in the Pig
Authors: Spouge J. D.
Published: March 2012

Formation of the junctional epithelium was studied by routine light microscopy in the molar teeth of commercially slaughtered pigs. It was found that the process whereby the reduced enamel epithelium (REE) contributed to the junctional epithelium formation corresponded largely with changes in man previously described by Schroeder and Listgarten (Monographs in Developmental Biology, Vol. II, Basel, S. Karger, 1971).

The configuration of the marginal rests of Malassez (ROM) and their relationship to the junctional epithelium and REE was similarly studied by means of true serial sections. It was found that the ROM in that portion of the periodontium below the alveolar crest formed a well defined network of epithelial strands, but the network became more poorly defined and diverged away from the surface of the cementum as the cementoenamel junction was approached. The coronal border of this network ultimately became continuous with the REE by means of a relatively few vertical strands of epithelium.

The possibility that the presence of epithelial residues in the periodontium may contribute to pocket formation and the potential effects of its configuration and continuity with the junctional epithelium are speculatively considered.
A Periodontitis Severity Index
Authors: Adams R. A. , Nystrom G. P.
Published: March 2012

A Periodontitis Severity Index (PSI) was developed and then tested in a population of 154 patients attending the University of Mississippi School of Dentistry screening clinic. Patients were grouped by age decade. The premises of the PSI follow: (1) Periodontitis is diagnosed on the concurrence of clinically apparent marginal inflammation and vertical loss of supporting periodontium (the severity of the associated clinical inflammation does not seem to be related to the severity of the tissue loss) and (2) a Schei ruler is used to determine from the radiograph the percentage of bone loss for a tooth surface.

For each patient, a 0 to 1 Clinical Inflammation Score (CIS) was determined at the mesial and distal of every tooth. A CIS of 0 reflected no demonstrable clinical inflammation, whereas a CIS of 1 meant that clinical inflammation could be detected. A modified Schei ruler was used to determine the percentage of bone loss at each interproximal site. A Bone Loss Score (BLS) was calculated on a 0 to 10 whole number continuum. A BLS of 0 meant no bone loss, 1 = up to 10%, etc., up to BLS 10 = 90 to 100% loss.

The PSI was then calculated for each mesial and distal surface. PSI = BLS × CIS. The PSI could be 0 if either no bone loss could be determined or the gingiva was healthy. In the presence of marginal inflammation, the PSI value was directly proportional to the percentage of bone loss. Mean PSI values were calculated for each age group. The PSI tended to increase with age.

The PSI offers several advantages. Healthy sites can be distinguished from diseased sites, ratio data can be produced, arbitrarily weighted clinical observations can be largely avoided, and direct measurements of periodontitis severity can be made.
The Prevalence, Location and Conformation of Palato‐Radicular Grooves in Maxillary Incisors
Authors: Kogon S. L.
Published: March 2012

Palato‐radicular grooves in maxillary lateral incisors have been implicated as an initiating factor in localized gingivitis and periodontitis. Focal loss of periodontal attachment associated with these grooves, some of which may extend to the apical third of the root, could result in a hopeless prognosis for tooth retention. There is disagreement as to the prevalence of this anomaly. As well, little is known about the shape, location and length of the defect. This study examined 3168 extracted maxillary lateral and central incisors. Of these teeth 4.6% had a palato‐radicular groove. About half of the grooves terminated on the root and 58% of these extended more than 5 mm from the cementoenamel junction. A poorly described deformity, displacement of the cementoenamel junction, occurred in 38% of the grooves which crossed that structure. Although an extension of enamel in the groove has been suggested as a possible factor in the progression of localized periodontal disease, its presence was rarely observed.
Periodontal Adaptation Following Extensive Extrusion and Rotation of a Horizontally Impacted Maxillary Central Incisor
Authors: Khouri Suhail Awwad
Published: March 2012

This report reviews the literature concerning the periodontal considerations involved in nonextraction management of impacted teeth. Further, it describes the clinical and radiographic features of periodontal tissue response to an 18‐mm extrusion and 160 degree simultaneous rotation of a horizontally impacted maxillary central incisor in a 22‐year‐old female patient.

Following surgical exposure of the unerupted incisor, an elastic thread traction was used to orthodontically move the tooth to the line of occlusion. Posttreatment evaluation of the periodontal and gingival response to a tooth movement of this complexity and magnitude was very favorable from the esthetic and functional aspects.
Prevalence and Distribution of Attached Cementicles on Human Root Surfaces
Authors: Holton William L. , Hancock Everett B. , Pelleu George B.
Published: March 2012

A study was undertaken to determine the prevalence and distribution of attached cementicles on different root surfaces of 415 extracted human incisors, canines, premolars and molars. The teeth were boiled in water and soaked in a 5.25% solution of sodium hypochlorite to clean the root surfaces of any soft tissue and debris. Examination with a dissecting microscope showed cementicles on 144 (34%) of the teeth. Cementicles were seen on approximately 50% of the canines and molars and on fewer than 50% of the other teeth. On canines, cementicles were found most frequently in the middle and apical thirds of the roots. On molars, cementicles were found most frequently in furcations. A relationship was noted between the presence of enamel pearls in molar furcations and enamel projections from the cementoenamel junction. The findings suggest that cementicles occur in certain locations frequently enough to be of clinical importance.
Long‐Term Effect of Thin Interdental Alveolar Bone on Periodontal Health after Orthodontic Treatment
Authors: Årtun Jon , Osterberg Stig K. , Kokich Vincent G.
Published: March 2012

The present experiment was undertaken to determine if an interproximal area with a thin interdental bone septum following orthodontic treatment provides less resistance against marginal periodontal breakdown than an interproximal area with a normal width of bone between the roots. Only adult patients, at least 16 years after active orthodontic treatment, were studied. The distance between the roots was measured directly on periapical radiographs. Gingival health, level of attachment and bone level in sites with thin interdental bone were compared with neighboring or contralateral sites with a normal width of bone between the roots. No statistically significant differences in inflammation, level of attachment and clinical scores for bone level were observed. When measured radiographically the distance from the cementoenamel junction to the alveolar bone was significantly shorter in neighboring control sites (P < 0.05). This discrepancy was most likely due to radiographic distortion. The results of this investigation suggest that in anterior areas marginal periodontal breakdown is unrelated to the thickness of bone between the roots. Too few molar sites were included to draw conclusions regarding such areas.
Effect of Periodontal Therapy on Patients Maintained for 15 Years or Longer
Authors: Goldman Marc J. , Ross Ira Franklin , Goteiner David
Published: March 2012

A retrospective study of tooth loss in 211 patients who were treated for periodontal disease in private practice and maintained for 15 to 34 years on 3‐ to 6‐month recall schedules is reported. The average age of the patients was 42 years, and the average length of time in maintenance was 22 years. On the basis of response to therapy, the patients were classified as Well‐Maintained (62%), Downhill (28%) and Extreme Downhill (10%). Seven hundred and seventy‐one (771) teeth were lost (13.4%) due to all causes. Molar teeth are the most prone to loss and the mandibular cuspid is the most resistant. The importance of maintenance therapy is emphasized.
Chlorhexidine: An Adjunct to Periodontal Therapy
Authors: Greenstein Gary , Berman Charles , Jaffin Robert
Published: March 2012

Chlorhexidine is an effective antimicrobial agent. Its application can enhance periodontal therapy. The pharmacology of Chlorhexidine and suggestions for its use are outlined. In addition, its potential for inducing cancer and bacterial resistance are discussed.
Full Dentition Periodontal Surgery Using Intravenous Conscious‐Sedation: A Report of 10,000 Cases
Authors: Ceravolo Francis J. , Meyers Herbert E. , Michael John J. , Bennett C. Richard
Published: March 2012

In 1980 ceravolo, et al, reported the results of 5200 cases of periodontal surgery performed in dental offices on patients while under conscious sedation. In no instance was a major complication noted. Successful case management coupled with a high degree of patient acceptance prompted the authors to continue to perform full dentition periodontal surgery with the aid of conscious sedation plus local anesthesia. To date, 10,000 cases have been completed in this manner. As yet no major complications have been noted.
Inhibition of Superoxide Generation by Human Polymorphonuclear Leukocytes with Chlorhexidine
Authors: Goultschin Josef , Levy Haim
Published: March 2012

During the acute phase of periodontal disease, as many as 60% of the cells of the junctional epithelium may be accounted for by polymorphonuclear cells (PMNs). It is generally accepted that these cells play a dominant role in the destruction of connective tissue by virtue of the proteinases they release and the free oxygen radicals they generate. Modulation of the proteolytic activity and free radical production seems to be essential for the inhibition of tissue destruction. We have therefore studied the effect of Chlorhexidine on the generation of free oxygen radicals and luminol‐dependent chemiluminescence (LDCL) by stimulated human PMNs. Nontoxic Chlorhexidine concentrations (0.1–1 μg/ml) were found to inhibit Superoxide production but did not affect LDCL. We therefore suggest that in addition to its antiseptic effect, Chlorhexidine may also modulate the generation of free radicals by activated PMN cells in the inflamed gingiva.
The Presence of Bacteria in the Oral Epithelium in Periodontal Disease
Authors: Saglie F. R. , Smith C. T. , Newman M. G. , Carranza F. A. , Pertuiset J. H. , Cheng L , Auil E. , Nisengard R. J.
Published: March 2012

Serial histological sections of gingiva obtained from each of six advanced adult periodontitis, two localized juvenile periodontitis and two periodontally healthy patients were used for specific identification of bacteria within the oral epithelium and adjacent connective tissue. Healthy gingival biopsies served as controls. Sections from patients and control biopsies were Gram‐stained and also screened with antibacterial sera associated with the peroxidase immunocytochemical technique for specific bacterial identification. The „Pop‐off” electron microscopic technique was also used to further demonstrate the bacterial nature of peroxidase‐stained material. In addition, the possible correlation between bacteria and areas of possible reduced keratinization was investigated. The results showed that sections of orthokeratinized healthy gingiva did not contain bacteria. Gram‐stained sections from diseased sites contained large numbers of bacteria in the oral epithelium and adjacent connective tissue. Bactewides gingivalis and to a lesser extent Capnocytophaga gingivalis were found in periodontitis, and Actinobacillus actinomycetemcomitans was found in juvenile periodontitis when the immunoperoxidase technique was used. The bacterial nature of peroxidase‐stained material was confirmed by the „pop‐off” technique. In the disease biopsies, bacterial presence was correlated with areas of reduced amounts of keratin suggesting that the oral epithelium may be a portal of entry for bacteria into gingival tissues.
Antibodies to Actinobacillus actinomycetemcomitans in a Korean Population
Authors: Chung Chong‐Puoung , Lee Young‐Kwan , Choi Sang‐Mook , Nisengard Russell J.
Published: March 2012

Previous studies demonstrated that serum antibodies to Actinobacillus actinomycetemcomitans strain Y4 are significantly elevated in sera from localized juvenile periodontitis (LJP) and postlocalized juvenile periodontitis (P‐LJP) patients compared to normal controls in United States populations. This study examined the age of subjects in relation to the antibody levels to A. actinomycetemcomitans in a Korean population. Seven groups were investigated including sera from newborns, infants, children, periodontally normal puberty and adult groups and LJP and P‐LJP groups. Antibody levels were determined by an enzyme‐linked immunosorbent assay (ELISA) to A. actinomycetemcomitans strain SNUDC 10–1 (serotype C) isolated from a Korean LJP patient.

In the healthy non‐LJP and non‐P‐LJP subjects, IgG levels decreased from the newborn group to the 5‐month‐old group and then gradually increased through the adult group. The IgM levels in these groups continuously increased from birth until a plateau was reached in the 2‐ to 6‐year group. Serum IgA levels to strain SNUDC 10–1 were too low to be measured by this assay.
Occurrence of Actinobacillus actinomycetemcomitans and Spirochetes in Relation to Age in Localized Juvenile Periodontitis
Authors: Asikainen Sirkka
Published: March 2012

Occurrence of Actinobacillus actinomycetemcomitans (A.a.) and spirochetes was examined in relation to the age of patients suffering from localized juvenile periodontitis (LJP). Twenty LJP patients were divided into three age groups: 14–16, 17–19, and 20–25 years of age. Two sites with radiographic alveolar bone loss and two sites without bone loss were examined in each patient. Probing depth, gingival bleeding after probing, and orthopantomographic alveolar bone loss were recorded. Subgingival bacterial samples were taken from the same four sites for cultivation of A.a., and for dark‐field microscopic assessment of spirochetes. A.a. was isolated in the youngest group more frequently than in the two older ones. Spirochetes were detected in the youngest group as well, but were not related to the age of the patients. A.a. occurred as frequently with as without spirochetes, both in pockets exhibiting and not exhibiting bone loss. There was no difference in the spirochete proportions between the A.a.‐positive and ‐negative sites.

The occurrence of A.a. was not related to the absence, presence, or proportions of the spirochetes, but, unlike the situation with spirochetes, was related to the age of the LJP patients. Thus the occurrence of A.a. is possibly associated with the activity of the disease.
Fluorescent Antibody and Flagella Stains for Rapid Detection of Bacteria at Periodontally Healthy and Diseased Sites
Authors: Drisko Connie L. , Brandsberg John W. , Walters Perry L. , Killoy William J. , Tira Daniel E.
Published: March 2012

Two rapid methods of identifying bacteria associated with periodontal disease were investigated to determine their diagnostic usefulness in longitudinal or epidemiologic studies. Three nonmotile organisms were identified by fluorescent antibody stains (FA) while percentages of motile bacteria were assessed by counting all spirochetes, flagellated and nonflagellated organisms stained with a simplified silver‐plating stain for flagella. Relationships between disease activity and these bacteria from subgingival plaque samples taken at 18 individual sites (12 diseased, 6 healthy) were determined by correlating the quantity of detectable bacteria with the Gingival Index (GI), Plaque Index (PLI) and probing depth (PD). The highest correlations found with the FA stains were between Bacteroides gingivalis and probing depth (rs = 0.85), GI(rs = 0.80) and PLI(rs = 0.80). Bacteroides melaninogenicus and/or Bacteroides intermedius also correlated well with the GI (rs = 0.66), PLI (rs = 0.64), and PD (rs = 0.59), but to a lesser degree than B. gingivalis. Flagella stains showed that spirochetes correlated highly with PD (rs = 0.82), as did the total motile group with PLI (rs = 0.82). Motile bacteria alone were only moderately associated with the clinical parameters measured. The results of this investigation suggest that FA‐ and flagella‐staining methods can be valuable screening tools for the detection of bacterial species and motile organisms in longitudinal or epidemiologic studies.
Plaque Reduction Unaccompanied by Gingivitis Reduction
Authors: Spindel Lawrence M. , Chauncey Howard H. , Person Philip
Published: March 2012

The effects of brushing with three different dentifrices on plaque accumulation and gingival inflammation were studied in 83 subjects. The Turesky modification of the QuigleyHein plaque index and a modified Löe‐Silness gingivitis index were employed. Index scores were obtained in a randomized, double‐blind study design, at 0 (baseline), 3‐, 6‐, and 9week intervals. ANOVA analyses of results showed no significant differences between any of the three dentifrices used with respect to observed effects. Of interest, however, was the observation that with all three dentifrices reductions in plaque accumulations occurred, at 1% and 5% significance levels, without a corresponding commensurate improvement in the inflammatory status of the associated gingivae (using paired sample t‐test analyses). The above results and relevant literature are discussed in support of the thesis that at times, for reasons as yet inexplicable, plaque and gingival inflammation may not be causally related in the manner so commonly observed.
A Clinical and Microbiologic Examination of Gingival Disease in Parapubescent Females
Authors: Yanover Lawrence , Ellen Richard P.
Published: March 2012

A longitudinal study of 18 subjects progressing normally through puberty (Group 1) and a cross‐sectional study of nine subjects with precocious puberty (Group 2) were undertaken to evaluate the effect of puberty on clinical and microbiologic parameters of periodontal health. The most inflamed first molar was selected for subgingival plaque sampling. There was no significant change in mean Plaque Index (PII), Gingival Index (GI) or dark‐field microscopic counts of the associated microflora in Group 1 from session to session. Individual subjects changing black pigmented Bacteroides (BPB) carrier status at a session also experienced a change in GI when compared to the group as a whole. A positive correlation was observed between GI and P1I at all sessions in the study. No radiographic evidence of destructive periodontal disease was observed. A correlation was noted between the presence, but not the levels, of BPB and plasma estradiol concentration in Group 2 subjects. Isolation of BPB, almost all B. intermedius, was not correlated with physical maturation in either group. During puberty, mild gingivitis may exist prior to detectable colonization by spirochetes or BPB. Hormonal events of puberty do not necessarily foster the colonization of pathogens implicated in adult periodontitis.
Neutropenic Ulceration
Authors: Barrett Anthony P.
Published: March 2012

Neutropenic ulceration is a distinctive clinical entity observed in severely myelosuppressed patients, such as those with acute leukemia. This case report demonstrates that evidence of its initial resolution may indicate the earliest stages of bone marrow recovery before this is reflected in the peripheral circulation through the return of functioning neutrophils. The possible influences of leukemic infiltration and bacterial superinfection in its initiation and progression are discussed.
Comparative Effectiveness of Ultrasonic and Hand Scaling for the Removal of Subgingival Plaque and Calculus
Authors: Breininger David R. , O'Leary Timothy J. , Blumenshine Ruth V. H.
Published: March 2012

The purpose of the study was two‐fold: to determine the nature of stainable deposits on periodontally diseased root surfaces subsequent to in vivo scaling and root planing procedures, and to quantify the distribution of residual plaque on instrumented root surfaces. Thirty molar and 30 nonmolar teeth which were condemned for periodontal or prosthetic reasons and had proximal probing depths of 4 to 7 mm were treated. Half of these were instrumented with I.U. curettes and the other half with an ultrasonic scaling device. Instrumentation was continued until the root surface felt hard and smooth to an explorer tip. The location of the gingival margin was recorded by notching the treated proximal surface with a No. 1/2 round bur. Twenty control teeth, 10 molar and 10 nonmolar, were extracted without instrumentation. Control and experimental teeth were irrigated with saline and stored in a 2.5% glutaraldehyde fixative solution until the time of assessment.

All teeth were stained with a 0.5% solution of toluidine blue, and the amount of residual stained material and calculus was assessed under the stereomicroscope using an eyepiece fitted with a 10 × 10 optical grid. Stained deposits were marked by placing small V‐shaped notches in the adjacent root surface as an aid to identification after the specimens were processed for scanning electron microscopic (SEM) examination. The nature of stained deposits on selected teeth was then characterized using the SEM. Treated root surfaces were also surveyed in detail to assess the quantity and extent of residual plaque deposits.

The findings showed that although a large percentage of the treated proximal root surface may possess stainable deposits, these surfaces were often unexpectedly free of microbial organisms. In this study, the majority of stained deposits were composed of adherent fibrin and instrumentation debris. When bacterial plaque was present, it was usually found in small „mini‐colonies” smaller than 0.5 mm across. Such findings cast doubt on the validity of using histologic and disclosing stains as an indicator for the presence of bacterial plaque immediately after instrumentation. Although only partially effective in removing subgingival calculus, both methods of instrumentation in this study appeared to be remarkably effective in bacterial debridement of subgingival root surfaces.
Radiographic Detection of Dental Calculus
Authors: Buchanan S. A. , Jenderseck R. S. , Granet M. A. , Kircos L. T. , Chambers D. W. , Robertson P. B.
Published: March 2012

To determine the sensitivity and specificity of the radiographic detection of calculus, 275 proximal tooth surfaces from 18 patients were evaluated. Standardized periapical radiographs obtained before extraction were coded, batch processed, and evaluated independently by two investigators under optimum viewing conditions. After extraction, the teeth were photographed and evaluated both microscopically and by planimetry on 40 × linear projections. Evaluation of calculus by conventional radiography showed low sensitivity: radiographic deposits were detected on only 44% of surfaces that demonstrated calculus microscopically. Specificity was high and the rate of false positives was only 7.5%. Detection of calculus was influenced by the thickness of calculus, the percentage of root surface occupied by calculus, and by tooth type; but not by attachment loss, probing depth, proximal surface, or arch location. These results show that present radiographic techniques are not appropriate for detecting calculus on root surfaces.
Treatment of a Patient with Papillon‐Lefèvre Syndrome
Authors: Lu Hsein‐Kun Jackson , Lin Che‐Tong , Kwan Hsueh‐Wan
Published: March 2012

A vital root submersion procedure was performed in a rare case of Papillon‐Lefevre syndrome (PLS). Although the etiology and pathogenesis are obscure, possible host genetic defects and known or unknown periodontal pathogens may play important roles in the progression of PLS. Since this patient did not respond to conventional periodontal therapy, a submersion procedure was employed to maintain the alveolar ridge and resulted in controlling the progression of the patient's severe periodontitis. The following is a report of the treatment and the rationale for therapy.
Effects of Subgingival Irrigation on Periodontal Status
Authors: Greenstein Gary
Published: March 2012

Periodontal diseases are localized, plaque‐related infections. Often, clinical signs of inflammation are not eradicated by supragingival plaque control, dictating that subgingival microbial populations must be reduced. Confirmation that it is possible to deliver medicaments to the base of deep pockets stimulated numerous investigations. This report evaluates the role of site‐specific pharmacotherapy to enhance periodontal status.
Bacterial Invasion in Experimental Gingivitis in Man
Authors: Saglie F. R. , Pertuiset J. H. , Rezende M. T. , Sabet M. S. , Raoufi D. , Carranza F. A.
Published: March 2012

Gingival biopsies of the mesial papilla area of the first molar were obtained from each patient at 0‐, 14‐ and 21‐day intervals during plaque formation. The biopsies were fixed, serially sectioned, and Gram‐stained. The incidence and distribution of the bacteria‐like structures were studied by microscopy. In all the specimens the bacterial nature of Gramstained material was substantiated. In the epithelium the highest number of bacteria was found at the outer layer of marginal oral epithelium, sulcular epithelium and apical oral epithelium along with a decreasing pattern of penetration progressing deeper into the layers of tissue. For junctional epithelium the situation was just the opposite. Each subject had significantly higher counts at Day 21 than at Day 14 for both epithelium and connective tissue. Also significantly higher counts were found in connective tissue compared with the epithelium. The higher bacterial density of intragingival bacteria was associated with the higher gingival and plaque indices. This study suggests that early stages of gingival inflammation may be mediated by invasion of bacteria.
Odontomas
Authors: Swan Richard H.
Published: March 2012

Odontogenic tumors normally occur within the tooth‐bearing areas of the jaws. When they involve the dentogingival complex of adjacent teeth, their removal may become the responsibility of the periodontist. The odontomas are the most common of the odontogenic solid tumors and will be encountered most often by the periodontist. A review of the odontomas is presented followed by a case report and a discussion of the periodontal considerations in their removal. Emphasis is placed on following standard hygiene procedures before and after any periodontal surgery along with conservative removal of the lesion to preserve the periodontal attachment around the adjacent teeth.
Yeasts in Juvenile Periodontitis
Authors: González S. , Lobos I. , Guajardo A. , Celis A. , Zemelman R. , Smith C. T. , Saglie F. R.
Published: March 2012

Through the use of the electron microscope, yeasts were found invading gingival connective tissue in juvenile periodontitis (JP). Samples (3‐mm punch biopsies, including epithelium and underlying connective tissue) were taken apically to periodontal pockets before and after patient treatment with spiramycin. Some samples underwent in vitro treatment with spiramycin. Oval and round yeast cells were found before and after in vivo and after in vitro spiramycin treatment. Larger numbers of yeast cells were seen after spiramycin treatment indicating that their growth might be favored after patient treatment with this antibiotic. This observation has an obvious clinical implication. Budding processes, indicating active yeast multiplication, were observed. Some yeast cells also showed the presence of glycocalyx. Further studies on the role of yeast in the pathogenesis of JP are necessary.
A Comparison of the Effectiveness of Hand Scaling and Ultrasonic Debridement in Furcations as Evaluated by Differential Dark‐Field Microscopy
Authors: Leon Linda E. , Vogel Richard I.
Published: March 2012

There have been no previous reports in the literature comparing the effects of hand scaling with ultrasonic debridement in furcations, or which have used dark‐field microscopy for this comparison. The purpose of this study was to compare the efficacy of these two modes of debridement in various classes of furcations, using gingival crevicular fluid flow and dark‐field microscopy as parameters. A total of 33 furcated molars were evaluated. Results indicated that both hand scaling and ultrasonic debridement were equally effective in Class I furcations in changing the gingival fluid flow and bacterial proportions to those of a healthy state. In contrast, ultrasonic debridement was significantly more effective than hand scaling in Class II and Class III furcations in altering these parameters.
Relationships of Serum Opsonins and Complement in Human Experimental Gingivitis
Authors: Henry Clay A. , Ungchusri T. , Charbeneau Thomas D. , Winford Thomas E.
Published: March 2012

This study assessed the phagocytosis of polymorphonuclear neutrophils and the opsonic capacity of serum in experimental human gingivitis. Relationships were sought among these two measurements, clinical indices of gingivitis and complement‐related Opsonins. Measurements of chemiluminescence provided an index of phagocytosis and of opsonic capacity. Test group Plaque Index scores were higher than the control group on Days 7, 14, and 21, while the Gingival Index of the test group was elevated only on Day 21. Phagocytosis of test subjects' PMNs and opsonic capacity of their sera were no different from that of the controls'. Levels of C3 in both nonactivated and activated sera of the test group were significantly lower than that of the control group only on Day 14. In the test group, differences of per cent C3 conversion occurred between Days 14 and 21, and Plaque Index scores were inversely correlated with the order of per cent C3 data on these same days. Our results also indicate that complement contributes significantly to the serum opsonic capacity. The levels of developing plaque and subsequent gingival inflammation are apparently related to the degree of complement activation.