bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Mutation of the Cathepsin C Gene in Papillon‐Lefévre Syndrome
Authors: Cury Vanessa F. , Costa José E. , Gomez Ricardo S. , Boson Wolfanga L. , Loures Cyro G. , De Marco Luiz
Published: February 2005

Background: Papillon‐Lefévre syndrome (PLS) is a disorder that involves destruction of the periodontium and abnormal hyperkeratosis of the palms of the hands and soles of the feet. Mutations of the lysosomal protease cathepsin C gene (CTSC) have been associated with PLS. However, genotypic and phenotypic correlation has not been established. In the present study we investigated the CTSC gene in a Brazilian cohort affected by PLS.

Methods: Eight consanguineous members of a kindred with PLS were studied. DNA was extracted and all exons of the gene amplified by the polymerase chain reaction (PCR) using specific primers. Mutations were identified by DNA sequencing of the coding region and introns of the CTSC gene.

Results: Sequence analysis of CTSC from subjects affected by PLS identified a novel mutation (587T → C) in exon 4, predicted to cause a Leu196Pro amino acid substitution. Three of 3 subjects were homozygous for cathepsin C mutations inherited from a common ancestor. One patient was heterozygous and showed plantar hyperkeratosis without periodontal disease. Two other family members were also heterozygous but did not present palmoplantar hyperkeratosis and/or periodontal disease.

Conclusions: This study describes a novel mutation of the cathepsin C gene in a Brazilian kindred with Papillon‐Lefévre syndrome. J Periodontol 2002;73:307‐312.
Efficacy of Chlorhexidine Mouthrinses With and Without Alcohol: A Clinical Study
Authors: Borrajo J.L. Leyes , Varela L. Garcia , Castro G. Lopez , Rodriguez‐Nuñez I. , Figueroa M. Garcia , Torreira M. Gallas
Published: February 2005

Background: Plaque control is the main method for preventing periodontal diseases. Chlorhexidine digluconate mouthrinse is widely recognized as helping to maintain plaque control. Most of these mouthrinses contain alcohol, making them impractical for many patients, including those with oral mucosal hypersensitivity. Mouthrinses without alcohol might cause fewer side effects, but also be less efficient. In this study, we evaluated the efficacy of a 0.12% chlorhexidine mouthrinse without alcohol against one with 11% ethanol and a placebo.

Methods: This a double‐blind, parallel group study with 96 patients who tested 3 mouthrinses containing 1) chlorhexidine digluconate 0.12% sodium fluoride 0.05%, and ethanol 11% (group 1; CHX‐A); 2) the same solution without alcohol (group 2; CHX‐NA); and a placebo (group 3; P). Plaque and bleeding indexes were recorded in all patients prior to treatment and at 14 and 28 days.

Results: There were significant differences in plaque, gingivitis, and papilla bleeding indexes in both chlorhexidine rinses compared to placebo, but no differences between the 2 CHX products.

Conclusions: In this study, the alcohol‐free rinse was as effective as one containing alcohol in controlling plaque and reducing gingival inflammation. Therefore, it would seem that its use can be recommended in all patients, but especially in patients for whom the use of alcohol is contraindicated. J Periodontol 2002;73:317‐321.
Application of Enamel Matrix Derivative in Autotransplantation of an Impacted Maxillary Premolar: A Case Report
Authors: Ninomiya Masami , Kamata Nobuyuki , Fujimoto Ryoichi , Ishimoto Tomoko , Suryono  , Kido Jun‐ichi , Nagayama Masaru , Nagata Toshihiko
Published: February 2005

Background: The success of tooth transplantation or replantation depends on the viability of periodontal ligament in the planted tooth. Mechanical injury to periodontal tissues frequently results in dental root resorption and dental ankylosis, which leads to the failure of transplantation or replantation. Enamel matrix derivative (EMD) has been recently used to induce periodontal regeneration. In this report, we show a clinical case of EMD application in the transplantation of an inversely impacted and immature tooth.

Methods: An impacted second premolar was found in the right maxilla of a 16 year‐old girl. The tooth was inversely impacted and the dental root was incomplete. When transplantation was carried out, EMD was applied to the periodontal tissues of the extracted premolar. The tooth was fixed at the correct position and the clinical condition was followed for evaluation for 6 months.

Results: Radiographs after 3 months exhibited new bone formation surrounding the transplanted tooth. After 6 months, considerable growth of dental root was evident, periodontal ligament‐like radiolucency appeared, the vital reaction of the planted tooth was detected, and there were no signs of root resorption or ankylosis.

Conclusion: Short‐term results from this case indicate that EMD application was effective in the transplantation of an inversely impacted and immature tooth and that EMD might contribute to the growth of dental root and to the prevention of ankylosis.J Periodontol 2002;73:346‐351.
Root Surface Morphological Changes After Focused Versus Defocused CO2 Laser Irradiation: A Scanning Electron Microscopy Analysis
Authors: Barone A. , Covani U. , Crespi R. , Romanos G.E.
Published: February 2005

Background: Many studies have observed damages to root surfaces treated by CO2 laser in continuous mode with a focused beam. The morphologic changes observed were always associated with temperature increase induced by high energy release.

Methods: The purpose of this study was to analyze by scanning electron microscopy (SEM) the effects of CO2 laser in 2 different modes on root surfaces. Study samples consisted of 30 extracted single‐rooted periodontally compromised human teeth. Root specimens were randomly assigned to 3 groups: group A (12) treated with CO2 laser in continuous mode with a focused beam of 0.8 mm; group B (12) treated with CO2 laser in pulsed mode with defocused beam of 4 mm; and group C (6), untreated controls.

Results: Group A (continuous mode) showed severe damages to dentin surfaces such as craters and fissures. Group B (defocused mode) did not result in any damages to the root surfaces, showing flat and smooth surfaces with apparent fusion of the smear layer and dentinal tubules almost completely sealed. The untreated control group was characterized by irregular and amorphous surfaces with several shallow depressions.

Conclusions: Although both laser modes resulted in changes to the treated root surface specimens, the changes resulting in a smooth surface from use of defocused pulsed beam may present an advantage in periodontal treatment. J Periodontol 2002;73:370‐373.
Comparison of Clinical, Radiographic, Histometric Measurements Following Treatment With Guided Tissue Regeneration or Enamel Matrix Proteins in Human Periodontal Defects
Authors: Windisch Péter , Sculean Anton , Klein Filip , Tóth Vilmos , Gera István , Reich Elmar , Eickholz Peter
Published: February 2005

Background: The purpose of this study was to compare the clinical and radiographic parameters with the histometric findings following 2 different regenerative procedures in humans.

Methods: Fourteen advanced intrabony defects at teeth scheduled for extraction were randomly treated as follows: 8 with guided tissue regeneration (GTR) using bioabsorbable barriers and 6 with an enamel matrix protein derivative (EMD). Standardized radiographs, probing depths (PD), and attachment levels (CAL) at baseline and 6 months after therapy were evaluated and compared to the histometric measurements made following the removal of teeth and surrounding tissues 6 months after the surgery.

Results: Significant PD reductions (GTR: –5.62 mm; EMD: –5.00 mm) and CAL gains (GTR: 3.87 mm; EMD: 2.67 mm) were observed in both groups. Six months after surgery, minor resorptions of the alveolar crest (AC) (GTR: 0.40 mm; EMD: 0.33 mm) and bony gain at the bottom of the defects (GTR: 0.47 mm; EMD: 1.05 mm) were observed radiographically. No statistically significant differences in the change of clinical and radiographic parameters between the GTR and EMD groups were found. Histometrically, significant amounts of new connective tissue attachment (i.e., cementum with inserting collagen fibers) were observed in both groups (GTR: 2.29 mm; EMD: 1.81 mm). Bone regeneration was found to be significant only in the GTR group (GTR: 1.93 mm; EMD: 0.78 mm). However, the study lacked statistical power for determining equivalence between the groups.

Conclusions: Within the limitations of the present study, it may be concluded that at 6 months after GTR or enamel matrix protein derivative therapy, formation of new cementum and bone may be histometrically demonstrated. Except for the formation of new bone, no statistically significant differences between both therapies could be seen for clinical, radiographic, and histometric results 6 months after surgery. J Periodontol 2002;73:409‐417.
In Vivo Ultrasonic Debridement Force in Bicuspids: A Pilot Study
Authors: Ruppert Martin , Cadosch Johann , Guindy Joseph , Case Douglas , Zappa Urs
Published: February 2005

Background: Hand instruments lead to application of excessive forces, resulting in extensive root substance removal. Ultrasonic debridement primarily removes accretions from root surfaces. However, there is a lack of information on procedural aspects of ultrasonic debridement. The purpose of the present study was to assess the forces applied by different therapists during ultrasonic root surface debridement of bicuspids in periodontal patients in vivo.

Methods: Ten dentists and 10 dental hygienists each debrided 1 aspect of a bicuspid with moderate chronic periodontitis using an ultrasonic curet. The forces applied were recorded using a piezo‐electric receiver built into the handle of the ultrasonic curet, an electronic transducer, and an analogous writer. The force recordings were converted from millivolts into Newtons N). Mean positive and negative forces were calculated for each therapist, and t tests were used to assess differences in these forces between dentists and dental hygienists.

Results: The results showed that the mean positive force applied by dentists was 1 .OO N (range 0.53 to 1.34 N). The cor‐responding mean value for dental hygienists was 0.77 N (range 0.20 to 1.22 N). The mean root debridement time was 110.2 seconds (range 38 to 165 seconds) for dentists and 90.8 secconds (range 38 to 244 seconds) for dental hygienists. The mean percentage of total debridement time used for positive force application by dentists was 76.1%, and for dental hygienists 63.9%. Negative forces impacting on the periodontal soft tissues were also recorded. These negative forces reached a mean of 0.16 N for dentists and 0.31 N for dental hygienists.

Conclusions: From these observations, it may be concluded that application of ultrasonic debridement therapy is highly sub‐jective, and that dentists and dental hygienists may not be adequately trained to use these instruments optimally. J Periodontol 2002;73:418‐422.
Nicotine Modulation of In Vitro Human Gingival Fibroblast β1 Integrin Expression
Authors: Snyder Harold B. , Caughman Gretchen , Lewis Jill , Billman Michael A. , Schuster George
Published: February 2005

Background: Smoking is clearly a high‐risk behavior for the development of periodontal disease, and nicotine is the major vasoactive component in tobacco. Integrins are a large family of homologous transmembrane adhesion proteins serving as the principal receptors on animal cells to bind and communicate with many extracellular matrix proteins such as collagen, fibronectin, and laminin. This study's aim was to evaluate nicotine's effects on β1 integrin expression as a function of either 1) the generalized effects on RNA/protein synthesis or 2) as a specific modulation of β1 integrin synthesis.

Methods: Pooled human gingival fibroblasts (HGFs) were cultured in nicotine concentrations commonly seen in smokers (0.025 to 0.8 μM), and relative incorporation of [35S]methionine into newly synthesized protein or [3H]uridine into newly synthesized RNA was measured. Cultures were harvested at various times, and duplicate cell aliquots were homogenized and fractionated to obtain cell membraneenriched preparations or solubilized to obtain whole cell lysates. Radiolabeled RNA and proteins were quantitated by trichloroacetic acid (TCA) precipitation and liquid scintillation spectrometry. β1 integrin subunits were detected by SDS‐PAGE and Western blotting, and the relative intensities of reactive bands were quantitated by scanning densitometry.

Results: After 17 hours of exposure, 0.4 and 0.8 μM nicotine resulted in a dose‐dependent increase in β1 integrin in whole cell lysates, and a decrease in β1 integrin in the corresponding membrane‐enriched fractions. There was also a statistically significant decrease (P ≤ 0.05) in radiolabeled proteins in culture. Although there appeared to be a mild, generalized reduction in radiolabeled RNA in nicotine‐treated cultures compared to controls, a 1‐way analysis of variance showed no statistical significance between values.

Conclusions: Our results suggest that nicotine may induce an altered compartmentalization process in which β1 integrin molecules are produced, but are not appropriately transferred to the membrane. Nicotine effects on cellular protein synthesis and its modulation of β1 integrin expression may impair gingival fibroblast ability to adhere to and communicate with one another and with the extracellular matrix, which could impair wound healing and/or exacerbate periodontal disease. J Periodontol 2002;73:505‐510.
Fcγ Receptor Genes as Risk Markers for Localized Aggressive Periodontitis in African‐Americans
Authors: Fu Yali , Korostoff Jonathan M. , Fine Daniel H. , Wilson Mark E.
Published: February 2005

Background: Receptors for the Fc fragment of immunoglobulin G (FcγRs) play a crucial role in host defense against bacterial infection by linking humoral and cell‐mediated immune responses. Allelic variants of certain FcγRs have been shown to differ relative to their biologic activity. Thus, genes encoding allotypes with diminished activity have been suggested as potential risk factors for infectious diseases. The goal of this study was to determine whether specific FcγRIIa, FcγRIIIa, and FcγRIIIb alleles and/or genotypes could be used to predict susceptibility to localized aggressive periodontitis (LAgP) in an African‐American population.

Methods: Whole blood or saliva was obtained from 48 LAgP and 67 periodontally‐healthy African‐American subjects. DNA was prepared from each sample. FcγRIIa and FcγRIIIa genotyping was analyzed by polymerase chain reaction (PCR) amplification of DNA with allele‐specific primers followed by allelespecific restriction digestion of the products. FcγRIIIb genotyping was done by allele‐specific PCR.

Results: There was a statistically significant over‐representation of the FcγRIIIb‐NA2 allele in LAgP patients compared to controls (P = 0.024). Relative to the FcγRIIIb‐NA1/NA2 and homozygous NA1/NA1 genotypes, the prevalence of the FcγRIIIb NA2/NA2 genotype was higher in the LAgP group relative to the control population. Individuals expressing this genotype appeared at greater risk for developing LAgP (odds ratio 2.271, 95% confidence interval: 1.005 to 5.132). There were no significant differences in the distribution of the FcγRIIa H/R or FcγRIIIa‐158 F/V genotypes nor their allelic frequencies between the LAgPpatients and controls.

Conclusions: These data suggest that the FcγRIIIb NA2 allele and/or NA2/NA2 genotype may represent risk markers for susceptibility to LAgP in African‐Americans. J Periodontol 2002;73:517‐523.
Oral Hygiene Practices and Periodontitis in Health Care Professionals
Authors: Merchant Anwar , Pitiphat Waranuch , Douglass Chester W. , Crohin Constant , Joshipura Kaumudi
Published: February 2005

Background: One in 3 adults in the United States has periodontitis, yet there are few widely applied methods for its prevention. Few studies have assessed oral hygiene practices related to periodontitis.

Methods: There were 533 participants in this study (14.8% male dentists; 13.7% male non‐dentist health care professionals; and 71.5% female nurses), all of whom are enrolled in ongoing cohort studies in the United States which have inquired about their oral hygiene practices and whether they have professionally diagnosed periodontitis. We studied the relationship between oral hygiene practices and periodontitis, controlling for potential confounders.

Results: The participants were 69 years old on average, 84.2% white, 12.4% current smokers, and 8.3% diabetic. Seventy percent of the dentists and nurses brushed at least twice a day compared to 56% of the other health professionals. Two‐thirds of the nurses, 56.3% dentists, and 36.4% other health professionals flossed at least once daily. Persons brushing twice daily were as likely to have periodontitis as those brushing once or less daily (odds ratio [OR] = 1.16; 95% confidence interval [CI]: 0.64 to 2.10); persons flossing less than once a day were as likely to have periodontitis as those who flossed daily (OR = 1.16, 95% CI: 0.63 to 2.13) after controlling for profession, age, gender, smoking, diabetes, coronary heart disease, history of periodontal surgery, and number of teeth present.

Conclusions: People who reported better oral hygiene practices did not report less periodontitis, after controlling for potential confounders. Oral hygiene practices were not associated with periodontitis in this population. J Periodontol 2002;73:531‐535.
Pain Experienced by Patients During Periodontal Maintenance Treatment
Authors: Karadottir Hildur , Lenoir Lettie , Barbierato Barbara , Bogle Mary , Riggs Matt , Sigurdsson Thorarinn , Crigger Max , Egelberg Jan
Published: February 2005

Background: The aims of this study were to assess the degree of pain experienced by patients during probing and debridement and to determine whether the pain responses could be predicted by the patient's age, gender, percentage of sites ≥4 mm deep, and responses to a questionnaire on dental anxiety.

Methods: Prior to the maintenance procedures, 26 adult patients completed an anxiety questionnaire. Subsequently, measurements of probing depths were performed. The patients activated a tallying device at each probe entry that evoked pain (pain frequency). Pain levels for each quadrant were also assessed with a visual analog scale (VAS). Following probing, the same protocol was repeated during instrumentation (debridement).

Results: Most patients showed low pain responses to both probing and instrumentation as evaluated by both methods of measurement. However, using arbitrary thresholds of pain frequency ≥50% and VAS ≥40 mm, approximately 15% of the patients had a painful experience. Stepwise multiple regression analyses disclosed that significant portions of the pain levels could be predicted by gender and the patients' answers to 2 of the dental anxiety questions.

Conclusions: Recognition of patients who are likely to experience pain during periodontal treatment can be facilitated by the use of 2 questions on dental anxiety and the VAS response to probing during examination. J Periodontol 2002;73:536‐542.
Effect of Enamel Matrix Derivative on the Differentiation of C2C12 Cells
Authors: Ohyama Mariko , Suzuki Naoto , Yamaguchi Yoko , Maeno Masao , Otsuka Kichibee , Ito Koichi
Published: February 2005

Background: Although enamel matrix derivative (EMD) can initiate de novo cementum and bone formation by stimulating and inducing differentiation of mesenchymal cells in the periodontal ligament, the molecular mechanism of this phenomenon is not fully understood. The purpose of this study was to determine the effect of EMD on the differentiation of pluripotential mesenchymal cells.

Methods: A typical pluripotential mesenchymal cell line, C2C12, was used to clarify the effect of EMD on cell differentiation. The cells were cultured in 5% serum‐containing medium to induce cell differentiation, either with or without the addition of EMD. Differentiation to myoblasts was analyzed by immunostaining of desmin and type II myosin heavy chains. Osteoblast differentiation was evaluated by measuring alkaline phosphatase (ALPase) activity. Furthermore, to verify the cell lineage after culture with EMD, mRNA expression of cellular phenotypespecific markers characterizing osteoblasts (ALPase and osteocalcin), chondroblasts (type X collagen), myoblasts (desmin and MyoD), and adipocytes (lipoprotein lipase) was studied using semiquantitative reverse transcription‐polymerase chain reaction.

Results: C2C12 cells cultured in differentiation medium without EMD altered their phenotype to myoblasts, exhibiting positive reactions to desmin and myosin heavy chains by immunological analysis. However, the cells cultured in the presence of EMD were strongly inhibited from developing into myoblasts, and showed high ALPase activity that was approximately 2 to 4 times greater than that of the vehicle. The mRNA expression of ALPase, osteocalcin, and type X collagen was increased markedly by the EMD‐stimulated medium, whereas the expression of desmin, MyoD, and lipoprotein lipase was drastically decreased.

Conclusions: Our study provides clear evidence that EMD converts the differentiation pathway of C2C12 cells into the osteoblast and/or chondroblast lineage. J Periodontol 2002;73:543‐550.
Treatment of Periodontal Disease in a Patient With Ehlers‐Danlos Syndrome. A Case Report and Literature Review
Authors: Perez Luis A. , Al‐Shammari Khalaf F. , Giannobile William V. , Wang Hom‐Lay
Published: February 2005

Background: Ehlers‐Danlos syndrome (EDS) designates a heterogeneous group of connective tissue disorders characterized by skin elasticity, tissue fragility, and chronic joint pain. Dental findings have been reported with some types of EDS. This case report describes the periodontal findings in a patient with a previously undiagnosed EDS type VIII.

Methods: Diagnostic aids utilized included microbial testing, histological examination, gingival crevicular fluid (GCF) analysis for the levels of C‐telopeptide pyridinoline cross‐links (ICTP), and genetic counseling. Periodontal treatment consisted of mechanical debridement and adjunctive antibiotic therapy.

Results: Genetic counseling and clinical presentation confirmed the diagnosis of EDS type VIII. Periodontal treatment led to marked clinical improvements and GCF levels of the bone resorptive marker ICTP were significantly reduced. The patient and her siblings are currently pursuing appropriate medical care and genetic counseling.

Conclusion: Periodontal involvement may lead to the diagnosis of an underlying systemic condition. Identification of suspected etiological factors of periodontal disease may prove critical for the general wellbeing of some patients.J Periodontol 2002;73:564‐570.
Tooth Auto‐Transplantation With Double Periodontal Ligament Stimulation to Replace Periodontally Compromised Teeth
Authors: Gault Philippe C. , Warocquier‐Clerout Rita
Published: February 2005

Background: The healing process of autotransplantation puts 2 different tissues in competition: the ligament on the root surface and the bone tissue the alveolus. This study shows the effects of a protocol with 2 surgical stages, which promote ligament repair, inhibit adhesion between bone and dental root, and reduce the occurrence of the ankylosis‐root resorption phenomenon.

Methods: Forty‐three patients, 33 to 73 years old, received 47 transplantations of mature teeth (including retained teeth) during a 5‐year period. During the first surgical step, the transplanted tooth is extracted, measured, immediately replaced in its origin site, and maintained with an original suture technique. The alveolus to which the tooth will be transplanted is adapted after extraction of the periodontally compromised tooth. The second surgery occurs at day 14, when regeneration of periodontal ligament (PDL) is at a maximum (first stimulation). The tooth is transplanted in its new alveolus and retained using the same suture technique to avoid a rigid splint and to create mechanical stimulation of the PDL (second stimulation).

Results: The results were 95.75% positive with normal PDL, with a 4.25% failure rate (transplant loss) and no ankylosis. Mean probing reduction was 8.37 ± 3.0 mm. Mean radiographic bone gain was 7.73 ± 4.32 mm.

Conclusions: This study suggests that auto‐transplantation with double PDL stimulation can be a viable treatment in clinical practice, especially to replace teeth with large periodontal lesions, deep furcation defects, and/or root fractures. This study shows the high potential of stimulated PDL to regenerate alveolar bone and periodontal structures in severe destruction sites. J Periodontol 2002;73:575‐583.
The Modulation of Androgen Metabolism by Estradiol, Minocycline, and Indomethacin in a Cell Culture Model
Authors: Tilakaratne A. , Soory M.
Published: February 2005

Background: This investigation attempts to clarify the proanabolic effects of minocycline and indomethacin by studying their effects on androgen metabolism and mediation by estradiol. A cell culture model was used with androgen substrates because of the proanabolic effects of androgen metabolites.

Methods: Monolayer cultures of human gingival fibroblasts (HGF) derived from 6 patients were incubated in duplicate with 14C‐ testosterone or 14C‐4‐androstenedione as substrates and optimal concentrations of estradiol (E1,3 μg/ml) and minocycline (M25 μg/ml) or indomethacin (I, 1 μg/ml) alone and in combination (E1,3+I1 or E1,3+M25 μg/ml); similar experiments were carried out with human oral periosteal fibroblasts (HPF), M, I, E, and the combinations. At the end of a 24‐hour incubation period in Eagle's MEM, the medium was solvent extracted with ethyl acetate and the metabolites were separated by TLC in a benzene:acetone solvent system (4:1 v/v). The separated metabolites were quantified using a radioisotope scanner.

Results: Both androgens were metabolized to 5α‐dihydrotestosterone (DHT) and 4‐androstenedione (4‐A) or testosterone (T) at baseline and in response to the agents tested, by HGF and HPF. With HGF, there were significant increases in the yields of DHT and 4‐A or T in response to M, E, and M+E, resulting in 50% to 2.4‐fold increases in these metabolites over control incubations (n = 6; P <0.01). The responses to I and combinations of I+E were similar. HPF also demonstrated significant increases of 29% to 4‐fold in the yields of androgen metabolites in response to M, E, and M+E (n = 6; P <0.01). I and E similarly increased the yields of androgen metabolites, alone and in combination.

Conclusions: Adjunctive periodontal treatment with minocycline or indomethacin can contribute to hormone‐modulated anabolic responses in males and females in gingival and periosteal fibroblasts derived from a chronically inflamed source. J Periodontol 2002;73:585‐590.
Genetic Dependence of the Specific T‐Cell Cytokine Response to Porphyromonas gingivalis in Mice
Authors: Gemmell Erica , Carter Christine L. , Bird Philip S. , Seymour Gregory J.
Published: February 2005

Background: Susceptibility to periodontal infections may, in part, be genetically determined. Porphyromonas gingivalis is a major periodontopathogen, and the immune response to this organism requires T‐cell help. The aim of the present study was to examine the specific T‐cell cytokine responses to P. gingivalis outer membrane antigens in a mouse model and their relationship with H‐2 haplotype.

Methods: BALB/c and DBA/2J (H‐2d), CBACaH (H‐2k), and C57BL6 (H‐2b) mice were immunized with P. gingivalis outer membrane antigens weekly for 3 weeks. One week after the final injection, the spleens were removed, and 6 T‐cell lines specific for P. gingivalis were established for each mouse strain. The percentage of CD4 and CD8 cells in the P. gingivalis‐specific T‐cell lines staining positive for intracytoplasmic interleukin (IL)‐4, interferon (IFN)‐γ, and IL‐10 was determined by 2‐color flow cytometry.

Results: The cytokine profiles of T‐cell lines from BALB/c and DBA/2J mice showed no significant differences. Significantly fewer IL‐4+, IFN‐γ+, and IL‐10+ CD4 cells than IL‐4+, IFN‐γ+, and IL‐10+ CD8 cells, respectively, were demonstrated for both strains. P. gingivalis‐specific Tcell lines generated from CBACaH mice were similar to those generated from BALB/c and DBA/2J mice; however, the mean percentage of IL‐4+ CD4 cells in CBACaH mice was lower than the percentage of IFN‐γ+ CD4 cells. Also, the mean percentage of IFN‐γ+ CD4 cells in CBACaH mice was significantly increased compared to DBA/2J mice. Unlike the other 3 strains, T‐cell lines established from C57BL6 mice contained similar percentages of cytokine‐positive cells, although the percentage of IL‐4+ CD4 cells was reduced in comparison to the percentage of CD8 cells. However, comparisons with the other 3 strains demonstrated a higher percentage of IL‐4+ CD4 cells than in lines established from the spleens of DBA/2J mice, IFN‐γ+ CD4 cells than in lines established from BALB/c and CBACaH mice, and IL‐10+ CD4 cells than in lines established from all 3 other strains. No significant differences in the percentage of positive CD8 cells were demonstrated between lines in the 4 strains of mice.

Conclusion: The specific T‐cell response to P. gingivalis in mice may, in the case of the CD4 response, depend on MHC genes. These findings are consistent with the concept that patient susceptibility is important to the outcome of periodontal infection and may, in part, be genetically determined. J Periodontol 2002;73:591‐596.
Periodontal Assessment of Patients Undergoing Angioplasty for Treatment of Coronary Artery Disease
Authors: Bazile Anca , Bissada Nabil F. , Nair Ravi , Siegel Burton P.
Published: February 2005

Background: The purpose of this cross‐sectional study was to assess the periodontal condition of patients with coronary artery disease (CAD) in order to verify the association between CAD and certain periodontal parameters.

Methods: Eighty patients (48 males and 32 females) were recruited from the Cleveland University Hospitals, Division of Cardiology (aged 23 to 83, median age 54 years). Upon cardiac catherization, 50 were diagnosed with severe CAD (experimental group) and 30 with no angiographic evidence of CAD (control group). Patients with CAD were divided into 3 subgroups according to the clinical diagnosis of acute infarction (AI) (n = 20), stable angina (SA) (n = 20), and unstable angina (UA) (n = 10). The following dental, medical, and social histories were recorded: number of dental visits/year, frequency of brushing/day and flossing/week, tobacco use, presence/absence of hypertension, diabetes, total cholesterol level, and the highest level of education completed. The following periodontal parameters were also assessed for each subject: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and number of missing teeth. Logistic regression analysis was used to determine whether there was a significant correlation between these periodontal parameters and CAD.

Results: The significant confounding factors for the present study were found to be age and gender. The periodontal condition of the 80 subjects was clinically diagnosed as gingivitis and/or mild periodontitis. Analysis of the data after adjusting for age and gender demonstrated a statistically significant association between BOP and GI and CAD in patients with AI; and facial/lingual CAL in patients with UA. No significant associations were found between PD, interproximal CAL, number of missing teeth, or dental/medical histories and CAD.

Conclusion: Based on the results of this study, gingival inflammation may be considered a more significant risk factor for CAD than previously reported. J Periodontol 2002;73:631‐636.
Scanning Electron Microscopy and Fourier Transformed Infrared Spectroscopy Analysis of Bone Removal Using Er:YAG and CO2 Lasers
Authors: Sasaki Katia M. , Aoki Akira , Ichinose Shizuko , Yoshino Toshiaki , Yamada Sachiko , Ishikawa Isao
Published: February 2005

Background: A thorough analysis of laser‐ablated bone tissue is required before applying the technique to osseous surgery. In this study, we examine the morphological features and chemical composition of the bone surface after Er:YAG and CO2 lasers ablation.

Methods: Six Wistar rats were used. An Er:YAG laser was used for ablation at an output energy of 100 mJ/pulse and a pulse rate of 10 Hz (1 W). Continuous CO2 laser irradiation was performed at an output energy of 1 W. Sites drilled using a conventional micromotor were used as controls. Analysis using scanning electron microscopy (SEM) and Fourier transformed infrared (FTIR) spectroscopy was performed.

Results: Er:YAG laser ablation produced a groove with similar dimensions to that produced by bur drilling, whereas the CO2 laser produced only a charred line with minimal tissue removal. SEM observations revealed that the groove produced by the Er:YAG laser had well‐defined edges and a smear layerfree surface with a characteristically rough appearance and with entrapped fibrin‐like tissue. The melting and carbonization produced by the CO2 laser were not observed on sites irradiated by the Er:YAG laser. FTIR spectroscopy revealed that the chemical composition of the bone surface after Er:YAG laser ablation was much the same as that following bur drilling. The production of toxic substances that occurred after CO2 laser irradiation was not observed following Er:YAG laser irradiation or bur drilling.

Conclusion: These results suggest that the use of Er:YAG laser ablation may become an alternative method for oral and periodontal osseous surgery. J Periodontol 2002;73:643‐652.
Oral Pemphigoid Masquerading as Necrotizing Ulcerative Gingivitis in a Child
Authors: Musa Nour J. , Kumar Vijay , Humphreys Lewis , Aguirre Alfredo , Neiders Mirdza E.
Published: February 2005

Background: Cicatricial pemphigoid (benign mucous membrane pemphigoid) is an autoimmune vesiculobullous disease that affects mucosal tissues of adults and rarely presents in children. Only 9 cases in the English literature have reported cicatricial pemphigoid in children, primarily as oral mucosal lesions. This paper presents a case of childhood cicatricial pemphigoid that clinically manifested as necrotizing ulcerative gingivitis (NUG).

Methods: A 9‐year‐old girl presented with gingival bleeding and discomfort for 2 weeks. NUG was suspected and the patient was treated with antibiotics and an oral hygiene regimen. When the condition did not improve after repeated treatment trials, routine hematoxylin and eosin (H&E) and direct immunofluorescence examinations were performed.

Results: Microscopic examination of H&E stained sections showed a non‐specific ulceration with chronic inflammation. Direct immunofluorescence studies of peri‐lesional tissue showed linear deposition of C3 at the basement membrane zone that was consistent with a diagnosis of cicatricial pemphigoid.

Conclusion: Cicatricial pemphigoid is an autoimmune ulcerative condition that is rarely seen in children. Immunofluorescence studies are essential to differentiate this condition from other ulcerative oral lesions. J Periodontol 2002;73:657‐663.
Aggressive Periodontitis: 5‐Year Follow‐Up of Treatment
Authors: Buchmann Rainer , Nunn Martha E. , Van Dyke Thomas E. , Lange Dieter E.
Published: February 2005

Background: The hypothesis that in subjects with aggressive periodontitis, a long‐term stability of periodontal health can be achieved following comprehensive mechanical/surgical and systemic antimicrobial therapy was tested in this prospective study.

Methods: Thirteen patients (36.9 ± 7.4 years) with aggressive periodontitis were monitored before and up to 5 years following periodontal therapy. Clinical attachment levels (CAL) were assessed pretherapy, and at 3 months following completion of active periodontal therapy supplemented by amoxicillin plus metronidazole. All subjects were subsequently enrolled in a maintenance program and provided with supportive periodontal therapy with 3 to 4 appointments annually. Reexaminations were performed after 6 months and 1, 2, 3, 4, and 5 years. The data were analyzed using the method of generalized estimating equations (GEE) for CAL changes from baseline to the 3‐month visit, and from completion of periodontal therapy to each annual visit up to the 5‐year followup reappointment.

Results: During the 5‐year study, all subjects strongly benefited from periodontal treatment. Between baseline and the 3‐month reexamination, the CAL levels revealed a significant decrease of 2.23 mm (95% confidence interval [CI]: 1.77 to 2.69 mm; P ≤0.001). At the 5‐year maintenance visit, the CAL changes ranged from ‐0.04 to +0.29 mm with no further statistically significant periodontal breakdown (P >0.05). Five years after surgery, 3.2% of the treated sites demonstrated a further CAL gain ≥3 mm. A stabilization (CAL ‐2 to +2 mm) occurred in 94.6% of the cases. The number of periodontal sites experiencing a breakdown varied from 5.3% at 6 months to 2.2% at 5 years.

Conclusions: In aggressive periodontitis, comprehensive mechanical/surgical and antimicrobial therapy is an appropriate treatment regimen for long‐term stabilization of periodontal health. In this study, periodontal disease progression was successfully arrested in 95% of the initially compromised lesions, while 2% to 5% experienced discrete or recurrent episodes of loss of periodontal support. J Periodontol 2002;73: 675‐683.
The Single‐Tooth Implant: A Viable Alternative for Single‐Tooth Replacement
Authors: Mayer Todd M. , Hawley Charles E. , Gunsolley John C. , Feldman Sylvan
Published: February 2005

Background: The use of dental implants for single‐tooth replacement cases introduces a challenge to the performance of these restorations. Clinical data suggest that single‐tooth implant restorations do not benefit from lateral support from the surrounding dentition as do bridged implants, and that these restorations are subjected to greater masticatory forces. Therefore, single‐tooth implants are exposed to an increased risk of failure. This prospective clinical trial was designed to evaluate the cumulative success rate of dual acid‐etched single‐tooth replacement implants in two clinical centers.

Methods: The study protocol included 59 patients between 19 and 73 years. Implants were evaluated for mobility, infection, and crestal bone loss from 30.9 to 60 months.

Results: Seventy‐one (71) implants were placed in 59 patients, 20 male and 39 female. Forty‐seven (47) were placed in the maxilla and 24 in the mandible. The percentages of anterior and posterior implants were 45.1 % and 54.9%, respectively. A total of 13 (18.4%) implants were placed in soft, poor quality (Type IV) bone. Beginning 1 month post‐implant placement, cases were followed for 30.9 to 60 months with a mean followup of 45.9 months. One implant failed (peri‐implant infection) yielding an overall success rate of 98.6%.

Conclusions: This success rate for single‐tooth replacement dual acid‐etched implants compares favorably with bridged implants and with success rates of other single‐tooth implant studies. Dual acid‐etched implants performed well even under conditions of poor quality bone, where concomitant bone augmentation was performed, and when used for immediate replacement of extracted teeth. J Periodontal 2002;73:687‐693.
Effect of Polylactide/Glycolide (PLGA) Membranes Loaded With Metronidazole on Periodontal Regeneration Following Guided Tissue Regeneration in Dogs
Authors: Kurtiş Bülent , Ünsal Berrin , Çetiner Deniz , Gültekin Elif , Özcan Gönen , Çelebi Nevin , Ocak Ömer
Published: February 2005

Background: Bioabsorbable membranes have been successfully used for guided tissue regeneration (GTR) and local delivery systems because they are biocompatible and do not require second surgery for removal. Several studies have demonstrated that metronidazole, when applied topically, produced immediate effects on microbiological and clinical parameters, most notably a reduction in probing depth and loss of attachment. The purpose of this study was to evaluate the regenerative potential of a metronidazole‐loaded biodegradable (polylactide/glycolide) (PLGA) GTR membrane in dogs.

Methods: Six male adult dogs with 36 created osseous defects were enrolled. Bilateral dehiscence type defects in 5 mm diameter were created at buccal aspect of the alveoler bone in maxillary premolar teeth. After full thickness flap elevation, exposed root surfaces were thoroughly planed. In the experimental sites, PLGA membranes with or without metronidazole were fitted and placed over the defects. On the control defects only root planing was performed. Gingival flaps were replaced slightly coronal to the cemento‐enamel junction. Animals were sacrified at 60 days. The histometric analysis was evaluated with the following parameters: defect height (DH), apical extension of junctional epithelium (AEJE), new cementum height (NCH), new bone height (NBH), and new gingival connective tissue height (NCTH).

Results: Postoperative clinical healing was similar in the 3 groups. There were no statistically significant differences between the 2 experimental groups in any parameters. Statistically significant differences were observed for AEJE, NCH, NBH, and NCTH in experimental groups when compared with the controls. Statistically significantly greater NCH, NBH, and NCTH were seen in the experimental groups than the controls and control defects showed longer AEJE than the experimental defects.

Conclusions: These results suggest that PLGA membranes with and without metronidazole may have a beneficial effect on periodontal regeneration. J Periodontol 2002;73:694‐700.
Level of Neopterin, a Marker of Immune Cell Activation in Gingival Crevicular Fluid, Saliva, and urine in Patients With Aggressive Periodontitis
Authors: Ozmeriç Nurdan , Baydar Terken , Bodur Ayşen , Engin Ayse Basak , Uraz Ahu , Eren Kaya , Sahin Gonul
Published: February 2005

Background: Neopterin, a marker of cellular immune activation, is produced by human macrophages after induction by interferon gamma that is secreted by T lymphocytes. Neopterin concentrations in diverse body fluids have been reported to increase in parallel with bacteria in the clinical course of infections. Therefore, determination of neopterin in body fluids was thought to be useful for predicting the prognosis and diagnosis of aggressive forms of periodontal disease, in which the cell‐mediated immune response plays an important role in immunopathogenesis. The aim of the present study was to observe the role of neopterin in the pathogenesis of aggressive periodontitis (AgP).

Methods: Thirteen individuals who were systemically and periodontally healthy and 16 systemically healthy individuals diagnosed with AgP were recruited for this study. Mixed saliva and urine samples were collected from each subject. Gingival crevicular fluid (GCF) samples were obtained from 6 teeth with ≥5 mm probing depth (PD). After evaluation of GCF amount from paper strips, enzyme‐linked immunosorbent assay (ELISA) was employed to determine the amount of neopterin in urine, saliva, and GCF.

Results: The amount of neopterin in urine and saliva measured 235.77 ± 405.31 µmol neopterin/mol creatinine and 9.85 ± 7.66 nmol/l, respectively, for the AgP group and 225.45 ± 100.72 µmol neopterin/mol creatinine and 5.25 ± 5.76 nmol/l, respectively, for controls. The present data demonstrate that, while salivary neopterin levels were found to be significantly different between periodontitis and control subjects, there were non‐significant differences in urine neopterin levels. The amount and concentration of neopterin in GCF measured was 18 ± 12.75 nmol/l and 3.67 ± 2.40 nmol/ml for the AgP group and 2.51 ± 1.72 nmol/l and 3.88 ± 4.50 nmol/ml for the control group. When total amounts of neopterin are taken into consideration, a significant difference between AgP and controls is shown; however, no significant difference in net concentration of neopterin was found between both groups.

Conclusions: This study is the first report to evaluate the involvement of neopterin in AgP and this might be considered of value in understanding periodontal disease mechanisms. J Periodontal 2002;73:720‐725.
Inhibition of Matrix Metalloproteinase‐Mediated Periodontal Bone Loss in Rats: A Comparison of 6 Chemically Modified Tetracyclines
Authors: Ramamurthy Nungavarum S. , Rifkin Barry R. , Greenwald Robert A. , Xu Jing‐wen , Liu Yu , Turner Gloza , Golub Lorne M. , Vernillo Anthony T.
Published: February 2005

Background: Chemically modified tetracyclines (CMTs), devoid of antimicrobial activity, inhibit pathologically elevated collagenase activity both in vivo and in vitro. In the current study, doxycycline and 5 different CMTs were tested to prevent matrix metalloproteinase (MMP)‐dependent periodontal tissue breakdown in an animal model of periodontitis.

Methods: Adult male rats received intragingival injections with either 10 µl of physiologic saline or Escherkhia coli endotoxin (1 mg/ml) every other day for 6 days and were distributed into 8 treatment groups (12 rats/group): saline (S), endotoxin alone (E), E + CMT‐1, E + CMT‐3, E + CMT‐4, E + CMT‐7, E + CMT‐8, and doxycycline. All animals were treated daily with 1 ml of 2% carboxymethyl cellulose (CMC) alone or containing one of the above‐mentioned CMTs (2 mg/day) orally. The gingival tissues were removed, extracted, and assayed for gelatinase (GLSE). Some rat maxillary jaws from each treatment group were fixed in buffered formalin and processed for histology and immunohistochemistry for the cytokines tumor necrosis factor (TNF), interleukin (lL)‐1, and IL‐6, and MMP‐2 and MMP‐9.

Results: Endotoxin injection induced elevated GLSE activity (functional assay and osteoclast‐mediated bone resorption), the former identified as predominantly MMP‐9 (92 kDa GLSE) by gelatin zymography. All 6 tetracyclines (2 mg/day) inhibited periodontal breakdown in the following order of efficacy: CMT‐8 > CMT‐ 1 > CMT‐3 > doxycycline > CMT‐4 > CMT‐7. Immunohistochemistry was positive for TNF, IL‐ 1, and IL‐6 in the inflammatory cells from untreated endotoxin rat tissues, whereas treatment with CMTs decreased the number of immuno‐positive stained cells for cytokines and MMPs. The in vivo efficacy of these drugs varied with CMT structure and was significantly correlated with bone resorption: r2 = ‐0.77, P <0.01; gelatinase inhibitory activity: r2 = −0.84, P <0.01; and serum drug concentrations.

Conclusion: Since both conventional (antimicrobial) and non‐antimicrobial tetracyclines inhibited periodontal bone resorption induced by endotoxin injection, MMP‐mediated bone loss in this model can be prevented by inhibition of MMPs. J Periodontol 2002;73:726‐734.
Prevalence and Severity of Periodontal Disease at Mandibular Molar Teeth in Smokers With Regular Oral Hygiene Habits
Authors: Kerdvongbundit Varunee , Wikesjö Ulf M.E.
Published: February 2005

Background: Smoking appears to be detrimental to health because it has been associated with several diseases including cancer and cardiovascular diseases. Smoking also appears to be a major environmental factor associated with periodontal disease progression. The objective of this study was to evaluate the prevalence and severity of periodontal destruction as influenced by smoking in a Thai population.

Methods: Gingival health and periodontal conditions at mandibular molar furcation sites in 120 Thai dental patients (60 smokers and 60 never‐smokers, age range 31 to 60 years) with generally high oral hygiene standards and regular dental care habits were evaluated.

Results: Smokers exhibited more frequent and severe mandibular molar periodontal destruction than never‐smokers. The prevalence and severity of gingival recession, periodontal pocket formation, clinical attachment loss, furcation involvement, and tooth mobility were significantly increased in smokers compared to never‐smokers. Seventy‐three percent of the smokers exhibited furcation involvement in contrast to only 20% of the never‐smokers.

Conclusions: The results of this study suggest that smoking appears to be a major environmental factor associated with accelerated periodontal destruction in adult smokers with generally high oral hygiene standards and regular dental care habits in a Thai population.J Periodontol 2002;73:735‐740.