bluuebunny/crossref_metadata_2025 huggingface dataset:
Problems of Genetic Model Testing in Early Onset Periodontitis
Authors: Boughman J. A. , Beaty T. H. , Yang P. , Goodman S. B. , Wooten R. K. , Suzuki J. B.
Published: March 2012

Familial aggregation of early onset or juvenile Periodontitis (JP), a disorder that varies in expression and age of onset, has been recognized for some time. Autosomal recessive and X‐linked inheritance patterns have been suggested, and one large pedigree has demonstrated autosomal dominant inheritance. The variability and age limitations in clinical phenotypic diagnosis present several problems to genetic analysis, because information on members of the youngest and older generations may be lost to the analysis. The purpose of the present study was to elucidate the genetic basis of JP by formal pedigree analysis and comparison of competing genetic models. Twenty‐eight families were included, with general and specific autosomal models, and an X‐linked model being compared. The autosomal recessive model provided the most parsimonious explanation of the data, and its likelihood was not significantly different from the more general model. Likelihoods for the sporadic (nongenetic) and X‐linked models were considerably lower than the autosomal models. While comparison of genetic models suggests recessive inheritance of JP, the serious complications to pedigree analysis posed by limitations warns against acceptance of this conclusion, without more exhaustive evaluation of: (1) a more extensive collection of family data, (2) more complete investigation of the effects of age limitations on comparisons among competing models, and (3) elucidation of the importance of diagnosis and phenotype assignment of adults through past dental records.
A Longitudinal Study Comparing Scaling, Osseous Surgery and Modified Widman Procedures
Authors: Becker William , Becker Burton E. , Ochsenbein Clifford , Kerry Gloria , Caffesse Raul , Morrison Edith C. , Prichard John
Published: March 2012

The purpose of this study was to compare, longitudinally, the effectiveness of scaling and root planing, osseous surgery, and the modified Widman procedures. The study was carried out in a private practice setting. Sixteen adult patients with moderate to advanced adult Periodontitis were treated with initial scaling and oral hygiene procedures. Posthygiene data were used for comparison of changes in probing depth, clinical attachment levels and gingival recession. The initial examination data were used to compare changes in plaque and gingival indices. Frequency distributions were used to compare changes that occurred at individual sites. At one year, plaque and gingival indices were significantly reduced when compared with the initial examination. At one year, shallow pockets (1‐3 mm) were reduced when compared to posthygiene. Four‐ to six‐millimeter pockets were significantly reduced by the three procedures. Osseous surgery and modified Widman had significantly greater pocket reduction when compared with scaling. For pockets >7 mm, osseous surgery and the modified Widman had significantly greater reduction when compared with scaling. For pockets 1–3 mm at one year osseous surgery had significantly greater clinical attachment loss when compared with scaling. For 4–6 mm pockets at one year, the three procedures had slight gains in clinical attachment levels. The results were similar for pockets with >7 mm.

Interproximal soft tissue craters were measured for six postoperative weeks. Initially, the modified Widman had a higher percentage of soft tissue craters when compared with osseous surgery. At six weeks, however, there were no significant differences when the surgical procedures were compared. Recession was measured at each examination. Recession for 1– 3 mm pockets at one year was greater for osseous surgery when compared with scaling and the modified Widman. Recession for 4–6 mm and >7 pockets was greater for the surgical procedures than scaling. The results from this study indicate that with three‐month maintenance recalls, both the modified Widman and osseous surgery are effective for pocket reduction, and each will produce a slight gain of clinical attachment over one year. Scaling was effective at maintaining attachment levels but was not as effective in reducing pocket depth.
Microbiological and Clinical Effects of Surgery plus Doxycycline on Juvenile Periodontitis
Authors: Mandell Robert L. , Socransky Sigmund S.
Published: March 2012

It was previously determined that surgery plus the antibiotic doxycycline were effective in eliminating or suppressing Actinobacillus actinomycetemcomitans (Aa), an organism strongly associated with disease in localized juvenile Periodontitis (LJP). Eight patients with LJP participated in this surgical study. Patients were reexamined three and 12 months following therapy. The results of this study strongly suggest that surgery plus doxycycline effectively eliminate Aa from periodontal pockets. This elimination results in clinical improvement and attachment gain at three and 12 months following surgery. Further destruction was seen in individuals who continued to harbor high levels of Aa.
The Use of Chlorhexidine in the Management of Gingivitis in Children
Authors: de la Rosa M. , Sturzenberger O. P. , Moore D. J.
Published: March 2012

Two double‐blind studies were conducted in 191 children in Mexico. Following a dental prophylaxis, either a 0.12% Chlorhexidine gluconate mouthrinse or a placebo was used under supervised conditions in comparable groups twice per day. The Chlorhexidine treatments resulted in a significant decrease of gingivitis when compared to the placebo rinse. Although superficial mucosal desquamations were seen in some Chlorhexidine users, they were transient and without discomfort. The increase of cosmetic side effects, e.g., dental stain and supragingival calculus, was without consequence to the gingival health of the subjects.

The use of a Chlorhexidine rinse twice per day and as adjunct to regular oral hygiene procedures achieved a considerable benefit against gingivitis in children in two studies extending over ten and 12 weeks.
Scanning Electron Microscopy Observations of Initial Clot Formation on Treated Root Surfaces
Authors: Steinberg Arnold D. , Willey Ruth
Published: March 2012

This study presents the morphological sequence of events in initial blood clot formation on various root surfaces of freshly extracted human teeth. Four teeth with periodontal disease (PD) and three teeth without PD were extracted and the roots sectioned into halves. Those root surfaces with PD had four treatment areas: (1) intact periodontal ligament (PDL), (2) unplaned PD, (3) PD plus planed, (4) PD plus planed plus application of pH 1 citric acid (CA). The roots with no PD had three treatment areas: (1) intact PDL, (2) planed, (3) planed plus CA. Both root halves were reinserted together into the original extraction site. Each root half was then removed at either zero, one, two or four minutes and prepared for scanning electron microscope (SEM) evaluation. SEM observations suggested that plasma proteins were deposited initially on all root surfaces. Platelets and erythrocytes enmeshed in fibrin deposited most rapidly and consistently over the plasma protein layer where intact PDL was present. Similar observations were noted on the planed plus CA surfaces and appeared to occur at an earlier time than on the planed‐only surfaces. A constant feature at all time periods was the absence of organized clot formation over the plaque‐free zone of the PD root surfaces. By two minutes all surfaces, except the plaque‐free zone of the PD area, appeared to have clot lysis occurring. While clot formation appeared to occur more rapidly over surfaces in the non‐PD roots, no marked morphological differences in clot formation were observed between PD and non‐PD teeth with similar root surface treatments.
Oral Findings in Fanconi's Anemia
Authors: Opinya Gladys N. , Kaimenyi Jacob T. , Meme Julius S.
Published: March 2012

A case of Fanconi's anemia was referred to the Dental School from the Department of Pediatrics. The patient was a 24‐year‐old male and a product of a consanguineous marriage. His chief complaint was loose and falling teeth, which had started at the age of 16 years. The first teeth to fall out were the first permanent molars followed by mandibular and maxillary anteriore. General examination showed that the patient was of normal intelligence and small for his age. He had no palmar plantar hyperkeratosis and was not diabetic. A total of 19 teeth remained in the mouth, most of them with grade three mobility. The remaining molars and first maxillary premolars had grade three furcation involvement. Most of the teeth had periodontal pockets more than 10 mm deep. Full mouth intraoral periapical radiographs and orthopantomographic views showed severe horizontal bone loss uncommensurate with the patient's age. In view of the patient's history and severe bone loss at an early age, the diagnosis was juvenile Periodontitis associated with Fanconi's anemia.
An Evaluation of New Attachment Formation Using a Microfibhllar Collagen Barrier
Authors: Tanner Michael G. , Solt Charles W. , Vuddhakanok Suchada
Published: March 2012

The objective of this study was to evaluate the effectiveness of microfibrillar collagen as a barrier to prevent epithelial migration and allow for guided tissue regeneration. Fourteen study teeth were selected. Mucoperiosteal flaps were elevated and roots were debrided and planed. Avitene® was placed over teeth and alveolar bone. Raps were then sutured over it. At control sites no Avitene was placed. At 90 days, block sections were obtained and processed for histologic and histometric evaluation. Results revealed that all specimens had a long junctional epithelial attachment. New attachment was present within the area of the root notch at the original level of the alveolar bone, and there was no significant difference in mean connective tissue attachment between the control and experimental specimens (P = 0.614). Avitene did not form an effective barrier to epithelial migration nor did it allow for guided tissue regeneration and significant new attachment formation in humans.
Comparison of Scanning and Transmission Electron Microscopy of the Epithelial Pocket Wall in Juvenile and Adult Periodontitis
Authors: Shafik S. S. , Zaki A. E. , Ashrafi S. H. , Nour Z. M. , ElNesr N. M.
Published: March 2012

Using scanning (SEM) and transmission (TEM) electron microscopy, this study compared fine structural features of the pocket walls in both juvenile and adult Periodontitis (JP and AP, respectively) in 40 cases. Gingiva was also obtained from a control group consisting of periodontally noninvolved teeth. Clinical parameters were assessed in both JP and AP patients as well as in controls. Clinical findings showed low plaque accumulation, marked periodontal tissue destruction and less gingival inflammation in JP. Bone destruction and attachment loss were more marked in JP than in AP. AP had a higher plaque index and more evident gingival inflammation. SEM observations of JP as compared to AP showed gross distortions in pocket walls, an increased beaded appearance of microridges, and separation between pocket epithelial cells. TEM showed partially desquamated and separated superficial epithelial cells, but only in JP were fine granular precipitates observed in the intercellular spaces.

The observations demonstrated structural features indicative of more prominent degenerative changes in JP than in AP. Also, these features were coincidental with a higher plaque index in AP than in JP, where clinical features (including a low plaque index) were not proportional to the epithelial destructive changes present.
Rapidly Progressive Acute Periodontal Infection in a Patient with Acute Leukemia
Authors: Stansbury Dianna M. , Peterson Douglas E. , Suzuki Jon B.
Published: March 2012

The clinical course of an adult patient with acute lymphocytic leukemia and localized, rapidly progressive periodontal disease in a setting of marrow regeneration is described. Initial presentation of this condition was consistent with herpes simplex virus infection involving the gingiva; however, more extensive evaluation including radiographs, cultures and biopsy revealed necrotic tissue, nonspecific bacterial growth and acute gingival inflammation, with no evidence of viral infection. While most acute oral infections in chemotherapy patients occur during the development of marrow aplasia, this lesion initially developed late during the marrow recovery phase. The characteristics of this lesion are compared with those occurring in noncancer patients with rapidly progressive Periodontitis and who have genetically governed neutrophil and/or lymphocyte defects.
Dental Status of Adults with and without Periodontitis
Authors: Sewón Liisi A. , Parvinen Tuija H. , Sinisalo Tauno V. H. , Larmas Markku A. , Alanen Peniti J.
Published: March 2012

All 30‐ to 59‐year old subjects (N = 757) from a representative sample of adult Finns (total sample = 1,105), showing advanced Periodontitis (marginal bone loss more than 30%, n = 125), were compared with their age‐ and sex‐matched pairs showing no marginal bone loss (n = 291) with respect to the number of intact teeth (no caries experience) present. Both male (n = 83) and female (n = 42) subjects with advanced Periodontitis had more intact teeth and intact molars than their matched pairs (113 men and 178 women) (P ≤ 0.01 for intact teeth and P ≤ 0.05 for intact molars in both groups). The total number of teeth present did not differ significantly between the compared groups.

Contrary to earlier hypotheses, our results suggest that Periodontitis and dental caries do not necessarily share a common etiology.
Quantification of Bacterial Penetration in Spontaneous Periodontal Disease in Beagle Dogs
Authors: Coons David B. , Charbeneau Thomas D. , Rivera‐Hidalgo Francisco
Published: March 2012

The role of bacteria in the pathogenesis of periodontal disease is controversial. Although bacterial penetration has been demonstrated in human Periodontitis, relationships of bacteria to varying levels of periodontal health in other animals has not been well documented. In this study of beagle dog periodontium, bacteria were counted within the various tissue regions of sites which exhibited periodontal health, gingivitis, or Periodontitis.

Affected sites within whole block sections from two aged beagle dogs were prepared for investigation by light (LM) and scanning electron microscopy (SEM), and bacterial counts were subjected to statistical analysis for differences.

Periodontitis sites viewed with LM had more bacteria than healthy sites. Neither LM nor SEM observations yielded any other differences in bacterial counts between the levels of periodontal health. When viewed using SEM, the sulcular epithelium had more bacteria than the other tissue regions in diseased sites. Relative to the number of bacteria in plaque, however, counts from all microscopic observations were very low.

These findings indicate that the presence of bacteria within the periodontium is of questionable significance in the pathogenesis of spontaneous periodontal disease in beagle dogs.
Different Cross‐Linked Types of Collagen Implanted in Rat Palatal Gingiva
Authors: Minabe M. , Kodama T. , Kogou T. , Tamura T. , Hori T. , Watanabe Y. , Miyata T.
Published: March 2012

Collagen membrane preparations were manufactured with the aim of enhancing wound healing following periodontal surgery. After crosslinking by various processing methods (with ultraviolet and hexamethylenediisocyanate) and to various extents, two types of collagen (atelocollagen and tendon collagen) were implanted into a dissection site within palatal gingival tissue. The time course of healing responses was investigated histologically. Collagen implantation was found to accelerate fibrous connective tissue attachment to the root surface and inhibit apical migration of the junctional epithelium. Cross‐linked atelocollagen was superior in biocompatibility to the other collagen membranes studied.
Effect of Subgingival Irrigation with Tetrapotassium Peroxydiphosphate on Scaled and Untreated Periodontal Pockets
Authors: Listgarten M. A. , Grossberg D. , Schwimer C. , Vito A. , Gaffar A.
Published: March 2012

A total of 20 test and 20 control subjects completed an 8‐week double blind clinical trial aimed at testing the therapeutic efficacy of a 7% tetrapotassium peroxydiphosphate (PDP) solution administered as a subgingival irrigant to scaled and untreated periodontal pockets. Each patient provided similar contralateral pockets with probing depths at base line of 5 mm or more (mean 6.25 mm). One pocket was selected at random for a thorough scaling, immediately following the base line examination (examination 1). The examination of each experimental site consisted of Plaque Index (P1I) and Gingival Index (GI) scores, probing depth (PD) and attachment level (AL) measurements (in mm), and a differential microscopic proportional count of certain subgingival bacterial morphotypes, namely coccoid cells, motile bacteria (not including spirochetes), spirochetes and all residual bacterial morphotypes. Test patients received coded irrigators containing the active ingredient PDP, while control patients received irrigators containing a placebo rinse similar to the test solution, but without PDP. The participants were instructed to irrigate the test sites twice a day. They were re‐examined after four weeks (examination 2) and eight weeks (examination 3) from the base line examination.

The results indicated that scaling and irrigation produced a significant decrease from the initial P1I and GI scores, and the PD and AL measurements. The proportions of coccoid cells were significantly increased, while the proportions of motile bacteria and spirochetes were significantly decreased. Irrigation of unsealed pockets resulted in a modest, but significant decrease in the P1I and GI scores. No effect on PD or AL was detectable. There was no detectable difference between the therapeutic effect of irrigation with PDP vs. the placebo solution.
Scaling and Root Planing Effectiveness: The Effect of Root Surface Access and Operator Experience
Authors: Brayer William K. , Mellonig James T. , Dunlap Robert M. , Marinak Kenneth W. , Carson Robert E.
Published: March 2012

This study investigated two variables associated with scaling and planning (S&RP): operator experience level and root surface access. One hundred and fourteen periodontally involved, single‐rooted teeth designated for extraction were randomly distributed among four operators of various experience levels for either an open or closed session of S&RP. Immediately after treatment, the teeth were extracted, washed, and scored for residual calculus in a blind manner. Results showed that there was no difference in S&RP effectiveness for experience level or type of procedure in shallow (1–3 mm) pockets. However, in moderate (4–6 mm) and deep (> 6 mm) periodontal pockets, S&RP combined with an open flap procedure was more effective than S&RP alone for both experience levels. Also, the more experienced operators produced a significantly greater number of calculus‐free root surfaces than the less experienced operators in periodontal pockets with moderate and deep probing depths. Clinical application of these results suggests that surgical access is associated with thorough surface debridement in periodontal pockets with moderate‐to‐advanced probing depths. However, more experienced operators could be expected to render more effective soft surface debridement.
Effects of Adjunctive Treatment of Periodontitis With Tetracycline and Spiramycin
Authors: Al‐Joburi W. , Chin Quee T. , Lautar C. , Iugovaz I. , Bourgouin J. , Delorme F. , Chan E. C. S.
Published: March 2012

The present study was undertaken to compare the efficacy of two antibiotics, spiramycin and tetracycline, with a placebo when used adjunctively with scaling and root planing in the treatment of advanced adult chronic Periodontitis. This was a double‐blind, parallel, randomized trial with one factor (drug) at three levels. Ninety–six patients (mean age 46 ± 1) were randomly assigned into one of three groups. All groups were scaled and root planed with each respective group receiving either spiramycin, tetracycline, or a placebo for 2 weeks. Two sites with probing depth of at least 7 mm were evaluated and the following clinical parameters were measured at baseline, 2, 8, 12, and 24 weeks: plaque index, bleeding on probing, crevicular fluid, probing depth, and change in the attachment level. The changes in the subgingival bacteria were monitored also using a differential staining technique. Seventy–nine patients completed the study. At the end of 24 weeks, although all three groups had shown clinical improvement when compared to the baseline data, there were no significant intergroup differences in any of the clinical parameters measured. While the proportion of spirochetes were significantly decreased (P < 0.05) at 2‐ and 8‐week intervals in both tetracycline and spiramycin groups (26% to 0.04% and 28% to 0.04%, respectively), compared to the placebo group (30% to 7%), only in the spiramycin group was the proportion of spirochetes significantly lower than the placebo group at the 24–week interval (3% and 11%, respectively). At week 24, the proportion of spirochetes in the tetracycline group had rebounded to 7%, which was not significantly different from the placebo group. We concluded that mechanical debridement with or without adjunctive spiramycin was effective in improving clinical parameters. Although the adjunctive use of antibiotics aided in preventing recolonization of spirochetes, the data did not support any short‐term clinical benefit since no statistical intergroup differences existed. (J Periodontol 1989;60:533–539)
5‐Year Evaluation of Durapatite Ceramic Alloplastic Implants in Periodontal Osseous Defects
Authors: Yukna Raymond A. , Mayer Elizabeth T. , Amos Suzanne Miller
Published: March 2012

Six patients who participated in a clinical study comparing the response of periodontal osseous defects to either grafting with Periograf (durapatite) hydroxylapatite (HA) ceramic or debridement alone (DEBR) were followed under an active maintenance program for 5 years. Mean values for gingival recession and attachment levels remained essentially stable following either treatment over the 5 year period. However, mean probeable pocket depths shifted from being significantly (P < 0.05) shallower for DEBR sites at 6 months and 1 year to being significantly shallower for HA sites at 5 years. The probing pocket depth change for grafted sites was steady and the change from presurgical values was significantly greater than the change for DEBR areas, which became about 1.5 mm deeper over the 5 year postsurgical period. Intrapatient comparisons showed that recession, attachment gain, and pocket depth decrease were most frequently greater for the Periograf‐treated sites. Assessment of the pattern of clinical changes during the 5 year postsurgical period demonstrated that the attachment level of grafted sites improved or stayed the same 86% of the time compared to only 62% stability or improvement in the DEBR only sites. In fact, 38% of the DEBR sites were worse at 5 years than at the time of surgery, a 3 times greater failure rate than that found in the HA‐grafted sites. Pocket depth measurements showed that 98% of the Periograf‐treated sites were better or the same as presurgically (2% worse), while only 80% of DEBR sites showed positive results and 20% had deeper pockets than at the time of surgery. These findings suggest that Periograf–treated sites were stable for 5 years following surgery and resulted in a high frequency of clinical improvement, while areas treated by open flap debridement alone were not stable and regressed at a rate 3 to 5 times that of the grafted sites. It is probable that other grafting materials would demonstrate similar comparative results to debridement alone. (J Periodontol 1989;60:544–551)
The Presence of Nicotine on Root Surfaces of Periodontally Diseased Teeth in Smokers
Authors: Cuff Murray J. A. , McQuade Michael J. , Scheidt Michael J. , Sutherland Donald E. , Van Dyke Thomas E.
Published: March 2012

There is a growing body of scientific evidence to support the concept that the use of tobacco products significantly contributes to the progression of periodontal disease or is detrimental to healing following periodontal therapy. Several studies have shown toxic effects of nicotine on peripheral circulation and the immune response. The purpose of the present study was to identify and compare the quantity of nicotine present on root planed and non– root planed surfaces of teeth from smokers. Twenty–nine single–rooted teeth from 11 smokers were extracted, brushed clean, and the roots sectioned longitudinally. The respective halves were either left untreated (Group A) or thoroughly root planed (Group B). Pulpal tissue was removed and the individual root sections weighed. Each half was extracted for nicotine using a methylene chloride technique. Quantification was performed using high pressure liquid chromatography (HPLC) and the sections compared on a nicotine per root weight basis. Results showed a greater amount of nicotine present on non–root planed sections than on treated sections, although some treated specimens revealed small amounts of the substance. These findings suggest that nicotine is present on the root surface but is largely removed by thorough root planing. Its presence is not surprising in light of the recent finding that nicotine and cotinine, the major metabolite of nicotine, are found in gingival crevicular fluid. Recent studies have shown a particularly harmful effect of nicotine on fibroblasts. Its presence on root surfaces may, therefore, impair wound healing and alter the host response in periodontal disease. The use of tobacco products in conjunction with periodontal therapy may interfere with optimal healing and/or lead to further periodontal breakdown. {J Periodontol 1989;60:564–569)
The Effect of Local Doxycycline With and Without Tricalcium Phosphate on the Regenerative Healing Potential of Periodontal Osseous Defects in Dogs
Authors: Al‐Ali Waleed , Bissada Nabil F. , Greenwell Henry
Published: March 2012

The purpose of this study was to evaluate the clinical and histological effects of high concentration doxycycline on osseous regeneration in adult beagle dogs. Four 5 mm two– wall periodontal osseous defects were created in the premolar and molar area of each quadrant yielding a total of 48 defects in the three dogs. Ligature‐induced Periodontitis was maintained for 6 weeks. Two weeks following ligature removal, one of the following graft procedures was randomly assigned to each defect: 1) doxycycline alone (DOX); 2) tricalcium phosphate alone (TCP); 3) a combined graft of DOX plus TCP, or 4). surgically debrided control. All areas received thorough scaling and root planing at the time of surgery. Clinical parameters evaluated at 4, 12, and 20 weeks after the surgical treatment included the gingival index and probing depths. Crevicular fluid was examined at 3, 10, and 28 days postoperatively for tetracycline fluorescence. Direct clinical measurements from the CEJ to a notch placed at the base of the defect and from the CEJ to the alveolar crest were made at the time of surgical treatment and reentry. The reentry procedures were performed at 4, 12, and 20 weeks postoperatively. Immediately following reentry block sections were obtained from each quadrant and prepared for examination with the light microscope. The gingival index and probing depth measurements showed greater improvement in the DOX and DOX + TCP groups. Increased regeneration (new bone, cementum, and periodontal ligament) and reduced alveolar crest resorption were observed more frequently in DOX and DOX + TCP defects, while healing by long junctional epithelium was more common in defects not treated with doxycycline. Epithelial migration tended to halt just coronal to root–bound doxycycline. Root–bound doxycycline was observed both histologically and with a UV light for up to 20 weeks. When TCP grafts were combined with DOX, the TCP was more rapidly enclosed by bone than when TCP alone was used. The high concentration of doxycycline used in the present study tended to provoke a pronounced inflammatory response that diminished over time. A limitation of the present study was the number (3) of dogs available. Within the limitations of this sample size the following observations were made: 1) Defects treated with high concentration doxycycline tended to have more regenerative healing and less crestal resorption; 2) root bound doxycycline served as a barrier to the downgrowth of junctional epithelium; and 3) the combination of doxycycline plus tricalcium phosphate resulted in more bone formation and less crestal resorption than either doxycycline alone or tricalcium phosphate alone.
Comparison of Decalcified Freeze–Dried Bone Allograft and Porous Particulate Hydroxyapatite in Human Periodontal Osseous Defects
Authors: Bowen James A. , Mellonig James T. , Gray Jonathan L. , Towle Herbert T.
Published: March 2012

The purpose of this study was to clinically compare the healing potential of the osteoinductive decalcified freeze–dried bone allograft (DFDBA) with an osteoconductive synthetic graft, particulate porous hydroxyapatite (HA). Six patients ranging in age from 28 to 52 (mean age 42.6) participated in this investigation. They were without significant systemic disorders and had advanced Periodontitis with at least two comparable periodontal defects. Each patient received initial therapy consisting of oral hygiene instruction, scaling, root planing, and occlusal adjustment as indicated. Probing pocket depth, gingival recession, attachment levels, and bleeding on probing were recorded in the posthygiene phase of therapy. Alveolar crest height and depth of osseous defect were obtained at the time of surgery. The cemento–enamel junction was used as the fixed reference point. All measurements were repeated at the time of a 6–month reentry. There was no significant difference in any of the soft tissue measurements when DFDBA and HA were compared. However, both treatment modalities reduced pocket depth and demonstrated a gain in clinical attachment levels. There was 2.2 mm of bone repair with DFDBA and 2.1 mm with HA. These values corresponded to a percent defect fill of 61% for DFDBA and 53% for HA. These values were likewise not statistically different. (Journal of Periodontology 1989;60:647– 654)
Periosteal Microvasculature in the Dog Alveolar Process
Authors: Nobuto Takahiro , Yanagihara Kazuaki , Teranishi Yoshihiro , Minamibayashi Shigeyoshi , Imai Hisao , Yamaoka Akira
Published: March 2012

Most periodontal surgery has been performed on the basis of the regenerating capacity of the periosteum. Recently it has been pointed out that the blood supply is important to the osteogenic and fibrogenic activity of the periosteum. The purpose of the present study was three‐dimensional observation of blood vessels distributed within the gingival periosteum and the periosteum beneath the alveolar mucosa of adult mongrel dogs. Corrosion cast specimens of vessels were observed from three directions: mucosal side, bone side, and horizontal cut surface. It was revealed that the plexus distributed in the periosteum of the gingiva formed a coarse network structure, which consisted mainly of arterioles and venules. In contrast, in the periosteum of the alveolar mucosa, a dense network structure consisting of arterioles, capillaries, and venules formed a vascular bed. Thus, the mucogingival junction was easily located even in the plexus of periosteum which was distributed beneath the gingiva and the alveolar mucosa, suggesting that the difference in tissue specificity was reflected in the plexus of the periosteum. (Journal of Periodontology 1989;60:709–715)
Unusual Periodontal Findings in an AIDS Patient With Burkitt's Lymphoma
Authors: Vallejo Gonzalo Hernández , García María Dolores , López Antonio , Mendieta Carlos , Moskow Bernard S.
Published: March 2012

This report deals with a case of AIDS‐related Burkitt's lymphoma in which some of the earliest findings were dental and periodontal in nature. The patient presented initially with painless and extremely loose teeth accompanied by progressive paresthesia of the lower jaw. Unique radiographie findings included extensive periodontal ligament space widening and bulbous, granuloma‐like lesions about the apices of the teeth. These findings were associated with progressive tumor infiltration of the mandible and do not appear to be related to other reports of aggressive Periodontitis associated with impaired immunologic functions in AIDS patients. [Journal of Periodontology 1989;60:723–727)
Nitrendipine–Induced Gingival Overgrowth in Dogs
Authors: Heijl Lars , Sundin Yvonne
Published: March 2012

This study assessed the development of gingival overgrowth in dogs given nitrendipine, a new antihypertensive dihydropyridine. Nine male Beagle dogs with established plaque and gingivitis were used. Following a baseline examination, which involved assessment of plaque, gingivitis, and gingival enlargement, six dogs (test) received nitrendipine twice daily in a high dose, while 3 dogs (control) received placebo. Clinical scorings were repeated after 10 and 20 weeks. At termination of the study gingival biopsies were excised and examined morphometrically. Already at the 10‐week examination definite changes in gingival size had occurred, and following 20 weeks of nitrendipine treatment the gingival enlargement had markedly increased. In none of the control dogs were there any signs of gingival size changes. The histopathological examination showed that the only principal changes in histopathological morphology were that areas of non‐infiltrated connective tissue in test specimens showed an increase in vascularity and appeared more loose compared with the dense tissue in control specimens. The morphometric analysis demonstrated minor differences between test and control specimens in regard to all tissue fractions observed; however, such differences were numerically very small, and were not considered biologically significant. Thus, the results demonstrated that nitrendipine administered to Beagle dogs during a 20‐week period causes marked overgrowth of gingival tissue of apparently normal composition. The fact that cases of gingival overgrowth have been reported among patients receiving other dihydropyridines suggest that the observed gingival overgrowth is an effect of this class of drugs.
Application of a Local Drug Delivery System to Periodontal Therapy:
Authors: Minabe Masato , Uematsu Atsuo , Nishijima Kayo , Tomomatsu Eiko , Tamura Toshiyuki , Hori Toshio , Umemoto Toshio , Hino Tsunetoshi
Published: March 2012

For the purpose of applying a local drug delivery system to periodontal therapy, atelocollagen preparations with immobilized tetracycline (TC) were prepared by modifying the form of the collagen, the concentration of the immobilized TC, and the time of the cross‐link process with glutaraldehyde. The course of the TC release from the collagen preparations into an aqueous solution was determined in relation to time. The preparations were also inserted into periodontal pockets, and the amount of TC remaining in the pocket was determined daily. The results obtained were as follows: 1) The degree of drug release could be controlled to some extent by adjusting the TC concentration and the time of the crosslink process; and 2) an amount of TC exceeding the effective dose in the gingival crevicular fluid was present in the periodontal pocket even 10 days after the insertion of TC fixed in the cross‐linked processed collagen film in the periodontal pockets.
The Effect of Citric Acid on Retained Plaque and Calculus
Authors: Tanaka Koji , O'Leary Timothy J. , Kafrawy Abdel H.
Published: March 2012

Five extracted human teeth with clinically demonstrable calculus were used. One proximal surface of each tooth was partly scaled, leaving a small amount of calculus. The crown was then cut off at the cementoenamel junction and the scaled proximal surface was divided vertically into two segments using a thin separating disk. One segment was treated by rubbing cotton pellets soaked in citric acid (pH1) over the surface for three minutes and then immersing the segment in saline to stop the reaction. The other (control) segment was treated by rubbing cotton pellets soaked in saline over the surface for three minutes. When viewed under a scanning electron microscope, the control sections displayed scaling striations, considerable surface debris, and large numbers of bacteria at the borders of the residual calculus. Citric acid‐treated specimens displayed little debris on cementum or residual calculus and virtually no bacteria at the junction between calculus and cementum. The surface morphology of the citric acid‐treated calculus varied from layered‐like to honeycomb.
Clinical Effect of a Sanguinaria Dentifrice on Plaque and Gingivitis in Adults
Authors: Mallatt M. E. , Beiswanger B. B. , Drook C. A. , Stookey G. K. , Jackson R. D. , Bricker S. L.
Published: March 2012

A clinical trial was conducted to evaluate the effects of a sanguinaria‐zinc chloride dentifrice on the prevention of plaque formation and gingivitis. A total of 59 young adults, 18 to 30 years of age, either performed supervised brushing with a 0.075% sanguinaria0.05% zinc chloride dentifrice, a 0.24% sodium fluoride dentifrice, or rinsed daily with a 0.05% NaF solution. Clinical evaluations for plaque and gingivitis were performed after 7, 14, and 21 days of the test regimen. After 21 days, all subjects resumed twice daily supervised brushing and flossing and post‐test evaluations were conducted after two weeks. The results showed that after 7, 14, and 21 days both groups using dentifrices had significantly less plaque and gingivitis than the group using the rinse, and there were no significant differences between the two groups using either the sanguinaria‐ZnCl2 or the NaF dentifrices.
The Prognosis of Tunnel Preparations in Treatment of Class III Furcations
Authors: Hellden Leif B. , Elliot Agnetha , Steffensen Bjorn , Steffensen Jane E. M
Published: March 2012

The present study evaluated the long‐term prognosis of tunnel preparations performed in a large number of teeth with advanced periodontal furcation defects. One hundred seven (107) patients, in which 156 teeth had been treated by tunnel preparations, were recalled for an evaluation, which was based on a questionnaire, a clinical examination, and radiographs; 102 patients attended (149 teeth = 95%). The mean observation time per tooth was 37.5 months (range 10 to 107 months). The results showed that 10 teeth (6.7%) had been extracted and 7 teeth (4.7%) hemisected. The indication for 12 of these extractions or hemisections was root caries. Among the remaining 132 teeth, 23 (15.4%) showed initial or established caries. There was no relationship between caries development and length of the observation time. Thus, approximately 75% of the teeth were still caries‐free and in function.

The findings demonstrated that tunnel preparations have a considerably better prognosis than previously reported and should be considered a valid treatment alternative.
Comparison of Freeze–Dried Bone Allograft and Porous Hydroxylapatite in Human Periodontal Defects
Authors: Barnett J. D. , Mellonig J. T. , Gray J. L. , Towle H. J.
Published: March 2012

This study was conducted to clinically compare the efficacy of freeze‐dried bone allograft (FDBA) and porous hydroxylapatite granules. Nineteen pairs of intraosseous defects were grafted in seven patients. One defect of each pair was implanted with FDBA, the other with granular porous hydroxylapatite. Matching defects were treated similarly in all other aspects. Evaluations were based on both preoperative and postoperative measurements from a fixed reference point, standardized radiographs, surgical osseous measurements, and histology of degranulated tissues. Grafted sites were reentered 6 to 11 months postsurgery. Results showed a mean osseous fill of 2.1 mm for FDBA versus 1.3 mm for granular porous hydroxylapatite (P =.07). A mean clinical attachment gain of 2.2 mm for FDBA versus 1.3 mm for granular porous hydroxylapatite (P <.05), and a mean decrease in probing depths of 3.0 mm for FDBA verses 1.4 mm for granular porous hydroxylapatite (P < 0.5) was found. FDBA was clinically indistinguishable from host bone, whereas porous hydroxylapatite appeared to be separated from host bone by soft tissue. The data and clinical findings suggested that FDBA may have some enhanced reparative potential when compared to granular porous hydroxylapatite in the treatment of periodontal defects in humans.
Comparative Effectiveness of Flossing and Brushing in Reducing Interproximal Bleeding
Authors: Graves Richard C. , Disney Judith A. , Stamm John W.
Published: March 2012

This study assesses the comparative effectiveness of three types of dental floss and toothbrushing in reducing interproximal bleeding sites, measured by stimulation with wooden interdental cleaners using the interdental bleeding index assessment method. The 119 adult subjects with gingival inflammation were randomly assigned to one of four groups at the beginning of a supervised 2 week clinical trial. The toothbrushing only group achieved a 35% reduction in bleeding sites and the three flossing groups all demonstrated dramatic reductions of about 67%. The three varieties of dental flosses were about equally effective in reducing interproximal bleeding and doubly effective as toothbrushing alone. Compared to probing, the interdental bleeding index method is considered a simplified method of assessing interproximal gingival inflammation.
The Effect of Ofloxacin on Experimental Periodontitis in Hamsters Infected with Actinomyces viscosus ATCC 15987
Authors: Kametaka Shigeru , Miyazaki Tadaaki , Inoue Yoshiko , Hayashi Shin'ichi , Takamori Akira , Miyake Yoichiro , Suginaka Hidekazu
Published: March 2012

Syrian hamsters were infected with Actinomyces viscosus ATCC 15987 by inoculation into the oral cavity to induce experimental Periodontitis. The effect of an antibiotic, Ofloxacin (OFLX), on the experimental Periodontitis was examined. In Group A, OFLX gel was applied daily to the gingival mucosa, 2 weeks after bacterial inoculation. Groups B and C were an infected control and a noninfected control, respectively. The hamsters in these three groups were fed a powdered high‐sucrose diet. The hamsters in Group D, also a noninfected group, were fed an ordinary solid diet. Salivary occult blood test, evaluation of gingival and plaque index, measurement of alveolar bone loss, bacterial examination, and histological observation were performed 11 weeks after infection.

Group B exhibited significantly higher levels of gingival index, plaque index, and alveolar bone loss than the noninfected controls. Severe inflammation of the gingivae, formation of gingival pockets, migration of many inflammatory cells, and obvious bone loss were also observed in Group B. However, these inflammatory changes were milder in Group A, which was treated with OFLX.
Repopulation of Dentin Surfaces by Periodontal Ligament Cells and Endothelial Cells
Authors: Terranova Victor P. , Odziemiec Christine , Tweden Katherine S. , Spadone Donald P.
Published: March 2012

The regeneration of connective tissue attachment is a major goal of clinical periodontics. Recent investigations on biochemically mediated periodontal regeneration have attempted to define the various biological response modifiers which may provide a mechanism for periodontal regeneration. Fibronectin and endothelial cell growth factor have been shown to selectively enhance periodontal ligament (PDL) cell adhesion, migration, and proliferation. In addition, dentin preconditioned with tetracycline HCl (TTC) or citric acid (CA) supports PDL cell adhesion, presumably by exposing collagen fibers. We have now extended these studies to include basic fibroblast growth factor (b‐FGF) as a potential meditor of periodontal regeneration. Using AFSCM (assays for specific cell migration), b‐FGF in concentrations as low as 10 ng per dentin block significantly stimulated PDL cell Chemotaxis, while the antibody against b‐FGF inhibited both the chemotactic and proliferative characteristics of the mitogen. We also found that 5 ng and above of b‐FGF per dentin block significantly stimulated human endothelial cell migration and proliferation. Using 125I–b– FGF, we demonstrated that the factor binds to native dentin. This binding was increased when the dentin blocks were preconditioned by TTC or CA and reduced when the dentin was subsequently treated with collagenase. 125I–b–FGF also bound with moderate affinity to a type I collagen affinity column whereas the binding to a hydroxylapatite affinity column was negligible. The combination of FN and b–FGF was a marginally more potent chemoattractant than b–FGF alone for PDL cells. The data indicate that b–FGF can stimulate PDL and human endothelial cell migration and human endothelial cell proliferation. BasicFGF binding is increased by the exposure of type I collagen in dentin.
Coronal Positioning of Existing Gingiva:
Authors: Allen Edward P. , Miller Preston D.
Published: March 2012

Although not a new procedure, coronal positioning of existing gingiva may be used to enhance esthetics and reduce sensitivity. Unfortunately when recession is minimal and the marginal tissue is healthy, many periodontists do not suggest treatment. This article outlines a simple surgical technique with the criteria for its use which results in a high degree of predictability and patient satisfaction.
Scanning Electron Microscope Evaluation of Wear of Stainless Steel and High Carbon Steel Curettes
Authors: Tal H. , Kozlovsky A. , Green E. , Gabbay M.
Published: March 2012

Root planing depends on quality instrument cutting edges. The sharpness and wear of stainless steel (SS) and high carbon steel (HCS) dental curettes were compared before and after standardized root planing procedures. Forty working edges of dental curettes, 20 of each alloy, were examined by scanning electron microscope (SEM) prior to any root planing (control), after 15 strokes, and after 45 strokes. Root planing was carried out on freshly extracted, single‐rooted teeth, mounted in natural positions in mannikin jaws. Working areas measuring 3 ×5 mm were marked on root surfaces previously exposed by Periodontitis. Each working edge was examined at points 1 mm and 2 mm from the tip under the same magnification (× 240). Microscopic observations showed that edge deformation increased from the control (factory sharpened) group, to the “15 stroke” group, and from the “15” to the “45 stroke” group, in both SS and HCS curettes. SS curettes, however, demonstrated significantly more wear than HCS curettes. After 45 strokes, only 5% of the SS curettes were sharp, compared to 20% of the HCS curettes. While 65% of the SS curettes showed severe edge deformation by the end of the study, only 20% of the HCS curettes were severely deformed (P < 0.01). The results indicate that HCS curettes are more resistant to wear than SS curettes. Further study is indicated to evaluate the relationship between actual bevel dimensions and root planing effectiveness.