bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of surface roughness and calcium phosphate coating on the implant/bone response
Authors: Hayakawa Tohru , Yoshinari Masao , Nemoto Kimiya , Wolke Joop G. C. , Jansen John A.
Published: March 2003

The influence of surface roughness and calcium phosphate (Ca‐P) coating on the bone response of titanium implants was investigated. Four types of titanium implants, i.e. as‐machined, grit blasted, as‐machined with Ca‐P sputter coating, and grit blasted with Ca‐P sputter coating, were prepared. The Ca‐P sputter‐coating, produced by using the RF magnetron sputter technique, was rapid heat‐treated with infrared radiation at 600°C. These implants were inserted into the left and right femoral condyles and the left and right tibial diaphyses of the rabbits. After implantation periods of 2 and 12 weeks, the bone–implant interface was evaluated histologically and histomorphometrically. Histological evaluation revealed no new bone formation around different implant materials after 2 weeks of implantation. After 12 weeks, bone healing was almost completed. For both tibial and femoral implants, Ca‐P coated implants always showed a higher amount of bone contact than either of the non‐coated implants. On the other hand, surface roughness improved only the response to implants inserted into the tibial diaphysis. On the basis of these findings, we concluded that 1) deposition of a sputtered Ca‐P coating on an implant has a beneficial effect on the bone response to this implant during the healing phase, and 2) besides implant surface conditions the bone response is also determined by local implant site conditions.
Incorporation of composite bone implants in the facial skeleton
Authors: Merkx Matthias A. W. , Maltha Jaap C. , Freihofer Hans‐Peter M.
Published: March 2003

The purpose of this study was to evaluate the capacity of composite grafts consisting of either particulated cancellous or particulated cortical bone and anorganic bovine bone mineral (BBM) (Bio‐Oss®) to induce regeneration in standardized critical size bony defects overlying the frontal sinus. Four full thickness critical size bone defects were made in the frontal bone in each of 8 skeletally mature female goats. These defects were filled at random with composite cancellous bone/BBM grafts or composite cortical bone/BBM grafts. Control defects were not included but could be evaluated using data from a previous study in which the same experimental setting was used (Merkx et al. 1999a). Fluorochrome bone markers were injected subcutaneously 1 and 5 weeks after implantation, and 1 week before the animals were killed. Two animals were killed at 3, 6, 12 and 24 weeks after surgery respectively. The results were evaluated by histological means including fluorescence microscopy. In conclusion, composite grafts consisting of autogenous cancellous bone/BBM yield good results, combining the advantages of each material alone and reducing the disadvantages of each when used separately. Critical size defects in the maxillofacial area, overlying a paranasal sinus, filled with this material heal uneventfully within 12 weeks. Composite grafts consisting of cortical bone and BBM show less favorable results. These grafts induce osteoclasts, probably by the presence of non‐functional BBM, resulting in resorption of the cortical bone chips.
Biostimulation of bone marrow cells with a diode soft laser
Authors: Dörtbudak Orhun , Haas Robert , Mailath‐Pokorny Georg
Published: March 2003

In recent years, the use of low‐intensity red light in regeneration of soft tissue has been increasingly pursued. As far as hard tissue is concerned, the biostimulating effect of laser has already been demonstrated successfully in more rapid healing of tibial bone fractures in mice at a dosage of 2.4 J. However, the effect of light of a low dose laser directly on osteoblasts has not been investigated yet. The aim of this study was to determine the effect of continuous wave diode laser irradiation on osteoblasts derived mesenchymal cells. Three groups of 10 cultures each were irradiated 3 times (days 3, 5, 7) with a pulsed diode soft laser with a wavelength of 690 nm for 60 s. Another 3 groups of 10 cultures each were used as control groups. A newly developed method employing the fluorescent antibiotic tetracycline was used to compare bone growth on these culture substrates after a period of 8, 12 and 16 days, respectively. It was found that all lased cultures demonstrated significantly more fluorescent bone deposits than the non‐lased cultures. The difference was significant, as tested by the Tukey Test (P<0.0001) in the cultures examined after 16 days. Hence it is concluded that irradiation with a pulsed diode soft laser has a biostimulating effect on osteoblasts in vitro, which might be used in osseointegration of dental implants.
Effect of loading on the development of nerve fibers around oral implants in the dog mandible
Authors: Wada Shin , Kojo Tatsuro , Wang Yi‐Huei , Ando Hironobu , Uchida Yasunari , Nakanishi Eiko , Zhang Min , Fukuyama Hiroshi
Published: March 2003

Abstract: Occlusal forces cause stress which morphologically affects the supporting tissues of implants. The aim of this study was to examine the effects of occlusal forces on the distribution of neurofilament protein (NFP)‐positive nerve fibers in the tissue of peri‐implant bone. The bilateral 2nd, 3rd and 4th mandibular premolars and the 1st molars were extracted from three mongrel dogs. After 4 months of healing, 4 screw‐type implants were inserted in the oral cavity. Three months after insertion, the implants on the molar site were loaded by occlusal forces, while those on the premolar site were unloaded. After a further 3 months, the dogs were sacrificed, and specimens were prepared for immunohistochemical NFP‐positive staining by the labeled‐streptavidin‐biotin method. Many NFP‐positive nerve fibers were found in the tissues of the loaded site when compared with the unloaded site. These fibers were localized in both the bone marrow space and in the peri‐implant fibrous tissue. They had two types of nerve endings: simple free nerve endings, and nerve endings with tree‐like ramifications. The present results suggest that loading by occlusal force causes an increase in the number of NFP‐positive nerve fibers, many of which have free nerve endings in the peri‐implant tissue. The possible role of these NFP‐positive nerve fibers is discussed.
Resonance frequency and removal torque analysis of implants with turned and anodized surface oxides
Authors: Sul Young‐Taeg , Johansson Carina B. , Jeong Youngsoo , Wennerberg Ann , Albrektsson Tomas
Published: March 2003

Abstract: The present experimental study was designed to address two issues. The first was to investigate whether oxide properties of titanium implants influenced bone tissue responses after an in vivo implantation time of six weeks. If such a result was found, the second aim was to investigate which oxide properties are involved in such bone tissue responses. Screw‐shaped implants with a wide range of oxide properties were prepared by electrochemical oxidation methods, where the oxide thickness varied in the range of 200 nm to 1000 nm. The surface morphology was prepared in two substantially different ways, i.e. barrier and porous oxide film structures. The micropore structure revealed pore sizes of 8 μm in diameter, with a range in opening area from 1.27 μm2 to 2.1 μm2. Porosity ranged from 12.7% to 24.4%. The crystal structures of the titanium oxide were amorphous, anatase and a mixture of anatase and rutile type. The chemical compositions consisted mainly of TiO2. Surface roughness ranged from 0.96 μm to 1.03 μm (Sa). Each group of test samples showed its own, defined status with respect to these various parameters. The oxide properties of turned commercially pure titanium implants were used in the control group, which was characterized by an oxide thickness of 17.4 ± 6.2 nm, amorphous type in crystallinity, TiO2 in chemical composition, and a surface roughness of 0.83 μm (Sa). Bone tissue responses were evaluated by resonance frequency measurements and removal torque tests that were undertaken six weeks after implant insertion in rabbit tibia. Implants that had an oxide thickness of approximately 600, 800 and 1000 nm demonstrated significantly stronger bone responses in the evaluation of removal torque values than did implants that had an oxide thickness of approximately 17 and 200 nm (P < 0.05). However, there were no difference between implants with oxide thicknesses of 17 and 200 nm (P = 0.99). It was concluded that oxide properties of titanium implants, which include oxide thickness, micropore configurations and crystal structures, greatly influence the bone tissue response in the evaluation of removal torque values. However, it is not fully understood whether these oxide properties influence the bone tissue response separately or synergistically.
Evaluation of implants placed with barrier membranes
Authors: Lorenzoni Martin , Pertl Christof , Polansky Raoul A. , Jakse Norbert , Wegscheider Walther A.
Published: March 2003

Abstract: This follow‐up study evaluated clinical and radiographic parameters of dental implants placed in combination with guided bone regeneration with barrier membranes. All implants functioned well up to 60 months after insertion. Forty‐one patients, with a total of 72 augmented implants, who participated in a regular maintenance protocol, were investigated. Annual Periotest values (median value, − 3) revealed stable periimplant conditions and sustained osseointegration. At 6 months and annually thereafter up to five years, the radiographic evaluation yielded mean bone losses of 0.8, 1.25, 1.39, 1.42, 1.42 and 1.39 mm, respectively, with a range from 0 to 3.5 mm. No implant failures or losses were recorded. The results demonstrated stable periimplant conditions up to five years after membrane‐protected osseous regeneration, with no significant differences in the radiographic bone level in regard to region, jaw or bone graft. Premature membrane exposure resulted in a significantly higher crestal bone loss up to 24 months. The newly formed bone appeared to be able to withstand functional loading for up to 60 months in a predictable manner.
Appositional bone formation in marginal defects at implants
Authors: Botticelli Daniele , Berglundh Tord , Buser Daniel , Lindhe Jan
Published: March 2003

Abstract: In a previous experiment, it was demonstrated that a wide marginal defect around an implant can heal with a high degree of osseointegration. The present experiment was performed to evaluate the degree and quality of de novo bone formation and osseointegration in marginal defects adjacent to submerged titanium implants. All mandibular premolars and 1st molars were extracted in four Labrador dogs. Four experimental sites were identified in the right side of the mandible. In two sites, custom‐made implants with a sandblasted, large grit, acid‐etched (SLA) surface were installed without further ostectomy (control sites). In the two remaining sites (test sites), a specially designed step drill was used to widen the marginal 5 mm of the canal. A barrier membrane was used to cover the implants in the defect sites. All implants were submerged. One month later, an identical procedure, including site preparation and implant installation, was performed in the left side of the mandible. Two months following the first implant installation procedure, biopsies were collected and prepared for sectioning. Ostectomy and implant installation in the control location resulted in a series of bone tissue alterations which eventually allowed newly formed bone to establish contact with the SLA surface. The marginal defect lateral to the implant in the test locations gradually became filled with newly formed bone. De novo bone formation started within the walls of the surgically prepared defect. Bone‐to‐implant contact was first established in the apical portion of the gap. This new bone tissue was in the coronal direction continuous with a dense, non‐mineralized ‘implant attached’ soft tissue which, over time, also became mineralized to increase the height of the zone of bone‐to‐implant contact. The results suggest that healing of a wide marginal defect around an implant is characterized by appositional bone growth from the lateral and apical bone walls of the defect.
Advanced imaging: Magnetic resonance imaging in implant dentistry
Authors: Gray Crawford F. , Redpath Thomas W. , Smith Francis W. , Staff Roger T.
Published: March 2003

Abstract: For accurate and safe placement of dental implants, and planning of associated surgery, a full assessment of the surgical anatomy of the site is necessary. Thus, it is highly desirable to have tomographic, sectional information available, to permit the implant to be aligned correctly. In recent years, X‐ray computed tomography (CT) has become accepted as the gold standard in assessment, but the exposure to ionising radiation can be substantial. Artefacts due to dental restorations can also be significant, and some doubts may exist over the accuracy of reformatted CT. Magnetic resonance imaging (MRI) entails no exposure to ionising radiation, and allows direct acquisition of tomographic information in any desired plane. Sequential studies may be safely performed, allowing us a valuable insight into bone graft behaviour. Other than in a small number of cases, MRI may be safely used for presurgical assessments. Artefacts are few and in most cases localised. The surgical confidence from the sectional information gained is a significant step forward in the safe placement of dental implants.
Accuracy of drilling guides for transfer from three‐dimensional CT‐based planning to placement of zygoma implants in human cadavers
Authors: Van Steenberghe Daniel , Malevez Chantal , Van Cleynenbreugel Johan , Serhal Charbel Bou , Dhoore Ellen , Schutyser Filip , Suetens Paul , Jacobs Reinhilde
Published: March 2003

Abstract: The accuracy of surgical drilling guides was assessed for placement of zygoma implants. Six zygoma fixtures of length 45 mm (Nobel Biocare, Göteborg, Sweden) were placed in three formalin‐fixed human cadavers using surgical drilling guides. The fabrication of these custom‐made drilling guides was based on three‐dimensional computerized tomography (3D‐CT) data for the maxillary‐zygomatic complex. The installation of the implants was simulated preoperatively using an adopted 3D‐CT planning system. In addition, anatomical measurements of the zygomatic bone were performed on the 3D images. The preoperative CT images were then matched with postoperative ones in order to assess the deviation between the planned and installed implants. The angle between the planned and actually placed implants was < 3° in four out of six cases. The largest deviation found at the exit point of one of the six implants was 2.7 mm. The present study showed that the use of surgical drilling guides should be encouraged for zygoma implant placement because of the lengths of the implants involved and the anatomical intricacies of the region.
The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12‐month results
Authors: Cugini M. A. , Haffajee A. D. , Smith C. , Kent R. L. , Socransky S. S.
Published: March 2003

Background/aims:

Previously, we reported that SRP resulted in a decrease in

mean pocket depth and attachment level and reduced prevalence and levels of Bacteroides forsythus, Porphyromonas gingivalis, and Treponema denticola at 3 and 6 months post‐SRP in 57 subjects with adult periodontitis. 32 of the 57 subjects were monitored at 9 and 12 months. Thus, the purpose of the present investigation was to evaluate the microbial and clinical effects of SRP in 32 (mean age 48±11) subjects over a 12‐month period.

Method: Clinical assessments of plaque, gingival redness, suppuration, bleeding on probing, pocket depth and attachment level were made prior to SRP and at 3, 6, 9, and 12 months post‐therapy. Subgingival plaque samples were taken at each visit and analyzed using the checkerboard DNA‐DNA hybridization technique for the presence and levels of 40 subgingival species. Each subject also received maintenance scaling at each of the subsequent monitoring visits. Differences in clinical parameters and prevalence and levels of bacterial species were analyzed pre‐ and post‐therapy using the Wilcoxon signed ranks test. The Quade test for related samples was used for analysis of multiple visits.

Results: Mean pocket depth (mm±SEM) decreased from 3.2±0.3 at baseline to 2.9±0.3 at 12 months (p<0.01). Mean attachment level showed significant reduction at 6 months, but did not diminish further. Bleeding on probing and plaque were significantly reduced at 12 months (p<0.001, p<0.05, respectively). P. gingivalis, B. forsythus and T. denticola decreased in prevalence and levels up to the 6‐month visit and remained at these lower levels at 9 and 12 months. Significant increases in levels and prevalence were noted at 12 months for Actinomyces naeslundii genospecies 2, Actinomyces odontolyticus, Fusobacterium nucleatum ss polymorphum, Streptococcus mitis, Capnocytophaga sp, and Veillonella parvula.

Conclusions: The data suggest that the maintenance phase of therapy may be essential in consolidating clinical and microbiological improvements achieved

as a result of initial therapy.
A controlled study of relative periodontal attachment loss in people with HIV infection
Authors: Robinson P. G. , Boulter A. , Birnbaum W. , Johnson N. W.
Published: March 2003

Objective: To compare the progression of periodontal destruction in people with and without HIV.

Method: Relative attachment loss on 6 index teeth was compared between 19 people with HIV and 17 people without HIV infection over 12 and 18 month follow ups.

Results: The proportions of sites with 1, 2 or 3 mm of relative attachment loss were similar in the study and control groups. Mean maximum relative attachment loss was similar in both groups after 12 months but greater in the study group after 18 months.

Conclusions: The data are not compelling evidence of greater periodontal destruction associated with HIV infection. Large scale cohort studies or meta‐analyses would be more conclusive.
A controlled re‐entry study on the effectiveness of bovine porous bone mineral used in combination with a collagen membrane of porcine origin in the treatment of intrabony defects in humans
Authors: Camargo Paulo M. , Lekovic Vojislav , Weinlaender Michael , Nedic Melica , Vasilic Nikola , Wolinsky Lawrence E. , Kenney E. Barrie
Published: March 2003

Aim: The purpose of this study was to evaluate the clinical effectiveness of a bovine porous bone mineral used in combination with a porcine derived collagen membrane as a barrier in promoting periodontal regeneration in intrabony defects in humans.

Material and Methods: The study employed a split‐mouth design. 22 paired intrabony defects were treated and surgically re‐entered 6 months after treatment. Experimental sites were grafted with bovine porous bone mineral and received a collagen membrane for guided tissue regeneration. Control sites were treated with an open flap debridement.

Results: Preoperative pocket depths, attachment levels and trans‐operative bone measurements were similar for control and experimental sites. Post surgical measurements revealed a significantly greater reduction in pocket depth (differences of 1.89±0.31 mm on buccal 0.88±0.27 mm on lingual measurements) and more gain in clinical attachment (differences of 1.51±0.33 mm on buccal and 1.50±0.35 mm on lingual measurements) in experimental sites. Surgical reentry of the treated defects revealed a significantly greater amount of defect fill in favor of experimental sites (differences of 2.67±0.91 mm on buccal and 2.54±0.87 mm on lingual measurements).

Conclusions: The results of this study indicate that clinical resolution of intrabony defects can be achieved using a combination of bovine porous bone mineral and an absorbable, porcine derived collagen membrane when employing a technique based on the principles of guided tissue regeneration. The nature of the attachment between the newly regenerated tissue and the root surfaces needs to be evaluated histologically to confirm the presence of new attachment.
Persistent bacterial colonization of Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans in periodontitis and its association with alveolar bone loss after 6 months of therapy
Authors: Chaves Eros S. , Jeffcoat Marjorie K. , Ryerson Carol C. , Snyder Brian
Published: March 2003

Background, aims: The purpose of this study was to determine whether the presence of bacterial antigens for Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), and Actinobacillus actinomycetemcomitans (Aa) in subgingival plaque of periodontitis patients after periodontal treatment was associated with progressive alveolar bone loss.

Method: 39 (39) subjects in good general health previously diagnosed with adult periodontitis within the last 2 years, and still presenting with probing depth >5 mm in 2 to 6 teeth, were studied. All subjects were treated with scaling and root planing. Half of the subjects were randomly assigned to receive adjunctive systemic doxycycline (200 mg the 1st day, then 100 mg per day for 21 days). Subgingival plaque samples were taken at baseline, 1, 3 and 6 months after therapy. A modified ELISA test (EvalusiteTM, Periodontal Test Kit, Eastman Kodak Co., Rochester, NY) was used to test for plaque antigens associated with P. gingivalis, P. intermedia and A. actinomycetemcomitans. Progressive alveolar bone loss was determined using digital subtraction radiography with standardized radiographs taken at baseline and 6 months after treatment.

Results: The presence of P. gingivalis in plaque after treatment was significantly associated with progressive bone loss (positive predictive value 84%, negative predictive value 85%, odds ratio 31.9, p<0.0001). In contrast, the presence of P. intermedia in plaque after treatment was not indicative of progressive loss (positive predictive value 39%, negative predictive value 82%). Too few sites had evidence of A. actinomycetemcomitans to be amenable to statistical analysis. No significant difference in bone loss was attributable to the systemic antibiotic therapy.

Conclusion: These data indicated that, in this population, the presence of P. gingivalis in plaque after treatment might be indicative of progressive alveolar bone loss.
A study on the imaging of complex furcation forms in upper and lower molars
Authors: Plagmann Hans‐Christian , Holtorf Sven , Kocher Thomas
Published: March 2003

Background, aims: The form of the molar roots and their furcated region influence both the pathogenesis of periodontal destruction and therapeutic attempts.

Method: Using a specially‐constructed measuring device, 359 1st and 2nd molars, both upper and lower, were analysed 3‐dimensionally. The parameters measured were horizontal furcation concavity, height of root trunk, degree of root taper, the distance between the root prominences adjacent to the furcation entrances and the angle of root separation.

Results: The mean horizontal furcation concavity in lower molars was 0.5 mm at a distance of 1 mm apical to the cemento‐enamel‐junction (CEJ) and 3 mm at the distance of 4 mm apical to the CEJ. The angle of root separation was between 16° (lower jaw molars lingual) and 29° (upper jaw molars distal). The vertical distance from root separation to CEJ averaged 3.3 mm in lower jaw molars and 4.8 mm in upper jaw molars.

Conclusions: Our findings underline the variability of furcation morphology.
Untreated periodontal disease in Indonesian adolescents
Authors: Timmerman M. F. , Van der Weijden G. A. , Abbas F. , Arief E. M. , Armand S. , Winkel E. G. , Van Winkelhoff A. J. , Van der Velden U.
Published: March 2003

Background, aims: In order to investigate the rôle of various putative clinical and microbiological risk markers, a longitudinal study was initiated in a young population deprived of regular dental care. In 1987 all inhabitants in the age range 15–25 years living in a village with approximately 2000 inhabitants at a tea estate on Western Java, Indonesia, were examined clinically and microbiologically. In total, 167 subjects of the original group of 255 adolescents were re‐examined in 1994. The material presented in this paper describes the clinical periodontal condition at baseline (1987) and at follow‐up (1994), 7 years later. Furthermore, the relationship between progression of the disease and baseline clinical and microbiological data was assessed.

Methods: Plaque index (PI), bleeding on probing (BOP), pocket depth (PD), and attachment loss (AL) were scored at the approximal surfaces of the vestibular aspects of all teeth. The number of approximal surfaces of the Ramfjord teeth showing subgingival calculus was recorded. At baseline, the dorsum of the tongue, the buccal gingiva in the upper jaw, the saliva and the deepest bleeding pocket without clinical loss of attachment were sampled for microbiological examination with phase contrast microscopy and indirect immunofluorescence.

Results: Mean values at baseline and at follow‐up were PI: 1.01 and 1.15, BOP: 0.80 and 1.16, PD 3.26 mm and 3.32 mm, AL: 0.33 mm and 0.73 mm, respectively. All parameters except PD showed a statistically significant increase over the 7‐year period. The prevalence of the studied bacteria irrespective of the sample site was: A. actinomycetemcomitans 53%, P. gingivalis 88%, P. intermedia 100%, spirochetes 89% and motile micro‐organisms 100%. At the full mouth level, logistic regression showed significant odds ratios for progressive disease with age (1.15), subgingival calculus (1.20) and subgingival presence of A. actinomycetemcomitans (4.61). Presence of any of the selected micro‐organisms on the mucous membranes was not related with progressive disease. In order to study local factors to explain local disease activity, each subject was characterized using the sampled pocket, which was the deepest bleeding pocket without LA at baseline, as a single response site per patient. In this constrained design, the main statistical factors associated with progressive disease were presence of motile micro‐organisms and the plaque score.

Conclusions: This study identified 3 main risk markers for disease progression at the full mouth level: age, amount of subgingival calculus and subgingival presence of A. actinomycetemcomitans.
Isolation and genotyping of black‐pigmented anaerobes from periodontal sites of HIV‐positive and non‐infected subjects in Thailand
Authors: Teanpaisan R. , Douglas C. W. I. , Nittayananta W.
Published: March 2003

Abstract Background, aims: The aims of this study were to investigate the prevalence of periodontitis, the prevalence of black‐pigmented anaerobes and the genotypes of Porphyromonas gingivalis and Prevotella intermedia present in HIV‐infected and control subjects in a heterosexual Thai population.

Method: 50 AIDS patients and 50 control subjects were included in the study. Their periodontal condition was examined by assessment of bleeding on probing, attachment loss and probing depth, and presence of erythema around 6 teeth (16, 21, 24, 36, 41, 44). Subgingival plaque was collected from the mesiobuccal sites of these teeth and was cultured anaerobically for black‐pigmented bacteria. Species were characterised using biochemical profiles and total protein profiles. Genotyping of each isolate was performed using PCR techniques.

Results: There was little clinical evidence of HIV‐associated periodontitis in the HIV‐positive subjects and no difference was found in the prevalence or genotype distribution of black‐pigmented anaerobes between HIV‐infected and control subjects.

Conclusions: These data suggest lack of severe periodontal destruction due to HIV‐infection in Thailand and that these subjects are not colonised by more numerous or characteristic clones of certain putative periodontal pathogens.
Effects of carrier release kinetics on bone morphogenetic protein‐2‐induced periodontal regeneration in vivo
Authors: Talwar Richard , Di Silvio Lucy , Hughes Francis J. , King Gaston N.
Published: March 2003

Abstract Background: Bone morphogenetic proteins (BMPs) have shown considerable promise as a therapeutic agent to enhance periodontal regeneration although the optimal characterisitics of a suitable release system are not known.

Aim: The aim of this study was to compare the effects of slow and fast degrading gelatin carriers on BMP‐2‐induced periodontal healing.

Method: Recombinant human bone morphogenetic protein‐2 (rhBMP‐2) was incorporated into gelatin and subsequently differentially cross‐linked to produce slow and fast release carrier systems. Release kinetics were confirmed in vitro, by measuring release of 125I‐growth hormone from similar gelatin plugs. Effects of BMP were evaluated in surgically created rat periodontal fenestration defects which were processed for histology 10 days post‐operatively. The rats were divided into 4 groups and the control defects were treated with either slow or fast degrading gelatin (CONs or CONf respectively), whilst test groups were treated with 1.25 μg rhBMP‐2 in the slow or fast degrading gelatin (BMPs or BMPf respectively).

Results: BMPf greatly increased bone formation compared with the control (CONf) (1.67±0.65 versus 0.34±0.11×10−4 m2), but no significant differences were observed with BMPs and CONs. In contrast, new cementum formation was significantly greater in the BMPs group compared with all other groups (p<0.05).

Conclusion: Release kinetics of BMP may have important effects on the outcome of BMP‐induced periodontal regeneration. New bone formation may be affected by rapid‐release kinetics although further investigation is necessary to confirm this. In contrast, new cementum formation is promoted by slow release of BMP.
Interleukin‐4 polymorphisms in early onset periodontitis
Authors: Michel J. , Gonzáles J. R. , Wunderlich D. , Diete A. , Herrmann J. M. , Meyle J.
Published: March 2003

Background, aims: Periodontitis is the result of a complex interplay between oral bacteria and the host response, often modulated by behavioral factors. Early‐onset periodontitis (EOP) is defined by the age of onset, the distribution of lesions and specific microbial pathogens.

Method: Studies in twins suggested a genetic contribution to the pathogenesis of periodontitis. EOP heritable factors may be related to immune mechanisms which could enhance the pathogenic potential of plaque bacteria in susceptible individuals. Among others, Interleukin 4 (IL‐4) is a potent cytokine in the immune response and is a potent down regulator of macrophage function. In the present study, we report a specific genotype of the IL‐4 gene, which was detected by specific primers and PCR analysis.

Results: In the EOP‐group 27.8% were IL‐4 promotor‐ and intron polymorphism positive (PP+ and IP+). None of the age‐matched healthy controls or patients with adult periodontitis (n=25) carried the markers. Moreover, serum IL‐4 levels of PP+ and IP+ patients were below the detection limit and significantly different (p<0.01) from the IL‐4 concentrations of healthy controls and PP− and IP− patients.
Interleukin‐10 gene promoter polymorphism in Japanese patients with adult and early‐onset periodontitis
Authors: Yamazaki Kazuhisa , Tabeta Kouichi , Nakajima Takako , Ohsawa Yutaka , Ueki Kaoru , Itoh Harue , Yoshie Hiromasa
Published: March 2003

Background: IL‐10 is an anti‐inflammatory cytokine, which may modulate disease expression in chronic inflammatory periodontal disease. 3 dimorphic polymorphisms within the IL‐10 gene promoter have recently been identified and appear to influence regulation of its expression.

Aim: The aim of the present study was to investigate whether the promoter polymorphisms are associated with adult periodontitis (AP) and generalized early‐onset periodontitis (G‐EOP).

Methods: Genomic DNA was obtained from 34 AP patients, 18 G‐EOP patients and 52 controls. The promoter region between −506 and −1140 was amplified by polymerase chain reaction, and polymorphisms were detected by nucleotide sequencing.

Results: The haplotype frequencies in Japanese were quite different from those of Caucasian and were even slightly different from those of southern Chinese with systemic lupus erythematosus. We found no significant difference in allele or haplotype frequencies between patients and controls.

Conclusions: IL‐10 production may be regulated within the complex cytokine network in chronic inflammatory periodontal disease, rather than the gene polymorphisms.
Periodontitis in smokers and non‐smokers: intra‐oral distribution of pockets
Authors: Van Der Weijden G. A. , De Slegte C. , Timmerman M. F. , Van Der Velden U.
Published: March 2003

Aim: The purpose of the present study was to establish retrospectively whether the disease severity differs between smokers and non‐smokers.

Methods: The study population consisted of 183 periodontitis patients, 79 smokers and 104 non‐smokers. These subjects had been referred by general dentists to the Clinic for Periodontology, Utrecht, because of periodontal problems and were selected on the basis of the clinical diagnosis: adult periodontitis. The proportion of bleeding sites and the intra‐oral distribution of probing pocket depth was evaluated.

Results: No statistically‐significant differences between smokers (SM) and non‐smokers (NSM) were found regarding the mean % of sites that bled upon probing (SM=76%, NSM=72%). Overall differences in the prevalence of probing depths 5 mm between smokers and non‐smokers were found (SM=44%, NSM=34%). The proportion of sites with a probing pocket depth of 5 mm was consistently higher in smokers in the anterior, premolar and molar regions. The data also show that in the upper jaw at the anterior and premolar teeth, the largest differences are found between smokers and non‐smokers. Smokers have more sites with a pocket depth 5 mm, especially on the lingual surfaces of these teeth.

Conclusions: The present study indicates that cigarette smoking is a factor associated with deeper periodontal pockets and an intra‐oral distribution that is suggestive of a local effect.
Comparison of the bleeding on marginal probing index and the Eastman interdental bleeding index as indicators of gingivitis
Authors: Barendregt D. S. , Timmerman M. F. , Van Der Velden U. , Van Der Weijden G. A.
Published: March 2003

Aim: The purpose of the present study was to compare 2 indices, i.e., the Eastman interdental bleeding (EIB) index and the bleeding on marginal probing (BOMP) index. The comparison was made (a) in terms of the degree of bleeding provoked and the relationship with plaque in natural gingivitis and (b) for the ability of these 2 methods to detect differences between the development of experimental gingivitis in a control group and a group in which the development of gingival inflammation was suppressed by treatment. For the present studies, subjects were selected without interdental recession of the gingival tissues.

Methods experiment 1: In this experiment, 43 subjects having established moderate gingivitis were assessed using a random splitmouth design (1st and 3rd/2nd and 4th quadrant). Plaque was scored on all approximal sites after which the BOMP index was assessed in one half of the mouth and the EIB index in the other.

Results experiment 1: The BOMP index showed a bleeding score of 84% and the EIB index of 87%. The significant correlation between plaque and gingival bleeding for the BOMP index (0.55) was higher than for the EIB index (0.44).

Methods experiment 2: For this experiment, 25 subjects participated in an experimental gingivitis trial of the lower jaw. At baseline, first the BOMP index and immediately thereafter the EIB index were assessed at all approximal sites. Experimental gingivitis (EG) was carried out in one randomly assigned quadrant and as a treatment modality only floss was used in the other (FL). Results experiment 2: In the EG quadrant, the BOMP index increased to 69% and the EIB index to 73%. Both indices showed a significant correlation with plaque; 0.60 and 0.64 respectively. In the FL quadrant, the BOMP index increased to 38% and the EIB index to 30%. No significant correlation between both gingivitis indices and the amount of plaque was present in the FL quadrant. Conclusion: The ability of the BOMP index and the EIB index to assess the level gingival inflammation appears to be comparable.
Effect of an amine‐fluoride‐triclosan mouthrinse on plaque regrowth and biofilm vitality
Authors: Arweiler Nicole B. , Henning G. , Reich E. , Netuschil L.
Published: March 2003

Background: The purpose of this double‐blind, prospective, latin‐square crossover randomised study was to examine the efficacy of a mouthrinse solution containing a combination of triclosan, amine fluoride and sodium fluoride on supragingival plaque regrowth compared to a placebo and a chlorhexidine solution.

Methods: 12 volunteers refrained after professional oral prophylaxis from all mechanical hygiene measures for the following 96 h and rinsed instead cross‐over in a randomised order with either chlorhexidine dicluconate (0.2%, positive control), a verum solution (0.5% amine fluoride, 0.028% sodium fluoride, 0.03% triclosan) or a placebo solution. The plaque index was assessed after 24 and 96 h (PI 1, PI 2) and the plaque area (PA) photographed and calculated after 96 h of undisturbed plaque regrowth. Moreover plaque samples were taken after 24 and 96 h and examined with the vital fluorescence technique to assess the vitality of the biofilm microbiota (VF 1, VF 2).

Results: The amine‐fluoride‐triclosan solution reduced the clinical parameters (PI and PA) as well as the vitality of the plaque flora (VF) significantly when compared to the placebo solution. The verum reached a 36.5% (p<0.05) and a 39.8% reduction (p<0.0001) in PI 1 and PI 2, respectively, concomittant with a reduction of 23.8% and 32.2% (p<0.001) in VF 1 and VF 2 and of 46.9% (p<0.0001) in PA at day 4. This was less than the reductions found with the positive control, i.e., the 0.2% chlorhexidine solution (54.2% and 71.1% reduction in PI 1 and PI 2, 40.0% and 53.4% in VF 1 and VF 2 and 71.5% in PA). However, significant differences between both active solutions were only established for PI 2 and PA.

Conclusion: During 4‐day plaque regrowth the amine‐fluoride‐triclosan product displayed a significant antibacterial and plaque‐reducing action in comparison to the control.
Associations of serum concentrations of IgG, IgA, IgM and interleukin‐1β with early‐onset periodontitis classification and race
Authors: Albandar Jasim M. , DeNardin Ann M. , Adesanya Margo R. , Winn Deborah M. , Diehl Scott R.
Published: March 2003

Background: The significance of serum concentrations of various antibodies and cytokines in the pathogenesis of early‐onset periodontitis (EOP) is not well understood. Recent reports suggest differences between young blacks and whites in certain humoral responses, regardless of periodontal status. This study was undertaken to compare the serum concentrations of IgG, IgA, IgM, and IL‐1β in EOP subjects with that of healthy controls, and to study the effect of race on these levels.

Material and Methods: This case‐control study included 228 individuals, 19–25 years old who were selected from a larger population examined in the National Survey of Oral Health of United States Children in 1986/1987. The subjects were classified by their EOP status and they included 166 subjects with EOP and 62 healthy controls. Blood samples were used to assess the serum concentrations of IgG, IgM, IgA, IgG subclass, and IL‐1β.

Results: The serum concentrations of IgG, IgG subclasses, IgA, and IgM in blacks were not significantly different in the generalized, localized and incidental EOP groups as compared to the healthy controls. The serum IL‐1β concentration was slightly and uniformly lower in the EOP groups than in the control group, although not statistically significant. Blacks had significantly higher serum concentrations of total IgG, and of IgG1, IgG2 and IgG3 than whites and Hispanics. Hispanics had significantly higher serum concentrations of IgM and IgG4 than whites and blacks. Hispanics also had a significantly higher serum concentration of IL‐1β than blacks.

Conclusions: Total antibody response in blacks is not associated with EOP classification. Race has a significant effect on serum antibody concentrations irrespective of disease classification, with blacks having significantly higher serum concentrations of IgG1, IgG2 and IgG3 than whites and Hispanics.
Relationship between oral health and mortality rate
Authors: Jansson Leif , Lavstedt Stig , Frithiof Lars
Published: March 2003

Background/Aims: Some symptoms of diseases or causes of death are often related to oral health, especially cardiovascular diseases. The purpose of this study was to investigate the relationship between poor oral health and mortality risk, especially when cases of fatal cardiovascular diseases were excluded.

Material and methods:  An odontological investigation was made on a sample of 1393 individuals, aged 18–65 years, in 1970 in the County of Stockholm with a follow‐up in 1997, when the mortality rate and causes of death in the sample during the time period 1971–1996 were registered. Oral health was defined as a sum of scores for number of missing teeth, apical lesions, caries lesions and marginal bone loss.

Results:  A significant correlation was found between poor oral health and an increased mortality risk even when persons dying from cardiovascular diseases were excluded from the analyses.

Conclusion:  Poor oral health was found to be a risk indicator of all‐cause mortality. The lack of specificity of the associations between oral health and mortality strengthens the hypothesis that the significant correlations could be explained by not identified confounding factors.
Healing of intrabony defects following treatment with a bovine‐derived xenograft and collagen membrane
Authors: Sculean Anton , Berakdar Mohammad , Chiantella Giovanni C. , Donos Nikolaos , Arweiler Nicole B. , Brecx Michel
Published: March 2003

Aim: The purpose of the present study was to compare clinically the treatment of deep intrabony defects with a combination of a bovine‐derived xenograft (BDX) and a bioresorbable collagen membrane to access flap surgery.

Methods: Twenty‐eight patients suffering from chronic periodontitis, and each of whom displayed one intrabony defect, were randomly treated with BDX + collagen membrane (test) or with access flap surgery (control). Soft tissue measurements were made at baseline and at 1 year following therapy.

Results: No differences in any of the investigated parameters were observed at baseline between the two groups. Healing was uneventful in all patients. At 1 year after therapy, the test group showed a reduction in mean probing depth (PD) from 9.2±1.3 to 3.9±0.7 mm (p<0.001) and a change in mean clinical attachment level (CAL) from 10.2±1.5 to 6.2±0.5 mm (p<0.0001). In the control group, the mean PD was reduced from 9.0±1.2 to 5.2±1.8 mm (p<0.001) and the mean CAL changed from 10.5±1.5 to 8.4±2.1 mm (p<0.01). The test treatment resulted in statistically higher PD reductions (p≤0.05) and CAL gains (p<0.001) than the control one. In the test group all sites (100%) gained at least 3 mm of CAL. In the control group no CAL gain occurred in four sites (29%), whereas at six sites (43%) the CAL gain was 2 mm. A CAL gain of 3 mm or more was measured in four defects (29%).

Conclusions: Within the limits of the present study, it can be concluded that: (i) at 1 year after surgery both therapies resulted in significant PD reductions and CAL gains, and (ii) treatment with BDX+collagen membrane resulted in significantly higher CAL gains than treatment with access flap surgery.
Clinical significance of non‐surgical periodontal therapy: an evidence‐based perspective of scaling and root planing
Authors: Cobb Charles M.
Published: March 2003

Analysis of Egyptian hieroglyphics and medical papyri indicate that non‐surgical periodontal treatment was common 3000‐4000 years ago. Even today, scaling and root planing (SRP) remains an essential part of successful periodontal therapy. The collective evidence from numerous clinical trials reveals a consistency of clinical response in the treatment of chronic periodontitis by SRP using manual, sonic, or ultrasonic instrumentation. Thus, SRP remains the ‘gold standard’ to which more recently developed therapeutic modalities must be compared. Inherent to the clinical evaluation of SRP are such concerns as manual versus sonic and ultrasonic instrumentation, control of sub‐gingival bacterial populations, removal of calculus, root smoothness and changes in various clinical parameters, e.g. probing depth, attachment levels, bleeding on probing and gingival inflammation. Lastly, an abbreviated discussion is presented on a relatively new paradigm of complete mouth ‘disinfection’ in a compressed time‐frame that includes SRP as a significant component of the treatment regimen.
Trends in oral cancer rates in the United States, 1973–1996
Authors: Shiboski Caroline H. , Shiboski Stephen C. , Silverman Sol
Published: March 2003

Abstract – Objectives: To explore changes in demographic distribution, incidence and survival rates of oral cancer in the United States from 1973 through 1996. Methods: From the Surveillance, Epidemiology, and End Results (SEER) data, we computed the proportion of oral cancer by demographic characteristics, site, and stage at diagnosis for 1973–84 and 1985–96. We estimated incidence and 5‐year relative survival rates of oral cancer by age, gender, and race/ethnicity, and compared survival rates between the two periods. The estimated annual percent change (EAPC) was used to explore trends in incidence rate from 1973 through 1996. Results: Most of the tongue and floor of mouth cancers (>54%) reported during 1973–84 and 1985–96 had spread to a distant site at time of diagnosis. The age‐adjusted annual incidence rates of oral cancer decreased among white men from 1973 through 1996, but increased among black men aged 65–69 years, and among young white men (aged 30–34 years) and women (aged 25–29 years). These changes in trend were all statistically significant (testing EAPC=0 at the 0.05 level). Overall, there was no improvement in the 5‐year relative survival rate of either whites or blacks with oral cancer. Conclusion: There was little change in early detection of oral cancer or in 5‐year relative survival rates between 1973–84 and 1985–96 in nine SEER regions. This suggests a deficiency in professional and public education regarding early diagnosis of oral cancer. Furthermore, the increasing trend of oral cancer among older black men and among younger whites merits further investigation.