bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbiological Study of HIV‐Related Periodontitis
Authors: Rams Thomas E. , Andriolo Mario , Feik Diane , Abel Stephen N. , McGivern Thomas M. , Slots Jørgen
Published: March 2012

The subgingival microbiota in 14 persons with HIV‐periodontitis was examined. Subgingival plaque samples were collected with paper points, transported in VMGA III, and plated on anaerobic enriched brucella blood agar and various selective media. HIVperiodontitis sites revealed Actinobacillus actinomycetemcomitans, Wolinella recta, Peptostreptococcus micros, and Bacteroides intermedias, each averaging 7% to 16% of the cultivable subgingival flora in positive patients. High levels of spirochetes also were detected in diseased sites with phase‐contrast microscopy. Low levels of Candida albicans or enteric Gram‐negative rods were recovered in the subgingival flora in 7 HIVperiodontitis patients or Bacteroides fragilis, Fusobacterium necrophorum, Fusobacterium varium, and Eubacterium aerofaciens were recovered in 8 patients. These findings suggest that the major components of the subgingival microbial flora in HIV‐periodontitis are similar to those associated with adult periodontitis in systemically healthy persons. However, HIV‐periodontitis lesions also may contain organisms which are rarely found in common types of periodontitis. The etiological significance of specific periodontal organisms in HIV‐periodontitis awaits further longitudinal study. J Periodontol 1991;62:74– 81.
Clinical and Microbiological Patterns of Adults With Periodontitis
Authors: Kornman Kenneth S. , Newman Michael G. , Alvarado Robert , Flemmig Thomas F. , Nachnani Sushma , Tumbusch James
Published: March 2012

Although current data suggest that periodontitis may actually be multiple diseases each with varying responses to therapy, little evidence exists to support this theory in adult patients. This report describes the design and initial findings of a longitudinal field trial involving the diagnosis and treatment of adult and refractory periodontitis patients in private practice. Adult patients (N = 221) who met specific clinical criteria were selected from the private practices of 22 periodontists. Clinical characteristics were recorded and subgingival plaque samples were sent to microbiology laboratories at either UCLA or The University of Texas Health Science Center at San Antonio (UTHSCSA). Samples were processed according to protocols standardized between the 2 centers. Five different combinations of the initial clinical and microbial findings were evaluated for patterns in the data by means of cluster analysis. Plaque, bleeding on probing, bone loss scores, probing depth distributions, and microbial findings produced multiple cluster solutions. Solutions involving 6 clusters explained 39.4% to 76.4% of the variation between patients and produced ratios for variation between clusters to variation within clusters of 5.2 to 15.3. The optimal cluster solution incorporated both clinical and microbial findings, with some clusters characterized by high plaque and moderate bleeding on probing and bone loss, whereas others had low plaque but high bleeding on probing and bone loss. Microbial findings of each cluster exhibited distinct patterns with some clusters having a high prevalence (83% to 100%) of specific target bacterial species while other clusters had an absence of these species. This unique multicenter study demonstrated that it is possible to cluster adult and refractory periodontitis patients into distinct clinical and microbial patterns. This approach provides the basis for determining whether certain diagnostic information may truly be of value in targeting periodontal therapy. In addition, the potential advantages and disadvantages of conducting studies in a field trial format are discussed. J Periodontol 1991;62:634–642.
Influence of Polishing Procedures on Sonic Scaling Root Surface Roughness
Authors: Leknes Knut N. , Lie Tryggve
Published: March 2012

The present in vitro study aimed to evaluate the efficacy of various polishing procedures in reducing root roughness caused by sonic scaling. Proximal root surface areas of extracted, formalin‐stored teeth were scaled in a bucco‐lingual direction by a sonic sealer. The resulting roughness was measured along the direction of scaling and perpendicular to that direction by a profilometer. The specimens were then split into two groups. Group 1 was polished by an air‐powder polishing instrument followed by a rotating rubber cup and chalk; Group 2 was polished by pumice followed by chalk. Root roughness (Ra) was recorded for each step in the procedures. The measurements revealed lower Ra values when the stylus of the profilometer was running perpendicular to the scaling direction, and a weak negative correlation was found when scaling time and Ra values were compared. In both groups Ra values were significantly reduced at each step of the polishing procedures and the terminal result was similar for the groups. Pumice and air‐powder polishing gave a similar reduction of the sonic scaling roughness. J Periodontol 1991; 62:659–662.
The Use of a Synthetic Skin Substitute as a Physical Barrier to Enhance Healing in Human Periodontal Furcation Defects: A Follow‐Up Report
Authors: Flanary Deidra B. , Twohey Sheila M. , Gray Jonathan L. , Mellonig James T. , Gher Marlin E.
Published: March 2012

The purpose of this investigation is to compare the clinical response of guided tissue regeneration using a synthetic wound dressing with open flap debridement versus open flap debridement alone in the treatment of human furcation defects. The study group was composed of 19 patients with moderate to advanced adult periodontitis and at least one bilateral pair of Class II molar furcation defects. After the hygiene phase of therapy was completed, measurements were made with calibrated periodontal probes of the clinical attachment levels, probing depths, and soft tissue recession. Paired sites were randomly selected for treatment with either open flap debridement alone (control) or open flap debridement and placement of the synthetic wound dressing over the furcation (experimental). At the time of surgery, measurements of vertical and horizontal open probing attachment were recorded. The dressing was removed 5 to 6 weeks post‐surgery. The sites were reentered at 6 months to evaluate healing and to repeat all measurements. Statistical comparisons using the Wilcoxon Sign Rank Test were made between the control and experimental sites. The results of 19 pairs of Class II molar furcation defects reveal statistically significant differences between the experimental and control sites in attachment levels, probing depths, and horizontal open probing attachment. These differences were of such small magnitude that they may not be clinically relevant. There were no other significant differences for any other clinical parameter, and none of the furcations in either group was completely closed. In conclusion, the synthetic wound dressing as used in this study in comparison with open flap debridement showed a small, but statistically significant, improvement in attachment levels and horizontal probing of Class II molar furcation defects. J Periodontol 1991; 62:684–689.
Histologic Comparison of Regeneration in Human Intrabony Defects When Osteogenin Is Combined With Demineralized Freeze‐Dried Bone Allograft and With Purified Bovine Collagen
Authors: Bowers G. , Feiton F. , Middleton C. , Glynn D. , Sharp S. , Mellonig J. , Corio R , Emerson J. , Park S. , Suzuki J. , Ma S. , Romberg E. , Reddi A.H.
Published: March 2012

A bone‐inductive protein, osteogenin, has been isolated from long bones of humans and offers promise as a grafting material. Studies, however, suggest that osteogenin must be combined with a bone‐derived matrix in order to initiate bone differentiation. The purpose of this study was to determine if osteogenin combined with demineralized freeze dried bone allograft (DFDBA), a bone‐derived matrix, and with a bovine tendon‐derived matrix will enhance regeneration of intrabony defects in humans. The tendon‐derived maxtrix and DFDBA used alone served as controls. The ability of each material to form a new attachment apparatus was evaluated independently in submerged and nonsubmerged environments in 2 patient populations. Lymphocyte testing was performed to assess development of an immune reaction to osteogenin. The most apical level of calculus on the root served as the histologic reference point to measure regeneration. Biopsies were obtained at 6 months and regeneration was measured histomorphometrically by 2 blinded evaluators. Serial sections from 36 submerged defects in 8 patients and 50 nonsubmerged defects in 6 patients were submitted for statistical analysis. Mean results indicate that osteogenin combined with DFDBA significantly enhanced regeneration of a new attachment apparatus and component tissues in a submerged environment. DFDBA plus osteogenin and DFDBA alone formed significantly more new attachment apparatus and component tissues than either the tendon‐derived matrix plus osteogenin or the tendon‐derived matrix alone in both submerged and nonsubmerged environments. There were no significant differences between the tendon‐derived matrix plus osteogenin and the tendon‐derived matrix alone in either the submerged or nonsubmerged environment. Osteogenin does not impair normal lymphocyte blastogenesis at 6 months postsurgical challenge. J Periodontol 1991; 62:690–702.
Compliance With Supportive Periodontal Therapy
Authors: Mendoza Anthony R. , Newcomb Guy M. , Nixon Kenneth C.
Published: March 2012

All new patients commencing supportive periodontal therapy (periodontal maintenance) after treatment in a specialist periodontal practice from 1983 to 1986 were identified from practice records. Based on their compliance with the recommended schedule of visits, the patients were classified as either compliant or non‐compliant. The results indicated that there were no significant differences between compliant and non‐compliant patients with regards to age, sex, number of missing teeth, plaque score, or periodontal disease severity. More non‐compliant patients than compliant patients were smokers (P < 0.05). By contrast, more compliant patients were covered by private dental insurance (P<0.01) and more had periodontal surgery during treatment (P<0.001). Only 36% of the initial patient sample was found to be compliant at the end of 1989, with the greatest patient loss in the first year of supportive periodontal therapy of about 42%. The annual attrition rate decreased in subsequent years to average about 10% of those remaining in each year, indicating that a patient is more likely to remain compliant if he or she attends for at least 1 year of supportive periodontal treatment. Non‐compliant patients were sent a questionnaire seeking reasons for their non‐compliance. Forty percent of the questionnaires were returned. The most common reason given for non‐compliance was that a general dental practitioner was attending to the patient's periodontal treatment needs. Many considered supportive periodontal therapy to be too expensive, while a significant proportion considered that they no longer required treatment. The results suggest that embarrassment, nervousness, lack of time, practice location, beliefs/ideals, and personal crises were not significant reasons for non‐compliance. J Periodontol 1991; 62:731–736.
Root Substance Removal by Scaling and Root Planing
Authors: Zappa U. , Smith B. , Simona C. , Graf H. , Case D. , Kim W.
Published: March 2012

The amount of root substance removed by scaling and root planing is largely unknown. The present study evaluated in vitro the root substance loss caused by a defined number of working strokes at known forces. Forty extracted teeth with loss of connective tissue attachment into the middle third of the roots were washed and embedded in plaster, leaving one entire corono‐apical tooth aspect exposed. The teeth were reproducibly repositioned in a bench‐vise, where a profilometer repeatedly measured root surface levels at the same location. In a standard area of the roots a total of 40 working strokes were applied. Low forces were used in 30 teeth and high forces in 10 teeth. The forces were recorded using a piezo‐electric receiver built into the upper shank of the curet. Root substance loss was measured after 5, 10, 20, and 40 working strokes. The results showed that the mean low force used per working stroke across all 40 strokes was 3.04 Newtons for the low forces, and 8.48 Newtons for the high forces. Mean cumulative loss of root substance across 40 strokes was 148.7 μm at low forces, and 343.3 μ at high forces. The mean force per stroke increased slightly across the 40 strokes, while substance removal per stroke decreased. Substance removal per stroke during strokes 1 to 5 was 6.8 μm using low forces and 20.6 μm using high forces. During strokes 21 to 40 mean removal per stroke was 2.3 μm at low forces, and 5.6 μm at high forces. These results suggest that high forces remove more root substance, and loss per stroke becomes less with increasing numbers of strokes. J Periodontol 1991; 62:750‐754.
Mechanical and Chemical Root Preparation In Vitro: Efficiency of Plaque and Calculus Removal
Authors: Eschler Bradford M. , Rapley John W.
Published: March 2012

The aim of this investigation was to compare the effectiveness of several different methods of root instrumentation by measuring and comparing the amount of residual stained material following treatment. Also, 2 different methods of quantitating residual stained material were compared. A total of 90 periodontally‐involved teeth were extracted and randomly assigned to 1 of 8 treatment groups or to the untreated control group. Experimental treatments consisted of one or a combination of the following: Columbia 13‐14 curet, P‐10 ultrasonic instrument, diamond‐coated P‐10 ultrasonic instrument, or antiformin/citric acid chemical treatment. Selected samples were examined using light microscopy in order to determine the amount of cementum removed during root instrumentation. Residual stained material was quantitated using a method of grid‐square analysis as well as by the use of photographs and a digitizing tablet. Following instrumentation, it was noted in histologic sections that the complete removal of cementum was rare, although all of the cementum was removed by some experimental treatments in some areas. All mechanical methods of root instrumentation were found to be essentially equal in effectiveness with respect to the removal of plaque and calculus. Chemical debridement alone was found to be ineffective. It was further noted that the grid‐square method of analysis produced measurements that were 2 to 8 times higher than measurements produced by the digitizing tablet. J Periodontol 1991; 62:755‐760.
The Use of Autogenous Periosteal Grafts as Barriers for the Treatment of Class II Furcation Involvements in Lower Molars
Authors: Lekovic Voja , Kenney E. Barrie , Carranza Fermin A. , Martignoni Massimiliano
Published: March 2012

This study clinically analyzed the efficacy of a connective tissue graft including the periosteum used as a barrier to enhance new attachment and osseous regeneration. Fifteen patients, with no systemic diseases, and adult periodontitis including 2 Class II furcation involvements in lower molars comprised the study group. After completion of the initial phase of therapy, all patients were treated with full‐thickness periodontal flaps, using sulcular incisions, and thorough scaling and root planing. One furca, selected at random, had a connective tissue graft, obtained from the palate and including the periosteum, placed over the furca with the flap sutured over the top of this graft. Control furcas received no graft and the flap was sutured in its original position. Both molars were treated in the same session. The following presurgical measurements were made: probing pocket depth, attachment level, gingival recession, sulcular bleeding index, and plaque index. The horizontal and vertical dimensions of the osseous defects were recorded after flap elevation and debridement. Six months later all clinical parameters were again measured and reentry flaps were performed to measure the bony defects. No statistically significant differences were found preoperatively between control and experimental molars with respect to soft tissue and osseous measurements. Six months after surgery, the experimental molars showed, in comparison to the controls, significant reduction in pocket depth and gain in attachment level as well as in vertical and horizontal measurements of the inter‐radicular osseous defect. J Periodontol 1991; 61:775‐780.
Humoral Immune Responses to Porphyromonas gingivalis Before and Following Therapy in Rapidly Progressive Periodontitis Patients
Authors: Chen Hua A. , Johnson Bradley D. , Sims Tom J. , Darveau Richard P. , Monda Bernard J. , Whitney Coralyn W. , Engel David , Page Roy C.
Published: March 2012

We have performed studies aimed at elucidating the nature of the humoral immune response in rapidly progressive periodontitis (RPP). We analyzed the sera of 36 periodontally normal subjects and 36 RPP patients for titers and avidities of IgG antibodies reactive with the antigens of Porphyromonas gingivalis using ELISA, prior to and following treatment. We used whole‐cell sonicate, purified lipopolysaccharide (LPS), and total extractable protein as plate antigens. Twelve of the patients had antibody titers at least 2‐fold greater than the median of the controls and were designated as seropositive. The remaining 24 patients had titers that did not exceed twice the median titer of the controls and were designated as seronegative. For both patient groups, antibody titers were highest when whole‐cell antigen was used, intermediate for LPS, and lowest for the protein fraction. Following treatment, median titer for seropositive patients decreased from pretreatment values of 241.7 to 76.5, while median titer for seronegative patients increased from 39.5 to 80.1. Avidities of pretreatment sera from both patient groups for all 3 antigen preparations were lower than the median avidities of the control sera. Avidity significantly increased following treatment to levels greater than those for control sera in both patient groups. Thus, some young adults with severe periodontitis mount a humoral immune response and produce high levels of serum IgG antibodies reactive with antigens of P. gingivalis, while others do not. The antibodies produced are of relatively low avidity, and may therefore be relatively ineffective biologically. Therapy, which greatly reduces antigen load, appears to stimulate production of higher avidity IgG antibodies in both patient groups; in the seropositive group, low avidity antibodies appear to be replaced by antibodies of higher avidity. Both the purified LPS and protein fractions contain reactive antigen(s), although LPS binds more antibody. Our data are consistent with the idea that many RPP patients do not produce protective levels of biologically functional antibody during the course of their natural infection, but they may be stimulated to do so by treatment. J Periodontol 1991; 62:781–791.
Titanium Endosseous Implant‐Soft Tissue Interface: A Literature Review
Authors: Donley Timothy G. , Gillette William B.
Published: March 2012

Background information about normal periodontal anatomy and titanium used in endosseous implant fabrication is provided. Literature is reviewed concerning epithelial and connective tissue attachment to titanium. Information about the adequacy of cell attachment to implants, possible mechanisms of cell attachment formation, and the effect of implant surface properties on attachment is presented. A chemical attachment between titanium implant surface oxide layer and epithelium has been demonstrated in vitro and in vivo. This attachment is mediated by a glycoprotein similar to that seen between epithelium and natural tooth surfaces. While only minimal histological evidence exists, connective tissue fibers adjacent to titanium implanted surfaces may bring the tissue in tight apposition to the implant without an absolute biologic attachment between the implant and connective tissue. Alteration of the titanium surface morphology may selectively enhance the attachment of either epithelial cells or fibroblasts, theoretically enhancing the formation of a biologic seal between the implanted titanium surface and its adjacent tissue. A greater understanding of the mechanisms of attachment and of the factors which enhance the integrity of the biologic seal between implant and soft tissues should permit an improved prognosis for functioning titanium implants. J Periodontol 1991; 62:153—160.
Temperature Gradients in Periodontal Pockets
Authors: Meyerov R.H. , Lemmer J. , Cleaton‐Jones P.E. , Volchansky A.
Published: March 2012

This study was undertaken to determine whether there is any correlation of temperature within periodontal pockets with their depths. Pocket temperatures were measured with a thermocouple at 1 mm intervals of depth in 247 pockets, in 20 patients with periodontitis, mesiobucally and mesiopalatally/mesiolingually in relation to 6 standard teeth. Pocket temperatures increased consistently with pocket depth. Maxillary pockets were cooler than mandibular pockets, but in both jaws the differences between buccal and palatal/lingual pockets were not statistically significant. The findings are in keeping with knowledge about the increased temperature of inflamed tissues and the study appears to have relevance to the diagnosis of disease activity in pockets, but further studies are necessary to establish reference levels of pocket temperature. J Periodontol 1991;62:95– 99.
Progression of Probing Attachment Loss in Adult Periodontitis
Authors: Jeffcoat Marjorie K. , Reddy Michael S.
Published: March 2012

Thirty patients with adult periodontitis were monitored using an automated periodontal probe for 6 months in order to determine the prevalence of active sites and the overall pattern of disease progression in active sites. The automated probe is capable of measuring probing attachment levels relative to the cemento‐enamel junction with better than 0.2 mm of accuracy. The prevalence of disease activity was dependent on the threshold for probing attachment loss used. When the smallest threshold (0.4 mm) was used the prevalence of active disease was 29%, whereas a large threshold (2.4 mm) detected only 2% active sites. Regression analysis of the active sites revealed that 76% of the sites lost probing attachment consistent with a continuous model for disease progression. A small subset of sites demonstrated either bursts of activity or exacerbations and remissions of disease activity. J Periodontol 1991; 62:185–189.
Monoclonal Antibodies to Periodontal Ligament Cells
Authors: DuBois William T. , Edmondson Jeffery , Milam Stephen B. , Winborn William B. , Hay Robert , Carnes David L. , Kornman Kenneth S. , Klebe Robert J.
Published: March 2012

Ten mouse monoclonal antibodies were prepared against cultured bovine periodontal ligament cells to be used as reagents for the study of periodontal disease and wound healing. Using standard immunohistochemical methods, these antibodies were found to recognize cell surface antigens in formalin‐fixed bovine periodontium. Three of the 10 monoclonal antibodies (i.e., PDL‐1, PDL‐2, and PDL‐10) cross‐reacted with cells found in primate periodontium. While the isolated monoclonal antibodies appeared to distinguish subpopulations of cells located in the supporting tissues of teeth, immunohistological examination of other organs (dermis, kidney, skeletal muscle, thyroid, and parotid gland) indicated that a number of cell types of mesenchymal origin share an antigen(s) found on periodontal cells. The monoclonal antibodies described in this report should prove to be useful in studies of periodontal disease and guided tissue regeneration by providing both analytical reagents and immunochemical methods for isolating selected cell populations of the periodontium. J Periodontol, 1991; 62:190–196.
A Randomized, Placebo‐Controlled Trial of Doxycycline: Effect on the Microflora of Recurrent Periodontitis Lesions in High Risk Patients
Authors: Kulkarni Gajanan V. , Lee Wilson K. , Aitken Sharon , Birek Peter , McCulloch Christopher A.
Published: March 2012

Twenty‐seven patients with a recent history of periodontal abscesses and/or loss of gingival attachment level (GAL) despite active periodontal therapy were enrolled in a double‐blind, randomized, placebo‐controlled trial. Clinical measurements and subgingival scaling were performed every 2 months. When a site exhibited ≥ 2 mm loss of GAL or a periodontal abscess, patients were administered either doxycycline at a dosage of 200 mg to start and 100 mg per day for 3 weeks, or a placebo. Clinical measurements of GAL and microbial analysis of subgingival plaque at study and control sites were made at the time of active disease and at intervals of 1 week and 7 months after completion of the drug regime. Plaque samples were screened for the presence of Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Bacteroides intermedius (Bi), Eikenella corrodens (Ec) and Fusobacterium nucleatum (Fn) by indirect immunofluorescence antibody technique and for spirochetes (Sp) using Ryu's stain. Based on presence or absence analysis of the sum scores of the 6 pathogens, both the placebo (n = 10) and the doxycycline groups (n = 17) exhibited similar scores at the time of detection of active disease (x placebo = 2.38 ± 0.32; x doxycycline = 2.95 ± 0.27; P = 0.18). One week after treatment, the probability of detection was unchanged in the placebo group (x placebo = 3.14 ± 0.47), but was significantly reduced in the doxycycline group (x doxycycline = 1.77 ± 0.26; P = 0.0002). Study (active) sites exhibited scores 2 to 3 times higher than control (inactive) sites before doxycycline treatment. After doxycycline treatment, scores for control sites did not change significantly. The species most reduced by doxycycline were Pg, Bi, Fn, and Sp, while Aa and Ec exhibited no consistent decrease. Patients treated with doxycycline demonstrated no further disease activity for up to 7 months, while all but 2 of the placebo‐treated patients showed further active disease. However, there was no significant difference (P = 0.82) of bacterial scores between the doxycycline and placebo groups at 7 months. Consistent with low in vitro inhibition of whole plaque samples at the dosages used here, the clinical efficacy of doxycycline in vivo over the long‐term may not be mediated solely by suppression of the periodontopathic microflora. J Periodontal 1991; 62:197–202.
Intrafamilial Transmission of Actinobacillus actinomycetemcomitans
Authors: Alaluusua Satu , Asikainen Sirkka , Lai Chern‐Hsiung
Published: March 2012

Cross‐sectional studies have shown that Actinobacillus actinomycetemcomitans is a frequent member of the oral flora in children with primary teeth. The purpose of the present study was to obtain information of the transmission of A. actinomycetemcomitans. Three types of families were studied for the prevalence and serotype distribution of A. actinomycetemcomitans. First, families whose periodontally healthy child member harbored A. actinomycetemcomitans; second, families of periodontally healthy children who did not harbor A. actinomycetemcomitans; third, families whose adult member harbored A actinomycetemcomitans and had been referred to treatment for severe periodontitis. As a whole the study included 23 families. All the family members were invited for the examination. The final study population consisted of 38 children and 32 adults. The results showed that when a child was positive for A. actinomycetemcomitans, either the mother or the father was also positive with one exception, whereas when the adult member harbored A. actinomycetemcomitans, the children were infected in only 2 of the 9 families. Using immunodiffusion technique it was found that the child always harbored the same serotype of A. actinomycetemcomitans as the parent. In conclusion, the results suggest the intrafamilial transmittance of A actinomycetemcomitans. J Periodontol 1991; 62:207–10.
The Influence of Gingival Inflammation, Tooth Type, and Timing on the Rate of Plaque Formation
Authors: Quirynen Marc , Dekeyser Christel , van Steenberghe Daniel
Published: March 2012

The undisturbed supragingival plaque formation was recorded twice over a 100 hours period in 14 healthy dental students; first after induction of gingival inflammation and a second time starting from a healthy gingiva. During each experimental segment plaque formation was recorded on 42 randomly selected and clean teeth at the start and after 6, 12, 24, 30, 36, 48, 54, 60, 72, 84, and 96 hours. Four hours later all teeth up to the first molars were examined. The presence of disclosable plaque was calculated planimetrically as percent of the total labial surface area of the tooth. The rate of plaque formation was found to be significantly greater (P = 0.001) in the presence of gingival inflammation (+ 29.0%). Moreover, this study indicates an important variation in the plaque growth rate within the dentition; the highest scores were found for the upper premolare, the upper molars, and the lower front teeth. Finally, the rate of plaque formation was found to decrease during the night. J Periodontol 1991; 62:219–222.
Metastatic Chondrosarcoma of the Gingiva Mimicking a Reactive Exophytic Lesion: A Case Report
Authors: Taicher Shlomo , Mazar Avital , Hirshberg Abraham , Dayan Dan
Published: March 2012

Metastases of chondrosarcoma to the oral mucosa are very rare. The present case describes such a metastasis to the maxillary gingiva which mimics a benign reactive exophytic lesion. The literature concerning this matter is reviewed. The differential diagnosis and pathogenesis of such lesions are discussed. J Periodontol 1991; 62:223– 226.
Antibiotic Prophylaxis for Medical‐Risk Patients
Authors: Pallasch Thomas J. , Slots Jørgen
Published: March 2012

The three current regimens for the prevention of infective endocarditis are discussed and compared along, with at‐risk patients and dentally‐induced bacteremias. The principles of antibiotic prophylaxis, and other medical conditions where antibiotic prophylaxis is controversial or inadequately documented is critically analyzed. J Periodontol 1991; 61:227–231.
Microflora and Bacterial DNA Restriction Enzyme Analysis in Young Adults With Periodontitis
Authors: van Steenbergen T.J.M. , van der Velden U. , Abbas F. , de Graaff J.
Published: March 2012

As a result of an epidemiological survey on the periodontal status of young adults, a school was found with a relatively high number of subjects showing loss of attachment (18 out of 87). In 10 of these subjects the microflora of one pocket and of the dorsum of the tongue was investigated with special reference to black‐pigmented species and Actinobacillus actinomycetemcomitans. Prevotella intermedia was the most prevalent species, being found in 9 patients. A. actinomycetemcomitans was isolated from 3 subjects and Porphyromonas gingivalis from 2 subjects. To determine whether cross‐infection had occurred, the P. intermedia, P. gingivalis, and A. actinomycetemcomitans isolates were examined by restriction endonuclease analysis of the DNA after digesting with one or a combination of the endonucleases Pst I, Bam HI, and Hind III. Evaluation of the restriction endonuclease typing method showed it to be sensitive and useful for the typing of P. intermedia, P. gingivalis, and A. actinomycetemcomitans. Using this restriction endonuclease typing method, all isolates of A. actinomycetemcomitans, P. gingivalis, and P. intermedia obtained from single individuals showed different digest patterns. We conclude that in the present study bacterial cross‐infection did not occur among subjects in this school. J Periodontol 1991; 62:235–241.
Cigarette Smoking and Periodontal Bone Loss
Authors: Bergström Jan , Eliasson Sören , Preber Hans
Published: March 2012

The association between smoking and loss of periodontal bone height was investigated in Swedish dental hygienists. The study group included 210 subjects: 24 to 60 years of age, 30% smokers, 32% former smokers, and 38% non‐smokers. The study was based on bite‐wing radiographs, where loss of the interproximal bone height was measured as the distance from the cemento‐enamel junction (CEJ) to the interdental septum (IS). The magnitude of the CEJ‐IS distance was read at 12 sites, representing 3 maxillary and 3 mandibular bone septa in each subject. The CEJ‐IS distance was significantly greater for smokers when compared to non‐smokers, mean ± SEM 1.71 ± 0.08 mm and 1.45 ± 0.04 mm, respectively. The mean ± SEM for former smokers was 1.55 ± 0.05 mm. In smokers, the CEJ‐IS distance increased with increased smoking exposure. The results, based on adults with good oral hygiene, suggest that loss of periodontal bone is related to smoking. The smoking related bone loss is not correlated with plaque infection. J Periodontol 1991; 62:242‐246.
Alveolar Bone Loss in Two Children With Short‐Bowel Syndrome Receiving Total Parenteral Nutrition
Authors: Wright Kevin B. , Holan Gideon , Casamassimo Paul S. , King Dennis R.
Published: March 2012

Two preschool children who were receiving total parenteral nutrition (TPN) for short‐bowel syndrome (SBS) were noted to have radiographic evidence of alveolar bone loss in their primary dentition. Tooth mobility, gingival recession, and premature tooth loss were clinical findings in these children. Both had a 2‐year history of recurrent infections and fluctuating serum electrolytes prior to identification of their dental problems. J Periodontol 1991; 62:272–275.
Treatment of Periodontal Defects With an Absorbable Membrane (Polyglactin 910) With and Without Osseous Grafting: Case Reports
Authors: Gager Arthur H. , Schultz Allen J.
Published: March 2012

The purpose of these reports is to illustrate the possible use of polyglactin 910 as an absorbable membrane for periodontal healing. Eleven surgical sites in 10 patients are reported. Vicryl mesh was used on all sites, and osseous allograft material was used in 8 of these sites. Radiographic evaluation and sounding with anesthesia indicate improvement in the treated areas. Few adverse effects were seen at the treated sites. Therefore, polyglactin offers promise as a material for use in periodontal therapy, especially in deep infrabony pockets. Further controlled studies comparing polyglactin 910 and other resorbable materials as barrier membranes are needed to establish their safety and efficacy. J Periodontol 1991; 62:276–283.
Longitudinal Observation of Cementum Regeneration Through Multiple Fluorescent Labeling
Authors: Ogura Nobuya , Mera Toyotune , Sato Fernando , Ishikawa Isao
Published: March 2012

The assessment of new attachment after periodontal treatment has been the focus of continuous research. An approach to longitudinally examine the deposition of cementum was devised by using fluorescence microscopy (FL), contact microradiography (CMR), and toluidine blue staining (TBS) after the injection of three labeling agents known to be incorporated within newly mineralized tissues with different tones: tetracycline, calcein, and alizarin complexion. Three adult Japanese monkeys (male, 6.0 to 8.3 Kg weight) were used for this experiment. Bone defects were surgically created in 24 mandibular sites and a copper plate was inserted for a period of 4 weeks to promote microbial colonization to form periodontal pockets. Scaling and root planing (baseline) were then performed, and the fluorescent agents were administered twice weekly leaving a 1 week interval between the different agents. The mandibular specimens were fixed in neutralized formalin and embedded in polyester resin. Undecalcified sections were prepared 3, 6, and 9 weeks after baseline. Cementum regeneration was confirmed in 18 out of 24 sites; in 6 samples only epithelial proliferation was observed. Regeneration could be seen as early as 2 weeks after debridement. Cementum was identified by observation under FL of a labeled structure, discrimination in the degree of mineralization of dentin by CMR, and by the presence of functional collagen fibers and location of the epithelial border by TBS. In this study the use of three different labeling agents using the three observation techniques was shown to be effective for the longitudinal assessment of cementum regeneration. J Periodontol 1991; 62:284–291.
Development of a Rapid Qualitative Assay for Determining Elevated Antibody Levels to Periodontopathic Organisms
Authors: Mealey Brian L. , Ebersole Jeffrey L.
Published: March 2012

To allow more widespread use of systemic antibody analysis in clinical settings, a rapid test for determining elevated antibody to periodontitis‐associated bacteria was developed. The technique utilizes dot‐immunoblotting (DIB) on nitrocellulose paper with whole formalinized Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia. An ELISA was used to compare IgG antibody levels to these organisms in venous serum and peripheral capillary blood from 44 subjects. Correlation between serum and capillary levels ranged from r = 0.760 to 0.900 (P < 0.00001). Capillary blood antibody levels averaged 55% of those detected in serum. The assay was developed using a variety of antigen and reagent concentrations and multiple chromogenic enzyme‐substrate systems. Subsequently, 34 periodontally diseased and 10 periodontally healthy subjects were analyzed for serum IgG antibodies using a quantitative ELISA. The qualitative DIB was performed using capillary blood obtained by digi‐puncture and results were compared in a blind fashion to the ELISA data. Relative to its ability to detect elevated antibody levels to these 3 organisms, the DIB had an overall sensitivity of 93% and a specificity of 87% (P < 0.000001). Using peripheral capillary blood and the DIB, detection of elevated systemic antibody levels can be performed in approximately 2 hours. The DIB may be a useful aid in assessing the host response to putative periodontopathic microorganisms. J Periodontol 1991;62:300–307.
Periodontal Implications of Furcation Entrance Dimensions in Chinese First Permanent Molars
Authors: Chiu Bonnie M. , Zee Kwan Y. , Corbet Esmonde F. , Holmgren Christopher J.
Published: March 2012

Narrow dimensions of the entrance to furcations of multi‐rooted teeth can complicate the periodontal management of furcation involvements. The objectives of this study were to measure the furcation entrance dimensions of first permanent molars from Hong Kong Chinese, and to compare these dimensions with those of the blade widths of periodontal instruments generally advocated for root surface instrumentation. A total of 363 first permanent molars, of which 185 were maxillary, were examined under 1.5 x magnification. Furcation entrance dimensions were measured using calibrated test gauges ranging from 0.3 mm to 1.5 mm. Furcation entrance dimensions equal to or less than 0.75 mm (the blade width of a new Gracey curet being 0.76 mm) in maxillary first molars were found in 79% of buccal entrances, 39% of mesial entrances, and 43% of distal entrances. In mandibular first molars, entrance dimensions equal to or less than 0.75 mm were encountered in 36% and 47% of buccal and lingual furcation entrances respectively. One‐half of all furcation entrance dimensions of these first molars were less than the blade width of new Gracey curets. This high prevalence of narrow furcation entrances should be considered in the periodontal management of furcation involvement of first molars in Chinese. J Periodontol 1991; 62:308–311.
Enhanced Repair and Regeneration of Periodontal Lesions in Tetracycline‐Treated Patients. Case Reports
Authors: Moskow Bernard S. , Tannenbaum Paul
Published: March 2012

A group of cases is presented in which dramatic repair and regeneration of periodontal tissues lost as a result of periodontitis have occurred following systemic administration of tetracycline either alone or in combination with other forms of periodontal therapy. The nature and extent of regeneration demonstrated in these patients appears to be more dramatic than what has been shown previously when more conventional forms of periodontal therapy were utilized, even including bone grafting and guided tissue regeneration. The type of repair described has been shown in many instances to be long standing and is probably not totally related to the antibacterial characteristics of tetracycline. It is suggested that the ability of this drug to inhibit collagenolytic enzymes (collagenases) may have influenced the favorable clinical results achieved. The anti‐collagenolytic properties of tetracycline are being considered with increasing frequency in the treatment of other systemic diseases characterized by collagen breakdown such as corneal ulcers, rheumatoid arthritis, diabetes, and dystrophic epidermolysis bullosa. Given the highly collagenous nature of the tissues of the periodontium, this report suggests that tetracycline could be of considerable value in the treatment of some types of periodontitis. J Periodontol 1991; 62:341–350.
Treatment of Periodontal Furcation Defects. Mandibular Class III Defects
Authors: Gantés Bernard G. , Synowski Blake N. , Garrett Steven , Egelberg Jan H.
Published: March 2012

Twenty‐seven mandibular Class III furcation defects were treated in 27 subjects using a regenerative therapy that included citric acid root conditioning and coronally positioned flaps secured by crown‐attached sutures. In addition to this therapy, 13 of the 27 defects received freeze‐dried, decalcified allogenic bone grafts. The effect of these therapies was evaluated from soft tissue probing measurements, including furcation probings to determine soft tissue closure of the defects. At 6 months postsurgery, the mean vertical probing depth reduction and the mean probing attachment level gain in the furcation area were 2.6 mm and 2.2 mm for the non‐grafted defects and 1.9 mm and 1.5 mm for the grafted defects. One of the 14 non‐grafted defects and 3 of 13 grafted defects were judged to show soft tissue clinical closure by a panel of 3 independent examiners. No statistically significant differences were observed between defects treated with or without bone grafts. J Periodontol 1991;62:361–365.
Destructive Forms of Periodontal Disease in Adolescents. A 3‐Year Longitudinal Study
Authors: Albandar Jasim M. , Buischi Yvonne A. P. , Barbosa Maria F. Z.
Published: March 2012

We studied the periodontal disease progression and the relationship between some forms of destructive periodontitis in a group of Brazilian adolescents with high prevalence of periodontal destruction, and evaluated the adequacy of reducing data by limiting the measurement of disease to first molars and by aggregating and pooling site‐scores into subject‐level scores. Over a period of 3 years 222 adolescents were examined annually by bite‐wing radiographs. Individuals displaying arc‐shaped bone lesions adjacent to ≥ 2 first molars were diagnosed as juvenile periodontitis (JP) patients, while those with ≥ 1 first molars showing vertical lesions were regarded as periodontal risk subjects. Teenagers with ≥ 2 first molars exhibiting longitudinal bone loss were defined as high‐risk patients. At the ages of 13 and 16 years, 3 (1.3%) and 4 (1.8%) subjects had JP, while 12 (5.4%) and 28 (12.6%) were regarded as periodontal risks; 8 (3.6%) subjects were assigned to the high‐risk group; 4 (1.8%) 13‐year olds had > 1 first molars missing; hence, no loss of posterior teeth occurred over a period of 3 years. Analyzing the data at the site‐level revealed progressive loss and little fluctuation in the alveolar bone height in the high‐risk group, and a more pronounced bone loss at the mesial than at the distal surfaces. Simpler data sets were constructed by aggregating some of the site‐scores or by pooling these into subject‐level scores. This procedure facilitated the identification of high‐risk subjects and studying the disease activity over time at the subject level. The results indicate that early periodontitis and JP are closely related but distinguishable forms of periodontal disease in adolescents, and stress the importance of early identification of subjects at risk of developing destructive periodontal diseases. The pattern of disease progression in adolescents appears to resemble that reported in adults. The findings also suggest that the employed methods of data reduction are useful in epidemiological studies on periodontal disease progression in adolescents. J Periodontol 1991;62:370–376.
Incidence of Periodontitis Recurrence in Treated Patients With and Without Cultivable
Authors: Listgarten Max A , Slots Jørgen , Nowotny Alois H. , Oler Jacqueline , Rosenberg Judy , Gregor Barbara , Sullivan Pamela
Published: March 2012

A total of 98 adults previously treated for moderate to advanced periodontitis and on a trimonthly recall schedule were screened for the presence of critical levels of Actinobacillus actinomycetemcomitans, Prevotella (Bacteroides) intermedia, and Porphyromonas (Bacteroides) gingivalis. Patients with at least 2 positive sites were placed in a positive group and patients without or with low levels of these bacteria in a negative group. During the 30‐month study the incidence of disease recurrence was greater in the positive group, but did not reach statistical significance. Positive patients with deeper pockets tended to be at greater risk of developing recurrent disease than those with shallower pockets. In the positive group only, both A. actinomycetemcomitans recovery and antibody levels to A. actinomycetemcomitans strain NCTC 9710 (serotype c) were inversely correlated with disease recurrence. The presence of A. actinomycetemcomitans and P. intermedia above critical levels did not reliably predict future episodes of disease recurrence in this population. The sparse recovery of P. gingivalis did not permit us to assess its diagnostic value. With the exception of P. gingivalis, for which insufficient data were available, the results indicate that the presence or absence of the above bacterial species cannot of itself serve as a reliable predictor of future episodes of recurrent disease in a population of treated patients on a regular trimonthly recall schedule. J Periodontology 1991;62:377–386.
Episodic Factitious Gingival Injury Secondary to Topical Anesthesia. A Case Report
Authors: Raab Frank J. , Young Louis L.
Published: March 2012

The contribution of topical anesthesia to the incidence of severe factitious gingival injury in an adult patient is reported. A brief review of the literature is also presented. J Periodontol 1991; 62:402–406.
The Electron Microscopic Immunolocalization of a Copper‐Zinc Superoxide Dismutase in Association with Collagen Fibers of Periodontal Soft Tissues
Authors: Jacoby Bennett H. , Davis Walter L.
Published: March 2012

Periodontal soft tissues were cleaved from freshly extracted human teeth. Tissues were then prepared for subsequent biochemical and morphological studies according to the following plan: 1) immediate immersion in liquid nitrogen for the biochemical assay of Superoxide dismutase (SOD); 2) immediate fixation prior to routine preparation for routine transmission electron microscopy; 3) immediate fixation prior to preparation for electron microscopic immunohistochemistry. Biochemical analysis showed that the human periodontal ligament contained about twice as much SOD activity as human skin (dermis), but considerably less enzyme activity than that seen in red blood cells. Interestingly, periodontal SOD activity appeared to decrease with age. Immunohistochemistry localized enzyme activity to the periphery of matrix collagen fibrils and to the glycocalyx of tissue fibroblasts. The pathophysiology of this enzyme regarding inflammatory diseases such as periodontitis is discussed. J Periodontol 1991; 62:413†420.