bluuebunny/crossref_metadata_2025 huggingface dataset:
Herpesviruses and Periodontopathic Bacteria in Trisomy 21 Periodontitis
Authors: Hanookai Delaram , Nowzari Hessam , Contreras Adolfo , Morrison John L. , Slots Jørgen
Published: February 2005

Background: Little is known about the etiology and pathogenesis of periodontal disease in Trisomy 21 patients. This study determined the occurrence of herpesviruses and putative periodontopathic bacteria in Trisomy 21 periodontitis.

Methods: Nineteen Trisomy 21 patients (17 to 37 years of age) contributed subgingival samples from molar and bicuspid teeth presenting interproximal periodontitis lesions (probing depths, 5 to 8 mm) and from shallow periodontal sites (probing depths, 1 to 3 mm). Samples were obtained at baseline, and at 1 and 4 weeks after subgingival debridement by means of hand instruments and ultrasonic scalers. Epstein‐Barr virus type 1 and 2 (EBV‐1 and EBV‐2), human cytomegalovirus (HCMV), and herpes simplex virus (HSV) were identified by sensitive and specific nested polymerase chain reaction. Putative periodontopathic bacteria were identified by means of non‐selective and selective culture.

Results: Of 19 Trisomy 21 periodontitis lesions, 6 (32%) were positive for EBV‐1, 5 (26%) were positive for HCMV, 3 (16%) were positive for HSV, and 2 (11%) showed viral co‐infection. Of 19 shallow periodontal sites, only one revealed HCMV. Prevotella intermedia, Bacteroides forsythus, and Capnocytophaga species were detected in higher proportions in deep than in shallow periodontal pockets (P = 0.02). Subgingival debridement did not reduce genomic herpesvirus presence but caused a decrease in proportions of Porphyromonas gingivalis and Capnocytophaga species.

Conclusions: Periodontal herpesvirus‐bacteria coinfections may play important roles in the pathogenesis of destructive periodontal disease in Trisomy 21 patients. Herpesviruses may reduce the periodontal defense and promote growth of subgingival bacteria capable of causing periodontal breakdown. J Periodontol 2000;71:376‐384.
Changes in the Periodontal Status of Patients Undergoing Bone Marrow Transplantation
Authors: Pattni R. , Walsh L.J. , Marshall R.I. , Cullinan M.P. , Seymour G.J. , Bartold P.M.
Published: February 2005

Background: Patients receiving an HLA‐matched bone marrow transplant (BMT) from a relative or unrelated donor undergo a permanent alteration of their immune system, followed by a prolonged period of immunodeficiency. This study aimed to examine alterations in the periodontal status of patients over 6 months post‐bone marrow transplantation.

Methods: Thirty‐seven patients scheduled for bone marrow transplantation participated in this study. One calibrated examiner carried out periodontal examinations (clinical and radiographic) immediately prior to and at 3 and 6 months after transplantation. All patients followed an intense oral care program. Subgingival plaque samples were analyzed by enzyme‐linked immunosorbent assay (ELISA) for the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, and Prevotella intermedia. Data were subjected to statistical analyses to determine the relationships between the frequency distribution of the radiographic and clinical variables over time.

Results: Gains in clinical attachment level (CAL) of ≤2 mm at 4 or more sites from baseline to 6 months post‐BMT were noted in 9/16 patients (56%), while 6/16 (38%) patients experienced a loss of CAL ≤2 mm at 4 or more sites in the same period. At a site level, 4.8% of sites exhibited a gain in CAL ≤2 mm between baseline and 3 months post‐BMT while 2.3% of sites showed a loss of CAL ≤2 mm in the same period. From baseline to 6 months, a gain in CAL of ≤2 mm was recorded at 3.1% of sites, and 2.4% of sites experienced a loss of ≤mm. A significant improvement in the gingival index occurred between all sequential time periods when assessed at a site level. At a patient level, 11/18 (61%) patients showed a significant change in gingival index between baseline and 3 months and 10/16 (63%) between baseline and 6 months. There was no significant relationship between clinical changes and the prevalence of the periodontal pathogens at the various time periods.

Conclusions: An improvement in periodontal health was recorded between baseline and 6 months post‐transplantation. Most of the improvement in periodontal status was noted in the first 3 months after BMT, with a slight decline in periodontal health between 3 and 6 months post‐transplant. No significant alteration was noted in the prevalence of periodontal pathogens during the study period. J Periodontol 2000;71:394‐402.
Tissue Engineered Bone Formation Using Chitosan/Tricalcium Phosphate Sponges
Authors: Lee Yong‐Moo , Park Yoon‐Jeong , Lee Seung‐Jin , Ku Young , Han Soo‐Boo , Klokkevold Perry R. , Choi Sang‐Mook , Chung Chong‐Pyoung
Published: February 2005

Background: Chitosan is a biodegradable natural polymer that has been shown to improve wound healing. This study aimed to develop chitosan/tricalcium phosphate (TCP) sponges as tissue engineering scaffolds for bone formation by threedimensional osteoblast culture.

Methods: The sponges were prepared by freeze‐drying and cross‐linking a mixture of chitosan solution with TCP. Fetal rat calvarial osteoblastic cells were isolated, cultured, and seeded into the sponges. The cell‐sponge constructs were cultured for 56 days. Cell proliferation, alkaline phosphatase (ALPase) activity, and calcium deposition in the cell‐sponge constructs were measured at 1, 7, 14, 28, and 56 days. Histologic examination was performed with light microscopy and scanning electron microscopy.

Results: Chitosan/TCP sponges supported the proliferation of osteoblastic cells as well as their differentiation as indicated by high ALPase activities and deposition of mineralized matrices by the cells. Light and scanning electron microscopic examination indicated that seeded osteoblastic cells were well attached to sponge matrices and proliferated in a multi‐layer fashion. Small bone‐like spicules were observed on the sponge matrix at 14 days. Seeded cells appeared to be embedded in the newly formed tissue matrix, which is characteristic of the osteoblast differentiation and their progression into osteocytic cells. The amount of mineralized tissue formed in the sponge at 56 days was significant.

Conclusions: These results suggest that the chitosan/TCP sponge is a feasible tool as a scaffolding material to grow osteoblast in a three‐dimensional structure for transplantation into a site for bone regeneration. J Periodontol 2000;71:410‐417.
Volatile Components of Cigarette Smoke: Effect of Acrolein and Acetaldehyde on Human Gingival Fibroblasts In Vitro
Authors: Cattaneo V. , Cetta G. , Rota C. , Vezzoni F. , Rota M.T. , Gallanti A. , Boratto R. , Poggi P.
Published: February 2005

Background: Tobacco and some of its volatile and non‐volatile components have been found to affect many types of cells including gingival fibroblasts. Since normal gingival fibroblast functioning is fundamental to the maintenance of the periodontal connective tissue, as well as to wound healing, we examined the effect of acrolein and acetaldehyde, volatile components of cigarette smoke, on proliferation, attachment, and ultrastructure of human gingival fibroblasts (HGFs) in culture.

Methods: Human gingival fibroblast (HGF) strains derived from healthy individuals with non‐inflamed gingiva were used in this study. The cells were incubated in the presence of different concentrations of acrolein and acetaldehyde. Cell attachment and proliferation were evaluated after incubation for 3 hours and 5 days, respectively. In addition, the cells were examined with a transmission electron microscope in order to evaluate their morphology.

Results: The results show that acrolein and acetaldehyde produced dose‐dependent inhibition of HGF attachment and proliferation. The cytotoxic effect was, however, reversible when both substances were removed, after 3 days, from the medium. The main ultrastructural finding for the HGF cytoplasm was the presence of vacuoles and lysosomal structures that became prominent with increasing concentration of acrolein and acetaldehyde.

Conclusions: Our experimental data suggest that acrolein and acetaldehyde, volatile components of tobacco smoke, are detrimental to HGF survival and consequently to the oral connective tissue. According to our morpho‐functional evidence, these findings corroborate clinical and epidemiological investigations demonstrating smoke as a risk factor in the development of periodontal disease. J Periodontol 2000;71:425‐432.
Non‐Hodgkin's Lymphoma and Periodontitis. A Case Report
Authors: Hokett Steven D. , Cuenin Michael F. , Peacock Mark E. , Thompson Stevan H. , Van Dyke Thomas E.
Published: February 2005

Background: We describe an unusual case of extranodal non‐Hodgkin's lymphoma that developed in the maxillae associated with localized severe periodontitis in a 64‐year‐old Caucasian male. The lymphoma was diagnosed less than 2 years following routine periodontal surgery and 8 weeks after the extraction of hopeless teeth in the associated area.

Methods: Two months following the extractions, the patient experienced pain and swelling in the maxillary right edentulous area mimicking an abscess, and reported for emergency care. An expansile lesion measuring 2.0 × 2.5 cm in diameter was noted on radiographic examination to extend into the right maxillary sinus. A definitive biopsy diagnosis of highgrade, small, non‐cleaved, diffuse non‐Hodgkin's lymphoma of the right posterior maxillae was established. The patient was subsequently treated by a combination of radiation, chemotherapy, and bone marrow transplantation.

Results: The maxillary tissues healed uneventfully, and the patient has been closely observed for approximately 5 years without symptoms or recurrence of the lymphoma.

Conclusions: This case highlights the need for careful debridement of extraction sockets associated with severe periodontitis and argues for the routine submission of extracted teeth with adjacent soft tissue for microscopic analysis, to assist in the early diagnosis of potentially life‐threatening malignancies. J Periodontol 2000;71:504‐509.
Foreign Body Granuloma Following Placement of Hard Tissue Replacement Material: A Case Report
Authors: Girard Bruno , Baker Gerald , Mock David
Published: February 2005

The placement of grafting material in extraction sites for ridge preservation is an increasingly common practice among clinicians. This is a case report of a patient presenting with a symptomatic, foreign body granuloma following the placement of hard tissue replacement (HTR) in extraction sockets. The surgical specimen revealed numerous histiocytes and foreign body type giant cells. The grafting material was surgically removed and the patient's symptoms were alleviated. Although biocompatibility of HTR has previously been shown, specific applications may be contraindicated or some patients may exhibit sensitivity to this material. J Periodontol 2000;71:517‐520.
The Effect of Interleukin‐11 on the Progression of Ligature‐Induced Periodontal Disease in the Beagle Dog
Authors: Martuscelli Gianluca , Fiorellini Joseph P. , Crohin Constant C. , Howard Howell T.
Published: February 2005

Background: The rate of progression of periodontal disease is dependent on the complex regulatory interactions between bacteria and the immune modulators of the host response. The purpose of this investigation was to determine if recombinant human interleukin‐11 (rhIL‐11), known to downregulate several inflammatory modulators, has the ability in subcutaneous administration to reduce the rate and/or extent of periodontal attachment loss and radiographic bone loss in a ligature‐induced periodontal disease beagle dog model.

Methods: Twenty 18‐month‐old female beagle dogs were brought to optimal periodontal health over a 2‐week period. Periodontal disease was induced by placing 2.0 silk ligatures around the mandibular first molar and premolar teeth. The dogs were divided into 3 treatment groups and one control group. The 3 treatment groups received subcutaneous injections of either 15, 30, or 80 µg/kg of rhIL‐11 in saline buffer twice a week. The placebo group received buffer only subcutaneously twice a week. The gingival health of each animal was measured by recording the presence or absence of gingival inflammation, plaque, and bleeding upon probing. Attachment levels and bone height were also measured. Treatment administration and clinical and radiographic evaluations were performed in a masked fashion.

Results: At week 8, the placebo group had 3.89 mm of attachment loss and 73.8% radiographic bone remaining. The 15 µg/kg group had 1.99 mm attachment loss and 89.5% bone remaining; the 30 µg/kg group had 0.84 mm attachment loss and 92.5% bone remaining; and the 80 µg/kg group had 1.05 mm attachment loss and 85.5% bone remaining. All 3 treatment groups lost significantly less attachment and retained significantly more bone than did the placebo group.

Conclusions: The study indicates that subcutaneous injections of rhIL‐11 were able to slow the progression of attachment and radiographic alveolar bone loss in a ligature‐induced beagle dog model. J Periodontol 2000;71:573‐578.
Clinical Validation of a New Subtraction Radiography Technique for Periodontal Bone Loss Detection
Authors: Nummikoski Pirkka V. , Steffensen Bjorn , Hamilton Kathy , Brent Dove S.
Published: February 2005

Background: Diagnostic subtraction radiography (DSR) is a new digital radiographic image subtraction method designed to enhance detection of crestal or periapical bone density changes and to help evaluate caries progression in teeth. In this clinical study, the performance of the DSR method was evaluated for its ability to detect periodontal bone loss and was compared with that of conventional evaluation of radiographs and the standardized cephalostat‐guided image acquisition and subtraction technique (LRA) which served as the “gold standard.”

Methods: In each of 25 subjects with alveolar crestal bone loss created by periodontal surgery, one set of DSR radiographs and one set of LRA radiographs were obtained before and after the surgery. Subtraction images were then generated by both the proprietary DSR and the LRA techniques. Four viewers evaluated the paired film sets and both subtraction image sets using a 5 point confidence scale to determine the presence or absence of crestal bone loss. Receiver operating characteristics (ROC) statistical procedures were applied to analyze the diagnostic accuracy and statistical differences between the three imaging modalities.

Results: The DSR subtraction viewing generated an ROC area of 0.882. For 2 of the viewers this represented a statistically significant gain (P <0.05) over the conventional viewing of the radiographs which had an average ROC area of 0.730. In comparison, the LRA method achieved an area of 0.954. The differences between the LRA and the DSR subtraction methods were not statistically significant, but the statistical power for claiming equality was low ranging from 0.2 to 0.6.

Conclusions: The use of the DSR technique in clinical radiographic image acquisition and subsequent subtraction analysis clearly enhanced the accuracy of alveolar crestal bone loss detection when compared to conventional film viewing. Because this methodology is less resource demanding than LRA and the film exposure techniques and computer‐based image analysis skills may be acquired with only a few hours of training, the DSR has potential in clinical practice. J Periodontol 2000;71:598‐605.
Osteoporosis and Implant Failure: An Exploratory Case‐Control Study
Authors: Becker William , Hujoel Philippe P. , Becker Burton E. , Willingham Harold
Published: February 2005

Background: Osteoporosis has been suggested as a risk factor for implant failure, but data supporting such a link are limited.

Methods: A case‐control study was designed to evaluate the association between osteoporosis and dental implant failure. Cases (n = 49) and controls (n = 49) were selected from a private practice. The following measures were collected for each patient: 1) peripheral dual‐energy x‐ray absorptiometry (pDEXA) bone measurements at the distal and proximal radius and ulna; 2) classification of bone quality and quantity at the time of implant placement; and 3) questionnaire data regarding potentially confounding variables. Generalized estimating equations were used to relate the likelihood of having at least one implant failure in an individual to osteoporosis measures.

Results: The results suggested that there was no association between pDEXA scores at the radius and ulna and the risk for implant failure. For every 1‐unit increase in bone density as measured by pDEXA t‐score at proximal and distal radius and ulna, the risk for a patient to lose at least one implant changed by +14% and ‐6%, respectively (odds ratio, 1.14; 95% confidence interval, 0.80‐1.62 and odds ratio, 0.94; 95% confidence interval, 0.71‐1.23). The simple visual assessment of local bone quality had a moderately sized relationship to implant failure. Implants placed in sites with thin cortical bone increased the chance for a patient to lose at least one implant by 130% when compared to implants placed in a thick cortical layer or compact bone (odds ratio, 2.3; 95% confidence interval, 1.0‐5.4).

Conclusions: This exploratory study suggests that a simple visual assessment of bone quality at the site of implant placement may be more informative regarding implant failure than pDEXA bone density measures obtained at peripheral bones. In order to determine whether peripheral osteoporosis measurements have a small or moderate association with implant loss, studies with larger sample sizes will be required. J Periodontol 2000;71:625‐631.
In Vivo and In Vitro Natural Frequency Analysis of Periodontal Conditions: An Innovative Method
Authors: Lee Sheng‐Yang , Huang Haw‐Ming , Lin Ching‐Yi , Shih Yung‐Hsun
Published: February 2005

Background: When measuring periodontal disease, various types of equipment for making objective measurements of tooth mobility have been proposed. However, these devices and methodology are insufficient in terms of reliability. An innovative method using vibrational theories to assess the periodontal attachment level of natural teeth is presented in this study.

Methods: Modal testing technique, a non‐destructive and time‐saving method, was used for non‐invasive and quantitative measurement of the natural frequencies of the upper central incisor in vivo and in vitro. A finite element model was established, and modal testing experiments were simulated to assess the relationship between bone level and teeth.

Results: The first dominant natural frequency of healthy human upper central incisors ranges from 710 Hz to 3,360 Hz, with an average of 1,701 ± 679 Hz. Both in vitro experiment and finite element simulation showed that lowering of the attachment level causes a significant decrease in the natural frequencies, and a strong relationship (r = ‐0.99, P <0.01) was observed between the frequency and the bone level height.

Conclusions: Our results suggested that natural frequency is an important parameter for assessing the periodontal condition and that the modal testing technique is a useful supplemental method for assessing the attachment conditions of the periodontium. J Periodontol 2000;71:632‐640.
Alveolar Bone Height and Postcranial Bone Mineral Density: Negative Effects of Cigarette Smoking and Parity
Authors: Hildebolt Charles F. , Pilgram Thomas K. , Yokoyama‐Crothers Naoko , Vannier Michael W. , Dotson Mary , Muckerman Jane , Hauser Jay , Cohen Sheldon , Eugenia Kardaris E. , Hanes Philip , Shrout Michael K. , Civitelli Roberto
Published: February 2005

Background: Our objective was to test the association between cemento‐enamel junction, alveolar‐crest distance (CEJ‐AC, as measured on digitized vertical bite‐wing radiographs) and postcranial bone mineral density (BMD) relative to clinical, dietary, and demographic variables.

Methods: Data were collected in a cross‐sectional study of 134 postmenopausal women. CEJ‐AC distances were determined from digitized vertical bite‐wing radiographs. Lumbar spine and proximal femur BMDs were determined from dual‐energy x‐ray absorptiometric scans. Correlation analysis and Student t tests were used to identify those variables most associated with CEJAC distance. The selected variables were modeled with a backward stepwise regression analysis, with CEJ‐AC distance as the dependent variable.

Results: Parity (number of pregnancies to term), cigarette smoking, and the interaction of lateral spine BMD with cigarette smoking were independent predictors of CEJ‐AC distance (P ≤0.05). Statistical models containing these variables accounted for 19% of the variation in CEJ‐AC distances.

Conclusions: CEJ‐AC distance in postmenopausal women is the result of a complicated interaction of many effects, including but not limited to, parity, cigarette smoking, and skeletal BMD. J Periodontol 2000;71:683–689.
Effects of Nicotine on the Strength of Attachment of Gingival Fibroblasts to Glass and Non‐Diseased Human Root Surfaces
Authors: Tanur Eduardo , McQuade Michael J. , McPherson James C. , Al‐Hashimi Ibtisam H. , Rivera‐Hidalgo Francisco
Published: February 2005

Background: The aim of this study was to evaluate the effect of nicotine on the strength of attachment of human gingival fibroblast cells to glass and non‐diseased human root surfaces.

Methods: Human gingival fibroblast cells (HGF) were trypsinized, suspended in RPMI 1640 medium, and incubated with autoclaved human root and glass sections and nicotine (NIC) concentrations of 0 (control), 25, 50, and 100 ng/ml for 1 week. HGF attached and grew on glass and root surfaces for 4 weeks at all NIC concentrations. HGF cultures were subjected to a rotary shaker machine for 30 minutes to test the strength of attachment of these cells at 100, 150, and 200 rpm. The root and glass sections were examined at 48 hours by light microscopy.

Results: Control groups exhibited a monolayer of long, spindle‐shaped fibroblasts with a parallel alignment and minimal overlapping. With a concentration of NIC of 50 or 100 ng/ml as well as with increasing “speeds,” the number of cells attached to these surfaces decreased dramatically. When 200 rpm was used for both groups at all NIC concentrations, very few HGF remained attached to these surfaces.

Conclusions: This study showed that the nature of cell attachment to either glass or root surfaces is altered by nicotine, and marked detachment was noted when nicotine exposure was coupled with vigorous agitation at different rpm. Marked detachment noted in all specimens at 200 rpm indicates that this speed is excessive for use in subsequent experimentation. J Periodontol 2000;71:717‐722.
Genetic Polymorphisms of the IL‐1α and IL‐1β Genes in African‐American LJP Patients and an African‐American Control Population
Authors: Walker Stephen J. , Van Dyke Thomas E. , Rich Stephen , Kornman Kenneth S. , di Giovine F.S. , Hart Thomas C.
Published: February 2005

Background: A functional polymorphism of the interleukin‐1 beta (IL‐1β) gene has been proposed to be a risk factor for periodontitis. In adult forms of periodontitis, non‐smokers of northern European heritage carrying the “2” allele of the IL‐1α‐889 and the IL‐1β +3953 RFLPs in either the heterozygous or the homozyous state at both loci were observed to have a greater risk for developing severe periodontitis. Studies of early‐onset periodontitis (EOP) found that allele “1” of both IL‐1alpha;‐889 and IL‐1β +3953 was transmitted more frequently with the EOP phenotype. The purpose of the present study was to determine the prevalence of the IL‐1α and IL‐1β genotype polymorphisms in an African‐American (AA) control population and in 37 African‐Americans with localized juvenile periodontitis (LJP).

Methods: The IL‐1α +4845 and IL‐1β +3953 loci were genotyped by PCR amplification, followed by restriction enzyme digestion and gel electrophoresis. The IL‐1α +4845 locus, in linkage disequilibrium (>99%) with IL‐1α‐889, was genotyped because it is technically easier. Data were analyzed using r × c contingency tables.

Results: The IL‐1β +3953 allele “1” was carried by >99% of the AA control population and by 100% of the AA LJP group, with most individuals being homozygous 1,1. The prevalence of the composite genotype with at least one allele “2” at each of the IL‐1β +3953 and IL‐1α +4845 loci was 14% (AA control group) and 8% (AA LJP group).

Conclusions: Given the high frequency of the IL‐1β allele “1” in the African‐American population, it would appear that knowledge of this +3953 polymorphism would provide little diagnostic or predictive information for LJP. J Periodontol 2000;71:723‐728.
A Rapid DNA Probe Method for Detection of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans
Authors: Komiya Akiyo , Kato Tetsuo , Nakagawa Taneaki , Saito Atsushi , Takahashi Junichi , Yamada Satoru , Okuda Katsuji
Published: February 2005

Background: The objective of the present study was to develop a rapid DNA probe method for the microbiological detection of periodontitis that can be used in dental clinics. By using the DNA probe, we also investigated the correlation between the occurrence of putative periodontopathic bacteria and clinical parameters.

Methods: This rapid DNA probe method minimizes the use of a water bath for ordinary hybridization and washing in order to shorten the total reaction time. The detection process could be completed within 2 hours. In order to evaluate the clinical application of the DNA probe, subgingival plaque samples were taken from patients with periodontitis before initial therapy. After the therapy, the patients were microbiologically and clinically evaluated.

Results: When the DNA probe method was compared with the culture method, the agreement was 88% for Porphyromonas gingivalis and 67% for Actinobacillus actinomycetemcomitans. A statistically significant association was found between the detection of P. gingivalis and probing depth, bleeding on probing (χ2 test: P <0.001, P <0.05). A significant association was also shown between the detection of A. actinomycetemcomitans and probing depth in patients aged 35 or older (χ2 test: P <0.001). The detection rate of A. actinomycetemcomitans was highest in teenagers. At shallow periodontal pocket sites (PD ≤3 mm) in teenagers, no P. gingivalis was found, while 22% of the sites harbored A. actinomycetemcomitans. After the therapy, the frequency of detection of P. gingivalis decreased significantly only in the clinically improved sites (χ2 test: P <0.001).

Conclusions: The rapid DNA probe method appears promising as an efficient tool for rapid clinical detection of periodontopathic bacteria. J Periodontol 2000;71:760‐767.
Defective Calcium Influx Factor Activity in Neutrophils From Patients With Localized Juvenile Periodontitis
Authors: Shibata Kazuyuki , Warbington Martha L. , Gordon Barbara J. , Kurihara Hidemi , Van Dyke Thomas E.
Published: February 2005

Background: Localized juvenile periodontitis (LJP) is an earlyonset periodontal disease associated with neutrophil dysfunction, including defective chemotaxis, reduced protein kinase C (PKC) activity, and reduced calcium entry. These observations are important because reduced availability of cytosolic‐free calcium concentration in the cell will have detrimental consequences for the numerous cytosolic calcium concentration‐dependent pathways. In particular, there is a direct relationship between Ca2+ flux and the cell activation enzyme PKC. In this report, we focused on the mechanism of calcium entry, investigating a newly described molecule, calcium influx factor (CIF). CIF is thought to be a second messenger for the opening of membrane calcium channels when intracellular calcium stores are depleted. We examined CIF activity in neutrophils from normal subjects and LJP patients.

Methods: Neutrophils from 11 LJP patients, 3 adult periodontitis (AP) patients, and 12 normal subjects were isolated from peripheral venous blood. CIF was extracted with thapsigargin, a Ca2+‐ATPase inhibitor, from isolated neutrophils and CIF activity measured using a 45CaCl2 uptake assay.

Results: The CIF activity in neutrophils from LJP patients ranged from 98.9 to 281.5 units/mg protein (mean = 180.2 ± 56.3) and from 291.9 to 755.5 units/mg protein (mean = 528.8 ± 153.8) in non‐periodontal disease controls. CIF activity in AP patients was also measured and found to be similar to controls. The CIF activity in LJP patients was statistically significantly reduced compared to that in normal subjects (P <0.001).

Conclusions: This study suggests that CIF activity may be important determinant in neutrophil abnormalities in LJP. J Periodontol 2000;71:797‐802.
Gingival Peripheral Odontoma in an Adult: Case Report
Authors: Ide Fumio , Shimoyama Tetsuo , Horie Norio
Published: February 2005

Background: Odontoma arising in the extraosseous soft tissue is extremely uncommon. We describe our experience of gingival peripheral odontoma in which the initial presentation was a small asymptomatic nodule.

Methods: Case study.

Results: A 44‐year‐old man reported with a firm gingival mass of the anterior maxilla which had been gradually enlarging over 5 years. Radiographic examination showed a dense radiopaque mass occupying most of the tumor and no evidence of underlying intraosseous lesion. The pathology was reported as odontoma.

Conclusions: This is the fourth reported case of peripheral odontoma in the gingiva. J Periodontol 2000;71:830‐832.
Immediate Versus Non‐Immediate Implantation for Full‐Arch Fixed Reconstruction Following Extraction of All Residual Teeth: A Retrospective Comparative Study
Authors: Schwartz‐Arad Devorah , Gulayev Nathan , Chaushu Gavriel
Published: February 2005

Background: Immediate implants placed into fresh extraction sites are considered a predictable and acceptable procedure. The main biological advantage is the preservation of bone height and width. However, there is no direct proof of the clinical and surgical importance of this. The purpose of this study was to evaluate the correlation between implant dimensions, anatomic factors, and survival rates of immediate versus non‐immediate implants.

Methods: From 1989 to 1996, 380 implants (117 immediate and 263 non‐immediate) were placed in 43 patients (50 jaws) following extraction of all residual teeth. A total of 253 implants were placed in the maxilla and 127 in the mandible, with a mean of 7.65 and 7.9 per jaw, respectively. Of the implants, 31% were placed immediately into fresh extraction sites.

Results: Total 5‐year cumulative survival rate (CSR) was 92%, mandibular 96% and maxillary 90%. Immediate implants had a better 5‐year CSR (96%) versus non‐immediate implants (89.4%). The maxilla mainly contributed to this difference (95% versus 88%). The mean potential contact surface area (PCSA) was 230 mm2. Implants with significantly higher values yielded a higher 5‐year CSR in the maxilla (96.6% versus 82.9%). Immediate implants in the posterior maxilla had a 100% 5‐year CSR versus 72% with the non‐immediate implants.

Conclusions: 1) Implant‐supported fixed ceramo‐metal prosthesis is a predictable treatment modality for edentulous patients; 2) factors favorably affecting the survival of implants placed to support full‐arch ceramo‐metal prosthesis include immediate implantation, higher PCSA values, and implant location; 3)immediate implantation exerts its effect through higher PCSA values and by a compensatory effect to bone quality; 4) immediate implantation does not carry additional morbidity; and 5) potential contact surface area (PCSA) is a reliable mean that accurately represents implant dimensions and may replace length and diameter in future studies. J Periodontol 2000;71:923‐928.
Interleukin‐8 and Granulocyte Elastase in Gingival Crevicular Fluid in Relation to Periodontopathogens in Untreated Adult Periodontitis
Authors: Jin Lijian , Söder Birgitta , Corbet Esmonde F.
Published: February 2005

Background: This study aimed to determine the relationships among interleukin (IL)‐8 and granulocyte elastase levels in gingival crevicular fluid (GCF) and the concomitant presence of periodontopathogens in untreated adult periodontitis.

Methods: GCF and subgingival plaque samples were collected from 16 patients with untreated adult periodontitis and 10 healthy control subjects. IL‐8 levels were determined by enzymelinked immunosorbent assay (ELISA). Granulocyte elastase was analyzed with a neutrophilic granulocyte‐specific, low molecular weight and chromogenic substrate, L‐pyroglutamyl‐Lprolyl‐L‐valine‐p‐nitroanilide, and the maximal rate of elastase activity (MR‐EA) was calculated. Five DNA probes were used to detect the presence of A. actinomycetemcomitans (A.a.), B. forsythus (B.f.), P. gingivalis (P.g.), P. intermedia (P.i.), and T. denticola (T.d.).

Results: Lower IL‐8 concentrations and higher granulocyte elastase activities were found in patients than in healthy controls as well as in diseased conditions co‐infected with B.f., P.g., P.i., and T.d. as compared to healthy conditions without the target species (P <0.05). IL‐8 concentrations were positively correlated with MR‐EA levels in the periodontitis conditions coinfected with B.f., P.g., P.i., and T.d. (P <0.05). A wide range of IL‐8 concentrations was found among 15 patients when the periodontitis condition was characterized by co‐infection with B.f., P.g., P.i., and T.d. MR‐EA levels in the high IL‐8 group of subjects were significantly higher than those in the low IL‐8 group of subjects (P <0.01).

Conclusions: The present study shows that the local hostbacteria interactions in untreated periodontitis are diverse in terms of the intensity of inflammatory responses measured by IL‐8–related granulocyte elastase activity in GCF. This might reflect different phases of the inflammatory response due to shifts in host‐bacteria interactions and therefore be indicative of a range of periodontal disease activity levels. J Periodontol 2000;71:929‐939.
Mast Cells Are Not Involved in the Development of Cyclosporin A‐Induced Gingival Hyperplasia: A Study With Mast Cell‐Deficient Mice
Authors: Asahara Yoji , Nishimura Fusanori , Yamada Hisa , Naruishi Koji , Kataoka Masatoshi , Kido Jun‐ichi , Nagata Toshihiko , Murayama Yoji
Published: February 2005

Background: A previous study suggested that mast cells (MC) are involved in the development of cyclosporin A‐induced gingival hyperplasia, since an increased number of MC were observed in the tissue sections of enlarged gingiva. To determine the role of MC in gingival hyperplasia, an MC‐deficient mouse model was used in the current study.

Methods: MC‐deficient mice (WBB6F1xW/Wv) and their littermates (+/+) were fed sucrose‐containing diets supplemented with or without varying concentrations (300, 400, 500, 600 mg) of cyclosporin A/kg of diet. After 30 days, the mice were sacrificed and the degree of gingival hyperplasia was evaluated by the appearance of the gingiva. Tissue MC were stained with toluidine blue to confirm the presence or absence of MC in the enlarged gingiva.

Results: Both W/Wv and +/+ mice, when fed with 600 mg cyclosporin A/kg diet for 30 days, exhibited a similar degree of gingival hyperplasia, while other test mice or control mice did not. Toluidine blue staining of the tissue sections confirmed the presence of MC in the enlarged gingiva of the +/+ mice, but not the W/Wv mice.

Conclusions: These results indicate that mast cells are not necessary in the development of cyclosporin A‐induced gingival hyperplasia, and that the increased number of MC observed in the enlarged gingiva may be a secondary effect of gingival hyperplasia. We also conclude that a study of mice lacking certain molecules or cells would be quite useful in determining the molecules or cell types responsible for the pathogenesis of druginduced gingival hyperplasia. J Periodontol 2000;71:1117‐1120.
An In Vitro Screening Model to Evaluate Root Conditioning Protocols for Periodontal Regenerative Procedures
Authors: Baker Pamela J. , Rotch Heather A. , Trombelli Leonardo , Wikesjö Ulf M.E.
Published: February 2005

Background: Preclinical studies have shown that the condition of the root surface may play a decisive role for outcome of wound healing between a mucogingival flap and a denuded root surface. Root surface demineralization has been shown to promote the establishment of a new connective tissue attachment. Conversely, root conditioning with extracellular matrix proteins or fluorides has produced outcomes characterized by a long junctional epithelium. Collectively, present evidence suggests that early events in the healing sequel; i.e., the adsorption and adhesion of blood elements to the root surface are critical for outcomes of wound healing between a mucogingival flap and a denuded root surface. Ultimately understanding and control of these events are vital for successful design and execution of periodontal regenerative protocols, particularly those involving root conditioning. Consequently, the objective of this study was to develop a screening model for immediate evaluation of the influence of root conditioning protocols on the adsorption and adhesion of blood to dentin surfaces.

Methods: Planed and citric acid‐treated human dentin surfaces were exposed to fresh blood allowed to clot and were then rinsed before scanning electron microscopy evaluation.

Results: Citric acid treated planed dentin surfaces presented a thick network of fibrin directly attaching to the dentin surface entrapping cellular elements, mainly erythrocytes. In contrast, untreated, planed dentin exhibited an amorphous appearance with sparse strands of adsorbed fibrous proteins and few adherent erythrocytes.

Conclusions: This in vitro screening model may effectively distinguish dentin surfaces with potential for enhanced adsorption and adhesion of blood elements. Periodontal regenerative protocols involving root conditioning unsuccessful in maintaining the experimentally imposed fibrin clot in this model may have lesser clinical significance than those that do. J Periodontol 2000;71:1139‐1143.
Dietary Vitamin C and the Risk for Periodontal Disease
Authors: Nishida Mieko , Grossi Sara G. , Dunford Robert G. , Ho Alex W. , Trevisan Maurizio , Genco Robert J.
Published: February 2005

Background: Vitamin C has long been a candidate for modulating periodontal disease. Studies of scorbutic gingivitis and the effects of vitamin C on extracellular matrix and immunologic and inflammatory responses provide a rationale for hypothesizing that vitamin C is a risk factor for periodontal disease.

Methods: We evaluated the role of dietary vitamin C as a contributing risk factor for periodontal disease utilizing the Third National Health and Nutrition Examination Survey (NHANES III) which is representative of the U.S. civilian, non‐institutionalized population.

Results: A sample of 12,419 adults (20 to 90+ years of age), with dental measurements and assessment of dietary information as well as demographic and medical histories were included in the studies. Dietary vitamin C was estimated by a 24‐hour dietary record. Individuals with periodontal disease were arbitrarily defined as those who had mean clinical attachment levels of ≥1.5 mm. Using multiple logistic regression analysis, we found a relationship between reduced dietary vitamin C and increased risk for periodontal disease for the overall population (odds ratio [OR] = 1.19; 95% CI: 1.05 to 1.33). Current and former tobacco users who were taking less dietary vitamin C showed an increased risk of periodontal disease with OR of 1.28, 95% CI: 1.04 to 1.59 for former smokers, and an OR of 1.21, 95% CI: 1.02 to 1.43 for current tobacco users. There was a dose‐response relationship between the levels of dietary vitamin C and periodontal disease with an OR of 1.30 for those taking 0 to 29 mg of vitamin C per day, to 1.16 for those taking 100 to 179 mg of vitamin C per day as compared to those taking 180 mg or more of vitamin C per day.

Conclusion: Dietary intake of vitamin C showed a weak, but statistically significant, relationship to periodontal disease in current and former smokers as measured by clinical attachment. Those taking the lowest levels of vitamin C, and who also smoke, are likely to show the greatest clinical effect on the periodontal tissues. J Periodontol 2000;71:1215‐1223.
Spontaneous Early Exposure of Submerged Implants: II. Histopathology and Histomorphometry of Non‐Perforated Mucosa Covering Submerged Implants
Authors: Tal Haim , Dayan Dan
Published: February 2005

Background: Spontaneous early exposure is a complication that could account for significant interference during the early healing phase of dental implants. Spontaneous perforations of the mucosa covering implants have been classified according to the degree of implant exposure from 0 (no perforation) to IV (complete exposure). In this study, the characteristics of the epithelium and connective tissue of clinically non‐perforated mucosa over submerged implants are histologically and histomorphometrically evaluated.

Methods: Ten randomly selected tissue disks of intact (Class [Cl]‐0) mucosa covering submerged implants were removed using a biopsy punch. Identical mucosal punch specimens were obtained from edentulous sites treated by non‐submerged (1‐stage) implants for use as controls. Specimens were histopathologically examined. The epithelial width and inflammatory infiltrate adjacent to the epithelium were histomorphometrically measured and the data statistically analyzed.

Results: Non‐perforated mucosa covering the submerged implants (Cl‐0) was characterized by an inflammatory fibro‐epithelial hyperplasia. In 70% of Cl‐0 hematoxylin and eosin‐stained sections, there was mineralized material in the connective tissue, mostly sequestra. The epithelial width was 1.5 times higher (0.553 ± 0.187 mm) when compared to controls (0.345 ± 0.129 mm; P <0.0001). Concomitantly, the chronic inflammatory infiltrate was almost double in Cl‐0 specimens (1,411 ± 617 cell/mm2) when compared to controls (833 ± 275 cells/mm2; P <0.001). A positive correlation between the linear combination of the epithelial width and the linear combination of the inflammatory cell concentration was found in both groups: Cl‐0: r = 0.669, P = 0.0001; control: r = 0.541, P = 0.005.

Conclusions: Different factors may result in the formation of spontaneous early perforation, most of which are associated with mechanical trauma to the mucosa or tension in the tissue flaps covering the implants. Bone debris produced during the osteotomy could act as an additional predisposing factor; these are sequestrated and accompanied by chronic inflammatory cell infiltration as well as epithelial‐covering reaction. Since this study focused only on specimens from intact mucosa, until further investigation of this phenomenon in spontaneously perforated sites is conducted, no conclusions on the role of these histopathological findings can be made. J Periodontol 2000;71:1224‐1230.
Evaluation of Recombinant Human Bone Morphogenetic Protein‐2 in Oral Applications Including the Use of Endosseous Implants: 3‐Year Results of a Pilot Study in Humans
Authors: Cochran David L. , Jones Archie A. , Lilly Leslie Clark , Fiorellini Joseph P. , Howell Howard
Published: February 2005

Background: This study evaluated patients who had been treated with recombinant human bone morphogenetic protein‐2 (rhBMP‐2) loaded in an absorbable collagen sponge (ACS) in human extraction sites or in sites that required alveolar ridge augmentation. An earlier report on the same patients revealed that after 4 months, implantation of rhBMP‐2/ACS was safe, as determined by clinical, radiographic, systemic, and immunological analyses. In this longer‐term follow‐up, eligible patients were restored with endosseous dental implants in the area treated with rhBMP‐2/ACS and bone biopsy samples were taken for histological analysis of the treated human bone tissue. The primary objective was to monitor the long‐term safety of patients treated with rhBMP‐2/ACS. Another objective was to evaluate the dental implants placed in the sites treated with rhBMP‐2.

Methods: Patient safety was evaluated by clinical examinations, periapical radiographs, and occurrence of adverse experiences. Dental implants were evaluated by radiographic and clinical examination. All 12 patients have been followed for 3 years.

Results: Two years following surgical implantation of rhBMP‐2/ACS, no serious or unexpected adverse experiences occurred. The adverse experiences that did occur were mostly benign and compatible with the dental implant surgeries performed in these patients. No adverse experiences were deemed as related to the rhBMP‐2/ACS. Furthermore, no safety concerns in the local area of rhBMP‐2/ACS placement were noted, based on oral wound examinations. In the 10 patients (6 extraction socket patients and 4 augmentation patients) who received endosseous implants, all implants were clinically stable at all assessments and all 10 patients have been functionally restored. Histological evaluation of the human bone core biopsies revealed normal bone tissue formation identical to the surrounding native bone. Three‐year follow‐up clinical examinations revealed that all implants had stable marginal bone levels and healthy peri‐implant tissues.

Conclusions: These 3‐year results demonstrate that rhBMP‐2/ACS can be used safely in human patients. Human bone biopsies reveal normal bone formation in areas treated with rhBMP‐2/ACS. Endosseous implants placed in these areas were all stable with no radiographic or clinical complications. The results from this study suggest that rhBMP‐2/ACS (0.43 mg/ml) can be safely used in tooth extraction sites and in local ridge augmentation procedures and that endosseous dental implants placed in bony areas treated with rhBMP‐2/ACS are stable and can be functionally restored without complication. J Periodontol 2000;71:1241‐1257.
Comparison of Bioabsorbable and Non‐Resorbable Membranes in the Treatment of Dehiscence‐Type Defects. A Histomorphometric Study in Dogs
Authors: da Silva Pereira Sergio L. , Sallum Antonio Wilson , Casati Marcio Z. , Caffesse Raul G. , Weng Dietmar , Nociti Francisco H. , Sallum Enilson A.
Published: February 2005

Background: The goal of this investigation was to compare, histologically and histometrically, the healing process of dehiscence‐type defects treated by guided tissue regeneration (GTR) with bioabsorbable polylactic acid (PLA) membranes and nonresorbable expanded polytetrafluoroethylene (ePTF) membranes.

Methods: Six mongrel dogs were used. Buccal osseous dehiscences were surgically created on the distal roots of the mandibular third and fourth premolars. The defects were exposed to plaque accumulation for 3 months. After this period, the defects were randomly assigned to one of the treatments: GTR with bioabsorbable membrane (PLA), GTR with non‐resorbable membrane (ePTFE), open flap debridement (OFD), and non‐treated control (NTC). After 3 months of healing, the dogs were sacrificed and the blocks were processed. The histometric parameters evaluated included: gingival recession, epithelial length, connective tissue adaptation, new cementum, and new bone area.

Results: A superior length of new cementum was observed in the sites treated by GTR, regardless of the type of barrier used, in comparison with OFD (P <0.05). No statistically significant differences were found between PLA and ePTFE in any of the parameters with the exception of bone area. PLA presented a greater bone area when compared to ePTFE, OFD, and NTC (P <0.05).

Conclusions: Within the limits of this study, it can be concluded that both barriers are equally effective for new cementum formation. The bioabsorbable membrane may provide a greater bone area than the non‐resorbable membrane. J Periodontol 2000;71:1306‐1314.