bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Clindamycin Hydrochloride in Refractory Periodontitis: 24‐Month Results
Authors: Gordon Jeffrey , Walker Clay , Hovliaras Christine , Socransky Sigmund
Published: March 2012

The purpose of this investigation was to evaluate the use of clindamycin hydrochloride in the treatment of adult refractory periodontitis. Thirty patients with a history of unsuccessful treatment with scaling, periodontal surgery, and the use of tetracyclines were entered into the study. Upon entry, the suspected refractory patients were scaled several times and then monitored for the presence of active disease by probing attachment level measurements performed in duplicate. Active disease was defined as a 3.0 mm or greater loss in attachment from the baseline examination or the occurrence of a periodontal abscess. When active disease was detected, patients were treated with scaling and clindamycin 150 mg qid for 7 days. Patients served as their own controls. Twenty four patients demonstrated further attachment loss following scaling alone and were treated with clindamycin hydrochloride. Scaling and clindamycin treatment decreased the incidence of active disease from an annual rate of 8.0% to 0.5% of sites per patient (P<.001). The mean time required to detect the first active site increased from 4.9 ± 3.7 months following scaling alone to 16.7 ±7.6 months following scaling and clindamycin (P<001). Active sites lost an average of 3.1 mm of probing attachment following scaling alone but “gained” back 2.0 mm at 6 months and 1.5 mm at 24 months post‐antibiotic and scaling treatment. Bleeding on probing was significantly reduced (P<.05) from 31.8% of sites pre‐clindamycin treatment to 12.3% at 12 months and 17.9% of sites at 24 months post‐clindamycin treatment. The findings in this investigation suggest that clindamycin hydrochloride was an effective agent in controlling the extent and rate of disease progression in refractory adult periodontitis patients. J Periodontol 1990; 61:686–691.
The Effect of Clindamycin on the Microbiota Associated With Refractory Periodontitis
Authors: Walker Clay , Gordon Jeffrey
Published: March 2012

The purpose of this investigation was to determine the effect of clindamycin hydrochloride, as an adjunct to scaling, on the microbiota associated with refractory periodontitis and to elucidate the probable causative bacteria associated with the disease. Microbial samples were collected from a subset of 9 patients with severe adult periodontitis who had not responded to conventional treatment modalities including the use of tetracycline and other antibiotics. Microbial samples were collected from a relatively deep site determined to be actively losing attachment and a comparably deep, but quiescent, control site in each patient prior to clindamycin therapy. Samples continued to be collected from the same sites for up to 1 year post‐therapy. The microbial flora of each sample were enumerated by darkfield microscopy and predominant cultivable methods. Prior to clindamycin therapy, both active and control sites consisted on average of approximately 50% spirochetes and motile rods and 40% Gram‐negative anaerobic rods. Bacteroides intermedius and Porphyromonas gingivalis (formerly B. gingivalis) were elevated in the active, as compared to control, sites and accounted for approximately 20% of the cultured microbiota in the former. Following treatment with clindamycin, the Gram‐negative components of the microbiota were either eliminated or severely suppressed. At 1 year post‐therapy, spirochetes and motile rods together accounted for about 15% of the microscopic flora. Total Gram‐negative anaerobic rods accounted for approximately 20%, and B. intermedius and P. gingivalis combined accounted for less than 2% of the cultured microbiota from historical active sites. Antibiotic susceptibilities were determined using strains isolated prior to and at 1 year after therapy. No significant increases in 6 bacteria resistant to clindamycin were noted in the post‐therapy microbiota. The suppression of the Gram‐negative portion of the microbiota coincided with previously reported clinical improvements obtained following the adjunctive use of clindamycin. J Periodontol 1990; 61:692–698.
The Osteogenic Potential of Two Composite Graft Systems Using Osteogenin
Authors: Doll B.A. , Towle H.J. , Hollinger J.O. , Reddi A. H. , Mellonig J.T.
Published: March 2012

The purpose of this study was to determine the quantity of new bone formation in critical sized calvaria defects in rats treated with two composite graft systems. The systems consisted of either a combination of the bone inductive protein (osteogenin) plus type I collagen (Os + C) or the combination of osteogenin with coralline hydroxyapatite (Os + HA). Additional treatments consisted of coralline hydroxyapatite (HA) or untreated control defects. After 28 days the calvaria were recovered and processed for quantitative radiography (radiomorphometry) and histomorphometry. Histomorphometric results were based on quantitation of regenerated trabecular bone. Results indicated that the Os + C combination produced substantially more bone than the Os + HA, HA, or control groups (P < 0.05). Radiomorphometric assessment was based on the detection of radiopacity in the calvarial wounds. Due to the radiopaque property of HA, it was not possible to accurately quantitate the radiopacity of the regenerating bone from HA and host bone. Therefore, conclusions about the efficacy of the treatments must be derived from histomorphometric data. Results from histometric measurements of healing indicate that the Os + C combination has the greatest potential for regenerating calvarial bone defects. The potential for osteogenin in regenerating alveolar bone lost due to periodontal disease is suggested by these studies. J Periodontol 1990; 61:745–750.
Necrotizing Ulcerative Gingivitis and Cancrum Oris (noma) in Ibadan, Nigeria
Authors: Osuji Oliver O.
Published: March 2012

This study analyzed 58 cases of necrotizing ulcerative gingivitis (NUG) and 5 cases of cancrum oris among children who sought treatment at the Ibadan University College Hospital, Dental Centre in a 1‐year period. The peak occurrence of NUG was among 4and 5‐year old children and 84.5% of them were in the 2 to 7 years age range. Seventytwo percent presented in the rainy season with positive history of recent febrile illness in 55 cases. There was no statistically significant association of NUG and rainy season. Possible predisposing factors in NUG and cancrum oris such as malnutrition, infectious childhood diseases, HIV infection, and immune compromise are discussed. It is suggested that children at risk should be advised to maintain good oral hygiene, adequate nutrition, and proper medical care. J Periodontol 1990; 61:769–772.
The Effect of Air Abrasive Polishing on Blood pH and Electrolyte Concentrations in Healthy Mongrel Dogs
Authors: Snyder Joseph A. , McVay Jesse T. , Brown Frederic H. , Stoffers Kenneth W. , Harvey Roger C. , Houston Glen D. , Patrissi Geoffrey A.
Published: March 2012

The recent re‐emergence of air abrasive polishing as an adjunct to professional tooth cleaning has been accompanied by a substantial amount of research. Most of this research has focused on the efficacy of the Prophy‐Jet and similar devices in the removal of plaque and stain and on the effects of such devices on restorative materials and the various hard structures of the tooth. Little attention has been paid to the effects of mucosal absorption of the sodium bicarbonate in the polishing abrasive. The purpose of this study was to measure any changes in arterial blood chemistry resulting from the use of the Prophy‐Jet. The values for pH, sodium, and bicarbonate, as well as other electrolytes, were measured in 10 dogs over a 2 hour period following a 5 minute timed use of the Prophy‐Jet. Of all the parameters examined, only the potassium concentration showed a statistically significant change, and the magnitude of this change was not felt to be clinically significant. The pH and concentrations of sodium and bicarbonate remained essentially unchanged with the use of the Prophy‐Jet. J Periodontol 1990;61:81–86.
Histological Differences Between Teeth With Adult Periodontitis and Pre‐Pubertal Periodontitis
Authors: López Néstor J. , Gigoux Carlos , Canales Maria L.
Published: March 2012

Thirty‐nine permanent teeth from three siblings aged 11 to 14 years were extracted because of generalized prepubertal periodontitis (PP) and studied histologically with light microscopy. Twenty healthy teeth (HT) removed for orthodontic procedures from 10 children of similar ages and 22 teeth affected by adult periodontitis (AP) extracted from patients over 50 years old were used as controls. The cementum of the PP teeth was much thicker than that of the healthy teeth. A high percentage of resorption, unrelated to inflammation, was found in all the teeth studied. In 24 PP teeth the cementum was infiltrated by microorganisms and bacterial substances. All PP teeth showed a cuticle ranging from 10 to 80 μm in thickness on the diseased cementum. No similar structure was noted on the diseased cementum of the AP teeth. The PP teeth did not show any structural changes which could account for the severity of the periodontal lesions. J Periodontol 1990;61:87–94
Localized Ridge Augmentation in Dogs: A Pilot Study Using Membranes and Hydroxyapatite
Authors: Seibert Jay , Nyman Sture
Published: March 2012

This study was designed to evaluate the potential to reconstruct localized ridge defects with bone by preventing non‐osteogenic extraskelatal connective tissue from participating in the process of healing following experimental ridge augmentation treatment procedures. Following the elevation of buccal muco‐periosteal flaps, buccal, interproximal, and interradicular bone was removed to the apical level of the second and third premolar teeth and the teeth were extracted to create bucco‐lingual ridge defects that averaged 13 mm x 7 mm x 3.5 mm in each quadrant of two adult beagle dogs. The defects were permitted to heal for 90 days. The defects did not fill in with new bone. Subsequently, buccal muco‐periosteal flaps were elevated and a membrane was placed over the defect and positioned so that it rested on bone that was exposed adjacent to the defect. In two quadrants test support materials were used to ensure that a space was maintained between the surface of the defect and the membrane. One quadrant was maintained as a sham‐operated control site, three sites received membranes and no supporting implants and two sites received supporting implants and no membranes. The surgical schedule was designed to yield sacrifice times of 8 to 12 weeks. In the three quadrants available for study that were covered with membranes, bone and/or nonmineralized connective tissue was found to fill all of the space that had been provided by the membrane. Histologic examination confirmed that the space was filled with young, actively growing bone by 90 days. No new bone formation (bone fill) was observed in the sham‐operated control site. J Periodontol 1990;61:157‐165.
The Association Between Palatal Grooves in Upper Incisors and Periodontal Complications
Authors: Bačić Miljenko , Karakaš Zlatko , Kaić Zvonimir , Šutalo Jozo
Published: March 2012

Palatal groove is a rare morphological defect of upper incisors, frequently associated with localized destruction of periodontal tissue with endodontic complications. In this study, a sample of 1,081 male, young adult subjects, aged 20 to 22, palatal grooving was recorded in 11 (1.01%) subjects, affecting 15 incisors. Among 634 adult subjects, aged 35 to 50, with periodontal disease, palatal groove was found in 5 (0.79%) incisors. Second incisors were more frequently (75%) associated with this anomaly. In the young adults, the mean probing pocket depth in the groove region and around other teeth of the intercanine area was 3.8 mm and 1.2 mm, respectively. In the group of periodontal patients, the mean probing pocket depth was significantly greater at the site of palatal groove (8.8 mm vs. 4.0 mm). J Periodontol 1990;61:197‐199.
Bone Formation in Tricalcium Phosphate‐Filled Periodontal Intrabony Lesions. Histological Observations in Humans
Authors: Saffar J.L. , Colombier M.L. , Detienville R.
Published: March 2012

The capacity of a tricalcium phosphate (TCP) ceramic to promote bone formation after grafting in intrabony defects was studied in humans. Five biopsies were collected from 4 patients during reentry surgery 16 to 40 months after implantation. They were processed without demineralization for histological examination. In the less mature samples, the grafted material was surrounded by a highly fibrous, highly cellular, and poorly vascularized connective tissue. Howship's lacuna‐like cavities were clearly visible at the surface of the material. They contained resorbing mononuclear phagocytes. At a more mature stage, TCP granules were embedded in an acellular fibrous material which underwent mineralization from the medullary spaces towards the granules. The bone formed was subsequently remodeled. The implanted material itself was progressively modified. It first acquired the staining appearance of bone. After its structure became loose and vacuolated, it was invaded by cells and vessels. The present data indicate that TCP has osteogenic potential and is subject to degradation. Unlike in experimental wounds, these processes are of long duration in human defects. J Periodontol 1990; 61:209–216.
Susceptibility and Resistance of Plaque Bacteria to Minocycline
Authors: O'Connor B.C. , Newman H. N. , Wilson M.
Published: March 2012

The in vitro susceptibility of 55 strains of subgingival plaque bacteria to minocycline was determined. A concentration of 1 μg/ml minocycline was found to inhibit 85% of the strains tested and the MIC ranged from 0.03 to 32 μg/ml. For 71% of the strains tested the MBC was at least 4 times greater than the corresponding MIC, suggesting a bacteriostatic activity for minocycline. A concentration of 20 mg/ml of magnesium ions was capable of neutralizing 8 μg/ml of minocycline and was used to eliminate “carryover” effects inherent in the experimental procedure. After 6 to 7 weeks exposure to sub‐lethal concentrations of minocycline there was no appreciable increase in the MICs of most organisms with the exception of Actinobacillus actinomycetemcomitans NCTC 10981 and Campylobacter concisus NCTC 11485. Short term (6 hour) exposure of bacteria to minocycline (8 μg/ml) markedly reduced the viability of a number of periodontopathogens but had little effect on the viability of Veillonello parvula NCTC 11456 and Fusobacterium nucleatum NCTC 11326. These in vitro investigations have demonstrated that minocycline is capable of inhibiting most of the periodontitis‐associated bacteria tested and can kill some of these bacteria after a comparatively short exposure time. However, some of the organisms tested exhibited a low susceptibility to minocycline and others became less susceptible following exposure to low concentrations of the antibiotic for several weeks. J Periodontol 1990;61:228‐233.
Effects on the Periodontium Following Corticotomy‐Facilitated Orthodontics. Case Reports
Authors: Gantes Bernard , Rathbun Eugene , Anholm Milford
Published: March 2012

This report describes the corticotomy surgical technique used in conjunction with orthodontic therapy and its effect on the periodontal status of the involved teeth. The surgical procedure included intracrevicular incisions and elevation of buccal and lingual mucoperiosteal flaps. Buccal and lingual vertical grooves penetrating the cortical bone were then made between the roots. These grooves were extended from just below the interproximal alveolar bone margin to beyond the apex levels of the teeth. Buccal and lingual horizontal grooves joined the apical extensions of the vertical grooves. The orthodontic appliance was activated immediately upon wound closure. Plaque scores, probing depths, and probing attachment levels were recorded before the surgical procedure and after the completion of the orthodontic treatment in 5 patients. The results showed that the corticotomy procedure caused minimal changes in the periodontal attachment apparatus. J Periodontol 1990;61:234‐238.
Detection of Bacteroides gingivalis Antigenic Proteins by Immunoblotting Analysis
Authors: Laosrisin Narongsak , Nakashima Keisuke , Ishikawa Isao
Published: March 2012

Elevated serum IgG antibody levels against B. gingivalis have been found in patients with periodontitis. In this study, we determined the antigenic specificity of the serum antibodies directed towards antigens of B. gingivalis. The serum samples collected from 19 control subjects with clinically healthy gingiva, 26 adult periodontitis (AP), and 21 rapidly progressive periodontitis (RPP) patients were analyzed by using SDS‐PAGE and Western blots. The sonicated cell extract of B. gingivalis 381 was solubilized in sodium dodecyl sulfate solution by heating at 100†C for 5 minutes. After SDS‐PAGE, the proteins were transferred to nitrocellulose membrane, and then were probed with serum samples. The strong reaction observed at the apparent molecular weight of 44 kDa protein suggested that it might be an important component which was specific to the antibody of patients (P<0.01). A clear difference in the antibody binding between the serum samples from AP and RPP was also recognized. The antibodies from AP frequently reacted with high molecular weight proteins (82, 57, and 44 kDa) while those from RPP frequently reacted with lower molecular weight proteins (44, 27, 25, and 18 kDa). The results indicate that the antigenic components detected in B. gingivalis are in sufficient amounts and specificities to be immunogenic to the host, particularly in patients with periodontitis. J Periodontol 1990;61:261‐268.
A Computer‐Aided Image Analysis System for Area Measurement of Tooth Root Surfaces
Authors: Verdonschot E.H. , Sanders A.J. , Plasschaert A.J.
Published: March 2012

The characteristics of a computer‐aided Image Analysis System (IAS) to conduct linear and area measurements on tooth root surfaces were investigated. The borders of the features to be measured were extracted from a digitized video image by histogrambased thresholding and binarization. The lengths and square areas were expressed in the number of pixels. The reference‐length and area of one pixel were obtained through measurement of the diameter of a metal ball of known diameter in the same digital image. The validity of the IAS was tested using radiographs of teeth containing round metal restorations of known diameter and area. The accuracy of the length measurements ranged from –2.0 to 2.1%, whereas the accuracy of area measurement was between –5.3 and 0.8%. The precision of the IAS to identify the borders of a tooth root surface and to reproducibly calculate its area, expressed in a coefficient of variation, ranges from 0.49 to 4.11%. The results indicate that imaging techniques can be applied to obtain very accurate measurements of tooth root surfaces. J Periodontol 1990;61:275–280.
The Effect of Systemic Metronidazole After Non‐Surgical Treatment in Moderate and Advanced Periodontitis in Young Adults
Authors: Söder Per‐Östen , Frithiof Lars , Wikner Sune , Wouters Francis , Engström Per‐Erik , Rubin Björn , Nedlich Ulla , Söder Birgitta
Published: March 2012

The effect of adjunctive systemic Metronidazole was studied in patients with moderate and advanced periodontitis recalcitrant to comprehensive non‐surgical treatment. The material originated from a randomly selected part of the population aged 31 to 40 years. After non‐surgical treatment of 149 patients, 98 with persisting pathological pockets ≥ 5 mm (52 men and 46 women) became the subjects for the study. Clinical parameters were registered and pocket contents subjected to laboratory analysis. The subjects were randomized into two groups according to a code list known only by the manufacturer and the statistician. The test group took three 400 mg metronidazole tablets daily for 1 week and the control group took placebo tablets. Reassessment 6 months later showed statistically significant clinical improvement, with a reduction in the number of sites ≥ 5 mm in both test and control groups. Complete healing, with no pockets ≥ 5 mm, was noted in 30% of the test group and 9% of the control group. The difference is statistically significant and shows the supplementary effect of adjunctive metronidazole in non‐surgical treatment of moderate and advanced periodontitis. J Periodontol 1990;61:281–288.
A Quantitative Study of Cementum Removal With Hand Curettes
Authors: Coldiron Nancy B. , Yukna Raymond A. , Weir Jim , Caudill Richard F.
Published: March 2012

An in vitro study was conducted to quantitatively measure the depth of root surface removal using curettes of standardized sharpness and with definite stroke number. Extracted periodontally healthy teeth from patients 10 to 15, 16 to 25, and 26 to 40 years old had periodontal ligament remnants removed with dry gauze before being secured in a vertical position during root planing. The force applied to the root surface was measured with a tension load cell. The “bright line” test was used to assess curette sharpness. After histologic processing, the thickness of cementum adjacent to the root defect, the cementum (if any) in the root defect, total amount of cementum removed, and depth of root defect were measured by a microscopic ocular grid. Teeth from each age range were evenly distributed into 6 groups of 10 teeth each. In the majority of teeth from the 20 stroke group through the 70 stroke group, complete cementum removal was observed at the site of planing. However, in some sections from each group, fragments of cementum remained on the root surface. A positive relationship (r/s = 1) was found between the number of strokes and the force applied to the root surface and the mean depth of defect (P < 0.05). However, an inverse relationship existed between mean force per stroke and mean defect depth (r/s = –.99) such that as mean force per stroke increased, the mean defect depth decreased. As the root surface became smoother with an increasing number of strokes, the forces increased and were more consistent. This study showed that for “healthy” root surfaces, total cementum removal was generally achieved with a minimum of 20 strokes at the same exact location on the root surface; however, cemental fragments remained in various sections even in the 70 stroke group. This finding emphasizes the inconsistency of present mechanical therapy and points to the significance of chemical treatment or detoxification in achieving a predictable healing response. The results also suggest that effective root planing in a quadrant would take at least 90 minutes. J Periodontol 1990;61:293–299.
Estimation of Dental Plaque Levels and Gingival Inflammation Using a Simple Oral Rinse Technique
Authors: Tal Haim , Rosenberg Mel
Published: March 2012

A simple, non‐invasive test (the Oratest) has recently been proposed, which provides an estimate of oral microbial levels based on the rate of oxygen depletion in expectorated milk samples. Following 30 seconds of vigorous rinsing with sterilized milk, 3 ml of the expectorate is added to a test tube containing the redox indicator, methylene blue, and the time required for a color change from blue (i.e., aerobic conditions) to white (anaerobic conditions) at the bottom of the test tube is recorded. In the present study, Oratest scores were compared to clinical parameters (Plaque Index [PI] and Gingival Index [GI]) in a group of 49 volunteers. Significant correlations were found between the logarithm of Oratest results and PI (r= –0.58; P = 0.001) as well as GI (r= –0.66; P = 0.001). The data indicate that the Oratest provides a reliable estimate of gingival inflammation, thus extending the previously reported strong correlations between Oratest scores and microbial counts. The data suggest that the Oratest may have potential as a clinical and research tool. J Periodontol 1990; 61:339–342.
Association of Smoking With Periodontal Treatment Needs
Authors: Goultschin Josef , Cohen Harold D. Sgan , Donchin Milka , Brayer Laurentiu , Soskolne W. Aubrey
Published: March 2012

A total of 344 jerusalem hospital personnel participated in the present survey which examined periodontal needs according to CPITN (a measure of treatment needs) and smoking habits. Females and younger subjects were found to be generally periodontally healthier than their male and older counterparts. The effect of both smoking and the number of cigarettes smoked were shown to have a clearly deleterious effect on periodontal status when assessed using the CPITN. Younger women were found to be most susceptible to this effect. J Periodontol 1990;61:364–367.
Assessment of Relationships Between Site‐Specific Variables
Authors: Hujoel P.P. , Loesche W.J. , DeRouen T.A.
Published: March 2012

The assessment of relationships between site‐specific variables has been a matter of controversy because of the claim that periodontal sites within individuals can be used as independent observations in statistical models. One problem with this approach is the unreliability of the calculated Type I and Type II error rates. Another problem is that such inappropriate analysis may prohibit a correct assessment of causal relationships between site‐specific variables. The host‐factor can act as an effect modifier and modulate the magnitude of the site‐specific effects and/or the host‐factor can act as a confounder by superimposing a patient‐effect on the studied site‐specific effects leading to bias. As a result, site‐specific biological mechanisms of disease progression may be misinterpreted. Sites can be used as the experimental unit of analysis, but the sampling design from which the site‐specific data originated should not be ignored. J Periodontol 1990;61:368–372.
Serum Antibodies to Periodontal Bacteria
Authors: Gunsolley J.C. , Tew J.G. , Gooss C. , Marshall D.R. , Burmeister J.A. , Schenkein H.A.
Published: March 2012

The purpose of this study was to determine how serum antibodies reactive with periodontitis‐associated bacteria with relates to the diagnosis of periodontitis subjects. Study groups included localized juvenile periodontitis (LJP) subjects, severe periodontitis (SP) subjects, chronic adult periodontitis (AP) subjects, and age matched controls. Twentytwo bacterial strains, representing 18 different species most commonly found in early onset periodontitis were evaluated using serum from LJP, SP, and age matched controls. Serum IgG reactive with these organisms was determined using a radioimmunoassay (RIA). Serum antibody reactive with 13 bacterial strains differed significantly (P<0.01) between the three clinical groups. Discriminate analysis revealed that antibodies reactive with 5 bacterial strains of the 13 were able to identify the clinical group to which subjects belonged 79% of the time with control subjects being correctly identified 100% of the time, LJP subjects 78% of the time, and SP subjects 60% of the time. These strains included two strains of Actinobacillus actinomycetemcomitans (Y4 and N27), Fusobacterium nucleatum (E1D1), Eubacterium brachy, and Bacteroides gingivalis. The low classification rate of SP subjects suggested heterogeneity. The SP group could be divided into three subgroups using the serological data. One subgroup, with “super” severe attachment loss, generally lacked antibody reactive with these five organisms, another subgroup was serologically similar to LJP subjects, while the third subgroup had antibodies to additional organisms. This suggests that some SP subjects may represent a more advanced form of LJP. Comparison of antibody reactivity of AP subjects with age matched controls to 23 bacterial types revealed that mean serum antibody reactivity to only Bacteroides gingivalis was higher in AP subjects. The results of this study suggest that current clinical classifications can yield heterogeneous groups of patients and that serum antibody reactive with some organisms may help separate these larger groups into more homogeneous subgroups. J Periodontol 1990;61:412–419.
Periodontal Effects Associated With the Use of Smokeless Tobacco
Authors: Robertson P. B. , Walsh M. , Greene J. , Ernster V. , Grady D. , Hauck W.
Published: March 2012

This report describes periodontal findings from a comprehensive study of smokeless tobacco use in professional baseball players. Subjects consisted of 1,094 players, coaches, and training staff of seven major league and their associated minor league teams. Before being examined, subjects completed questionnaires on patterns of smokeless tobacco use (validated by blood chemistry studies), rinsed their mouths under supervision, and were cautioned not to discuss their use of tobacco with the dental examiners. They then received a complete oral examination that included recording of all mucosal abnormalities, missing teeth, caries, extrinsic stain, attrition, Plaque Index, Gingival Index, pocket depth, attachment loss, and gingival recession. More than 50% of team members reported using smokeless tobacco, and 39% reported use during the current week. Among current week users, 46% had oral mucosal lesions, located primarily in the mandible at sites where the smokeless tobacco quid was placed. The use of smokeless tobacco was not necessarily associated with severe forms of periodontal disease, and the presence of poor oral hygiene and gingivitis in these users was not related to the development of oral lesions. However, sites adjacent to mucosal lesions in smokeless tobacco users showed significantly greater recession and attachment loss than in sites not adjacent to lesions in users or comparable sites in non‐users. J Periodontol 1996;61:438–443.
The Histologic Evaluation of New Attachment in Periodontally Diseased Human Roots Treated With Tetracycline‐Hydrochloride and Fibronectin
Authors: Alger F.A. , Solt C.W. , Vuddhakanok S. , Miles K.
Published: March 2012

The purpose of this study was to determine how the treatment of human tooth roots with tetracycline‐HCl and fibronectin during periodontal surgery influences the attachment of the gingiva to the root surface. Mucoperiosteal flap surgery was performed on 22 teeth with periodontal disease. Teeth were assigned to three groups. Group one received surgery with degranulation and root planing. Group two received surgery with treatment of roots with tetracycline‐HCl. Group three received surgery with treatment of roots with tetracycline‐HCl and fibronectin. At 90 days, block sections were taken and teeth, gingiva, alveolar bone, and periodontal ligament were evaluated histologically. Controls healed with a long junctional epithelial attachment. Tetracycline and tetracycline with fibronectin groups demonstrated some reattachment, but only within the notches placed in the root at the original level of the bone. There was a trend for greater connective tissue attachment following tetracycline‐HCl treatment of roots. The additional application of fibronectin to tetracycline treated roots appeared to partially negate the enhanced connective tissue attachment observed with tetracycline treatment alone. J Periodontol 1990; 61:447–455.
The Effects of Scaling Titanium Implant Surfaces With Metal and Plastic Instruments on Cell Attachment
Authors: Dmytiyk John J. , Fox Steven C. , Moriarty John D.
Published: March 2012

This study examined the ability of tissue culture fibroblasts to attach and colonize on the surface of pure titanium dental implants following instrumentation of the implant surface with curettes of dissimilar composition. Pure titanium dental implants were scaled with a plastic, titanium‐alloy, or stainless steel curette and then immersed in a cell suspension of 3T3 fibroblasts. Counts of attached cells were made at 24 and 72 hours; the implants were then processed for scanning electron microscopy (SEM). At 24 hours, only surfaces scaled with a stainless steel curette showed a significant reduction in number of attached cells relative to untreated control surfaces. At 72 hours, both stainless steel and titanium‐alloy curette instrumented surfaces showed significantly fewer attached cells than untreated control surfaces, with the greatest reduction in cell attachment observed on the stainless steel curette instrumented surfaces. SEM observations showed that fibroblasts on stainless steel instrumented surfaces tended to show a somewhat rounded morphology and a relatively reduced degree of spreading; while fibroblasts on untreated control, plastic, or titanium‐alloy instrumented surfaces showed a well‐spread, polygonal morphology, more typical of fibroblasts in favorable culture conditions. To the extent that such observations of cell attachment and morphology are indicative of in vivo biocompatibility, these findings could have clinical implications for the proper maintenance of titanium dental implants. J Periodontol 1990; 61:491–496.
Comparison of Measurement Variability Using a Standard and Constant Force Periodontal Probe
Authors: Osborn Joy , Stoltenberg Jill , Huso Beverly , Aeppli Dorothee , Pihlstrom Bruce
Published: March 2012

This study compared the intra‐ and inter‐examiner reliability of the Florida Probe, Florida Disk Probe, and conventional periodontal probe. Using these instruments, each of three examiners made repeated measurements of probing depth (using the Florida Probe and conventional probe), relative attachment level (using the Florida Disk Probe), and clinical attachment level (using a conventional probe) at posterior, proximal sites in 10 subjects with early periodontitis. The mean intra‐examiner standard deviation of differences in repeated probing depth measurements ranged from 0.46 to 0.77 mm demonstrating similar levels of reproducibility between the Florida Probe and conventional probe. The mean intra‐examiner standard deviation of differences in repeated relative attachment level measurements using the Florida Disk Probe ranged from 0.44 to 0.57 mm using double passes and from 0.98 to 1.41 mm using single passes of measurements. For clinical attachment level measurements obtained using single passes of measurements with a conventional probe, the mean intra‐examiner standard deviation of differences ranged from 0.78 to 0.95 mm. Inter‐examiner variability was generally greater than intraexaminer variability for all instruments. It was concluded that double passes with the Florida Disk Probe offers significant advantages for measuring relative attachment level in longitudinal studies of early periodontitis when decisions for change must be made as soon as possible. J Periodontol 1990; 61:497–503.
Scanning Electron Microscopic Observations of Cell Population and Bacterial Contamination of Membranes Used for Guided Periodontal Tissue Regeneration in Humans
Authors: Selvig Knut A. , Nilveus Rolf E. , Fitzmorris Linda , Kersten Betty , Khorsandi Sam S.
Published: March 2012

Fourteen intrabony periodontal defects and six furcation defects (Class II) were treated by a flap procedure which included the use of a polytetrafluoroethylene membrane to allow guided tissue regeneration. After 4 to 6 weeks of healing, the membranes were retrieved and examined by scanning electron microscopy for the presence of adherent cells and other tissue elements. The cervical open pore‐structured collar of the membrane, which in most cases had become partially exposed to the oral cavity, had a deposit of bacterial plaque. Bacterial colonies and a scatter of single cells in some instances extended into the mid‐third of the membrane. Fibroblast‐like cells and, in some specimens, blood vessels and fibrous structures were seen in the mid‐third and deep parts of the membrane. Generally, however, the occlusive portion of the membrane was characterized by a sparseness of adherent tissue elements. There did not seem to be a systematic difference in the nature and distribution of the adherent structures on the inner and outer surfaces of the membrane. The findings suggest that, in addition to preventing flap tissues from contacting the root surface, an important function of the membrane is to protect the integrity of the underlying blood clot by diverting mechanical stress acting on the flap during early stages of healing. J Periodontol 1990; 61:515–520.
Periodontal Disease Activity: A Critical Assessment
Authors: Greenstein Gary , Caton Jack
Published: March 2012

Review of investigations using longitudinal probing and radiographic assessments indicate that the prevalence, magnitude, rate, and temporal patterns of periodontal destruction as well as the ability of clinical and laboratory tests to detect and predict loss of clinical attachment need further investigation. These unresolved issues are discussed and their impact on the practice of periodontics is examined. J Periodontal 1990; 61:543–552.
Effects of Anesthetics Containing Epinephrine on Catecholamine Levels During Periodontal Surgery
Authors: Davenport Robert E. , Porcelli Robert J. , Iacono Vincent J. , Bonura Concetta F. , Mallis George I. , Baer Paul N.
Published: March 2012

Nine stable cardiovascular disease patients were evaluated in a double‐blind crossover trial during periodontal surgery using 2% lidocaine with epinephrine 1:100,000 or lidocaine alone. In the lidocaine with epinephrine group, epinephrine levels increased from 198 ±54 pg/ml to 592±166 pg/ml at 2 minutes post‐injection. In the lidocaine alone group, epinephrine levels increased from a baseline of 115±34 pg/ml to 150±34 pg/ml at 2 minutes post‐injection. Despite these elevations in epinephrine, no significant changes in heart rate or mean arterial pressure were noted. Plain lidocaine provided unsatisfactory levels of hemostasis and/or anesthesia during periodontal surgery. This study documents acute elevations in plasma epinephrine levels following local dental anesthesia for periodontal surgery. These elevations in plasma epinephrine failed to produce a significant cardiovascular response in a group of stable cardiovascular disease patients. This suggests that the cardiac effects of local anesthetics containing epinephrine are small and that they can be safely used in stable cardiovascular disease patients. J Periodontol 1990; 61:553–558.
Treatment of Class II Furcation Defects Using Porous Hydroxylapatite in Conjunction With a Polytetrafluoroethylene Membrane
Authors: Lekovic V. , Kenney E.B. , Carranza F.A. , Danilovic V.
Published: March 2012

The purpose of the present study was to determine whether the use of a porous hydroxylapatite in conjunction with guided tissue regeneration technique influenced the clinical results in the treatment of Class II furcation defects in humans. Fifteen subjects with a mean age of 39.4 ± 9.3 years were used in this study. All subjects had Class II furcation defects on the buccal surfaces of 2 lower molars. In each subject one furcation defect was filled with granular porous hydroxylapatite and then a barrier of polytetrafluoroethylene periodontal material was positioned over the furcation. The other furca was treated in the same manner except that no hydroxylapatite was used. The flaps were placed coronally to their presurgical level. Before the surgery and 6 months postsurgery all areas were clinically evaluated using the same clinical parameters. Reentry procedures were used to repeat measurements of the osseous defects made during the initial surgery. At 6 months both surgical procedures resulted in statistically significant reduction in pocket depth and gain in probing attachment level with no significant difference between the two surgical procedures. When porous hydroxylapatite was used in conjunction with a polytetrafluoroethylene membrane, however, less gingival recession and more defect fill were obtained. This study suggests that there is a difference in healing of molar furcations when porous hydroxylapatite is used in conjunction with a barrier membrane. The lesions treated with porous hydroxylapatite gain in clinical attachment and horizontal and vertical bone fill, while the lesions treated with membrane only gain probing attachment with less bony fill. J Periodontol 1990; 61:575‐578.
Recolonization of the Subgingival Microflora After Scaling and Root Planing in Human Periodontitis
Authors: Sbordone Ludovico , Ramaglia Luca , Gulletta Elio , Iacono Vincent
Published: March 2012

The purpose of this study was to evaluate the recolonization patterns of the subgingival microflora of adult periodontitis patients after a single session of scaling and root planing. In each of eight patients, three clinically diseased sites were investigated microbiologically by darkfield microscopy and cultural analysis. After initial clinical and microbiological parameters were determined, each subject received a single session of scaling and root planing but no oral hygiene instructions. Clinical indices were measured and microbial parameters were reassessed 7, 21, and 60 days after treatment in a manner such that each of the test sites was sampled only once after treatment. Recolonization was evaluated by matching any single site with its own preoperative site. A significant improvement in probing depth was noted for up to 60 days after treatment, while the gingival index did not change markedly during the course of the study. The microbial composition of treated sites 7 days after scaling and root planing, as determined by both cultural and darkfield data, was similar to that of periodontally healthy sites. Differences between cultural and darkfield data became apparent at the 21 day sampling point. The darkfield data showed that the sites consisted of cocci with few spirochetes. Cultural data demonstrated that the majority of the cocci were anaerobic, namely Streptococcus intermedius, Veillonella parvula, and Peptostreptococcus micros. At 60 days, there was no significant variation in any of the parameters from pretreatment levels. The most prevalent anaerobic rods prior to and 60 days after therapy were Fusobacterium nucleatum, Bacteroides gingivalis, and B. intermedius. These results indicate that a single session of scaling and root planing is clearly insufficient to maintain a healthy subgingival microflora. The conflicting findings between darkfield microscopy and cultural microbiology and between darkfield microscopy and clinical gingival inflammation suggest that darkfield microscopy is inadequate to identify a pathogenic microflora. J Periodontol 1990; 61:579–584.
Formation of a Periodontal Ligament Around Titanium Implants
Authors: Buser Daniel , Warrer Kirsten , Karring Thorkild
Published: March 2012

The aim of this study was to examine wound healing events around titanium implants in the presence of retained root tips whose periodontium could serve as a source for cells which could participate in the healing process. Hollow cylinder implants with a titanium plasma‐sprayed surface were placed in the mandible of monkeys where the apical portions of previously removed teeth were retained. After a healing period of 12 months, free of functional loading, the implants with surrounding tissues were removed and specimens analyzed in undecalcified sections. This report describes histologic findings of six such implants. Microscopic analysis revealed that in regions where implants were close to retained roots, a periodontal ligament had formed around large portions of the implant. Furthermore, there was a distinct layer of cementum on the implant surface and a periodontal ligament with collagen fibers perpendicularly oriented to the implant surface, implanted into the cementum on the implant surface as well as to the opposing bone. This initial observation suggests that it may be possible to achieve an anchorage of certain dental implants with a periodontium simulating that found surrounding the normal tooth. Furthermore, these findings provide the basis for further studies on regeneration of all components of the periodontal attachment apparatus including cementum, periodontal ligament, and bone. J Periodontol 1990;61:597–601.
Nifedipine‐Induced Gingival Hyperplasia: A Clinical and In Vitro Study
Authors: Nishikawa Seiji , Tada Hiroko , Hamasaki Akihiro , Kasahara Shinji , Kido Jun‐ichi , Nagata Toshihiko , Ishida Hiroshi , Wakano Yoichi
Published: March 2012

Two cases of gingival hyperplasia associated with long‐term administration of nifedipine, a drug that dilates coronary arteries, are reported. The clinical and histopathological features of the gingival hyperplasia induced by nifedipine were similar to those induced by phenytoin, an anticonvulsant drug. In the present cases, gingival inflammation had developed before drug administration. In one case, extensive dental plaque control in addition to surgical removal of the overgrown gingival tissues resulted in satisfactory progress without the need to discontinue drug administration, suggesting that the preexisting gingival inflammation was involved in the development of this periodontal disease. In the other case, change from nifedipine to another drug resulted in spontaneous recovery, strongly suggesting that the drug had induced the gingival hyperplasia. Nifedipine had no direct effects in vitro on proliferation or collagen synthesis of gingival fibroblastic cells from one of the patients. Study of these two cases suggests that both local inflammatory factors and long‐term administration of nifedipine were responsible for the gingival hyperplastic changes observed. J Periodontol 1991;62:30–35.
Localization of Interleukin‐lβ in Human Periodontal Tissue
Authors: Jandinski J.J. , Stashenko P. , Feder L.S. , Leung C.C. , Peros W.J. , Rynar J.E. , Deasy M.J.
Published: March 2012

Interleukin‐ 1β (IL‐1β) is the predominant form of IL‐1 produced by macrophages. IL‐1β possesses numerous and diverse biological activities. Several of these activities, including fibroblast proliferation, potentiation of the immune response, and stimulation of bone resorption may be of relevance to the pathogenesis of periodontal disease. This study was designed to examine the presence of IL‐1β in human periodontal tissue. An antiserum directed against the N‐terminal segment (117‐131) of human IL‐1β was used to detect IL‐1β using immunofluorescent staining techniques. IL‐1β positive staining cells were observed in both normal and diseased tissue and were limited to the lamina propria. Brightly staining cells were increased by almost 3‐fold in periodontally diseased tissue when compared to normal tissue. Low intensity staining cells were equally distributed in the normal and diseased specimens. We propose that IL‐1β and IL‐1β produced by cells in periodontal tissues may be related to the pathological processes associated with periodontal disease. J Periodontol 1991;62:36–43.
Prognosis Versus Actual Outcome: A Long‐Term Survey of 100 Treated Periodontal Patients Under Maintenance Care
Authors: McGuire Michael K.
Published: March 2012

One hundred treated periodontal patients under maintenance care were evaluated for 5 years, and 39 of these patients were followed for 8 years to determine the accuracy of assigned prognoses based on commonly taught clinical criteria. The results suggested that this population reflected many of the same characteristics seen in well‐maintained patients. The ultimate fate of teeth initially labeled as hopeless varied substantially, and even though the average prognosis of the teeth studied at each interval remained relatively stable over time, individual prognosis categories and individual tooth prognoses changed frequently. Possible reasons for these shifts are discussed. In conclusion, it was found that projections were ineffective in predicting any prognosis other than good, and that prognoses tended to be more accurate for single rooted teeth than for multi‐rooted teeth. Further evaluation of the data is needed to determine how each of the prognostic indicators relate to the success or failure of our projection. / Periodontol 1991; 62:51–58.