bluuebunny/crossref_metadata_2025 huggingface dataset:
Periodontal Repair in Dogs: Effect of a Composite Graft Protocol on Healing in Supraalveolar Periodontal Defects
Authors: Wikesjö Ulf M.E. , Bogle Gary C. , Nilvéus Rolf E.
Published: March 2012

This study evaluated the effect of a composite graft as an adjunct to gingival flap surgery in induced chronic supraalveolar periodontal defects in the mandibular premolar region in beagle dogs. The vertical dimension of the defects, measured from the cemento‐enamel junction to the alveolar bone, approximated 5 mm. Root surface treatment in quadrants receiving the graft protocol included conditioning with both critic acid and tetracycline. The composite graft (including: hydroxyapatite, freeze‐dried decalcified bone, tetracycline, and fibronectin) was then fitted to the defects. Flaps were placed and sutured to cover most of the crowns of the teeth, but the tips of the cusps. The root surfaces in contralateral jaw quadrants were conditioned with citric acid and the flaps similarly placed and sutured. Dogs were sacrificed 6 weeks after surgery and tissue blocks including teeth and surrounding structures processed for histometric analysis. Connective tissue repair to the root surface in teeth treated with the graft protocol approximated 60% of the defect height. Connective tissue repair in teeth treated with citric acid only was significantly greater and averaged 98% of the defect height (P ≥0.01). Cementum formation was limited following both treatments (approximately 6% of the defect height). Bone regeneration was significantly smaller in grafted sites than in sites treated with citric acid only (approximately 2% and 10% of the defect height, respectively; P ≤0.05). Root resorption was observed in almost all teeth. Ankylosis was present in two citric acid‐treated specimens, both from the same dog. Synergistic effects of some or all of the components of the graft protocol may have dictated the healing events in the grafted defects. The composite graft protocol did not offer any advantages over citric acid conditioning of the root surface as an adjunct to gingival flap surgery for periodontal reconstruction in this model system. It is unlikely that the composite graft offers any advantages over any other of its components used alone in regeneration attempts of periodontal defects. J Periodontol 1992; 63:107–113.
Root Surface Characteristics Associated With Subgingival Placement of Monolithic Tetracycline‐Impregnated Fibers
Authors: Morrison Scott L. , Cobb Charles M. , Kazakos George M. , Killoy William J.
Published: March 2012

The purpose of this investigation was to inspect and characterize the subgingival root surface after a 10‐day exposure in vivo to 25% tetracycline hydrochloride by weight in an ethylene vinyl acetate copolymer fiber matrix with and without root planing therapy. The root surfaces were examined by fluorescent‐light microscopy (FLM), scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS). Thirty‐two teeth were selected for study, 4 from each of 8 patients. The teeth of each patient were randomly assigned to one of four treatment groups: non‐treated control (C), scaling and root planing only (RP), tetracycline‐impregnated fiber only (F), and scaling and root planing with tetracycline‐impregnated fiber application (RP/F). SEM revealed a visible reduction in the subgingival microbial flora in both the F and RP/F treatment groups in comparison with the C group specimens. Many of the residual bacteria observed in F and RP/F specimens appeared non‐viable, exhibiting obvious loss of membrane integrity. In contrast, the RP specimens exhibited randomly distributed areas of residual subgingival plaque and calculus with newly developing plaque fronts; the plaque fronts undoubtedly having formed during the 10 days post‐therapy. All RP/F specimens exhibited an incomplete removal of adsorbed root surface pellicle and demineralization of the subsequently exposed root surface. EDS analysis of large crystals adhering to root surfaces of F and RP/F specimens revealed high chloride peaks, suggesting the presence of residual tetracycline. FLM examination of F and RP/F treated specimens showed a superficial penetration of tetracycline into the root surface of about 10 μm. Areas of demineralized root showed slight tetracycline penetration into exposed dentinal tubules. J Periodontol 1992; 63:137–143.
Cementai Tear Related to Rapid Periodontal Breakdown: A Case Report
Authors: Haney J. Marc , Leknes Knut N. , Lie Tryggve , Selvig Knut A. , Wikesjö Ulf M.E.
Published: March 2012

Cemental tears have been described both in exposed and unexposed cementum. The phenomenon is believed to be elicited by overloading or acute trauma from occlusion. In this case report a patient, with a history of periodontal health, presented with an acute periodontal lesion on the distal aspect of a bridge abutment tooth. Periapical radiographs demonstrated an extensive vertical intrabony defect adjacent to the vital abutment tooth containing a radiopaque “foreign body.” Histological examination of the surgically removed “foreign body” revealed a piece of dental cementum with some attached soft tissue. The lesion responded well to a surgical approach. Healing was uneventful and periodontal health was restored. This case illustrates that cemental tear should be considered as a differential diagnostic entity in isolated sites with rapid periodontal breakdown. J Periodontol 1992;63:220–224.
Soft Tissue Reactions to Non‐Submerged Unloaded Titanium Implants in Beagle Dogs
Authors: Buser Daniel , Weber Hans Peter , Donath Karl , Fiorellini Joseph P. , Paquette David W. , Williams Ray C.
Published: March 2012

The soft tissue reactions to non‐submerged unloaded titanium implants were examined. A total of 24 implants were placed in 6 beagle dogs. The implants differed in their crestal area by having either a rough sandblasted, a fine sandblasted, or a polished surface. After 3 months, all implants were firmly anchored in the bone and had no clinical signs of peri‐implant inflammation. Undecalcified histologic sections demonstrated that all implants achieved osseointegration with direct bone contact. The epithelial structures showed a peri‐implant sulcus with a non‐keratinized sulcular epithelium and a junctional epithelium. None of the sections exhibited epithelial downgrowth to the alveolar crest. In the supracrestal area, a direct connective tissue contact to the implant post was observed. An approximately 50 to 100 μm wide zone of dense circular fibers was found close to the implant surface. It was free of blood vessels and resembled closely an inflammation‐free scar tissue formation. This zone was surrounded by a looser connective tissue with a 3‐dimensional network of collagen fibers running in different directions. No significant differences concerning soft tissue reactions were found between the 3 implant surfaces. In particular, the length of direct connective tissue contact was similar. Concerning bone reactions, a significantly shorter distance from the top of the implant to the most coronal bone‐implant contact was observed for rough surfaces. It is concluded that non‐submerged unloaded titanium implants achieved a complication‐free tissue integration with a dense connective tissue in direct contact to the implant surface in the supracrestal area, and epithelial structures similar to those around natural teeth. The different surface textures did not influence the healing pattern of the soft tissues, but had an influence on the location of the most coronal bone‐implant contact. J Periodontol 1992; 63:226–236.
Risk Indicators for Future Clinical Attachment Loss in Adult Periodontitis. Tooth and Site Variables
Authors: Grbic John T. , Lamster Ira B.
Published: March 2012

In an earlier report, we examined the relationship of patient‐derived clinical and epidemiological variables to the risk for future clinical attachment loss (CAL) in chronic adult Periodontitis. We determined that the extent of the patient's existing periodontal disease as measured by mean attachment loss (MAL) and the patient's age were the most important patient‐derived risk indicators for CAL among those factors evaluated. In this study, we examined the tooth and site variables that were associated with CAL. Seventyfive patients with chronic adult Periodontitis were followed for 6 months. Clinical data at baseline, including attachment level and probing depth, were obtained from six sites per tooth. The hazard rate for CAL at all sites was 2.0%, and 4.1% of teeth displayed at least one site with CAL. Mandibular and maxillary molars and maxillary premolars displayed the highest incidence of CAL (6.1%, 5.6%, 5.5%, respectively), while maxillary anterior teeth (1.8%) and mandibular premolar teeth (2.1%) demonstrated the lowest incidence. The greatest number of sites demonstrating CAL had an existing attachment level of 4 to 7 mm and a probing depth of ≤ 5 mm. When the data were converted to hazard rates, however, an increase in hazard rate was seen with increasing existing attachment loss or probing depth. When MAL was considered, patients with mild and moderate Periodontitis demonstrated a relatively low incidence of CAL at sites with ≤ 7 mm of existing attachment loss. Patients with severe Periodontitis exhibited greater hazard rates for sites with 0 to 3, 4 to 5 and 6 to 7 mm of existing attachment loss. Regardless of the patient category, all sites with ≥ 8 mm of existing attachment loss demonstrated a significantly higher incidence of CAL. Similar results were seen for probing depth. When age was considered as a patient variable, all sites in patients who were in the 30 to 49 year‐old group demonstrated low hazard rates for CAL. For patients who were 50 to 59 years old, the hazard rate gradually rose with increasing existing attachment loss or increasing probing depth. For patients in the 60 to 69 year‐old group, sites with ≤ 5 mm of existing attachment loss and ≤ 3 mm probing depth did not differ in hazard rate from that seen in patients who were 50 to 59 years old. In the oldest group, sites with ≥ 6 mm of existing attachment loss and ≥ 4 mm of probing depth demonstrated hazard rates that were significantly greater than what was observed in the younger groups. These results suggest that both patient‐derived and site‐derived variables should be considered when developing a risk profile for CAL. These data may be useful in both treatment planning and selection of appropriate therapeutic modalities. J Periodontol 1992; 63:262–269.
Treponema denticola and Porphyromonas gingivalis as Prognostic Markers Following Periodontal Treatment
Authors: Simonson Lloyd G. , Robinson Peter J. , Pranger Rory J. , Cohen Mark E. , Morton Harold E.
Published: March 2012

Subgingival plaque samples were collected from individuals with advanced periodontitis before and 3 to 11 weeks after scaling and root planing periodontal treatment. The plaque levels of Treponema denticola and Porphyromonas gingivalis antigens were measured before and after treatment by a quantitative immunoassay procedure using monoclonal antibodies specific for these oral bacteria. A decrease in mean levels of T. denticola (P <.05) and P. gingivalis antigens (P <. 09) were observed following periodontal therapy. Improved health, as measured by a decrease in probing depth, was associated with a decrease in T. denticola antigen (P <.05). These results suggest that the T. denticola levels of successfully treated sites decreased, while non‐responding sites had levels of this microbial marker which were equal to or greater than the pre‐treatment levels. These results provide additional evidence that T. denticola is associated with human adult severe periodontal disease, and can serve as a prognostic marker for disease recurrence. J Periodontol 1992;63:270–273.
Microbiology of Healthy and Diseased Periodontal Sites in Poorly Controlled Insulin Dependent Diabetics
Authors: Mandell Robert L. , Dirienzo John , Kent Ralph , Joshipura Kaumudi , Haber Jerome
Published: March 2012

A group of poorly‐controlled insulin dependent diabetes mellitus (IDDM) patients were examined in a cross‐sectional design for total microbial levels, microbial incidence, and the percent levels of selected periodontal microorganisms. These organisms were selected on the basis of prior reports that associated them with either periodontal disease or health. One periodontally‐healthy and one periodontally‐diseased site were examined in each IDDM patient. Increased levels of the periodontal pathogens Prevotella intermedia, P. melaninogenica spp., Bacteroides gracilis, Eikenella corrodens, Fusobacterium nucleatum and Campylobacter rectus (formerly Wolinella recta) were found at the periodontal diseased sites. Increased prevalence of the organisms P. intermedia, P. melaninogenica spp., and C. rectus were found at the diseased sites. A significantly higher percentage of P. intermedia was found at the sites exhibiting deep pockets and attachment loss. J Periodontol 1992; 63:274–279.
Comparison of Measurement Variability in Subjects With Moderate Periodontitis Using a Conventional and Constant Force Periodontal Probe
Authors: Osbom Joy B. , Stoltenberg Jill L. , Huso Beverly A. , Aeppli Dorothee M. , Pihlstrom Bruce L.
Published: March 2012

This study compared the intra‐ and inter‐examiner measurement error of the Florida Probe, Florida Disk Probe, and conventional periodontal probe in persons having moderate to severe periodontitis. Single pass measurements using the conventional probe were compared to both single and double pass (corrected) measurements using the Florida Probe and Florida Disk Probe. The mean intra‐examiner standard deviations of differences in repeated site probing depth measurements ranged from 0.60 to 0.93 mm for the Florida Probe and from 0.52 to 0.89 mm for the conventional probe. Based on overall averages, the conventional probe measured deeper probing depths than the Florida Probe at the same sites. This difference was especially evident in pockets ≥ 6 mm in depth. Based on sites, the mean intra‐examiner standard deviations of differences in repeated relative attachment level measurements using the Florida Disk Probe ranged from 0.55 to 0.82 mm. The mean standard deviations of site measurements for attachment level obtained with the conventional probe ranged from 0.62 to 1.14 mm. Inter‐examiner measurement error was greater than intra‐examiner measurement error for each probing method. It was concluded that use of the Florida Probe and Florida Disk Probe may offer significant advantages in reducing measurement error for some clinical examiners. For other examiners, use of the Florida Probes do not necessarily result in less measurement error than use of conventional probing methods. J Periodontol 1992; 63:283–289.
Risk Indicators for Periodontitis in a Military Treatment Population
Authors: Horning Gregory M. , Hatch Craig L. , Cohen Mark E.
Published: March 2012

The association between the periodontal diagnosis and a variety of subject characteristics was studied in a group of 1,783 patients examined at a large military dental clinic. In order of importance, age greater than 30, smoking, male sex, and Filipino racial background were all found to be statistically significant risk indicators for the presence of moderate or advanced periodontitis. A logistic regression equation serving as a predictive model employing these four variables was presented. The strong association found between smoking and advanced periodontitis is consistent with the hypothesis that smoking has cumulative detrimental effects on periodontal health. While these and other risk indicators are neither causative, diagnostic, nor prognostic, they may be helpful in alerting the clinician to more carefully evaluate other clinical signs or laboratory findings of disease. J Periodontol 1992; 63:297‐302.
Microbiological Testing in the Diagnosis of Periodontal Disease
Authors: Listgarten Max A.
Published: March 2012

The oral microbiota plays a primary role in the initiation and progression of the most common forms of periodontal disease. Because of the multiplicity of factors that control the establishment and long‐term evolution of the oral microbiota, a great deal of heterogeneity exists in the composition of the periodontal microbiota among individual subjects. Despite these individual differences and the complex interactions between bacteria and the host and among bacteria, an association has been demonstrated between certain species and various forms of periodontal disease. However, the predictive value of either positive or negative tests for selected bacterial species has not proved to be high enough for routine use in clinical practice. Nevertheless, bacteriological tests have been of value in the management of patients with juvenile Periodontitis and refractory forms of periodontal disease. The increasing availability of diagnostic laboratory services and diagnostic kits for office use will make it easier for the practitioner to select appropriate antimicrobial treatments and monitor patients undergoing antimicrobial therapy. J Periodontol 1992; 63:332–337
Host Response Tests for Diagnosing Periodontal Diseases
Authors: Page Roy C.
Published: March 2012

Extensive data collected over the past decade demonstrate clearly that diseaseactive and disease‐inactive periodontal pockets exist, disease progression is infrequent and episodic, and most progression occurs in a small proportion of highly susceptible individuals. Furthermore, traditionally used diagnostic procedures do not identify susceptible individuals nor distinguish between disease‐active and disease‐inactive periodontal sites. New diagnostic tests based on host response factors that will aid in resolving these problems appear to be possible. Sources of material for use in such tests include gingival crevicular fluid (GCF), blood cells, and blood serum. Of these, components in GCF are most promising, at least in the immediate future. Although more than 40 GCF components have been studied, efforts that attempt to relate the presence and amount of a given component to an independent measure of active disease are very few in number. As a consequence, we do not yet know the potential for most GCF components as the basis of diagnostic tests. Those components that have been documented to associate with active disease as measured by attachment loss of 2 mm or greater include alkaline Phosphatase, β‐glucuronidase, prostaglandin‐E2, aspartate aminotransferase, and IgG4 antibody subclass. Even in these cases, the data base is small and additional clinical studies are needed to document claims. At the present time, tests based on β‐glucuronidase, nonspecific neutral proteases, and aspartate aminotransferase are being commercialized. One test has received FDA approval. Tests based on blood cells have limited application for patients with adult periodontitis, but are useful for patients with earlyonset forms of periodontitis. An abnormality in the leukocyte adherence molecules on the surfaces of neutrophils is diagnostic for generalized prepubertal periodontitis, and defects in chemotactic receptor numbers and in a surface molecule designated as GP110 are found on the neutrophils of most but not all localized juvenile periodontitis patients. Recent data indicate that enhanced unstimulated or stimulated release of PGE2 and Interleukin‐1 by peripheral blood monocytes may be an indicator of susceptibility to severe periodontitis. Assessment of the humoral immune response as reflected by serum antibodies to antigens of periodontopathic bacteria shows little promise as the basis for tests diagnostic of site‐specific disease activity. However, the capacity of an individual to mount an IgG2 subclass response to carbohydrate antigens may have potential as an indicator of disease susceptibility. J Periodontol 1992; 63:356–366.
Diagnosis of Periodontitis by Physical Measurement: Interpretation From Episodic Disease Hypothesis
Authors: Goodson J. Max
Published: March 2012

Physical measurements including the evaluation of probing depth, bleeding on probing, tooth mobility, and inflammation form the basis for most periodontal diagnostics in use today. The interpretation of these observations and the methods available for their measurement, however, have begun to change significantly. The episodic disease activity concept has done much to implement these changes. Observation of episodic attachment loss has been correlated with parallel radiographic changes, alteration in levels of probable pathogens, and changes in inflammatory mediator levels. The failure of pocket depth, suppuration, and bleeding on probing to predict episodic attachment loss has been given plausible explanations and enhanced meanings. Although attachment loss by a continuous process cannot be excluded in some disease conditions, the hypothesis of periodontal disease progression by episodic activity supplements and expands understanding of the disease process. Interest in periodontal diagnostics has accelerated in the last decade. As a parallel development, the technology of small computers has decreased in cost and increased in sophistication. The combination of these factors has created an environment for the development of intelligent diagnostic systems. Four commercially available systems and two systems under development are described. The systems, which measure pocket depth, pocket depth or attachment level, tooth mobility, and pocket temperature, all utilize computer processing of measurements. The result is to provide a simplified and more meaningful presentation of diagnostic information. As intelligent diagnostic systems prove themselves, some of these instruments are likely to become common to dental practice. The promise of more accurate identification of areas of the mouth that are diseased can increase both the efficiency and effectiveness of periodontal therapy. J Periodontol 1992; 63:373–382.
Incorporating New Technologies in Periodontal Diagnosis into Training Programs and Patient Care: A Critical Assessment and a Plan for the Future
Authors: Fine Daniel H.
Published: March 2012

New diagnostic technologies may be capable of providing the dental practitioner with powerful tools that can assist in the early identification of periodontal disease that can result in expediated treatment. In this paper, clinical, host, and microbiological parameters will be evaluated for their ability to assess disease activity and to assist in the treatment decision‐making process. The discussion will focus on: 1) the perceived need for markers of disease activity; 2) the most commonly proposed markers of disease activity currently under consideration for clinical application; and 3) a plan for future use of disease activity markers. The review concludes that: 1) tooth loss and most forms of rapid disease progression is limited to a small subset of patients within the periodontally diseased population; 2) no single parameter will stand alone as a measure of disease activity; 3) different aspects of treatment may require different combinations of tests to successfully intercept disease in this vulnerable patient group; and 4) early diagnosis can affect long‐term periodontal status. Best estimates are presented for: 1) pre‐disease identification of high‐risk population groups; 2) early diagnosis of disease activity on a site and patient basis; and 3) assistance in the therapeutic decision‐making process. It is further concluded that the complexity of the problem may require a re‐examination of priorities such that more time and money is allocated to early diagnosis as opposed to treatment in this highly vulnerable patient population. J Periodontal 1992; 63:383‐393.
The Effect of Cyclosporin and Lipopolysaccharide on Fibroblasts: Implications for Cyclosporin‐Induced Gingival Overgrowth
Authors: Barber Michael T. , Savage Neil W. , Seymour Gregory J.
Published: March 2012

Drug‐induced gingival overgrowth is an adverse side effect associated principally with 3 different types of drugs; specifically the antiepileptic phenytoin, the calcium channel antagonist nifedipine, and the immunosuppressant cyclosporin. The present study has analyzed the effect of cyclosporin and lipopolysaccharide on fibroblasts from 3 different sources: 1) normal healthy human gingiva (NHGF); 2) overgrown gingiva from 2 patients taking cyclosporin (CHGF); and 3) human fetal lung (WI‐38). Fibroblasts isolated from cyclosporin‐associated gingival overgrowth were significantly less responsive to cyclosporin in terms of DNA, total protein, and proteoglycan synthesis. This finding supports the in vivo response where few fibroblasts are seen but marked overgrowth of fibrous tissue occurs. Lipopolysaccharide derived from Fusobacterium nucleatum and Escherichia coli was capable of inhibiting DNA synthesis significantly in all 3 fibroblast types. Total protein synthesis by CHGF cells was inhibited differentially by Fusobacterium nucleatum LPS and addition of cyclosporin to this system resulted in reversal of the inhibition. A synergistic effect was noted when the proteoglycan output of NHGF cells was assessed in response to co‐incubation with cyclosporin and Escherichia coli LPS. The study shows that bacterial LPS may be an important co‐factor in the pathogenesis of cyclosporin‐induced gingival overgrowth. J Periodontol 1992; 63:397– 404.
Subgingival Distribution of Periodontal Pathogenic Microorganisms in Adult Periodontitis
Authors: Christersson Lars A. , Fransson Christer L. , Dunford Robert G. , Zambon Joseph J.
Published: March 2012

The association between specific plaque microorganisms and periodontal diseases has been the subject of much recent interest due to its potential importance in the diagnosis and classification of these diseases. In order to optimize microbiological tests in periodontal therapy, it is important to know how many subgingival plaque samples must be assayed from a single patient in order to ascertain infection with a periodontal pathogen. To answer this question the present study assessed the distribution of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, and Prevotella intermedia in multiple subgingival plaque samples. The samples were quantitatively assessed for specific bacteria by indirect immunofluorescence, a technique previously found to correlate well with cultural assessment of these same organisms. Subgingival plaque from the mesial pockets/sulci of all teeth except third molars was sampled in 12 patients with adult periodontitis, 22 to 28 sites/patient for a total of 315 samples. These patients demonstrated an average mesial probing depth and loss of attachment of 3.7 ± 1.2 mm and 3.1 ± 1.5 mm, respectively (mean ± SD). P. gingivalis, P. intermedia, and B. forsythus were demonstrated in one or more sites from all patients, while A. actinomycetemcomitans was found in one or more sites in 8 of 12 patients. The proportion of positive sites per subject varied, but it was, on average, similar for the 3 blackpigmented organisms and ranged from 44% to 54%. In contrast, A. actinomycetemcomitans was identified, on average, in only 11.4% of the sites in these same patients. Based on these prevalence rates and association with certain clinical measures, it is recommended that 6 or more random sites from adult periodontitis patients or 4 or more sites with probing pocket depth ≥5 mm be sampled in order to detect P. intermedia and 25 or more random sites to detect A. actinomycetemcomitans at a 95% confidence level. Six or more random sites or 3 or more subgingival sites with probing pocket depth ≥ 5 mm need to be sampled in order to detect B. forsythus or P. gingivalis at 95% probability. J Periodontal 1992; 63:418–125.
Clinical, Laboratory, and Immunological Studies of a Family with a High Prevalence of Generalized Prepubertal and Juvenile Periodontitis
Authors: López Néstor J.
Published: March 2012

A study of a consanguineous family with a high prevalence of localized juvenile Periodontitis (LJP) and generalized prepubertal Periodontitis (GPP) was done over a 7and‐a‐half year period. The parents had adult Periodontitis, while 2 daughters, aged 13 and 15, had LJP. Furthermore, 2 other daughters, ages 14 and 10, and a son, aged 9, were affected by GPP. Two remaining siblings were not affected. Clinical and radiographic examinations on all family members were done, and Chemotaxis for blood neutrophils was assessed. Laboratory tests, immunological examinations, and evaluation for neutrophil functions were done on the GPP patients. Microbiological cultures were performed on 2 of the GPP patients, as well as in the mother. The mother, the 2 LJP patients, and 1 of the unaffected siblings had depressed PMN Chemotaxis. The other family members, including the 3 GPP patients, had normal PMN Chemotaxis. GPP patients did not have any systemic disease, and evidence of major defects in the immunological functions was not detected. LJP patients were successfully treated with root planing, subgingival curettage, and tetracycline therapy. Intensive periodontal therapy, combined with systemic administration of antibiotics, was not effective in halting periodontal tissue destruction in the 3 GPP patients. Results indicate that the underlying cause of GPP is not always related to leukocyte dysfunction. Since Actinobacillus actinomycetemcomitans was the most frequent pathogen found in subgingival microflora of 2 of the GPP patients, it is assumed that it may play a key role in the etiology of GPP. J Periodontol 1992; 63:457–468.
In Vitro Phagocytosis by Crevicular Phagocytes in Various Forms of Periodontitis
Authors: Sigusch B. , Klinger G. , Holtz H. , Süss J.
Published: March 2012

Phagocytes from the gingival crevice fluid (CF‐cells) of 11 patients with localized juvenile and post‐juvenile periodontitis (LJP/PJP), 14 with rapidly progressive periodontitis (RPP), 11 with adult periodontitis (AP), and 14 controls without periodontal disease were examined. Phagocytic activity in vitro was assessed. Crevicular washings were obtained from healthy sites of controls and diseased sites of patients after completion of the oral hygiene phase (professional and home care). The cells were carefully processed to avoid mechanical damage. The in vitro phagocytosis by uptake of opsonized C. albicans was performed in a moist chamber (30 minutes, 37°C) and examined by light microscopy. CF‐cells were differentiated on the basis of their morphological appearance. The majority of cells in crevicular washings were PMNs, some macrophages, and few lymphocytes. Phagocytic activity in patients with LJP/PJP and RPP was significantly decreased in comparison with that from AP and the control group. The decreased percentage of cells phagocytosing opsonized C. albicans was associated with the enhanced adherence of opsonized C. albicans. Moreover cell viability of CF‐cells from LJP/PJP sites was significantly reduced. The data from the present study suggest that the in vitro phagocytosis of crevicular phagocytes in juvenile and rapidly progressive periodontitis lesions is diminished. J Periodontol 1992; 63:496–501.
Clinical and Light Microscopic Observations of Gingivitis and Early Ligature‐Induced Periodontitis in the Cynomolgus Monkey
Authors: Wirthlin M. Robert , Hussain M. Zamirul
Published: March 2012

Clinical and histological observations were made on gingivitis and ligature‐induced periodontitis in 4 adult female cynomolgus monkeys (Macaca fascicularis) to define the changes occurring in the early periodontitis lesion. Silk ligatures were tied around selected posterior teeth and replaced weekly for 4 weeks. The changes from gingivitis to periodontitis induced by ligation, and back to a state of clinical health after ligature removal, scaling and polishing, were characterized by Plaque Index, Gingival Index, probing pocket depth, attachment loss, and histologic evaluation. A mild, chronic marginal gingivitis was the normal finding in the gingiva of posterior teeth. The inflammatory infiltrate in the connective tissue contained primarily lymphocytes. Hygienic measures once a week reduced the amount of infiltrate and the epithelial proliferation, but did not eliminate it. Placement of silk ligatures rapidly changed the clinical picture to a moderate or severe gingivitis, which presented an almost bizarre response of sulcular and oral epithelium, with an increase in polymorphonuclear neutrophil infiltration. Within 2 weeks there was significant probing attachment loss. The clinical response on removal of ligatures and plaque was almost as rapid as the onset. The animal model is useful for manipulating variables in ways not possible in the study of human periodontitis. J Periodontol 1992:63:533–539.
The Effects of Chlorhexidine on the Attachment and Growth of Cultured Human Periodontal Cells
Authors: Cline Nancy V. , Layman Don L.
Published: March 2012

The purpose of this investigation was to evaluate the effects of Chlorhexidine (CHX) on the attachment and growth of human gingival fibroblasts and periodontal ligament cells using an in vitro system where periodontal cells were grown on root surfaces treated previously with CHX. Our results indicate that the attachment of periodontal cells onto root surfaces was not adversely affected when roots were treated for 15 minutes with up to 0.12% CHX. However, cell attachment and morphology were adversely altered with prior 0.2 to 2.0% CHX treatment. The cells appeared round and retracted from roots treated with 0.2% CHX. With 2% CHX treatment, the cells exhibited a foamy appearance in which most of the cytoplasm seemed to have been extracted from the cells. Although 0.12% CHX treatment did not adversely affect the attachment of periodontal cells onto roots, direct exposure to as little as 0.01% CHX caused a 90% reduction in 3H‐thymidine incorporation by cultured gingival fibroblasts. We conclude that although 0.12% CHX did not inhibit the attachment of cultured periodontal cells to pretreated roots, direct exposure of cells to much lower concentrations of CHX (0.0025 to 0.01%) caused a dose‐dependent inhibition of growth. J Periodontol 1992; 63:598–602.
A Comparative Clinical Study of the Safety and Efficacy of Three Toothbrushes
Authors: Khocht Ahmed , Spindel Lawrence , Person Philip
Published: March 2012

This single (examiner) blind, randomized, 4‐week study compared the safety and efficacy of a new electric toothbrush (experimental) regarding plaque removal and reducing gingivitis with two other brushes, an electric brush (control electric) and a manual toothbrush (control hand). Ninety‐six subjects with 1) a minimum of 15 suitable teeth in acceptable occlusion; 2) a minimum gingivitis score of 0.9; and 3) a minimum plaque score of 1.8 were entered into the study. The subjects were randomly assigned to one of 3 groups: a control hand group (31 subjects), an experimental group (32 subjects), and a control electric group (33 subjects). Device use instructions were given according to the manufacturer's recommendations. Two examiners separately determined either gingival scores or plaque scores at baseline and 4 weeks. In regard to gingivitis, use of all 3 brushes for the study period showed statistically significant improvements in gingivitis scores (P values <0.01) within each of the 3 groups. Between group analyses of covariance showed that of the 3 groups, the control hand group improvement was better than both the experimental and the control electric groups (P <0.05). When interproximal gingivitis scores were analyzed separately, similar improvements were noted. Regarding effectiveness of plaque removal during a single brushing event at the initial and final visits, each of the 3 brushes was effective in reducing plaque for every tooth surface scored (P values <0.01). However, between group analyses of covariances showed that the experimental group was better than the other two (P <0.01). When facial surfaces were analyzed separately, all 3 brushes were equally effective in plaque removal. But, when palatal/lingual surfaces were analyzed separately, the experimental group was better than both control groups (P <0.01). When interproximal surfaces were analyzed separately, again the experimental group was better than both control groups (P <0.01). The safety and efficacy of the experimental toothbrush with respect to plaque and gingivitis score improvements during the 4‐week study interval were demonstrated. J Periodontol 1992; 63:603–610.
Pneumoparotitis Associated With the Use of an Air‐Powder Prophylaxis Unit
Authors: Brown Frederic H. , Ogletree Robert C. , Houston Glen D.
Published: March 2012

A case reporting barotrauma to the parotid gland secondarily to the use of an airpowder prophylaxis unit is presented. Air pressure associated with these units usually exceeds that for air/driven turbines or air/water dental syringes, yet the reported incidence of iatrogenic trauma is very low. Improper angulation in the use of these instruments may result in serious sequellae. Differential diagnosis and physical examination following trauma to the parotid is discussed. J Periodontol 1992; 63:642–644.
Computerized Methodology for Detection of Alveolar Crestal Bone Loss From Serial Intraoral Radiographs
Authors: Hausmann E. , Allen K. , Carpio L. , Christersson L.A. , Clerehugh V.
Published: March 2012

The aim of this study was to develop a computerized measurement system for analysis of unstandardized serial radiographic images. A new approach for estimating the error associated with the determination of alveolar crest loss is described. The study shows that a difference of 0.87 mm in cemento‐enamel junction‐crest measurement between unstandardized serial radiographs taken within accepted clinic routine is required for a significant loss in crestal bone height. The ability to detect with significance a difference of less than 1 mm in crestal bone height makes the appropriate use of traditional bitewing radiographs a useful diagnostic tool for the assessment of periodontal maintenance. J Periodontol 1992; 63:657–662.
Southern Blot Detection of Human Papillomaviruses (HPVs) DNA Sequences in Gingival Tissues
Authors: Madinier Isabelle , Doglio Alain , Cagnon Laurence , Lefébvre Jean‐Claude , Monteil Roger A.
Published: March 2012

The highly sensitive and specific methods of molecular biology emphasize the frequency of subclinical infections in the genital tract tissues by the human papillomaviruses (HPVs). The purpose of this work was to investigate occult viral infections by the HPV type 6, 11, 16, and 18 in the gingival tissues. The Southern blot method with 32P‐radiolabeled DNA probes applied under stringent conditions to 20 interproximal gingival papilla specimens revealed homologous viral sequences in 1 of 6 cases of adult Periodontitis (HPV 16), 1 of 2 cases of rapidly progressive Periodontitis (RPP) (HPV 6/ HPV 11), 2 of 2 cases of acute gingivitis in psychiatric institutionalized patients (HPV 6; HPV 6/HPV 11), and 2 of 10 cases of acute gingivitis in AIDS patients (HPV 6/HPV 11/HPV 16; HPV 6). No periodontal or extraperiodontal specimen hybridized with the HPV 18 probe. Simultaneous hybridization with two or three HPV types was common (3/6 cases). The present detection of HPV 6,11,16 DNAs or related‐DNAs in periodontal tissues without obvious clinical signs of viral infection suggests that the gingival epithelium may act as a reservoir. J Periodontol 1992; 63:667–673.
Association Between Detection of Oral Actinobacillus actinomycetemcomitans and Radiographic Bone Loss in Teenagers. A 4‐Year Longitudinal Study
Authors: Aass Anne Merete , Preus Hans R. , Gjermo Per
Published: March 2012

The aim of the present study was to assess a possible association between radiographic bone loss and presence of Actinobacillus actinomycetemcomitans on the site and subject level over time. Forty‐six teenagers with registered radiographic bone loss and 8 controls participated in the study, which began in 1984. In 1986 and 1988 new sets of bite‐wing radiographs were obtained and examined for bone loss. Subgingival plaque was sampled from both diseased and contralateral healthy sites in the same individual. Only 15 of the 46 originally diseased sites persisted with bone loss in 1986, and 60% of these sites harbored A. actinomycetemcomitans. Of the 31 “healed” sites, 29% contained A. actinomycetemcomitans. The difference was statistically significant at P <0.05. Six of the contralateral healthy sites had developed bone loss during these 2 years and 50% of them contained A. actinomycetemcomitans, while 35% of the remaining contralateral sites harbored A. actinomycetemcomitans. The difference was not statistically significant (P >0.05). The difference between patients with and without persistent bone loss regarding presence of A. actinomycetemcomitans was statistically significant in 1986; however, none of the observed differences were statistically significant in 1988. A actinomycetemcomitans was found 2 to 3 times more frequently in patients with radiographic bone loss at all examinations than in “healthy” subjects. Detection of A. actinomycetemcomitans on the site level appeared to be a poor predictor of future radiographic bone loss. J Periodontol 1992; 63:682–685.
Treatment of an Osseous Lesion Associated With a Severe Palato‐Radicular Groove: A Case Report
Authors: Jeng Jiiang Huei , Jackson Lu Hsein‐Kun , Hou Lein Tuan
Published: March 2012

This is a case report that describes the management of a severe periodontal defect associated with a palato‐radicular (palato‐gingival) groove affecting the maxillary right lateral incisor of a 50 year‐old male. The patient presented with pain, gingival swelling, and a 10 mm periodontal pocket on the distopalatal aspect of the right maxillary lateral incisor. The defect was initially treated by scaling and root planing. Several days later a flap was elevated, the osseous defect was debrided, and odontoplasty was performed to eliminate the groove. The root surface was treated with citric acid for 3 minutes, the osseous defect was filled with non‐porous hydroxyapatite, a periodontal membrane was placed, and the flap was readapted to the tooth. Postoperative care included systemic (minocycline) and local (Chlorhexidine) antimicrobial therapy. The membrane was removed 6 weeks postoperatively and 14 months postoperatively the gingiva appeared healthy; radiographs suggested substantial resolution of the osseous defect and about 7 mm of probing attachment gain was recorded. Further studies are necessary to determine which of the several modes of therapy used to treat this lesion are necessary for success. J Periodontol 1992; 63:708–712.
Inhibition of Bone DNA and Collagen Production by Surface‐Associated Material From Bacteria Implicated in the Pathology of Periodontal Disease
Authors: Meghji Sajeda , Henderson Brian , Nair Sean , Wilson Michael
Published: March 2012

Gentle extraction of oral bacteria implicated in the pathogenesis of periodontal disease, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, or Eikenella corrodens, with saline removes the extracellular components while leaving the bacteria intact. This readily‐solubilized surface‐associated material (SAM) has been demonstrated to significantly inhibit DNA and collagen synthesis by murine calvaria at concentrations as low as 10 ng/ml. DNA and collagen synthesis in isolated calvarial osteoblasts were also inhibited by these SAM preparations with similar dose responses. The inhibitory effect of these bacterial expolymers was blocked by 1uM indomethacin. The potent inhibitory actions on bone synthesis of the SAM from these bacteria may contribute to the alveolar bone loss found in patients with periodontal disease. J Periodontol 1992; 63:736–742.
Cell Populations Associated With Active Probing Attachment Loss
Authors: Zappa Urs , Reinking‐Zappa Marcela , Graf Hans , Case Douglas
Published: March 2012

The purpose of this study was to evaluate the ability of cell populations to differentiate between untreated progressing periodontitis sites (P) and untreated non‐progressing sites (NP). Pairs of biopsies were obtained from untreated periodontal patients, one biopsy from a site which had lost probing attachment of 2 mm or more within the previous month, the other biopsy from a non‐progressing site. Cell populations were identified on 1 μm sections in a defined connective tissue area at the junctional epithelium. The cell types counted were fibroblasts, mast cells, monocytes/macrophages, polymorphonuclear leukocytes (PMNs), lymphoid cells, plasma cells, endothelial cells, total inflammatory cells, and the total number of cells. The number of fibroblasts, mast cells, monocytes/ macrophages, and inflammatory cells, as well as their percentage of the total number of cells, differed significantly between P‐ and NP‐sites. In addition, the actual total counts differed between groups. The difference between groups was more significant for percent fibroblasts than for any other cell type. It appears that cell populations, particularly fibroblast counts, can aid in the histological discrimination between P and NP periodontitis lesions. J Periodontol 1992; 63:748–752.
A Comparison of T4:T8 Lymphocyte Ratio in the Periodontal Lesion of Healthy and HIV‐Positive Patients
Authors: Steidley Kenneth E. , Thompson Stevan H. , McQuade Michael J. , Strong Scott L. , Scheidt Michael J. , Van Dyke Thomas E.
Published: March 2012

Previous reports describe a characteristic, rapidly progressive, Periodontitis that is unique to patients who are seropositive for HIV antibody (Western blot +). The purpose of this study was to compare the T4 and T8 lymphocyte subpopulations in the peripheral blood and periodontal lesions of these HIV patients with those of healthy controls. T‐cell subsets in peripheral blood were quantified by flow cytometry. The values from this analysis were used to calculate the peripheral T4:T8 lymphocyte ratio for each patient. Gingival tissue (papilla) was obtained from 8 HIV + patients and from 6 healthy HIV− control patients during routine gingival surgery. The T‐cell subpopulations in the gingival tissue were determined using serial cryostat sections that were labeled with monoclonal antibodies for T4 and T8 cells and developed using an avidin‐biotin‐peroxidase system. Six sections were taken from each of the 14 tissue specimens (one per patient). The sections were examined at 450 × and the mean number of T4 and T8 cells calculated for each section. These mean values were then used to determine the T4:T8 lymphocyte ratio for each tissue specimen. The peripheral blood analysis revealed a mean serum T4:T8 ratio of (2.07 ± 0.455) for the controls and (0.58 ± 0.26) for the HIV patients. The significantly lower T4:T8 ratio in HIV patients is consistent with their diagnosis. Although the results indicated that the mean T4:T8 lymphocyte ratio in the gingiva of controls was highly variable (2.70 ± 1.344), the gingiva of HIV patients consistently exhibited a complete absence of T‐cells. The lack of locally present immune effector and regulatory cells in HIV seropositive patients with periodontal disease could in part explain the characteristic and rapidly progressive nature of their periodontal disease. J Periodontol 1992; 63:753–756.