bluuebunny/crossref_metadata_2025 huggingface dataset:
The Pocket Epithelium: A Light‐ and Electronmicroscopic Study
Authors: Müller‐Glauser W. , Schroeder H. E.
Published: March 2012

The pocket epithelium is important for the pathogenesis of gingivitis and periodontitis. However, this epithelial variant has never been adequately described. The bioptic material with supraalveolar pockets originated from previous studies in which cotton floss ligatures were placed around the crowns of premolare in eight dogs. After periods of 4 to 21 days or up to 5 months, block biopsies comprising dental and gingival tissues were taken on the buccal side. The tissues were processed for light‐ and electron microscopic examination. The observations revealed that the pocket epithelium (1) does not attach to the tooth, (2) forms irregular ridges and, over connective tissue papillae, thin coverings which occasionally ulcerate, (3) consists of cells only some of which show a tendency to differentiate, (4) presents a basal lamina complex with discontinuities and multiplications, and (5) is infiltrated mainly by lymphocytes, T‐ and B‐blasts and plasma cells, and is transmigrated by neutrophilic granulocytes. It is concluded that the mosaic‐like structure of the pocket epithelium reflects the heterogeneity of the adjacent plaque, that this structure together with the absence of membrane coating granules is the basis for an extremely high permeability, and that epithelial ridges may conduct and collect foreign substances which thereby become more easily recognizable for leukocytes.
The Lateral Periodontal Cyst and Isolated Periodontal Defects
Authors: Filipowicz Francis J. , Page Dennis G.
Published: March 2012

Over a period of 4 years, 41 isolated, advanced periodontal defects were selected for histologic examination. The objective of this study was to establish the presence of cystic epithelium. Twenty of the biopsies fulfilled the criteria for lateral periodontal cyst (LPC). These results indicate that there is a distinct possibility that proliferation of epithelial elements other than crevicular could be implicated in isolated periodontal defects.
Oral Manifestations of Hereditary Hemorrhagic Telangiectasia (Osler‐Weber‐Rendu Disease): Review and Case Reports
Authors: Bartolucci Enrico G. , Swan Richard H. , Hurt William C.
Published: March 2012

A review of hereditary hemorrhagic telangiectasia (Osler‐Weber‐Rendu Disease) is presented. Special emphasis is placed on the oral manifestations which include hemorrhagic vesicles, nodules, papules and ulcers that involve the gingiva and other areas of the mucosa. Two cases are included which were seen in a periodontic clinic prior to the medical diagnosis. The nature of the practice of periodontics necessitates a broad understanding of the systemic diseases reflected in the oral cavity. Hereditary hemorrhagic telangiectasia is one such disease.
Effect of a New Anti‐Plaque Agent (CK‐0569A) on Developing Plaque and Gingivitis in Man
Authors: Wennström Jan L.
Published: March 2012

This study investigated the effect of l,4‐bis[3‐(n‐hexylcarbamylguanidine)propyl]piperazine dimethanesulfonic acid salt (CK‐0569A), used as a mouthrinse, on the development of plaque and gingivitis in humans. Fourteen dental students participated in a double‐blind cross‐over study. At the start of each of the two 14‐day periods of mouthrinsing (one period with CK‐0569A and one period with a placebo solution) the participants were examined for the presence of plaque (PlI) and gingivitis (GI). In addition, supragingival plaque samples were obtained and analyzed by darkfield microscopy. Clinical examination of plaque and gingivitis was repeated 4, 7 and 14 days after the start of the no‐toothbrushing periods. Bacterial samples were obtained after 7 and 14 days of trial.

The results demonstrated that a mouthrinse containing CK‐0569A prevented the colonization of motile + curved rods and spirochetes in developing plaque. Furthermore, rinsing twice daily with 0.1% solution CK‐0569A significantly reduced the amount of dental plaque formed and retarded the development of gingivitis.
Relationship Between Alveolar Bone Measured by 125I Absorptiometry With Analysis of Standardized Radiographs: 2. Bjorn Technique
Authors: Ortman Lance F. , McHenry Kenneth , Hausmann Ernest
Published: March 2012

The bjorn technique is widely used in periodontal studies as a standardized measure of alveolar bone. Recent studies have demonstrated the feasibility of using 125I absorptiometry to measure bone mass. The purpose of this study was to compare 125I absorptiometry with the Bjorn technique in detecting small sequential losses of alveolary bone.

Four periodontal‐like defects of incrementally increasing size were produced in alveolar bone in the posterior segment of the maxilla of a human skull. An attempt was made to sequentially reduce the amount of bone in 10% increments until no bone remained, a through and through defect. The bone remaining at each step was measured using 125I absorptiometry. At each site the 125I absorptiometry measurements were made at the same location by fixing the photon source to a prefabricated precision‐made occlusal splint. This site was just beneath the crest and midway between the borders of two adjacent teeth. Bone loss was also determined by the Bjorn technique. Standardized intraoral films were taken using a custom‐fitted acrylic clutch, and bone measurements were made from the root apex to coronal height of the lamina dura. A comparison of the data indicates that: (1) in early bone loss, less than 30%, the Bjorn technique underestimates the amount of loss, and (2) in advanced bone loss, more than 60%, the Bjorn technique overestimates it.
Longitudinal Evaluation of Free Autogenous Gingival Grafts: A Four Year Report
Authors: Dorfman Howard S. , Kennedy James E. , Bird William C.
Published: March 2012

This ongoing study was designed to determine the necessity for and effectiveness of the free autogenous graft in maintaining periodontal attachment. Four‐year data are presented for 42 patients who initially had bilateral facial surfaces with inadequate attached keratinized gingiva including 22 patients who began with bilateral areas of recession and no attached gingiva. In both populations a free autogenous gingival graft was placed on one side and the contralateral side was treated by scaling and root planing to serve as the control. The results indicate that plaque and gingival indices significantly decreased over 4 years on both experimental (grafted) and control (nongrafted) sides. Neither side had further attachment loss but the grafted side showed “creeping” attachment with a concomitant decrease in recession. This study would indicate that facial gingival units with minimal or no attached keratinized gingiva can maintain attachment levels when inflammation is controlled.
Inhibition of Neutrophil Chemotaxis by Soluble Bacterial Products,
Authors: Van Dyke T. E. , Bartholomew E. , Genco R. J. , Slots J. , Levine M. J.
Published: March 2012

Bacterial‐neutrophil interactions may be critical determinants of virulence in periodontal diseases. This study was undertaken to examine the ability of major bacterial species from the human oral cavity to inhibit (1) peripheral blood neutrophil Chemotaxis, (2) chemotactic formylmethionyl peptide binding, and (3) phagocytosis. Included were cultured supernatants and sonic extracts obtained from strains of Capnocytophaga, Bacteroides gingivalis, Fusobacterium nucleatum, Bacteroides asaccharolyticus, Capnocytophaga species, Actinobacillus actinomycetemcomitans, Neisseria, Actinomyces viscosus, Bacterionema matruchotii, Streptococcus mitis, Streptococcus mutans, and Streptococcus sanguis. Chemotaxis was measured using Boyden chambers; phagocytosis was determined using Staphylococcus aureus as the indicator organism and radioactive chemotactic peptide binding was assessed by a rapid filtration assay. None of the test organisms were cytotoxic to neutrophils or inhibited neutrophil phagocytosis. Capnocytophaga species., Bacteroides species., A. actinomycetemcomitans, and F. nucleatum produced factors which specifically inhibited neutrophil Chemotaxis. Activity was lost after dialysis. Extracts of Bacteroides species, A. actinomycetemcomitans and F. nucleatum, which were not chemotactic by themselves, inhibited binding of chemotactic peptide suggesting that in vitro Chemotaxis inhibition was mediated by nonchemotactic components that compete for the chemotactic factor receptor on the neutrophil. The exception was Capnocytophaga which appeared to inhibit Chemotaxis by inhibition of a post‐binding event. Such chemotactic inhibitors from periodontopathic organisms that inhibit neutrophil function may be important determinants of virulence.
Stimulated Osteoperiosteal Pedicle Grafts in Dogs
Authors: Goldman H. M. , Smukler H. , Lugo‐Romeu F. , Swart N. , Bloom A.
Published: March 2012

This descriptive study compared the healing of mucoperiosteal and “stimulated” osteoperiosteal flaps for the treatment of surgically created periodontal recessions in dogs. Surgically created defects on the canine teeth of 10 healthy mongrel dogs were covered by specially designed, cemented copper bands for 4 weeks (Several maxillary premolar teeth were managed in the same way). A plaque and calculus‐promoting diet was fed to the animals during this period. When the bands were removed the diet was altered and an intensive oral hygiene program was instituted. The contralateral tooth, chosen randomly, was utilized for placement of the mucoperiosteal lateral sliding flap and acted as the control. The experimental side was surgically stimulated 21 days prior to elevation of a “stimulated” osteoperiosteal flap for repositioning over the denuded roots. The animals were sacrificed with an overdose of Nembutal and block sections for histologic study were taken at periods ranging from 14 to 50 days. Histologic findings indicate that healing of the stimulated flaps was accompanied by the formation of a relatively short dentogingival epithelium, cementogenesis which varied in amount and type, and new connective fiber insertion into cementum. By contrast, the mucoperiosteal flaps healed with a long dentogingival epithelial relationship and no cementogenesis or connective tissue reattachment.
Effect of Periodontal Trauma Upon Intrabony Pockets
Authors: Polson A. M. , Zander H. A.
Published: March 2012

Conflicting results have been reported regarding the effect of periodontal trauma upon progression of periodontitis. In these studies, different initial pocket morphologies were present. This study investigated the effect of trauma superimposed upon existing intrabony pockets. Localized intrabony pockets were produced adjacent to the mesial and distal surfaces of the mandibular third bicuspids in 10 squirrel monkeys. Two animals were killed after 10 weeks of periodontitis. In four (experimental) of the remaining eight animals, mesio‐distal jiggling of the third bicuspid was begun 10 weeks after induction of periodontitis, and continued for another 10 weeks. The other four animals (control) were killed 20 weeks after initiation of periodontitis. Step‐serial histologic sections were selected from experimental and control specimens and analyzed for loss of connective tissue attachment, loss of crestal alveolar bone and percentage of bone in the coronal interproximal periodontium. When corresponding dimensions from experimental and control surfaces were compared statistically, there were no differences in loss of connective tissue attachment but a greater loss of bone had occurred in specimens with the combination of periodontitis and trauma. In addition, there was a marked difference in osseous morphology between the experimental and control specimens. It was concluded that trauma superimposed upon existing intrabony pockets increased loss of alveolar bone and altered osseous morphology, but did not affect the loss of connective tissue attachment.
Observations on Temperature and Temperature Patterns of the Gingiva: II. Estimations of the Error in Measurement
Authors: Chebib F. S. , Holthuis A. F.
Published: March 2012

The diagnostician may expect an error associated with the measurements of clinical parameters. It is important to know how precise these measurements are. The purpose of this study was to make an estimation of the measurement error by comparing repeated measures of the same site. Six dental hygiene students were examined for gingival and sublingual temperatures as well as pocket depths and sulcular bleeding. All measurements were recorded twice. The maximum error associated with 95% of the temperature data and the average error were calculated as 1.3°C and 0.65°C, respectively. The probabilities of making a correct assessment of pocket depth and of sulcular bleeding were computed to be 0.864 and 0.840, respectively. The need for repeated measures was statistically analyzed. It can be concluded from our data that the thermocouple thermometer used in this study is a suitable instrument for measuring the gingival temperature. However, it is necessary to acquire a higher level of precision for the assessment of pocket depth and sulcular bleeding. This can be accomplished by increasing the number of clinical measures on each point.
The Effect of a Televised Periodontal Campaign on Public Periodontal Awareness
Authors: Bakdash M. Bashar , Lange Allan L. , McMillan Donald G.
Published: March 2012

The purpose of this investigation was to evaluate the impact of the Minnesota Dental Association's 1979 to 1980 periodontal awareness television campaign in terms of (1) reaching the target population, (2) improving public knowledge regarding the major reason for tooth loss in adults and (3) increasing intended future preventive dental visits. Based on the Health Belief Model, a 30‐second television message was developed presenting periodontal disease as an often overlooked but compelling reason to seek preventive dental care. The message was aimed at adults 18 years of age and older who did not visit the dentist regularly. It was broadcast 1280 times over two separate 6‐week periods on 17 statewide television stations. A postcampaign personal interview of a representative cross section of 1,000 Minnesota adults indicated that the campaign reached 79% of the population surveyed, or 786 individuals. Eighty‐two percent (534) of the 654 individuals who made regular dental visits and 73% (252) of the 346 individuals who did not, indicated exposure to the message. Of the 786 persons who viewed the message, 90% (707) correctly recalled the message content. Seventy‐five percent (488) of the 654 individuals who made regular dental visits and 63% (219) of the 346 individuals who did not, correctly recalled the message content. As a result of exposure to the television campaign. 10% (76) of the 786 viewers indicated their intention to make more preventive dental visits in the future. Among individuals stating such an intention were 10% (71) of the 707 viewers who correctly recalled the message and six percent (5) of the 79 viewers who were not able to correctly recall the message content.
Rapidly Advancing Periodontitis in a Patient With Sarcoidosis: A Case Report
Authors: Makris George P. , Stoller Norman H.
Published: March 2012

A brief review of sarcoidosis is presented. It is a multisystem granulomatous disease of unknown etiology. Typically the sarcoidosis patient manifests depressed T‐cell function but has hyperactive B‐cells. This case report deals with a 27‐year old black female who was diagnosed as having sarcoidosis. Prior to the onset of the disease, radiographs taken of her periodontium revealed incipient alveolar bone loss. Two years after the apparent onset of the sarcoidosis, periapical radiographs manifested advanced destruction of the alveolar bone. In addition to the usual clinical indices, the effect of the patient's serum on cultures of normal PMNs and Actinobacillus actinomycetemcomitans (A. a.) was studied. The serum from this patient inhibited the leukotoxic effect of the (A. a.) organism. A similar effect has been observed in juvenile patients with rapidly advancing periodontitis.
Degradation of Basement Membrane Collagen by Proteinases From Human Gingiva, Leukocytes and Bacterial Plaque
Authors: Uitto Veli‐Jukka
Published: March 2012

Basement membranes in human gingiva are found in dento‐epithelial junction, epithelial‐connective tissue junction and endothelium‐connective‐tissue junction where they have important attachment and filtering functions. The ability of plaque and gingiva‐derived proteinases to degrade Type IV collagen, the major protein of basement membranes, was examined in vitro. The basement membrane collagen (Type IV) isolated from bovine lens capsules was incubated in the presence of enzyme samples. The degradation was assayed by the release of hydroxyproline from the insoluble substrate and by examining the peptide pattern of the residue by polyacrylamide gel electrophoresis. Salt extracts of inflamed gingival specimens degraded basement membrane collagen into soluble form and produced degradation products that were similar to those produced by human leukocyte extracts. Gingival crevicular fluid collected from patients with severe adult periodontitis also digested the substrate but the degradation pattern was different from the leukocyte and gingival extract samples. The pattern closely resembled the degradation produced by bacterial plaque extracts. A third type of cleavage was observed when collagenase from Clostridium histolyticum was incubated with basement membrane collagen. Crevicular fluid and the extracts from gingiva, leukocytes and plaque also contained gelatinase and elastase‐like enzyme activities that have earlier been shown to be potent in degrading basement membrane. It was concluded that enzymes capable of degrading basement membrane collagen in gingivitis and periodontal disease may originate from both plaque bacteria and human leukocytes. It also appeared that the enzymes responsible are more likely to be gelatinase and elastase‐like enzymes than specific collagenases.
Intraoral Melanoacanthoma
Authors: Wright John M. , Binnie William H. , Byrd D. Lamar , Dunsworth Arlet R.
Published: March 2012

Two cases of melanoacanthoma occurring on oral mucous membranes are presented. Melanoacanthoma is considered to be a benign mixed tumor of keratinocytes admixed with pigment‐laden dendritic melanocytes. All intraoral melanoacanthomas reported thus far have been pigmented lesions of the buccal mucosa and have occurred in young to middle‐aged black females. These tumors may grow rapidly and therefore they often mimic the radial growth phase of an intraoral melanoma. Because melanoacanthomas have no distinguishing clinical features, biopsy is mandatory.
The Comparative Effectiveness of Various Agents in Detoxifying Diseased Root Surfaces
Authors: Sarbinoff James A. , O'Leary Timothy J. , Miller Chris H.
Published: March 2012

This study evaluated five agents for their ability to detoxify periodontally‐involved root surfaces. An ultrasonic scaler was used to remove all visible calculus from a proximal surface of 250 teeth extracted because of advanced periodontal disease. The teeth were then randomly divided into five groups of 50 each. One‐half of a proximal surface of each tooth in each group was considered a control and was treated by rubbing the surface continuously for 3 to 5 minutes with cotton pellets soaked in sterile saline. The control area was then removed with a sterile bur, with the grindings for each group of teeth being collected, weighed and stored frozen. The remaining half of the proximal surface of all teeth in each group was treated with one of the following agents: (1) saturated citric acid for 3 minutes; (2) 15% EDTA for 5 minutes; (3) sodium hypochlorite for 5 minutes, followed by a 30‐second application of 5% citric acid; (4) sodium hypochlorite alone for 5 minutes; and (5) 2% sodium deoxycholate for 1 minute, followed by a 1‐minute rinse in distilled water, and then a 1‐minute application of 5% Cohn's fraction IV1. The experimental areas were then removed with sterile burs and the grindings from each group were collected and weighed. The five control and five experimental grinding samples were treated by the phenol‐water extraction technique of Westphal and Jann and subjected to the Limulus Amebocyte Lysate test for determining the endotoxin content. Exposure to saturated citric acid or to sodium deoxycholate followed by Cohn's fraction IV1 had little or no effect on endotoxin while use of EDTA resulted in only partial elimination of endotoxin. Sodium hypochlorite or sodium hypochlorite followed by citric acid neutralization resulted in endotoxin levels of less than 1 ng/gram of tooth material. Additional testing of the effect of citric acid using a standard E. coli endotoxin showed that the acid had no effect on endotoxin levels.
Sensitivity of Oral Tissues to Herpes Simplex Virus—in Vitro
Authors: Rones Y. , Hochman N. , Ehrlich J. , Zakay‐Rones Z.
Published: March 2012

Epithelial and fibroblast cells from the human gingival sulcus area were cultivated in vitro, and their sensitivity to the herpes simplex virus (HSV) was studied. Fibroblasts were sensitive to HSV infection and supported virus multiplication as evidenced by nuclear inclusion bodies and a cytopathogenic effect. Epithelial cells which were primarily devoid of HSV antigens were infected with HSV as demonstrated by positive immunofluorescent staining and damage to the cells at a later stage. Epithelial cells that were found to harbor HSV antigens upon removal from the patients prior to infection in vitro, maintained these antigens throughout the period of in vitro cultivation. The sensitivity of both epithelial cells and fibroblasts from the gingival sulcus area to HSV infection in vitro is significant for the understanding of the role of these tissues as a primary site of infection and as a possible reservoir for the latent virus between recurrences.
Attachment, Growth and Synthesis by Human Gingival Fibroblasts on Demineralized or Fibronectin‐Treated Normal and Diseased Tooth Roots
Authors: Fernyhough Will , Page Roy C.
Published: March 2012

Regeneration of a fibrous attachment to tooth roots previously exposed to periodontal pockets requires interaction between the root surface and fibroblasts. Experiments were designed to assess whether or not fibroblasts will attach, grow and synthesize normally on tooth roots and determine the efficacy of various treatments of diseased root surfaces on these activities. Extracted teeth were collected, washed and stored frozen until used. The roots were sectioned and the surface area determined. All roots were thoroughly planed to remove most of the cementum and some were then treated with fibronectin or citric acid. Each root was placed in a Linbro well and a suspension of fibroblasts in Dulbecco Vogt medium with 10% fetal calf serum added. After cell attachment, each root was transferred to a fresh well and incubated. Some roots were examined by scanning electron microscopy. Attachment and growth were assessed by harvesting and counting cells after various incubation times. The pattern of protein synthesis was determined by preparing fluorographs from cultures pulse labeled with radioactive S35‐methionine. Cells attach and grow on planed root surfaces. The number that attach to normal and diseased roots is greatly enhanced by pretreatment with fibronectin or citric acid. By day three, the cells become confluent at approximately 20,000/cm2. The pattern of proteins produced is comparable to that seen in cultures maintained in petri dishes. After root planing, cells attach, grow and synthesize equally well on diseased and normal roots.
The Use of Six Selected Teeth in Population Measures of Periodontal Status
Authors: Gettinger G. , Patters M. R. , Testa M. A. , Löe H. , Anerud A. , Boysen H. , Robertson P. B.
Published: March 2012

Selected teeth have been used to respresent the entire dentition in many epidemiological and clinical investigations. The present study sought to assess the relationship between the six selected teeth described by Ramfjord and the entire dentition for the Plaque Index, Gingival Index, Calculus Index and Loss of Attachment. The computations were performed on measurements obtained in investigations of the natural history of periodontal disease in Norway and Sri Lanka. A consistently strong correlation was observed between the tooth subset and whole mouth for all indices in both populations. This relationship persisted even though single members or pairs of the subset of teeth were removed from the calculations. Some bias, however, was observed with all indices. Plaque and gingival indices obtained from the six teeth underestimated whole mouth scores in the low range (<1.0) and overestimated scores in the high range (>2.0). Use of the tooth subset for calculus and loss of attachment consistently overestimated scores for the entire dentition.
The Distribution of Plasma Cells in Naturally Occurring Periodontitis Lesions in Rats: A Light and Electron Microscopic Study
Authors: Garant Philias R. , Paik Ki‐Suk , Cho Moon‐Il
Published: March 2012

Plasma cells are widely distributed in inflamed periodontal tissues, the adjacent periodontal ligament and nearby alveolar bone spaces, of old rats (20 and 27 months) raised on a conventional diet in a normal laboratory environment. Electron microscopy revealed three morphologic types (or perhaps stages) of these cells based on the arrangement and content of the granular endoplasmic reticulum. Close contact between plasma cells and other cell types, such as lymphocytes, macrophages and fibroblasts, were commonly observed. It is suggested that plasma cell infiltration is a widespread and prominent feature of naturally occurring periodontitis in old rats, resembling the condition known to exist in humans, monkeys and dogs. The occurrence of large numbers of apparently fully differentiated plasma cells in otherwise normal alveolar bone marrow is discussed.
The Effect of Vitamin E on the Healing of Gingival Wounds in Rats
Authors: Kim Jungnam Ego , Shklar Gerald
Published: March 2012

Forty male and female albino rats received a standardized gingival wound (gingivectomy) between the mandibular incisor teeth. One half of the animals received 60 I.U. of d‐α‐tocopheryl acetate daily, administered orally by pipette. An additional control group of 20 animals was not wounded and half of these animals received 60 I.U. of d‐α‐tocopheryl daily. Four animals in each of the two gingivectomy groups (Groups 1, 2) were sacrificed at periods of 1, 2, 4, 7 and 14 days following gingivectomy. Two animals in each of two control unwounded groups (Groups 3, 4) were sacrificed at similar times. Gingival healing was studied grossly and histologically. The animals receiving the vitamin E supplements healed more rapidly, with almost complete restoration of gingiva by 7 days. Complete healing was seen in both control and experimental groups by 14 days. Vitamin E was shown to accelerate gingival wound healing in experimental animals.
Toothbrushing With Hydrogen Peroxide‐Sodium Bicarbonate Compared to Toothpowder and Water in Reducing Periodontal Pocket Suppuration and Darkfield Bacterial Counts
Authors: West Theodore L. , King William J.
Published: March 2012

This study attempted to isolate and test the therapeutic effectiveness of toothbrushing with hydrogen peroxide‐sodium bicarbonate supplemented with scaling and systemic antibiotics. Forty‐two subjects selected for pocket suppuration were divided into two groups. Group I was treated sequentially with brushing, scaling and systemic antibiotics. Group II was treated with brushing and scaling performed concurrently. Half of each group were control subjects using an inert toothpowder. Subjects were monitored by darkfield microscopy for spirochetes and motile rods. In Group I, toothbrushing alone showed approximately a ⅓ reduction in the number of suppuration sites, no difference between experimental and control subgroups and no significant changes in the darkfield counts. Scaling, whether subsequent to the toothbrushing (Group I) or concurrent with the toothbrushing (Group II), showed a statistically significant reduction (about 70%) in the number of suppuration sites in all subgroups. Darkfield counts after scaling were reduced significantly in some subgroups but not in others. The addition of systemic antibiotics in Group I resulted in an almost total elimination of suppuration sites and spirochetes in 15 subjects, but there were no significant differences between the test and control subgroups. In both Groups I and II, neither experimental peroxide‐bicarbonate subgroup could be differentiated statistically from its toothpowder‐water control at any time.
The Evaluation of a New Technique for Anaerobic Sampling of Deep Periodontal Pockets
Authors: Gajewska Maria , Smales Frederick C. , Hardie Jeremy M. , Kho Pearl
Published: March 2012

A new technique for the anaerobic sampling of deep periodontal pockets has been developed and evaluated in vitro and in vivo. The mean percentage difference of total viable counts from pairs of samples from nine deep periodontal pockets was found to be 76.4%. This compared favorably with an established technique for which the equivalent figure was 147.4%. Evidence was obtained that the first sample taken with the new sampler depleted the site. When correction was made for that effect, the mean percentage difference was found to be 31.1%. That value was in good agreement with the variation obtained by taking repeat samples from centrifuged deposits of pure cultures of bacteria.
Effect of Achromycin Ointment on Healing Following Periodontal Surgery
Authors: Breloff Joseph P. , Caffesse Raul G.
Published: March 2012

This study evaluated the effect of applying 3% Achromycin on healing following periodontal surgery. Twelve patients participated, and 15 contralateral sides with similar disease were compared. The parameters assessed included amounts of gingival crevice fluid quantitated with the Periotron, gingival bleeding tendencies, mobility scores and attachment levels. No significant differences in bleeding tendency, mobility or attachment levels were found. Significant changes were noted on amounts of gingival crevicular fluid, however. The amounts of gingival crevicular fluid collected were significantly lower on the side not treated with Achromycin throughout the observation period. Applying 3% Achromycin did not have a beneficial effect on the healing of periodontal wounds. Whether the application of an antibiotic on sutured flaps limited the bacterial contamination of the gingival tissues through a “wicking effect” of the silk suture material, or if this bacterial contamination had any consequence on gingival healing or reattachment of the periodontal tissues adjacent to the tooth, cannot be determined from this study.
Leukocyte Function in the Etiology of Acute Necrotizing Ulcerative Gingivitis
Authors: Cogen Ronald B. , Stevens Alvin W. , Cohen‐Cole Steven , Kirk Katherine , Freeman Arthur
Published: March 2012

Patients with the diagnosis of acute necrotizing ulcerative gingivitis (ANUG) and their controls, matched for age, sex, race and general plaque accumulation, donated blood for differential white blood cell counts and for assay of several leukocyte functions. The leukocyte function assays included polymorphonuclear leukocyte (PMN) responsiveness to chemotaxis and phagocytosis, and lymphocyte responsiveness to stimulation by nonspecific mitogens. The differential leukocyte counts were within the normal range for all subjects tested, and there was no diffference between ANUG patients and controls. The ANUG patients did, however, display significantly depressed PMN responsiveness in both chemotaxis and phagocytosis, compared to the controls. There was also reduced DNA synthesis by ANUG patients' lymphocytes upon stimulation by a nonspecific mitogen (Con A). The data presented in this report suggest that depression of some host defense mechanisms, particularly PMN chemotaxis and phagocytosis, may be important in the pathogenesis of ANUG.
Comparison of Results Following Modified Widman Flap Surgery With and Without Surgical Dressing
Authors: Allen Donald R. , Caffesse Raul G.
Published: March 2012

The clinical effects of a periodontal dressing after modified Widman flap surgery were studied. A total of thirty surgical sites in 13 patients were included in the study. Half of the sites were not covered by a periodontal dressing while the other half were. To effect a blind evaluation, the dressings were placed and removed by someone other than the examiner. Gingival crevicular fluid flow and gingival inflammation were measured prior to surgery, 2 weeks, 1 month and 2 months after surgery. Clinical attachment level and pocket depth were measured prior to surgery, 1 month and 2 months after surgery. All patients were instructed in oral hygiene procedures and received rubber cup prophylaxes and flossing at 1 week, 2 weeks, 1 month and 2 months postoperatively. At the conclusion of the study, a questionnaire was administered to each patient. No significant differences were found between dressed and undressed segments regarding changes in clinical attachment levels, pocket depth, or gingival inflammation. The omission of a dressing did not result in a greater incidence of discomfort. More patients stated preference for no dressing.
Association Between Smoking Different Tobacco Products and Periodontal Disease Indexes
Authors: Feldman Roy S. , Bravacos Julianne S. , Rose Charles L.
Published: March 2012

Six indexes of periodontal health were recorded in cigarette smokers, pipe/cigar smokers and nonsmokers from the Veterans Administration Dental Longitudinal Study. These indexes included calculus deposition, plaque accumulation, gingival inflammation, periodontal pocket depth, alveolar bone loss and tooth mobility. Cigarette smokers had significantly more calculus deposition than pipe/cigar smokers, although both smoker groups had more calculus than nonsmokers. Cigarette smokers accumulated slightly less plaque than pipe/cigar smokers, and both smoker groups accumulated less plaque than nonsmokers. Gingival inflammation and tooth mobility did not differ between smokers and nonsmokers, nor between the two smoker groups. Cigarette smokers had significantly greater pocket depth than nonsmokers, in contrast to pipe/cigar smokers who were not different from nonsmokers. Radiographic measurements indicated that cigarette smokers had significantly more alveolar bone loss than either pipe/cigar or nonsmokers. After covariance adjustment for age and calculus, all smokers had less plaque, gingival inflammation and tooth mobility than nonsmokers, similar periodontal pocket depth, but only cigarette smokers had greater bone loss. This finding of greater alveolar bone loss in cigarette smokers suggests a tobacco product‐related effect in systemic physiologic action.
Ultrastructure of Nondecalcified Supragingival and Subgingival Calculus
Authors: Friskopp Johan
Published: March 2012

The ultrastructure of nondecalcified supragingival and subgingival calculus was studied in mature deposits. To facilitate sectioning of the embedded material, a thin reinforcing film of plastic was painted on the block. A new film was applied for each section. Light microscopy showed that supragingival calculus was heterogeneous with islets of calcified material within the covering plaque and with noncalcified areas within the calculus. Under transmission electron microscopy supragingival calculus was heterogeneous, dominated by microorganisms, small needle‐shaped crystals and large ribbon‐like crystals. In the covering soft plaque small crystals were often scattered in the intermicrobial matrix. In the supragingival calculus itself noncalcified microorganisms were surrounded with densely packed small crystals. There were also rosettes and bundles of large crystals. Subgingival calculus was homogeneous in light microscopy. The covering plaque contained no calcified material and only calcified material was seen within the calculus itself. Transmission electron microscopy of subgingival calculus revealed crystals of small size only. Subgingivally very few noncalcified microorganisms were seen within the calculus. The bacterial cell wall seemed to be the structure that was last calcified, both supragingivally and subgingivally.
Mycoplasma in Periodontal Disease: Isolation in Juvenile Periodontitis
Authors: Newman M. G. , Saglie R. , Carranza F. A. , Kaufman A. K.
Published: March 2012

Mycoplasma have been identified in one case of juvenile periodontitis by size, morphology, hemadsorption and cultural techniques. These microorganisms were found on the surface of the tooth, on the surface of pocket epithelium and invading the gingival epithelium and adjacent connective tissue. These observations suggest the need for further studies on the role of Mycoplasma in the pathogenesis of advanced periodontal infections. The role of Mycoplasma in periodontal disease is discussed.
Unusual Wound Healing Following Removal of Donor Tissue for Soft Tissue Graft
Authors: Adcock John E. , Spence Dennis
Published: March 2012

Soft tissue grafts are regularly used in most periodontal practices to augment attached gingiva. Postoperative complications are few and of minor consequence. This case describes a possible arterio‐venous shunt following removal of palatal mucosa as the donor tissue in a soft tissue autograft. The complication was managed by a surgical excision of the cavernous lesion. Healing thereafter was uneventful.
Effects of Gold Salts on Experimental Periodontitis: III. Ultrastructural Observations
Authors: Freeman Eric , Novak M. John , Polson Alan M.
Published: March 2012

Previous studies showed that the systemic administration of soluble gold salts resulted in significantly less periodontal destruction after 2 weeks of experimentally induced periodontitis. The present study compared the ultrastructural characteristics of the inflammatory lesion in animals receiving gold salts (experimental) with those in animals that had not received gold salts (control). Maxillary gingival biopsy specimens were obtained from the buccal aspect of ligatured teeth after 2 weeks of experimental periodontitis. A cellular and extracellular ultrastructural characterization was done in an “epithelial and superficial connective‐tissue zone,” and a “deep connective‐tissue zone.” Experimental (gold‐receiving) specimens had an intact sulcular epithelium with narrow intercellular spaces overlying a collagen dense connective tissue. Control specimens had a degenerating disrupted epithelium overlying a collagen‐poor connective tissue in which polymorphonuclear leucocytes predominated and often were closely apposed to morphologically altered fibroblasts. The cellular distribution of electron‐dense deposits of gold salts was demonstrated, and their possible role in modulating mechanisms of cell cytotoxicity and collagen turnover is discussed.
Histologic Comparisons of Interproximal Gingival Tissues Related to the Presence or Absence of Bleeding
Authors: Abrams Keith , Caton Jack , Polson Alan
Published: March 2012

Interproximal gingival tissues were compared histologically relative to the presence or absence of bleeding after stimulation with a wooden interdental cleaner. Fifteen bleeding and 15 nonbleeding interproximal gingival biopsy specimens were obtained from 30 patients and processed for light microscopic evaluation. Morphometric analysis of tissue components revealed that bleeding areas had a significantly greater per cent of inflamed connective tissue. The inflammatory lesion in the bleeding specimens was primarily in the midinterproximal area. From a diagnostic standpoint, this information provides a rationale for the use of bleeding to detect inflammatory lesions in the midinterproximal region.
Longitudinal Evaluation of Durapatite Ceramic as an Alloplastic Implant in Periodontal Osseous Defects after 3 Years
Authors: Yukna Raymond A. , Mayer Elizabeth T. , Brite Darlene V.
Published: March 2012

Seven patients who participated in a clinical study comparing the response of periodontal osseous defects to either grafting with Durapatite ceramic or debridement alone were followed under an active maintenance program for 3 years. Comparison of mean values showed that gingival recession, attachment levels and probeable pocket depths remained essentially stable for Durapatite sites over the 3 years. Attachment levels for debridement sites also remained constant, but these areas showed significant coronal migration of the free gingival margin and increases in probeable pocket depths. These latter changes became apparent and significant only after 3 years. Intrapatient comparisons showed that recession and attachment gain were most frequently greater and pocket depths most frequently less for Durapatite sites. These findings suggest that the Durapatite‐treated sites were stable for 3 years following surgery, while areas treated with debridement alone regressed.
Differential Effects of Collagen in Oral Tissues and Skin by Protein‐Energy Malnourished Newborn Rats and Lactating Dams
Authors: Nakamoto Tetsuo , Mallek Henry M.
Published: March 2012

Effects of protein‐energy malnutrition were studied in newborn rats and their dams. Upon delivery, dams received 6%, 12% or 20% protein diets. At Day 15 pups received 14C(U)‐proline. The posterior tongue, hard palatal mucosa, soft palatal mucosa and skin were analyzed for collagen and counts incorporated (collagen synthesis, that is, the rate of 14C‐proline converted to 14C‐hydroxy‐proline into gingival collagen). These regions of the dams were also removed to study collagen content. Although soft palatal mucosal collagen of newborns in the 6% and 12% protein groups was decreased, that of skin in the 6% protein group was increased. No such differences were observed in tongue and hard palatal mucosa. Counts incorporated was decreased in the tongue, soft palatal mucosa and skin, but not in hard palatal mucosa. Collagen contents of tongue and hard palatal mucosa and skin of the dams showed no differences, whereas that of soft palatal mucosa in the 6% protein groups was increased. Effects of protein‐energy malnutrition on oral tissues and skin were therefore different between newborns and lactating dams. Furthermore, one part of oral mucosa is affected differently from other parts of mucosa and in both, degree of malnutrition has different influences.
Bactericidal Action of Bicarbonate Ion on Selected Periodontal Pathogenic Microorganisms
Authors: Newbrun Ernest , Hoover Charles I. , Ryder Mark I.
Published: March 2012

Organisms representative of soil, skin and fecal flora and of supragingival and subgingival flora were tested for inhibition of growth and killing by various salts (NaHCO3, NaCl, MgSO4). The antimicrobial activities of KHCO3, NaF, sodium lauryl sulfate (SLS) and chloramine T were also compared with that of NaHCO3, and the rate at which NaHCO3 exerts its bactericidal effect was studied. Suspected periodontal pathogens were more susceptible to salts than were control non‐oral bacteria. Supragingival plaque organisms showed intermediate susceptibility. Periodontal pathogens were more susceptible to NaHCO3 than to NaCl; NaHCO3 and KHCO3 showed similar activity against all strains tested. Accordingly, the antibacterial activity of NaHCO3 is not simply an osmotic effect and is due to the bicarbonate ion.

NaF, SLS and chloramine T had greater antimicrobial activity than NaHCO3. Supragingival bacteria required at least 6‐hour exposure to 1.0 m NaHCO3 to produce 99% lethality (decrease colony‐forming units by 2 log10), whereas selected periodontal pathogens were killed more rapidly (30–120 minutes). The higher the concentration of bicarbonate, the faster the lethality. Morphologic examination by transmission electron microscopy of organisms exposed to bactericidal salt concentrations revealed marked fibrillar condensations within the cytoplasm and shrinkage of the cytoplasm from the outer membrane.

For NaHCO3 to be clinically effective, a high concentration must be introduced into the periodontal pocket and maintained there long enough to kill periodontal pathogens. Furthermore, NaHCO3 must be reapplied often enough to prevent recolonization by these pathogens. An advantage of NaHCO3 over NaF, SLS and other antimicrobial agents is its safety, availability and low cost.
The Effect of Root Planing and Citric Acid Applications on Flap Healing in Humans: A Histologic Evaluation
Authors: Kashani H. G. , Magner A. W. , Stahl S. S.
Published: March 2012

Four human teeth and their facial gingival attachment were removed en block 3 months after periodontal flap therapy and citric acid root conditioning and then prepared for histologic evaluation. At the time of periodontal surgery, and prior to citric acid application, the facial root surface was grooved at midline and citric acid was applied only to one‐half of each root surface. Tissues were decalcified and histologically prepared as horizontally oriented, step serial sections from the level of the gingival margin to the level of the facial crest. The gingival margins demonstrated reformation of a crevice. The corium at this level showed a mild inflammatory infiltrate. Apical to this level, junctional epithelium adhered to both sides of the root surface and to the central groove. Further apically, supracrestal fiber groups were encountered. No new cementum was noted in these areas. Fiber attachment was present apical to this level. Since no new cementum was seen at this area of attachment, it may represent collagen attachment present prior to periodontal surgery. In the four specimens examined, no differences were seen in the soft tissue closures between the rootplaned citric acid‐treated root surfaces and root surfaces which received root planing alone.
Eubacterium brachy: Reactivity in In Vitro Bone Resorptive Bioassay
Authors: Vincent Jack W. , Falkler William A. , Heath James R.
Published: March 2012

Recent studies have demonstrated an association of Eubacterium sp. with the subgingival microflora of patients with chronic periodontitis. One species, Eubacterium brachy, was evaluated to determine the possible mechanisms by which this microorganism may contribute to this disease. An extracellular antigen was identified in the culture supernatant which reacted with antibodies in human sera. This antigen was isolated by methanol precipitation and purified by gel filtration. The purified extracellular antigen was reacted in vitro with 45CaCl2‐labeled fetal rat bone in a bone resorptive bioassay. This antigen was shown to have a molecular weight of 170,000, to share a line of identity with a sonicated preparation of E. brachy whole cells and to result in increased 45CaCl2 release from fetal rat bones when cultures were exposed to the purified extracellular antigen at concentrations of 10 to 53 μg/ml.
Epithelial Reattachment After Gingivectomy in the Rat
Authors: Sabag N. , Mery C. , García M. , Vasquez V. , Cueto V.
Published: March 2012

It is known that an epithelial reattachment occurs a few days after gingivectomy. Depending upon the surgical procedure and the animal species used, different times have been proposed to obtain a complete reattachment. Nevertheless, it is not known whether there is a correlation between the time required and the sequence of morphologic events involved in this process.

To investigate this matter, gingivectomies were performed in the maxillary molars of rats. Specimens were taken 1 to 14 days after the operation and processed for light and electron microscopy.

The new junctional epithelium appeared at the 5th day, but the earliest signs of reattachment complex formation were evident at the 8th day. Rudimentary hemidesmosomes and lamina lucida appeared in epithelial cells bordering remnants of fibrin. Anchoring filaments that formed between the earliest hemidesmosomes and the subjacent fibrin crossed the lamina lucida. Simultaneously, segments of lamina densa appeared. At the 11 th day insertion of tonofilaments into the attachment plaques and insertion of anchoring filaments in the lamina densa were observed. At the 14th day, full development of the reattachment complex was evident.