bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Periodontal Treatment on the Protein Composition of Whole and Parotid Saliva
Authors: Henskens Yvonne M.C. , van der Weijden Fridus A. , van den Keijbus Petra A.M. , Veerman Enno C.I. , Timmerman Mark F. , van der Veiden Ubele , Amerongen Arie V. Nieuw
Published: March 2012

Cystatins are physiological inhibitors of cysteine proteinases and widely distributed in human tissues and fluids including saliva. Cystatins S, SA, SN, and D are only found in glandular saliva and tear fluid whereas cystatin C has been detected in all tested biological fluids. Previous studies demonstrated that total cystatin activity and cystatin C concentration were highest in whole and parotid saliva of periodontitis patients compared to healthy subjects suggesting a response of the salivary glands to an inflammatory condition of the oral cavity. Based on these results we studied a possible change in the concentration of cystatin S, cystatin C, albumin, IgA, amylase activity, and cystatin activity in whole and parotid saliva of 20 periodontitis patients as a consequence of periodontal treatment. Saliva samples were quantified for cystatins S and C, albumin, and IgA by enzyme‐linked immunosorbent assay. Amylase was determined in an activity assay and total cystatin activity was measured towards papain. The clinical condition of the subjects improved significantly after 6 months of periodontal therapy whereas biochemical analyses of whole and parotid saliva indicated that significant changes in salivary protein composition occurred only in whole saliva. Total cystatin activity (P < 0.05) and cystatin C concentration (P < 0.05) of whole saliva samples collected after periodontal treatment decreased to normal healthy control values. Further, concentrations of cystatin S were unchanged during the periodontal treatment process. These results suggest that other sources of cystatins than the parotid gland; i.e., other salivary glands or crevicular fluid, are involved in the decrease of total cystatin activity in whole saliva after periodontal treatment. J Periodontol 1996;67:205–212.
Radiographic Evaluation of Bone Regeneration Following Periodontal Surgery With or Without Expanded Polytetrafluoroethylene Barriers
Authors: Eickholz Peter , Benn Douglas K. , Staehle Hans J.
Published: March 2012

In 16 patients with advanced periodontitis, 23 teeth exhibiting interproximal intrabony defects were treated by conventional periodontal surgery (n = 10, control) or guided tissue regeneration (GTR) technique using expanded polytetrafluoroethylene (ePTFE) barriers (n = 13, test), respectively. Clinical parameters were assessed before and 6 months after surgery. Presurgically and 3 and 6 months postsurgically standardized bite‐wing radiographs were taken. Using a loupe and a computer‐assisted system, respectively, the distances from the cemento‐enamel junction (CEJ) to alveolar crest (AC) and CEJ to the most apical extension of bony defect (BD) were measured. The average gain of attachment was assessed 2.33 mm in the control group and 3.17 mm in the test group. The bony fill was measured 0.97 mm and 0.97 mm in the control group and 0.93 mm and 1.68 mm in the test group after 3 and 6 months, respectively, using a loupe. Using a computer‐assisted system 0.83 mm and 1.82 mm of bone fill could be measured (control) and 0.76 mm and 1.79 mm (test) after 3 and 6 months, respectively. Compared to the gold standard of surgical measurements, the computer‐assisted analysis of radiographs underestimated bone loss significantly less than evaluation with a loupe (P < 0.002). Compared to conventional periodontal surgery, the GTR technique resulted in higher attachment gain and bony fill. However, the high variation of surgical results in the test group prevented the calculation of a statistically significant difference. J Periodontol 1996;67:379–385.
Clinical Significance of Furcation Anatomy of the Maxillary First Premolar: A Biometric Study on Extracted Teeth
Authors: Joseph Ida , Varma B.R.R. , Bhat K. Mahalinga
Published: March 2012

Multirooted teeth in which chronic periodontitis has progressed to involve the furcation present special problems in treatment. The apical placement of furcation, narrow furcation entrance, concavities on the root surface, and the undesirable root configuration make instrumentation and plaque control difficult. Furcation involvement, when present in maxillary first premolars in particular, presents á poor prognosis as the furcation opens mesiodistally. This study on 100 extracted maxillary first premolars is an attempt to determine the frequency of bifurcation, the proximity of bifurcation to cemento‐enamel junction, the depth of concavities on the root trunk and the furcal aspect of root, the diameter of furcation entrance, and the extent of root divergence. J Periodontol 1996;67:386–389.
Microbial Flora in the Acute Phase of Periodontitis and the Effect of Local Administration of Minocycline
Authors: Umeda Makoto , Tominaga Yumiko , He Tao , Yano Kazuko , Watanabe Hisashi , Ishikawa Isao
Published: March 2012

Periodontitis, similar to other infectious diseases, is known to progress as chronic inflammation with recurrent acute phases. The purpose of this study was to clarify the microbiological composition of the acute phase and to compare the bacterial flora with that of comparable chronic periodontal pockets. We also evaluated the effect of application of minocycline gel locally on the change in the microflora in the acute pockets. Microbial flora from the subgingival pockets of 28 patients in the acute phase of periodontitis and of 12 patients in a comparable chronic phase as the control were investigated by various bacterial culture methods including TS blood agar and TSBV plates. Minocycline gel was applied to the acute periodontal pockets. Changes in the microbiological proportion and clinical parameters at one week after baseline examination were followed by dark‐field analysis, culture method, and indirect immunofluorescence technique. Characteristic features of bacterial proportions in the acute site were observed as an increase in Bacteroides forsythus. The number of Porphyromonas gingivalis and black pigmented anaerobic rods also increased. Application of minocycline gel in the acute pocket without any debridement produced improvement in clinical symptoms at one week. Black‐pigmented anaerobic rods, P. gingivalis, and B. forsythus decreased significantly at one week after the application. Results indicate that periodontopathic bacteria including B. forsythus and P. gingivalis were predominant in the acute phase of periodontitis and a locally delivered antibiotic may be effective as an alternative modality of treating the acute inflammation. J Periodontol 1996:67:422–427.
Adjacent Gingival Recession Treated With Expanded Polytetrafluoroethylene Membranes: A Report of 2 Cases
Authors: Ito Koichi , Murai Seidai
Published: March 2012

We report two cases illustrating treatment for adjacent facial gingival recession using guided tissue regeneration (GTR) with expanded polytetrafluoroethylene membranes. The clinical results showed that GTR obtained soft tissue coverage of the root surfaces and was effective in reducing hypersensitivity and improving the esthetics. In both cases, satisfying clinical results have been maintained for 6 to 12 months after re‐entry procedure. J Periodontol 1996;67:443–450.
Juvenile Hyaline Fibromatosis of Gingiva: A Case Report
Authors: Piattelli A. , Scarano A. , Bellucci A. Di , Matarasso S.
Published: March 2012

Juvenile hyaline fibromatosis is an extremely rare inherited condition, probably resulting from an inborn error of metabolism. It is characterized by cutaneous nodules, gingival hypertrophy and joint contractions. It affects children but usually it is not present at birth, and is microscopically characterized by a conspicuous hyalinization of the connective tissue. J Periodontol 1996;67:451–453.
In Vitro Permeability Evaluation and Colonization of Membranes for Periodontal Regeneration by Porphyromonas gingivalis
Authors: Ricci Giano , Rasperini Giulio , Silvestri Maurizio , Cocconcelli Pier Sandro
Published: March 2012

The use of membranes for periodontal regeneration is well established. In clinical use, the exposure of membranes to the oral microflora may result in a pathway for periodontal infections. An important role in this process is played by Porphyromonas gingivalis. The purpose of the present study was to examine the colonization of 6 different bioresorbable and nonresorbable membranes for periodontal regeneration by the strain DSM 20709 of P. gingivalis and to determine the time needed by this microorganism to pass through the membranes. A device consisting of a tube sealed with the membranes and filled with a medium suitable for the growth of P. gingivalis was incubated in a bigger tube containing the same medium to study the process of colonization and the crossing of membranes. The outer tube was inoculated with 104 cells of P. gingivalis DSM 20709. The passage of bacteria through the membranes was monitored at 6, 24, and 48 hours by counting the number of cells in the inner tube. The colonized membranes were observed using a scanning electron microscope. Differences in the behavior of the 6 membranes analyzed were demonstrated J Periodontol 1996;67:490–496.
Analytical Performance of an Immunologic‐Based Periodontal Bacterial Test for Simultaneous Detection and Differentiation of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia
Authors: Snyder Brian , Ryerson Carol C. , Corona Holly , Grogan Elizabeth A. , Reynolds Homer S. , Contestable Paul B. , Boyer Bradley P. , Mayer Janice , Mangan Timothy , Norkus Norbert , Zambon Joseph J. , Genco Robert J.
Published: March 2012

The analytical performance of a membrane‐based immunoassay for the simultaneous detection and differentiation of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia (including Prevotella nigrescens) was investigated. Positive reactions were observed for 71 of 71 reference strains and recent oral isolates of A. actinomycetemcomitans, P. gingivalis, and P. intermedia. No cross‐reactivity was observed with 39 other common oral and environmental species. The specificity of the test was unaffected by the presence of potential oral interferents including whole blood, white blood cells, mucin, saliva, toothpastes, and oral rinses. A proficiency test by dental professionals using a standardized set of unknown simulated samples yielded a sensitivity of 97% (116/120) and a 100% specificity (240/240). An additional group including dental professionals and high school students was shown to be 99% proficient (1385/1397) in distinguishing proper from improper test function when processing control samples with normal test devices and devices with simulated error conditions. Comparisons to a culture standard for 104 subgingival plaque samples collected from 26 adult periodontitis patients yielded > 98% specificity for each of the test bacteria. In addition, the detection threshold for the test was determined to be equivalent to 104 cultivable test bacteria when compared to the culture standard. The data indicate that this membrane immunoassay is a valid and easy‐to‐use method for the detection of A. actinomycetemcomitans, P. gingivalis, and P. intermedia in subgingival plaque, at levels above the detection threshold of the test. J Periodontol 1996;67:497–505.
Free Gingival Graft Following Biopsy: A Case Report of Tissue Management
Authors: Anderegg Charles R. , Metzler David G.
Published: March 2012

Excisional biopsies require wide margins to facilitate removal of diseased tissue. Such margins often result in soft‐tissue defects. These defects can cause reduced esthetics, ineffective oral hygiene performance, and postsurgical root sensitivity. This case documents the combination of two dental procedures: biopsy and the free gingival graft. A pyogenic granuloma, as diagnosed by histologic report, was removed by excisional biopsy and the resultant defect repaired by using a free gingival graft. Palatal tissue was grafted immediately ta the site of the biopsy and sutured in place to cover the loss of attached tissue and papilla. At 6 months, the graft appeared to restore gingival health and maintain both esthetics and function in the surgical biopsy site. The patient was well served by correcting the resultant biopsy defect in a onestep procedure which encouraged healing and an excellent esthetic result. J Periodontol 1996;67:532–535.
Indices to Measure Gingival Bleeding
Authors: Newbrun Ernest
Published: March 2012

Gingival bleeding is an objective, easily assessed sign of inflammation that is associated with several periodontal diseases. Many bleeding indices have been devised; some assess bleeding as simply present or absent, whereas others use grading in an attempt to assess severity of bleeding. The choice of which index to use depends on whether the purpose is an epidemiological survey, a clinical study, diagnosis and treatment, or patient motivation. Bleeding may be elicited manually with toothpicks, dental floss, or a periodontal probe, but a controlled‐force probe, although more expensive, causes less trauma and less false‐positive bleeding from healthy tissues. As a predictor of periodontal disease progression, bleeding on probing has low sensitivity owing to a high frequency of false‐positive responses, but has high specificity in that failure to bleed indicates health. There is evidence that smokers have less, or delayed, gingival bleeding when compared with non‐smokers; therefore smoking needs to be controlled for in studies of gingival bleeding. Measurement of gingival bleeding tendency should be an integral part of a comprehensive oral examination. In clinical practice, the use of a graded bleeding index is more likely to identify sites that are at risk of further destructive activity. For monitoring individual patients, both for response to initial therapy and during maintenance, a modified Sulcus Bleeding Index (mSBI) with three bleeding scores is recommended in preference to dichotomous scoring of bleeding. J Periodontol 1996;67:555–561.
Efficacy of a 2‐Phase Oil:Water Mouthrinse in Controlling Oral Malodor, Gingivitis, and Plaque
Authors: Kozlovsky Avital , Goldberg Sarit , Natour Iyas , Rogatky‐Gat Ariel , Gelernter Ilana , Rosenberg Mel
Published: March 2012

The purpose of the study was to examine the anti‐malodor, anti‐gingivitis, and plaque reducing properties of a 2 phase oil:water mouthrinse compared with a control mouthrinse. Fifty subjects rinsed with one of the two rinses for 30 seconds twice a day over 6 weeks, while continuing their normal oral hygiene habits. Measurements were made at time zero (prior to beginning the rinsing regimen), and ≥ 9 hours following rinsing, at intervals of 1, 3, and 6 weeks. Malodor of whole mouth, as well as tongue dorsum anterior and posterior, was assessed on a 0 to 5 semi‐integer scale by two odor judges. Volatile sulphide compounds (VSC) were determined using a sulphide monitor. Gingival, plaque, and bleeding indices were recorded for Ramfjord teeth. Oral microbial levels were assessed using the oratest. Salivary levels of diamines (putrescine and cadaverine) were analyzed by HPLC. Results were analyzed by 2tailed covariant ANOVA, with the time zero value as covariant. Dramatic improvements were observed in parameters associated with malodor, periodontal health, plaque accumulation, and microbial levels in both groups. As compared to time zero scores, whole mouth odor, tongue dorsum anterior and posterior odors decreased continuously over time, attaining 80%, 79% and 70%, reductions, respectively following 6 weeks, in the 2‐phase mouthrinse group, versus 70%, 77% and 59% for the control group. For whole mouth and tongue dorsum posterior, the reductions observed in the 2‐phase mouthrinse group were significantly greater than those obtained with the control mouthrinse (P = 0.026 and P = 0.025, respectively), suggesting that the 2‐phase mouthrinse is superior to the control mouthrinse in long‐term reduction of oral malodor. For bleeding index, gingival index, oral microbial levels, and VSC, differences between the groups were not significant. Diamine levels were not significantly reduced in either group. The control mouthrinse reduced plaque index more significantly than the 2‐phase mouthrinse (P < 0.005). The results of this randomized clinical trial suggest that the 2‐phase oikwater mouthrinse formulation is superior to the control mouthrinse in long‐term reduction of oral malodor. J Periodontol 1996;67:577–582.
Microbiology of Periapical Abscesses and Associated Maxillary Sinusitis
Authors: Brook Itzhak , Frazier Edith H. , Gher Marlin E.
Published: March 2012

Aspirate of pus from 5 periapical abscesses of the upper jaw and their corresponding maxillary sinusitis were studied for aerobic and anaerobic bacteria. Polymicrobial flora were found in all instances, where the number of isolates varied from 2 to 5. Anaerobes were recovered from all specimens. The predominant isolates were Prevotella sp., Porphyromonas sp., Fusobacterium nucleatum, and Peptostreptococcus sp. Concordance in the microbiological findings between periapical abscess and the maxillary sinus flora was found in all instances. However, certain organisms were only present at one site and not the other. Five beta‐lactamase‐producing. organisms were present in the five specimens. These data confirm the importance of anaerobic bacteria in periapical abscesses.and demonstrate their predominance in maxillary sinusitis that is associated with them. J Periodontol 1996;67:608–610.
Exostosis Associated With Autogenous Gingival Grafts: A Report of 9 Cases
Authors: Otero‐Cagide Francisco J. , Singer David L. , Hoover Jay N.
Published: March 2012

This report describes 9 cases presenting exostosis at mandibular and maxillary sites where autogenous gingival grafts have been used to increase the amount of attached gingiva. The exostoses were recognized during routine dental examinations and identified by palpation, horizontal sounding, occlusal radiographs, and in one case by histologic examination. Only in three cases was there a surgical removal of exostosis and recurrence was not observed during a follow‐up evaluation. The remainder of the cases were not treated and the exostoses appeared to have limited growth. Apparently, a correlation between the presence of tori and the development of exostosis could not be established in these series of case reports, but a possible explanation with respect to the mechanism of bone formation is discussed along with the clinical implications of this interesting clinical finding. J Periodontol 1996;67:611–616.
Prognosis Versus Actual Outcome. III. The Effectiveness of Clinical Parameters in Accurately Predicting Tooth Survival
Authors: McGuire Michael K. , Nunn Martha E.
Published: March 2012

Tooth loss for 100 treated periodontal patients (2,509 teeth) under maintenance care was evaluated to determine the effectiveness of commonly taught clinical parameters utilized in the assignment of prognosis in accurately predicting tooth survival. Previous studies in this series evaluated prognosis as a surrogate variable representing the condition of the tooth at a particular point. In this study, survival analysis was used to evaluate the relationship of these common clinical parameters to an actual end point, tooth loss. Robust log rank tests indicated that initial probing depth, initial furcation involvement, initial mobility, initial crown‐to‐root ratio, and initial root form were all associated with tooth loss. In addition, smoking and increased initial bone loss were both found to be associated with increased risk of tooth loss while fixed abutment status was associated with a decreased risk of tooth loss. A Cox proportional hazards regression model showed that initial probing depth, initial furcation involvement, initial mobility, initial percent bone loss, presence of a parafunctional habit without a biteguard, and smoking were all associated with an increased risk of tooth loss. This model suggests that patients are twice as likely to loose their teeth if there is increasing mobility, if they have a parafunctional habit and do not wear a biteguard, or if they smoke. From these data there does appear to be a relationship between the assigned prognosis and tooth loss. Teeth with worse prognosis have a worse survival rate, but the commonly taught clinical parameters used in the traditional method of assignment of prognosis do not adequately explain that relationship. Furthermore, initial prognosis did not adequately explain the condition of the tooth or accurately predict the tooth's survival. These results seem to indicate that the effect of these clinical parameters on tooth survival is only partially reflected in the assigned prognosis initially, suggesting that perhaps some of the clinical parameters should be weighed more heavily than others when assigning prognosis. Further studies are needed to develop a more accurate method for the assignment of prognosis. J Periodontol 1996;67:666–674.
Levels of Cigarette Consumption and Response to Periodontal Therapy
Authors: Kaldahl Wayne B. , Johnson Georgia K. , Patil Kashinath D. , Kalkwarf Kenneth L.
Published: March 2012

Seventy‐four patients with moderate to advanced periodontitis were classified by cigarette consumption at the initial exam: heavy smokers (HS) ≥ 20 cigarettes/day (n = 31); light smokers (LS) ≤ 19 cigarettes/day (n = 15); past smokers (PS) had a history of smoking but had quit by the initial exam (n = 10); and non‐smokers (NS) had never smoked (n = 18). All patients were treated with four modalities of periodontal therapy followed by supportive periodontal treatment (SPT) for a period of up to 7 years. Clinical parameters including probing depth (PD), clinical attachment level (CAL), recession (REC), presence of bleeding on probing (BOP), and supragingival plaque (PL) were assessed at six sites around each tooth. Horizontal probing attachment level (HAL) was obtained at molar furcation sites. Data were collected initially, 4 weeks after non‐surgical therapy, 10 weeks after surgical therapy, and yearly during SPT. HS and LS demonstrated less PD reduction and less CAL gain than PS and NS following active treatment and throughout SPT. Following active treatment, HAL changes were similar for all groups, but during 7 years of SPT, HS and LS experienced greater loss of HAL. There were no differences in BOP among the four groups. HS demonstrated a higher percentage of PL positive sites compared to the other groups. In summary, HS and LS responded less favorably to therapy than PS and NS. A past history of smoking was not deleterious to the response to therapy. J Periodontol 1996;67:675–681.
Human Monocyte Response to Cementum Extracts From Periodontally Diseased Teeth: Effect of Conditioning With Tetracycline
Authors: Shapira Lior , Houri Yael , Barak Vivian , Halabi Amal , Soskolne W. Aubrey , Stabholz Ayala
Published: March 2012

Monocyte inflammatory cytokines, such as TNFα and IL‐1β, have been implicated in the pathogenesis of periodontal destruction. The present study was designed to test the ability of extracts of cementum from periodontally diseased teeth to induce the secretion of these mediators by monocytes, to evaluate the role of adsorbed endotoxin in this process, and to test the effect of cementum conditioning with tetracycline on the monoc'yte response. Human monocytes were incubated with varying concentrations of cementum extracts, and TNFα and IL‐1β levels in the media were measured. The results showed that while extracts of healthy cementum had no effect on monocyte secretion, concentration as low as 0.5 mg/ml of cementum from diseased sites raised the levels of TNFα and IL‐1β secretion 10‐fold. This response was dosedependent. Diseased cementum were found to contain 1.5 ng/mg endotoxin, while endotoxin was not detectable in the extracts of the healthy cementum. However, neutralization of the endotoxin by polymyxin B only partially reduced the monocyte secretory response by 50 to 70%, suggesting that other factors in the extracts are also involved in monocyte stimulation. To simulate the effect of root conditioning, cementum was first agitated in a tetracycline or control solution prior to its extraction in media. Pretreatment of diseased cementum with tetracycline (50 mg/ml) was found to block the secretion of TNFα from cementum‐stimulated monocytes. Pretreatment of the diseased cementum with 10 mg/ml tetracycline was not more effective than saline and HCl controls, with all treatments reducing cytokine secretion by ≈80%. The direct addition of tetracycline to cementum‐stimulated monocyte culture was found to block TNFα secretion in a dose dependent manner. The results suggest that extracts from diseased cementum are potent stimulators of monocyte secretion, and that endotoxin as well as other factor(s) appear to be involved. These factors are partially extracted by washing and a 10 mg/ml tetracycline solution is not more effective than saline in achieving this goal. In addition, tetracycline was found to be a potent inhibitor of TNFα secretion by cementum‐stimulated monocytes, suggesting a novel mechanism for this drug in periodontal therapy. J Periodontol 1996;67:682–687.
Correlation Between Gingivain/Gingipain and Bacterial Dipeptidyl Peptidase Activity in Gingival Crevicular Fluid and Periodontal Attachment Loss in Chronic Periodontitis Patients. A 2‐Year Longitudinal Study
Authors: Eley B.M. , Cox S.W.
Published: March 2012

The aim of this study is to determine whether either gingival crevicular fluid (GCF) bacterial gingivain/gingipain or dipeptidyl peptidase (DPP) levels, total activity (TA) and concentration (EC), predict progressive attachment loss (AL) in 75 patients with moderate periodontitis. GCF was collected from 16 molar and premolar mesiobuccal sites and then clinical attachment level (CAL) and probing depth (PD) were measured with an electronic constant pressure probe. Lastly, gingival, gingival bleeding, and plaque indices were scored. Prior to the baseline visit, patients were given basic periodontal treatment after which the above procedures were repeated. In addition, carefully localized radiographs were taken of the test teeth and repeated annually. Patients were then seen every 3 months for 2 years and the clinical measurements repeated at each visit. In 48 patients, 124 AL sites, 91 rapid AL (RAL), and 33 gradual AL (GAL) were detected. Gingivain/gingipain and bacterial DPP levels (TA and EC) at RAL sites were significantly higher (P ≤ 0.0001) than at paired control sites at the attachment loss time (ALT) and prediction time (PT). Mean levels over the study period of both proteases (TA and EC) at GAL sites were significantly higher (P ≤ 0.0001) than those at paired control sites. The GCF levels of gingivain/gingipain were always higher than those of DPP. Critical values (CV) of 5 μU/30 seconds (TA) and 30 μU/μL (EC) for both proteases showed high sensitivity and specificity values for TA and EC, which were the same at both ALT and PT. The positive predictive values were higher for gingivain/gingipain. Mean site levels, over the course of the study, of both proteases (TA and EC) were significantly higher (P ≥ 0.0001) at AL, RAL, and GAL sites than nonattachment loss (NAL) sites in AL patients and mean patient levels were significantly higher (P ≤ 0.0001) in AL, RAL, and GAL patients than NAL patients. These results indicate that both of these bacterial proteases in GCF may be predictors of periodontal attachment loss. J Periodontol 1996;67:703–716.
Plasminogen Activator Activity Is Decreased in Rat Gingiva During Diabetes
Authors: Chang Kuang‐min , Rani Akula Shoba , Chang Kuang‐chao , Kumar Surriender
Published: March 2012

Diabetes produces extensive alterations of collagen metabolism including enhanced gingival collagenase activity. However, the mechanism for this enhanced enzyme activity is unclear. Collagenase is secreted from cells in a latent form and plasmin has been proposed as an important in vivo activator of procollagenase. Plasmin is converted from its precursor, plasminogen, by the proteolytic action of a serine proteinase, plasminogen activator (PA). The current study was therefore undertaken to determine the effect of diabetes on gingival PA activity in the rat. Since doxycycline is a potent collagenase inhibitor, the effect of doxycycline on gingival PA activity was also investigated. Eighteen male, Sprague‐Dawley rats were made diabetic by streptozotocin injection (7 mg/100 g). Control rats (N = 8) were sham‐treated. Doxycycline (5 mg/day/rat) was administered to 9 of the 18 diabetic rats by gavage on a daily basis. The other 9 diabetic rats were administered with saline. After 3 weeks, blood and gingival tissue were collected from each rat for the determination of glucose level and gingival PA activity. The tissues were then minced and extracted with 5 mM sodium phosphate containing 1% Triton X‐100. PA assay was performed using chromatogenic substrate to determine PA activity in the extracts. Gingival PA activity in the diabetic rats was significantly reduced compared to the control (13.5 ± 1.6 vs. 36.0 ± 3.3 punits/100 μg protein, P < 0.01). Doxycycline administration to diabetic rats had no effect on the already reduced gingival PA activity (10.4 ± 3.5 in doxycycline‐treated rats vs. 13.5 ± 1.6 μunits/100 μg protein in untreated diabetic rats). PA activities in gingival tissues from the diabetic, nondiabetic control and doxycyclinetreated diabetic groups were also demonstrated on zymographs as lytic bands. Regarding the well‐known fact that gingival collagenase activity is enhanced during diabetes, our results did not support the notion that this biochemical alteration is attributed to increased activation of procollagenase by PA. J Periodontol 1996;67:743–747.
Characterization of Matrix Metalloproteinase (MMP‐8 and ‐9) Activities in the Saliva and in Gingival Crevicular Fluid of Children With Down's Syndrome
Authors: Halinen Sirkka , Sorsa Timo , Ding Yanli , Ingman Tuula , Salo Tuula , Konttinen Yrjö T. , Saari Herkko
Published: March 2012

Previous studies have shown increased susceptibility to periodontal diseases in children with Down's syndrome (DS). The mechanisms involved in the periodontal inflammatory processes in DS are not fully understood. The present study characterized the periodontal status of 9 non‐institutionalized DS children 9 to 17 years old (mean 13.6 years) relative to their age‐matched systemically and periodontally healthy controls. The periodontal status was assessed by visible plaque index (VPI), gingival bleeding index (GBI), and probing depth. We also assessed, by sodium dodecyl sulphate Polyacrylamide gel electrophoresis/laser densitometry and by zymography, the collagenase and gelatinase activities in the gingival crevicular fluid (GCF) and saliva samples collected from DS patients and from the controls. Eight of the nine DS children showed a periodontium comparable to that seen in healthy controls; beginning alveolar bone loss was radiographically seen in the DS patient with deep periodontal pockets. The endogenously active collagenase and total collagenase activities were slightly higher in GCF of DS children compared to healthy controls. Western blot demonstrated that GCF collagenase of DS patients was human neutrophil collagenase (MMP‐8 or collagenase‐2), which occurred in 75 kDa proMMP‐8 and in DS patients, but not in controls, also in 65 kDa active MMP‐8 form and occasionally lower 40–50 kDa MMP‐8 species. Zymographic analysis revealed the presence of 120 kDa (MMP‐9 complexed with neutrophil gelatinase associated lipocalin or NGAL), 92 kDa (MMP‐9) and 72 kDa (MMP‐2) gelatinases in DS and control GCF. Especially in DS GCF MMP‐9 occurred in part in 82‐85 kDa activated form. Salivary collagenase in DS was high when compared to controls but of the same MMP‐8 type as in control saliva. Our findings suggest that in vivo activated MMP‐8 in GCF derived from triggered PMNs and/or cytokine‐induced periodontal fibroblasts may reflect periodontal tissue and alveolar bone destruction seen in the early stages of gingivitis/periodontitis associated with Down's syndrome. J Periodontol 1996;67:748–754.
Interleukin‐1 Beta, Prostaglandin E2, and Immunoglobulin G Subclasses in Gingival Crevicular Fluid in Patients Undergoing Periodontal Therapy
Authors: Alexander David C.C. , Martin James C. , King Philip J. , Powell Jonathan R. , Caves Janice , Cohen Mark E.
Published: March 2012

Determination of the presence of inflammatory products found in gingival crevicular fluid (GCF) may be of value in evaluating both periodontal disease status and the outcome of therapy. Immunoglobulin G subclasses 1 through 4 (IgGs), interleukin 1‐β (IL‐1β), and Prostaglandin E2 (PGE2) have all been shown to be present in GCF. This study monitored IgGs, IL‐1β, and PGE2 in GCF of 18 adult patients as they progressed through periodontal treatment toward maintenance therapy. Sites were selected from the most severely affected sextant as determined by probeable crevice depth (PD) at initial examination (IE). GCF was collected on four occasions: initial examination; 4 weeks after completion of initial therapy (oral hygiene counseling, and scaling and root planing); 3 months after completion of surgery; and 7 to 9 months later at a maintenance visit. All variables were reduced to binary form (positive or negative), and break points chosen to separate the approximately symmetrical bellshaped areas (negatives) from the skewed tails (positives). Repeated measures analyses of variance were performed to detect significant changes in all variables across time. Significant improvements were observed for all the clinical variables measured: PD, attachment level, and bleeding on probing. However, significant reductions for the GCF components only occurred in the concentrations of IL‐1β and PGE2, but were not evident until the maintenance sampling. Surprisingly, GCF:serum ratios of IgG subclasses did not change significantly over the course of the investigation. The robustness of the levels of these components may be due to inflammation associated with the healing process, or to a further plaque induced response. J Periodontol 1996;67:755–762.
Quantitative Analysis of Periodontal Defects in a Skull Model by Subtraction Radiography Using a Digital Imaging Device
Authors: Young Shawn J. , Chaibi Mohamad S. , Graves Dana T. , Majzoub Zeina , Boustany Fred , Cochran David , Nummikoski Pirkka
Published: March 2012

This paper describes a quantitative study of periodontal defects produced in a skull model using subtraction images obtained with a digital imaging device, radiovisiography (RVG). Analysis using radiovisiography was compared to changes in weight and volume determined by physical measurements. Four types of periodontal defects were studied: 2‐wall, 3‐wall, crater, and furcation. All defects were fabricated on posterior teeth in alveolar bone and done with triplicate samples. Defects were made progressively larger in approximately 1 mm steps allowing examination of defects ranging from 1 mm to 5 mm. Radiographic images before and after each step were obtained with a radiovisiography system and subtracted. Changes in weight and defect volume were also recorded and compared to the results obtained after each step from the digital subtraction. For each defect type, a regression analysis was performed to compare changes in bone mass determined by weight with calculated bone loss determined by subtraction radiography or by volume measurements. When the calculated bone losses were compared to the true bone losses it was evident that the subtraction method frequently, but not always, underestimated the lesion sizes. For all lesions the average underestimation was 22%. The largest underestimation occurred with furcation lesions where the measured bone loss was underestimated on average by 67%. Two‐walled lesions were underestimated by 30%, 3‐wall lesions by 3%, and crater lesions were overestimated by 10%. Furthermore, the accuracy of each 1 mm step in bone loss varied considerably. At present, the imaging system is not sufficiently accurate to establish absolute determinations of the bone loss, but would be clinically useful in determining relative changes in bone loss or gain after treatment. In addition, caution must be taken in interpreting a given change in calculated bone loss, since considerable variation may result in either underestimation or overestimation of bone loss. J Periodontol 1996;67:763–769.
Levels of Cytokines and Collagen Type I and Type III as a Function of Age in Human Gingivitis
Authors: Yakovlev Elena , Kalichman Ina , Pisanti Sara , Shoshan Shmuel , Barak Vivian
Published: March 2012

The objective of this study was to examine the age‐dependent relationships between levels of inflammatory cytokines and collagen in human gingival inflammation. The gingival biopsies were obtained from 142 patients, divided into the following age groups: 6 to 14 years (prepubertal children); 18 to 35 years (young adults); 36 to 54 years (mature adults); and 55 years or above. The patients were also divided according to the severity of gingivitis. The tissues were analyzed for the contents of the inflammatory cytokines interleukin (IL)‐1β, IL‐6, IL‐8, and tumor necrosis factor alpha (TNF‐α) using specific ELISA kits, and interstitial collagen type I and type III using the ELISA method and specific antibodies. We found that in young adults, levels of IL‐1β and IL‐6 were significantly higher in inflamed than in non‐inflamed gingiva. Total collagen in the young adults, however, was lower in inflamed than in noninflamed gingiva. There was no significant difference in the levels of either IL‐8 or TNF‐α between inflamed and non‐inflamed gingiva independent of age. No difference in the level of collagen type I between the inflamed and non‐inflamed gingiva was found in any age groups. The level of collagen type III was lower in inflamed than in non‐inflamed gingiva in both children and ≥ 55 year group. The results indicate a disparity in the effect of age on the levels of cytokines and of collagen type I and type III in both clinically normal and inflamed gingiva. J Periodontol 1996;67:788–793.
Short‐Term Responses to Periodontal Therapy in Insulin‐Dependent Diabetic Patients
Authors: Smith G. Todd , Greenbaum Carla J. , Johnson Bradley D. , Persson G. Rutger
Published: March 2012

This investigation studied relative changes in periodontal conditions of 18 insulin‐dependent diabetic patients. Measures of gingival inflammation, crevicular fluid aspartate aminotransferase (AST) levels, probing depth and attachment levels, the presence of three periodontal pathogens (Porphyromonas gingivalis, Bacteroides forsythus, and Actinobacillus actinomycetemcomitans) and serum antibody titers to these bacteria, and blood sugar levels (glycosylated hemoglobin, HbAlc) were studied before and 2 months after non‐surgical debridement. Antibody titers to the same bacteria were also studied in sera from 18 sex‐ and age‐matched periodontally healthy and non‐diabetic subjects. Periodontal conditions showed significant improvement. The mean probing depth at 4 of the worst sites selected in each patient decreased from 5.7 mm to 4.8 mm (P < 0.0001). The mean full width probing depth changed from 2.9 mm (s.d. ± 0.2) to 2.5 mm (s.d. ± 0.3). A mean gain of 0.4 mm attachment level was recorded (P < 0.0001). The mean AST value decreased from 1009 μIU to 518 μIU (P < 0.006). Minimal differences in mean glycosylated hemoglobin values (HbAlc) were noticed before and after treatment. A. actinomycetemcomitans was never detected. P. gingivalis was present at 7% of the sites both before and after treatment. B. forsythus was found at 29% of sites (50% of patients) before and at 36% of sites (61% of patients) after treatment. Positive associations were found between the presence of B. forsythus and AST values, gingival index, probing depth, and attachment level (P < 0.05). Baseline serum IgG titers to P. gingivalis were significantly lower in the patients with diabetes (9.5 ELISA units vs. 28.5 ELISA units in the healthy controls). IgG titers to B. forsythus did not differ between diabetic and non‐diabetic subjects. No changes in IgG titers occurred after treatment. Clinical improvements after mechanical non‐surgical therapy in patients with insulin‐dependent diabetes mellitus were modest after 2 months. Treatment did not eliminate B. forsythus and P. gingivalis and did not affect IgG titer responses. More intense therapy, and longer follow‐up times, may be necessary to see more pronounced clinical and systemic effects. J Periodontol 1996;67:794–802.
Comparing Measures of Reliability for Indices of Gingivitis and Plaque
Authors: Spolsky Vladimir W. , Gombein Jeffrey A.
Published: March 2012

The purpose of this methodological study was to compare methods used to assess reliability for gingival inflammation and plaque. Duplicate examinations were conducted by one examiner on 17 subjects (506 scoring sites), using the gingival index (GI), bleeding points index (BPI), and plaque index (PI). The percentage of agreement, the weighted and unweighted kappa coefficients, and Pearson correlation coefficients were calculated as statistics of reliability for mesial buccal site scores and whole mouth mean scores when appropriate. For mesial buccal sites the respective values of the GI, BPI, and PI for weighted kappas were: 0.47, 0.49, and 0.75; for the correlation coefficients: 0.47, 0.49, and 0.76; for unweighted kappas, 0.39, 0.49, and 0.39; and for percentage of agreement 66.2%, 76.1%, and 51.2%. For whole mouth means the correlation coefficients for the GI, BPI, and PI were 0.87, 0.59, and 0.87, respectively. In conclusion, the most useful statistics in assessing the intraexaminer reliability of a solo examiner in descending order were the weighted kappa coefficient, Pearson correlation coefficient, the unweighted kappa coefficient, and percentage of agreement. J Periodontol 1996;67:853–859.
Ability of Commercial Demineralized Freeze‐Dried Bone Allograft to Induce New Bone Formation
Authors: Schwartz Z. , Mellonig J.T. , Carnes D.L. , De La Fontaine J. , Cochran D.L. , Dean D.D. , Boyan B.D.
Published: March 2012

Demineralized freeze‐dried bone allograft (DFDBA) has been used extensively in periodontal therapy. The rationale for use of DFDBA includes the fact that proteins capable of inducing new bone; i.e., bone morphogenetic proteins, can be isolated from bone grafts. Commercial bone banks have provided DFDBA to the dental practitioner for many years; however, these organizations have not verified the osteoinductive capacity of their DFDBA preparations. The aim of this study was to determine the ability of commercial DFDBA preparations to induce new bone formation. DFDBA with particle sizes ranging from 200 to 500 μm was received from six bone banks using various bone production methods. Different lots of DFDBA from the same tissue bank were sometimes available. A total of 14 lots were examined. The surface area of bone particles in each sample was measured morphometrically and the pH of a solution containing the particles after suspension in distilled water determined. Samples from each DFDBA lot were implanted intramuscularly (10 mg) or subcutaneously (20 mg) into three different animals and tissue biopsies harvested after 4 weeks. One sample from each tissue bank was implanted and harvested after 8 weeks. At harvest, each area where DFDBA had been implanted was excised and examined by light microscopy. The ability of DFDBA to produce new bone was evaluated and the amount of residual bone particles measured. The results show that bone particles from all tissue banks had a variety of shapes and sizes, both before implantation and after 1 or 2 months of implantation. The pH of particle suspensions also varied between batches, as well as between tissue banks. None of the DFDBA induced new bone formation when implanted subcutaneously. Intramuscular implants from three banks induced new bone formation after 1 and 2 months. DFDBA from two banks caused new bone formation only after 2 months. However, DFDBA from one bank did not induce new bone at all. Particle size before implantation correlated with particle size after implantation. However, particle size did not correlate with ability to induce bone. The results show that commercial DFDBA differs in both size and ability to induce new bone formation, but that the two are not related. The study also indicates that wide variation in commercial bone bank preparations of DFDBA exist and that ability to induce new bone formation also varies widely. Furthermore, the results suggest that methods or assays for evaluating the ability of DFDBA to induce new bone should be developed and standardized. J Periodontol 1996;67:918–926.
Evaluation of Bioabsorbable Elastin‐Fibrin Matrix as a Barrier in Surgical Periodontal Treatment
Authors: Da Costa‐Noble Reynald , Soustre Emmanuelle Courcier , Cadot Sylvie , Lauverjat Yves , Lefebvre Françoise , Rabaud Michel
Published: March 2012

The purpose of this investigation was to test clinically the efficiency of a recently described bioabsorbable matrix as a guided tissue regeneration membrane. This matrix was prepared from an original reaction between elastin and fibrin monomers and is now extensively used in several domains of surgery. The study group was composed of 26 patients, with a total of 35 lesions (22 intrabony defects, 8 Class II furcations and 5 Class III furcations) presenting moderate to advanced adult periodontitis. After initial therapy, measurements were made with a calibrated periodontal probe. Probing depth (PD) and gingival margin location (GM) measurements were taken twice: immediately before surgery and after 6 months before re‐entry. Clinical attachment level (CAL), vertical osseous level (VOL) and alveolar crest location (AC) measurements were taken during surgery and after 6 months with re‐entry procedures for all the patients. Color change of the gingival margin was only observed in 4 defects and device exposure occurred in the proportion of 2 out of the 35 defects. No foreign body reaction was observed in any case. At the intrabony defects mean PD reduction was 5 mm (P < 0.001) and mean gain of CAL was 4 mm (P < 0.001). Mean VOL was 4.3 mm (P < 0.001), mean gingival recession was 0.9 mm (P < 0.05) and mean AC was 0.2 mm (NS). At the Class II furcation defects the mean PD reduction was 4.5 mm (P < 0.001), mean gain CAL vertical was 3.2 mm and CAL horizontal was 4.5 mm (P < 0.001). Gingival recession averaged 1 mm (NS). A complete closure was observed in 2 out of the 8 defects. At the Class III furcation defects the mean PD reduction was 3.6 mm (P < 0.05) and mean CAL‐V gain was 1.5 mm (P < 0.02). However the 5 sites showed no horizontal attachment gain and none were unchanged. A very low gingival recession, gingival reaction, crestal bone loss, and device exposure occurred during this study. This preliminary study suggests that the use of a biosynthetic barrier may have beneficial effects in the treatment of intrabony defects and Class II furcation defects. Randomized controlled trials are necessary to evaluate the efficacy and safety of this bioabsorbable membrane in periodontal therapy. J Periodontol 1996;67:927–934.