bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Human Comparison of Expanded Polytetrafluoroethylene Barrier Membrane and Freeze‐Dried Dura Mater Allografts for Guided Tissue Regeneration of Lost Periodontal Support. I. Mandibular Molar Class II Furcations
Authors: Yukna Raymond A.
Published: March 2012

The response of mandibular Class II facial furcations to guided tissue regeneration treatment with expanded polytetrafluoroethylene barrier membrane (e‐PTFE) or freeze‐dried dura mater allograft (FDDMA) barriers was evaluated in 11 pairs of molars in 11 patients. Following initial preparation, full thickness flaps were raised in the area being treated, the bone and furcation defects debrided of granulomatous tissue, and the involved root surfaces mechanically and chemically prepared. By random allocation, e‐PTFE or FDDMA barriers were fitted over the furcations, secured in place, and the host flap repositioned or coronally positioned. Postsurgical deplaquing was performed every 10 days leading up to e‐PTFE removal at about 6 weeks (the resorbable FDDMA did not require removal). Continuing supportive periodontal therapy was provided until surgical re‐entry at one year for documentation and any further necessary treatment. Direct clinical measurements demonstrated essentially similar clinical results with both barrier materials for bone and soft tissue changes (few statistically or clinically significant differences). Exceptions were the amount of horizontal furcation fill and the change in the width of the keratinized gingiva, both of which were better with FDDMA (P <0.05). Improvements in open probing attachment levels observed at the time of e‐PTFE removal were lost over the intervening months, more so for the vertical than the horizontal component of the furcation lesion. Intrapatient comparisons suggested better horizontal furcation responses with FDDMA. The findings of this study suggest equal clinical results with e‐PTFE and FDDMA barriers utilizing the GTR technique. These results in Class II mandibular furcations are less favorable than those reported by others. Barrier techniques to handicap the race between different tissues of the periodontal complex appear to be of some clinical benefit and deserve further evaluation. J Periodontol 1992;63:431–442.
Incidence of Verapamil‐Induced Gingival Hyperplasia in a Dental Population
Authors: Miller Craig S. , Damm Douglas D.
Published: March 2012

The records of 5,000 dental patients were reviewed for history of Verapamil use between 1987 and 1990. Twenty‐four dentate patients who received Verapamil for more than 1 year were identified. Of these, gingival hyperplasia occurred in 1 patient (4.1%) that was limited to the mandibular attached gingiva. Onset of gingival overgrowth was associated with drug dosage, bacterial accumulation, and gingival inflammation. His tologically, the findings resembled that seen in hyperplasia induced by phenytoin, cyclosporin, and other calcium channel blockers. Our data suggest that gingival hyperplasia caused by Verapamil occurs less frequently than nifedipine‐induced gingival hyperplasia. J. Periodontol 1992; 63:453–456.
Subgingival Delivery by an Oral Irrigation Device
Authors: Braun Robert E. , Ciancio Sebastian G.
Published: March 2012

Irrigating devices have been incorporated into numerous oral hygiene regimens. Newer types of these devices are designed to deliver irrigating solutions directly into the periodontal pocket. We examined the ability of a powered irrigating device with a soft rubber tip to deliver subgingivally into periodontal pockets. When subgingival irrigation was used, the mean pocket penetration was 90% of the pocket depth (≤ 6 mm) compared to a mean of 21% in the oral rinse group. The irrigation was not uncomfortable to patients. J Periodontol 1992; 63:469–472.
The Natural History of Periodontal Disease in Man: Prevalence, Severity, and Extent of Gingival Recession
Authors: Löe Harald , Ånerud Åge , Boysen Hans
Published: March 2012

This paper describes the occurrence and levels of gingival recession in 2 cohorts of individuals participating in parallel longitudinal studies in Norway (1969–1988) and Sri Lanka (1970–1990), covering the age range from 15 to 50 years. In the Norwegian cohort gingival recession had begun early in life. It occurred in ≥60% of the 20 year‐olds and was confined to the buccal surfaces. At 30, ≥70% had recession, which still was found mainly on buccal surfaces. As the group approached 50 years of age, more than 90% had gingival recession; ≥25% of the buccal surfaces were involved, ≥15% of lingual, and 3 to 4% of the interproximal surfaces. In the Sri Lankan cohort ≥30% exhibited gingival recession before the age of 20 years. By 30 years, 90% had recession on buccal, lingual, and interproximal surfaces; and at 40 years, 100% of the Sri Lankans had recession. As they approached 50 years, gingival recession occurred in ≥70% of the buccal, ≥50% of the lingual, and 40% of the interproximal surfaces. Based on the special features of the two cohorts, the working hypothesis is advanced that there is more than one type of gingival recession and probably several factors determining the initiation and development of these lesions. J Periodontol 1992;63:489–495.
Detection of Herpes Simplex Virus in Gingival Tissue
Authors: Amit Rivka , Morag Abraham , Ravid Zohar , Hochman Nira , Ehrlich Jacob , Zakay‐Rones Zichria
Published: March 2012

The presence of herpes simplex virus (HSV) antigens was shown by immunofluorescence staining in 26 of 66 (39.3%) specimens of clinically healthy gingiva, but only one sample contained infectious virus. HSV DNA sequences were clearly identified in intact gingival cells by dot blot hybridization in one specimen, and a weak pattern in a second one. Both specimens harbored viral antigens. These findings of viral genome and protein expression suggest that the virus is present in the latent form in the gingiva. J Periodontol 1992; 63:502–506.
Analysis of Site Specific Periodontal Bacteria Sampling Schemes
Authors: Gunsolley J.C. , Chinchilli V.N. , Savitt E.D. , Killoy W. , Darack A.P. , Christersson L.A. , Fransson C.F. , Dunford R.G. , Zambon J.J.
Published: March 2012

A great deal of controversy has existed in the periodontal literature as to whether the site or the subject should be the unit of analysis. Using the site as the unit of analysis assumes that observations of sites within the same subject are independent and ignores between subject variation. The purpose of this report is to evaluate the influence that the unit of analysis has on estimating the number of necessary site specific bacterial samples from each subject. The number of bacterial samples per subject was defined as the number of samples that would insure a clinician at a 95% confidence level that, if the bacteria were present in a subject, it would be discovered. From two data sets in which 20 to 30 bacterial samples were taken from each subject and data generated from a simulation, appropriate within‐subject sample size was determined. In one data set the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, and Prevotella intermedia was determined by indirect immunofluorescence. In the other data set the presence of A. actinomycetemcomitans, P. gingivalis, and P. intermedia was determined using DNA probes. Results of this study demonstrate that there is a large between subject variation in site specific bacterial prevalence, as indicated by an elevated intraclass correlation. Simulated data in this report demonstrated that the number of necessary bacterial samples per subject increased with increasing values of intraclass correlation. The number of necessary within subject samples also increased with decreasing prevalence rate. For A. actinomycetemcomitans, which had a low prevalence rate (0.11 to 0.18), the number of necessary samples per subject was very high (31 to 35). On the other hand, for the other bacterial types, and especially for samples taken at deep periodontal pockets, the prevalence was much higher (0.62 to 0.94), and the number of necessary samples per subject was low (2 to 4). When the site was used as the unit of analysis, and between subject variation was ignored, the within subject sample size was underestimated. Therefore, in the determination of the appropriate number of bacterial samples, within subject effects cannot be ignored and the subject, not the site, must be the unit of analysis. J Periodontol 1992; 63:507–514.
Gingival Lesions in Lipoid Proteinosis
Authors: Israel Harry
Published: March 2012

Lipoid proteinosis is a rare heritable disease of the skin and mucous membranes characterized by subepithelial deposits of hyaline material. The morbid factors include disfiguring papulo‐nodular lesions particularly of exposed skin, hoarseness of voice due to vocal cord infiltration, nodular deformation of the eyelids, and board‐like rigidity of the tongue. Infiltration of the gingiva is usually unreported, and when mentioned has been equivocally related to the overall disease process. This patient demonstrates striking ulceration and hypertrophy with histologic evidence of heavy deposition of amorphous material confirming a gingival component to the lipoid proteinosis entity. J Periodontol 1992; 63:561–564.
Immunohistological Localization of Cell Adhesion Proteins and Integrins in the Periodontium
Authors: Steffensen Bjorn , Duong Anh H. , Milam Steven B. , Potempa Cheryl L. , Winborn William B. , Magnuson Victoria L. , Chen Dali , Zardeneta Gustavo , Klebe Robert J.
Published: March 2012

The distribution of the cell adhesion proteins vitronectin, fibronectin, tenascin, and laminin as well as several integrin subunits, α2, α5, and αv, was studied in primate periodontal tissues. Full baboon mandibular sections were analyzed by immunohistochemical methods in order to localize the molecules studied in both soft and hard tissues. Vitronectin was associated with the connective tissue of the marginal gingiva, the periodontal ligament, as well as the endosteum and periosteum. A notable finding was the particularly high staining intensity of vitronectin in the periodontal ligament. Fibronectin was widely distributed in the periodontal connective tissue and was also localized to the pericellular matrix of osteocytes and blood vascular elements. Epithelial basement membranes stained positively for both fibronectin and tenascin. These proteins were also expressed in the periosteal and endosteal connective tissues and the periodontal ligament. The staining intensity for tenascin was higher in zones along the cementum and bone surfaces. Laminin was, characteristically, limited to basement membranes of epithelium and endothelium. The distribution of fibronectin, tenascin, and laminin is related to previous findings in other species. The localization of the several integrin α‐subunits is also described in full baboon mandibular sections. The vitronectin receptor (αv) had a uniquely strong expression in osteoclasts of the alveolar bone and was found, at lesser intensity, on periodontal ligament fibroblasts. The fibronectin receptor α subunit, α5, was also observed on osteoclasts, and, in addition, was widely distributed on fibroblasts, cementoblasts, and osteoblasts. The collagen receptor subunit, α2, was detected on fibroblasts, osteoblasts, cells lining the alveolar bone, and root cementum, as well as basal cells of the epithelium. These findings demonstrate a characteristic distribution of several adhesion proteins and integrins in the primate periodontium. The results should provide a better understanding of cell‐extracellular matrix interactions in the periodontal tissues and create the basis for future functional studies of extracellular matrix molecules in the periodontium. J Periodontol 1992; 63:584–592.
Rinsing With Delmopinol 0.2% and Chlorhexidine 0.2%: Short‐Term Effect on Salivary Microbiology, Plaque, and Gingivitis
Authors: Collaert Bruno , Edwardsson Stig , Attström Rolf , Hase Jan C. , Åström Mikael , Movert Rolf
Published: March 2012

The aim of this short‐term study was to compare the effect of delmopinol HCl 0.2% and chlorhexidine digluconate 0.2% rinses on the development of dental plaque, the healing of experimental gingivitis, and the salivary microbiology. As part of a larger study protocol, 45 healthy males enrolled in an oral hygiene program to upgrade their oral health. For this portion of the study, participants had their teeth professionally cleaned on day 0. The participants then abstained from standard mechanical oral hygiene procedures, but applied a placebo solution twice daily for 2 weeks. At the end of this period the subjects received a second professional cleaning and were then assigned to 2 treatment groups: Group 1 rinsed with 10 ml of delmopinol HCl 0.2% and Group 2 rinsed with 10 ml of chlorhexidine digluconate 0.2% for 1 minute twice daily for the next 2 weeks and continued to refrain from mechanical oral hygiene procedures. At the end of the placebo and active treatment periods 1) saliva samples were taken and cultivated on a series of media; 2) the degree of gingivitis was assessed with gingival crevicular fluid (GCF) and gingivitis index (GI); and 3) the plaque index was assessed and the stainable buccal plaque extension was analyzed planimetrically. No changes in the salivary microbiological counts were detected for the subjects rinsing with delmopinol. Subjects rinsing with chlorhexidine showed significant reductions of anaerobes, aerobes, and S. mutans in saliva. The amounts of GCF and GI were reduced largely to the same extent in both treatment groups. Mean plaque extension was reduced by 52% after delmopinol and 88% after chlorhexidine rinsing. The results show that rinsing with delmopinol for a period of 14 days 1) does not give rise to detectable changes in the cultivable salivary microflora; 2) reduces plaque regrowth less effectively than chlorhexidine; and 3) promotes the healing of an experimentally induced gingivitis largely to the same extent as chlorhexidine. J Periodontol 1992; 63:618–625.
The Effect of Nd:YAG Laser Exposure on Root Surfaces When Used as an Adjunct to Root Planing: An In Vitro Study
Authors: Morlock Bradley J. , Pippin David J. , Cobb Charles M. , Killoy William J. , Rapley John W.
Published: March 2012

The purpose of this study was to evaluate the effects of Nd:YAG laser treatment on root surfaces in vitro when used alone or in combination with conventional scaling and root planing. The study population consisted of 18 unerupted third molars, each with a 3 mm diameter treatment site outlined on the root surface. Three specimens were randomly assigned to each of 6 different treatment groups: 1) untreated control; 2) root planed only; 3) laser treated only using 1.25 W of energy; 4) laser treated only using 1.50 W of energy; 5) laser treated with 1.25 W of energy followed by root planing; and 6) laser treated with 1.50 W of energy followed by root planing. Following their respective treatment, all specimens were prepared for evaluation by scanning electron microscopy. Specimens from Group 2, root planed only, exhibited a smear layer of scalelike texture with parallel instrument tracks resulting from curet use. Specimens treated by laser only, Groups 3 and 4, featured various surface changes not observed in controls such as charring and carbonization of the cementum surface, randomly distributed pitting and crater formation, and melting of the root mineral phase with subsequent resolidification as porous globules. Those specimens treated by laser followed by root planing, Groups 5 and 6, exhibited surface characteristics similar to those noted in Group 2 specimens. Further, there were areas of exposed dentinal tubules resulting from a “peeling” of the cementum layer. The results of this in vitro study suggest that laser use during root preparation, even at relatively low energy levels, will result in physical changes to the root surface. The surface alterations are not apparent after scaling and root planing. Whether the laser‐induced surface changes are detrimental to the goals of periodontal therapy remains to be answered. J Periodontol 1992; 63:637–641.
A Preliminary Study on the Effects of the Nd:YAG Laser on Root Surfaces and Subgingival Microflora In Vivo
Authors: Cobb Charles M. , McCawley Thomas K. , Killoy William J.
Published: March 2012

The purpose of this study was to examine the effects of root preparation using the pulsed Nd:YAG laser, either alone or in combination with manual instrumentation. Study specimens consisting of 18 teeth with associated periodontal pockets from 8 different patients were treated as follows: 5 specimens were root planed with curets followed by laser exposure for 3 minutes using energy settings of 3.0 W at 20 pps; 2 specimens were root planed and then laser treated for 3 minutes using settings of 2.25 W and 20 pps; 4 specimens were treated by laser for 1 minute at settings of 1.75 W and 20 pps followed by root planing; 4 specimens were treated by laser only for 1 minute using settings of 1.75 W and 20 pps; and the remaining 3 teeth served as untreated controls. Both prior to and after completion of the laser and root planing treatments, microbiological samples were obtained from the treated pockets and submitted to a commercial laboratory for analysis of levels of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia. With the exception of two 7‐day specimens, all others were extracted immediately post‐therapy and processed for SEM examination. All treated specimens, regardless of treatment sequence, exhibited some degree of laser‐induced root surface alteration. Notably, laser‐treated calculus deposits were free of their characteristic surface layer of microbial plaque. Microbial sampling indicated a post‐therapy reduction in levels of all 3 putative microbial pathogens compared to pre‐treatment samples and control specimens. However, SEM examination revealed residual deposits of plaque and calculus in all treatment groups. Subgingival use of Nd:YAG lasers appears to be technique sensitive and long‐term therapeutic benefits remain to be established. J Periodontol 1992;63:701‐707.
Multiple Focal Pigmented Lesions in the Maxillary Tuberosity and Hard Palate: A Unique Display of Intraoral Junctional Nevi
Authors: Biesbrock Aaron R. , Aguirre Alfredo
Published: March 2012

The pigmented conditions located in the oral cavity have a diverse genesis ranging from vascular lesions to exogenous and endogenous pigmentations. In this report we have documented the unusual occurrence of multiple intraoral junctional nevi in a patient. A review of the patient's past dental records revealed that 2 of these lesions were first noticed 8 years earlier; however, no efforts were made to identify the nature of the pigmentations. Removal of 4 lesions and subsequent histopathological analysis revealed the presence of junctional nevi. This case illustrates the importance of a thorough clinical and histological work‐up when dealing with pigmented lesions in the oral cavity. The excision of all suspected oral nevi is warranted because they cannot be clinically differentiated from other pigmented lesions, including oral melanoma. In addition, the potential of junctional nevi to undergo malignant transformation in the oral cavity is undetermined. J Periodontol 1992; 63:718–721.
Entrance of Actinobacillus actinomycetemcomitans into HEp‐2 Cells In Vitro
Authors: Schytte Blix Inger J. , Hars Renate , Preus Hans R. , Helgeland Kristen
Published: March 2012

A strain of actinobacillus actinomycetemcomitans, freshly isolated from a juvenile periodontitis patient, and the FDC Y4 laboratory strain of Aa were tested for their capacity to adhere to and enter the epithelial cell line HEp‐2 cells in vitro. Immunofluorescence microscopy as well as scanning electron microscopy (SEM) and transmission electron microscopy (TEM) showed that both strains adhered to the outer surface of the HEp‐2 cells. In the TEM studies, the specimens were also treated with Aa specific antibodies and gold labeled protein A. These examinations showed that only the freshly isolated strain of Aa was found within the HEp‐2 cells. The intracellular Aa were found to be viable, and in one case one of them was seen to undergo division. It is concluded that freshly isolated Aa has the ability to enter epithelial HEp‐2 cells in vitro, and it is tentatively suggested that this may play a role in the pathogenesis of periodontal disease. J Periodontal 1992; 63:723–728.
Evaluation of a Simple Modified Radiographic Alignment System for Routine Use
Authors: Carpio Lillian C. , Hausmann Ernest , Dunford Robert G. , Allen Kristin M. , Christersson Lars A.
Published: March 2012

Radiographic frames used for longitudinal studies may be in part unreadable for measuring crestal bone change. Sites may not be present on the film, or the measurement reliability may be compromised because of dissimilar geometry. Several techniques used to address this problem are expensive, time‐consuming, and require great skill. For the present study a commercially‐available alignment system was simply modified by addition of a reference pin in the bite block, facilitating the repositioning of the film holder for a second exposure. This study determined the ability of the modified instrument to: 1) improve the geometrical correspondence between serial radiographs; and 2) reduce the frequency of missed sites in the film. Two pairs of x‐rays were taken for each of 40 subjects, 1 pair with the standard alignment instrument of an assigned site and 1 pair with the modified instrument of the contralateral site. Measurements of alveolar bone height were performed using the “side by side” technique. The modified instrument yielded significantly smaller measurement differences and a significantly better geometrical correpondence than the conventional system (P <0.05). Also, the modified instrument yielded significantly greater (P <0.01) readable sites (86%) as compared to the conventional instrument (62%). The simply‐modified instrument facilitates the correct interpretation of serial radiographs. J Periodontol 1994;65:62–67.
Effect of Local Metronidazole Application on Periodontal Healing Following Guided Tissue Regeneration. Clinical Findings
Authors: Sander Lone , Frandsen Ellen Voigt G. , Arnbjerg Dorte , Warrer Kirsten , Karring Thorkild
Published: March 2012

The effect on periodontal healing after guided tissue regeneration (GTR) in association with local application of metronidazole gel was evaluated in this study. Twelve patients with one pair of vertical periodontal bone defects of comparable size and configuration participated in the study. In a matched paired design, the test defects were treated by GTR using expanded polytetrafluoroethylene (ePTFE) membranes in combination with local application of metronidazole gel. The controls were treated in the same way except for application of metronidazole. During the first month of membrane implantation, no statistically significant differences between test and control surfaces were noted with respect to inflammation of the marginal gingiva. Six weeks following insertion, the membranes were removed. Six months after removal of the membrane, the median gain in probing attachment level as a percentage of the initial defect depth was 92% for test defects and 50% for control defects (P =.001). No statistically significant differences were found between test and control sites regarding plaque, bleeding on probing, reduction in pocket depth, gain in bone height, or recession of the gingival margin. In conclusion, the results of the present study indicate that local application of metronidazole gel has a beneficial effect on healing of periodontal vertical defects treated by guided tissue regeneration. J Periodontol 1994;65:914–920.
Effect of Local Metronidazole Application on Periodontal Healing Following Guided Tissue Regeneration. Microbiological Findings
Authors: Frandsen Ellen V.G. , Sander Lone , Arnbjerg Dorte , Theilade Else
Published: March 2012

The bacteriological colonization of healing periodontal defects was investigated after treatment with guided tissue regeneration using expanded polytetrafluoroethylene membranes together with local metronidazole gel (25%, 250 mg/g). Twelve patients, each with one pair of comparable defects, had the test defect treated with the membrane plus metronidazole gel and the control defect treated with the membrane alone. Thirty weeks after removal of the membrane, the median gain in probing attachment level as a percentage of the initial defect depth was 92% for the test defects and 50% for the control defects (P = 0.001). The median number of cultivable bacteria decreased from 1.2 × 106 at the presurgical examination to 3.0 × 105 at the one week examination in the test group (P = 0.02), whereas an increase was observed in the control group. Similarly, a lower median proportion of black‐pigmented Gram‐negative anaerobic rods was observed one week postsurgically in the test group (0.004%) compared to the control group (3.5%) (P = 0.02). Two weeks after membrane insertion, and at all following examinations, no microbiological differences between test and control group were observed. Consequently, the influence of the metronidazole gel on the treatment result appears to have been confined to the initial regeneration phase. Despite the good clinical results in the test group, all membranes from both test and control pockets were heavily colonized with bacteria at the time of removal. To ensure maximal periodontal regeneration with formation of bone, future research in this area should concentrate on reducing the microbial colonization of the wound area. J Periodontol 1994;65:921–928.
Smokeless Tobacco Effects on Monocyte Secretion of PGE2 and IL‐1β
Authors: Payne Jeffrey B. , Johnson Georgia K. , Reinhardt Richard A. , Maze Constance R. , Dyer John K. , Patil Kashinath D.
Published: March 2012

The use of smokeless tobacco (st) products is associated with mucosal lesions, gingival recession, and attachment loss at the site of tobacco placement. Monocytes/macrophages are primary producers of PGE2 and IL‐1β, inflammatory mediators which are thought to play a role in the destruction of the periodontium. The purpose of this study was to determine the effect of ST alone and in combination with a major stimulator of inflammation, bacterial lipopolysaccharide (LPS), on monocyte secretion of these mediators. Peripheral blood monocytes (PBM) were isolated by counterflow centrifugal elutriation from 15 healthy donors who were non‐ST users. PBM were incubated for 24 hours in RPMI 1640 containing various concentrations of ST (0%, 0.005%, 0.01%, 1%) with or without 10 μg/ml LPS (Porphyromonas gingivalis LPS or Escherichia coli LPS). Of the ST preparations, only 1% ST resulted in PBM mediator secretion (7.7 ± 2.0 ng/ml for PGE2 and 1.3 ± 0.2 ng/ml for IL‐1β) above that of control (unstimulated) cultures. Furthermore, the combination of 1% ST and LPS resulted in a potentiation of PGE2 release (5‐fold for E. coli LPS + 1% ST and 10‐fold for P. gingivalis LPS + 1% ST; P < 0.0001, one‐way ANOVA) relative to the LPS preparations alone. In contrast, PBM IL‐1β release decreased more than 2‐fold upon E. coli LPS and 1% ST exposure, relative to treatment with E. coli LPS alone (P < 0.0001, one‐way ANOVA). PBM IL‐1β release either increased or decreased following treatment with P. gingivalis LPS + 1% ST, depending on the magnitude of the P. gingivalis LPS response alone. These data indicate that ST has profound effects on monocyte secretion of PGE2 and IL‐1β, and modulates the LPS‐mediated monocyte response. J Periodontol 1994;65:937–941.
Contaminated Implant Surfaces: An In Vitro Comparison of Implant Surface Coating and Treatment Modalities for Decontamination
Authors: Dennison David K. , Huerzeler Markus B. , Quinones Carlos , Caffesse Raul G.
Published: March 2012

The relationship between implant surfaces and decontamination treatments was studied in vitro to determine which implant surfaces were most effectively decontaminated, and which treatment was most effective for treating a particular implant surface. The implants used in the study were press fit cylindrical titanium units with machined, plasma sprayed, and hydroxyapatite‐coated surfaces. Radioactive endotoxin (125I‐LPS) was prepared from Porphyromonas gingivalis (ATCC 33277). Implants were coated with 125I‐LPS and treated by burnishing with a cotton pellet soaked in water, citric acid solution (CA), or 0.12% chlorhexidine (CHX); or treated with an air‐powder abrasive (AIR). Radioactivity was determined after each of two treatment cycles. The results for each implant surface were analyzed using ANOVA to determine differences between treatments. The remaining 125I‐LPS after two treatment cycles were: for machined implants AIR < CA, with AIR = water = CHX and water = CHX = CA; for plasma sprayed implants AIR<water = CHX = CA; for hydroxyapatite implants AIR = CA <water<CHX. In evaluating treatment modalities, it was found that machined implants were decontaminated more effectively than the other surfaces by all treatments; the exception was citric acid treatment which was equally effective on either machined or hydroxyapatite surfaces. These results indicate that machined implants (without surface coating) are most readily decontaminated by a variety of methods; this characteristic should be considered, since long‐term success of implants may involve treating peri‐implantitis. Further, the results indicate that air abrasives are effective for decontaminating implant surface, with the exception that hydroxyapatite coated surfaces can be treated equally with air abrasives or citric acid. J Periodontol 1994;65:942–948.
Cytokine‐Dependent Synergistic Regulation of Interleukin‐8 Production From Human Gingival Fibroblasts
Authors: Takigawa Masayuki , Takashiba Shogo , Myokai Fumio , Takahashi Keiso , Arai Hideo , Kurihara Hidemi , Murayama Yoji
Published: March 2012

Human gingival fibroblasts (HGF) may have an important role in the orchestration of immuno‐participant cells infiltrating the gingiva in response to continuously recurring bacterial infection. To examine the cytokine network regulating HGF‐derived interleukin (IL)‐8, a potent neutrophil chemotactic cytokine, we analyzed the effects of inflammatory cytokines alone and in combination on IL‐8 production by HGF. IL‐1β, tumor necrosis factor‐α (TNF‐α), interferon‐γ (IFN‐γ), IL‐6, and IL‐8 were used as stimulants. HGF secreted IL‐8 in a dose‐dependent manner after stimulation with either IL‐1β or TNF‐γ, but not with IFN‐γ or IL‐6. Furthermore, IL‐8 itself did not affect IL‐8 mRNA accumulation in HGF in an autocrine manner. The combination of IL‐1β and TNF‐α synergistically enhanced the secretion of IL‐8, whereas IFN‐γ suppressed IL‐8 secretion by IL‐1β‐ or TNF‐α‐stimulated HGF. These effects were also observed at each level of IL‐8 mRNA expression in HGF. IL‐8 secretion by cytokine‐stimulated HGF was not influenced by the inhibition of PGE2 synthesis with indomethacin, indicating that endogenous PGE2 was not involved in IL‐8 production by HGF. These results indicate that IL8 production by HGF is synergistically stimulated by specific cytokines, IL‐1β and TNF‐α, and suggest that these stimulatory effects are down‐regulated by IFN‐γ at the transcriptional level through PGE2‐independent pathways. Thus, neutrophil‐mediated processes in periodontal disease may be regulated in part by HGF in the cytokine network of immuno‐participant cells. J Periodontol 1994;65:1002–1007.
Phenotypic Characterization of Mononuclear Cells Following Anorganic Bovine Bone Implantation in Rats
Authors: Cohen Robert E. , Mullarky Richard H. , Noble Bernice , Comeau Robin L. , Neiders Mirdza E.
Published: March 2012

The purpose of this study was to measure inflammatory changes associated with implantation of anorganic bovine bone and bovine bone/collagen composite grafts, and to compare the response to that obtained following grafting with hydroxyapatite. Anorganic bovine bone, either with or without bovine collagen, as well as granular and block forms of synthetic hydroxyapatite, were implanted subcutaneously in Wistar rats. Saline and turpentine oil were used as controls. Biopsies were obtained after 3 days and at 1, 2, 4, 6, and 8 weeks. A panel of 6 monoclonal antibodies was used to detect monocytes, several distinct macrophage subsets, Ia‐antigen expression, and T‐ and B‐lymphocytes. Cells identified by each antibody were counted after immunocytochemical staining, and sera obtained 6 weeks after grafting were used in immunoblotting assays to detect antibodies to bovine serum proteins and collagen. Anorganic bovine bone, bovine bone/collagen, and hydroxyapatite all produced a transient macrophage infiltrate that was maximum 3 days after implantation, but resolved to normal levels within 6 to 8 weeks. Lymphocyte infiltration was not elicited by any bovine graft material, and antibodies to bovine serum proteins or type I collagen were not detected in any of the animals examined. These data indicate that a systemic or local immune response does not develop following implantation with anorganic bovine bone or with anorganic bovine bone/collagen materials. It appears appropriate to explore further the merits of these materials for periodontal regenerative procedures. J Periodontol 1994; 65:1008–1015.
Mechanism of Irrigation Effects on Gingivitis
Authors: Chaves Eros S. , Kornman Kenneth S. , Manwell M. Agnes , Jones Archie A. , Newbold Dewey A. , Wood Robert C.
Published: March 2012

Although gingivitis is initiated by plaque and plaque removal controls gingivitis, gingival irrigation with water has been shown to reduce gingivitis without reducing plaque. This study attempted to explore possible mechanisms involved in the treatment of gingivitis by water irrigation. Patients (n = 125) with more than 20 teeth, less than 4 sites with probing depth (PD) deeper than 6 mm, bleeding on probing (BOP) frequency of 30% or higher, and no systemic disease were randomized to one of four treatment groups: toothbrushing alone (brush), toothbrushing plus chlorhexidine 0.12% rinse 2×/day (CHX), toothbrushing plus water irrigation 1×/day (irr+H2O), or toothbrushing plus Chlorhexidine 0.04% irrigation 1×/day (irr+CHX). Six sites/tooth were examined at baseline, and at 3 and 6 months for BOP and PD using an automated probe, and for gingival index (GI) and plaque index (PI) by standard means. A prophylaxis and oral hygiene instructions were provided after baseline and 6 month measurements. Subgingival microbial samples and crevicular fluid (GCF) were collected from 2 teeth/subject at each time point. Microbial samples were processed for anaerobic culture and the predominant cultivable flora was determined. CHX and irr+CHX had a 30 to 35% decrease in mean PI, while brush and irr+H2O had only a 12 to 16% decrease. BOP was reduced by 14% in the brush group and 23 to 24% in the other groups. GI was significantly correlated with PI in the brush, CHX, and irr+CHX groups, but not in the irr+H2O group. Prevotella intermedia was significantly reduced in both irrigation groups, but not CHX or brush groups. Comprehensive analysis of selected components of the gingival crevice fluid is in progress and will be reported in the future. The current findings indicate that the mechanism of gingivitis reduction by water irrigation is not related to plaque reduction but may involve specific host‐microbiota alterations in the subgingival environment. J Periodontol 1994;65:1016–1021.
Evaluation of an Absorbable Collagen Membrane in Treating Class II Furcation Defects
Authors: Wang Hom‐Lay , O'Neal Robert B. , Thomas Clifford L. , Shyr Yu , MacNeil R. Lamont
Published: March 2012

Recent research has focused upon the utilization of an absorbable collagen membrane in guided tissue regeneration (GTR). Concern exists as to whether this type of membrane is beneficial in the treatment of periodontal defects. The purpose of this study was to evaluate the effect of a type I bovine collagen membrane on treatment of Class II furcation defects. Twelve systemically healthy patients (six male and six female, ages 32 to 68) were treated. Each had bilateral mandibular furcation defects with attachment loss ≥6 mm. Prior to surgery all patients completed initial therapy including scaling and root planing. At the time of the surgery, teeth were randomly assigned to either a control (flap debridement alone) or test (flap debridement plus collagen membrane) group. Data were collected on the day of surgery, and 2, 4, and 6 months post‐surgery and at the 12 month re‐entry surgery. Clinical measurements included probing depth (PD), clinical attachment level (CAL), gingival recession (GR), Stent to base of defect (SB), crestal bone to base of defect (CB), width of defect, and mobility. Statistical analysis was performed utilizing the paired t test. Both control and test groups demonstrated significant (P< 0.05) improvement at 12 months re‐entry in PD, CAL, SB, and CB when compared to the presurgery status. While there is no significant difference in PD, CAL, GR, width of defect, and mobility between control and test groups, sites treated with the collagen membrane had significantly higher bone fill (SB and CB) at re‐entry. A significant improvement of furcation horizontal bone repair and defect improvement was noted in the collagen membranes‐treated sites as compared to the presurgery status. No foreign body reaction was observed in either group during this study. This study suggests that the use of absorbable collagen membrane may have beneficial effects in the treatment of Class II furcal defects. J Periodontol 1994; 65:1029–1036.
Microbiota of Rapidly Progressive Periodontitis Lesions in Association With Clinical Parameters
Authors: Kamma Joanna J. , Nakou Mela , Manti Frieda A.
Published: March 2012

The microbial population in 73 rapidly progressive periodontitis (RPP) lesions in 10 young adults aged 25 to 35 years (5 males, 5 females) was studied in relation to the clinical parameters probing depth, bleeding on probing, and suppuration, which were recorded at the sampled sites. Porphyromonas gingivalis was found to predominate (26.7%) in 73 periodontal lesions with clinical probing depth >6 mm, followed by Bacteroides forsythus (23.6%), and Prevotella intermedia (15.7%). The prevalence of P. gingivalis was 91.7%, Fusobacterium nucleatum, 90.4%; Streptococcus intermedius, 87.7%; and B. forsythus, 53.4%. Significant differences between bleeding index 0, 1, and 2 (P <0.05) in frequency of detection were found for P. intermedia, Campylobacter concisus, Selenomonas sputigena, and Peptostreptococcus micros at bleeding sites and for Streptococcus sanguis, Actinobacillus actinomycetemcomitans, and B. forsythus (P <0.001) at non‐bleeding sites. Between suppurating and non‐suppurating sites, significant differences (P <0.05) in frequency of isolation were found for P. intermedia, Capnocytophaga ochracea, and A. actinomycetemcomitans at suppurating sites and for F. nucleatum at non‐suppurating sites. J Periodontol 1994;65:1073–1078.
The Vasculature of the Periodontal Ligament: A Scanning Electron Microscopic Study Using Corrosion Casts in the Rat
Authors: Selliseth Nils J. , Selvig Knut A.
Published: March 2012

The purpose of this study was to examine the 3‐dimensional architecture of the microvascular system of the rat periodontal ligament (PDL). Vascular corrosion casts were prepared and examined by scanning electron microscopy. Cervically, arterioles and venules communicated with the profuse capillary network of the gingiva. The mid‐root segment of the PDL contained arterioles and venules that mainly coursed occluso‐apically near the alveolar wall, as well as capillary loops located closer to the root surface. Arterioles entered the PDL through vascular canals from the bone marrow, then coursed coronally and branched into an interconnected network of capillaries. The capillaries formed hairpin loops pointing coronally. At the tip, the capillary loops were enlarged in diameter and had an irregular luminar surface. The capillaries then coursed apically, anastomosing freely, until entering a venule. Large venules mainly followed a coronalapical path, giving the PDL vasculature a palisade‐like appearance. These vessels either left the PDL through vascular canals in the alveolar wall or connected in an apical, venous cap with venules exiting through the apical foramen. The results show that the microvasculature forms a highly organized system presumably related to the specialized functions of the periodontium. Cervically, a dense capillary system may be required for antimicrobial defense and rapid tissue turnover. The vasculature in the middle segment supports the suspensory structures, while the venous cap in the apical region may be designed to cushion masticatory forces. The large vessel diameter combined with an irregular lumina surface at the tip of capillary loops indicates reduced blood velocity and turbulence in the functional part of the PDL vasculature where exchange of metabolites mainly occurs. J Periodontol 1994; 65:1079–1087.
Periodontal Disease in Non‐Insulin Dependent Diabetes Mellitus (NIDDM)
Authors: Cerda G. Juan , de la Torre Carlos Vázquez , Malacara Juan Manuel , Nava Laura E.
Published: March 2012

The association of periodontal disease with diabetes was studied in non‐insulin dependent diabetes mellitus (NIDDM) patients. In a cross‐sectional design, 100 patients (46 males and 54 females) were selected in 4 groups according to age and years since diagnosis of diabetes. The groups were: group 1, > 55 years old, diabetes diagnosed ≥ 5 years; group 2, ≤ 55 years old, diabetes diagnosed ≥ 5 years; group 3, > 55 years, diabetes diagnosed < 5 years; and group 4, ≤ 55 years, diabetes diagnosed < 5 years. Buccal and lingual pockets were deeper and lingual and buccal recessions greater for groups diagnosed 5 or more years ago, (P < 0.0001). In groups diagnosed less than 5 years, higher recession indices were found for patients older than 55. The loss of buccal insertion was also greater for groups diagnosed 5 or more years ago (P < 0.0001). For groups diagnosed less than 5 years ago, the loss was greater in the group older than 55 (P = 0.01). There was a marginal difference in gingival bleeding among the 4 groups (P = 0.047). Post‐hoc analysis showed differences between the 2 groups who had been diagnosed less than 5 years, with lower indices for patients ≤ 55. All groups were statistically different regarding bone loss (P < 0.0001), with higher indices for the groups with older age, and for groups with 5 or more years since diagnosis. There was no difference in dental mobility among the 4 groups (P = 0.0981). It was concluded that years since diagnosis of diabetes is more significant than age for severity of periodontal disease in NIDDM. J Periodontol 1994; 65:991–995.
Controlled Clinical Evaluation of the Subpedicle Connective Tissue Graft for the Coverage of Gingival Recession
Authors: Borghetti Alain , Louise Francis
Published: March 2012

The purpose of this study was to clinically evaluate the 1‐year coverage of gingival recessions by a subpedicle connective tissue graft according to the original technique compared to untreated recessions by measuring probing sulcus depth (PSD), height of keratinized tissue (HKT), and mucogingival junction location changes. Paired gingival recessions were selected in 15 patients. In each patient, one recession was randomly assigned for treatment (test group) and the other recession was left untreated (control group) for 1 year. Surgery consisted of a connective tissue graft covered by a double papilla full thickness flap. Height of recession (HR), PSD, HKT, and cemento‐enamel junction to mucogingival junction distance (CEJ‐MGJ) were recorded with a calibrated probe before surgery and 1 year postoperatively. The control group showed no statistically significant differences in any of the parameters. In the test group, HR mean decreased significantly (P <0.0006) from 3.66 mm to 1.09 mm, representing a mean root coverage of 70.5%. HKT mean increased significantly (P <0.0006) from 1.60 mm to 4.30 mm, and PSD mean showed no statistical difference. CEJ‐MGJ remained statistically unchanged. The subpedicle connective tissue graft may provide a good amount of root coverage and a substantial increase of keratinized tissue. Connective tissue grafted beneath the alveolar mucosa does not induce its transformation into keratinized gingival tissue. J Periodontol 1994; 65:1107–1112.
Substance P: An Immunohistochemical and Biochemical Study in Human Gingival Tissues. A Role for Neurogenic Inflammation?
Authors: Bartold P.M. , Kylstra A. , Lawson R.
Published: March 2012

Substance P has been studied in relation to its distribution within gingival tissues as well as its effect on cultured human gingival fibroblasts. The tissue distribution was varied depending on the degree of inflammation present. In healthy tissues substance P was found in the connective tissues interspersed between the collagenous elements and was particularly prominent in the areas immediately subjacent to the epithelial rete pegs. In inflamed tissues, substance P was markedly increased particularly around the blood vessels as well as in close association with much of the inflammatory cell infiltrate. The effect of substance P on human gingival fibroblast proliferation was monitored by [3H]thymidine incorporation and indicated substance P to be mitogenic for these cells at low concentrations (1 × 10−9 M) and tended towards an inhibitory effect at higher concentrations (1 × 10−4 M). Substance P did not have any effect on the release of either total proteins or proteoglycans into the culture medium. However, exposure of the cells to substance P did cause a greater accumulation of both total protein and proteoglycan with the cell layer material. These findings suggest a potential role for substance P on gingival tissues and in particular their resident fibroblastic cells and can therefore be used as a basis for more detailed studies into the relationship between neuropeptide release associated with neurogenic inflammation and periodontal pathology. J Periodontol 1994; 65:1113–1121.
Prostaglandin E2 Inhibits Interleukin‐6 Release But Not Its Transcription in Human Gingival Fibroblasts Stimulated With Interleukin‐1β or Tumor Necrosis Factor‐α
Authors: Takigawa Masayuki , Takashiba Shogo , Takahashi Keiso , Arai Hideo , Kurihara Hidemi , Murayama Yoji
Published: March 2012

Inflammatory mediators produced by human gingival fibroblasts (HGF) have been implicated in the initiation and progression of periodontal disease. The purpose of this study was to examine whether Prostaglandin E2 (PGE2), which is produced in abundance from HGF after stimulation with interleukin (IL)‐1β or tumor necrosis factor‐α (TNF‐α), could regulate IL‐6 production by HGF. HGF stimulated with either IL‐1β or TNF‐α showed a rapid and dose‐dependent increase in IL‐6 mRNA accumulation and IL‐6 secretion, as demonstrated by reverse transcription‐polymerase chain reaction analysis and bioassay. IL‐6 secretion from either IL‐1β‐ or TNF‐α‐stimulated HGF was enhanced by the inhibition of PGE2 synthesis with indomethacin. Furthermore, the addition of PGE2 inhibited IL‐6 secretion from these cells. In contrast, indomethacin or PGE2 did not affect the accumulation of IL‐6 mRNA in IL‐1β‐stimulated HGF. These data indicate that IL‐6 production by HGF is up‐regulated by specific cytokines, IL‐1β and TNF‐α, and suggest that this production may be partially down‐regulated by endogenous and exogenous PGE2 at the post‐transcriptional level. J Periodontol 1994; 65:1122–1127.