bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphometric Analysis of Cellular and Vascular Changes in Gingival Connective Tissue in Long‐Term Insulin‐Dependent Diabetes
Authors: Seppälä B. , Sorsa T. , Ainamo J.
Published: March 2012

This study examined cellular and vascular changes in gingival connective tissue samples by stereologic point‐counting procedures and interactive digital analyzing systems in long‐term insulin‐dependent diabetes mellitus patients. Gingival connective tissue capillaries representing a clinically healthy sulcus with no evidence of periodontal disease at the site of biopsy were studied in 29 patients with diabetes. Based upon their long‐term medical records, 19 were identified as having poorly controlled (PIDD) and 10 as controlled insulin‐dependent diabetes mellitus (CIDD). Ten nondiabetic, age‐ and gender‐matched individuals served as controls. Thirty‐nine biopsies were processed for light microscopy, and the blood vessel area was analyzed using an interactive digital analyzing system; 9 gingival biopsies, 5 diabetic and 4 controls, were processed for morphometric electron microscopic analysis. For each individual, site‐specific recordings were made for the plaque index, bleeding index, probing depth, loss of attachment, and radiographic loss of interproximal alveolar bone. No evident signs of periodontitis occurred at the biopsy sites. For each PIDD patient, respective volumetric and numeric densities of cellular components including fibroblasts, neutrophilic granulocytes, monocyte/macrophages, mast cells, lymphocytes, blast cells, and plasma cells were recorded in the inflamed connective tissue (ICT). Non‐cellular components such as collagen fibers and blood vessels were also recorded. PIDD patients had elevated plasma cell levels relative to controls and they appeared also to have a decreased collagen fiber density. In addition, fibroblasts occupied less volume in the ICT of PIDD patients than in controls. PIDD patients had the largest mean area of cross‐section of the blood vessels, but this difference was not statistically significant (P ≥ 0.211; f‐test). No specific characteristics of ICT or vascular changes were detectable in adult well‐controlled long‐term diabetics under similar plaque conditions. Swollen and proliferated endothelial cells were frequently found in PIDD patients and the mean distance from the lumen to the outer border of basement membrane was greater in the PIDD than in the controls (P < 0.001; t‐test). Overall, our findings that cellular, vascular, and connective tissue changes indicative of increased catabolism rather than anabolism detected in gingiva are especially associated with poorly controlled long‐term insulin‐dependent diabetes. J Periodontol 1997;68:1237–1245.
The Effects of Diabetes on the Interface Between Hydroxyapatite Implants and Bone in Rat Tibia
Authors: Takeshita Fumitaka , Iyama Shinji , Ayukawa Yasunori , Kido Mizuho A. , Murai Kenji , Suetsugu Tsuneo
Published: March 2012

We examined the influence of diabetes on the implant‐bone interface of hydroxyapatite (HA) implants inserted transcortically and extending into the medullary canal of rat tibiae, and quantitatively assessed the differences in bone reaction using an image processing system. Forty male Wistar King A rats (aged 5 weeks) were used in this experiment; they were sacrificed 84 days after implant placement. Toluidine blue‐stained undecalcified sections were prepared for histological observation and image analysis, and the labeled sections were observed by confocal laser scanning microscopy. The HA implants in the bone marrow area in the control group were completely encapsulated with a bone layer, and there were some osteoblast‐like cells in the bone lacunae apposing the implant surface. The HA implants in the diabetesinduced (DI) group were partially surrounded with a thin bone layer, and there were some fibroblasts running parallel to the implant surface at areas of no bone contact. Quantitative evaluation indicated that the control group showed significantly higher bone contact rate, bone contact thickness, and bone contact area than the DI group. The DI group showed approximately 30% reduction in the percentage of bone contact and 50% reduction in the thickness and the area of surrounding bone tissue. J Periodontol 1997;68:180–185.
Vascular Response to Guided Tissue Regeneration Procedures Using Nonresorbable and Bioabsorbable Membranes in Dogs
Authors: Vergara Jaime A. , Quiñones Carlos R. , Nasjleti Carlos E. , Caffesse Raul G.
Published: March 2012

Revascularization of the periodontal tissues was studied following guided tissue regeneration (GTR) procedures using both nonresorbable and bioabsorbable membranes. The procedures were performed in 8 female beagle dogs, 4 to 6 years old. Second, third, and fourth mandibular premolars were involved; experimental periods covered from 3 days to 49 days. After elevation of soft tissue flaps, Class II furcation defects were prepared by removing buccal alveolar bone from the teeth and exposed root surfaces were planed in order to remove root cementum. The quadrant was then flushed with sterile saline. Randomly selected, in one quadrant, the second and fourth premolars received nonresorbable expanded polytetrafluoroethylene (ePTFE) membranes. The other quadrant, second and fourth premolars, received the bioabsorbable membranes, made of glycolide and lactide polymers. After the membranes were in place, they were sutured. The third premolars of both quadrants served as negative controls. The animals were sacrificed by exsanguination under general anesthesia and then perfused through the carotid arteries with a combined solution of equal parts of India ink and 10% buffered formalin. Following fixation and demineralization, part of the blocks were processed to obtain cleared specimens following the method of Spalteholtz. The remaining blocks were processed for routine histologic examination. The findings, mainly from the cleared specimens, showed that at the early phase of healing, ePTFE membranes interfered with the revascularization while they were in place. Contrary to this, bioabsorbable membranes allowed earlier anastomosis of the vasculature of the flap and regenerated tissues. However, the long‐term vascular response was similar for both membranes. J Periodontol 1997;68:217–224.
Healing of Intrabony Defects and Its Relationship to Root Canal Therapy. A Histologic and Histometric Study in Dogs
Authors: Lima Luiz A. , Anderson Gissela B. , Wang Ming M. , Nasjleti Carlos E. , Morrison Edith C. , Kon Simão , Caffesse Raul G.
Published: March 2012

The purpose of this study was to evaluate the importance of root canal therapy in the healing process of severe intrabony defects. Four beagle dogs were used and 32 interproximal intrabony defects, up to the apical third, were created. Wire ligatures were placed into these defects for plaque accumulation. Three weeks later, the ligatures were removed and 4 different treatment modalities were employed: group 1) scaling and root planing (SRP); group 2) modified Widman flap (MWF); group 3) modified Widman flap and root canal therapy performed at the same time (RCT/MWF); and group 4) modified Widman flap and root canal therapy performed 3 weeks after the surgical procedure (MWF+RCT). Postoperative oral hygiene was obtained by spraying a 0.12% Chlorhexidine solution 3 times a week. The animals were sacrificed 7 weeks after treatment. Blocks were obtained and processed for routine histology. Results were expressed as a percentage of the total defect length (TDL). No differences were observed when SRP was compared to MWF. New bone formation (BF) presented better results for SRP (43.4%) and MWF (53.4%) when compared to RCT/MWF (15.5%). New cementum formation (CF) presented better results for SRP (59.8%) and MWF (64.6%) when compared to RCT/MWF (19.3%) and MWF+RCT (31.5%). Connective tissue repair (CTR) presented better results for SRP (72.4%) and MWF (74.2%) when compared to RCT/MWF (47.5%) and MWF+RCT (44.4%). Results were statistically significant at the level of 0.05. Within the limits of this study, it was concluded that root canal therapy performed simultaneously or 3 weeks after surgery modified the healing of intrabony defects, impairing new bone formation, new cementum formation and new attachment. J Periodontol 1997;68:240–248.
Inflammatory and Immune Mediators in Crevicular Fluid From HIV‐Infected Injecting Drug Users
Authors: Grbic John T. , Lamster Ira B. , Mitchell‐Lewis Dennis
Published: March 2012

Gingival crevicular fluid (GGF) levels of the polymorphonuclear leukocyte (PMN) lysosomal enzyme beta‐glucuronidase (βG), the pro‐inflammatory cytokine interleukin 1β (IL‐1β), and Immunoglobulins (IgA, IgG, and IgM) were examined in 16 HIV seropositive (HIV+) and 10 HIV seronegative (HIV–) injecting drug users (IDU). Each subject received a periodontal examination including assessment of probing depth, attachment level, bleeding on probing, and plaque and calculus accumulation. GCF was collected from the mesial surfaces of premolar and molar teeth using filter paper strips. Although HIV+ subjects had a significantly lower number of peripheral blood CD4+ T cells/mm3 compared to HIV–subjects, there were no significant differences in mean probing depth, percentage of sites exhibiting bleeding on probing, or plaque and calculus accumulation between HIV− and HIV+ subjects. When the GCF components were analyzed, we found no significant differences between HIV− and HIV+ subjects in GCF levels of βG, IL‐1β, IgA or IgM, but GCF levels of IgG were significantly increased in HIV+ subjects. When sites were categorized by probing depth, no differences in the levels of βG, IgA, IgG, and IgM existed between sites with probing depth s 3 mm compared to sites with probing depth ≥ 4 mm in both HIV− and HIV+ IDU. However, levels of IL‐1β in GCF were increased in the deeper sites (≥ 4 mm) in HIV+ IDU when compared to sites with PD ≤ 3 mm. Analyzing GCF constituents in relation to the CD4 cell number, no differences were found between subjects with ≤ 400 or > 400 CD4 cells/mm3 with respect to the levels of IL‐1β, IgG, and IgM. However, the level βG was significantly decreased in the HIV + IDU with ≤ 400 CD4 cells when compared to those with > 400 CD4 cells/mm3, while levels of IgA were significantly higher in HIV+ subjects with ≤ 400 CD4 cells/mm3. Our results suggest that levels of IgG, and in immunodeficient subjects IgA were increased in GCF of HIV+ IDU while decreased levels of βG were found in immunodeficient HIV+ IDU. These findings may be local manifestions of systemic alterations and suggest that analysis of GCF may provide insight into the immune and inflammatory responses of HIV‐infected individuals to periodontal microorganisms. J Periodontol 1997;68:249–255.
Active and β‐1 Proteinase Inhibitor Complexed Leukocyte Elastase Levels in Crevicular Fluid From Patients With Periodontal Diseases
Authors: Meyer Jean , Guessous Fadila , Huynh Christine , Godeau Gaston , Hornebeck William , Giroud Jean‐Paul , Roch‐Arveiller Monique
Published: March 2012

Human leukocyte elastase is present in large amounts in the crevicular fluid of patients with periodontal disease and was considered as a putative biological marker of the evolution of such diseases. The aim of this work was to measure spectrophotometrically amounts of active elastase (AE) and elastase complexed to α1 proteinase inhibitor (E‐α1‐PI) in gingival crevicular fluid obtained from patients suffering from rapidly progressive periodontitis (RPP group) or adult periodontitis (AP group) with different probing depths (3 to 5 mm and > 6 mm). AE and E‐α1‐PI concentrations were negligible in healthy individuals. AE, but not E‐α1‐PI, concentration appears to vary significantly with the probing depth in patients suffering either from rapidly progressive or adult periodontitis. No correlations were found between levels of AE and E‐α1‐PI in the different groups of patients. AE concentration seems to be a marker of periodontal diseases in relation with probing depth. J Periodontol 1997;68:256–261.
A Histological Investigation on Tissue Responses to Titanium Implants in Cortical Bone of the Rat Femur
Authors: Ohtsu Akira , Kusakari Haruka , Maeda Takeyasu , Takano Yoshiro
Published: March 2012

Implant materials are placed under various sites—including cortical bone, spongy bone, and bone marrow—at the same time according to the depth at implantation. Although cortical bone is an important site for the prognosis of implantation, detailed reports on tissue responses to implantation have been meager. The present study aims to reveal tissue responses to pure titanium implantation in rat femoris cortical bone. The rats received titanium bars surgically in their femurs and were sacrificed 1 day to 40 weeks post‐implantation. The prepared tissue specimens were processed for light and transmission electron microscopy (TEM). Further histochemical detections were performed. One day post‐implantation, empty osteocytic lacunae indicating degeneration of osteocytes were found in pre‐existing cortical bone around the implant. Such pre‐existing bone was replaced by new bone, but remained in part even 40 weeks post‐implantation. Light microscopy showed that direct contact between the implant and new bone was identified 12 weeks post‐implantation. Chronological and ultrastructural observation showed that new bone deposition appeared to proceed toward the implant, and that the intervening layer at the interface was derived from the degenerated debris of multinucleated giant cells and/or osteoblasts. Furthermore, it seemed that the width of intervening layer varied in relation to the distance from the blood vessels. The cells showing tartrate resistant acid phosphatase activity possessed cytological features of osteoclasts under TEM; they were frequently observed in perivascular sites near the implants even after osseointegration, suggesting that bone remodeling took place steadily around the implant. J Periodontol 1997;68:270–283.
CD40 Mediated Activation of Gingival and Periodontal Ligament Fibroblasts
Authors: Sempowski Gregory D. , Chess Patricia R. , Moretti Antonio J. , Padilla Josué , Phipps Richard P. , Blieden Timothy M.
Published: March 2012

CD40 is a 50 kDa transmembrane protein important for regulating B lymphocyte proliferation and differentiation. This novel activation antigen is primarily expressed by hematopoietic cells including B lymphocytes, follicular dendritic cells, and monocytes. Recently, human fibroblasts from.a variety of tissues were shown to display CD40; however, its function was unknown. Cellular responses mediated by CD40 are naturally triggered by its counter‐receptor, the CD40 ligand, which is displayed on activated T cells, mast cells, eosinophils, basophils, and B lineage cells. This study investigated the functional significance of CD40 expression on periodontal fibroblasts, in the context of periodontal inflammation. The experiments reported herein demonstrate constitutive CD40 expression on cultured periodontal ligament (PDL) and gingival fibroblasts. Interestingly, cells of gingival origin displayed up to 13‐fold higher constitutive levels of CD40, versus fibroblasts from PDL. Interferon gamma (IFN‐γ) treatment enhanced CD40 expression on PDL and gingival fibroblasts, with up to 61‐fold induction of expression. Immunohistochemical staining was used to detect CD40 on fibroblastic cells in both normal and acutely inflamed gingival tissue. Expression of CD40 in inflamed tissue was significantly higher than in uninflamed tissue. Western blot analysis of anti‐CD40 triggered cells revealed the induction of tyrosine phosphorylation on a 50 kDa protein in PDL and gingival fibroblasts. These results indicate that CD40 is an active signaling conduit in periodontal fibroblasts. This concept was further substantiated by the fact that CD40 engagement stimulated interleukin 6 (IL‐6) production by gingival fibroblasts, but not periodontal ligament fibroblasts. Overall, these results demonstrate that CD40 on periodontal fibroblasts may functionally interact with CD40L‐expressing cells. This CD40/CD40L interaction can stimulate fibroblast activation and synthesis of the proinflammatory cytokine IL‐6. J Periodontol 1997;68:284–292.
Failing Hollow Implants Examined by Light Microscopy and Image Processing
Authors: Takeshita Fumitaka , Iyama Shinji , Ayukawa Yasunori , Suetsugu Tsuneo , Oishi Masamichi
Published: March 2012

The purpose of this study was to evaluate the radiologic, histologic, and histometric findings of three failing hollow implants. On periapical radiographs, these implants showed vertical bone loss up to the hollow portion around the implant. Examination of the histologic sections disclosed that the hollow portions of all the implants were almost filled with bone tissue, although slight bone resorption and presence of granulation tissue infiltrated with inflammatory cells was observed coronal to the hollow portion. Histometric analysis disclosed that the average percent bone contact was 93.1% in case 1, 90.9% in case 2, and 84.3% in case 3 and the average percent bone filling was 42.1%, 50.5%, and 33.8%, respectively. Consequently, there seems to be some potential for successful treatment of these implants because the destructive changes were limited to the coronal aspects of the implant. J Periodontol 1997;68:293–298.
Clinical and Microbiological Effects of Subgingival Antimicrobial Irrigation With Citric Acid as Evaluated by an Enzyme Immunoassay and Culture Analysis
Authors: Renvert Stefan , Dahlén Gunnar , Snyder Brian
Published: March 2012

The purpose of the present study was to compare an enzyme immunoassay with culture samples from untreated and non‐surgically treated periodontal pockets and to assess the clinical and microbiological effects of citric acid irrigation as a supplement to scaling and root planing. The enzyme immunoassay used in this study is a chairside diagnostic tool aimed at identifying the presence of P. gingivalis, P. intermedia, and A. actinomycetemcomitans. Six sites with pocket depths ≥6 mm in each of 16 patients were monitored for 24 weeks using clinical and microbiological parameters. In two out of the six sites, scaling and root planing was supplemented with subgingival citric acid irrigation of the pocket after completion of the mechanical treatment. The sensitivity of the immunoassay in relation to culture was calculated to 85.5% and the specificity to 90.2%. The immunoassay corresponded to a detection level of 104 as estimated by culture. Sites treated with a combination of scaling and irrigation with citric acid demonstrated a similar healing pattern as sites treated with scaling and root planing alone. The profile of the marker bacteria was almost parallel for the two groups. The results of this investigation thus indicated that the immunoassay can be used as a screening tool for selected periodontal pathogens and that adjunctive irrigation with citric acid has no measurable clinical or microbiological effects. J Periodontol 1997;68:346–352.
Exocellular Phospholipase C Activity From a Propionibacterium acnes Strain Isolated From a Periodontal Pocket
Authors: Bulkacz Jaime , Erbland John F.
Published: March 2012

The culture supernatant of a strain of Propionibacterium acnes was investigated for its phospholipase (PL) activity. The microorganism was isolated from a periodontal pocket of a patient with periodontal disease. Supernatants from cultures of this microorganism were used as a source to obtain enzymes. Proteins from the supernatants were concentrated, and their enzymatic activity was partially purified through molecular sieving. The procedure yielded two peaks of activity. This activity was shown to hydrolyze phosphatidyl choline (PC) and phosphatidyl ethanolamine (PE) and was effective in a pH range of 5 to 9, with an optimal activity at pH 7.0. Divalent cations were not required for activity of the enzymes. Analysis of the products obtained from the hydrolysis of PC labeled in the choline, phosphoryl, or acyl moieties and PE containing labeled oleic acid indicated that the supernatants' activity was mostly phospholipase C (PL‐C). Phospholipase C can act synergistically with other factors to produce tissue damage, and hence may contribute to the pathogenesis of periodontal disease. J Periodontol 1997;68:369–374.
Bacterial Transmission in Periodontal Diseases: A Critical Review
Authors: Greenstein Gary , Lamster Ira
Published: March 2012

This review paper addresses intra‐ and extra‐familial transfer of bacteria associated with periodontal diseases. Recent advances in molecular biology provide sensitive methods to differentiate organisms within the same species, thereby facilitating tracking routes of their transmission. Evidence for the passing of microorganisms between parents and children is particularly strong. In this regard, molecular genetic techniques have demonstrated that if a child is colonized by a potentially pathogenic species, then one of the parents will usually harbor genotypically identical bacteria. The data also indicate that transfer of bacteria between spouses occur, but it appears to happen infrequently. Saliva appears to be a major vector for bacterial transmission. However, the transfer of organisms does not necessarily result in colonization or infection of the host. Furthermore, individuals who harbor putative pathogens frequently do not manifest any signs of periodontal disease. This is attributed to host defenses, bacterial antagonism, and possibly lack of pathogenicity of infecting organisms. It is concluded, based upon current evidence, that periodontal pathogens are communicable; however, they are not readily transmissible. J Periodontol 1997;68:421–431.
Clinical Evaluation of the Speed and Effectiveness of Subgingival Calculus Removal on Single‐Rooted Teeth With Diamond‐Coated Ultrasonic Tips
Authors: Yukna Raymond A. , Scott J. Brent , Aichelmann‐Reidy Mary E. , LeBlanc Denis M. , Mayer Elizabeth T.
Published: March 2012

Several studies have found incomplete calculus removal during periodontal treatment with traditional hand curets, sonic, and ultrasonic instruments. This study evaluated the speed and effectiveness of subgingival calculus removal with new diamondcoated ultrasonic tips on single‐rooted teeth. Single session subgingival scaling and root planing was performed on 80 teeth with 5 to 12 mm probing depths in 15 patients. Each patient provided groups of 4 teeth that were randomly treated with either hand curets (HAND); standard smooth ultrasonic tip (US); or fine grit (FINDIAM) or medium grit (MEDDIAM) diamond‐coated ultrasonic tips. The time taken to reach the therapeutic endpoint of a clean, smooth root surface in a defined region on each tooth with each instrument by the 3 therapists with differing experience levels was recorded. The teeth were then atraumatically extracted, stored in a surfactant, photographed at 10X, and the percent of calculus present in the area of the pocket or on a comparable control surface calculated by histometric point counting. ANOVA and paired t tests showed that mean percent remaining calculus on treated versus control surfaces was HAND 4.6 ± 5.3 versus 57.5 ± 28.2, US 4.7 ± 6.4 versus 54.4 ± 25.9, FINDIAM 4.3 ± 5.2 versus 37.5 ± 22.1, and MEDDIAM 3.4 ± 4.2 versus 50.7 ± 20.1, respectively (all P < 0.01). The mean time in seconds to reach the clinical endpoint ranged from HAND 289 ± 193, US 194 ± 67, FINDIAM 167 ± 71, to MEDDIAM 147 ± 92. All powered instruments were significantly faster than HAND (P < 0.05), but did not differ from each other. On a 0 = “smooth” to 3 = “rough” scale, most often HAND resulted in “smooth” surfaces (10/20), the powered tips of all types “sligh” surface roughness (10/20 each), and US the most “moderate” roughness (7/20). There were no differences in percent calculus remaining, surface roughness, or time spent among the 3 treating clinicians despite their varying experience levels. The results of this study showed that percent calculus remaining was <5% with all the instruments given time ad libitum on a given root surface. Root roughness was generally slightly greater with all 3 powered tips. All of the powered instruments took significantly less time than the HAND. Both DIAM tips took less time than US. Diamond‐coated ultrasonic tips appeared to be much more efficient than HAND or US in removing calculus in moderate‐deep probing depths on single‐rooted teeth in vivo. J Periodontol 1997;68:436–442.
A Short‐Term Study of the Effects of SBHAN, a Novel Compound, on Gingival Inflammation in the Beagle Dog
Authors: Cutler Christopher W. , Ghaffar Khaled A.
Published: March 2012

Unique hydroxyl ion‐modulating compounds based on the amino acid glycine have been developed that possess both antimicrobial and pro‐healing properties. The purpose of the present study was to determine the effects of one of these compounds, 8.5% (w/v) sodium N, N‐bis‐2 (hydroxylethyl) aminoacetate (SBHA) with 0.3% (w/v) NaOH (SBHAN) on ligature‐induced gingival inflammation in the beagle dog. Fifteen purebred beagle dogs were subjected to a 14‐day oral hygiene regimen, consisting of manual scaling and daily toofhbrushing with plain pumice. Gingival inflammation was then initiated by tying ligatures around 12 study teeth per dog and by placing the dogs on water‐softened dog chow. After 30 days, ligatures were removed, dogs were placed on a hard diet and randomly assigned to five treatment groups by the flip of two coins. The five treatments included: 1) distilled, pyrogen‐free water; 2) 8.5% (w/v) SBHAN; 3) 4.3% (w/v) SBHAN; 4) 0.12% Chlorhexidine; and 5) 8.5% SBHA (w/v) (SBHAN without added NaOH). Solutions were placed in opaque spray bottles to shield their identity from the examiner. Treatment consisted of a daily aerosol application of 2 ml of each solution in a calibrated spray bottle to the affected teeth. The following measures were taken from the dogs at baseline (after hygienic phase), 30 days after initiation of gingival inflammation (before ligature removal), and 2 weeks and 4 weeks after ligature removal: 1) plaque index (PI); 2) gingival index (GI); 3) probing depths (PD); 4) relative attachment levels (RAL); and 5) gingival crevicular fluid volume (GCF). Analysis of subgingival plaque for anaerobic and aerobic colony forming units/ml was also performed at each time point. Gingival biopsies were performed, sectioned and stained with hematoxylin and eosin to quantify the inflammatory cell infiltrate (ICI). After ligature placement, increases were observed in PI, GI, PD, RAL, GCF, aerobic and anaerobic subgingival microbial counts, and ICI. After ligature removal, spontaneous resolution of gingival inflammation and plaque accumulation around the teeth of all dogs was observed with any treatment. Statistical analysis (Tukey's pairwise comparisons) of the mean PI, GI, PD, RAL, ICI, and GCF after 4 weeks of treatment with each agent, however, revealed that 8.5% SBHAN was significantly (P < 0.05) more effective than water, 4.3% SBHAN, or 8.5% SBHA in reducing PI, GI, PD, and GCF, but not RAL or ICI. Moreover, 0.12% chlorhexidine was more effective than water, 4.3% SBHAN, or 8.5% SBHA at reducing GI, PD, and GCF, but not PI, RAL, or ICI. No adverse reactions to the SBHAN were observed visually or histologically in any of the dogs during the course of the investigation. These data suggest that further investigation in a larger study population of the potential of SBHAN as an anti‐gingivitis compound is warranted. J Periodontol 1997;68:448–455.
The Effect of Smoking on Mechanical and Antimicrobial Periodontal Therapy
Authors: Kinane D.F. , Radvar M.
Published: March 2012

The aim of this investigation was to evaluate the effect of smoking on the outcome of periodontal therapy. The study consisted of 54 patients who participated in a 4‐group parallel‐arm clinical trial on the efficacy of three locally delivered antimicrobial systems as adjuncts to scaling and root planing in the treatment of sites with persistent pocketing after a course of scaling and root planing. These groups included scaling and root planing either alone (S) (n = 3), or in conjunction with the application of 25% tetracycline fibers (S&T) (n = 13), 2% minocycline gel (S&Mi) (n = 14), or 25% metronidazole gel (S&Me) (n = 14). In each patient four pockets > 5 mm with bleeding on probing (BOP) and/or suppuration were studied. The number of subjects who smoked was: 8 (61.5%) in the S&T group, 8 (57.1%) in the S&Mi group, 6 (42.9%) in the S&Me group, and 6 (46.2%) in the S group. The probing depth, attachment level and other clinical parameters were assessed at baseline and 6 weeks after treatments. The clinical results of this comparative study have been previously reported. Regardless of the type of treatment, the change in the probing depth (ΔPD) and attachment gain (ΔAL) were greater in non‐smoker subjects than smoker subjects. ΔPD was 1.14 mm versus 0.76 mm (P = 0.019), and ΔAL was 0.52 mm versus 0.50 mm at (P = 0.845) for non‐smokers and smokers respectively. The analysis of variance using the general linear model (GLM) was used for ΔPD and ΔAL and took into account the variations in the treatments, number of smoker subjects per group, and baseline probing depth. There was a significant interaction between the “smoking” and the “baseline PD.” Further analysis using linear regression indicated that, while there was a significant relationship between the baseline PD and the ΔPD or ΔAL among the non‐smokers, weak and insignificant relationship existed among the smoker subjects. Thus, smoking may have an important role in determining the prognosis of periodontal treatment, particularly in persistent and deep pockets. J Periodontol 1997;68:467–472.
The Influence of Anatomic and Iatrogenic Root Surface Characteristics on Bacterial Colonization and Periodontal Destruction: A Review
Authors: Leknes Knut N.
Published: March 2012

Periodontitis is a multifactorial infectious disease affecting primarily a subset of subjects and a subset of sites. Recent microbiological data have acknowledged that before disease progression can occur, a susceptible host and site are required, in addition to the presence of pathogenic bacteria. This review discusses factors affecting periodontal disease progression and focuses in particular on the influence of anatomic and iatrogenic root surface characteristics. Retrospective studies clearly suggest a strong association between anatomic aberrations and periodontal attachment loss. Cemental tear seems to have the potential to initiate an aseptic, rapid, site‐specific periodontal breakdown in a non‐infected environment, illustrating the complexity of the attachment loss process. Recent experimental findings, furthermore, demonstrate a significant influence of root surface instrumentation roughness upon subgingival plaque formation and gingival tissue reactions, as well as a significant and positive relationship between subgingival plaque accumulation and inflammatory cell mobilization. These results indicate that subgingivally located irregularities may form stagnant sites or ecological niches which favor both retention and growth of organisms. Such events in addition to the progressive inflammatory changes may critically influence the subgingival environment by turning a stable site into an unstable or active periodontitis site. Thus, local anatomic and iatrogenic root surface characteristics may have a more profound effect on gingival health than previously assumed, particularly on a site level. J Periodontol 1997;68:507–516.
Reactive Change in Proliferative Activity of the Junctional Epithelium After Topical Application of Lipopolysaccharide
Authors: Takata Takashi , Miyauchi Mutsumi , Ogawa Ikuko , Ito Hiroshi , Kobayashi Joji , Nikai Hiromasa
Published: March 2012

It is well established that apical migration of junctional epithelium (JE) along a root surface is an important factor in periodontal pocket formation and deepening. However, the exact mechanism and, more specifically, the role of inflammatory products in influencing the activity of cells within the JE is not known. To address this issue lipopolysaccharide (LPS) was applied topically into rat molar gingival sulcus and then tissues evaluated immunohistochemically for expression of proliferating cell nuclear antigen (PCNA). Tissues were prepared for histological analysis at designated times. Histologically, infiltration of neutrophils with associated edema was noted in JE and gingival connective tissues 6 hours after LPS application and was prominent at 12 hours. These inflammatory changes persisted in the 2‐ and 3‐day specimens, and disappeared at 5 days. In normal gingiva, before the LPS application, the JE showed few PCNA positive cells, while almost all cells in the basal and suprabasal cell layers of the oral gingival epithelium and the oral sulcular epithelium were PCNA positive. No increase in the number of PCNA positive cells in the JE beyond zero time was observed at 6 and 12 hours after LPS application. One day after LPS application, PCNA positive cells appeared in the basal cell layer of the JE, with a continued increase number of PCNA positive cells in the JE continued at 2 and 3 days. By day 5 the number of PCNA positive cells were decreasing with a return to a normal range by 7 days. These results showed that 1) under normal physiological conditions, cells within the JE have minimal mitotic activity and 2) the JE cells can enter the proliferating cell cycle when exposed to LPS, and suggest that the enhanced proliferating activity in the JE is an important factor for the deepening of the periodontal pocket, if the connective tissue attachment is broken down. J Periodontol 1997,68:531–535.
Periodontal Regeneration in Naturally Occurring Class II Furcation Defects in Beagle Dogs After Guided Tissue Regeneration With Bioabsorbable Barriers
Authors: Bogle Gary , Garrett Steven , Stoller Norman H. , Swanbom Deryl D. , Fulfs Jon C. , Rodgers Peter W. , Whitman Susan , Dunn Richard L. , Southard G. Lee , Polson Alan M.
Published: March 2012

The efficacy of a bioabsorbable polylactic acid based barrier was evaluated using naturally occurring buccal Class II furcation defects in beagle dogs. Sixteen furcation sites (8 control and 8 experimental) were treated in 6 adult animals. After full thickness flap reflection, exposed furcations and root surfaces were thoroughly root planed. In experimental sites a customized barrier was formed and fitted to cover the defect. Surgical flaps were replaced slightly coronal to the cemento‐enamel junction. Animals were sacrificed at 6 months and specimens processed for histologic evaluation. Histologic and histometric analyses were done using 6 μm step serial sections in the buccal‐lingual plane, corresponding to the buccal‐lingual extent of the furcation. Results were: mean total defect experimental sites 1.92 mm; control sites 1.47 mm. Mean new cementum formation experimental sites 1.36 mm (71% of initial defect); control sites 0.25 mm (17% of initial defect). Mean new bone formation experimental sites 1.42 mm (74% of initial defect); control sites 0.20 mm (14% of initial defect). Mean junctional epithelium formation experimental sites 0.42 mm (22% of initial defect); control sites 1.21 mm (82% of initial defect). Statistical analysis demonstrated significant differences in all healing parameters favoring experimental (barrier‐treated) sites. In this model, regeneration (new bone, cementum, and periodontal ligament) of 71% of the original defect in experimental sites and only 14% in control sites demonstrated a response that highly favored use of the barrier. J Periodontol 1997;68:536–544.
Assessment of Guided Tissue Regeneration Procedures in Intrabony Defects with Bioabsorbable and Non‐Resorbable Barriers
Authors: Weltman R. , Trejo P.M. , Morrison E. , Caffesse R.
Published: March 2012

The purpose of this study was to assess periodontal regenerative techniques in intrabony defects utilizing a bioabsorbable, polylactic acid (PLA) barrier or the nonresorbable, expanded polytetrafluoroethylene (ePTFE) barrier. Thirty patients (26 to 64 years old) each with one radiographically evident intrabony periodontal lesion of probing depth ≥ 6 mm participated in a 12‐month controlled clinical trial. The subjects were randomly divided into two independent groups. The test group (n = 16) received a PLA barrier. The control group (n = 14) received an ePTFE barrier. Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and bone fill were recorded by a single calibrated examiner not involved with the surgical treatment prior to surgery, and at 6, 9, and 12 months postsurgery. The treatment results were statistically analyzed utilizing two sets of data. The “averaged‐site” data set consisted of values computed from the averaging of measurements from all sites encompassing the defect. The second data set was comprised of only the deepest measurement of the defect. Statistical tests used to analyze these data sets included the t‐test and paired t‐test for parametric data and the Wilcoxon rank sum test and the Wilcoxon signed rank test for non‐parametric data. Analyses with both the averagedsite data and deepest‐site data resulted in significant improvements in PD reductions, CAL, and bone fill, after 12 months of healing with both the PLA and ePTFE barrier devices. Comparisons of healing response between treatments found no significant differences when the averaged‐site data were analyzed. When only the deepest site of the defect was considered, the control group resulted in significantly more attachment gain (ePTFE, 3.36 mm; PLA, 1.75 mm; P < 0.02) and shallower probing depths (ePTFE, 3.29 mm; PLA, 4.69 mm; P < 0.01) than the test group. In intrabony defects, the use of PLA or ePTFE barriers in GTR procedures yielded comparable clinical results; however, in this study, data analysis using the deepest site of the defect found, after 12 months of healing, significantly more attachment gain and shallower probing depths with ePTFE. J Periodontol 1997;68:582–591.
Evidence for Healing of Class II and III Furcations After GTR Therapy: Digital Subtraction and Clinical Measurements
Authors: Eickholz Peter , Hausmann Ernest
Published: March 2012

In 21 patients with advanced periodontitis, 39 teeth exhibiting class II (n = 21) and class III (n = 18) furcations were treated by the guided tissue regeneration technique using expanded polytetrafluoroefhylene (ePTFE) membranes (n = 20) or bioabsorbable barriers (n = 19), respectively. Clinical parameters were assessed before and 6 months after surgery. Presurgically and 6 months postsurgically, 35 pairs of standardized bitewing radiographs were taken. Using subtraction radiography, gain of bone density within furcation areas was assessed. Eighteen radiographs showed sufficiently accurate geometry to be analyzed by subtraction. Within the defects suitable for subtraction, the average gain of vertical attachment assessed was 1.35±1.27 mm in the class II furcation group and 1.58±1.37 mm in the class III furcation group. The average horizontal attachment gain in the class II furcation group was 1.96±0.59 mm. No statistically significant differences were observed between results after GTR therapy using non‐resorbable and bioabsorbable barriers. Radiographic bone gain as assessed by subtraction analysis correlated with vertical (r = 0.458, P < 0.025) and horizontal (r = 0.734, P < 0.005) attachment gain. A statistically significant number of more radiographs for maxillary molars were not suitable for subtraction analysis than mandibular molars (P < 0.05). Further, statistically more radiographs that were taken with potentially unstable support of the filmholder were not suitable for subtraction analysis than those with stable support (P < 0.05). There is a statistically significant correlation between clinical improvements and bony fill within furcation defects. Only 18 of 35 pairs of radiographs were suitable for subtraction analysis. Subtraction analysis of maxillary molars seems to be more difficult than assessment of radiographic bone changes in mandibular molars. Potentially stable support of the filmholder seems to be a condition to provide radiographs suitable for subtraction analysis. J Periodontol 1997;68:636–644.
Comparison of Bioabsorbable Laminar Bone Membrane and Non‐Resorbable ePTFE Membrane in Mandibular Furcations
Authors: Scott Tracy A. , Towle Herbert J. , Assad Daniel A. , Nicoll Brian K.
Published: March 2012

The purpose of this study was to compare clinical parameter changes and osseous regeneration in 12 pairs of comparable Class II mandibular molar furcation invasion defects using either a bioabsorbable demineralized laminar bone allograft membrane or a non‐resorbable expanded polytetrafluoroethylene (ePTFE) membrane as a barrier in guided tissue regeneration. Measurements with calibrated periodontal probes were made to determine soft tissue recession, probing depth, and attachment levels. Defects within each pair were randomly selected for treatment with either bioabsorbable demineralized bone allograft membrane or ePTFE membrane. All defects were concurrently grafted with particulate demineralized freeze‐dried bone allograft (DFDBA). Additional measurements were made at surgery to determine crestal resorption and the vertical and horizontal dimensions of the osseous defects. The temporal course and extent of membrane exposures were also recorded. The non‐resorbable membrane was retrieved 6 weeks following placement. Six months following initial surgical treatment, each site was surgically re‐entered and all soft and hard tissue measurements repeated. Descriptive statistical analysis revealed that both treatments resulted in significant within‐group mean vertical and horizontal osseous fill, but no statistical difference emerged between the groups. As based on this pilot study, laminar bone membrane may be as effective as ePTFE when used in conjunction with DFDBA for treatment of Class II mandibular molar furcation bone defects. This pilot study of low power suggests that these two materials may be equivalent when used in conjunction with DFDBA. Further studies of much higher power and of the laminar bone alone as compared to positive and negative controls are required. Laminar bone does not require a secondary surgical procedure for removal and may undergo less frequent instances and degrees of exposure during healing. J Periodontol 1997;68:679–686.
Cervical Enamel Projection and Intermediate Bifurcational Ridge Correlated With Molar Furcation Involvements
Authors: Hou Guey‐Lin , Tsai Chi‐Cheng
Published: March 2012

In this study, we investigated the cervical enamel projection (CEP) and intermediate bifurcational ridge (IBR) correlated with localized molar furcation involvement (FI). Study samples consisting of 87 hopeless permanent mandibulars (56 first and 31 second molars), which required extraction for periodontal therapy, were randomly collected from the School's Dental Clinic. The furcal defects, CEPs, and IBRs of molars were diagnosed via clinical probing, periapical radiographs, and inspection of ground tooth sections of extracted teeth with a stereomicroscope. Prevalence and distribution of molars with CEPs and/or IBRs were also analyzed. Probing depths (PD), clinical attachment loss (CAL), gingival index (GI), and plaque index (PLI) were measured for the buccal and lingual surfaces of molar furcal areas. Moreover, the relationships between the molar FI with and without CEPs and IBRs and periodontal status were analyzed using Student's paired t‐test. Based on those results, we can conclude the following: 1) among 87 molars with FIs examined, 63.2% (55/87) had cervical enamel projections and bifurcational ridges, and the prevalence was greatest in mandibular first (67.9%, 38/56) and second (54.8%, 17/31) molars; and 2) the differences in mean PD, CAL, PLI, and Gl between the molars with and without CEPs and IBRs were highly significant (P < 0.001) in the mandibular first and second molars. J Periodontol 1997;68:687–693.
A Comparison of IgG Antibody Reactive With Bacteroides forsythus and Porphyromonas gingivalis in Adult and Early‐Onset Periodontitis
Authors: Califano Joseph V. , Gunsolley John C. , Schenkein Harvey A. , Tew John G.
Published: March 2012

Recent work has indicated that Bacteroides forsythus and Porphyromonas gingivalis are significant local risk factors for periodontitis. Several reports find that both organisms are frequently associated with periodontitis lesions and often are present together. We have previously shown that early‐onset periodontitis patients seropositive for P. gingivalis have less attachment loss than seronegative patients. In this study, we determined serum IgG antibody concentrations reactive with B. forsythus in adult and early‐onset periodontitis patients using an ELISA and used P. gingivalis in the same populations as a positive control. The results for P. gingivalis were consistent with previous work and indicated that 47%, 36%, and 33% of adult, generalized earlyonset, and localized juvenile patients were seropositive, respectively. Mean serum IgG concentrations for the three groups were 5.36 μg/ml, 5.65 μg/ml, and 5.44 μg/ml for adult, generalized early‐onset, and localized juvenile patients, respectively. In contrast, for B. forsythus only 11%, 14%, and 10% of adult, generalized early‐onset, and localized juvenile patients were seropositive, with mean serum IgG concentrations of 0.46 μg/ml, 0.46 μg/ml, and 0.47 μg/ml, respectively. This suggests that B. forsythus is either poorly immunogenic or less invasive than P. gingivalis. If most patients fail to mount an immune response to B. forsythus and it is invasive, it may explain why this organism is a risk factor for disease. J Periodontol 1997;68:734–738.
Migration of Gingival Fibroblasts on Fibronectin and Laminin
Authors: Dean John W. , Blankenship Jane Anne
Published: March 2012

The migrational behavior of fibroblasts is critical for the maintenance and healing of the periodontium. The purpose of this study was to determine, in vitro, the differences found in gingival fibroblast migration on the following substrates: fibronectin, laminin, bovine serum albumin (BSA), or plastic. Filter paper strips soaked in solutions of the test molecules were placed in 35 mm culture dishes. Equimolar amounts of the various proteins were allowed to dry onto the plastic in a discrete band. The bands were masked and 5.0 × 104 cells seeded. Rat gingival fibroblasts were allowed to attach for 1.5 hours and the protein bands uncovered and incubation continued for 24 hours under standard conditions. Cells were fixed, stained and cell images captured, computer digitized and migrational areas and cell numbers and areas quantified after converting pixels to μm. Cell migration was enhanced on fibronectin substrates. Statistically significant differences (P < 0.01) were found for total area covered (fibronectin, mean = 110.8 mm2 vs. controls: plastic, mean = 28.2 mm2; BSA, mean = 18.2 mm2) and the number of cells migrating as compared to controls (fibronectin, mean = 1184 vs. controls: plastic, mean = 304, BSA, mean = 230). No significant differences in area covered or numbers of cells migrating were found between controls and cells exposed to other substrates. Mean spread area per cell was not statistically significantly different for any of the conditions. Numbers of cells migrating on substrates other than fibronectin were reduced even more when protein synthesis was inhibited using cycloheximide. In this system fibronectin serves as a cue to recruit significantly greater numbers of fibroblasts to migrate for greater distances than the other molecules tested. J Periodontol 1997;68:750–757.