bluuebunny/crossref_metadata_2025 huggingface dataset:
Plaque Score Changes Based Primarily on Patient Performance at Specific Time Intervals
Authors: DeVore Cheryl H. , Beck Frank M. , Horton John E.
Published: March 2012

Patient plaque removal is a major component of periodontal therapy and should be continuously monitored during and following treatment. There do not appear to be studies which address plaque score changes achieved primarily by patient performance from the time of initial presentation to, during, and following active therapy. We assessed individual tooth surfaces and segment plaque scores for 24 adult subjects presenting with periodontitis, the majority of which was ADA case types III and IV, at 3 time points (initial presentation, post‐initial preparation, and at 3 months following active therapy), using the O'Leary Plaque Index. The assessments describing surfaces and segments were made prior to any professional intervention. Analysis of buccal (B), interproximal (I), and lingual (L) plaque retentive surfaces at t‐0 indicated the mean plaque index on B and L surfaces (30.7% and 41.9% respectively) was less than that on I surfaces (79.6%). At t‐1 and t‐2, the mean plaque index on all three surfaces was significantly (P < 0.05) less than at t‐0. Analysis of plaque indices in each of 6 segments at each time point revealed that plaque scores in all segments, except the mandibular right segment, were analogously reduced from t‐0 to t‐1 and to t‐2. Our results indicate that plaque reduction for all subjects based primarily on patient performance consistently approaches or exceeds 50% on all surfaces and that interproximal surfaces present with and retain more plaque than buccal and lingual surfaces. Furthermore, patient plaque performance achieved at the time of post‐initial preparation may be a predictor of the plaque control achievable during therapy based on patient performance. J Periodontol 1990;61:343–346.
Clinical Efficacy of a Dentifrice and Oral Rinse Containing Sanguinaria Extract and Zinc Chloride During 6 Months of Use
Authors: Harper D. Scott , Mueller Laura J. , Fine James B. , Gordon Jeffrey , Laster Larry L.
Published: March 2012

The efficacy of combined use of toothpaste and oral rinse containing sanguinaria extract and zinc chloride was compared to placebo products in a 6‐month clinical trial. Sixty subjects with moderate levels of plaque and gingivitis were randomly assigned to active and placebo groups. Noninvasive measures of plaque and gingivitis were assessed at baseline and at 2, 6, 8, 14, 20, and 28 weeks. Bleeding on probing was measured at baseline and 6, 14, and 28 weeks. Active group scores were significantly lower (P <.0001) than placebo scores at each post‐baseline time point for all indices, with the exception of plaque at 2 weeks. The 28 week active group scores were 21% lower than the placebo group for plaque, 25% lower for gingivitis, and 43% lower for bleeding on probing. No dental staining or taste alteration was reported in the active group. Three of 30 active group subjects exhibited minor soft tissue irritations that resolved spontaneously without discontinuation of product use. Results indicate that the test products showed good levels of safety and efficacy when administered in a combined use regimen for 6 months. J Periodontol 1990;61:352–358.
Periodontitis Associated With Papillon‐Lefèvre Syndrome
Authors: Bimstein Enrique , Lustmann Joshua , Sela Michael N. , Neriah Ziva Ben , Soskolne W. Aubrey
Published: March 2012

The predominant subgingival microflora, host immune response, and genetic history of a 14‐year‐old girl with Papillon‐Lefèvre Syndrome (PLS) are reported. The patient had high counts of Actinobacillus actinomycetemcomitans and surface translocating bacteria. She had significantly raised levels of antibodies to five of the bacterial species studied with the levels to A. actinomycetemcomitans remaining high after antibiotic therapy. The polymorphonuclear leukocytes (PMN) also released significantly increased amounts of O2 compared to controls. The data presented support a role for A. actinomycetemcomitans and PMN dysfunction in the pathogenesis of PLS. J Periodontol 1990;61:373‐377.
A New Degradable Controlled Release Device for Treatment of Periodontal Disease: In Vitro Release Study
Authors: Steinberg D. , Friedman M. , Soskolne A. , Sela M. N.
Published: March 2012

The substantivity of a drug in the periodontal pocket is an important factor determining its effect on the subgingival flora. Therefore, one of the predominant factors in the development of a sustained release delivery device is the ability to control the rate of release of the drug. Previous studies have demonstrated the advantages of the local sustained release of Chlorhexidine from nondegradable devices in the treatment of periodontal diseases. The aim of this study was to develop a degradable sustained release device composed of a cross‐linked protein containing Chlorhexidine as the therapeutic agent. The in vitro release profile of Chlorhexidine from the degradable films was altered by the amount of Chlorhexidine incorporated into the film, by the cross‐link density of the polymer, and by the Chlorhexidine salt used. The Chlorhexidine in the final pharmaceutical preparation did not lose its antibacterial activity as was shown in an in vitro antibacterial test. This work demonstrates that the release of Chlorhexidine from a degradable delivery system and the degradation of the matrix can be controlled by variation in the formulation. This presents a new dental drug delivery system that can be used as an adjunct in the treatment of periodontal diseases in the future. These studies enable us to choose the pharmaceutical formulations for clinical trials to be conducted testing the efficacy of this treatment modality. J Periodontol 61;1990:393–398.
Effects of Subgingival Irrigation on Bacteremia Following Scaling and Root Planing
Authors: Waki Marc Y. , Jolkovsky David L. , Otomo‐Corgel Joan , Lofthus John E. , Nachnani Sushma , Newman Michael G. , Flemmig Thomas F.
Published: March 2012

The purpose of this study was to determine the effects of professional subgingival irrigation, together with subsequent patient administered home marginal irrigation, on the incidence of bacteremia after scaling and root planing (Sc/RP). A total of 60 periodontal maintenance patients were assigned to either Group 1: subgingival irrigation, with 0.12% CHX and daily marginal irrigation with 0.04% CHX; Group 2: subgingival irrigation with 0.12% CHX and daily marginal irrigation with water; Group 3: subgingival and daily marginal irrigation with water; Group 4: Non‐irrigation (control). Patients entered the study after receiving a thorough periodontal maintenance appointment including a complete examination, Sc/RP, and standard oral hygiene instruction. Blood samples were taken at the 3‐month visit before and after Sc/RP. Microbiological culturing was done using the Septi‐Chek system, selective and non‐selective media. Results from 54 patients showed that bacteremia was detected prior to Sc/RP in 2 patients and after Sc/RP in 10 patients. No significant effect by treatment regimens on post Sc/RP bacteremia could be detected. The organisms isolated included Eubacterium lentum, Propionibacterium acnes, Streptococcus species, Neisseria species, Candida albicans, Staphylococcus species, and un‐identified Gram‐negative rods. J Periodontol 1990; 61:405– 411.
Episodic Probing Attachment Loss in Humans: Histologic Associations
Authors: Zappa U. , Simona C. , Schäppi P. , Graf H. , Espeland M.
Published: March 2012

Marginal periodontitis in humans is characterized by episodes of probing attachment loss followed by periods of quiescence. The purpose of the present study was to assess characteristics of the inflammatory infiltrate in periodontal lesions where episodic probing attachment loss had occurred within the previous month. In 10 systemically healthy adult human subjects with untreated advanced periodontitis, probing attachment levels were measured at baseline and every 30 days thereafter for 10 months. Measurements were made at six sites of every tooth using an acrylic onlay as a reference point and a pressure sensitive probe. Sites where double measurements confirmed that probing attachment loss of 2 mm or more had occurred within the previous month were identified (P‐sites), as were corresponding contralateral non‐progressing sites (C‐sites). Biopsies of the supracrestal tissues were taken from these sites, processed, and cut in 1 μ sections for histologic evaluation. Counts of inflammatory cells in standard areas of the sections were compared between P and C sites. The results indicated that 5.04% of 1566 sites under investigation lost probing attachment during the 10‐month observation period. Inflammatory cell counts were higher in P‐sites as compared to C‐sites. P‐sites with more than 2 mm attachment loss (P > 2 sites) had significantly more inflammatory cells within standard areas at the apical end of the junctional epithelium than non‐progressing C‐sites (P<0.02). There was no significant difference in counts between P‐sites progressing 2 mm (P‐2 sites) and corresponding C‐sites. From these results it appears that episodic probing attachment loss beyond a threshold of 2 mm is associated with significantly increased inflammatory cell counts in the progressing periodontal lesion. Histological parameters may provide a standard against which potential noninvasive diagnostic indicators of actively progressing periodontal sites could be evaluated. J Periodontol 1990;61:420–426.
Irrigation With 0.06% Chlorhexidine in Naturally Occurring Gingivitis. II. 6 Months Microbiological Observations
Authors: Newman Michael G. , Flemmig Thomas F. , Nachnani Sushma , Rodrigues Andre , Calsina Gloria , Lee Yu‐Sook , de Camargo Paulo , Doherty Frances M. , Bakdash M. Bashar
Published: March 2012

In an examiner blind positive/negative controlled 6‐month study, the efficacy of supragingival irrigation with 0.06% Chlorhexidine gluconate on the marginal and subgingival microflora in naturally occurring gingivitis was evaluated. The 222 patients enrolled in the study were assigned to one of four groups: Group 1: Once daily irrigation with 300 ml water followed by irrigation with 200 ml 0.06% Chlorhexidine gluconate (experimental); Group 2: Twice daily rinsing with 15 ml 0.12% Chlorhexidine (positive control); Group 3: Once daily irrigation with 500 ml water (irrigation control) and Group 4: Sodium fluoride dentifrice for normal oral hygiene only (negative control). All groups received the same sodium fluoride dentifrice for tooth brushing. All patients received a supra‐ and subgingival oral prophylaxis after baseline examination and at the end of the investigation. Plaque samples were analyzed from 105 patients at baseline, 93 patients at 3 months and 88 patients at 6 months. The 6‐months results demonstrated that, when compared with tooth brushing alone, adjunctive supragingival irrigation with 0.06% Chlorhexidine gluconate was most effective by significantly reducing (P≤ 0.008) both log10 CFU and % of Gram‐negative anaerobic rods and black‐pigmented Bacteroides. Chlorhexidine rinse also significantly (P≤ 0.008) reduced log10 CFU of black‐pigmented Bacteroides at 6 months. Both Chlorhexidine regimens significantly (P≤ 0.008) increased the % of Gram‐positive facultative cocci compared to water irrigation at 3 months. Water irrigation had a limited effect on any of the assessed bacterial groups (log10 CFU and %). This study demonstrates that twice daily rinsing with 0.12% Chlorhexidine has a beneficial effect on the microflora of patients with naturally occuring gingivitis. Furthermore, once daily irrigating with 300 ml water followed by irrigation with 200 ml 0.06% Chlorhexidine has an incremental beneficial effect on the marginal and subgingival microflora of these patients. J Periodontol 1990;61:427–433.
Alveolar Bone Loss in Patients with Long‐Term Supportive Care
Authors: Layport Cynthia A. , Greco George W. , McFall Walter T.
Published: March 2012

Radiographic record audits were conducted on 63 patients diagnosed as having periodontitis who had been treated and maintained for 10 years or longer in dental school clinics. Acceptable bite‐wing radiographs were available for 50 of these patients. Bitewing radiographs taken 8 to 34 years apart (mean 14.9 years) were assessed for bone loss. Recall maintenance had been accomplished for 60% of these patients at 6 to 9 month intervals, while 24% had been seen more frequently. The mean annual rate of bone loss was 0.037 mm (range of –0.19 to 0.20). There were no significant differences in bone loss between maxillary/mandibular, molar/premolar, or mesial/distal sites respectively. Alveolar bone loss in this dental school population compares well with other reported studies. Progression of disease as assessed by radiographic bone loss in treated and maintained periodontitis patients is minimal. J Periodontol 1990;61:434–437.
Bone Formation in Peripheral Giant Cell Granuloma
Authors: Dayan Dan , Buchner Amos , Spirer Shoshana
Published: March 2012

Mineralized products were analyzed in a series of 62 cases of peripheral giant cell granuloma of the gingiva or alveolar ridge of man. Histologic sections were examined by routine light microscopy and under polarized light to assess the extent and composition of mineralized tissues in these lesions. In 35% of the cases, mineralized tissue was identified in the form of woven and/or lamellar bone and dystrophic calcification. The most common type was the woven bone which appeared alone or in combination with lamellar bone in 82% of the lesions containing mineralized material. Unlike peripheral ossifying fibroma, no cementum‐like material was identified in peripheral giant cell granuloma. J Periodontol 1990;61:444–446.
Periodontal Repair in Dogs: Effect of Saliva Contamination of the Root Surface
Authors: Wikesjö Ulf M. E. , Hagen Karin , Nielsen David D.
Published: March 2012

This study evaluated whether periodontal repair following reconstructive surgery may be compromised by saliva contamination of the root surfaces during the surgical procedure. Circumferential periodontal defects, 5 to 6 mm in vertical dimension, were surgically created in the mandibular premolars in 9 beagle dogs and immediately treated. The denuded root surfaces in left and right jaw quadrants in 4 dogs were treated with either filter sterilized saliva or saline, while in the remaining 5 dogs the root surfaces were treated with unfiltered saliva or saline. The wounds were closed and allowed to heal for 4 weeks. The dogs were sacrificed and tissue blocks prepared for histometric analysis. Results showed no difference between teeth treated with filtered or unfiltered saliva and the saline treated controls. Connective tissue repair to the root surfaces exceeded 70% of the defect height in all experimental groups. Regeneration of cementum and alveolar bone was limited and did not exceed 30% of the defect height. The results indicate that contamination of the root surface by saliva during the surgical procedure does not necessarily compromise connective tissue repair to the root surface. J Periodontol 1990; 61:559–563.
Formation of Interdental Soft Tissue Defects After Surgical Treatment of Periodontitis
Authors: Jenkins William M. M. , Wragg Phillip F. , Gilmour W. Harper
Published: March 2012

This study monitored the development and repair of interdental soft tissue defects following surgical treatment of periodontitis in 21 patients. Open flap curettage was performed at 100 interdental areas with follow‐up examinations 1, 3, and 6 months later. Interdental gingival contours were assessed both clinically and indirectly with silicone elastomer impressions from which stone models were obtained; defect depths were then calculated using the Reflex Microscope. Two types of defect were identified at the 1month follow‐up: 13 interdental clefts (mean depth, 1.8 mm); and 30 craters, (mean depth, 1.6 mm). Although clefts tended to persist, craters showed a strong tendency to repair. Thus, at the 6‐month follow‐up, the mean depths of clefts and craters were 1.3 mm and 0.7 mm respectively. The development of soft tissue defects did not appear to be related to the use of a periodontal dressing nor did the existence of an underlying bone defect appear to be of etiological importance. Pre‐operative probing depths, however, were positively associated with the occurrence of soft tissue craters (P = 0.02). Pre‐operatively, the overall mean probing depth and frequency of bleeding on probing were 5.3 mm and 100% respectively. At 6 months, these values were reduced to 2.0 mm and 22%. When clefts, craters, and interdental areas with no soft tissue defect were compared, no significant differences in probing depth reduction or frequency of bleeding were observed at any time point. It is concluded that the development of clefts or craters during the early stages of healing had no adverse effect on the eventual establishment of periodontal health. J Periodontol 1990;61:564–570.
Diphenylhydantoin‐Induced Gingival Overgrowth in Man: A Clinico‐Pathological Study
Authors: Peñarrocha‐Diago M. , Bagán‐Sebastián J. V. , Vera‐Sempere F.
Published: March 2012

In a cross‐sectional, epidemiological study of diphenylhydantoin‐induced gingival overgrowth (DGO) in 60 epileptic patients, gingival lesion severity was statistically compared with other clinical, laboratory, and histopathological findings. Evident DGO was observed in 50% of patients, and positive correlations were detected between overgrowth severity and oral debris, calculus accumulation, plaque score, gingival inflammation, and probing depth. However, no valid correlation was observed between lesion severity and patient age, mouth breathing, daily drug dose, plasma diphenylhydantoin level, or duration of drug intake. Also, there were no significant correlations between connective fiber richness and the intensity of epithelial hyperplasia and severity of gingival overgrowth. / Periodontol 1990; 61:571‐574.
In Vitro Chemotactic Response of Osteoblast‐Like Osteosarcoma Cells to a Partially Purified Protein Extract of Demineralized Bone Matrix
Authors: Padley Richard A. , Cobb Charles M. , Killoy William J. , Newhouse Nancy L. , Boyan Barbara D.
Published: March 2012

The purpose of this investigation was to evaluate the chemotactic potential of a partially purified protein extract from bone matrix when tested against osteosarcoma cells with Osteoblast characteristics. The chemotactic response of ROS 17/2 cells to a lyophilized bovine bone extract purified to “Urist step eight” was evaluated in Boyden blind well chambers. A checkerboard design was employed to test cell migration against positive, negative, and no concentration gradients, thereby controlling the effects of chemokinesis and/or random migration on results. The results demonstrate that the partially purified protein extract from bovine bone matrix is chemotactic since more cells migrated to positive gradients than to negative gradients (P <.01). The chemotactic effect was confirmed by an increase in cell migration toward positive gradients of the bone extract compared to cell migration in the presence of no gradient (P <.01). When no gradient was present, the cells exhibited an increased response in the presence of equal concentrations of the bone extract (P <.01) indicating a chemokinetic effect. The proteinaceous nature of the chemoattractant was confirmed by its susceptibility to trypsin digestion and heat exposure. J Periodontol 1991;62:15–20.
Periodontal Healing Following Guided Tissue Regeneration With Citric Acid and Fibronectin Application
Authors: Caffesse Raul G. , Nasjleti Carlos E. , Anderson Gissela B. , Lopatin Dennis E. , Smith Billy A. , Morrison Edith C.
Published: March 2012

This study was undertaken to determine the effects of guided tissue regeneration (GTR) with and without citric acid conditioning and autologous fibronectin application. The study subjects were four female beagle dogs with spontaneous periodontitis. The dogs were given thorough root debridement and 4 weeks later, mucoperiosteal flaps were raised on both sides of the mandible involving the 2nd, 3rd, and 4th premolar and 1st molar teeth. After debridement, notches were placed on the roots at the level of supporting bone. Citric acid (pH 1) was topically applied for 3 minutes on the exposed root surfaces of one side (experimental). The roots were irrigated with normal saline solution. Both the root surfaces and the inner surface of the flap were then bathed in autologous fibronectin in saline. Following this, Gore‐Tex periodontal material was adapted to the roots of each tooth and sutured. The contralateral side, serving as control, was treated by surgery and application of Gore‐Tex periodontal material only. All membranes were removed 1 month after surgery, and the dogs sacrificed at 3 months. Both mesio‐distal and bucco‐lingual microscopic histological sections were evaluated by descriptive histology, and linear measurements and surface area determination of the furcal tissues were made. Periodontal healing following the use of GTR procedure resulted in an increase in connective tissue and alveolar bone regeneration. Adjunctive citric acid plus autologous fibronectin produced slightly better results, but these differences were not statistically significant for this sample. J Periodontol 1991;62:21–29.
Early Healing Events at the Dentin‐Connective Tissue Interface. Light and Transmission Electron Microscopy Observations
Authors: Wikesjö Ulf M. E. , Crigger Max , Nilvéus Rolf , Selvig Knut A.
Published: March 2012

The objective of these studies was to follow early healing at the dentin‐connective tissue interface. Small dentin blocks were surgically implanted in bone cavities under mucoperiosteal flaps in the edentulous alveolar ridges of five beagle dogs at various times. In two separate experiments, wound maturation on native dentin surfaces and on citric acid or heparin conditioned dentin surfaces was observed. Block specimens including bone, dentin, and surrounding soft tissues were obtained at 10 minutes, 1 and 6 hours, and 1, 3, and 7 days after flap closure and prepared for light and transmission electron microscopic examination of the interface. The very initial attachment to native dentin was mediated by a granular precipitate. At 1 and 6 hours, the intercellular matrix was more organized with fibrin formation around red blood cell aggregates and at the dentin surface. Polymorphonuclear leukocytes were observed throughout the interface. Red blood cells were undergoing degradation at day 1 and polymorphonuclear cells were prevalent at the dentin surface. The 3‐day observation interval was characterized by further maturation of the fibrin clot. Macrophages were observed near the dentin surface and fibroblasts could be identified. The 7‐day specimens exhibited areas of cell rich connective tissue attachment without inflammatory cells as well as areas showing the fibrin clot in various stages of decomposition. These observations suggest that connective tissue attachment to dentin surfaces is mediated by adsorption of plasma proteins to the surface and subsequent development and maturation of a fibrin clot. The sequence of healing events at dentin surfaces conditioned with citric acid or heparin was largely similar to healing at native dentin surfaces. However, at day 1 and later time points, clot adhesion to heparin‐conditioned dentin appeared compromised, whereas the fibrin clot seemed to adhere to citric acid‐conditioned dentin at all observation periods. These observations indicate that in the absence of mechanical trauma, epithelial proliferation, and infection, wound maturation at the dentin‐connective tissue interface may not necessarily be affected by treatments that either enhance or inhibit clot adhesion to the dentin surface. J Periodontol 1991; 62:5–14.
A Microbiological Comparison of Young Adults Based on Relative Amounts of Subgingival Calculus
Authors: Brown C. M. , Hancock E. B. , O'Leary T. J. , Miller C. H. , Sheldrake M. A.
Published: March 2012

This study compared the relative amounts of Actinobacillus actinomycetemcomitans (Aa), Eikenella corrodens (Ec), and black‐pigmented anaerobic rods, and the proportions of coccoid forms, nonmotile rods, motile rods, spirochetes, and total motile organisms in subgingival plaque samples from 2 groups of young adults with generalized moderate to severe periodontitis. Two groups of 12 untreated patients were selected based on the relative amounts of subgingival calculus detected. Subgingival plaque samples (2 sites/patient) were taken with a sterile curet, dispersed, and plated under anaerobic conditions on ETSA, ETSA‐kanamycin, ETSA‐clindamycin, and TSBV agar. Appropriate biochemical tests were performed to confirm suspected microorganisms. Phase‐contrast microscopy also was used to count the relative numbers of coccoid forms, nonmotile rods, motile rods, and spirochetes in each of the samples. Patients with no clinically detectable subgingival calculus harbored significantly greater proportions (%) of coccoid forms and Aa and greater amounts (CFU/mg) of Aa than did patients with obvious amounts of subgingival calculus. Subjects with clearly detectable subgingival calculus possessed greater proportions of motile rods, total motile organisms, and black‐pigmented anaerobic rods than did subjects with little or no subgingival calculus. Young adult patients with generalized moderate to severe disease and little or no detectable subgingival calculus may possess a subgingival microbiota with relatively higher numbers of Aa and coccoid forms, and a lower percentage of BPB, motile rods, and total motile organisms as compared to similar patients with greater amounts of subgingival calculus. J Periodontol 1991; 62:591–597.
Heparan Sulfate and Fibronectin Improve the Capacity of Collagen Barriers to Prevent Apical Migration of the Junctional Epithelium
Authors: Pitaru S. , Noff M. , Grosskopf A. , Moses O. , Tal H. , Savion N.
Published: March 2012

The objective of the present study was to assess the effect of bilayered/collagen barriers enriched with fibronectin and heparan sulfate on the prevention of apical migration of the epithelium during the initial stage of periodontal wound healing. Experimental osseous defects were produced on the labial aspect of maxillary canines in dogs. Experimental sites were treated with either bilayered enriched collagen barriers or with nonenriched bilayered collagen barriers, using the guided tissue regeneration technique. Control sites were treated with monolayered collagen barriers that were not enriched with fibronectin and heparan sulfate. Histologic and histomorphometric examinations performed on specimens obtained 20 days post‐operative indicate the formation of a short junctional epithelium in the experimental sites treated with enriched collagen barriers. In this group, 95% of the occlusal‐apical length of the defects was repopulated by connective tissue cells. In the other 2 groups, a long junctional epithelium developed with only 65% of the occlusal‐apical length of the defects being repopulated by connective tissue cells. These findings suggest that the enrichment of collagen barriers with fibronectin and heparan sulfate may be important to enhance the repopulation of exposed root surfaces by connective tissue cells and prevent the apical migration of the epithelium during the initial stages of periodontal wound healing. J Periodontol 1991;62:598–601.
Bacteremia Following Subgingival Irrigation and Scaling and Root Planing
Authors: Lofthus John E. , Waki Marc Y. , Jolkovsky David L. , Otomo‐Corgel Joan , Newman Michael G. , Flemmig Thomas , Nachnani Sushma
Published: March 2012

The purpose of this study was to determine the incidence of bacteremia after a single professional subgingival irrigation with a 0.12% Chlorhexidine gluconate mouthrinse (CHX) as well as after a subsequent scaling and root planing (S/RP) during the same visit. Thirty subjects each with at least 1 site that probed 4 mm or more and bled on probing were randomly assigned to the following groups: 1) irrigation with 0.12% CHX; 2) irrigation with sterile water; and 3) non‐irrigated controls. To begin the study blood was drawn just before and 2 minutes after irrigation. Thirty minutes later, blood was drawn again just before and 2 minutes after S/RP at the same site. Specimens were cultured for anaerobic and aerobic microorganisms using standard cultural techniques. Eighteen blood cultures from 15 subjects yielded positive cultures resulting in 23 isolates. Gram‐positive rods comprised 34.8% of the total isolates; Gram‐positive cocci 34.8%, Gram‐negative rods 21.7%, and Gram‐negative cocci 8.7%. In the CHX group, bacteremia was detected in 5 subjects after irrigation and in 2 other subjects after S/RP. In the water group, bacteremia was detected in one subject after irrigation and in 4 subjects after S/RP. The control group had 3 bacteremias after S/RP. There was no significant difference between the incidence of bacteremia associated with irrigation by CHX or sterile water (P = 0.141). There was also no significant difference in the incidence of bacteremia after S/RP between the CHX and sterile water irrigation groups and in patients who did not receive irrigation (control group) (P = 0.88). Thus it appears that subgingival irrigation, with or without medication, has no effect on the incidence of bacteremia following a subsequent S/RP. J Periodontol 1991; 62:602–607.
Clinical and Microbiological Effects of a Sanguinaria‐Containing Mouthrinse and Dentifrice With and Without Fluoride During 6 Months of Use
Authors: Kopczyk Raymond A. , Abrams Herbert , Brown Albert T. , Matheny James L. , Kaplan Alan L.
Published: March 2012

The purpose of this study was to test the efficacy and safety of sanguinaria‐containing regimens with and without fluoride using the American Dental Association guidelines for evaluating chemotherapeutic agents. The study was a 6‐month, double‐blind, 4‐cell, placebo‐controlled, parallel investigation involving 120 subjects. Following screening procedures, subjects were randomly assigned to 4 groups. Group 1 received a dentifrice containing 0.075% sanguinaria extract (SaE) and 2.0% zinc chloride (ZnCl2) in a dicalcium phosphate base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2‐ Group 2 received identical products without SaE or ZnCl2. Group 3 received a dentifrice containing 0.8% sodium monofluorophosphate, 0.075% SaE, and 0.05% ZnCl2 in a silica base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2. Group 4 products were identical to those of Group 3 but without SaE and ZnCI2. Supragingival plaque and gingival inflammation were scored at 0, 1, 2, 1.5, 3, 4.5, and 6 months; bleeding upon probing was measured at 1, 1.5, 3, and 6 months. Microbiological samples were taken from plaque, tongue, and cheek areas. The active products produced statistically significantly lower scores than the placebo agents for all indices (P <.0001). Six‐month plaque scores were 13.1% lower for Group 1 and 17.4% lower for Group 3 compared to placebo products. When the Plaque Severity Index was applied, the percentage reductions were 33% for Group 1 and 41% for Group 3 compared to placebos. Gingival inflammation scores were 16.7% lower for Group 1 and 18.1% lower for Group 3 at 6 months compared to placebo scores. Gingival bleeding upon probing scores were 31.5% lower for Group 1 and 41.2% lower for Group 3 compared to placebo groups at 6 months. Microbiological changes were not significant. Only 1 subject experienced an adverse reaction attributable to the use of active products. The active regimens of dentifrice plus oral rinse were significantly better than placebos and were clinically safe, with no evidence of deleterious microbiological changes. J Periodontol 1991;62:617–622.
Periodontal Status of HIV‐Seropositive and AIDS Patients
Authors: Friedman Richard B. , Gunsolley John , Gentry Anne , Dinius Ann , Kaplowitz Lisa , Settle Jane
Published: March 2012

Few reported studies have evaluated the periodontal status of individuals infected by human immunodeficiency virus (HIV). The majority of these reports have evaluated the periodontal status of individuals presenting to dental care facilities due to oral problems. These reports suggest that severe gingival inflammation and attachment loss are often associated with HIV seropositive patients. The purpose of this study was to evaluate the periodontal status of HIV seropositive patients without biasing the data towards those presenting to dentists with oral problems. Sixty‐three consenting male patients presenting to the infectious disease clinic at the Medical College of Virginia Hospitals were examined to determine the status of their periodontal health. Gingival index, plaque index, pocket depths, and attachment loss were determined using standard indices. Participants were first grouped according to the modified CDC Classification System for HIV infection and then categorized according to HIV risk factors for purposes of statistical analysis. No significant differences could be found in the gingival or periodontal status of subjects who were HIV seropositive versus those with AIDS. Periodontal status was also not significantly different for individuals based upon risk group. Periodontal health of the participants was similar to the general population (HIV status unknown). This would indicate that, although HIV gingivitis and HIV periodontitis have been documented in a number of HIV‐infected patients, the frequency of affected individuals is less than previous reports would suggest. J Periodontol 1991;62:623–627.
Resolution of Early Lesions of Juvenile Periodontitis With Tetracycline Therapy Alone: Long‐Term Observations of 4 Cases
Authors: Novak M. John , Stamatelakys Constantine , Adair Steven M.
Published: March 2012

Our previous studies have demonstrated that early‐identified lesions of localized juvenile periodontitis (LJP) can be treated by the use of systemically administered tetracycline alone (1 gm/day for 6 weeks). This therapy results in arrest of disease progression, decreased pocket depths, gains in clinical attachment, and significant repair of alveolar defects. This paper reports on the long‐term clinical and radiographic improvement in 4 subjects followed for 1 to 4 years after the completion of tetracycline therapy. Four patients (mean age 14 years) were examined 1 to 4 years following the completion of a single 6 week course of tetracycline. Mean pocket depth was reduced from the initial level of 7.1 mm to 3.6 mm. Mean attachment loss was reduced from 3.8 mm to 0.9 mm and angular bone defects had filled by an average of 72%. Pocket depths and attachment loss continued to decrease during the entire study period, while alveolar bone repair continued to increase. The findings support those of our previous investigation and confirm that: 1) early identified lesions of LJP can be effectively treated with 6 weeks of tetracycline therapy alone; 2) decreases in pocket depth, gains in clinical attachment, and repair of alveolar defects remain stable up to 4 years following antibiotic therapy; 3) clinical and radiographic improvement continues over time and may lead to complete resolution of some lesions; and 4) the reparative/regenerative potential of the periodontium in early onset disease in young individuals may exceed that observed in chronic adult periodontitis. J Periodontol 1991;62:628–633.
Reduction of Salivary Bacteria by Pre‐Procedural Rinses With Chlorhexidine 0.12%
Authors: Veksler Alberto E. , Kayrouz Ghassan A. , Newman Michael G.
Published: March 2012

The purpose of this study was to assess the effect of pre‐procedural rinsing (2 consecutive rinses) with 0.12% Chlorhexidine gluconate (CHX) on salivary bacteria during scaling and root planing procedures (S&RP). Because blood and debris arising from S&RP could inactivate CHX and decrease its antimicrobial effect, patients were evaluated throughout their appointment. Forty subjects rinsed with either 15 ml of CHX rinse or control (sterile water) for 30 seconds, expectorated and immediately rinsed again for 30 seconds. Unstimulated saliva samples were obtained at baseline (immediately before rinsing), and at 1 minute, 30 minutes, and 60 minutes after baseline. All 30 and 60 minute samples contained visible blood and debris. Samples were immediately diluted in transport fluid containing a CHX‐neutralizer and then plated on trypticase soy agar for enumeration of the total aerobic and facultative bacterial load. The dual rinses with 0.12% CHX immediately reduced the salivary bacterial load 97% and this reduction persisted for 60 minutes during S&RP. At 30 minutes and at 60 minutes aerobic bacteria were reduced 77% compared to control, and 96% compared to baseline. CHX was not inactivated by the high organic load (blood and debris) present during the procedure. Pre‐procedural rinsing with CHX has a profound and sustained effect on the aerobic and facultative flora of the oral cavity, which may contribute to a variety of clinical benefits. Pre‐procedural rinsing may also be of value in protecting patients and dental professionals during dental manipulations. J Periodontol 1991; 62:649–651.
CD4 to CD8 Ratio and In Vitro Lymphoproliferative Responses During Experimental Gingivitis in Pregnancy and Post‐Partum
Authors: Raber‐Durlacher J.E. , Zeijlemaker W.P. , Meinesz A.A.P. , Abraham‐Inpijn L.
Published: March 2012

The absolute numbers and percentages of peripheral T, B, and NK cells were assessed in 7 women, both during the second trimester of pregnancy and 6 months Postpartum. Furthermore, the in vitro responses of peripheral blood lymphocytes (PBL) to several mitogens and a preparation of Prevotella intermedia were compared in a period of experimentally‐induced gingivitis during pregnancy and post‐partum. Clinically, the periodontal pocket bleeding index (PPBI) was found to be higher during pregnancy than post‐partum. The absolute numbers of CD3, CD4, and CD19 positive cells appeared to be decreased during pregnancy as compared to post‐partum. However, the results did not indicate any evidence for a reduced in vitro PBL response to several mitogens and a preparation of P. intermedia during pregnancy. J Periodontol 1991; 62:663–667.
An In Vivo Study of Dentin Sensitivity: The Relation of Dentin Sensitivity and the Patency of Dentin Tubules
Authors: Cuenin Michael F. , Scheidt Michael J. , O'Neal Robert B. , Strong Scott L. , Pashley David H. , Horner Jack A. , Van Dyke Thomas E.
Published: March 2012

Dentin hypersensitivity can be a major problem for periodontal patients. The relationship between dentin hypersensitivity and the patency of dentin tubules in vivo has been established. Thirteen adult patients with teeth scheduled for extraction were selected and a stent fabricated to confirm location of the root surface being examined. Response to a constant air blast was recorded on a numeric pain rating scale (from 0 to 4) during the course of treatment. The tooth surface was initially treated with 0.5 molar EDTA (pH = 7.4), to remove the smear layer and expose tubules. The region was then treated with either a 3% monopotassium‐monohydrogen Oxalate solution or a 3% sodium chloride solution, both at pH = 2.4. Solutions were prepared to be indistinguishable to the examiner. Response to air was evaluated before and after EDTA treatment and after treatment with a desensitizing agent. The patient was anesthetized and the treated tooth extracted. Specimens were sectioned, critical point dried, sputter coated with gold, and examined under the scanning electron microscope. Photomicrographs were analyzed by computer assisted digital analysis to evaluate the degree of tubule occlusion. Statistical analysis by repeated measures ANOVA for univariate tests of hypothesis for within subject effects showed the sodium chloride solution was more effective in reducing dentin sensitivity than the potassium Oxalate solution. Scanning electron micrographic analysis revealed a mean dentin tubule aperture size of 1.720 square μm following EDTA treatment alone, 0.564 square μm following potassium Oxalate treatment, and 0.386 square μm following sodium chloride treatment. The data suggest that low pH NaCl solution may be an effective adjunct to the treatment of dentin hypersensitivity in post‐periodontal surgery or recession patients. J Periodontol 1991; 62:668–673.
In Vivo Determination of Radiographic Projection Errors Produced by a Novel Filmholder and an X‐Ray Beam Manipulator
Authors: Zappa U. , Simona C. , Graf H. , van Aken J.
Published: March 2012

Subtraction radiography requires radiographs made with identical projection geometry. The purpose of the present investigation was to develop and evaluate a new in vivo method to measure angular radiographic projection error. This included the development of a system for accurate control of the x‐ray beam angulation relative to the intraoral film and the evaluation of the in vivo projection errors (equivalent to the “angular difference” between repeated exposures) produced by the new system. A filmholder, an x‐ray beam manipulator, and an aiming device were newly constructed. Reference wires were attached for measuring the projection error on the filmholder and on the 22 bicuspids at the sites of investigation in 16 patients. Two exposures using standardized projection conditions were made of each site. The relative position of the reference wires on the duplicate radiographs was used to calculate the angular difference in the direction of the x‐ray beam which occurred between the 2 exposures. Triplicate measurements allowed the determination of measurement error. The angular projection errors were measured in a horizontal and vertical direction. The reference wires allowed determination of the angular projection errors relative to the filmholder, relative to the dentition and the angular error due to the repositioning of the filmholder in the patient's mouth. The average projection errors deviated only slightly from zero. The largest deviation registered was ‐0.11†. This applies to the horizontal and vertical direction and all relationships. The standard deviations varied between 0.403° and 0.697°. This applies to the standard deviation for all relationships in the horizontal, the vertical, and the oblique directions. The measuring error found from the triplicate measurements had a standard deviation of 0.08° to 0.19° depending on the distance between the reference wires. This new system for controlling in vivo projection errors seems to provide highly standardized radiographs in vivo. The new measuring system proved to be accurate enough to measure the in vivo projection errors between repeated radiographs produced with the new filmholder and x‐ray beam manipulator. The in vivo errors produced by the new system are markedly smaller than all in vivo and in vitro errors previously reported in the literature. J Periodontol 1991; 62:674–683
Effects of the Platelet‐Derived Growth Factor/Insulin‐Like Growth Factor‐I Combination on Bone Regeneration Around Titanium Dental Implants. Results of a Pilot Study in Beagle Dogs
Authors: Lynch Samuel E. , Buser Daniel , Hernandez Rafael A. , Weber H.P. , Stich H. , Fox Christopher H. , Williams Ray C.
Published: March 2012

The purpose of this study was to evaluate the early wound healing events of bone around press‐fit titanium implants inserted with and without the concurrent application of a combination of platelet‐derived growth factor (PDGF) and insulin‐like growth factor (IGF‐I). Nine months prior to implant placement all mandibular premolar teeth were extracted in 8 beagle dogs. Subsequently, 40 specially manufactured titanium implants with 2 transverse holes in the apical section were press fit into precise recipient sites in the dogs' mandibles. The dogs were sacrificed at 7 and 21 days following implant placement yielding 12 PDGF‐B/IGF‐I treated and 8 control (placebo gel or non‐treated) implants for each observation period. Coded undecalcified sections were analyzed for: 1) percentage of implant surface in contact with new bone; 2) percentage of peri‐implant space filled with new bone; and 3) percentage of implant hole filled with new bone. An analysis of variance was used to determine significant differences among the treatment groups. At 7 days, the percentage of bone fill in the peri‐implant spaces and the percentage of implant surface in contact with new bone were both significantly increased in PDGF‐B/IGF‐I treated sites (P < 0.01 for both groups). There was < 1.5% fill of the implant holes in both treated and control sites (no significant differences). At 21 days the percentage of bone fill in the peri‐implant spaces was significantly increased in the PDGF‐B/IGF‐I treated sites (P < 0.01). No significant differences were detected at this time in the percentage of implant hole filled with new bone nor in the percentage of implant surface in contact with new bone. However, 10 of the 12 PDGF‐B/IGF‐I treated implants exhibited a greater amount of new bone within the implant holes compared to the means of the placebo gel and non‐treated implants. These findings suggest that the PDGF‐B/IGF‐I combination can stimulate bone regeneration around press‐fit titanium implants. In this model the effect appears prolonged in areas where larger bone defects exist, such as in the peri‐implant marrow spaces. J Periodontol 1991; 62:710–716.
The Neutrophil: Mechanisms of Controlling Periodontal Bacteria
Authors: Miyasaki Kenneth T.
Published: March 2012

The control of potentially periodontopathic microorganisms by host neutrophils is crucial to periodontal health. Neutrophils may use oxidative or nonoxidative mechanisms and either kill bacteria, influence bacterial growth, or modify bacterial colonization in the periodontium. Delivery of antimicrobial substances by neutrophils involves respiratory burst activity, phagocytosis, secretion, or cytolysis/apoptosis. Neutrophils contain a number of antimicrobial components including calprotectin complex, lysozyme, defensins, cofactor‐binding proteins, neutral serine proteases, bactericidal/ permeability increasing protein, myeloperoxidase, and a NADPH oxidase system. Many of these components are multifunctional and exhibit several mechanisms of antimicrobial activity. When comparisons are made among periodontal bacteria, differences in sensitivity to different components are observed. A hypothesis of specific defense is presented: That specific periodontal diseases can result from the failure of specific aspects of the host immune system (the neutrophil, in particular) in its interaction with specific periodontal pathogens. Failure may be due to phenotypic variation (pleomorphism) within the host or bacterial evasive strategies. J Periodontol 1991; 62:761–774.