bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Pulpal Treatments on Cell and Tissue Reactions in the Marginal Periodontium
Authors: Blomlöf Leif , Lindskog Sven , Hammarström Lars
Published: March 2012

The effects of pulpal infection and intrapulpal application of calcium hydroxide and antibiotics were evaluated with special reference to cell and tissue reactions in the marginal hard/soft tissue interface in monkeys. Results indicate that pulpal conditions and endodontic dressings influence marginal healing and repair, provided an endodontic‐periodontic pathway such as patent dentin tubules is present. These results suggest that permanent endodontic treatment, with an inert material, should be performed before the protective cementum layer is removed. Pulpally aggravated periodontal lesions should therefore not be overlooked in periodontal diagnosis and treatment.
Effects of an Air‐Powder Abrasive Device Used During Periodontal Flap Surgery in Dogs
Authors: Pippin David J. , Crooks William E. , Barker Bruce F. , Walters Perry L. , Killoy William J.
Published: March 2012

An air‐powder abrasive system, the Prophy‐Jet, is a commercially available product intended for use during dental prophylaxis procedures. The purpose of this investigation was to assess the effects on periodontal tissues when the device is used as an adjunct to hand instrumentation in root preparation during periodontal surgery. The degree of tissue injury was assessed by evaluating clinical healing and by histometric analysis of the intensity of the inflammatory response at selected healing times. Surgical sites subjected to Prophy‐Jet treatment tended to have slightly lower histometric inflammation scores than control sites treated by hand instrumentation alone. As judged by the inflammatory response and clinical healing, additional effects to surgical exposure of tissues of the periodontium were benign. Use of the Prophy‐Jet instrument during periodontal surgery is effective and well tolerated.
Radiographic Evaluation of the Effect of Initial Periodontal Therapy on Thickness of the Maxillary Sinus Mucosa
Authors: Engström Helene , Chamberlain Durwin , Kiger Robert , Egelberg Jan
Published: March 2012

The thickness of the radiographic image of the maxillary sinus mucosa on intraoral radiographs was evaluated in 13 patients with advanced periodontal disease, prior to and 12 months following initial periodontal therapy. Before treatment, a relationship was observed between the thickness of the sinus mucosa and the mean probing depths of the teeth in the involved sextant. As many as 79% of the available sextants showed swelling of the mucosa prior to periodontal therapy, compared to only 17% after treatment. This report supports previous studies indicating that advanced periodontal disease may cause swelling of the maxillary sinus mucosa and that periodontal therapy will significantly reduce such swelling.
Regeneration of Attachment Apparatus Lost Due to Disease of Endodontic Origin
Authors: Goldman Henry M. , Schilder Herbert
Published: March 2012

Osseous defects may be due to endodontic or to periodontic involvement or a combination of the two. Careful diagnosis is required to determine the correct form of treatment.
The Osteogenic Potential of Two Human Demineralized Bone Preparations Using a Xenogeneic Model
Authors: Marinak Kenneth W. , Mellonig James T. , Towle Herbert J.
Published: March 2012

The relative osteogenic potential of two different preparations of lyophilized human demineralized bone were evaluated using a heterotopic site in a rodent model. Human diaphyseal cortical bone (75‐850 μm) was demineralized according to two different protocols for decalcified bone allograft (A. H. Reddi and M. R. Urist). Equal volumes of mineralized lyophilized human bone and a proprietary hydroxylapatite served as controls. Thirty‐two Long‐Evans rats divided into four groups received subcutaneous implants of one of these four preparations. Implants were harvested at two, four, and six weeks. Histometric analysis of limited serial sections at six weeks demonstrated new bone formation by the two demineralized preparations only. The Reddi protocol produced significantly more bone formation (1.13 ± 1.21%) than the Urist preparation (0.53 ± 0.31%). Although bone induction by both the Reddi and Urist protocol was sparse within this xenogeneic system, the Reddi preparation may offer some slight advantage of greater osteogenic potential and ease of preparation. The low yields of induced bone in response to implants of human demineralized bone would limit the use of this model system in assessing osteogenic potential prior to clinical use.
The Effect of an Antimicrobial Mouthrinse on Early Healing of Gingival Flap Surgery Wounds
Authors: Zambon J. J. , Ciancio S. G. , Mather M. L. , Charles C. H.
Published: March 2012

A randomized double‐blind crossover design study using 25 patients requiring bilateral gingival flap surgery was completed. The effect of rinsing postsurgically three times daily with an antimicrobial mouthrinse or physiological saline on dental plaque formation, gingival inflammation, bleeding, wound healing, and patient comfort was evaluated at 7, 14 and 28 days.

The antimicrobial rinse was statistically significantly 28.9% more effective than saline at seven days for reducing plaque. It was also significantly more effective for improving wound healing at day 7 as measured by edema (p < 0.04). There were no significant differences in gingival index scores or bleeding at any time period.

Use of an antimicrobial mouthrinse may be an effective aid in early healing of gingival flap surgery wounds.
The Effect of Health Beliefs on the Compliance of Periodontal Patients with Oral Hygiene Instructions
Authors: Kühner Matthias K. , Raetzke Peter B.
Published: March 2012

Problems of patient compliance in periodontics are evident. This study explored factors which may contribute to the degree of adherence. Using the “Health Belief Model” a questionnaire was constructed and administered to 120 patients of the Department of Periodontology, University of Frankfurt Dental School. Compliance of these patients during the hygienic phase was assessed using a bleeding index. The data set for statistical evaluation comprised 96 patients. The loss was due to missing of appointments and incomplete questionnaires. There was no significant correlation between patient compliance on the one hand and sociodemographic variables (age, sex, family status), disease parameters, and the health beliefs “susceptibility,” “barriers,” “dentist‐patient‐relationship,” and “experience with therapy” on the other hand. “Motivation,” “seriousness,” “benefits,” “experience with affected organ,” and tooth‐loss‐index were significant predictors with Spearman correlation coefficients running from 0.17 to 0.32. When the predictor variables were combined the coefficient was 0.59. This study further supports the assumption that health beliefs play a significant role in the determination of health related behavior.
Periodontal Manifestations of Adult Onset of Histiocytosis X
Authors: Artzi Zvi , Gorsky Meir , Raviv Mili
Published: March 2012

Histiocytosis X, a reticuloendothelial disorder, includes the three clinical syndromes: Letterer‐Siwe and Hand‐Schuller‐Christian diseases and eosinophilic granuloma of the bone. Twenty‐eight cases of adult onset of histiocytosis X involving the head and neck region were found in the literature during the past 20 years; 15 cases were confined to this area, out of which 13 involved jaw bones. Characteristic signs and symptoms of periodontal disease were observed in 22 out of 28 cases (79%) with the lower molar area as a predominant site.

A case report of a non‐osseous chronic disseminated histiocytosis X with periodontal involvement is presented. The importance of histiocytosis X, as an entity that should be kept in mind as a differential diagnosis of a process where destructive Periodontitis is involved, is discussed.
Subgingival Administration of Tetracycline on a Collagen Film
Authors: Minabe M. , Takeuchi K. , Tamura T. , Hori T. , Umemoto T.
Published: March 2012

The purpose of this study was to evaluate the duration of therapeutic effect after administration of the collagen film immobilized tetracycline (TC film). TC film or tetracycline non–immobilized placebo film was applied one time to the periodontal pocket (≧ 4 mm) of five Periodontitis patients (20 teeth). The clinical and microbiological effects are summarized as follows: The group that received TC film continued to show significantly low values for bleeding upon probing the pocket depth for 3 and 4 weeks, respectively, after administration, but there was no significant difference in the plaque index or gingival index when compared with the group that received a placebo film. In the TC film group, the density of microorganisms and the proportion of motile rods and spirochetes were also significantly decreased 3 weeks after administration. These findings suggest that topically administered TC film remains both clinically and bacteriologically effective for 2 to 3 weeks. (J Periodontol 1989;60:552–556)
Eikenella corrodens in the Human Oral Cavity
Authors: Chen C‐K Casey , Dunford Robert G. , Reynolds Homer S. , Zambon Joseph J.
Published: March 2012

The prevalence and distribution of the putative periodontal pathogen Eikenella corrodens in the human oral cavity was examined. A total of 508 oral bacterial samples were taken from 10 periodontally healthy adults (PH), 11 adult Periodontitis patients (AP), and 6 localized juvenile Periodontitis patients (LJP). From each subject, samples of supra– and subgingival plaque were obtained from six to eight teeth as well as samples from buccal mucosa, lateral and dorsal surfaces of tongue, tonsil, and saliva. E. corrodens was cultured from 70% of healthy subjects and 100% of Periodontitis patients. Dental plaque appears to be the main oral ecological niche of E. corrodens in PH subjects since it was found in, respectively, 26% and 31% of supra– and subgingival plaque samples and rarely found in other oral sites in these subjects. It was found in 59% of both supra– and subgingival plaque samples from AP subjects, as well as 48% and 64% of supra– and subgingival plaque samples of LJP subjects. In contrast to healthy subjects, E. corrodens was found on the buccal mucosa, tongue, tonsil and in the saliva of patients with Periodontitis. The microorganism constituted, on average, 1% to 2% of the total cultivable bacteria in supra– and subgingival plaque samples. The prevalence of E. corrodens in plaque samples was higher in AP and LJP subjects and was significantly different from PH subjects. Within the AP group, the prevalence of E. corrodens in subgingival plaque is significantly higher from sites with GI ≥ 2. These data suggest that E. corrodens is an indigenous oral microorganism which may be an opportunistic pathogen associated with gingival inflammation. (J Periodontol 1989;60:611–616).
In vitro Effectiveness of a Newly–designed Ultrasonic Sealer Tip for Furcation Areas
Authors: Oda Shigeru , Ishikawa Isao
Published: March 2012

This study was undertaken to perform an in vitro comparison of the accessibility and effectiveness of a newly–designed furcation tip for an ultrasonic system with conventional curets and ultrasonic sealers. The new furcation tip was spiral in shape with a spherical end. The study was conducted on three groups of 40 teeth, each comprising 20 maxillary and 20 mandibular molars. The furcation of each tooth was colored by black felt–tipped marker, after which the teeth were fixed into artificial jaw models. Each group was then instrumented by either the newly–designed furcation tip, a straight type ultrasonic sealer tip, or a Gracey curet. The teeth were photographed by a stereomicroscope from the dome surface of furcation, and the percentage of remaining colored area was calculated for each tooth. Replica models were also made and examined with scanning electron microscopy (SEM). The mean percentage of the remaining colored areas for each instrument was, for the maxillary molars and mandibular molars respectively, 15.1% and 16.7% with the newly– designed tip; 50.3% and 44.1% with the straight type ultrasonic sealer; and 61.1% and 39.5% with the Gracey curets. The newly–designed tip thus showed high levels of effectiveness and accessibility for furcation debridement. Although the SEM photographs showed that each instrument had affected the furcation surfaces in various degrees, the teeth instrumented by the newly–designed tip maintained relatively smoother surfaces. It was concluded that the newly–designed furcation tip was more effective than the straight type ultrasonic sealer or the Gracey curet in the debridement of furcation in vitro. (J Periodontol 1989; 60:634–639)
The Glycosylated Hemoglobin Assay for Diabetes: Its Value to the Periodontist
Authors: Piché Jon E. , Swan Richard H. , Hallmon William W.
Published: March 2012

The glycosylated hemoglobin assay is a relatively new test used in the diagnosis and monitoring of the diabetic patient. This assay should be of interest to the periodontist as it offers important advantages over traditional blood glucose testing methods. Most importantly, it gives an indication of the blood glucose level over an extended period of time (30 to 90 days), whereas traditional assays only indicate the glucose level at one point in time. Additionally, there is no requirement for fasting prior to testing. Two case reports are presented to illustrate how the glycosylated hemoglobin assay can be utilized by the periodontist. (J Periodontol 1989;60:640–642)
A Comparison of Freeze–Dried Bone Allograft and Demineralized Freeze–Dried Bone Allograft in Human Periodontal Osseous Defects
Authors: Rummelhart J. M. , Mellonig J. T. , Gray J. L. , Towle H. J.
Published: March 2012

This study was conducted to clinically compare freeze‐dried bone allograft (FDBA) and demineralized freeze–dried bone allograft (DFDBA). Twenty–two defects (11 intrapatient pairs) in 9 patients were grafted with either DFDBA or FDBA. Evaluations were based on standardized radiographs, presurgical and postsurgical soft tissue measurements using the cemento–enamel junction as a fixed reference point, and osseous measurements at the time of surgery. Grafted sites were re–entered at a minimum of 6 months following placement. A mean osseous repair of 1.7 mm (59%) occurred with DFDBA and 2.4 mm (66%) with FDBA. A mean clinical attachment gain of 1.7 mm was obtained with DFDBA and 2.0 mm with FDBA. Probing depths decreased a mean of 2.00 mm with both DFDBA and FDBA. These findings reveal no significant differences between the two materials in primarily intraosseous defects when evaluated at a minimum 6 months postsurgery. (Journal of Periodontology 1989;60:655–663)
Histologic Evaluation of New Attachment Apparatus Formation in Humans
Authors: Bowers Gerald M. , Chadroff Brian , Carnevale Robert , Mellonig James , Corio Russel , Emerson Jane , Stevens Mark , Romberg Elaine
Published: March 2012

Part 1 of this three‐part human study evaluated the formation of a new attachment apparatus (bone, cementum, and periodontal ligament) on pathologically exposed root surfaces in an open and closed environment. The most apical level of calculus on the root served as a histologie reference point to measure regeneration on root surfaces exposed to the oral environment. Attempts were made to initiate the formation of a new attachment apparatus by flap curettage, root planing, coronectomy, and submersion of vital roots beneath the mucosa. Nonsubmerged defects were treated by the same surgical technique and served as controls. Biopsies were obtained at 6 months and regeneration was evaluated histometrically by two investigators who were unaware of the treatment performed. Data from 9 patients with 25 submerged and 22 nonsubmerged defects were submitted for statistical analysis. Results indicate that a new attachment apparatus did not form in any of the 22 nonsubmerged teeth; a new attachment apparatus did form in a submerged environment (0.75mm); significantly more new attachment apparatus (P < 0.05), new cementum (P < 0.01), new connective tissue (P < 0.05), and new bone (P < 0.02) formed in submerged defects; new cementum was cellular in nature and formed equally well on old cementum and dentin. Greater percent positive regeneration of the attachment apparatus and all component tissues occurred in submerged defects and no extensive root resorption, ankylosis, or pulp death was observed on submerged or nonsubmerged roots. (Journal of Periodontology, 1989;60:664–674)
Evaluation of Guided Tissue Regeneration in Class II Furcation Defects
Authors: Lekovic V. , Kenney E. B. , Kovacevic K. , Carranza F. A.
Published: March 2012

Twelve patients with two comparable furcation Class II lesions in lower molars were included in this study. After adequate presurgical preparation and pertinent clinical measurements, the areas were treated with full thickness flaps and thorough debridement and scaling and planing of the root surfaces. One of the defects was randomly selected to be covered with Gore‐Tex periodontal material, held in place by sling sutures of expanded polytetrafluoroethylene. On both sites the flaps were positioned slightly coronal to their original level and sutured. After 6 months both sites were re‐entered surgically and remeasured. The test sites showed a statistically significant reduction in pocket depth and gain in attachment levels while the controls had not changed from preoperative levels. No changes in bone levels were detected in test or control sites. However, because of the large variability in the measurements, and the short period of observation, there may be differences in bony changes between the two therapies. Studies with larger groups, more accurate methods, and longer time intervals are needed to better evaluate the effects of barrier membranes in periodontal healing. {Journal of Periodontology, 1989;60:694–698)
The Effect of a 0.125% Chlorhexidine Rinse on Inflammation After Periodontal Surgery
Authors: Vaughan M. E. , Garnick J. J.
Published: March 2012

The purpose of this study was to determine the effect of a 0.125% Chlorhexidine gluconate rinse on inflammation and bacterial plaque formation after periodontal surgery. Nine patients who required two periodontal surgeries in two posterior areas were selected. The first surgical site was randomly assigned into either 1) active or 2) placebo groups. The patient's second site was assigned to the alternate group. In Group 1 the patients rinsed with Chlorhexidine (CH) and in Group 2 with placebo solution, both for 14 days. No periodontal dressing was used and at least 1 month elapsed before the second surgery was performed. Plaque index, gingival index, and crevicular fluid flow measurements were obtained at baseline, and at 1 and 2 weeks after surgery. The Chlorhexidine rinse significantly reduced the amount of plaque at both 1 and 2 weeks, and gingival inflammation remained similar to base line measurements at 2 weeks. Neither solution had any effect on the amount of crevicular fluid flow. There was an increase in amount of perceived postoperative pain and gingival swelling with the use of the Chlorhexidine rinse, but no difference in the number of pain pills taken during this study. The Chlorhexidine rinse was an effective plaque preventive agent after surgical procedures. (Journal of Periodontology 1989;60:704–708)
Osteomyelitis Associated With Chronic Periodontitis: A Report of Three Cases
Authors: Parrish Lawrence C. , Kretzschmar David P. , Swan Richard H.
Published: March 2012

Correctly differentiating between periodontal abscess (localized, acute suppurative infection of the periodontium) and osteomyelitis (the extension of an infection into the bone medullary cavity) is crucial since the former may not require antibiotics for resolution, while the latter will. Initial assessment and treatment of osteomyelitis should be based on clinical examination, radiographie interpretation, and experience. Three case histories of osteomyelitis are presented, ranging from a periodontally well‐localized case to one involving a hemimandible and crossing the midline. Successful early diagnosis and case management may benefit from scintigraphic interpretation and culture‐and‐sensitivity studies. {Journal of Periodontology 1989;60:716–722)
Periodontal Ligament Cells and Gingival Fibroblasts Respond Differently to Attachment Factors In Vitro
Authors: Somerman M. J. , Foster R. A. , Imm G. M. , Sauk J. J. , Archer S. Y.
Published: March 2012

One of the initial events required for regeneration of periodontal tissues lost due to disease is the establishment of connective tissue attachment to root surfaces. Thus, considerable research efforts have focused on developing reliable procedures to gain new connective tissue attachment. Our studies focus on evaluating agents for their ability to promote cell attachment and spreading using an in vitro assay. For these studies human gingival fibroblasts (GF) and human periodontal ligament (PDL) cells, after exposure to fibronectin; 44 kilodalton bone phosphoprotein (44K BPP‐osteopontin) or guanidine EDTA extracts of bone, cementum, or dentin, were compared as to degree of cell attachment and spreading. Fibronectin equally enhanced attachment and spreading PDL cells and GF. In contrast, 44K BPP, as well as guanidine EDTA extracts of bone and cementum, preferentially promoted attachment of GF when compared with attachment of PDL cells. For both PDL cells and GF the attached cells exhibited spreading. The guanidine EDTA extract of dentin did not promote attachment of either cell type. These results suggest that PDL cells and GF have different attachment properties which need to be considered for investigations directed at developing regenerative periodontal treatments.
Evaluating the Anti‐Plaque Capabilities of a Copper– Containing Prophylaxis Paste
Authors: Moore R. L. , Feldman S. M. , Abbott L. J. , Read C. J. , Williams J. N. , Wittwer J. W.
Published: March 2012

The purpose of this study was to evaluate a dental prophylaxis paste containing monocopper citrate (MCC) for short term anti‐plaque capabilities. In addition to other baseline data, plaque scores were recorded on 36 paid volunteer subjects from the dental school student, staff, and faculty populations. After scaling, two quadrants of each subject's dentition were polished with the MCC containing paste and two quadrants with the placebo paste, using a diagonal split mouth double blind design. Subjects did not brush or floss for two days. Plaque scores were recorded at 24 and 48 hours, after which they resumed normal hygiene.

Results showed that after 24 hours placebo areas had 92% higher plaque and after 48 hours 33% higher plaque than the active paste areas. This was statistically significant at the P <.001 level. The diminishing effect of the copper containing prophy paste over 48 hours might indicate that the copper ion should be applied on a daily basis for best anti‐plaque results.
Effects of Personal Oral Hygiene and Subgingival Scaling on Bleeding Interdental Gingiva
Authors: Caton Jack , Bouwsma Otis , Polson Alan , Espeland Mark
Published: March 2012

The aim of this study was to determine the effects of personal oral hygiene and subgingival scaling on bleeding interdental gingiva. The Eastman Interdental Bleeding Index (EIBI) was used to clinically evaluate interdental gingival status. Forty‐seven bleeding interdental sites in 47 patients were divided into three groups. Sites in Group I bled on stimulation with wooden interdental cleaners. Groups II and III initially bled but were converted to nonbleeding with oral hygiene alone or oral hygiene combined with subgingival scaling, respectively. Interdental gingival biopsies were obtained and subjected to morphometric analysis to compare the three groups. The findings from this study indicated that: (A) personal oral hygiene reduced the magnitude and extent of the interdental inflammatory lesion; (B) subgingival scaling plus oral hygiene decreased the interdental inflammatory lesion to a greater extent than oral hygiene alone; (C) significant repair of the interdental lesion occurred within four weeks; and (D) the EIBI was an effective method for monitoring the effects of therapy directed towards resolution of the interdental inflammatory lesion.
Histologic Evaluation of Bone Inductive Proteins Complexed with Coralline Hydroxylapatite in an Extraskeletal Site of the Rat
Authors: Glass David A. , Mellonig James T. , Towle Herbert J.
Published: March 2012

The purpose of this histologic and biochemical study was to assess the osteogenic potential of bone inductive proteins complexed with coralline hydroxylapatite as the carrier vehicle after implantation in an extraskeletal site of the rat. Inductive proteins were extracted from bovine demineralized bone. Implants were placed in 16 male, 3‐month old LongEvans rats (200–300 grams), using paired subcutaneous sites overlying the ventral thorax. There were four experimental groups, with eight implants per group. These included hydroxylapatite alone (HA), hydroxylapatite with inductive protein (HA + P), inactive demineralized bone matrix with (IBM + P), and without inductive protein (IBM). All implants were harvested at 21 days. Findings indicate a lack of osteogenic potential in groups HA, HA + P, and IBM. However, when HA and HA + P were compared, there was a 79% increase in standardized field mean nuclear point counts in the HA + P group. Also, compared to the other three implant groups, controls of IBM + P histomorphometrically showed chondroid bone formation and increased alkaline Phosphatase activity. In this model system it may be concluded that with a composite system of coralline hydroxylapatite and bovine‐derived inductive protein, bone formation was not seen; positive controls consisting of IBM + P demonstrated a statistically significant increase in AP activity with corresponding histologic evidence of bone formation.
Comparison of Chlorhexidine Delivery by Mouthwash and Spray on Plaque Accumulation
Authors: Kalaga A. , Addy M. , Hunter B.
Published: March 2012

The delivery of Chlorhexidine by spray systems have been found useful in controlling plaque in handicapped individuals. This study using a single blind crossover design compared Chlorhexidine delivery by mouthwash and spray for plaque inhibitory effects. A group of 14 volunteers participated in two 4 day, no oral hygiene regimens. During one regimen Chlorhexidine was professionally sprayed onto the teeth twice a day and during the other Chlorhexidine was rinsed twice a day under supervision. Plaque regrowth from a zero baseline was recorded using a plaque index and by area. Little plaque accumulated during the two periods. There was no significant difference in plaque measurements following the use of the spray or mouthwash. This study demonstrated that Chlorhexidine when sprayed under optimal conditions was as effective as a mouthwash at controlling plaque despite only requiring one seventh of a dose from a rinse. The results have implications for the use and delivery of Chlorhexidine for plaque control and are relevant to the proposed mode of action of this antiseptic.
Fiber Optic Probe Augmented Sonic Scaling Versus Conventional Sonic Scaling
Authors: Johnson Georgia K. , Reinhardt Richard A. , Tussing Gerald J. , Krejci Robert F.
Published: March 2012

Several factors, including access and visualization problems, make total deposit removal during scaling and root planing procedures extremely difficult. This study examined the effectiveness of a mode of therapy designed to improve access and visualization for sonic scaling compared to closed sonic instrumentation. Teeth with moderate to deep probing depths in six patients scheduled to receive immediate dentures were divided into three experimental groups: Group I, sonic scaling with access augmented by interdental papilla reflection and fiber optic illumination/ transillumination (34 surfaces); Group II, closed sonic scaling (34 surfaces); and Group III, untreated controls (35 surfaces). Immediately after treatment the experimental teeth were extracted, stained with toluidine blue, and interproximal areas evaluated for remaining accretions with a microscope‐digitizing pad‐computer system. Group I had a significantly lower percentage (P < 0.01) of remaining subgingival accretion coverage than Group II (1.30 ± 0.25% vs 6.35 ± 1.08%), and both Group I and II demonstrated significantly (P < 0.01) fewer deposits than the control surfaces (46.61 ± 4.32%). These findings suggest that minimal tissue reflection and fiber optic illumination/ transillumination are beneficial adjuncts to deposit removal in moderate to deep periodontal pockets.
Effects of Levamisole on Experimental Periodontitis
Authors: Novak M. John , Polson Alan M.
Published: March 2012

Although the Chemotaxis and efflux of functionally normal polymorphonuclear leukocytes (PMN) into the periodontal sulcus may have a protective role in Periodontitis, these cells are also associated with periodontal tissue destruction. The immunomodulating agent, levamisole hydrochloride, is known to enhance PMN Chemotaxis. The present study was designed to evaluate the effects of enhanced PMN Chemotaxis on the tissue destruction associated with an experimental Periodontitis. Levamisole was administered by oro‐gastric intubation to 4 squirrel monkeys (experimental) at 3 mg/kg/bw every 2 days for 18 days. After 2 doses of levamisole, marginal Periodontitis was induced around maxillary and mandibular bicuspids and the maxillary first molars by tying plaque‐retentive ligatures at the gingival margins. Periodontitis was induced around corresponding teeth in 4 animals (control) which had not received levamisole. All animals were killed 2 weeks after induction of Periodontitis. Clinically, gingival inflammation was more pronounced in experimental animals at both 7 and 14 days after Periodontitis induction. The progression of Periodontitis was evaluated histometrically and alterations in the cell populations characterized using step serial sections. The results were analyzed statistically. No significant differences were observed between the groups with respect to areas of infiltrated supracrestal connective tissue and total numbers of cells present, loss of connective tissue attachment and loss of coronal alveolar bone. However, in experimental specimens, a much denser band of inflammatory cells was evident between the apical extent of the bacterial plaque and the gingival sulcular tissues the connective tissue of which contained significantly fewer inflammatory cells and demonstrated more pronounced fibrogenesis. It was concluded that the enhancement of the inflammatory response by levamisole resulted in a denser band of inflammatory cells between plaque and gingival tissues, but that this afforded no additional protection against the initiation, progression, and extent of periodontal destruction. However, the enhanced cellular response may have promoted tissue repair within the periodontal lesion.
Clinical Periodontal Status of Regularly Attending Patients in General Dental Practices
Authors: McFall Walter T. , Bader James D. , Rozier R. Gary , Ramsey Dianne , Graves Richard , Sams Darlene , Sloame Beryl
Published: March 2012

Periodontal status of regular patients of general practitioners in the United States is unknown. A project assessing the effectiveness of continuing professional education in altering provider behavior and patient periodontal health provided the opportunity to clinically examine 1092 patients in the offices of 36 general practitioners. These regularly attending patients were selected by a random start systematic sample of patient records. The examination included recording missing teeth and assessing plaque, gingivitis, calculus, probing depth, and attachment loss on the facial and facial‐mesial surfaces of the Ramfjord teeth (PDI). The mean patient age was 48 years, and 63% were female. The mean number of missing teeth, not including third molars, was 3.9. Almost 78% of the patients had no sites with a P1I score greater than 1, but 52% of the patients had at least one site with bleeding. Calculus was present in 62% of the patients. Deepest pocket depth was 4 mm or greater in 9% of patients and 3.8% had sites with 4 mm or greater attachment loss. Mean attachment loss was 1.6 mm across all sites. Although the majority of these regular patients had plaque, calculus, and gingivitis, only a minority exhibited Periodontitis at the index sites.
Gingival Resistance to Probing Forces
Authors: Keagle J.G. , Garnick J.J. , Searle J.R. , King G.E. , Morse P.K.
Published: March 2012

This paper presents the results of a study designed to determine (1) if advancement of a periodontal probe under a given force against healthy gingiva differed from its advancement under a similar force, against inflamed gingiva, and (2) to select the diameter which best distinguishes healthy gingiva from that which is inflamed to varying degrees.

The teeth of eight beagle dogs were cleaned three times per week for two months until a Gingival Index (GI) of 0 and gingival fluid flow (GFF) of 9 or less, as measured by the Periotron, were obtained. Probes of diameters 0.4, 0.6, 0.7, and 0.8 mm were advanced perpendicularly against the attached gingiva in the incisor, premolar, and molar regions by an electromechanical device which simultaneously plotted force versus displacement following initial contact of the probe tip with the gingiva. These forces ranged from 0.1 to 0.9N. This process was repeated in the same animals following cessation of plaque control measures when the GI reached a value of 1 and GFF reached levels of 10 to 19. It was repeated again following placement of an irritating ligature when GI reached 2 and GFF greater than 20.

An analysis of covariance showed significant differences between all three levels of health and disease for all probe diameters. F values for the 0.6 mm probe were highest at all probing forces indicating that this diameter most consistently discriminated variation of gingival health status.
The Relationship Between Gingivitis and Plaque Levels
Authors: Breuer Miklos M. , Cosgrove Roberta S.
Published: March 2012

Some confusion exists in the literature whether correlations exist between gingivitis severity and plaque levels as measured by the corresponding indices. The results of a clinical trial and a re‐analysis of literature data indicate that a strong statistical correlation exists between the Löe‐Silness Gingival Index values and both the Löe and the Quigley‐Hein Plaque Index measurements. Furthermore, regression analyses also indicate that Löe‐Silness Gingival Index can be expressed as linear functions of either the Löe Plaque Index or the QuigleyHein Plaque Index and that for each unit increment in the mean plaque index values a half unit increase in the gingival index value can be expected.
Humoral Immune Response to Selected Subgingival Plaque Microorganisms in Insulin–Dependent Diabetic Children
Authors: Morinushi Takanobu , Lopatin Dennis E. , Syed Salam A. , Bacon George , Kowalski Charles J. , Loesche Walter J.
Published: March 2012

Juvenile diabetics have been shown to have an increased susceptibility to gingivitis and periodontitis following puberty. However, little data are available on changes in the microbial flora that occur at the onset of puberty. This study was performed to determine if antibacterial antibody titers to selected periodontal disease‐associated microorganisms might be helpful in revealing changes in plaque flora at the onset and conclusion of puberty. Sera was obtained from 35 subjects (ages 7 to 18 years) selected from a population of insulin‐dependent diabetics. The subjects were given a thorough medical examination which included an assessment of sexual maturation and a dental examination which included the recording of onset and magnitude of bleeding according to the papillary bleeding score. Antibody titers to A. naeslundii (AN), B. intermedius (BI), B. gingivalis (BG), F. nucleatum (FN), A. actinomycetemcomitans (AA), C. ochracea (CO) and T. denticola (TD) were determined using the microELISA. Stratification of antibody titers by age groups (≤12 years, 12 to 15 years, >15 years) revealed that titers to AN increased significantly (P < 0.025, ANOVA) and progressively (P < 0.05, regression analysis) with increasing age. In contrast, the titers to FN were maximal in the under 12 year group and decreased with age (ANOVA, P < 0.05; regression analysis, P < 0.05). There were no significant variations in titers observed for the other microorganisms. Stratification by sexual maturity revealed a similar progressive decrease of the titer to FN (ANOVA, P < 0.05; regression analysis, P < 0.005). In addition, correlation matrix analysis at the 95% confidence level indicated that the BI titers paralleled AN, and that the AA titer paralleled FN. While the relationship between the oral flora and diabetes is unclear, these findings suggest that there is a significant change in the oral microbial flora during puberty.
The Effect of Various Concentrations of Collagen Barrier on Periodontal Wound Healing
Authors: Kodama Toshiro , Minabe Masato , Hori Toshio , Watanabe Yoshihisa
Published: March 2012

Collagen membrane preparations were manufactured with the aim of enhancing wound healing following periodontal surgery. In order to clarify effects of different concentrations of collagen on wound healing, a basic study was performed. Solutions containing 0.5%, 1.0%, and 1.3% atelocollagen were treated with hexamethylenediisocyanate (HMDIC) for cross‐linking, and collagen membranes were prepared with each solution. Periodontal flap surgery was performed on the palatal gingiva beside the maxillary first molar teeth in rats. The root surface of the tooth was exposed and curetted. Then, a piece of atelocollagen membrane was implanted. The healing of the wound was studied histologically and the following findings were made. (1) Apical migration of the junctional epithelium occurred within 2 weeks postoperatively. (2) The implantation of atelocollagen membrane significantly reduced the apical migration. (3) The apical migration of the epithelium did not vary with collagen concentration.
Early Career Experiences of Young Periodontists
Authors: Born David O. , Nevins Myron
Published: March 2012

Studies conducted in 1979 and 1984 suggested that young periodontists in the early eighties were faced with a variety of stresses and challenges not faced by their counterparts of previous generations. Among the changes observed was the fact that sharply increased numbers of younger periodontists were practicing in multiple locations. The present study focused on multiple location practice and on other early career experiences in periodontology. Multiple site practice appears to be an outgrowth of expanding group practices and the increased popularity of part‐time associateship opportunities. Costs of establishing solo practice, as well as other factors, serve to encourage young specialists to seek such positions. Many specialists see this style of practice as one way to increase their market share, but stresses arising from multiple site practice include travel time and lack of continuity with patients. Thus far, younger periodontists remain satisfied with their careers, but the job market suggests that more and more periodontists will be practicing in multiple locations during the early years of their careers, thus prolonging stabilization of their economic and professional lives.
Defective Neutrophil Chemotaxis in Down's Syndrome Patients and Its Relationship to Periodontal Destruction
Authors: Izumi Y. , Sugiyama S. , Shinozuka O. , Yamazaki T. , Ohyama T. , Ishikawa I.
Published: March 2012

The degree of defective neutrophil Chemotaxis in patients with Down's syndrome (DS) and its relationship to the severity of periodontal disease were studied. Fourteen patients with DS and 14 healthy controls were examined. Oral hygiene, gingival inflammation, and pocket depths were measured in clinical surveys. Bone loss was evaluated on the oral radiographs. Neutrophil Chemotaxis was measured by the agarose plate method and the Boyden chamber method. The chemotactic index of the agarose plate method and the mean numbers of migrated cells of the Boyden chamber method were correlated with statistical significance (rs = 0.066, P < 0.01). DS patients showed significantly lower Chemotaxis than healthy volunteers with both methods. No difference was shown between the two groups in the random migration of the neutrophils. From the oral radiographie analysis, the DS patients exhibited various prevalence of bone loss which was inversely proportional to the chemotactic index and a significant correlation between them was shown (rs = ‐0.612 P < 0.05). A significant correlation was also found between the age of the patient and the prevalence of bone loss (rs = 0.591 P < 0.05). These results indicate that defective neutrophil Chemotaxis influences the progression of periodontal disease in DS patients.
Oral Hygiene and the Prevalence of Oral Group D Streptococci in Medically‐Physically Compromised and Periodontal Disease Patients
Authors: McCrary Benjamin R. , Streckfuss Joseph L. , Keene Harris J.
Published: March 2012

The relationship between oral hygiene and oral Group D streptococcal carrier status was examined in two groups of dental clinic patients. Eighteen medically–physically compromised and 20 periodontitis patients were selected for study. Oral hygiene status was assessed and the prevalence of oral Group D streptococci was determined by sampling the oral cavity with a vigorous 15 second rinse with 5 ml peptone–saline solution. Three ml of each sample was cultured at 40°C in 30 ml of SF broth for 72 hours. Esculin fermenting colonies isolated from the SF broth were characterized biochemically according to standardized procedures and patients were classified as either carriers or non–carriers. Group D streptococci were detected in 27.8% of the medically–physically compromised group and 4.5% of the periodontal disease patients. The mean DI–S score of the medically–physically compromised group was significantly lower than in the periodontal group. Within the medically–physically compromised group, the DI–S means of carriers and non–carriers were not significantly different. The data indicated no important relationship between oral hygiene and the prevalence of oral Group D streptococci in the groups studied.
Suppression of Fibroblast Growth by Bacteroides gingivalis Endotoxin Is Not Reduced by Serum Lipoproteins
Authors: Layman Don L. , Landreneau Lori A.
Published: March 2012

Previous studies indicated that Bacteroides and E. coli endotoxins caused a dosedependent inhibition of human fibroblast growth. However, these endotoxins were relatively weak inhibitors of growth. Since cells were grown with serum, we questioned whether serum lipoproteins, which lessen endotoxin cytotoxicity in vivo, reduced the growth inhibitory effects of endotoxins in vitro. To determine whether serum lipoproteins reduced the growth inhibitory effects of endotoxins, logarithmically growing human periodontal cells were incubated with endotoxin and high density (HDL) or low density lipoproteins (LDL). Neither HDL nor LDL significantly reduced the initial growth inhibitory effects of B. gingivalis or E. coli endotoxins, as judged by 3H‐thymidine incorporation. Even with prolonged exposure of up to 10 days in culture, HDL did not ameliorate growth inhibition by endotoxin, as determined by direct cell counts. We conclude that serum lipoproteins do not provide any significant protective effects against fibroblast growth inhibition by endotoxins in vitro.
Periodontal Manifestations of Hyperoxaluria and Oxalosis
Authors: Moskow Bernard S.
Published: March 2012

Dental and periodontal findings associated with primary hyperoxaluria in a 29–year old male patient are described. This is a rare, inherited, metabolic disease which results in excessive calcium Oxalate synthesis. The predominant and early manifestation of hyperoxaluria is nephrocalcinosis which results in chronic renal failure. Widespread extrarenal deposits of calcium Oxalate crystals, however, is a consistent finding. Extensive infiltration of crystals was noted in the pulps of the teeth, in the marrow spaces of the alveolar bone, in the gingival corium, and in the periodontal ligament. Crystalline calcium Oxalate deposits in the periodontal ligament provoked a granulomatous foreign–body reaction. This resulted in aggressive external root resorption leading to pulp exposure and tooth mobility.
Effect of a Chemotherapeutic Agent Delivered by an Oral Irrigation Device on Plaque, Gingivitis, and Subgingival Microflora
Authors: Ciancio Sebastian G. , Mather Maryanne L. , Zambon Joseph J. , Reynolds Homer S.
Published: March 2012

Sixty‐six adults were examined in a double‐blind study which examined the effect of an antimicrobial agent delivered by an oral irrigating device. Each subject received a randomized half mouth dental prophylaxis. The Gingival Index, gingival crevicular fluid volume, Plaque Index, Modified Papillary Bleeding Index, probing pocket depth, and probing attachment levels were determined at baseline, 3 weeks, and 6 weeks. The composition of the subgingival microflora in the prophied and non‐prophied quadrants was examined by phase contrast microscopy and by immunofluorescence.

This study demonstrates that an antimicrobial product delivered by an oral irrigating device could result in significant reductions in plaque, bacterial cell counts, and gingival bleeding and may, therefore, be an effective adjunct to normal oral hygiene.
Porous Hydroxyapatite Grafts in Chronic Subcrestal Periodontal Defects in Rhesus Monkeys: A Histological Investigation
Authors: Ettel R. G. , Schaffer E. M. , Holpuch R. C. , Bandt C. L.
Published: March 2012

The purpose of this investigation was to evaluate the histologie response to replamineform (porous) hydroxyapatite grafts in chronically inflamed, surgically created, periodontal pockets in Rhesus monkeys. Forty‐eight subcrestal defects were surgically created in 8 Rhesus monkeys. Orthodontic wires were adapted to the base of the defects and left in place for 8 weeks. The defects were randomly assigned a treatment modality so that 8 granular porous and 8 block porous hydroxyapatite grafts were done. Eight sites were left as unoperated controls. Twenty‐four contralateral sham‐operated sites were treated by open curettage. Histometric measurements of the length of regenerated connective tissue attachment were recorded. Block hydroxyapatite, granular hydroxyapatite, and sham‐operated sites exhibited similar amounts of regenerated connective tissue attachment, which was significantly greater than that which occurred in unoperated controls. Newly formed bone was observed within the porous channels of the hydroxyapatite grafts as well as in direct apposition on the surface of implant particles. New bone, cementum, and periodontal ligament was observed in grafted sites and in defects treated by open curettage. In some instances healing occurred by means of a long junctional epithelium. Histology confirmed that unoperated defects remained as unhealed, inflamed periodontal pockets. The results of this study suggest that porous hydroxyapatite grafts have the potential to regenerate the attachment apparatus in primates.