bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of Extracellular Matrix Macromolecules Around Demineralized Freeze‐Dried Bone Allografts
Authors: Xiao Yin , Parry David A. , Li Huika , Arnold Robin , Jackson William J. , Bartold P. Mark
Published: March 2012

In the present study histochemical techniques were used to identify specific macromolecular components of the extracellular matrix associated with the tissue reaction to demineralized freeze‐dried bone allografts (DFDBA) placed under barrier membranes for ridge augmentation. Small biopsies were obtained from tissues underneath the membranes at various times after placement of the DFDBA and processed for routine immunohistochemistry. Sections were stained with antibodies to osteocalcin, collagen type I, collagen type III, decorin, and biglycan. Non‐immune serum, irrelevant antibodies, and omission of the primary antibodies served as negative controls. Histologic examination of the biopsies revealed allograft particles surrounded by well‐formed fibrous connective tissue with little or no evidence of new bone formation. Vital autogenous bone fragments were present in the peripheral portions of the biopsies and served as positive controls for comparative purposes with the DFDBA particles. Only 7 out of the 20 biopsies studied were found to have any signs of bone formation around the DFDBA particles and in these such bone formation was irregular and inconsistent around the DFDBA particles. Around the periphery of the allograft particles, osteocalcin, collagen type I, collagen type III, decorin, and biglycan all showed relatively strong staining. Osteocalcin staining was also noted within the vital bone matrix but not in the surrounding fibrous connective tissue. Decorin, biglycan, collagen type I, and collagen type III were also found within the vital bone matrix. None of these antibodies stained the DFDBA particles. The unremarkable osteogenic response of the tissues to the DFDBA particles after healing periods of up to 12 months raises questions as to the predictability of these agents in inducing new bone. J Periodontol 1996;67:1233–1244.
Squamous Cell Carcinoma of the Gingiva With an Atypical Appearance
Authors: Wallace Marshall L. , Neville Brad W.
Published: March 2012

An atypical presentation of squamous cell carcinoma of the mandibular gingiva is presented. This case, along with previously reported cases in the literature, demonstrate the need for thorough intraoral examination and investigation of any unexplained, persistent lesions. Emphasis is placed upon histopathologic examination of such lesions in order to arrive at a definitive diagnosis. J Periodontol 1996;67:1245–1248.
Use of Chlorhexidine Chewing Gum Significantly Reduces Dental Plaque Formation Compared to Use of Similar Xylitol and Sorbitol Products
Authors: Tellefsen Georg , Larsen Greg , Kaligithi Ravi , Zimmerman Grenith J. , Wikesjö Ulf M.E.
Published: March 2012

A double‐blind 3‐treatment crossover design employing a 6‐day trial period without mechanical oral hygiene measures was used to compare dental plaque formation following use of chlorhexidine (CHX) acetate‐, xylitol‐, and sorbitol‐containing chewing gum. Fourteen dental students were assigned a random ordering of use of the chewing gum products and received professional tooth cleaning at the start of trial periods. For each trial period, subjects were instructed to use 5 pieces of the unlabeled chewing gum daily (containing 5.0 mg CHX acetate/piece; 0.8 g xylitol/piece; or 1.0 g sorbitol/piece). Two pieces of chewing gum were used following each morning and evening meal and one piece following the noon meal. The subjects were instructed to use the products for 20 minutes at each occasion. A 7‐day washout‐period between trial periods was used. The Turesky modification of the Quigley and Hein index was used to assess plaque formation. Differences between treatments were evaluated using a repeated measures ANOVA with Newman‐Keuls multiple comparisons. The CHX‐containing chewing gum showed significantly reduced plaque values (0.7 ± 0.4) compared to the sorbitol‐ (2.7 ± 0.4; P < 0.01) and xylitol‐product (1.7 ± 0.3; P < 0.01). Furthermore, the CHX‐product significantly reduced plaque levels compared to the study subjects' regular plaque control routines (1.3 ± 0.4; P < 0.05). The xylitol‐product exhibited significantly lower plaque‐values than the sorbitol‐product (P < 0.01). Our results suggest that regular use of CHX‐containing chewing gum appears useful to control dental plaque formation. J Periodontol 1996;67:181–183.
Influence of Tooth Instrumentation Roughness on Gingival Tissue Reactions
Authors: Leknes Knut N. , Lie Tryggve , Wikesjö Ulf M.E. , Böe Olav E. , Selvig Knut A.
Published: March 2012

Histological studies have demonstrated a relationship between the amount of subgingival plaque and the magnitude and extension of gingival tissue reactions. The objective of the present study was to evaluate inflammatory reactions in the gingival tissues facing plaque accumulation at diamond and curet‐instrumented root surfaces. Experimental, deep periodontal defects were established at buccal surfaces of mandibular and maxillary canine teeth in 5 beagle dogs. The root surfaces were instrumented by a flame‐shaped, fine‐grained, rotating diamond point, or by a sharp curet. Next, the dogs were fed a plaque‐inducing diet for 70 days. The animals were then sacrificed, and tissue blocks of the experimental sites including teeth, alveolar bone, and gingival tissues were secured. The gingival soft tissue was processed for histomorphometric analyses at 3 levels. Epithelium and connective tissue area measurements showed no differences between the two instrumentations. Junctional epithelium (JE) cell point counts exhibited a higher proportion of inflammatory cells (IC) in specimens facing diamond compared to curet‐instrumented defects. A higher proportion of IC was present within the coronal compared to the apical aspect of the JE for both instrumentations (P < 0.05). A significant difference in IC density between instrumentations was detected for non‐infiltrated (P < 0.05), as well as for infiltrated (P < 0.01) connective tissue. The infiltrated connective tissue (ICT) inflammatory cell density was significantly (P < 0.01) and positively correlated to the JE inflammatory cell density (r = 0.75), and to area measurements of ICT (r = 0.55). The overall results demonstrate that the character of subgingival root instrumentations significantly affects gingival inflammatory reactions, most likely by influencing subgingival plaque formation. J Periodontol 1996;67:197–204.
Compliance With Supportive Periodontal Therapy
Authors: Novaes Arthur B. , Novaes Arthur B. , Moraes Noemia , Campos Geraldo Maia , Grisi Marcio F.M.
Published: March 2012

Analysis of 1,280 private patient records from a periodontal clinic showed poor compliance with supportive periodontal therapy (SPT). Data were analyzed according to sex, age, and type of treatment (with or without periodontal surgery). Analysis showed that 25.2% of the patients never returned and among those who report for SPT, only 40.1% did so regularly; the percent of surgical cases was greater (70.7%) and those patients had better compliance (77.6%); compliance of women was greater (76.5%); abandonment of supportive periodontal treatment was high (66.7%), and compliance increased with age. Several suggestions concerning clinical procedures are offered with the objective of motivating patients to give the necessary importance to supportive periodontal therapy. J Periodontol 1996;67:213–216.
Prostaglandin E2 Secretion, Cell Maturation, and CD14 Expression by Monocyte‐Derived Macrophages From Localized Juvenile Periodontitis Patients
Authors: Shapira Lior , Soskolne W. Aubrey , Van Dyke Thomas E.
Published: March 2012

Previous studies from our laboratory have demonstrated that freshly isolated peripheral blood monocytes from localized juvenile periodontitis (LJP) patients secrete more Prostaglandin E2 (PGE2) after stimulation by lipopolysaccharide (LPS) than do monocytes from healthy subjects. However, it is not clear if the altered function of LJP monocytes is intrinsic to the cells or is induced by the persistent infection of the periodontium. The present study was designed to compare PGE2 secretion by freshlyisolated peripheral blood monocytes (FIM) from LJP and control subjects to in vitro monocyte‐derived macrophages (MDM) from the same subjects. We also examined monocyte maturation into macrophage‐like cells and the cell‐surface expression of the LPS receptor, CD 14 during the culture period. FIM from LJP patients and controls were stimulated by different concentrations of LPS (0 to 30 μg/ml) for 24 hours. These experiments were performed immediately after cell separation and after 10 days in culture, which allowed differentiation of monocytes into MDM. PGE2 levels in the culture media were determined using a radioimmunoassay. Cell surface expression of CD71, a cell maturation marker, and CD 14 were assayed by cell‐ELISA in relation to β‐2‐microglobulin. LPS‐stimulated FIM from LJP patients secreted 3 to 4 times more PGE2 than control FIM at all LPS concentrations tested. After 10 days in culture, the LJP MDM secretion of PGE2 reduced to control MDM level of PGE2 secretion. These levels of PGE2 secretion were comparable to PGE2 secretion from FIM of controls. Cell maturation, as verified by CD71 expression, was found not to differ between the groups. However, the expression of CD 14 by LJP FIM was much lower than on control FIM (≈50%). After 5 or 10 days in culture, MDM from both control and LJP subjects expressed comparable amounts of CD 14. The results suggest that in vitro conditions reverse the hypersensitivity of LJP monocytes to LPS into control levels and CD 14 expression is not correlated to the hyper‐responsiveness of the cells to LPS. J Periodontol 1996;67:224–228.
Effects of Various Hygiene Procedures on the Surface Characteristics of Titanium Abutments
Authors: Meschenmoser Andreas , d'Hoedt Berndt , Meyle Jörg , Elßner Georg , Korn Dietmar , Hämmerle Horst , Schulte Willi
Published: March 2012

The use of cleaning instruments on titanium implants may cause undesired surface alterations. In a qualitative and quantitative assessment of these alterations, 5 titanium implant abutments were treated with a steel curet, a plastic curet, a prototype pure titanium curet, an air abrasive polishing system, and an ultrasonic system. Custommade polymer templates, used to secure the curet to a vertical guide bar and a spring scale to maintain a constant instrument pressure, guaranteed a standardized procedure and reproducible results. The ultrasonic and the air abrasive polishing method were also standardized. Evaluation by scanning electron microscopy (SEM) revealed surface alterations for all instruments and systems except the plastic curet, which did not roughen the surface at all. The confocal laser‐scanning microscope allows a 3‐dimensional reproduction of these surface alterations and their direct measurement. The profilometric tracing was not sensitive enough to register the minor effects caused by the titanium curet and the air abrasive polishing system. Dimensions of the resulting surface microstructure could be determined with the laser‐scanning microscope. Since the influence of such surface defects on the peri‐implant tissue reaction is unpredictable, the titanium curet and the air abrasive system can only be recommended with restrictions. The steel curet and the ultrasonic system proved to be totally unsuitable for cleaning titanium implants. J Periodontol 1996;67:229–235.
Immunological, Genetic, and Microbiological Study of Family Members Manifesting Early‐Onset Periodontitis
Authors: Nakagawa Masatsugu , Kurihara Hidemi , Nishimura Fusanori , Isoshima Osama , Arai Hideo , Sawada Koichi , Nagai Atsushi , Murayama Yoji
Published: March 2012

From the standpoint of host‐parasite interactions, family studies help us understand the host defensive factors and the molecular mechanisms involved in the periodontal immune response. In this study, we report the immunological profile of host‐defensive functions, human leukocyte antigen (HLA) phenotypes, and the microflora of a mother (rapidly progressive periodontitis), an older son (periodontally healthy), a younger son (localized juvenile periodontitis), and a daughter (localized juvenile periodontitis). We examined the peripheral neutrophil functions, phenotypic and functional analysis of peripheral lymphocytes, serum immunoglobulin G (IgG) antibody titers against periodontopathic bacteria, serological type of HLA class II antigens, and bacterial flora in all periodontal pockets. The results showed that Actinobacillus actinomycetemcomitans was dominant in the pockets of all subjects. The mother and two sons showed a depressed neutrophil chemotaxis to N‐formyl‐methionyl‐leucyl‐phenylalanine. All subjects except the older son exhibited low T4/T8 ratios. The mother and daughter had raised levels of IgG titers to Porphyromonas gingivalis. All subjects had HLA phenotypes of DRw52 and DQ1 in common. We found that the family members had similar disorders in certain defensive functions. This family has been a model for our understanding of the host defensive factors in the development of early‐onset periodontitis. J Periodontol 1996;67:254–263.
Cyclosporine A Upregulates Platelet‐Derived Growth Factor B Chain in Hyperplastic Human Gingiva
Authors: Nares Salvador , Ng May C. , Dill Russell E. , Park Bina , Cutler Christopher W. , Iacopino Anthony M.
Published: March 2012

Cyclosportne a (csa) is a widely used immunosuppressant for transplant patients and is also used for the treatment of a wide variety of systemic diseases with immunologic components. A prominent side effect of CSA administration is gingival overgrowth (hyperplasia). It has been postulated that CSA alters fibroblast activity through effects on various growth factors/cytokines. However, as yet, data concerning the molecular mechanisms involved in pathologic connective tissue proliferation are preliminary in nature. Our previous investigations concerning phenytoin‐induced effects on platelet‐derived growth factor B (PDGF‐B) gene expression have demonstrated that other drugs which cause gingival overgrowth can upregulate macrophage PDGF‐B gene expression in vitro and in vivo. The purpose of the present study was to evaluate PDGF‐B gene expression in gingival tissues of patients receiving CSA therapy and exhibiting gingival overgrowth to determine if similar PDGF‐B upregulation occurs in response to CSA and to identify PDGF‐B producing cells in these tissues. Quantitative competitive reverse transcription polymerase chain reaction (QC‐RTPCR) techniques were utilized to measure PDGF‐B mRNA levels in CSA overgrowth patients and normal controls (N = 6/group). Results were expressed as mean ± mRNA copy number and tested for significance using unpaired t‐tests. Gingival samples were harvested (standardized for local inflammation at the sample site), total RNA was extracted, and QC‐RTPCR was performed using specific PDGF‐B primers and a corresponding competitive internal standard. CSA‐treated patients exhibiting gingival overgrowth demonstrated approximately 48‐fold increase in PDGF‐B mRNA (7667.1 ± 477.4 copies for CSA patients vs. 158.2 ± 37.1 copies for controls; P < 0.001). Additionally, dual fluorescence immunohistochemistry for mature macrophage marker antigen (CD51) and intracellular PDGF‐B was utilized to identify and localize PDGFB producing cells in hyperplastic gingiva of CSA‐treated patients. PDGF‐B producing cells were demonstrated to be macrophages distributed in a non‐uniform manner throughout the papillary connective tissue. These results further support the hypothesis that the molecular mechanisms responsible for drug‐induced gingival overgrowth may involve upregulation of PDGF‐B macrophage gene expression. We continue to investigate specific CSA‐induced alterations of macrophage PDGF‐B gene expression in vitro and in vivo. J Periodontol 1996;67:271–278.
Repair Following Treatment of Circumferential Periodontal Defects in Dogs With Collagen and Expanded Polytetrafluoroethylene Barrier Membranes
Authors: Crigger Max , Bogle Gary C. , Garrett Steven , Gantes Bernard G.
Published: March 2012

This study was designed to evaluate healing following treatment of periodontal defects using 2 collagen barrier membranes with different degrees of cross‐linking, and to compare the results to those following use of an expanded polytetrafluoroethylene (ePTFE) membrane. Horizontal, circumferential defects were created in mandibular premolar teeth of 6 beagle dogs, followed by placement of membranes and wound closure. Postoperative healing was monitored clinically for 6 months, at which time the animals were sacrificed and specimens were taken for histological examination. Clinical observations indicated that the highly cross‐linked, slow‐resorbing collagen membrane did not integrate with the tissues the way the less crosslinked, rapidresorbing collagen did. Membrane exposure was typical for the slow‐resorbing membrane in contrast to the rapid‐resorbing membrane which remained covered. The inferiority of the slow‐resorbing membrane was evident by the extensive clinical recession and the attachment level measurements taken at 6 months, and it was decided to omit this membrane from histometric analysis. Histological examination of root surfaces treated with rapid‐resorbing collagen or ePTFE membranes revealed substantial reparative healing. The connective tissue repair amounted to 84% of the treated root surface height for the rapid‐resorbing collagen and 53% for the ePTFE membrane (difference not statistically significant). However, the connective tissue repair to the rapid‐resorbing collagen group root surfaces was often associated with a layer of ankylosis (44%, versus 8% of the ePTFE group). It appeared that much of the ankyloticresponse was initiated from the furcation area and extended around to the buccal and lingual surfaces. In addition, this study provided histological evidence that granulation tissue forming under clinically exposed and plaque contaminated ePTFE membranes can still result in connective tissue repair. It was concluded that the rapid‐resorbing collagen membranes and the ePTFE membranes seem capable of stimulating periodontal connective tissue repair, whereas the slow‐resorbing collagen membranes were unsuccessful in this effort, as seen in this dog model. J Periodontol 1996;67:403–413.
Osteoclast Inhibition by Factors From Cells Associated With Regenerative Tissue
Authors: Rowe Dorothy J. , Leung Wendy W. , Del Carlo Debra L.
Published: March 2012

Guided tissue regeneration (GTR) uses expanded polytetrafluoroethylene (ePTFE) membranes to favor the repopulation of the healing wound with cells with bone regenerative potential. As bone remodeling is a tightly coupled process, inhibition of osteoclast‐mediated bone resorption may be critical to regeneration. Thus, this study was undertaken to determine whether cells associated with regenerative tissue can inhibit osteoclast differentiation and activity and to begin characterizing and identifying the factor(s) mediating the observed effects. Conditioned media were harvested from human periodontal cell lines established in culture: cells adherent to ePTFE membranes, recovered from patients after GTR; cells adherent to ePTFE augmentation membranes, recovered from edentulous ridge augmentation procedures; and periodontal ligament cells from periodontally healthy bicuspids. Conditioned medium from each of these regenerative cell lines reduced the number of tartrate‐resistant acid phosphatase‐positive osteoclast‐like cells formed from hemopoietic precursors in mouse bone marrow cultures. Also, both the total resorbed surface area and number of resorption pits formed by these cells on calcium phosphate ceramic films were reduced. The factor in the conditioned medium which inhibited osteoclast differentiation was soluble, heat labile, and resided in the lower molecular weight (< 30 kDa) fraction, the same fraction which would contain cytokines. Western blot analysis of the conditioned medium detected a band at the molecular weight of interferon gamma (IFN‐γ), using a polyclonal rabbit anti‐human IFN‐γ. Thus, the factor in the conditioned medium with inhibitory activity may have identity with IFN‐γ or one of the other antiinflammatory cytokines. J Periodontol 1996;67:414‐421.
Effect of Selected Beta‐Blockers on Supragingival Calculus Formation
Authors: Breuer M.M. , Mboya S.A. , Moroi H. , Turesky S.S.
Published: March 2012

Supragingival plaque and calculus indices, salivary flow rates, pH, ionic and total calcium concentrations, total phosphate concentration, and the number of cervical restorations and caries lesions were measured in 29 subjects using systemic beta‐ (β) blockers and in 28 subjects who were not taking any systemic medication. After 8 weeks of normal oral hygiene following an oral prophylaxis, a second comparison of each of the above quantities was made. With the exception of the calculus indices and the incidence of cervical restorations, no significant differences were found for any of the measured quantities between the medicated and non‐medicated groups at either examination. The medicated group showed significantly lower mean calculus values than the non‐medicated group at both examinations and a higher incidence of cervical restorations at the baseline examination, suggesting that β‐blockers decrease the rate of mineralization in the oral cavity. Since β‐blockers did not appear to alter stimulated salivary pH, flow rate, phosphate, ionic calcium or total calcium concentrations, their effect on the mineralization processes must be attributed to other mechanisms. Two hypotheses appear plausible: changes in salivary mineralization rates caused by either direct physico‐chemical effects of the secreted β‐blockers in the saliva, or by alterations in the salivary protein/glycoprotein composition, enzymes and oral bacterial flora owing to systemic pharmacological effects of β‐blockers. J Periodontol 1996;67:428–432.
A Comparison of Chlorhexidine, Cetylpyridinium Chloride, Triclosan, and C31G Mouthrinse Products for Plaque Inhibition
Authors: Renton‐Harper P. , Addy M. , Moran J. , Doherty F.M. , Newcombe R.G.
Published: March 2012

There are a large number of mouthrinse products available to the general public for use as adjuncts to oral hygiene. Many have not been evaluated and relatively few comparisons of products have been made. This study compared 4 mouthrinse products containing cetylpyridinium chloride (CPC), chlorhexidine, C31G, or triclosan with saline rinse included as a placebo control. Twenty dentate volunteers took part in this 4‐day plaque regrowth study which had a single blind, randomized cross‐over design balanced for residual effects. On day 1 of each study period, volunteers were rendered plaque free by a professional prophylaxis, suspended normal oral hygiene measures, and rinsed twice daily for 1 minute with 15 mL of the allocated rinse. On day 5, subjects were scored for disclosed plaque by plaque index and plaque area. By both measures the order of decreasing product efficacy was chlorhexidine, CPC and triclosan, C31G, and saline. All the differences in favor of the chlorhexidine product were highly significant as were those in favor of the other rinses compared to saline. It is concluded that the findings of this study reflect the actual chemical benefits of the products divorced from the indeterminate variable of toothbrushing. J Periodontol 1996;67:486–489.
The “Cyclic” Regimen of Low‐Dose Doxycycline for Adult Periodontitis: A Preliminary Study
Authors: Crout R.J. , Lee H.M. , Schroeder K. , Crout H. , Ramamurthy N.S. , Wiener M. , Golub L.M.
Published: March 2012

Specially‐formulated low‐dose doxycycline (LDD) regimens have been found to reduce collagenase activity in the gingival tissues and crevicular fluid (GCF) of adult periodontitis subjects in short‐term studies. In the current, double‐blind, placebocontrolled study, adult periodontitis patients were administered for 6 months a “cyclical” regimen of either LDD or placebo capsules; and various clinical parameters of periodontal disease severity, and both collagenase activity and degradation of the serum protein, a,‐PI, in the GCF were measured at different time periods. No significant differences between the LDD‐ and placebo‐treated groups were observed for plaque index and gingival index. However, attachment levels, probing depth, and GCF collagenase activity and a,‐PI degradation were all beneficially and significantly (P < 0.05) affected by the drug regimen. We propose: 1) that LDD inhibits tissue destruction in the absence of either antimicrobial or significant anti‐inflammatory efficacy; and 2) that long‐term LDD could be a useful adjunct to instrumentation therapy in the management of the adult periodontitis patient. J Periodontol 1996;67:506‐514.
Detection of Local and Systemic Cytokines in Adult Periodontitis
Authors: Prabhu Anila , Michalowicz Bryan S. , Mathur Ambika
Published: March 2012

Periodontitis is a chronic inflammatory disease of the soft and hard supporting tissues of the teeth and is a major cause of tooth loss in adults. The local host response to periodontopathic bacteria results in the release of inflammatory mediators and cytokines. Since cytokines are indicative of effector functions, we compared the pattern of cytokine production in periodontal patients and healthy controls. Specifically, we investigated the simultaneous presence of cytokines produced by T helper (Th)l, Th 2, and inflammatory cells which could be involved in periodontitis. We also compared the expression of these cytokine mRNAs in healthy and diseased tissues. No significant differences were detected at the protein or mRNA levels of the cytokines in the systemic circulation of patients and controls. The surface markers CD 16 and CD56 were expressed on significantly fewer peripheral mononuclear cells of patients when compared to controls. γδ+ T cells were found in half of the diseased tissues, but in none of the healthy tissues of either patients or controls. Finally, significant differences were observed between healthy and inflamed gingival tissues in the cytokine mRNA profile. Expression of IL‐6 and IFN‐α mRNA was significantly higher in diseased tissues compared to healthy tissues in patients. J Periodontol 1996;67:515–522.
The Substantivity of a Number of Oral Hygiene Products Determined by the Duration of Effects on Salivary Bacteria
Authors: Elworthy A. , Greenman J. , Doherty F.M. , Newcombe R.G. , Addy M.
Published: March 2012

The persistence of action, or substantivity, of antimicrobial agents in the mouth appears to be a major variable influencing plaque inhibition. Such substantivity can be assessed by measuring the duration and magnitude of suppression of salivary bacterial numbers produced by antimicrobial agents. Although this has been determined for some agents, there is little information on the substantivity of the numerous products which contain these and other antimicrobial agents. This study was commissioned on the basis that efficacy cannot be assumed merely because a product contains a known active agent. Nine formulations or products were chosen: 2 rinses containing Chlorhexidine or C31G, 4 rinses containing cetylpyridinium chloride (CPC) (with and without fluoride and/or alcohol), a minus‐CPC control rinse, and 2 toothpastes with and without stannous fluoride. Additionally, water was used as a placebo control. Twenty health dentate volunteers took part in this blind, 10 cell, randomized, single rinse, cross‐over study, which was balanced for carryover. Mouthrinses were 15 ml volumes and toothpastes 3 gm in 10 ml water slurries rinsed for 60 seconds. On the day of each study volunteers suspended oral hygiene habits and at approximately 9:00 a.m. rinsed with the allocated formulation. Unstimulated saliva samples were obtained immediately before and 30, 60, 180, 300, and 420 minutes after rinsing. The samples were immediately processed for total anaerobic bacterial counts. All rinses except water and the minus CPC control rinse produced significant falls in counts to 30 minutes. Of more relevance in this inter‐treatment comparison‐designed study, the C31G rinse showed significant substantivity compared to water only for 60 minutes. C31G was highly significantly less substantive than Chlorhexidine from 30 minutes to 420 minutes. The CPC rinses were similar and significantly more substantive than their control rinse to between 180 and 300 minutes. The stannous fluoride and control pastes were similarly substantive to 300 minutes, with the stannous fluoride paste remaining substantive compared to water to 430 minutes. Based on antimicrobial action these formulations varied considerably in substantivity and this is likely to reflect their comparative plaque inhibitory properties. J Periodontol 1996;67:572–576.
A Multi‐Center Clinical Trial of a New Chairside Test in Distinguishing Between Diseased and Healthy Periodontal Sites. II. Association Between Site Type and Test Outcome Before and After Therapy
Authors: Magnussen Ingvar , Persson Rutger G. , Page C. , DeRouen Timothy A. , Crawford John M. , Cohen Rhonna L. , Chambers Donald A. , Alves Mario E.A.F. , Clark William B.
Published: March 2012

The aim of the present study was to evaluate the association between the outcome of a chairside test measuring gingival crevicular fluid (GCF) levels of the enzyme aspartate aminotransferase (AST) and other clinical measures of disease including probing depth, severity of inflammation, and GCF flow before and after therapy. We studied 91 patients with moderate to severe periodontitis. Eight sites with probing depths between 5 mm and 8 mm and obvious signs of inflammation were selected and designated diseased sites. Four sites with probing depth ≤ 3 mm with no or minimal signs of inflammation were selected and designated non‐diseased sites in patients. Thirty healthy individuals were enrolled and four sites in each were selected and designated healthy controls. Patients were treated with scaling and root planing and control subjects with supragingival prophylaxis. Measurements including GCF volume, gingival inflammation, and probing depth were performed at screening baseline, 1 week later at pretreatment baseline, and at weeks 2 and 4 after treatment. AST content of GCF was measured using a chairside colorometric test. It was concluded that the outcome of the test is an effective objective measure distinguishing between diseased sites and non‐diseased sites in patients and control subjects when evaluated both prior to and following application of therapy. Use of this simple chairside test, when combined with other standard diagnostic procedures, provides an objective measurement permitting improved capacity to distinguish between diseased and non‐diseased periodontal sites, and to better assess and monitor the outcome of therapy. J Periodontol 1996;67:589–596.
A Prospective Multi‐Center Study Evaluating Periodontal Regeneration for Class II Furcation Invasions and Intrabony Defects After Treatment With a Bioabsorbable Barrier Membrane: 1‐Year Results
Authors: Becker William , Becker Burton E. , Mellonig James , Caffesse Raul G. , Warrer Kirsten , Caton Jack G. , Reid Tricia
Published: March 2012

The purpose of this prospective multi‐center study was to evaluate a resorbable barrier membrane designed for periodontal regeneration. Thirty‐one Class II furcations and 30 two‐ and three‐wall intrabony defects were treated by flap debridement and bioabsorbable barrier membrane augmentation. The efficacy of treatment was evaluated in terms of changes in vertical probing depth (PD), horizontal probing depth (HPD), clinical attachment levels (CAL), and recession. Five centers participated in the study. Changes in clinical parameters are reported by individual center and by the average of the centers. All patients had either one molar with a Class II furcation or an intrabony defect. Baseline data were taken on the day of surgery. Post‐treatment data were collected at 6 months and 1 year. This report is based on the 1‐year findings. The average initial PD for Class II furcations was 6.1 mm. At 1 year the average PD was reduced to 3.6 mm, a 2.5 mm change. These differences were clinically and statistically significant (P < 0.0001). There was an average gain of 2.1 mm of clinical attachment (P < 0.0001) and 0.4 mm of recession (P < 0.04). There was a mean of 1.8 mm change in HPD (P < 0.0001). For intrabony defects, at 1 year there was an average PD reduction of 4.1 mm (P < 0.0001) and a mean gain of CAL of 2.9 mm (P < 0.0001). At 1 year the average recession was 0.9 mm which was statistically significant. When treatment outcomes were compared between centers there were no differences for either group of treated defects. There were differences between centers when baseline PD for furcations and intrabony sites were compared. The results of this study indicate that clinically and statistically significant improvements in PD, CAL, and HPD occurred after treatment of Class II furcations and 2‐ to 3‐wall intrabony defects with the bioabsorbable periodontal membrane. J Periodontol 1996;67:641–649.
Multi‐Center Evaluation of Bioabsorbable Collagen Membrane for Guided Tissue Regeneration in Human Class II Furcations
Authors: Yukna C.N. , Yukna R.A.
Published: March 2012

Clinical data related to GTR therapy for Class II furcations were analyzed from 7 treatment centers that evaluated one of two possible treatment pairs, either bioabsorbable collagen membrane (Type I bovine tendon collagen) (COLL) versus control surgical debridement (DEBR) or COLL versus expanded polytetrafluoroethylene (ePTFE). After initial preparation and re‐evaluation, full thickness flaps were reflected, the defects debrided, and the roots planed. Furcations and associated bony defects in each patient were randomly assigned to one of the 2 treatments in each pair, and the flaps closed. Patients received quarterly periodontal maintenance until surgical re‐entry at 6 to 12 (mean 11.1) months. Data from 59 pairs of Class II furcations were analyzed via paired t, Wilcoxon signed rank, and RM ANOVA tests. COLL showed better results than DEBR for vertical defect fill, percent defect resolution, and horizontal furcation fill. When COLL was compared to ePTFE in furcations across patients, no differences were found. Both COLL and ePTFE resulted in an improvement in clinical furcation Class about 50% of the time (compared to 7% frequency with DEBR). COLL use yielded 8 and ePTFE yielded 1 clinically‐complete furcation closures. COLL barriers resulted in generally favorable clinical results in furcation defects, appeared to be better than DEBR alone, and were at least similar to and often better than ePTFE. COLL of the type used in this study appears to be a useful and beneficial material for regenerative therapy in Class II furcation type periodontal defects. J Periodontol 1996;67:650–657.
Prognosis Versus Actual Outcome. II. The Effectiveness of Clinical Parameters in Developing an Accurate Prognosis
Authors: McGuire Michael K. , Nunn Martha E.
Published: March 2012

The assignment of prognosis is one of the most important functions undertaken in clinical practice, yet there is little evidence to support the current decision‐making process which is based on an outdated model of disease etiology and progression. This study evaluated 100 treated periodontal patients (2,484 teeth) under maintenance care for 5 years, with 38 of these patients followed for 8 years, to determine the relationship of assigned prognoses to the clinical criteria commonly used in the development of prognosis. The method of generalized estimating equations (GEE) for correlated data was utilized to determine the relationship of each clinical factor to the assignment of initial prognosis, improvement in prognosis at 5 years, and worsening in prognosis at 5 years. A multiple linear regression model was constructed for predicting initial prognosis based on initial clinical data. Increased probing depth, more severe furcation involvement, greater mobility, unsatisfactory crown‐to‐root ratio, malpositioned teeth, and teeth used as fixed abutments resulted in worse initial prognoses. The coefficients from this model were able to predict accurately the 5‐year and 8‐year prognoses 81% of the time. When teeth with “good” prognoses were excluded, the predictive accuracy dropped approximately 50%. Multiple logistic regression models indicated that improvement in prognoses and worsening in prognoses were both strongly associated with initial probing depth, initial furcation involvement, initial tooth malposition, and smoking when adjusted for initial prognosis. In addition, good hygiene was found to increase the probability of improvement in prognosis while initial mobility was found to decrease the likelihood of improvement in prognosis. Neither of these factors was found to be significant in worsening of prognosis. Smoking decreased the likelihood of improvement by 60% and doubled the likelihood of worsening in prognosis at 5 years. The results of this study indicate that some clinical factors used in the assignment of prognoses are clearly associated with changes in clinical condition over time. The data also demonstrated that the traditional approach for assigning prognoses is ineffective for teeth with an initial prognosis of less than good. Since most periodontally involved teeth are compromised, further work should include the development of a more effective method for assigning prognoses that is based on clear, objective clinical criteria. J Periodontol 1996;67:658–665.
Cellular Colonization and Bone Formation into Expanded Polytetrafluoroethylene Membranes: A Light Microscopical and Histochemical Time Course Study in the Rabbit
Authors: Piattelli A. , Scarano A. , Piattelli M. , Matarasso S.
Published: March 2012

We report on a time course study of cellular colonization of expanded polytetrafluoroethylene (ePTFE) membranes in rabbits. Bone defects (8 mm) were prepared with low speed burs in rabbit tibial metaphyses and covered with ePTFE membranes. The membranes were retrieved after 3, 6, 9, and 12 weeks. At 3 weeks, all membranes were filled by ‐cells and osteoid tissue: no mineralized tissue was found. Osteoblasts positive for alkaline Phosphatase (ALP) were observed on the outer surface and inside the material interstices of the membrane. At 6 weeks, it was possible to observe an increase of the quantity of the osteoid material inside the membranes. At 9 weeks, bone tissue was present and it usually originated from the most external part of the membrane, and spread to the central part of the membrane. Only the central portion of this bone appeared to be completely mineralized. A sharp decrease in the number of ALP‐positive osteoblasts was observed. At 12 weeks, the quantity of bone present appeared to be substantially increased. Only a small percentage of the bone inside the membrane appeared to be completely mineralized. No cells positive to acid phosphatase were observed. These histological results confirm the high biocompatibility of ePTFE membranes and the bone formation inside the ePTFE interconnected nodes could, probably, help in achieving a good biomaterialtissue integration with predictable results in bone regeneration. J Periodontol 1996;67:720–725.
Periodontal Management of Glanzmann's Thrombasthenia: Report of 3 Cases
Authors: Kantorci Alpdoǧan , Cebeci Irfan , Firatli Erhan , Atamer Tanju , Tuncer Özen
Published: March 2012

Glanzmann's thrombasthenia was reported and described as a bleeding diathesis seen in children and characterized by diminished clot retraction. It is an autosomal recessive bleeding disorder. The disease is marked by frequent mucocutaneous hemorrhages either due to defective function of the platelets or lack of fibrinogen binding membrane receptor glycoproteins IIb/IIIa which are located on the surface of the platelets. Case reports on 3 siblings, a girl of 11, and 2 boys of 12 and 16 years old with Glanzmann's thrombasthenia are reviewed. The major complaint of the patients was gingival bleeding. Periodontal treatment was performed under platelet transfusion and proper oral hygiene instruction was given. The patients were followed for 6 months and no periodontal complications developed during this time. Proper periodontal care for such patients is essential both for local and systemic health. J Periodontol 1996;67:816–820.
Histologic Evaluation of Human Extraction Sockets Treated With Demineralized Freeze‐Dried Bone Allograft (DFDBA) and Cell Occlusive Membrane
Authors: Brugnami Federico , Then Peter R. , Moroi Hidetada , Leone Cataldo W.
Published: March 2012

This study evaluated new bone formation in human extraction sockets treated with demineralized freeze‐dried bone allografts (DFDBA) and cell occlusive membranes. Hard tissue biopsies of 7 sites in 6 patients were obtained 14 weeks to 13 months following extraction and grafting. Histologic analysis revealed that individual particles of DFDBA were discernible up to 13 months in situ. In all samples, all particles of DFDBA were well incorporated within new bone, which exhibited osteocyte‐containing lacunae. Distinct cement lines clearly demarcated the DFDBA particles from the surrounding, intimately‐apposed woven and lamellar bone. The marrow demonstrated a mild degree of fibrosis without signs of inflammatory reaction. There was also a notable lack of fibrous encapsulation of the allograft, and little osteoclasis was observed. Our findings demonstrate that commercially available DFDBA has the potential to function physically as a nidus for appositional new bone growth in alveolar sockets following tooth extraction. Further investigations of the biological activity of DFDBA in situ are warranted. J Periodontol 1996;67:821–825.
Comparison of 3 Periodontal Local Antibiotic Therapies in Persistent Periodontal Pockets
Authors: Radvar M. , Pourtaghi N. , Kinane D.F.
Published: March 2012

The aim of this study was to evaluate the efficacy of 3 commercially available periodontal systems for local delivery of antibiotics as adjuncts to scaling and root planing in treatment of sites with persistent periodontal lesions following a course of scaling and root planing. Fifty‐four patients with 4 pockets ≥ 5 mm and bleeding on probing and/or suppuration were randomized in 4 treatment groups including: scaling and root planing plus application of 25% tetracycline fiber (S + Tet) (13 patients), scaling and root planing plus application of 2% minocycline gel (S + Min) (14 patients), scaling and root planing plus application of 25% metronidazole gel (S + Met) (14 patients), and scaling and root planing alone (S) (13 patients). Clinical measurements were taken at baseline and 6 weeks after the end of treatment periods. All treatments were applied using the distributors' recommended protocols and resulted in significant improvement in probing depth, attachment level, bleeding on probing and the modified gingival index (MGI) scores. The improvements in clinical parameters were greater in all three adjunctive treatment groups than scaling and root planing alone. The mean probing depth reductions were: S + Tet = 1.35 mm, S + Met = 0.95 mm, S + Min = 0.87 mm and S = 0.60 mm. The probing depth reduction was significantly greater in the scaling plus tetracycline fiber group than the scaling and root planing alone group (P = 0.002). The difference between groups in improvement of attachment level or bleeding on probing was not significant. Scaling plus tetracycline fiber treatment resulted in the greatest reduction in the MGI scores which was significantly greater than all other groups. While the frequency of sites with suppuration was markedly reduced following all treatments, it reached zero in the scaling plus tetracycline fiber group. No serious adverse effects were observed or reported for any treatment. While all three locally applied antimicrobial systems seem to offer some benefit over scaling and root planing alone, a treatment regimen of scaling and root planing plus tetracycline fiber replacement gave the greatest advantage in the treatment of persistent periodontal lesions at least during the 6‐week period following treatment. J Periodontol 1996;67:860–865.
Gingival Fibroblast Cytokine Profiles in Actinobacillus actinomycetemcomitans‐Associated Periodontitis
Authors: Dongari‐Bagtzoglou Anna I. , Ebersole Jeffrey L.
Published: March 2012

Within the in vivo environment human gingival fibre‐blasts (HGF) may be challenged with bacteria or bacterial products. This interaction may result in the release of cytokines which are directly or indirectly involved in connective tissue and bone catabolism, such as interleukin (IL)‐1β, IL‐6, and IL‐8. Our investigation has tested the hypothesis that HGF from Actinobacillus actinomycetemcomitans (Aa)‐infected patients with rapidly destructive forms of periodontitis, such as localized juvenile periodontitis (LJP), respond to Aa challenge with an exaggerated secretion of IL‐1β, IL‐6, and IL‐8. We have compared the in vitro profiles of these cytokines by Aachallenged HGF obtained from 2 healthy subjects, 2 Aa‐infected, slowly progressing adult periodontitis (AP) patients and 2 LJP patients. HGF were challenged throughout a 48‐hour period with formalinized whole bacterial cells, and culture supernatants were analyzed for cytokine content using RIA. No differences were noted in the IL‐1β secretion levels among the different HGF cultures. Although basal (unchallenged) IL‐6 and IL‐8 production was similar in all HGF cultures, HGF from the two LJP patients responded to Aa challenge with a more rapid IL‐6 and a more pronounced IL‐8 secretion than healthy or AP HGF. We also tested the ability of human serum antibodies against Aa to moderate the Aa‐elicited HGF cytokine secretion by adding human serum, with normal or elevated antibody content. Both sera appeared to have an upregulating effect on IL‐6 and IL‐8 secretion. Depletion of 95% of the anti‐Aa antibody from serum by absorption did not affect its activity. Based on the response of HGF from two LJP patients, we propose that Aa‐induced pathology in LJP may be modulated by stimulation of rapid and/or exaggerated secretion of cytokines with potential ‐catabolic effects, although studies with a larger group of LJP patients are needed to further test this hypothesis. Furthermore, serum antibodies against this microorganism do not appear to have a neutralizing effect in cytokine‐eliciting HGF‐Aa interactions. J Periodontol 1996;67:871–878.
Treatment of Periodontal Disease Based on Microbiological Diagnosis. A 5‐Year Follow‐Up on Individual Patterns
Authors: Dahlen G. , Wikström M. , Renver S.
Published: March 2012

Sixteen patients with advanced periodontitis (more than 3 sites with a probing depth ≥ 6 mm) were treated with the aim of eliminating Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis and reducing Prevotella intermedia below 5% of the total viable count. The patients were followed clinically and microbiologically for over 5 years and showed a Highly individual pattern with respect to presence of indicator bacteria, type of treatment needed to accomplish treatment goals, clinical response, and bacterial and disease recurrencies. The results of this study suggest that presence of the indicator bacteria in microbial samples taken after treatment may identify patients at risk for recurrent periodontitis. J Periodontol 1996;67:879–887.