bluuebunny/crossref_metadata_2025 huggingface dataset:
Elastase as an Indicator of Periodontal Disease Progression
Authors: Palcanis Kent G. , Lariava Ilona K. , Wells Bobby R. , Suggs Kenneth A. , Landis J. Richard , Chadwick David E. , Jeffcoat Marjorie K.
Published: March 2012

This study sought to evaluate the ability of gingival crevicular fluid (GCF) elastase to predict attachment and bone loss in human Periodontitis. Thirty subjects who were medically healthy and had a history of progressive Periodontitis were studied with an automated probe. Five sites in each patient were monitored bi‐monthly for a 6‐month period for attachment loss. Subtraction radiography was utilized at the beginning and end of the study to monitor bone loss. GCF elastase was measured at 0 month and then bi‐monthly by collecting GCF on paper strips impregnated with PMN leukocyte elastase substrate inserted into the gingival crevice for 15 seconds. After 8 minutes of reaction time, the strips were scored relative to fluorescent standards in an ultraviolet view box. Strips were then eluted in methanol and total elastase measured by spectrofluorometry. Total elastase was significantly higher in sites demonstrating progressive attachment loss than in inactive sites (2.81 ±.29 verus 2.03 ±.07, P < 0.0005) and sites demonstrating bone loss (2.32 ±.17 versus 2.01 ±.08 P < 0.05). When considering the joint presence of bone loss and attachment loss of 1.0 mm or greater in the 6‐month period following a visual elastase kit score of 2 or greater, the test kit shows a sensitivity and specificity of 82% and 66%, respectively. This study demonstrated that GCF elastase levels are significantly higher in sites demonstrating progressive periodontal attachment and bone loss assessed 6 months later and may serve as a predictor of future bone and attachment loss. J. Periodontol 1992; 63:237–242.
The Apical Border Plaque in Chronic Adult Periodontitis. An Ultrastructural Study. II. Adhesion, Matrix, and Carbohydrate Metabolism
Authors: Vrahopoulos Theofilos P. , Barber Pauline M. , Newman Hubert N.
Published: March 2012

The aim of this study was to characterize the plaque matrix and relevant aspects of metabolism of the apical border plaque in relation to teeth affected by chronic adult Periodontitis. The material comprised 56 teeth from 24 patients. Ruthenium red, alcian blue, lanthanum nitrate, and safranin 0 were used to label matrix polyanionic macromolecules and periodic acid‐thiosemicarbazide‐silver proteinate for intracellular Polysaccharide (IPS). The matrix components were amorphous, fibrillar, or globular. Many intact bacteria exhibited extracellular Polysaccharides or glycocalyces associated with their cell wall and cytoplasmic IPS granules. The latter varied in size and distribution and were evident even in the most apically‐advanced intact microorganisms. The results indicate that the matrix and IPS features of the apical border plaque in chronic Periodontitis in certain respects resemble those of subcontact area plaque on children's teeth, associated with chronic gingivitis and approximal caries. They also suggest the establishment of acidic regions in the microniches of the periodontal pocket. J Periodontol 1992;63:253–261.
Antibacterial Activity of Some Triclosan‐Containing Toothpastes and Their Ingredients
Authors: Wade William G. , Addy Martin
Published: March 2012

The antibacterial activity of 4 triclosan‐containing toothpastes was compared to a conventional fluoride dentifrice and triclosan and sodium lauryl sulphate (SLS), both singly and in combination. A panel of 17 bacteria was tested by an agar dilution method. At concentrations typical of those found in toothpastes, triclosan and SLS displayed approximately equal antibacterial activity. A paste containing triclosan and zinc citrate appeared more active than the other triclosan pastes which, in general, showed marginal superiority over the conventional paste. SLS, although included in dentifrice formulations for its detergent properties, may significantly contribute to the antibacterial profile of a product. The need for appropriate controls when evaluating experimental toothpastes is emphasized. J Periodontol 1992; 63:280–282.
Root Dentin Morphology After Different Modes of Citric Acid and Tetracycline Hydrochloride Conditioning
Authors: Labahn Roland , Fahrenbach Wolf H. , Clark Stephen M. , Lie Tryggve , Adams Donald F.
Published: March 2012

The purpose of this study was to assess the effect of citric acid and tetracycline HCl application to dentin surfaces by a “passive dripping” or an “active burnishing” technique. Twenty dentin blocks were prepared from freshly extracted non‐diseased human impacted third molars. The blocks were root planed and randomly assigned to two groups for treatment with either citric acid or tetracycline HCl. The duration of treatment was 30, 60, 120, or 240 seconds. Control blocks were treated with distilled water. After treatment the blocks were processed for observation and measurements in the scanning electron microscope (SEM). Application of either of the acid solutions resulted in removal of the smear layer. Measurements indicated a time dependent increase in the mean dentinal tubule orifice diameter ranging from 1.05 μm in control specimens to 3.18 μm after 4 minutes treatment (citric acid group). The increase in tubule diameter was significantly greater (P≤ 0.01) for both citric acid treatment modalities than tetracycline HCl treatment. There was also a time dependent increase in the depth of penetration as measured by a trumpeting of the tubule profiles, and this penetration was significantly greater (P≤ 0.01) after citric acid treatments. Passive or active application of the acids did not seem to have any major impact on the measurements or on the surface morphology. It was concluded that citric acid causes more extensive changes than tetracycline HCl and that the mode of application of the agent is probably not critical. J Periodontol 1992; 63:303‐309.
The Development of Osteoradionecrosis From Sites of Periodontal Disease Activity: Report of 3 Cases
Authors: Galler Cary , Epstein Joel B. , Guze Kevin A. , Buckles David , Stevenson‐Moore Peter
Published: March 2012

Osteoradionercrosis may develop following radiation therapy that involves bone, and most particularly following treatment of cancers within the head and neck. The mandible is at greatest risk of osteoradionecrosis because of the nature of its blood supply and its dense bone configuration. This paper describes 3 cases which demonstrate the development of osteoradionecrosis in the mandible from sites of periodontal disease activity following external beam radiotherapy. The pathogenesis of these events is reviewed, and recommendations for their management are discussed. A proposal for the use of Chlorhexidine digluconate and hyperbaric oxygen in the periodontal management of this condition is outlined. J Periodontol 1992; 63:310‐316.
Effect of Exogenously Applied Prostaglandin E2 on Alveolar Bone Loss—Histometric Analysis
Authors: Miyauchi Mutsumi , Ijuhin Naokuni , Nikai Hiromasa , Takata Takashi , Ito Hiroshi , Ogawa Ikuko
Published: March 2012

The effect of prostaglandin E2 (PGE2) on alveolar bone resorption was examined in 8‐week old Wistar rats by histometric analysis. One mg/ml PGE2 topically applied to gingival sulcus induced a marked increase in osteoclasts. The number of osteoclasts increased progressively and reached a maximum at 12 hours. Ultrastructurally, these osteoclasts were in active form with well developed ruffled borders and clear zones. The changes in numbers of osteoclasts after application of various concentrations of PGE2 were dose‐dependent (0.001 to 1.0 mg/ml), but higher concentrations of PGE2 (2 mg/ ml) were less effective. In addition, the number of osteoclasts in groups treated with both PGE2 and endotoxin was higher than those that received PGE2 only. These results indicate that bone resorption caused by PGE2 depends on activation and increase of osteoclasts, and suggests that endogenous PGE2 production by host cells stimulated by plaque‐associated bacterial endotoxin may be an important pathogenetic factor in periodontal disease. J Periodontol 1992; 63:405–411.
Cathepsin B/L‐, Elastase‐, Tryptase‐, Trypsin‐ and Dipeptidyl Peptidase IVLike Activities in Gingival Crevicular Fluid: A Comparison of Levels Before and After Periodontal Surgery in Chronic Periodontitis Patients
Authors: Eley Barry M. , Cox Stephen W.
Published: March 2012

Gingival crevicular fluid (GGF) was collected from the deepest probing site of each tooth of 10 chronic periodontitis patients prior to treatment, after scaling and hygiene treatment, and after periodontal surgery. Surgery was carried out at sites which had persistent probing depths in excess of 5 mm. The patients were given a full periodontal examination, including measurements of probing depth, gingival index, bleeding index, and plaque index before each GCF collection. Cathepsin B/L‐, elastase‐, tryptase‐, trypsin‐, and dipeptidyl peptidase IV‐like activities in the GCF samples were determined by fluorimetric assay with peptidyl derivatives of 7‐amino‐4‐trifluoromethyl coumarin. There were reductions in all clinical parameters and all protease activities after scaling and hygiene treatment and further reductions after periodontal surgery. Decreases were recorded for both total enzyme activities and concentrations. The reductions were statistically significant in inter‐patient comparisons using mean patient values and also in most intra‐patient comparisons using site data from individual patients. GCF protease levels appear to reflect the clinical status of periodontal lesions and may prove to be of value in monitoring disease activity. J Periodontol 1992; 63:412–417.
Relative Production of IL‐1β and TNFα by Mononuclear Cells After Exposure to Dental Implants
Authors: Perala Dennis G. , Chapman Robert J. , Gelfand Jeffrey A. , Callahan Michael V. , Adams Donald F. , Lie Tryggve
Published: March 2012

Interleukin‐1 (also known as osteoclast activating factor, OAF) is a cytokine produced primarily by monocytes and macrophages and is thought to mediate many of the immunologic, metabolic, and endocrine alterations seen with microbial infection, tissue injury, inflammatory disease, and bone loss. Stimuli for IL‐1 production include microorganisms, endotoxins (LPS), antigen‐antibody complexes, clotting components, and other cytokines. The purpose of this study was to determine whether dental implants stimulated peripheral blood mononuclear cells (PBMCs) to produce IL‐1β (OAF) as well as tumor necrosis factor (TNFα). This production may lead to bone loss or failure of an implant. Three duplicates of five different implants were incubated with 2 × 106 PBMCs/ ml in 20% autologous serum; the esterase positive PBMCs amounted to 14.5%. Measured by radioimmunoassay techniques and compared to controls, all of the implants except one caused significant in vitro generation of IL‐1β and TNFα. The stimulation of IL1β/TNFα production by these materials suggests that they are not physiologically inert and that the IL‐1β (OAF) production may contribute to a less favorable osseoadaptation. OAF has a physiologic (homeostatic) role in maintenance and alteration of osseous structures, but the level at which physiologic becomes pathologic is unknown. Although there were statistical differences between the cellular response to these implants, the clinical significance of the differences remains to be determined. J Periodontol 1992; 63:426–430.
Transmission Electron Microscopic and High Voltage Electron Microscopic Observations of the Bone and Osteocyte Activity Adjacent to Unloaded Dental Implants Placed in Dogs
Authors: Steflik David E. , Hanes Philip J. , Sisk Allen L. , Parr Gregory R. , Song Min J. , Lake Francis T. , McKinney Ralph V.
Published: March 2012

The purpose of this report is to describe ultrastructural observations of the bone and associated tissues supporting 24 unloaded endosteal dental implants placed in mongrel dogs (canis familiaris). The following 3 specific areas of the supporting tissues were targeted: 1) the osteocyte populations; 2) the mineralized collagen fiber matrix of the bone; and 3) an electron dense interfacial deposit. To investigate these areas, transmission electron microscopy and high voltage electron microscopic (HVEM) protocols were emphasized. HVEM permitted stereologic observations. Further, all observations were obtained from undecalcified tissues obtained from animals with commercially available implants placed into the mandible. From the study we observed a mineralization pattern of the implant supporting bone that was similar to those events occurring naturally within the mandibular bone. Osteocyte morphology was similar whether the osteocytes were found well below the implant interface or close to the interface. Osteocytes within lacunae were routinely found close to the implant interface, often extending cellular processes through canaliculi to the bone‐implant interface. At the interface, an electron dense deposit approximately 50 nm in thickness was often observed. In interfacial regions, densely mineralized collagen fibers were observed running primarily parallel to the implant surface. This dense mineralized tissue was separated from the interface by a mineralized, but finely fibrillar matrix of approximately 200 nm in thickness. J Periodontol 1992; 63:443–452.
Bone Regeneration Around a Failing Implant Using Guided Tissue Regeneration. A Case Report
Authors: Goldman Marc J.
Published: March 2012

An implant was determined to be clinically and radiographically failing. The implant was treated as if it were a natural tooth with periodontal disease. The defect around the implant was degranulated and a polytetrafluoroethylene periodontal membrane placed over the implant to cover the defect. The membrane was removed 6 weeks later. A 5‐month re‐entry found new bone around the implant and the implant could then be used as a prosthetic abutment. Further case studies may prove this to be a predictable procedure to save failing implants. J Periodontol 1992; 63:473–476.
The Connective Tissue and Partial Thickness Double Pedicle Graft: A Predictable Method of Obtaining Root Coverage
Authors: Harris Randall J.
Published: March 2012

Obtaining predictable root coverage has been a goal of periodontal therapy for some time. The purpose of this study is to present a technique for obtaining root coverage. This study reports the results of 20 patients (30 defects) treated with a connective tissue and partial thickness double pedicle graft. Root coverage of 100% was obtained in 24 of 30 defects, or 80% of the time. In all the treated defects the root coverage obtained was to within 0.5 mm of the cemento‐enamel junction. The mean percent root coverage was 97.4%. The mean amount of exposed root surface initially was 3.6 mm. At the final postoperative appointment the mean exposed root surface was 0.1 mm. This change represents a net root coverage of 3.5 mm or 97.2%. The number of sites with bleeding on probing and plaque present decreased. The esthetics, both color match and tissue contours, were acceptable to all the patients in all cases. With this technique root coverage can be accomplished in a predictable manner. J Periodontol 1992; 63:477–486.
Gingival Overgrowth Among Renal Transplant Recipients Related to Immunosuppressive Medication and Possible Local Background Factors
Authors: Pernu Hilkka E. , Pernu L.M. Hannele , Huttunen Kaisa R.H. , Nieminen Pentti A. , Knuuttila Matti L.E.
Published: March 2012

The aim of this study was to determine the occurrence of gingival overgrowth (GO) among renal transplant recipients and to analyze possible background factors causing GO among cyclosporine‐treated (CsA) patients as compared with others receiving azathioprine (Aza). A total of 32 recipients, 22 treated with CsA and 10 with Aza (ages 22 to 68 years) participated. The examination included determination of renal function, whole blood CsA concentration, and periodontal status. The tooth surface data were analyzed in terms of the given background variables for GO in the whole patient sample by logistic regression analysis. The occurrence of GO was significantly higher in the CsA group as compared with the Aza group (P <0.03). The CsA responders had significantly more gingival units overgrown as compared with the Aza responders (P < 0.005). There were no differences in age, sex, whole blood concentration of CsA, or duration of CsA medication between the responders and non‐responders. Expressed as individual means, the gingival inflammation scores were significantly higher among the CsA responders than among the CsA non‐responders (P < 0.005). Analysis of the surface data showed that CsA had an independent major effect on GO. Furthermore, simultaneous gingival bleeding increased the risk of overgrowth (odds ratio = 2). The results show that CsA medication is a significant factor for GO and the risk of the occurrence of GO is further increased by simultaneous gingival inflammation. J Periodontol 1992; 63:548–553.
Effect of a Social Cognitive Intervention on Oral Health Status, Behavior Reports, and Cognitions
Authors: Tedesco Lisa A. , Keffer Michele A. , Davis Elaine L. , Christersson Lars A.
Published: March 2012

An intervention designed to test the influence of cognitive restructuring on protective oral health behaviors was conducted with 108 patients with mild to moderate gingivitis. Subjects in the experimental group viewed slides of active, mobile bacteria taken from their mouths on 5 occasions: before and after prophylaxis and at 3 appointments, one month apart. A specially trained hygienist discussed with these participants the process of periodontal disease, the role of bacteria, and self‐efficacy (self‐control) for oral hygiene self‐care. Both experimental and control group subjects received instruction in oral selfcare procedures. Assessments of oral health using Löe and Silness' plaque and gingival indices (PI and GI) were taken throughout the study and at 3‐ and 6‐month follow‐up visits. Self‐efficacy, oral hygiene intentions, attitudes, and values comprised the set of cognition variables. Plaque and gingival indices mean differences between groups approached significance at visit 6. Analyses were also performed using percent of gingival surfaces scored at “0” (no visible bleeding on probing). A trend occurred for group differences in percent “0” scores at visit 6, with the experimental group maintaining higher percent zeros (better health) at this 3‐month follow‐up. At visit 7 (9‐month followup), PI and GI differences disappeared. No significant differences were found between groups for oral health cognitions or behavior reports over time. The data suggest that the cognitive‐behavioral intervention produced a delayed relapse in protective oral self‐care behaviors, and by extension, oral health status. Such a delay could be clinically relevant in promoting adherence to oral hygiene behavior between professional visits. J Periodontol 1992; 63:567–575.
E‐Test: A New Technique for Antimicrobial Susceptibility Testing for Periodontal Microorganisms
Authors: Nachnani Sushma , Scuteri Amalia , Newman Michael G. , Avanessian Alex B. , Lomeli Stacy L.
Published: March 2012

The purpose of the study was to validate the Epsilometer test (E‐test) method for antimicrobial susceptibility testing of selected periodontopathic microorganisms using the agar dilution method as a standard. The E‐test has been developed to provide a direct quantification of antimicrobial susceptibility of microorganisms. The device consists of a predefined, continuous, and exponential gradient of antibiotic concentrations immobilized along a rectangular plastic test strip. After 48 hours incubation a drop‐shaped inhibition zone intersects the graded test strip at the inhibitory concentration (IC) of the antibiotic. Twenty‐two subgingival plaque samples from Periodontitis sites were plated on trypticase soy agar supplemented with 5% rabbit blood or 5% sheep blood and trypticase soy agar supplemented with vancomycin and bacitracin. A total of 60 strains of key periodontal pathogens (Prevotella intermedia, Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Eikenella corrodens, Campylobacter rectus, and Capnocytophaga) isolated from 22 sites of 12 patients were studied. The antibiotics tested were Clindamycin, metronidazole, tetracycline, Ciprofloxacin, cefoxitin, and ampicillin at concentrations above and below the achieved blood or gingival crevicular fluid levels. As a standard reference the minimal inhibitory concentrations (MICs) were determined using the agar dilution method. MICs were compared with ICs determined using the Etest method. The results showed an agreement ranging from 67% to 100%; sensitivity ranging from 75% to 100%; predictability ranging from 56% to 100% and specificity ranging from 33% to 96%. The E‐test ICs for ampicillin, cefoxitin, and metronidazole against the Gram‐negative capnophilic and microaerophilic rods and the black‐ pigmented anaerobic rods ICs for ampicillin, Clindamycin, metronidazole, and tetracycline showed a high percentage of agreement with the agar dilution MICs. The E‐test demonstrated moderate to high sensitivity and predictability. The results regarding specificity are not clear, since for some of the antibiotics specificity was low or could not be detected. Overall, the results of this study document the potential feasibility of using the E‐test as a quick and useful method for testing antimicrobial susceptibility for periodontal pathogens. Additional work is necessary to evaluate samples more likely to harbor resistant strains in order to establish that the strains found resistant by the E‐test method are truly resistant by the control method. J Periodontol 1992; 63:576–583.
Effect of Free Gingival Grafts on Naturally‐Occurring Recession in Miniature Swine
Authors: Gould T.R.L. , Robertson P.B. , Oakley C.
Published: March 2012

Miniature swine exhibit naturally‐occurring, progressive recession on facial surfaces of the permanent mandibular incisors. The purpose of this study was to determine whether placing a free gingival graft to augment the width of keratinized gingiva of mandibular incisors in miniature swine would prevent or retard recession at the grafted site compared to an untreated contralateral control site. In 8 litter‐mate miniature swine, free gingival grafts were placed on the facial surface of the permanent central and lateral incisors on one side of the mandible. The contralateral mandibular incisors did not receive any treatment and served as controls. Clinical measurements, including eruption, recession, pocket depth, attachment level, and keratinized gingival width were obtained preoperatively, 2 to 3 weeks after surgery to assess the success of gingival augmentation, and 3, 6, and 9 months postoperatively. Eight grafted sites were successful and showed significant augmentation of the keratinized gingival width, with a mean increase of 5.8 ± 0.7 mm, while 6 grafts failed and showed a slight decrease in the mean width of −0.4 ± 0.5 from the preoperative to postoperative examination. All sites showed significant recession during the experimental period. Successful sites showed no statistically significant or clinically major difference in the rate or amount of recession than contralateral control sites. By 9 months, the average increase in recession from the baseline examination was 2.8 ± 1.5 mm for successfully grafted sites and 2.6 ± 1.3 mm for contralateral controls. However, in sites where surgery had been performed but the grafts had failed, there was a significantly greater amount of recession compared to contralateral controls, and by 9 months the average increase in recession was 5.2 ± 1.6 mm and 2.7 ± 1.4 mm, respectively. We conclude that augmenting the width of keratinized gingiva of mandibular incisors in this animal model does not prevent or retard naturally‐occurring recession at the grafted site compared to the untreated contralateral control site. J Periodontol 1992; 63:593–597.
Development of a Rapid Latex Agglutination Test for Periodontal Pathogens
Authors: Nisengard Russell J. , Mikulski Lynn , McDuffie Deborah , Bronson Paul
Published: March 2012

The studies reported here describe the development, characterization, and initial application of latex agglutination assays for periodontal pathogens. Latex reagents were prepared by sensitization of latex microspheres with rabbit IgG antibodies to either Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, or Prevotella intermedia. The protein concentration utilized for sensitization and microsphere size were optimized. One reagent was prepared to A. actinomycetemcomitans and a second combination reagent was prepared by mixing latex sensitized with antibodies to P. gingivalis and latex sensitized with antibodies to P. intermedia. The sensitivity of both latex reagents in the traditional wet and a dried format was evaluated. In addition, sensitivity and specificity with homologous and heterologous bacterial suspensions were evaluated. The reagents were found to demonstrate both specificity and sensitivity. Initial studies with subgingival human plaque demonstrated the ability of these reagents to detect the specific organisms in plaque. J Periodontol 1992; 63:611–617.
The Effects of the Nd:YAG Laser on in Vitro Fibroblast Attachment to Endotoxin‐Treated Root Surfaces
Authors: Trylovich David J. , Cobb Charles M. , Pippin David J. , Spencer Paulette , Killoy William J.
Published: March 2012

The purpose of this study was to evaluate the effects of the NdrYAG laser on in vitro fibroblast attachment to endotoxin‐treated root surfaces and to describe any laser‐induced cementum surface alterations. Thirty 4 mm × 4 mm cementum segments were obtained from unerupted third molars. The treatment groups were as follows: 1) control, healthy root segment; 2) non‐lased, endotoxin treated; and 3) lased, endotoxin treated. The endotoxin treated roots were soaked in E. coli 055:B5 lipopolysaccharide (556 EU/ml) for 72 hours. The lased, endotoxin‐treated root segments were treated with a Nd:YAG laser using a 320 μm contact optic fiber handpiece with an energy setting of 80 mJ at 10 pulses per second for one minute. The root segments were subsequently placed in fibroblast culture dishes for 40 hours and then prepared for scanning electron microscopy (SEM) observation. SEM examination revealed two different types of attachment: flat and round. Flat cells represented firmly attached cells due to well‐defined points of attachment and numerous lamellapodia. Round cells possessed few attachment processes and were, therefore, considered poorly attached. The lased, endotoxin‐treated root segments had significantly decreased numbers of flat fibroblasts versus the control and nonlased, endotoxin‐treated root segments. The absence of flat fibroblasts in the laser treated root segments was a consistent finding. The non‐lased, endotoxin‐treated root segments had significantly increased numbers of round fibroblasts versus the control and lased, endotoxin treated groups. The lased root segments exhibited surface alterations which included charring, crater formation, cementum meltdown, and tracking. The organic matrix appeared to have been burned off leaving behind a resolidified substance with a lava‐like appearance. The results of this in vitro study suggest that the laser alters the biocompatibility of the cementum surface so as to make it unfavorable for fibroblast attachment. Healing studies are necessary to determine if these effects observed in vitro are of clinical importance. J Periodontol 1992; 63:626–632.
Chemical Characterization of Lased Root Surfaces Using Fourier Transform Infrared Photoacoustic Spectroscopy
Authors: Spencer Paulette , Trylovich David J. , Cobb Charles M.
Published: March 2012

Recently lasers have been recommended as an alternative or adjunctive therapy in the control and treatment of periodontally diseased root surfaces. The purpose of this in vitro investigation was to characterize the chemical structure of lased root surfaces using Fourier transform infrared photoacoustic spectroscopy (FTIR/PAS). Cementum samples, 6 mm X 2 mm, were cut from the root surface of extracted non‐carious, unerupted human molars. The experimental samples were lased with a Nd:YAG laser at an average energy of 80 mJ at 10 pulses per second. Total lasing time ranged from 1 minute 45 seconds to 4 minutes. A non‐lased cementum sample served as the control. All spectra were recorded from 4000 to 400 cm‐1 using the photoacoustic cell attachment on an Analect RFX‐65 FTIR Spectrometer. Photoacoustic FTIR spectra of lased cementum samples showed a decrease in the protein/mineral ratio in comparison to the control. Breakdown of protein at the root surface potentially contributed to an ammonium band at 2010 cm‐1. The decreased protein/mineral ratio and the potential surface contamination with protein by‐products, may ultimately affect cell reattachment at the cementum surface. J Periodontol 1992; 63:633–636.
Distribution of Natural Killer Cells in Periodontal Diseases: An Immunohistochemical Study
Authors: Fujita Shuichi , Takahashi Hiroshi , Okabe Haruo , Ozaki Yukio , Hara Yoshitaka , Kato Ihachi
Published: March 2012

We studied the distribution and incidence of natural killer (NK) cells in gingiva affected with adult Periodontitis (AP) and rapidly progressive Periodontitis (RP) with immunohistochemical methods using antibodies Leu‐7 and Leu‐11b. The incidence of Leu‐7 positive cells revealed no significant difference among mild AP, severe AP, and RP. On the other hand, Leu‐11b positive cells were frequently found in severe AP and RP. The accumulation of NK cells reacting with Leu‐11b in the infiltrated connective tissue was greater in severe forms of periodontal disease (severe AP and RP) than in mild AP. These results suggest that Leu‐11b positive NK cells may play a role in the destruction of tissues in periodontal diseases. J Periodontol 1992; 63:686–689.
Multi‐Level Statistical Models in Studies of Periodontal Diseases
Authors: Albandar Jasim M. , Goldstein Harvey
Published: March 2012

Periodontal data typically have a hierarchical structure, with sites grouped within individuals, and individuals grouped within communities. Also, the occasion may be regarded as another level since the acquired knowledge indicates that periodontal disease activity may vary over time. Conventional statistical tests are based on unilevel analysis of data. However, this approach to statistical analysis is often inconvenient in periodontal research because of the variation in the outcome variables between the various levels in the hierarchy. Lately there have been important developments in the statistical theory which have made available powerful statistical techniques for analyzing multilevel or hierarchical data. This report describes a new approach for analyzing periodontal data and uses an illustrative example to build a model which explains part of the variability in the response variable. The results from this analysis are then compared to results from an earlier report which uses unilevel methods and the findings discussed. The present multilevel approach has several advantages over unilevel methods, mainly due to its statistical validity and efficiency. Further, it permits the incorporation of explanatory variables measured at the site and the subject levels, and those which vary across the time points. Multilevel analyses have a promising potential and are expected to have a significant impact on periodontal research. J Periodontol 1992; 63:690–695.
Synergistic Effect of Pyrophosphate and Sodium Dodecyl Sulfate on Periodontal Pathogens
Authors: Drake D.R. , Chung J. , Grigsby W. , Wu‐Yuan C.
Published: March 2012

Our previous studies have shown that pyrophosphate (PPi), the anticalculus component of tartar‐control dentifrices, inhibits the growth of organisms associated with coronal and root surface caries. The purposes of this investigation were to: 1) determine if periodontal pathogens are similarly susceptible to the growth‐inhibitory properties of PPi; and 2) determine if combinations of pyrophosphate‐sodium dodecyl sulfate (PPiSDS) inhibit growth synergistically. Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Eikenella corrodens, and Campylobacter rectus (formerly Wolinella recta) were cultured in appropriate enriched media under anaerobic conditions. Inhibition assays were performed in tubes containing media supplemented with PPi and/or SDS. A range of concentrations of PPi and SDS in 2‐fold increments was employed, with each concentration assayed in triplicate. Minimal inhibitory concentration (MIC) analyses revealed all of the bacteria were susceptible to PPi and SDS, with MICs of 0.67% (25 mM) and 0.01% w/v respectively. Combination studies with PPi‐SDS showed much greater growth inhibition against P. gingivalis and A. actinomycetemcomitans than achieved with the agents individually. Determination of fractional inhibitory concentration indices indicated a synergistic growth‐inhibitory effect. Under the constraints of the conditions employed, these studies demonstrate the efficacy of PPi‐SDS combinations in inhibiting the growth of periodontal pathogens. It is conceivable that these compounds may have clinical benefit as a subgingival irrigant.J Periodontol 1992; 63:696–700.
Tuberous Sclerosis With Gingival Overgrowth
Authors: Thomas Daniel , Rapley John , Strathman Robert , Parker Robert
Published: March 2012

A case of tuberous sclerosis with gingival overgrowth is presented. A brief literature review and diagnostic criteria of tuberous sclerosis are discussed. The patient had a fullmouth gingivectomy with frequent post‐operative maintenance visits. After 6 months, the overgrowth in conjunction with the tuberous sclerosis returned. J Periodontol 1992; 63:713–717.
Tissue Response to Biphasic Calcium Phosphate Ceramic With Different Ratios of HA/βTCP in Periodontal Osseous Defects
Authors: Nery Edmundo B. , LeGeros Racquel Z. , Lynch Kenneth L. , Lee Kelvin
Published: March 2012

The purpose of this study was to determine the optimal ratio of calcium hydroxyapatite (HA) to beta tricalcium phosphate (βTCP) in a biphasic porous calcium phosphate (BCP) ceramic for effective repair of periodontal osseous defects. Defects were surgically produced in beagle dogs and made chronic for 4 months to simulate periodontal disease. Mucoperiosteal periodontal flaps were reflected, followed by osseous defect debridement and root planing. Specially prepared ceramic with different HA/βTCP ratios were implanted into the prepared defects. The sites were allowed to heal for 6 months, animals were euthanized, and site‐blocks were removed for histological study. During the followup phase, scaling and polishing were done once a month, and standardized probing attachment levels were recorded pre‐ and 6‐months postoperatively. The Duncan's multiple range test showed that all the treatments produced statistically significant higher gain in probing attachment levels than the control group (OHA/OβTCP) (P <0.05). Among the 7 “active” treatment groups, 2 (65/35 and 85/15) had significantly higher gain in probing attachment levels than those in 3 groups (50/50, 100/0, and 0/100) (P < 0.05). Histologically, higher HA ratio (but not 100% HA) showed accelerated new bone formation and new attachment levels. Based on histological results, the 85HA/ 15βTCP ratio appears to demonstrate greater gain in attachment level and bone regeneration in the treatment of periodontal osseous defects. J Periodontol 1992; 63:729–735.
The Relationship of Gingival Fluid Leukocyte Elastase Activity to Gingival Fluid Flow Rate
Authors: Darany David G. , Beck F. Michael , Walters John D.
Published: March 2012

Recent studies have suggested that leukocyte elastase activity (EA) in tissue exudates is an indicator of inflammatory disease. We assayed gingival fluid (GF) EA with a selective peptide substrate and compared it to GF flow rate with regard to its ability to detect differences in the clinical status of existing inflammatory periodontal disease in 56 human subjects. Compared to healthy sites (Gingival Index = 0, 1 to 3 mm) and mild gingivitis sites (GI = 1, 2 to 5 mm), mean GF EA was significantly (P <0.05) higher at periodontitis sites with deep probing depths (GI = 2, 6 to 9 mm depth), but not at periodontitis sites with intermediate probing depths (GI = 2, 4 to 5 mm). When expressed as specific EA (i.e., normalized to GF protein content), mean EA was also significantly higher at deep periodontitis sites compared to healthy sites and mild gingivitis sites. In addition, specific EA was significantly higher at periodontitis sites with intermediate probing depths than at healthy sites. As predicted by previous studies, these significant increases in specific EA were associated with significant increases in mean GF flow rate. In contrast to specific EA, however, mean GF flow rate was significantly higher at gingivitis sites than at healthy sites. A strong correlation was observed between GF flow rate and specific EA (rs = 0.737, P = 0.0006). Thus, GF flow rate and GF EA appear to be related indicators of inflammation, but GF flow rate may be more sensitive to early inflammatory changes leading to mild gingivitis. J Periodontol 1992; 63:743–747.
Comparative Efficacy of the Standard Flossing Procedure and a New Floss Applicator in Reducing Interproximal Bleeding: A Short‐Term Study
Authors: Kinane Denis F. , Jenkins William M.M. , Paterson Andrew J.
Published: March 2012

This was a parallel stratified study which examined the effect on gingival health of a new floss holder and applicator, designed to deliver a 25μl dose of 0.1% Chlorhexidine solution to each interdental embrasure during the flossing procedure. Fifty‐two patients with simple chronic gingivitis were stratified according to age, sex, and baseline interdental bleeding score and then assigned to one of three treatment groups. One of the following interdental cleaning agents was used once daily during a 2‐week period: conventional floss; a flossing device with Chlorhexidine; or a flossing device with placebo solution. Gingival health was assessed using the interdental bleeding index (IBI); i.e., the ratio of bleeding sites to the number of sites tested by stimulation with an interdental cleaner. The percentage reduction in bleeding amounted to 38.3% for conventional floss, 51.5% for the flossing device with Chlorhexidine, and 51.4% for the flossing device with placebo. The reductions in both flossing device groups were significantly greater than that of the conventional floss group as determined by one‐way ANOVA (F = 4.0; P = 0.024) and multiple range tests. There were no statistically significant differences between the two flossing device groups. There was no difference in patients' perception of ease of use of their respective materials; however, 72% of Chlorhexidine users and 94% of placebo users, but only 24% of conventional floss users, felt that their interdental cleaning regimens left their mouths feeling fresher. It is therefore postulated that the pleasant tasting spray may have been an important stimulus to extended use of the new device and may explain its greater effectiveness. J Periodontol 1992; 63:757–760.
Non‐Oral Etiologies of Oral Malodor and Altered Chemosensation
Authors: Preti George , Clark Larry , Cowart Beverly J. , Feldman Roy S. , Lowry Louis D. , Weber Eric , Young In Min
Published: March 2012

A number of non‐oral causes for oral malodor have been discussed. Several well documented etiologies for non‐oral malodor include renal failure, cirrhosis of the liver, and diabetes mellitus. Each of these conditions has been examined using analytical instrumentation. In addition there appear to be several other metabolic conditions involving enzymatic and transport anomalies (such as trimethylaminuria) which lead to the systemic production of volatile malodors that manifest themselves as halitosis and/or altered chemoreception. Our studies include patients who have been referred to us after being examined by numerous clinical specialists with no identification or relief from their problem. This is due in part to the intermittent nature of many of these problems as well as an apparent lack of knowledge concerning many of these metabolic problems and their relation to oral symptoms. J Periodontol 1992; 63:790–796.
The Prevention of Localized Ridge Deformities Using Guided Tissue Regeneration
Authors: O'Brien Tiernan P. , Hinrichs James E. , Schaffer Erwin M.
Published: March 2012

Healing of extraction sockets where the buccal plate of bone has been destroyed often results in localized ridge deformities. This is most likely due to the ingrowth of extraskeletal connective tissue into the space originally occupied by the tooth which then fills with a combination of bone and soft tissue. Techniques for managing these defects have been described, but it would be preferable to prevent them from occuring at all. Using the principles of guided tissue regeneration, a surgical technique is described that can be applied to post‐extraction sites that are deficient in alveolar bone thereby preventing localized ridge deformities. Representative cases are presented illustrating the technique. J Periodontol 1994;65:17–24.
Modeling the Relationship Between Clinical, Microbiologic, and Immunologic Parameters and Alveolar Bone Levels in an Elderly Population
Authors: Wheeler Timothy T. , McArthur William P. , Magnussen Ingvar , Marks Ronald G. , Smith Jerry , Sarrett David C. , Bender Bradley S. , Clark William B.
Published: March 2012

A cross‐sectional periodontal study of 74 subjects aged 65 to 75 years was performed. Clinical data were collected and related to microbiological and immunological data. A statistical model (step‐wise multiple regression) of factors related to bone loss was created initially using clinical data only; then by adding either the microbiologic or immunologic data; and then by using clinical, microbiologic, and immunologic data together. When only clinical data were considered, three factors were found to have significant positive correlations with bone loss. Tooth mobility accounted for 17% of the variability in the alveolar bone level measurements, probing depth for 12%(r2), and plaque index for 3%, for a total of 32% of the variability explained by these clinical factors. Tooth mobility and probing depth were clinical factors which remained significant in the model when the microbiological data were also considered. As percentages of the total cultivable microbiota, E. corrodens (r2 = 14%) and black‐pigmenting Prevotella intermedia (r2 = 4%) correlated positively with alveolar bone loss. The addition of the microbiologic data only increased the r2 to 33%. When immunological data were considered with the clinical data, pocket depth and tooth mobility were the clinical parameters which remained in the model. IgG antibody levels to P. gingivalis W83 and/or 381 (r2 = 24%) A actinomycetemcomitans 627 (r2 = 2%) were the significant immunologic measures having a positive correlation with bone loss. Anti‐F. nucleatum levels had a significant negative correlation. A total of 50% of the variability in alveolar bone level was accounted for in the model by the addition of specific serum antibody levels to subgingival plaque microorganisms. When clinical, microbiological, and immunological measurements were all considered together, antibody to P. gingivalis W83 and/or 381 (r2 = 42%), percentage of B‐lymphocytes (r2 = 3%), probing depth (r2 = 4%), anti‐E. corrodens levels (r2 = 2%), and anti‐P. gingivalis 33277 levels (r2 = 4%) all had significant positive correlation with loss of alveolar bone. The number of enteric bacteria, anti‐F. nucleatum levels, and anti‐P. intermedia levels each had a significant negative correlation with alveolar bone heights. The r2 for this model was 75%. These results indicated that antibody levels to subgingival plaque microorganisms and tooth mobility were the best predictors of bone loss in the elderly patients tested in this study. J Periodontol 1994;65:68–78.
Regional Accelerated Phenomenon in the Mandible Following Mucoperiosteal Flap Surgery
Authors: Yaffe Avinoam , Fine Nachum , Binderman Itzhak
Published: March 2012

Striking remodeling activity occurs adjacent to the site of injury in orthopedic surgery. This reaction has been described as regional accelerated phenomenon (RAP), as it speeds up the healing stage. The phenomenon is a transient burst of localized remodeling process following surgical wounding of cortical bone. We explored whether RAP occurs following mucoperiosteal flap surgery in the jaw bone. Mucoperiosteal flaps were performed on 60 Wistar rats, either only on the buccal aspect or both on buccal and lingual aspects of the mandible. The surgical procedure lasted an average of 30 seconds and the flap was readapted without sutures. The rats were sacrificed at 3, 7, 10, 14, 21, and 120 days. High resolution x‐ray microradiography of 1 to 1.5 mm thick ground sections between premolar and molar regions of the mandible were analyzed and revealed large areas of radiolucency which correlated to massive resorption of the alveolar bone, as well as areas in the bone proper. The RAP was observed as early as 10 days in the treated side group. Striking resorption of the cortical bone, both on the surface and the bone proper, occurred on the periodontal aspect of the crestal bone leading to widening of the periodontal ligament space, where a mucoperiosteal flap was performed on the buccal aspect. The resorption was more prominent when a mucoperiosteal flap was performed both on the lingual and buccal aspect. The alveolar bone recovered almost to control levels 120 days after surgery. Both the histology sections and the microradiographs in the mesio‐distal direction demonstrated a typical RAP mechanism to potentiate tissue healing, a phenomenon observed by orthopedists in long bone. It is this phenomenon that might be responsible for the increasing mobility immediately following periodontal surgery. Also, bone dehiscences following periodontal surgery and open flap curettage may occur when the bone in the area is thin. J Periodontol 1994;65:79–83.