bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Guided Bone Regeneration Around Commercially Pure Titanium and Hydroxyapatite‐Coated Dental Implants. I. Radiographic Analysis
Authors: Stentz William C. , Mealey Brian L. , Nummikoski Pirkka V. , Gunsolley John C. , Waldrop Thomas C.
Published: March 2012

The purpose of this study was to determine which treatment of a large osseous defect adjacent to an endosseous dental implant would produce the greatest regeneration of bone and degree of osseointegration: barrier membrane therapy plus demineralized freeze‐dried bone allograft (DFDBA), membrane therapy alone, or no treatment. The current study assessed radiographic density changes in bone within the healed peri‐implant osseous defect. In a split‐mouth design, 6 implants were placed in edentulous mandibular ridges of 10 mongrel dogs after preparation of 6 cylindrical mid‐crestal defects, 5 mm in depth and 9.525 mm in diameter. An implant site was then prepared in the center of each defect to a depth of 5 mm beyond the apical extent of the defect. One mandibular quadrant received three commercially pure titanium (Ti) screw implants (3.75 × 10 mm), while the contralateral side received three hydroxyapatite (HA) coated root‐form implants (3.3 × 10 mm). Consequently, the coronal 5 mm of each implant was surrounded by a circumferential defect approximately 3 mm wide and 5 mm deep. The three dental implants in each quadrant received either DFDBA (canine source) and an expanded polytetrafluoroethylene membrane (ePTFE), ePTFE membrane alone, or no treatment (control). Standardized radiographs were taken at 1 week and 4 months post‐implant placement. Computer‐assisted densitometric image analysis (CADIA) was performed at 6 areas of interest (coronal, middle, and apical defect areas mesial and distal to each implant) for each of the implant sites. Significantly greater increase in bone density was obtained using DFDBA/ePTFE compared to ePTFE alone or the controls; likewise, ePTFE alone resulted in greater bone density change than the controls. There were no significant differences in radiographic bone density adjacent to Ti versus HA‐coated implants. When 3 dogs having postoperative membrane complications were eliminated from the analysis, the results were similar with the exception that defects adjacent to Ti implants had significantly less density gain when compared to HA‐coated implants. The results of this study indicate the use of DFDBA/ePTFE in large surgically‐created defects promotes a denser healing of bone adjacent to implants when measured radiographically than either ePTFE alone or no treatment. J Periodontol 1997;68:199–208.
Periodontal Bacteria Colonizing Oral Mucous Membranes in Edentulous Patients Wearing Dental Implants
Authors: Danser Monique M. , van Winkelhoff Arie J. , van der Velden Ubele
Published: March 2012

The purpose of this study was to investigate the prevalence of the microbiota on the oral mucosal surfaces and in the peri‐implant pocket in edentulous subjects with a past history of periodontitis. Twenty edentulous subjects wearing dental implants for at least one year and with a history of periodontitis participated in this study. Clinical parameters were assessed (plaque, redness, swelling, peri‐implant probing depth [PIPD], and bleeding on probing) and microbiological samples were taken (oral mucosal surfaces, saliva, plaque, and peri‐implant pocket). Based on the clinical results, the group as a whole showed healthy peri‐implant tissues. A mean PIPD of 3.6 mm was found. A statistically significant correlation was found between the PIPD and bleeding upon probing, plaque scores, redness, and swelling. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were not detected. The subjects harboring Prevotella intermedia showed presence of PIPD of ≥ 5 mm. All subjects harbored Peptostreptococcus spp., Fusobacterium spp., and other Prevotella species. Actinomyces odontolyticus, Bacteroides forsythus, Campylobacter rectus, Pseudomonas spp., and enterobacteria were detected less frequently. Three subjects showed signs of overt soft tissue inflammation. They harbored higher proportions of Peptostreptococcus spp. than the other subjects. The results corroborate the suggestion that the primary source of colonization for dental implants in edentulous patients are the oral mucous membranes. The results indicate that the microbiota of subjects wearing dental implants with a past history of periodontitis are composed of bacteria associated with a healthy periodontium or gingivitis. It is suggested that elimination of the subgingival environment by extraction of all natural teeth probably initiates the disappearance of the two periodontal bacteria A. actinomycetemcomitans and P. gingivalis. J Periodontol 1997;68:209–216.
Alveolar Bone Patterns in Sickle Cell Anemia and Non‐Sickle Cell Anemia Adolescent Nigerians: A Comparative Study
Authors: Arowojolu M. O. , Savage K. O.
Published: March 2012

The association between sickle cell anemia (SCA) and gnathopathy of the permanent incisors forms the basis of this study. The alveolar bone patterns of adolescent Nigerians were observed in a comparative study of 50 SCA subjects and 50 controls from the same environment. Periapical radiographs of the lower incisor and upper molar regions were taken. Alveolar bone levels were measured as a percent of the root lengths to account, in part, for angulation error. These readings were then compared between the two groups. No significant difference was observed in the radiographic bone level measurements when the two groups were compared. These results clearly show that in this population of adolescents, sickle cell anemia is not associated with a difference in alveolar bone levels. J Periodontol 1997;68:225–228.
Odontogenic Keratocysts: Review of the Literature and Report of a Case
Authors: Blanchard Steven B.
Published: March 2012

The odontogenic keratocyst is a common odontogenic cyst which accounts for 10% of all oral cysts. Odontogenic keratocysts are believed to arise from remnants of the dental lamina and are found in locations which may be encountered by periodontists. Keratocysts have a distinctive histopathologic appearance and are known to be locally aggressive and have a high recurrence rate, thus requiring close long‐term follow‐up. Odontogenic keratocysts are one component of the basal cell nevus syndrome and all patients with odontogenic keratocysts should be evaluated for this syndrome. This paper reviews odontogenic keratocysts and presents a case treated by conservative enucleation and ultrasonic debridement of the cystic cavity with no evidence of recurrence at five years. J Periodontol 1997;68:306–311.
Expression of Extracellular Matrix Proteins in Human Periodontal Ligament Cells During Mineralization In Vitro
Authors: Nohutcu Rahime M. , McCauley Laurie K. , Koh Amy J. , Somerman Martha J.
Published: March 2012

Periodontal regeneration is a complex process that requires coordinated responses from several cell types within the periodontium. It is generally accepted that the periodontal ligament (PDL) has a heterogeneous cell population, where some of the cells may be capable of differentiating into either cementoblasts or osteoblasts. Thus, it has been hypothesized that PDL cells play a role in promoting periodontal regeneration. However, definitive evidence to support this concept is lacking. Previously, we reported that PDL cells induce biomineralization as determined by Von Kossa histochemistry and transmission electron microscopy. To further determine the osteoblast‐like properties of PDL cells, human PDL cells were exposed to dexamethasone (DEX) in order to promote an Osteoblast phenotype, and then cell activity monitored during mineral nodule formation in vitro. For mineralization studies, cells were cultured in DMEM containing 10% FBS and a) vehicle only; b) ascorbic acid (50 μg/ml) and β‐glycerophosphate (10 mM); or c) ascorbic acid, β‐glycerophosphate and DEX (100 nM) for 30 days. In addition, the effects of DEX on PDL cells in non‐mineralizing media were determined. Cells were stained weekly to evaluate mineral‐like nodules, using the Von Kossa method. Northern blot analyses for rnRNA steady state levels for several bone‐associated proteins, i.e., osteopontin (OPN), bone sialoprotein (BSP), alkaline Phosphatase (ALP), osteocalcin (OCN), α2(1)(type 1) collagen and osteonectin (ON), were performed. DNA levels were also detennined during the 30‐day minerahzation period. Under phase contrast microscopy, PDL cells in non‐rnineralizing media treated with DEX exhibited a more spindle‐shaped morphology when compared with similar cells not exposed to DEX. Mineralizing conditions were required to induce mineral nodule formation. However, in this situation, mineral induction was independent of DEX; and furthermore, DEX‐treated cells did not exhibit a different morphological pattern when compared with non‐DEX treated cells. Mineral‐like nodules were first seen at day 15, in concert with an increase followed by a decrease in expression of type I collagen and ON rnRNA in both DEX‐treated and non‐treated cultures. Using Northern blot analysis for detection of specific proteins, we found that PDL cells did not express OPN, BSP, OCN, or ALP under any of the conditions used in this study. DEX did not alter DNA content in the cultures during the mineralization period. These results confirm that human periodontal ligament cells can be induced to mineralize in vitro and indicate that dexamethasone does not significantly alter the extent and pattern of mineralization. J Periodontol 1997;68:320–327.
Manifestations of Insulin‐Dependent Diabetes Mellitus in the Periodontium of Young Brazilian Patients. A 10‐Year Follow‐Up Study
Authors: Novaes Arthur B. , Silva Maristela A.P. , Batista Eraldo L. , dos Anjos Beatriz A. , Novaes Arthur B. , Pereira Antonio L.A.
Published: March 2012

Eight female and 3 male patients from a group of 30 patients studied 10 years earlier and who had received no periodontal treatment during this period, in order to evaluate the progression of untreated periodontal disease in patients with insulin‐dependent diabetes mellitus, were evaluated in terms of plaque accumulation, gingival inflammation, probing depth, and alveolar bone loss. The total number of dental surfaces that presented clinically detectable plaque deposits increased significantly (29% to 43%; P < 0.01; X2 = 46.36). Site‐specific comparisons for plaque index between studies showed a significant variation (P < 0.01) in the upper arch only for palatal surfaces and in the lower arch for the buccal and lingual surfaces. The total dental surfaces with inflamed surrounding gingiva increased from 11% to 33% in this study (P < 0.01; X2 = 175.78). Site‐specific comparison for gingival index showed a significant variation for all upper surfaces, while such difference for the lower arch was significant only for the buccal and lingual surfaces. The arithmetic means for the probing depth for the upper buccal, upper palatal, lower buccal, and lower lingual surfaces increased significantly (P < 0.01). The arithmetic means of alveolar bone loss also increased significantly for the upper posterior and lower regions (P < 0.01) and for the upper anterior and lower anterior regions (P < 0.05). The correlation between age and probing depth was significant only for the upper palatal region (P < 0.01). The correlation between age and bone loss was significant only for the upper posterior region (P < 0.05). The results of this follow‐up study suggest that despite little variation in plaque accumulation, gingival inflammation, probing depth, and bone loss increased after a 10‐year interval in patients who had received no periodontal treatment during this period. J Periodontol 1997;68:328–334.
The Use of Tetracycline‐Containing Controlled‐Release Fibers in the Treatment of Refractory Periodontitis
Authors: Vandekerckhove Betty N.A. , Quirynen Marc , van Steenberghe Daniel
Published: March 2012

The purpose of this study was to evaluate the safety and clinical efficacy of controlledrelease tetracycline‐containing fibers in patients with refractory periodontitis versus the preceding classical treatment. One hundred twenty‐one sites in 20 patients were followed from baseline to 6 months after fiber insertion. Each selected site was ≥5 mm deep and bled on probing. All 20 patients had at least one site ≥7 mm which bled on probing. Those pockets remained after intense and repeated conventional therapy (scaling and root planing and often surgery), often including the use of systemic antibiotics. This treatment period, the so‐called control period, preceded the experimental period by at least 3 years, when the fibers were placed. Both treatments (in control and test period) were performed in the Department of Periodontology at the University Hospital in Leuven. At the start of the experimental period, all pockets ≥5 mm were treated by the placement of fibers impregnated with 25% tetracycline. The fibers were removed after 10 days. Probing depth, clinical attachment level, gingival recession, and bleeding on probing were recorded at baseline, and at 1, 3, and 6 months following treatment. Analysis of data from all sites indicated that a significant decrease in probing depth and gain in attachment were present at all follow‐up visits. The mean probing depth reduction for sites ≥7 mm was 3.2 mm at month 6, with a gain in attachment of 2.7 mm, while this was −1.0 mm and −1.9 mm, respectively, during the preceding control period. The fraction of bleeding pockets was reduced from 77% to 27% and from 80% to 77% during the experimental and control periods, respectively. No significant adverse side‐effects were observed, except for a transient redness at fiber removal in 2 sites. Fiber insertion appeared to be time‐consuming even when the operator was familiarized with the procedure. The results of this study prove that tetracycline‐impregnated fibers can reduce probing depth significantly for a period of 6 months in patients not responding to thorough and repeated classical periodontal treatment. J Periodontol 1997;68:353–361.
Blur Reduction of Conventional Film‐Based Tomograms For Pre‐Surgical Evaluation of Potential Mandibular Implant Sites
Authors: Mayfield‐Donahoo Tracy L. , Stokely Ernest M. , Jeffcoat Marjorie K.
Published: March 2012

The usefulness of motion‐based cross‐sectional tomography to evaluate osseous support and adjacent anatomical structures for dental implant placement is limited by the inherent blurring in these images. The goal of this study was to develop a method to remove blurring while permitting accurate dimensional analysis of the potential implant site. Defined regions (anterior, cuspid, premolar, molar) on two preserved human mandibles were imaged using cross‐sectional linear tomography. Algorithms were developed as a personal computer application to remove the blur and to aid in identification of the cortical plate borders and the mandibular canal. The data set of eight tomograms was digitized and the blur reduced with the developed algorithm. An operator measured the height and width of the mandible on each original tomogram and each deblurred tomogram in triplicate. Method error was calculated as the difference between direct caliper measurements of the respective skull regions and image measurements of height and width for both the original digitized tomograms and the deblurred tomograms. Method error using the original images (height: –2.72 ± 2.15 mm; width: –0.58 ± 1.36 mm) compared to the deblurred tomograms (height: –0.58 ± 1.16 mm; width: 0.37 ± 0.59 mm) was significantly greater for both height (t‐test level of significance, P = 0.0047) and width (t‐test level of significance, P = 0.0001). These findings suggest that the method developed may greatly improve the ability of clinicians to accurately assess the implant site using cross‐sectional film‐based linear tomograms. J Periodontol 1997;68:362–368.
Recurrent Peripheral Giant Cell Granuloma Associated With Cervical Resorption
Authors: Nedir R. , Lombardi T. , Samson J.
Published: March 2012

A case of recurrent peripheral giant cell granuloma in a 38‐year‐old man is reported. The lesion was localized on the attached gingiva of the lower left second premolar (tooth #35). The surgical excision of the lesion revealed a superficial resorption of the cervical region of the involved tooth. The resorption was smoothed out, and there was no sign of recurrence or further resorption after 14 months. Root resorption, although extremely rare, may be associated with peripheral giant cell granuloma. J Periodontol 1997;68:381–384.
Experimentally Induced Periodontitis in Beagle Dogs Causes Rapid Increases in Osteoclastic Resorption of Alveolar Bone
Authors: Shibutani Toshiaki , Murahashi Yoshinobu , Tsukada Eiji , Iwayama Yukio , Heersche Johan N.M.
Published: March 2012

This study was undertaken to observe osteoclast differentiation related to inflammatory progression in aggressive periodontitis induced in beagle dogs by ligature of the gingival sulcus. To monitor osteoclastic activity, we used histochemical methods (staining for tartrate‐resistant acid phosphatase [TRAP]) to visualize osteoclasts and their TRAP‐positive precursors and biochemical methods (ELISA assay of pyridinium crosslinks) to detect bone matrix degradation products in gingival crevicular fluid (GCF), serum, and urine. For histochemical study, tissue specimens were prepared from 3 adult female beagle dogs induced with experimental periodontitis by silk ligature placement below the gingival margin of mandibular molars ligated for 3, 7, and 21 days. For biochemical study for pyridinoline measurement, the 24 mandibular molars of 4 male beagle dogs were ligated. GCF, urine, and serum were collected at day 0 and at 3, 7, 14, and 21 days after ligation. In the early inflammatory phase of ligatureinduced periodontitis (day 3), TRAP+ mononuclear and TRAP+ multinucleated cells were present in the gingival connective tissue, and active bone‐resorbing cells were found in excavated lacunae at the alveolar crest, but osteoclasts were not infiltrating the periodontal ligament during this early phase. During later stages of the inflammatory process (7 and 21 days), osteoclasts appeared at both the gingival and ligament side of the alveolar bone. Osteoclastic bone resorption appeared to be more severe on the bone surface at the gingival side than on the bone surface of the periodontal ligament side. Measurement of pyridinoline significantly increased in GCF and urine 3 days after ligation. The results suggested that bone at the crest of the alveolar bone is rapidly resorbed within 3 days of inducing experimental periodontitis. J Periodontol 1997;68:385–391.
Report of a Gingival “Surgical Cyst” Developing Secondarily to a Subepithelial Connective Tissue Graft
Authors: Breault Lawrence G. , Billman Michael A. , Lewis David M.
Published: March 2012

The subepithelial connective tissue graft is a valuable technique used to cover exposed root surfaces or to increase the zone of attached gingiva. Cysts, such as the gingival cyst of the adult, are epithelial‐lined cysts which may arise from heterotropic glandular tissue, a proliferating rete peg, remnants of the dental lamina, or traumatic implantation of epithelial tissue. In this paper, a case report is described of a “surgical cyst” or cystic morphogenesis of surgically implanted epithelium developing secondarily to a subepithelial connective tissue graft. J Periodontol 1997;68:392–395.
Progressive Cervical Root Resorption Related to Tetracycline Root Conditioning
Authors: Ben‐Yehouda Amos
Published: March 2012

Root resorption is reported as a microscopic finding in trials attempting to regenerate the periodontium using tetracycline or citric acid root conditioning. This report deals with a case of progressive cervical root resorption in a female patient who had been successfully treated by tetracycline root conditioning. The article emphasizes the possibility of this adverse effect, and discusses a possible mechanism inducing this phenomenon. J Periodontol 1997;68:432–435.
Comparative Effects of Cyclosporin on Glycosaminoglycan Synthesis by Gingival Fibroblasts
Authors: Newell Jeff , Irwin Chris R.
Published: March 2012

Histolotical studies show that drag‐induced gingival overgrowth results from an accumulation of the connective tissue component. Despite comprising a major part of gingival connective tissue, a role for glycosaminoglycans (GAGs) in the pathogenesis of gingival overgrowth has received scant attention. By analyzing the metabolism of 3H‐glucosamine, we have compared GAG and hyaluronan synthesis by fibroblasts derived from normal and overgrown gingival tissue, and the effects of cyclosporin on GAG output. GAG production was cell density‐dependent, fibroblasts cultured at low density synthesizing significantly increased quantities in comparison to confluent cultures. The effects of cyclosporin on GAG synthesis was also found to be both cell density‐ and cell strain‐dependent. However, cyclosporin‐stimulated GAG synthesis by 2/3 overgrown cell strains and 1/3 normal strains. These results suggest that a direct promotion of GAG synthesis by gingival fibroblasts in response to cyclosporin may play a role in the pathogenesis of gingival overgrowth. J Periodontol 1997;68:443–447.
Periodontal Findings in Cohen Syndrome With Chronic Neutropenia
Authors: Alaluusua Satu , Kivitie‐Kallio Satu , Wolf Juhani , Haavio Marja‐Liisa , Asikainen Sirkka , Pirinen Sinikka
Published: March 2012

Radiographic periodontal status and microbiological findings of periodontal pockets in subjects with Cohen syndrome are presented in this report. This hereditary disorder causes mental retardation, and neutropenia is one feature of the syndrome. Fifteen patients with Cohen syndrome and 15 controls matched for age and sex and, as far as possible, according to the degree of mental retardation were examined. Alveolar bone loss was evaluated from the panoramic radiographs. Two subgingival samples were obtained from the most affected anterior and posterior periodontal sites in each dentate subject and examined for the occurrence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedialnigrescens, Peptostreptococcus micros, Bacteroides forsythus, and Campylobacter rectus. Subjects with Cohen syndrome had alveolar bone loss more frequently and the bone loss was more extensive (Mann‐Whitney U‐test: P < 0.05) than in the controls. They also harbored one or several of the putative periodontal pathogens (Mann‐Whitney U‐test: P < 0.001) more often than the controls. We conclude that subjects with Cohen syndrome have increased susceptibility to early periodontal breakdown which is likely to be associated with neutropenia. J Periodontol 1997;68:473–478.
Odontogenic Myxofibroma Arising From the Periodontal Ligament in the Maxillary Molar Region
Authors: Okada Hiroyuki , Izumi Ryoji , Kaneda Takashi , Yamamoto Hirotsugu
Published: March 2012

A rare case of odontogenic myxofibroma, which arose from the periodontal ligament and expanded into the oral cavity resulting in an epulis‐like lesion in a 52‐yearold man, is reported including details of studies using lectin histochemistry, transmission electron microscopy (TEM), and immunohistochemistry. Most of the tumor cells, which appeared spindle‐like with abundant rough endoplasmic reticulum and some microfilaments by TEM, showed immunoreactivity for mesenchymal markers. Some tumor cells, which were polygonal and contained many microfilaments and some filament bundles, were immunoreactive for muscle markers. The present case was considered to consist of many fibroblasts and some myofibroblasts. J Periodontol 1997;68:479–484.
Cocaine‐Associated Rapid Gingival Recession and Dental Erosion. A Case Report
Authors: Kapila Yvonne L. , Kashani Hoshang
Published: March 2012

This case report chronicles the clinical presentation and unusual response to treatment of a patient with rapid gingival recession and dental erosion secondary to local cocaine application. The initial clinical diagnosis was necrotizing ulcerative periodontitis; only after several years of therapy did the patient voluntarily inform one of the therapists that cocaine had been regularly applied to the affected gingival sites. This case illustrates the importance of including cocaine application to gingival tissues in a differential diagnosis in cases of rapid gingival recession and dental erosion of unknown etiology. J Periodontol 1997;68:485–488.
Guided Periodontal Tissue Regeneration in Interproximal Intrabony Defects Following Treatment With a Synthetic Bioabsorbable Barrier
Authors: Hürzeler Markus B. , Quiñones Carlos R. , Caffesse Raul G. , Schüpbach Peter , Morrison Edith C.
Published: March 2012

This study evaluated guided periodontal tissue regeneration (GPTR) wound healing in interproximal intrabony periodontal defects following surgical treatment with a synthetic bioabsorbable barrier made from a copolymer of glycolide and lactide. Periodontal lesions were induced around the mandibular central incisor teeth of 10 adult male rhesus monkeys using orthodontic elastics. Once similar contralateral interproximal defects had been created, the elastics were removed and an oral hygiene program was initiated and maintained until completion of the study. Three weeks after commencing oral hygiene, flap surgery was performed in the mandibular incisor region and the root surfaces were thoroughly scaled and root planed to the apical portion of the defects. On the test sites, a bioabsorbable barrier was placed over the entire interproximal periodontal defect. Control sites did not receive a barrier. Five months after surgery, the animals were sacrificed and the teeth with their supporting periodontium were processed for light microscopic evaluation. Postoperative clinical healing progressed uneventfully and was similar in both control and test sites. Histologic observations from control specimens indicated reparative healing characterized by a long junctional epithelium with limited cementum and bone formation. Test specimens exhibited significantly more new connective tissue attachment, cementum deposition, and bone formation than the control sites (P < 0.001). The barriers had been completely resorbed with no apparent adverse effect on periodontal wound healing. It was concluded that this bioabsorbable barrier facilitated GPTR wound healing in interproximal intrabony periodontal defects. J Periodontol 1997;68:489–497.
Guided Periodontal Tissue Regeneration in Class II Furcation Defects Following Treatment With a Synthetic Bioabsorbable Barrier
Authors: Hürzeler Markus B. , Quiñones Carlos R. , Caffesse Raul G. , Schüpbach Peter , Morrison Edith C.
Published: March 2012

The purpose of this study was to evaluate guided periodontal tissue regeneration (GPTR) wound healing in Class II furcation defects following surgical treatment with a synthetic bioabsorbable barrier manufactured from a copolymer of glycolide and lactide. Periodonal lesions were induced in four adult male rhesus monkeys around the mandibular first, second, and third molar teeth using orthodontic elastics. After obtaining approximately 30% bone loss, the elastics were replaced by a stainless steel wire which had a projection extending into the furcation. Once similar contralateral Class II furcation defects had been created, the wires were removed, and an oral hygiene program was initiated and maintained until completion of the study. Three weeks after commencing oral hygiene, flap surgery was performed in the mandibular molar region and the root surfaces were thoroughly scaled and root planed to the apical portion of the defects. A bioabsorbable barrier was then placed to cover the furcation defects on one side of the jaw (i.e., test sites). No barriers were placed on the contralateral molars (i.e., control sites). Five months after surgery, the animals were sacrificed and the teeth with their supporting periodontium were processed for light microscopic evaluation. Clinical healing progressed normally and was similar in both groups. Histologic observations from control specimens indicated repair with epithelium and connective tissue occupying the majority of the furcation defects. Test specimens exhibited definitive evidence of regeneration with significantly greater new connective tissue attachment, cementum deposition, and bone formation than the control sites (P < 0.001). It was concluded that this bioabsorbable barrier facilitated GPTR wound healing in Class II furcation defects. J Periodontol 1997;68:498–505.
Effects of Interleukin‐1β on Matrix Metalloproteinase‐3 Levels in Human Periodontal Ligament Cells
Authors: Nakaya H. , Oates T.W. , Hoang A.M. , Kamoi K. , Cochran D.L.
Published: March 2012

Matrix metalloproteinase‐3 (MMP‐3), or stromelysin‐1, is an enzyme responsible for the degradation of a wide range of extracellular matrix proteins. Increases in MMP‐3 activity have been found in several chronic inflammatory diseases, and this increased activity is thought to be mediated by interleukin‐1β (IL‐1β). Because IL‐1β has been strongly associated with inflammatory periodontal disease, the purpose of this in vitro study was to investigate the role of IL‐1β on the regulation of MMP‐3 levels in cells derived from the human periodontal ligament (PDL). Human PDL cell cultures were treated with IL‐1β at varying concentrations (0.01‐1.0 ng/ml) for 24 hours prior to analysis at either transcript or protein levels. Following the isolation of total RNA, the relative levels of MMP‐3 mRNA were determined using reverse transcription‐polymerase chain reaction (RT‐PCR) with 32P‐end‐labeled primers. Immunocytochemical detection of MMP‐3 protein was performed using polyclonal antibodies to human MMP‐3. The results of RT‐PCR analysis demonstrated a concentrationdependent increase in MMP‐3 mRNA expression, with IL‐1β treatments of 0.1 and 1.0 ng/ml significantly (P < 0.01) increased over those cells not treated with IL‐1β. This increase in mRNA expression was paralleled by significant (P < 0.001) changes at the protein level, with an average of 27.6% of the cells stained positive for MMP‐3 following IL‐1β treatment (1.0 ng/ml), compared with control cells showing no positive staining for MMP‐3. In conclusion, the results of this study demonstrate that IL‐1β upregulates MMP‐3 in human PDL cells on both an mRNA and a protein level. These findings suggest possibly important roles for IL‐1β and MMP‐3 in both normal turnover and maintenance of the PDL and in the connective tissue degradation associated with periodontal disease. J Periodontol 1997;68:517–523.
Clinical Classification of Periodontitis in Adolescents and Young Adults
Authors: Albandar Jasim M. , Brown L. Jackson , Genco Robert J. , Löe Harald
Published: March 2012

The aim of this study was to determine the degree to which clinical classifications based on cross‐sectional assessments endure in the course of development of earlyonset periodontitis (EOP), and to introduce new criteria which might improve the clinical classification of these diseases. Subjects with EOP and a matched group without EOP were identified within a national probability sample examined during the 1986/87 survey of US schoolchildren. Of these, 265 subjects (mean age 16 years) were re‐examined during the 1992/93 school year. The clinical attachment level of teeth was assessed, and the individuals were classified into localized juvenile periodontitis (LJP), generalized juvenile periodontitis (GJP), incidental attachment loss (IAL), and no‐periodontitis groups using three classification methods previously described. A fourth method that considered the extent and severity of attachment loss and the number of missing teeth was introduced to classify the individuals at baseline and at follow‐up as having localized, generalized, or incidental EOP, and no‐periodontitis groups. Furthermore, the individuals were classified using criteria based on the rate and pattern of change in attachment loss during 6 years. The results showed low correlations between the baseline classifications and the classifications at the 6‐year follow‐up examination, irrespective of the method used. In addition, the crosssectional classifications were not predictive of the rate of progression of periodontal disease in these subjects. In the generalized disease group, two‐thirds of the individuals exhibited moderate/rapid disease progression, while one‐third had slow or no progression. In the localized disease group, one‐half of the individuals had moderate/rapid disease progression and one‐half had slow or no progression. In the incidental disease group one‐fourth of the individuals had moderate/rapid disease progression and threefourths had slow or no progression. We propose that the term early‐onset periodontitis be used as a generic term to describe periodontal disease before its normal onset. In addition, we suggest that incidental, localized, and generalized EOP are heterogeneous groups comprising rapidly and slowly progressing forms within each classification. The findings suggest that a classification system in which subsets of the disease that are defined according to a combination of cross‐sectional criteria and the disease progression may be useful in studies of EOP. Furthermore, the findings suggest that clinical classifications of EOP be used as generic descriptors until a full understanding of the pathogenesis of this disease is accomplished. J Periodontol 1997;68:545–555.
A Bone Regenerative Approach to Alveolar Ridge Maintenance Following Tooth Extraction. Report of 10 Cases
Authors: Lekovic V. , Kenney E. B. , Weinlaender M. , Han T. , Klokkevold P. , Nedic M. , Orsini M.
Published: March 2012

Ten patients who required two or more anterior teeth extractions were utilized in this study. Extraction procedures were carried out with a full thickness surgical flap approach. After flap reflection, teeth were removed with a minimum of trauma to the surrounding bone. Following extraction silicone‐based impression techniques were used to produce a model of the alveolar process and small metal pins were placed in the alveolus to be used as fixed points to make measurements of ridge dimensions. One socket was covered with an expanded polytetrafluoroethylene (ePTFE) barrier membrane (experimental site); the other socket was a conventional control. The soft tissue flaps were then mobilized using periosteal releasing incision and the wound closed with ePTFE mattress sutures. Six months following extraction, patients were treated with flap surgery to expose both extraction sites to remove the ePTFE membranes and to measure ridge dimensions using the pins as fixed points. Clinical and model measurements have shown statistically significant better ridge dimensions at experimental sites than at control (P ≤ 0.05). Three patients with exposed membranes had similar dimensional changes as controls. Results from this study suggested that this improved technique offers a predictable alveolar ridge maintenance enhancing the bone quality for dental implant procedures and esthetic restorative dentistry. J Periodontol 1997;68:563–570.
Immediate Loading of Titanium Plasma‐Sprayed Screw‐Shaped Implants in Man: A Clinical and Histological Report of Two Cases
Authors: Piattelli A. , Paolantonio M. , Corigliano M. , Scarano A.
Published: March 2012

This study reports on the histological findings of two immediately loaded titanium plasma‐sprayed (TPS) implants, retrieved for a fracture of the abutment and for psychological reasons, after 8 and 9 months of loading, respectively. The microscopical analysis showed that mature, compact, cortical bone was present around both implants, with the bone implant contact percentage about 60 to 70%. No fibrous tissue or gaps were present at the interface. No resorption was present in the peri‐implant bone. On both implants a few osteoblasts were found positive at the interface for alkaline phosphatase (ALP); while no cells positive for acid phosphatase (ACP) were present. Immediate loading can, perhaps, be used in very selected cases of good bone quality, with implants that have certain macro‐ (screw shape) and micro‐interlocks (titanium plasma‐sprayed surface) characteristics. Good results have been reported also for non‐TPS surface (e.g., machined surface). More data about different designs (e.g., cylinders) or coatings (e.g., hydroxyapatite) are needed before any firm conclusions about immediate loading can be reached. J Periodontol 1997;68:591–597.
Osseous Repair of a Lateral Periodontal Cyst
Authors: Lehrhaupt Nina B. , Brownstein Carol N. , Deasy Michael J.
Published: March 2012

The lateral periodontal cyst is a slow‐growing radiolucent, developmental lesion occurring most frequently in males during the sixth decade. As part of the differential diagnosis, it must be distinguished from the collateral keratocyst and the gingival cyst of adults as well as other entities. Speculation remains as to the lateral periodontal cyst's developmental origin. Whether it is from reduced enamel epithelium, remnants of dental lamina, or cell rests of Malassez remains to be determined. The following longitudinal case report describes the review of literature and clinical and histologic findings as well as unusual treatment of a through‐and‐fhrough perforating lateral periodontal cyst. Due to the large bony defect left after the cyst's removal, a decalcified freeze‐dried bone graft was placed to close the defect. The repair of the lesion was followed for 30 months. J Periodontol 1997;68:608–611.
Effects of Combined Topical Metronidazole and Mechanical Treatment on the Subgingival Flora in Deep Periodontal Pockets in Cuspids and Bicuspids
Authors: Hitzig C. , Fosse T. , Charbit Y. , Bitton C. , Hannoun L.
Published: March 2012

The effect on the subgingrval microflora of a single topical administration of a 95% collagen and 5% metronidazole device in combination with debridement was investigated in 30 adult periodontitis patients in comparison with mechanical treatment alone. For each patient, plaque samples from test and control sites in cuspids and bicuspids were collected for culture and enumeration of total anaerobically cultivable bacteria (TA), black‐pigmented anaerobes (BPA), and Actinobacillus actinomycetemcomitans (Aa). Spirochetes and fusiforme were quantified by direct microscopic examination after Giemsa staining. A decrease was observed for all parameters, and a significant difference in comparison with the control group was found for fusiforms. After treatment, a lower number of Aa positive sites were observed in the test group (13/25). These results show that a single application of topical metronidazole seems to be effective as adjunctive antimicrobial treatment in adult periodontitis. J Periodontol 1997;68:613–617.
Root Planing Following Short‐Term Pocket Distention
Authors: Shen E‐Chin , Maddalozzo Donna , Robinson Peter J. , Geivelis Milton
Published: March 2012

This study evaluated the effectiveness of root planing following short‐term pocket distention. Seventy‐five single‐rooted teeth with probing depths ≥ 5mm and ≤ 10mm were selected. The teeth were randomly divided into three treatment groups. In groups 1 and 2 a gingival retraction cord (aluminum sulfate‐impregnated in group 1 and non‐impregnated cord in group 2) was packed subgingivally for 30 minutes. Following removal of the cord, the teeth were scaled and root planed. In group 3 the teeth were root planed only. Following instrumentation, the teeth were extracted and examined under a stereomicroscope. The residual calculus on the root surface of each tooth was measured using a computerized image analysis system. The quantities were compared using a two‐way ANOVA and Chi‐square test. The results showed that 46.3% of all root surfaces had detectable residual calculus and that the mean percentage of residual calculus per root surface was 4.41% following root planing. Forty percent of the root surfaces in group 1 had residual calculus, 38.0% in group 2, and 61.0% in group 3. There was a statistically significant difference (P<0.01) between groups 1 and 2 compared to group 3. The mean calculus per root surface for groups 1, 2, and 3 was 3.03%, 3.04%, and 7.15%, respectively. Significant differences (P<0.005) were found between groups 1 and 2 compared to group 3. These results indicate that subgingival calculus removal in deep pockets is enhanced with shortterm pocket distention, and that there is no added benefit to having aluminum sulfate present in the retraction cord. J Periodontol 1997;68:632–635.
Regression of Nifedipine‐Induced Gingival Hyperplasia Following Switch to a Same Class Calcium Channel Blocker, Isradipine
Authors: Westbrook Perry , Bednarczyk Edward M. , Carlson Mark , Sheehan Helen , Bissada Nabil F.
Published: March 2012

Patients with nifedipine‐induced gingival hyperplasia (GH) often require continued calcium channel blocker therapy. Switches to diltiazem and Verapamil have been described; however, these drugs are of a different chemical class and present therapeutic limitations in some patients. The purpose of this study was to evaluate the effect on nifedipine‐induced GH of a switch to a dihydropyridine derivative with a low incidence of GH. Fourteen patients with nifedipine‐induced GH were given a medical exam and a periodontal exam. The following parameters were assessed: probing depth (PD), gingival margin (GM), gingival thickness (GT), plaque index (PI), and gingival index (Gl). Intraoral photographs, study models, and a gingival biopsy for histological examination were taken. Following baseline measures, patients were randomized to continued treatment with nifedipine or an equivalent dose of isradipine in a singleblind fashion. Biweekly periodontal parameters were taken for 8 weeks. At the end of 8 weeks, some patients elected to receive 4 weeks of open label isradipine therapy, with biweekly examination continuing through the open label phase. The isradipine treatment arm showed a mean decrease in PD of 0.59 mm at week 8 (P < 0.05). No other measured parameter (GM, GT, PI, GI) was significantly changed, compared either to baseline or to the alternate treatment arm. Clinically, 60% of patients treated with isradipine exhibited a decrease in hyperplasia, while 66% of patients treated with nifedipine demonstrated an increase in hyperplasia, a significant difference (P < 0.05). When combined with open label data, patients switching therapy to isradipine exhibited an increase in GM (increase in recession) of 0.74 mm from baseline to week 12 (P < 0.05). No patients treated with isradipine exhibited an increase in gingival overgrowth. All patients exhibited adequate control of hypertension. We conclude that in hypertensive patients with nifedipine‐induced GH, switching hypertensive therapy to isradipine may result in a regression of GH. When coupled with aggressive oral hygiene treatment, this drug may provide a reasonable option for patients requiring dihydropyridine treatment. J Periodontol 1997;68:645–650.
Subgingival Microbiota in Adult Chinese: Prevalence and Relation to Periodontal Disease Progression
Authors: Papapanou Panos N. , Baelum Vibeke , Luan Wen‐Min , Madianos Phoebus N. , Chen Xia , Fejerskov Ole , Dahlén Gunnar
Published: March 2012

The “checkerboard” dna‐dna hybridization technology was used to study the epidemiology of 18 microbial species associated with various states of periodontal health and disease, in a sample of 148 Chinese subjects never exposed to systematic dental therapeutic intervention, aged 30 to 39 and 50 to 59 years. Our aims were to: 1) describe the prevalence of these microorganisms; 2) correlate the microbiological and clinical profiles of the subjects; and 3) examine the association between the microbiological variables and the longitudinal changes of periodontal status that occurred over a preceding 10‐year period. A maximum of 14 subgingival samples were obtained from each subject—1,864 in all. The frequency of occurrence of the 18 species examined was high in this Chinese population, on both the subject and the tooth site level. However, all species were not found equally capable of reaching high numbers in the subgingival samples and, as a rule, colonized heavily only limited proportions of tooth sites within each mouth. There was a profound increase of certain species such as Porphyromonas gingivalis, Treponema denticola, and Bacteroides forsythus in deep pockets or progressing sites. Multivariate techniques using the subgingival profile could effectively discriminate between deep/shallow pockets and progressing/stable tooth sites. The microbiological variables showed an enhanced discriminating potential when classifications were performed on the individual subject level. Colonization by P. gingivalis, B. forsythus, Campylobacter rectus, and T. denticola at levels exceeding certain thresholds entailed a significantly increased probability (odds ratios >4) for an individual subject to harbor deep pockets or progressing tooth sites. J Periodontol 1997;68:651–666.
Comparison of a Bioabsorbable GTR Barrier to a Non‐Absorbable Barrier in Treating Human Class II Furcation Defects. A Multi‐Center Parallel Design Randomized Single‐Blind Trial
Authors: Garrett Steven , Polson Alan M. , Stoller Norman H. , Drisko Connie L. , Caton Jack G. , Harrold Charles Q. , Bogle Gary , Greenwell Henry , Lowenguth Roxanne A. , Duke Susan P. , DeRouen Timothy A.
Published: March 2012

This multi‐center single‐blind study compared clinical outcomes following guided tissue regeneration (GTR) treating human Class II furcation defects with a new polylactic‐acid‐based bioabsorbable barrier (test treatment) or a non‐absorbable ePTFE barrier (control treatment). Clinical parameters evaluated were change in vertical attachment level (VAL), horizontal attachment level (HAL), probing depth (PD), and gingival margin location (REC). Surgical treatment resulted in clinically and statistically equivalent changes when comparisons were made between test and control treatments. VAL gain was 2.0 mm for test and 1.6 mm for control groups; HAL gain was 2.1 mm for both test and control groups. PD reduction was 2.3 mm for the test group and 2.1 mm for the control group. Test sites experienced an additional 0.3 mm of recession beyond baseline; control sites, 0.5 mm. Within‐group comparisons showed that the amount of recession was not significantly different from baseline in the test group. Recession in the control group was significantly different from baseline. All other parameters in both the test and control groups were significantly different from baseline. Evaluation of safety data indicated no significant differences between test and control treatments, although there was a strong trend for the control group to have more postoperative abscess or suppuration than test sites (control = 11; test = 4; P = 0.06). J Periodontol 1997;68:667–675.
Prevalence of Amlodipine‐Related Gingival Hyperplasia
Authors: Jorgensen Michael G.
Published: March 2012

Calcium channel blockers are known to contribute to gingival hyperplasia. The vast majority of reports discuss patients taking the drug nifedipine. During the past few years a newer calcium channel blocker, amlodipine, has been used with increasing frequency. To date, six cases have been published indicating that amlodipine may also promote gingival hyperplasia; however, no data have been reported regarding the prevalence of this phenomenon. The purpose of this study was to examine a large group of patients taking amlodipine and determine the prevalence of gingival hyperplasia. One hundred fifty dentate patients who had been taking amlodipine, 5 mg per day for at least 6 months, volunteered to undergo a screening examination for gingival hyperplasia. Mild hyperplasia (<1/3 clinical crown) was found in five patients—a prevalence of 3.3%. This is significantly less (P <.001) than rates reported for patients taking nifedipine, and not significantly different from rates previously reported in control groups of cardiac patients not taking calcium channel blockers. The results from this group of patients indicated that amlodipine, 5 mg per day, did not induce gingival hyperplasia. J Periodontol 1997;68:676–678.