bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of Actinobacillus actinomycetemcomitans by Gold Immunolabeling and Scanning Electron Microscopy
Authors: Carrassi A. , Soligo D. , Vogel G. , Lambertenghi‐Deliliers G. , Zambon J.J.
Published: March 2012

Recent evidence suggests that dental plaque is not a homogeneous bacterial mass but, on the contrary, specific bacterial morphotypes and species may be preferentially located within certain microenvironments. The aim of the present study was to develop combined gold immunolabeling and scanning electron microscopic (SEM) techniques for the identification of periodontal pathogens in subgingival dental plaque and on the root surfaces of extracted teeth. Suspensions of pure A. actinomycetemcomitans cultures or suspensions of A. actinomycetemcomitans mixed together with other oral bacteria were prepared, labeled with goat anti‐rabbit IgG conjugated with 5 nm or 40 nm colloidal gold particles, and observed by SEM using both secondary and back‐scattered imaging. Scanning electron microscopy demonstrated that the A. actinomycetemcomitans bacterial cell surface was specifically labelled. There was no cross‐reaction with any of the other bacterial morphotypes. Only the labeled A. actinomycetemcomitans were visible in mixtures examined by back‐scattered imaging scanning electron microscopy. The combined techniques of gold immunolabeling and SEM may, therefore, be useful in identifying A. actinomycetemcomitans in subgingival plaque samples and on the root surfaces of extracted teeth as well as in studies of bacterial ecology in dental plaque, in general. J Periodontol 1990; 61:249‐253.
Antibody to Collagen Type I in Gingival Crevicular Fluid
Authors: Refaie A. , Anuksaksathiem O. , Singh G. , Moran J. , Dolby A. E.
Published: March 2012

Gingival crevice fluid (gcf) was collected from inflamed sites in 20 patients before and 6 weeks after treatment. Levels of IgG to human collagen Type I were measured in the GCF and autologous serum using an enzyme‐linked immunosorbent assay and compared with levels in control sera. IgG antibody to collagen was detected in GCF at significantly (P < 0.01) higher levels than in control sera, but these levels were not significantly (P > 0.05) different from those in autologous sera. The levels of IgG antibody in GCF and autologous sera did not alter significantly (P > 0.05) after treatment. IgG antibody to collagen Type I is present in GCF in the diseased and healing state. J Periodontol 1990;60:289–292.
The Use of Collagen Membrane Barriers in Conjunction With Combined Demineralized Bone‐Collagen Gel Implants in Human Infrabony Defects
Authors: Blumenthal Neil , Steinberg June
Published: March 2012

The present study evaluated the clinical efficacy of a combined graft of autolysed antigen‐extracted allogeneic (AAA) bone and microfibrillar collagen (Zyderm) covered with a resorbable collagen membrane in human infrabony defects. The results were compared at 1 year with debrided controls, AAA bone grafts alone, combined AAA bone‐collagen grafts (without membrane), and debrided defects covered only with collagen membranes. Ten adult patients having moderate periodontitis and one or more radiographically detectable angular defects probing 6 mm to 7 mm in each quadrant were included. Preoperative measurements of clinical attachment, probing depth, and recession were taken and compared at 1 year following surgery. Measurements at the time of surgery and at 1 year re‐entry evaluated osseous defect fill and crestal changes. Each patient received the 5 treatment modalities. Treatment results per patient were used for a series of 2‐way analyses of variance. When a significant difference was found, a Student‐Newman‐Keuls multiple range test was used to determine which treatments were statistically different (0.05 probability level) from each other. All treatment modalities showed improvement over the debrided controls. Similar advantages to using bonecollagen grafts with and without membranes were found in reducing probing depths and gaining new attachment. Significant differences were found when comparing the multifaceted bone graft collagen‐membrane technique to all others in achieving superior defect fill. Ninety three percent of all defects treated resulted in 50% or greater fill. J Periodontol 1990;61:319–327.
Human Gingival Langerhans Cells Stimulate Allogeneic Lymphocytes: Requirement for MHC Class II Antigens
Authors: Walsh Laurence J. , Seymour Gregory J. , Powell Robin N.
Published: March 2012

Langerhans cells (LC) are antigen‐presenting cells which express high levels of Class II MHC antigens on their plasma membranes. While the expression of these antigens on gingival LC has been documented, their functional significance is unclear. In this study, the mixed epithelial cell‐lymphocyte culture reaction (MECLR) between stimulator cells (LC) and allogenic lymphocytes was used as an in vitro model for investigating the role of the MHC Class II antigens HLA‐DR, ‐DQ, and ‐DP in alloantigen presentation by gingival LC. In epithelial cell suspensions prepared from human gingiva, MHC Class II antigen expression (HLA‐DR, ‐DP, ‐DQ) was confined to CD1a‐positive LC. Depletion of Class II antigen‐bearing LC from epithelial cells using monoclonal antibodies (L243, B7/21, and SK10) and complement inhibited the ability of epithelial cells to stimulate proliferation in the MECLR. Pre‐treatment of epithelial cell suspensions with the same monoclonal antibodies suppressed proliferation in the MECLR, as did direct addition of these antibodies to co‐cultures of epithelial cells and lymphocytes. These results indicate that HLA‐DQ and ‐DP, together with DR antigens on gingival LC, are involved in LC‐lymphocyte interactions. Since LC are potent antigen presenting cells, alterations in the expression of MHC Class II antigens on the surface of these cells will influence their ability to stimulate lymphocytes during the initiation of the cellular immune response to the accumulation of dental plaque.J Periodontol 1990;61:328–333.
Effects of Airpolishing on Dental Plaque Removal and Hard Tissues as Evaluated by Scanning Electron Microscopy
Authors: Kontturi‐Närhi Vuokko , Markkanen Seppo , Markkanen Helena
Published: March 2012

The effect of an air‐powder abrasive system on dental hard tissues was tested on 20 volunteers. Impressions of 150 randomly selected areas were taken before and after airpolishing and positive replicas were prepared for scanning electron microscopic examination (SEM). The amount of dental plaque on tooth surfaces was reduced by the treatment (P < 0.001). The abrasive changes caused by airpolishing on enamel were greater on the surfaces covered by dental plaque before the airpolishing compared to the surfaces without plaque (P < 0.01). The enamel and cemental surfaces were more abraded after the treatment compared with the initial condition. Despite the effectiveness of the dental airpolishing technique, the negative aspects should be considered in the decision to use airpolishing in routine prophylaxis, especially in patients with root surfaces exposed to the oral cavity. J Periodontol 1990;61:334–338.
Relationship of Gingival Bleeding, Gingival Suppuration, and Supragingival Plaque to Attachment Loss
Authors: Kaldahl Wayne B. , Kalkwarf Kenneth L. , Patil Kashinath D. , Molvar Michael P.
Published: March 2012

This study evaluated the relationship between the presence of gingival bleeding, gingival suppuration, and supragingival plaque at 3 month appointments to the incidence of probing attachment loss during a 2‐year period of maintenance therapy. The data included in this report were taken during the second and third year of maintenance from 75 periodontal patients who had previously received active therapy in an ongoing longitudinal study. The diagnostic sensitivity, specificity, and positive and negative predictive values were calculated for different frequencies of positive responses for each clinical parameter in relation to sites demonstrating ≥ 2 mm probing attachment loss. Gingival bleeding and plaque were not prognosticators and gingival suppuration was a weak prognosticator of attachment loss during a 2 year maintenance period. J Periodontol 1990;61:347–351.
Effect of 6 Months Use of a Dentifrice and Oral Rinse Containing Sanguinaria Extract and Zinc Chloride Upon the Microflora of the Dental Plaque and Oral Soft Tissues
Authors: Harper D. Scott , Mueller Laura J. , Fine James B. , Gordon Jeffrey , Laste Larry L.
Published: March 2012

This study documented the effect upon the oral flora of twice daily brushing with a dentifrice containing 0.075% sanguinaria extract and 2% zinc chloride, followed by use of a mouthrinse containing 0.03% sanguinaria extract and 0.2% zinc chloride. Sixty subjects were randomly assigned to treatment or placebo groups and monitored in a 6month double‐blind clinical trial. Bacteriological samples from the tongue, buccal mucosa, and supra‐ and subgingival plaque were characterized at 0, 14, and 28 weeks. Microbiological monitoring showed no increases in populations of yeast, staphylococci, coliform organisms, or Pseudomonas. Total Gram‐negative counts in supragingival plaque samples decreased 83% in the active group compared to a 232% increase for the control group. Populations of B. intermedius in supragingival plaque were significantly lower in the active group at 3 months and significantly lower counts of Fusobacterium sp. were observed at 3 and 6 months. Results indicate that use of the test products did not promote opportunistic overgrowth of pathogens in the oral flora. Additionally, the alterations in organisms associated with gingivitis may account for reductions in gingivitis seen in the active group. J Periodontol 1990;61:359‐363.
Comparative Clinical Study of Porous Hydroxyapatite and Decalcified Freeze‐Dried Bone in Human Periodontal Defects
Authors: Oreamuno Silvia , Lekovic Vojislav , Kenney E. Barrie , Carranza Fermin A. , Takei Henry H. , Prokic Boris
Published: March 2012

Interproximal bony defects were treated with either porous hydroxyapatite (PHA) or decalcified freeze‐dried bone allograft (DFDB) implants at two different clinical centers. Twelve paired defects in 12 patients were treated at each center. Six months postsurgically the defects were measured to assess changes from the presurgical status. No statistically significant differences were found between the groups in changes in gingival fluid, bleeding index, plaque index, or tooth mobility. The porous hydroxyapatite implant produced greater reduction in pocket depth (P = 0.03) and more gain in clinical attachment level (P = 0.001) and defect fill (P = 0.001) when compared with DFDB grafted sites. This study indicates that more clinical resolution of interproximal periodontal defects in humans can be obtained with the use of PHA than with the use of DFDB. J Periodontol 1990;61:399–404.
Neurofibroma of the Palatal Mucosa. A Case Report
Authors: Pollack Ralph P.
Published: March 2012

Neurofibromas have not been reported in the periodontal literature. In this case report, a 27‐year‐old female presented with a complaint of a lump in the maxillary left palatal tissue; periodontal evaluation revealed a mass 15 x 8 x 4 mm on the palatal mucosa. After removal, the region healed without recurrence. The patient was referred to her physician for a physical, and no evidence of neurofibromatosis was found elsewhere, suggesting that this case represented an example of an isolated oral neurofibroma lesion. J Periodontol 1990;61:456–458.
The Effects of Scaling a Titanium Implant Surface With Metal and Plastic Instruments: An in Vitro Study
Authors: Fox Steven C. , Moriarty John D. , Kusy Robert P.
Published: March 2012

The surface roughnesses of pure titanium implants were compared after scaling in vitro with curettes of dissimilar composition. Each of 10 transmucosal implant extensions (TIEs) was divided into three experimental surfaces and an untreated control surface. The three experimental surfaces were instrumented with either a titanium‐alloy tipped curette, a curette of stainless steel, or a plastic curette. All experimental surfaces received 30 strokes with the designated curette within a 2 mm wide area. Alteration of the surfaces due to instrumentation was evaluated by a helium neon (HeNe) laser and reported as relative specular reflectance (RSR). Scanning electron microscopy (SEM) confirmed the quantitative HeNe laser results. A significant decrease in mean RSR (greater roughness) was observed for surfaces treated by metal curettes compared to either untreated control surfaces (P < 0.01) or surfaces treated by the plastic curette (P < 0.01). No statistically significant difference was noted between untreated surfaces and those treated by the plastic curette. The titanium‐alloy curette produced a significantly lower mean RSR (greater roughness) compared to those surfaces treated by the stainless steel curette (P < 0.05). In summary, plastic instruments produced an insignificant alteration of the titanium implant surface following instrumentation, while metal instruments significantly altered the titanium surface. J Periodontol 1990; 61:485–490.
Inhibition of Attachment of Human Gingival Fibroblast‐Like Cells in Vitro by Saliva and Salivary‐Sulfated Glycoprotein in the Presence of Serum
Authors: Heaney T. G.
Published: March 2012

We have previously shown that human whole saliva and a high molecular weight sulfated glycoprotein (SGP) salivary component inhibits attachment of human gingival fibroblast‐like cells to plastic substrata in serum‐free conditions. The purpose of this study was to investigate the influence of saliva on attachment of these cells to tissue culture plastic in the presence of serum. Individual wells of multiwell dishes were coated with either sterile whole saliva or SGP, sequentially with fetal bovine serum followed by saliva or SGP, sequentially with the latter agents applied in the reverse order, with mixtures of saliva and serum or SGP and serum. Washed wells were seeded with 1.0 x 105 fibroblasts in α‐MEM and numbers of adhering cells determined after 30 minutes. Saliva or SGP inhibited cell adherence as previously reported. Cell adherence in wells treated sequentially with saliva or SGP followed by serum, or with the latter followed by the salivary agents, was reduced significantly compared with that in untreated control wells. Wells treated with mixtures of serum and saliva or SGP exhibited progressive reduction in numbers of adhering cells as the concentration of the salivary agents increased. Significant suppression of attachment compared with controls also occurred when cells in α‐MEM containing 15% serum were plated onto saliva‐ or SGP‐treated wells. These results are consistent with the hypothesis that adsorbed salivary glycoprotein may bring about periodontal wound healing by repair rather than by regeneration by inhibiting fibroblast attachment to root surfaces in vivo. J Periodontol 1990; 61:504– 509.
A Quantitative Analysis of the Migration, Attachment, and Orientation of Human Gingival Fibroblasts to Human Dental Root Surfaces in vitro
Authors: Fardal O. , Lowenberg B. F.
Published: March 2012

The purpose of this study was to assess the migration, attachment, and orientation of human gingival fibroblasts to human dental roots over a period of 21 days in vitro. The fibroblasts were incubated with a total of 120 periodontally diseased and non‐diseased root slices (200 μm thickness) which had been treated in the following manner: 1) Root planed diseased root (DT); 2) Root planed and citric acid demineralized diseased root (DTD); 3) Non‐treated diseased root (DNT); 4) Citric acid demineralized diseased root (DNTD); 5) Non‐diseased control (ND); 6) Citric acid demineralized non‐diseased root (CA); 7) Citric acid and collagenase digested non‐diseased root (CAC); 8) EDTA demineralized non‐diseased root (E); and 9) EDTA‐demineralized and collagenase‐digested non‐diseased root (EC). The results showed that the most active phase of cell attachment and orientation occurred during the first 10 days of the experiment. Statistical differences were observed between the variables, and, in terms of cell attachment and orientation to the root slices, it was concluded that: 1) Root planing improves diseased roots; 2) Acid demineralization subsequent to root planing improved diseased roots to such an extent as to render them comparable to non‐diseased roots; 3) Citric acid demineralization alone improved diseased roots to the same extent as root planed diseased roots; 4) The exposure of collagen fibrils resulting from acid demineralization of the roots is not the sole reason for the improvement of the root surface, but rather a combination of the exposed collagen fibrils with the creation of a more hospitable environment was found to be responsible. J Periodontol 1990;61:529–535.
Susceptibility of Oral Bacteria to Phenoxyethanol and Phenoxyethanol/ Chlorhexidine Combinations
Authors: Wilson M. , Bansal G. , Stanley A. , Newman H.N.
Published: March 2012

A total of 57 bacterial strains (26 different species) which may be isolated from subgingival plaque were tested for their in vitro susceptibility to phenoxyethanol, a commonly‐used antiseptic and preservative. Ninety‐five percent of the strains, including those associated with chronic inflammatory periodontal disease, were susceptible to concentrations of phenoxyethanol used topically (2% w/v). Phenoxyethanol at a concentration of 1% (w/v) was also found to have a rapid bactericidal effect achieving a 99.9% kill in 5 minutes or less for species such as Bacteroides gingivalis, Fusobacterium nucleatum, Eikenella corrodens, and Wolinella recta. Addition of Chlorhexidine to phenoxyethanol resulted in a mixture with increased antibacterial activity. For most bacterial strains, the presence of Chlorhexidine resulted in at least a four‐fold decrease in the concentration of phenoxyethanol required for inhibition of growth. These results imply that phenoxyethanol may be useful in the treatment of chronic inflammatory periodontal disease either by itself or in combination with Chlorhexidine. J Periodontol 1990; 61:536– 541.
The Retrocuspid Papilla of the Mandibular Lingual Gingiva
Authors: Buchner Amos , Merrell Phillip W. , Hansen Louis S. , Leider Alan S.
Published: March 2012

The retrocuspid papilla (rcp) is a circumscribed nodule that lies lingual to the mandibular cuspid on the gingival tissue. RCP is observed more frequently in young children and seems to regress or disappear with age. Little information is available in the literature on this entity and there are contradictory reports regarding its histologic features. Histomorphologic analysis of 30 specimens diagnosed as RCP revealed that in most cases (80%) it is composed of loosely‐arranged delicate fibrous connective tissue with stellate and multinucleated fibroblasts. Elongation of the rete ridges and/or increased vascularity are also present in a significant number of cases. Stellate and multinucleated fibroblasts are not unique to RCP and they have been described as prominent histologic features in other lesions of skin and mucous membrane. RCP is considered to be a “normal anatomical structure” or an “anatomic variation” of the gingiva. The clinical significance of RCP is that it may simulate pathological gingival conditions from which it must be differentiated. J Periodontol 1990; 61:586–590.
Generalized Juvenile Periodontitis: Report of a Familial Case Followed for 5 Years
Authors: Sbordone Ludovico , Ramaglia Luca , Bucci Eduardo
Published: March 2012

The case of a family, followed for 5 years and showing an exceptionally high prevalence of Generalized Juvenile periodontitis (GJP), is presented. Two siblings were affected by a severe form of GJP meanwhile the dycorial twin of one was periodontally healthy. Both the affected siblings showed infection by Actinobacillus actinomycetemcomitans (Aa), but only one presented a reduced Chemotaxis of the peripheral PMNs. The dycorial twin consistently displayed a freedom from Aa and a reduction in the peripheral PMNs Chemotaxis. The extraction of the compromised teeth in the two affected siblings has been followed by colonization of new sites by Aa; only repeated administration of systemic tetracyclines seems to protect the subjects from colonization of other sites. These findings may contribute to the understanding of the etiology, pathogenesis, and therapy of juvenile periodontitis. J Periodontol 1990;61:590–596.
Computerized Densitometric Analysis of Interproximal Bone Levels in a Controlled Clinical Study into the Treatment of Periodontal Bone Defects With Ceramic Hydroxyapatite Implant Material
Authors: Galgut P. N. , Verrier J. , Waite I.M. , Linney A. , Cornick D.E.R.
Published: March 2012

The aim of this controlled clinical study was to utilize computer‐assisted densitometric analysis of radiographs to assess the effectiveness of treating periodontal osseous defects with a sintered hydroxyapatite implant material. It was found that over the 2year period of the study for the osseous defects treated by the implant material, there was a gain in the height of the hard tissue relative to the cemento‐enamel junction; this gain was statistically significant compared with the results for the control sites. J Periodontol 1991; 62:44–50.
Angioedema as a Complication in Periodontal Surgery: Report of a Case
Authors: Peacock Mark E. , Brennan William A. , Strong Scott L. , Prior Robert F. , O'Neal Robert B. , Van Dyke Thomas E.
Published: March 2012

Angioedema is a diffuse swelling of the subcutaneous or submucosal tissues that occurs in both hereditary and non‐hereditary forms. It can be a temporarily disfiguring condition, but not usually a serious one unless the airway is compromised. In the majority of cases, no underlying cause can be identified. In this report, a case of “idiopafhic” angioedema that occurred while performing a periodontal surgical procedure is presented. This case is interesting because the patient was on long‐term use of an angiotensinconverting enzyme [ACE] inhibitor for hypertension, and recent evidence has shown that ACE inhibitors suppress the breakdown of circulating bradykinins. With high plasma levels of bradykinins, a local anesthetic, periodontal surgical procedures, or even emotional stress may trigger an attack of angioedema. Practitioners should be aware of the pharmacologic side effects of ACE inhibitors and be prepared to handle an emergency if a patient's airway becomes compromised. J Periodontol 1991;62:643–645.
Determining the Value of a Periodontal Diagnostic Test
Authors: Douglass Chester W. , Fox Christopher H.
Published: March 2012

The purpose of this analysis is to present a method to determine the value of diagnostic tests for evidence of bacterial activity related to periodontal disease. Five population studies are discussed: 1) screening the general population; 2) screening the patients of a general practice; 3) diagnosing initial patients referred to a periodontist; 4) monitoring periodontal maintenance patients; and 5) monitoring postsurgical refractory patients. A decision tree is constructed in which the primary decision branches are test and no test. Chance branches after the test branch were test positive and test negative. The treatment alternatives in the treatment branches were prophylaxis and oral hygiene, scaling and root planing, and advanced periodontal therapy (including surgical intervention and/or antibiotics or chemotherapies). Probabilities for the prevalence of disease in each population were obtained from epidemiological surveys. Disease activity and outcome states were estimated from clinical studies of periodontal treatment. For initial periodontal patients, using a sensitivity of.87 and a specificity of.84 the value of the test branch is.851 versus.566 for the no test branch. Assumptions on the diagnostic test's sensitivity and specificity and the utility of outcomes were tested with the decision analysis techniques of sensitivity and 2‐way threshold analyses. These analyses show that using a test had a greater value than no test for older patients in the general practitioner's office, and for the 3 types of periodontal treatment patients. In contrast, using the test had a lower value than not using the test in younger dental patients in the general practitioner's office and for screening the general population. The diagnostic and treatment schemes proposed here are amenable to rigorous testing to evaluate their reliability and usefulness. J Periodontol 1991; 62:721‐730.
The Histological Investigation of Gingiva From Patients With Chronic Renal Failure, Renal Transplants, and Periodontitis: A Light and Electron Microscopic Study
Authors: Yamalik Nermin , Delilbasi Lale , Gülay Hüseyin , Caglayan Feriha , Haberal Mehmet , Caglayan Güurhan
Published: March 2012

The clinical and histological appearance of gingiva was evaluated in renal transplant recipients (RTR) receiving immunosuppressive drugs, in patients with chronic renal failure (CRF) undergoing hemodialysis, and systemically healthy individuals with periodontitis. Although the amount of bacterial plaque accumulation was similar among the groups (P >0.05), the gingival inflammation was significantly less in RTR when compared to the other 2 groups (P <0.05). In light microscopic investigation the overall appearance of the connective tissue was similar in all of the groups. A mononuclear cell infiltration was present in all of the specimens; however, the number of inflammatory cells in patients with periodontitis was significantly higher than the other 2 groups (P <0.05). Prominent epithelial changes in the superficial layers of the oral epithelium; i.e., areas showing desquamation‐like appearance, were noticed in patients with CRF. In electron microscopic investigation, fibroblasts and plasma cells with well‐developed granular endoplasmic reticulum were found in connective tissue in RTR patients. In patients with CRF, epithelial cells presented swollen granular endoplasmic reticulum cisternae resembling vacuoles, indicating the presence of degeneration. It was suggested that with the use of immunosuppressive drugs the response to bacterial plaque did not diminish completely. J Periodontol 1991; 62:737‐744.
No Female Preponderance in Juvenile Periodontitis After Correction for Ascertainment Bias
Authors: Hart Thomas C. , Marazita Mary L. , Schenkein Harvey A. , Brooh Carol N. , Gunsolley John G. , Diehl Scott R.
Published: March 2012

Juvenile periodontitis (JP) is generally recognized to exist in 2 clinical forms: localized and generalized. Historically, females have been reported to be affected by both forms of JP at rates of 2 to 10 times greater than males. However, evidence suggests that females are more likely than males to seek dental care. If this is true, females will be diagnosed with JP more often than males even if juvenile periodontitis is equally prevalent among males and females in the general population. Thus, previous reports of a female predominance for JP may simply reflect this selection bias. The purpose of this study was to test our hypothesis that juvenile periodontitis occurs with equal frequency in males and females after correcting for selection bias. Twenty‐four juvenile periodontitis probands were ascertained from the VCU/MCV dental clinics. The families of these individuals were examined to determine the relative prevalence of JP among male and female relatives of these probands. Our results indicate that while females are 3 times more likely than males to be initially ascertained as juvenile periodontitis probands, among relatives of probands the proportion of affected males and females is equal. J Periodontol 1991; 62:745–749.
The Relationship Between Probing Attachment Loss and Computerized Radiographic Analysis in Monitoring Progression of Periodontitis
Authors: Deas David E. , Pasquali Lee A. , Yuan Cheng H. , Kornman Kenneth S.
Published: March 2012

This study attempted to evaluate quantitative changes in radiographic density as an indicator of progression of periodontitis. Twenty‐one subjects with a history of periodontitis were monitored at baseline, 3, 6, and 9 months using duplicate probing attachment level (PAL) measurements from Stents and computer assisted densitometric image analysis (CADIA) of standardized radiographs. Results indicate that the majority of sites exhibited no PAL change during the 9‐month period; however, the percentage of sites with loss increased with time. A mean of 6.1% of the sites/patient exhibited probing attachment loss during the study, as compared to a mean of 38.3% of the sites/patient that exhibited a loss of radiographic density. Due to the two dimensional nature of radiographs, density analysis was calculated in terms of radiographic “complexes” of multiple probing sites. There was significantly more density loss at complexes with ≥ 2 mm of attachment loss than at sites with no change in PAL at 9 months; there was no such difference noted at 3 and 6 months. Also, density loss tended to increase as more sites within each complex experienced PAL. Although there was a significant correlation between mean density and PAL changes during the same time interval, there were wide variations at individual sites. This study suggests that there is a complex relationship between density change on radiographs and PAL change. The difficulties inherent in comparing highly sensitive new technologies to relatively imprecise clinical measurements of the attachment level are discussed. Future studies should attempt to clarify the relationships between techniques that assess hard tissue and soft tissue changes in the periodontium and determine the clinical significance of the sensitive detection of radiographic density changes. J Periodontol 1991;62:135–141.
Bacterial Sampling by Absorbent Paper Points. An in vitro Study
Authors: Baker Pamela J. , Butler Rondi , Wikesjö Ulf M. E.
Published: March 2012

This in vitro study was designed to test the hypothesis that sampling of bacterial suspensions by absorbent paper points would accurately reflect the proportion of the bacterial species whether they are homogeneously or non‐homogeneously distributed in the sample site. The non‐homogeneously distributed populations consisted of equal numbers of colony forming units (CFU) of two periodontal bacterial species present as separate cultures, one layered on top of the other. The species in the top layer accounted for greater than 90% of the total number of CFU detected by paper point sampling, regardless of which species formed the top layer. In contrast, when the layers were mixed prior to sampling to give a homogeneous bacterial distribution, the paper points detected equal numbers of CFU of each species. Thus the hypothesis was not supported and the proportions yielded by paper point sampling are not the same when the bacteria are nonhomogeneously distributed as when they are homogeneously distributed. Ultrastructural observations have documented a non‐homogeneous distribution of bacterial species in periodontal pockets. If the specific microbiota in the apical portion of deep periodontal pockets are important to the periodontal disease process, these data suggest that bacterial samples obtained by absorbent paper points misrepresent the presence of such bacterial species. J Periodontol 1991;62:142–146.
Periodontal Repair in Dogs: Effect of Root Surface Treatment With Stannous Fluoride or Citric Acid on Root Resorption
Authors: Wikesjö Ulf M. E. , Claffey Noel , Nilvéus Rolf , Egelberg Jan
Published: March 2012

This study evaluated healing, with emphasis on root resorption, following root surface treatment with 1% aqueous stannous fluoride (SnF2), saturated citric acid (CA), or saline control (C) in conjunction with periodontal flap surgery. Supraalveolar periodontal defects were surgically created and immediately treated in the mandibular premolare in 6 beagle dogs. The defect height approximated 5 to 6 mm from the reduced alveolar bone to the cemento‐enamel junction. Root treatments were rotated between experimental teeth within jaw quadrants and duplicated in left and right quadrants in the dogs. Flaps were raised to cover most of the crowns of the teeth and sutured. The dogs were sacrificed 12 weeks after surgery and tissue blocks with teeth and adjacent structures were processed for histometric analysis. SnF2‐treated teeth healed with significantly longer junctional epithelium, less connective tissue repair to the root surface, and less bone regeneration than CA and C‐treated teeth. New cementum formation was limited in all treatment groups. Root resorption was observed in almost all teeth exhibiting connective tissue repair, however to a lesser amount and not as frequent in SnF2 treated teeth due to limited connective tissue repair. No differences were found in amount and frequency of root resorption in CA and C‐treated teeth. An inhibitory effect on root resorption of SnF2 could not be disclosed in this experiment, however, it may be concluded that CA treatment of the root surface in conjunction with reconstructive periodontal flap surgery does not seem to enhance root resorption. J Periodontol 1991; 62:180–184.
IgG Antibody Response of Localized Juvenile Periodontitis Patients to the 29 Kilodalton Outer Membrane Protein of Actinobacillus actinomycetemcomitans
Authors: Wilson Mark E.
Published: March 2012

Levels of serum IgG antibody to the 29 kilodalton outer membrane protein of A. actinomycetemcomitans Y4 in sera of periodontally healthy subjects and localized juvenile periodontitis patients were determined using an enzyme‐linked immunosorbent assay (ELISA). The 29 kDa protein was isolated by solubilization of an octylglucoside‐NaCl insoluble fraction by incubation at ambient temperature in 20 mM sodium phosphate, pH 7.5, containing 1% sodium dodecyl sulfate. The isolated protein migrated on SDSpolyacrylamide gels with an apparent molecular mass of 29 kDa following incubation in sample buffer at ambient temperature. However, the protein migrated with an apparent molecular mass of 34 kDa following incubation in sample buffer at 100° C for 10 minutes. Geometric mean IgG antibody titers to the 29 kDa protein were significantly higher in sera from LJP subjects than in sera obtained from periodontally healthy subjects. Twentytwo of 35 LJP sera (63%) had antibody titers > 2 standard deviations from the mean titer of the periodontally healthy group. Among LJP subjects, elevated antibody titers to the 29 kDa protein were found primarily in subjects ≥ 18 years of age, with the highest titers seen in patients 18 to 21 years of age. The results of this study indicate that the humoral response of LJP subjects to A. actinomycetemcomitans includes the production of IgG antibodies which recognize the major outer membrane proteins of this organism. J Periodontal 1991; 62:211–218.
Effects of Metronidazole on Periodontal Treatment Needs
Authors: Loesche Walter J. , Schmidt Edgar , Smith Billy A. , Morrison Edith C. , Caffesse Raul , Hujoel Philippe P.
Published: March 2012

Periodontitis, a common cause of tooth loss in adult populations, is an inflammatory response to the overgrowth of anaerobic organisms such as spirochetes and bacteroides and, in some cases, micro‐aerophilic organisms in the subgingival plaque. In the present investigation, using a double‐blind clinical design, we sought to determine whether 1 week of metronidazole treatment plus debridement of the tooth surfaces was superior to 1 week of placebo treatment plus debridement (positive control) in reducing the subsequent amount of periodontal surgery given to the patients. Thirty‐nine patients were randomly assigned to either the metronidazole or placebo (positive control) groups. All patients were given the necessary scaling and root planing and were unsupervised in their usage of the medication. After the completion of this treatment, they were reexamined and it was found that the metronidazole regimen caused a significant reduction in surgical needs of about 5 teeth per patient compared to the positive control (difference before and after treatment 8.3 ± 6.8 teeth metronidazole versus 2.9 ± 4.8 positive control, P = 0.007). The difference between groups was maintained during the 2 to 3 years' recall period. Metronidazole had a significant effect on the site specific reduction of spirochetes: 90% of the sites in the metronidazole group versus 64% in the positivecontrol group had a decrease in the percentage of spirochetes (P < 0.05). We conclude that systemic metronidazole given 250 mg tid for 7 days in conjunction with debridement of the tooth surfaces can significantly reduce the need for periodontal surgery compared to the standard regimen which included only debridement. J Periodontol; 1991; 62:247– 257.
Periodontal Repair in Dogs: Healing in Experimentally Created Chronic Periodontal Defects
Authors: Wikesjö Ulf M. E. , Selvig Knut A. , Zimmerman Grenith , Nilvéus Rolf
Published: March 2012

A need exists for well‐defined animal models to objectively evaluate surgical principles and a possible role for biochemical wound conditioning and biomaterials in promoting periodontal regeneration. To test an existing model for its usefulness in quantitative evaluation of periodontal wound healing, large supraalveolar periodontal defects were surgically created around the mandibular premolars (P2, P3, P4) in left or right jaw quadrants in 5 beagle dogs. The defects were exposed to the oral environment for 6 months and were then subjected to reconstructive flap surgery (chronic defects). Healing in these defects was compared to healing following reconstructive surgery in similar contralateral defects which had not been exposed to plaque and calculus (acute defects). The animals were sacrificed after a 4‐week healing period and tissue blocks including teeth and surrounding structures were processed for histometric analysis. Mean defect height (± s.d.) for chronic and acute defects amounted to 4.6 ± 0.3 and 4.4 ± 0.4 mm, respectively. Mean connective tissue repair to the root surface in chronic defects amounted to 62% (range 49% to 74%) of the defect height. Mean connective tissue repair in the acute defects exceeded 94% of the defect height in 4 of the dogs, but amounted to only 48% in 1 dog. Regeneration of alveolar bone and cementum was limited under both experimental conditions. Root resorption was frequently encountered, whereas ankylosis was seen in only few teeth. This study indicates that healing may vary not only as a result of controlled experimental variables, but also due to differences in biological response between dogs or to fortuitous traumatic factors. The variability in healing in the chronic defects imposes limitations on the use of this defect model to study periodontal regeneration, especially when a small number of animals is used. J Periodontol 1991; 62:258–263.
Periodontal Findings in Adult Twins
Authors: Michalowicz Bryan S. , Aeppli Dorothee , Virag John G. , Klump David G. , Hinrichs E. , Segal Nancy L. , Bouchard Thomas J. , Pihlstrom Bruce L.
Published: March 2012

Gingivitis and periodontitis are among the most common diseases known to man. Although bacterial plaque is generally accepted as the primary etiologic agent, little information is available concerning the influence that host genetic factors have on these diseases. The purpose of the present study was to examine the relative contribution of environmental and host genetic factors to clinical measures of periodontal disease through the study of both reared‐together twins and monozygous twins reared apart. Probing depth, clinical attachment loss, gingivitis, and plaque were assessed from the Ramfjord teeth in 110 pairs of adult twins (mean age 40.3 years), including 63 monozygous and 33 dizygous twin pairs reared together and 14 monozygous twin pairs reared apart. Bootstrap sampling was used to estimate and provide confidence limits of between‐pair and within‐pair variances, intraclass correlations and heritability. Based on ratios of within‐pair variances or heritability estimates, a significant (P<0.05) genetic component was identified for gingivitis, probing depth, attachment loss and plaque. Heritability estimates indicated that between 38% to 82% of the population variance for these periodontal measures of disease may be attributed to genetic factors. While there is general agreement that bacteria are important in the pathogenesis of the periodontal diseases, future etiologic studies should consider the role of host genetic influences. J Periodontol 1991; 62:293–299.
Risk Indicators for Future Clinical Attachment Loss in Adult Periodontitis. Patient Variables
Authors: Grbic John T. , Lamster Ira B. , Celenti Romanita S. , Fine James B.
Published: March 2012

We studied patient‐derived variables to identify individuals at risk for future clinical attachment loss (CAL). Seventy‐five patients with chronic adult periodontitis were followed for 6 months and clinical and epidemiological parameters collected at baseline were related to CAL. Clinical parameters were obtained from 6 sites per tooth and wholemouth averages were calculated. Epidemiologic parameters were obtained by questionnaire and interview. After the baseline examination, patients were treated with root planing and scaling. Thirty‐one patients (41.3%) demonstrated ≥ 1 site with CAL of ≥ 2.5 mm, while 16 patients (21.3%) demonstrated CAL at ≥ 2 sites. Epidemiological factors such as gender, health status, marital status, education, and occupation were not associated with CAL. In contrast, baseline mean attachment level, age, baseline mean probing depth, baseline mean recession, percentage of sites exhibiting bleeding on probing, and the number of missing teeth were related to CAL. Using logistic modelling, we found that baseline attachment level was the primary risk indicator for post‐treatment CAL. Nineteen percent of the patients with baseline attachment levels < 4.0 mm, 50% of the patients with 4.0 to 4.9 mm, and 85% (P <.005) of the patients with ≥ 5.0 mm exhibited CAL. The age of the patient was also a major risk indicator for CAL, and was independent of baseline attachment levels. Eighty‐nine percent of the 60 to 69 year old patients demonstrated CAL, compared to only 35% of patients between the ages of 30 and 59 (P ≤.005). In summary, patients with existing severe periodontal disease and patients over the age of 60 years were at greatest risk for periodontal breakdown after root planing and scaling. J Periodontol 1991; 62:322–329.
The Prevalence and Sex Ratio of Juvenile Periodontitis in a Young Racially Mixed Population
Authors: Melvin W. Lee , Sandifer Johnny B. , Gray Jonathan L.
Published: March 2012

The need to accurately determine the prevalence of a disease is important especially in establishing treatment needs for particular population groups. Reported prevalences for juvenile periodontitis (JP) have varied from less than 0.1% to 17%. The use of overall prevalence values to determine treatment needs in populations which include various ethnic groups is not reliable since there is evidence that the prevalence in different groups is unequal. The purpose of this study was to determine the prevalence and sex ratio of JP in a large group of military recruits and to compare these values between the different racial populations. Thirty‐eight cases of JP were diagnosed from a group of 5,013 young male and female recruits of varying ethnic origin. The overall prevalence was 0.76% and the femalermale ratio 1.1:1.0. These findings raise questions as to the continued quotation of a female:male ratio of 3:1, and provide additional evidence for an overall ratio closer to 1:1. In addition, prevalences of JP varied considerably between racial groups. Blacks had a much higher JP prevalence (2.1%) than Caucasians (0.09%). Black males had a higher prevalence (3.81%) than black females (1.99%). For black recruits the F:M ratio was 0.52:1. For Caucasian recruits the F:M trend is opposite (4.3:1), although the number of cases diagnosed in the Caucasian group was too low to compute a true ratio. The data support studies which show that in the blacks, the disease is less prevalent in females than in males. Caution must be exercised in interpreting results in any study in which the sample population is not categorized. J Periodontol 1991; 62:330‐334.
Clinical Evaluation of Guided Tissue Regeneration in the Treatment of Maxillary Class II Molar Furcation Invasions
Authors: Metzler David G. , Seamons Braden C. , Mellonig James T. , Gher Marlin E. , Gray Jonathan L.
Published: March 2012

This investigation assessed and compared the clinical efficacy of combined open flap debridement/occlusive membrane therapy versus open flap debridement therapy alone, in the treatment of maxillary periodontal furcation defects. Seventeen patients presenting with advanced adult periodontitis, including at least one pair of Class II maxillary furcal defects, comprised the study group. Following completion of a hygienic phase of treatment, measurements were made with calibrated periodontal probes to determine soft tissue recession, probing pocket depths, and attachment levels. Each pair of furcation defects was surgically exposed and hard tissue measurements obtained. Defects were treated with either open flap debridement and a polytetrafluoroethylene periodontal membrane or open flap debridement alone. Membranes were removed at 4 to 6 weeks. Six months postsurgery, soft tissue measurements were repeated and all sites were surgically re‐entered to obtain hard tissue measurements. No statistically significant differences were found in recession, probing depth reductions, clinical attachment gains, or resorption of alveolar crest height between test and control groups. Results for these parameters were inconsistent and unpredictable. Statistically significant improvements were found, however, in horizontal open probing attachment (HOPA) and vertical open probing attachment (VOPA) between experimental and control sites. The GTR procedure as used in this study likely has limited application as a therapeutic modality for Class II furcations of maxillary molars. Modifications or improvements in the procedure may result in more predictable healing of these lesions. J Periodontol 1991; 62:353–360.
Dentinal Tubule Occlusion and Root Hypersensitivity
Authors: Kerns David G. , Scheidt Michael J. , Pashley David H. , Horner Jack A. , Strong Scott L. , Van Dyke Thomas E.
Published: March 2012

Previous studies have established that root sensitivity is due in part to open dentinal tubules at the root surface. The purpose of this study was to longitudinally evaluate the occlusion of dentinal tubules by various clinical procedures including scaling and root planing and the application of potassium Oxalate. A model was developed to evaluate dentinal surfaces in vivo. Six 2 mm x 3 mm sections were taken from the roots of extracted teeth immediately below the CEJ. One half of the treated dentin samples from each donor was incorporated into the removable denture worn by the donor and the other half served as baseline. The dentin samples were evaluated at 1 week by scanning electron microscopy. At day zero no open tubules were observed in any of the samples due to the presence of a smear layer or Oxalate crystals. Evaluation of root planed samples revealed that by 7 days the tubules had re‐opened. The samples which had been treated with potassium Oxalate showed few Oxalate crystals by 7 days revealing open tubules. Control samples were etched with EDTA and evaluated in the same manner. Although the number of tubules did not significantly change in the EDTA etched control samples, the diameter of the tubules dramatically decreased by 4 weeks. It can be concluded that the creation of a smear layer or application of Oxalates to occlude dentinal tubules to reduce sensitivity are relatively short‐lived. These procedures may provide patient comfort prior to natural occlusion of the tubules. J Periodontol 1991; 62:421–428.