bluuebunny/crossref_metadata_2025 huggingface dataset:
The Further Localization of Antibody on Cemental Tissue
Authors: Everhart Donald L. , Dahab Omnia , Wolff Larry , Stahl S. Sigmund
Published: March 2012

In order to increase our understanding of the immunologic aspects of periodontal disease, three groups of extracted human teeth were evaluated for the presence of antibody on the cementum surface. Antibody was demonstrated by direct immunofluorescence using monospecific antibody with human α, γ and μ chain activity. The cemental surfaces of teeth with no clinical evidence of periodontal disease or teeth with gingivitis demonstrated no antibody. On the other hand, teeth involved with severe periodontal disease demonstrated positive fluorescence on root surfaces within the pockets, indicating the presence of antibody. No fluorescence was seen below the deepest point of the pocket. Furthermore, we have been studying a component recovered from the surface of teeth exposed to a periodontal pocket. Inhibition studies between serum antibody, extracted antigen and the antigen and antibody on the tooth surface suggest that we are dealing with the same antigen‐antibody complex in all cases.
The Effect of Metronidazole on Established Gingivitis and Plaque in Beagle Dogs
Authors: Heijl Lars , Lindhe Jan
Published: March 2012

This investigation compared metronidazole (Flagyl®) therapy and mechanical debridement for their effect on established plaque and gingivitis in seven female beagle dogs showing signs of advanced loss of periodontal tissue support. A phase of breakdown of the supporting structures was induced by installation of copper bands, subsequently replaced by cotton floss ligatures in the premolar and molar regions of the dentition. After 60 days the ligatures were removed but plaque and calculus were allowed to accumulate for the remaining 30 days of a preexperimental period. During the experimental period five dogs (test group) were given metronidazole systemically each day for 56 days. The teeth of the other two dogs (control group) were carefully scaled with curettes and the tooth surfaces polished. The mechanical debridement was repeated after 2 and 4 weeks. The control dogs were also subjected to daily tooth brushing. Clinical examination, collection of subgingival plaque and biopsy sampling were carried out on experimental Days 0, 14, 28 and 56. The result demonstrated that systemic administration of metronidazole in dogs with long‐standing gingivitis and advanced loss of alveolar bone and attachment, markedly altered the composition of the microbiota of the periodontal pockets and reduced the size of the connective tissue infiltrate in the gingiva. However, although the size of the connective tissue infiltrate was reduced, clinical parameters describing the degree of gingivitis (Gingival Index, Gingival Exudate) were not influenced by metronidazole therapy. Mechanical debridement followed by daily toothbrushing resulted in low Plaque and Gingival Index scores and in the establishment of a normal, noninfiltrated gingiva. The mechanical approach to treatment was superior to the drug therapy.
Immunopathology of Periodontal Disease. II. Immunofluorescent Studies on the Localized Immune Response in Periodontitis and Juvenile Periodontitis
Authors: Gebhard John D. , Newman Joseph T. , Matthews J. Lester , Hurt William C. , Stone Marvin J.
Published: March 2012

Local immunologic responses were studied in eleven patients with periodontitis, ten patients with juvenile periodontitis, and ten control subjects by performing immunofluorescence on gingival biopsies. F(ab′)2 monospecific conjugates to human IgG, IgM, IgA, IgD, and kappa and lambda light chains were used as well as monospecific conjugates to human IgE and properdin. Biopsies from patients with juvenile periodontitis displayed a more intensified immunologic response as evidenced by increases of (1) positive cells stained with a F(ab′)2 antihuman Immunoglobulin conjugate; (2) IgG, IgM, and kappa and lambda containing cells; (3) extracellular fluorescence of IgG, IgM, IgA, and kappa and lambda light chains; and (4) properdin deposition. Neither IgD nor IgE conjugates reacted significantly with biopsies from the three patient groups. These findings support our previous conclusion that immunologic responses in periodontitis and juvenile periodontitis appear qualitatively similar, but that patients with juvenile periodontitis exhibit a more intense immune response.
Histometric Comparison of Active and Inactive Lesions of Advanced Periodontitis
Authors: Davenport Robert H. , Simpson David M. , Hassell Thomas M.
Published: March 2012

This study examined the histopathologic features of advanced periodontitis lesions tentatively classified as active or inactive by the selected clinical criteria of bleeding or bleeding and suppuration within 15 seconds of probing or the absence thereof. The Gingival Index, Plaque Index, and pocket fluid flow also were assessed. From 12 human subjects, a total of nine bleeding and five nonbleeding periodontitis lesions were obtained. The biopsies consisted of an extracted tooth and the portion of attached soft tissue which formed the pocket wall at the location where the clinical evaluation was performed. The soft tissue included the entire pocket and junctional epithelia as well as the adjacent normal and infiltrated connective tissue (ICT) and oral epithelium. Major histologic differences were found between the two lesion types. Morphometric point counting using grid intersections revealed that the mean percentage of ICT was consistently much larger in bleeding (55.1 ± (5.1) than in nonbleeding lesions (30.5 ± 7.8). In comparing the composition of the ICT of the two lesion types, significant differences were found between the mean percent volume occupied by plasma cells (68% versus 24%), mononuclear cells (5.5% versus 22%), and extracellular space/connective tissue (18% versus 48%) in the bleeding versus nonbleeding lesions. Nonsignificant differences were present in the volume occupied by polymorphonuclear leukocytes, unidentifiable cells, and vessels in the two lesion types. The pocket epithelium of bleeding lesions consistently demonstrated thinned or ulcerated areas and long, tortuous strands of rete pegs extending deep into the ICT. While showing definite regional variations in polymorphonuclear and mononuclear leukocyte infiltration, the pocket and junctional epithelia of bleeding lesions always contained greater numbers of leukocytes. Bleeding or bleeding combined with suppuration upon probing is therefore indicative of characteristic histopathologic changes in lesions of advanced inflammatory periodontal disease. These changes may relate to the state of activity or inactivity of the disease process in the advanced lesion.
Comparison of Hypertonic Saline and Chlorhexidine Mouthrinses After the Inverse Bevel Flap Procedure
Authors: Newman P. S. , Addy M.
Published: March 2012

The value of periodontal dressings after periodontal surgery has been questioned. This study further evaluated chlorhexidine as a possible alternative. A group of nine patients requiring comparable bilateral inverse bevel flap procedures underwent preoperative oral hygiene instruction and scaling. Immediately before surgery and up to 3 months postoperatively, clinical records of plaque index, pocket depths and sulcus bleeding index were made. Records were taken of patients' postoperative discomfort and preferences. During the 1st postoperative week either a 0.2% chlorhexidine gluconate or a 1% saline mouthrinse was prescribed.

Plaque accumulation and sulcus bleeding were significantly reduced on the sides treated with chlorhexidine. Significant reductions in pocket depths were recorded for both groups but there were no differences between treatments.

Less postoperative discomfort was experienced with chlorhexidine, although the difference was not significant. Five patients preferred chlorhexidine, one saline, and three had no preferences. These and previous results suggest that a periodontal dressing is unnecessary or even undesirable after the inverse bevel flap procedure, and may be usefully replaced by a suitable antiplaque agent.
Salivary IgA in Periodontal Disease
Authors: Güven Orhan , De Visscher Jan G.A.M.
Published: March 2012

Unstimulated, whole‐salivary immunoglobulin A (IgA) was investigated by the multiple radial diffusion technique (MRD). IgA was detected in all salivary samples examined. Higher levels of IgA were observed in whole saliva collected from patients with gingival and periodontal diseases. These values were compared to normal salivary samples. There was a positive correlation between the severity of gingival and periodontal inflammation and IgA concentrations.
Maintenance of Healed Periodontal Pockets After a Single Episode of Root Planing
Authors: Caton J. , Proye M. , Polson A.
Published: March 2012

The present study evaluated the clinical stability of healed periodontal pockets over a 3 month time period to determine whether this time interval is appropriate for periodontal maintenance therapy. The clinical characteristics of 128 pockets (3–7 mm depth) distributed in 10 patients, were monitored immediately before and 4, 8 and 16 weeks after a single episode of subgingival root planing. The clinical parameters measured were: pocket depth and bleeding after probing with 15, 25 and 50 gm and manual probing, gingival margin location, clinical attachment level, and gingival and plaque indices. Oral hygiene instruction and supragingival cleaning were given at each time point. An average aggregated score for each subject and for each parameter was calculated at each time point. A repeated measure all within analysis of variance was done, and the Tukey multiple range test was used to assess the significance of differences among and between the means. The significant decreases in plaque, gingival and bleeding indices, and pocket depth as well as the significant gingival recession and gain of clinical attachment which were present at the 4 week point were maintained at 8 and 16 weeks after root planing. It was concluded that the favorable clinical changes which occur in periodontal pockets within 1 month after a single episode of subgingival root planing combined with improved oral hygiene can be maintained for an additional 3 month time period.
Effects of Sterilization on Periodontal Instruments
Authors: Parkes Roger B. , Kolstad Robert A.
Published: March 2012

The sharpness of surgical instruments is of particular importance to the periodontist. In order to study the effects of sterilization on the cutting edges of periodontal curets and sealers, new sharpened instruments were sterilized 10 cycles with saturated steam, formalin‐alcohol vapor or dry heat. The instruments were evaluated before and after sterilization with a scanning electron microscope. No visual damage to the cutting edges of stainless steel instruments was evident after sterilization by saturated steam at 250°F, formalin‐alcohol vapor at 270°F or dry heat up to 340°F. Carbon steel instruments were not damaged by formalin‐alcohol vapor at 270°F or dry heat up to 340°F. Saturated steam caused oxidation and dulling of carbon steel instruments.
Material Adherent to Probes During a Periodontal Examination: Light and Electron Microscopic Observations
Authors: Barnett M. L. , Baker R. L. , Olson J. W.
Published: March 2012

The material adherent to a periodontal probe during the examination of deep periodontal pockets was studied with light and electron microscopy. Most of the specimens contained bacteria with a morphology which has been associated with a pathogenic flora. The findings suggest that periodontal probes may have the potential of transmitting pathogenic bacteria from involved sites to other sites in the mouth, although it remains to be demonstrated that this will result in actual implantation of the organisms at the new sites.
Artificial Periodontal Defects in Beagle Dogs: A Clinical Evaluation During 24 Months
Authors: van Dijk L. J. , Jansen J. , Pilot T. , van der Weele L. Th.
Published: March 2012

Artificial periodontal defects were evaluated clinically for 24 months in six beagle dogs. Defects were created bilaterally around the lower second, third and fourth premolars. The gingiva was separated from the teeth by intrasulcular incisions and copper bands were cemented around the teeth as far apically as possible. After 3 weeks the bands were replaced by cotton ligatures, which were kept in place deep subgingivally for 11 weeks. The dogs were placed on a soft diet, allowing plaque accumulation throughout the study. One week after removal of the ligatures, probing depths of around 4.5 mm were recorded. During the evaluation period of 24 months, plaque accumulation was abundant and subsequently the gingiva was heavily inflamed. However, a distinct healing tendency was evident clinically. Two years after removal of the ligatures, probing depth was reduced to approximately 3.5 mm and the attachment level as assessed clinically had changed in a coronal direction. Part of this recorded increase in periodontal attachment may have been the result of changes in composition and condition of the periodontal tissues resulting in differences in probing depths.
Robert Neumann: A Pioneer In Periodontal Flap Surgery
Authors: Gold Steven I.
Published: March 2012

The contributions of Robert Neumann to the development of periodontal flap surgery are acknowledged. Neumann, born in 1882 was the leader of the Berlin group of dentists who advocated “the radical surgical treatment of pyorrhea”. This approach was widely reported in European journals and sometimes referred to as the “Neumann operation”. A biographical sketch and detailed descriptions of his operative procedures are included. Some of the historical background surrounding the priority question in the development of flap surgery is outlined.
Observations on Temperature and Temperature Patterns of the Gingiva: I. The Effect of Arch, Region and Health
Authors: Holthuis A. F. , Chebib F. S.
Published: March 2012

The purpose of this investigation was to study the pattern and constancy of temperatures recorded in the gingival crevices and some factors affecting them. The temperatures of the interproximal crevices in the maxillary and mandibular arch of 16 female dental hygiene students were evaluated at the time of examination, immediately afterwards and following a 14‐day interval. The temperature difference between each site and the subject's sublingual temperature were calculated. In the analysis, a comparison of sites with a confirmed status of bleeding tendency and pocket depth was carried out. The results show temperature differences between arches (mandible vs maxilla) and regions (posterior vs anterior). The differences are independent of the health status. Inflamed gingiva generally has a higher temperature than clinically healthy gingiva. There is an indication that healthy tissue, more than inflamed tissue, reacts to an outside stimulus with an increase in temperature. It is necessary that environmental and stimulative factors are strictly controlled if temperature gradients are to be applied for diagnostic purposes in periodontics.
Squamous Odontogenic Tumor: A Lesion of the Periodontium
Authors: Cataldo Edmund , Less William C. , Giunta John L.
Published: March 2012

The squamous odontogenic tumor (SOT) is a benign lesion of the periodontium most probably arising from the rests of Malassez. Most lesions are solitary tumors but multiple lesions may occur. There is equal distribution in the jaws with the posterior mandible and anterior maxilla, the most common sites. The majority of patients are under age 32 and there is no sex predilection. Radiographically the usual appearance is a triangular or semicircular radiolucency of alveolar bone with sclerotic and/or scalloped margins. Clinical findings include sensitivity of teeth, mobility and movement of teeth and deep pocket formation. The maxillary lesions tend to be more aggressive than those of the mandible, and extensive resection may be required. In most cases, however, conservative surgery appears adequate. The histopathologic findings are now clearly delineated so that the SOT should not be confused with ameloblastoma or epidermoid carcinoma.
Chronic Mucogingival Defects in Miniature Swine
Authors: Kalkwarf Kenneth L. , Krejci Robert F. , Berry Wesley C.
Published: March 2012

Controversy surrounds the importance of keratinized gingiva in maintaining periodontal health. A well‐defined animal model system is necessary to evaluate longitudinally the role of keratinized gingiva when plaque control is inadequate or where dental procedures (restorative, prosthetic or orthodontic) alter the periodontal environment. Facial gingiva was excised from eight primary incisors in miniature swine. Contralateral teeth were used as controls. The experimental teeth exhibited mucogingival defects at 3 and 6 month observation periods. The secondary teeth erupting into the experimental regions also exhibited recession and chronic mucogingival defects. The marginal tissue in regions devoid of keratinized gingiva demonstrated clinical signs of inflammation. No progressive gingival recession was present. Excision of keratinized gingiva to produce mucogingival defects in swine provides a convenient model system for evaluating the effect of dental procedures on periodontal health where little or no keratinized gingiva is present.
The Formation and Healing of Osseous Lesions in a Patient With Localized Juvenile Periodontitis: Case Report
Authors: Barnett M. L. , Baker R. L.
Published: March 2012

A case is presented of a 12‐year‐old female with localized juvenile periodontitis. Both the progression of the lesions from about the time of onset and the healing of the lesions following treatment are documented with radiographs over a 3‐year period. In addition, a radiolucent‐radiopaque area, resembling a calcifying supernumerary tooth, developed at the site of one of the lesions during the period of observation.
Healing Following Implantation of Healthy Roots, With and Without Periodontal Ligament Tissue, in the Oral Mucosa
Authors: López Néstor J. , Belvederessi Mario
Published: March 2012

This investigation, involving 44 patients, studied the physiological interactions of human dentine and cementum with the connective tissue of the oral mucosa by means of 26 autogenous implants of root fragments without periodontal ligament, and 18 implants with periodontal ligament. The implants together with the adjacent tissues were removed between the 3rd and 26th week after implantation. The implants without periodontal ligament failed to form cementum or bone‐like tissue and in the 26th week they still showed resorption. Ten implants with periodontal ligament showed deposition of cementum with collagen fibers attached to it after the 12th week. The formation of new attachment with new cementum deposition on the dentine or on the old cementum could be ascribed to the influence of cells of the remaining periodontal ligament on the implanted root fragments.
Root Surface Smoothness or Roughness in Periodontal Treatment: A Clinical Study
Authors: Khatiblou Farokh A. , Ghodssi A.
Published: March 2012

Twelve patients with localized advanced periodontitis were selected for this study. The 18 teeth used were divided into experimental and control groups. In both groups the loss of attachment and pocket depth were measured and modified Widman flap surgery was performed. In the experimental group, after root planing, a number of shallow horizontal grooves were made on the root surface to roughen them. Four months after surgery the same measurements were made. The results indicated that in both groups the pocket reduction and the gain of attachment were statistically significant. The differences between the two groups, as far as pocket reduction and gain of attachment are concerned, were not significant.
Ultrastructural Study of New Connective Tissue Attachment Following Phosphoric Acid Application on Human Root Dentin
Authors: Heritier M.
Published: March 2012

The present study was undertaken to verify whether acid conditioning of the root surface can promote new connective tissue attachment in man.

A flap was raised over two maxillary central incisors, with 6‐mm pockets, which had to be extracted in a 72‐year‐old woman. Following root planing, a rectangular area was delineated by a groove on the buccal surface of the teeth. Inside these limits, cementum was removed and the denuded dentin was etched with a 50% gelified phosphoric acid solution (pH, 1.3) for 1 minute and the flap was repositioned. Forty‐two days later, the experimental teeth were extracted, and undecalcified specimens were prepared routinely for transmission electron microscopy.

Results showed that new connective tissue attachment had occurred between healing connective tissues and acid‐treated dentin surface, with functionally oriented Sharpey's fibers. The mechanism of new connective tissue attachment could be observed as a typical cementum crystallites deposition on a denuded dentin matrix coupled with an active collagen fibrils synthesis. This process resulted in the incorporation of fibers into the new superficial layer of cementoïd tissue.
Histologic Study of a Freeze‐Dried Skin Allograft in a Human: A Case Report
Authors: Mishkin David J. , Shelley L. R. , Neville Brad W.
Published: March 2012

Histologic examination at 6 weeks of a freeze‐dried skin (FDS) allograft used to treat a mucogingival defect in the human revealed a striking prominence of elastic fibers within the graft, when compared to the adjacent gingiva and alveolar mucosa. This finding suggests that these fibers were retained from the donor material. The absence of a significant inflammatory infiltrate and the clinically normal healing that was observed indicates that FDS allografts are biocompatible with human oral tissue.
Current Status of Periodontal Dressings
Authors: Sachs H. A. , Famoush A. , Checchi L. , Joseph C. E.
Published: March 2012

A comprehensive review of periodontal dressings is presented. The rationale for the application of dressings, their advantages and disadvantages are described. Tissue reactions to dressings and the therapeutic and adverse effects of antimicrobial agents used in dressings are discussed. The present status and value of a surgical dressing is critically assessed in view of recent studies which indicate that the routine use of dressings in postsurgical care may be either unnecessary or undesirable.
Clinical Evaluation of the Effectiveness of Three Dentifrices in Relieving Dentin Sensitivity
Authors: Collins J. F. , Perkins Laura
Published: March 2012

It has been reported that sensitive dentin is present in no less than one out of seven normal patients with a higher incidence among postperiodontal therapy patients. Numerous agents have been developed to relieve this sensitivity without any being universally acceptable. Two new dentifrices, Protect and Protect with fluoride were compared clinically with Sensodyne to determine the relative ability of these three products to relieve both thermal and tactile sensitivity in sensitive dentin. Double blind analyses were completed and results compared using appropriate statistical tests for each hypothesis tested. The three dentifrices relieved both tactile and thermal sensitivity, but there was no statistical difference at 8 weeks between the three agents. There was a difference in the time it took the dentifrices to achieve a statistically significant reduction in dentin sensitivity.
Effects of Gold Salts on Experimental Periodontitis: II. Cell Population Characteristics
Authors: Polson Alan M. , Novak M. John , Freeman Eric
Published: March 2012

A previous study showed that the systemic administration of soluble gold salts (gold sodium thiomalate) resulted in significantly less periodontal destruction after 2 weeks of experimentally induced periodontitis. In order to provide information on the possible mechanisms of action of gold salts in the experimental periodontitis situation, the present study analyzed and compared the characteristics of the inflammatory cell populations in animals receiving gold salts with those present in animals which had not received gold salts. Maxillary gingival biopsy specimens were obtained from the buccal aspect of ligatured teeth after 2 weeks of experimental periodontitis. Cell populations were characterized and enumerated, on 1‐micron sections, in an epithelial and superficial connective tissue zone, and a deep connective tissue zone. Significantly fewer inflammatory cells were present in experimental (gold receiving) specimens, and this reduction was due primarily to fewer polymorphonuclear leucocytes (PMNs). No significant reduction occurred in any other inflammatory cell‐type. The reduction in number of PMNs in experimental specimens was associated with a decreased number of morphologically altered, degenerating fibroblasts in the connective tissue compared to the PMN‐dominated lesion of control specimens. Mechanisms whereby gold salts can reduce Chemotaxis and functional capabilities of inflammatory cells are discussed.
The Acro‐Osteolysis (Hadju‐Cheney) Syndrome: Review of the Literature and Report of a Case
Authors: Allen Carl M. , Claman Lewis , Feldman Randy
Published: March 2012

Acro‐osteolysis (hadju‐cheney) syndrome is a rare disorder of bone metabolism characterized by progressive destruction of the distal phalangeal bone, curvature of the spine, aplasia of the facial sinuses, and persistence of the cranial sutures. The purpose of this manuscript is to focus on the description of the oro‐facial and dental manifestations of the disorder.
Caries Levels in Patients With Juvenile Periodontitis
Authors: Fine D. H. , Goldberg D. , Karol R.
Published: March 2012

The degree and distribution of tooth decay in a group of juvenile periodontitis (JP) patients were compared with tooth decay in an age‐ and sex‐matched periodontally normal control group. The experimental group was comprised of 13 patients of no more than 20 years of age who were designated as localized juvenile periodontitis patients (LJP) according to the definition of Baer, and 10 patients of no more than 25 years of age who were designated as generalized juvenile periodontitis patients (GJP), as described by Manson and Lehner. Twenty‐three age‐ and sex‐matched patients with no periodontal disease served as the control group. Caries was evaluated by standard clinical and radiographic criteria and quantitated by decayed, missing, filled teeth and surfaces (DMFS). Decay was further categorized as active proximal decay and as total proximal decay, which included both active proximal caries and restored proximal surfaces.

A Student's t test revealed no statistical differences between the LJP and GJP groups. Moreover, there was no difference in the number of missing or filled teeth in the JP group as compared to the control group. However, 17 of the 23 JP patients had no proximal decay, whereas all but two of the 23 control patients had some proximal decay. Moreover, in the JP group (LJP and GJP) the mean values for active proximal decay and total proximal decay were both significantly lower than those in the control group (P < 0.001). Thus, a low number of proximal carious lesions were found in the presence of juvenile periodontitis. Furthermore, this unusual pattern of proximal dental disease was significantly different from that of the matched control group. The bacteriologic and immunologic significance of these findings deserves further attention.
The Effects of Topical Steroidal and Systemic Nonsteroidal Anti‐Inflammatory Drugs on Experimental Gingivitis in Man
Authors: Vogel Richard I. , Copper Stephen A. , Schneider Lawrence G. , Goteiner David
Published: March 2012

Retrospective studies in man and prospective studies in animals have indicated that systemically administered anti‐inflammatory drugs may decrease plaque‐induced inflammation and loss of attachment. The purpose of the present double blind study was to determine the effects of a systemically administered nonsteroidal anti‐inflammatory drug and a topically applied steroidal anti‐inflammatory drug on experimentally produced gingivitis. Eighteen dental students were brought to a state of optimal gingival health and then divided into three groups. One group received placebo gel to apply topically and placebo capsules. A second group received placebo gel and capsules containing sulindac, a nonsteroidal anti‐inflammatory drug. The third group received a topical steroidal gel and placebo capsules. All subjects refrained from home care for 22 days in the maxillary right quadrant. Results of the study indicate that the topical steroidal drug significantly inhibited gingival inflammation while the systemically administered nonsteroidal drug had no apparent effect.
Natural Killer (NK) Cell Activity Against Human Gingival Fibroblasts Exposed to Dental Plaque Extracts
Authors: Seymour Gregory J. , Horwood Brad W. , Aaskov John , Powell Robin N.
Published: March 2012

Natural killer (nr) cell activity against plaque pretreated human gingival fibroblasts and against the erythroblastoid cell line K562 also pretreated with plaque extract was studied. Supra‐ and subgingival plaque was collected and extracts prepared by sonication for 10 to 15 minutes at room temperature. The erythroblastoid cell line K.562 was given in RPMI (1640) medium, and served as the control. Gingival fibroblasts were grown from an expiant of human gingiva. The K562 cells and gingival fibroblasts were incubated in subcytotoxic doses of both supra‐ and subgingival plaque for 18 hours prior to the NK cell assay in serum free medium. Pretreatment of the K.562 cells with both supra‐ and subgingival plaque was found to reduce NK cell activity. On the other hand pretreatment of the human gingival fibroblasts with plaque extracts seemed to increase their sensitivity to NK cell activity. This suggests that the plaque pretreatment leads to a cytopathic change in the fibroblasts making them more sensitive to NK cell activity, or alternatively that by binding to target cells, plaque modulates the ability of NK cells to bind to, and kill these cells. Nevertheless, these results indicate that NK cell activity could play a role in tissue destruction in chronic inflammatory periodontal disease.
Revascularization Following a Combined Gingival Flap‐Split Thickness Flap Procedure in Monkeys
Authors: Kon Simao , Caffesse Raul G. , Castelli Walter A. , Nasjleti Carlos E.
Published: March 2012

A combined technique (gingival flap‐split thickness flap) was performed in monkeys. The clinical, histological and microvascular aspects of healing were studied, mainly focusing on the gingival flap, since some of the vessels supplying this area were severed during the second phase of the procedure. The animals were perfused with a combined solution of Pelikan carbon black and 10% formalin solution and killed from 1 to 35 days postoperatively. Cleared specimens and regular histology were obtained. It was concluded that: (1) the remaining periosteal vessels and surrounding structures provided enough nutrition for the survival of the gingival flap, (2) the microvascularization was normal at the 14 days postoperative period in both the gingival flap and the apically positioned split areas and (3) the exposed connective tissue remained narrow and exhibited an irregular vascular arrangement throughout the experiment.
Dextran Penetration Through Nonkeratinized and Keratinized Epithelia in Monkeys
Authors: Nasjleti Carlos E. , Caffesse Raul G.
Published: March 2012

The purpose of this study was to determine if polysaccharide dextrans would pass through intact‐nonkeratinized and induced‐keratinized sulcular epithelia in monkeys. Dextran penetration through normally keratinized oral gingival epithelium also was evaluated in the same gingival specimens. Each of three Rhesus monkeys received a thorough prophylaxis 1 week prior to the experiment. During this week, the monkeys also received daily IV injections of Achromycin. After the antibiotic treatment, the teeth were polished and cleaned with a rubber cup using prophylactic paste for 2 consecutive months, as follows: (1) the right maxillary and mandibular teeth received daily prophylaxes on weekdays and (2) the left maxillary and mandibular teeth received one prophylaxis weekly. These frequencies of plaque removal on one‐half of the mouth maintained clinically healthy gingiva and produced keratinization of the sulcular epithelium. At the end of the 2‐month prophylaxes, a 5% solution of dextrans derived from Leuconostoc mesenteroides was applied topically to the gingiva once daily for 3 consecutive weeks. During this time, the monkeys continued having dental prophylaxes following the previous time schedule. The study showed that inducedkeratinized sulcular epithelium as well as normally keratinized oral gingival epithelium resisted penetration of dextrans, whereas intact‐nonkeratinized sulcular epithelium apparently lacked a surface layer resistant to penetration.
Clinical Manifestations of Hypervitaminosis A in Human Gingiva: A Case Report
Authors: de Menezes A. C. , Costa I. M. , El‐Guindy M. M.
Published: March 2012

Periodontal inflammation caused by excessive doses of vitamin A was studied in a patient who had taken 200,000 international units daily for more than 6 months. Clinical manifestations of the disease disappeared when the use of vitamin A was interrupted. The role of vitamin A as a factor in periodontal inflammation is discussed.
Histopathological and Ultrastructural Findings in a Case of Papillon‐Lefèvre Syndrome
Authors: Sloan P. , Soames J. V. , Murray J. J. , Jenkins W. M. M.
Published: March 2012

Gingiva from a 3‐year‐old iranian boy suffering from Papillon‐Lefèvre syndrome was examined by light and electron microscopy. Deep pockets associated with predominantly Gram‐negative plaque were present. The gingival lesion was dominated by plasma cells, many of which were degenerate. Russell bodies were a prominent feature. No defect of epithelium was detected.
Dentin Permeability: Effects of Desensitizing Dentifrices in Vitro
Authors: Pashley D. H. , O'Meara J. A. , Kepler E. E. , Galloway S. E. , Thompson S. M. , Stewart F. P.
Published: March 2012

Patients using placebo dentifrices in clinical trials usually show a significant decrease in dentin sensitivity over a 2‐ to 4‐week period. If their sensitivity were due to hydrodynamic fluid movement, then the results suggest that there was a decrease in their dentin permeability. This hypothesis was tested in vitro by measuring the ease with which fluid could flow (i.e., hydraulic conductance) across dentin discs before and after brushing the discs with a variety of dentifrices, including most of the marketed desensitizing dentifrices. All dentifrices decreased the hydraulic conductance of dentin. An experimental dentifrice containing Oxalate as the active ingredient was far more effective than any of the marketed dentifrices. The results tend to support the hypothesis that, at least part of the reduction in clinical sensitivity in patients with hypersensitive dentin is due to the abrasive action of the dentifrice.
Aspartate Aminotransferase Increases in Crevicular Fluid During Experimental Periodontitis in Beagle Dogs
Authors: Chambers Donald A. , Crawford John M. , Mukherjee Sabyasachi , Cohen Rhonna L.
Published: March 2012

A ligature‐induced periodontitis model employing the beagle dog was used to study the levels of aspartate aminotransferase (AST) in crevicular fluid before and after ligation. A significant increase in AST level occurred in crevicular fluid 2 weeks after ligation whereas no increase of enzyme was found in serum. Enzyme levels in crevicular fluid were 10‐ to 100‐fold higher than in serum. Dental plaque did not appear to be the source of the enzyme. Since aspartate aminotransferase has been documented as a marker of cellular injury arising during heart disease and liver disease, this study suggests that aspartate aminotransferase, in like fashion, reflects cellular damage arising from active periodontal disease.
Dextran‐lnduced Inflammation and Its Effect on Keratinized Gingival Epithelium in Monkeys
Authors: Nasjleti Carlos E. , Caffesse Raul G. , Kowalski Charles J.
Published: March 2012

The cell population present during dextran‐induced inflammation and its effect upon induced keratinization of the sulcular epithelium was investigated in two young adult male Rhesus monkeys. Keratinization of the sulcus epithelium was induced by a combined regimen of scaling, an intravenous injection of achromycin and daily rubber cup prophylaxes. After keratinization was confirmed by means of biopsies, inflammation was induced either by injecting 200 μl of a 5% dextran saline solution or by applying the solution topically on the marginal gingiva for 2 weeks. Clinical grade dextran, molecular weight 70,000, was used. Physiologic saline solution, either injected or topical, was also used. At the same time, the daily prophylaxes were continued. After the 2 weeks, gingival biopsies were taken from each tooth treated with the different regimens. One‐half of each biopsy was routinely processed and stained with hematoxylin and eosin or Rhodamine B, while the other half was processed for and stained with alcoholic and aqueous PAS to detect dextran in tissues. Histologic evaluation was carried out in three areas: a crestal zone, a cervical zone and an oral gingival zone. An Inflammatory Index (II) was determined and the width and length of keratin were measured. Dextran, either topical or injected, produced mainly a chronic inflammatory response characterized by lymphocytes (30–35%), monocytes‐macrophages(5–10%), plasma cells (10%), polymorphonuclear leukocytes (PMNs) (15%) and unidentified cells (35%). Conversely, the physiologic saline‐induced inflammation showed PMNs (75%), lymphocytes (5%) and unidentified cells (20%). The II for injected areas was significantly higher than for those topically treated or for nontreated controls. However, the increased II did not affect the degree of keratinization achieved. The results indicate that chronic inflammation may not necessarily affect tissue keratinization if thorough removal of bacterial plaque is well maintained.
Linear Variation of the Root Surface Area of the Maxillary First Molar
Authors: Gher Marlin W. , Dunlap Robert W.
Published: March 2012

The variation of root surface area (RSA) in 1‐mm increments from the cementoenamel junction (CEJ) to the apex was determined for the maxillary first molar. Twenty extracted maxillary first molars were cross sectioned every millimeter, and each section was photographed, projected and measured with a calibrated opisometer. The RSA and percentage of RSA were calculated for each 1‐mm section. The location of furcation entrances, root separations and roofs of the furcations was also determined. Analysis of the mean measurements demonstrated that (1) the largest per cent of RSAs were found in the furcation area; (2) the mean distance from the CEJ was 3.6 mm for the mesial furcation entrance, 4.2 mm for the facial furcation entrance and 4.8 mm for the distal furcation entrance; (3) the mean distance from the CEJ to the point at which the roots separate from the root trunk was 5.0 mm for the mesiobuccal root and 5.5 mm for the distobuccal root; (4) in 11 of the 20 teeth the roof of the furcation was coronal to all root separations, forming a concave dome between roots. According to the individual and mean measurements, horizontal attachment loss of 6.0 mm or greater would have resulted in Grade III furcation involvement in all the teeth studied.
Evidence for a Junctional Epithelial Attachment to Ceramic Dental Implants
Authors: McKinney Ralph V. , Steflik David E. , Koth David L.
Published: March 2012

The interface of the crevicular gingiva with the surface of a dental implant is a critical zone representing the potential biological seal which protects the underlying bone and soft tissue‐supporting mechanisms from destructive extraneous substances. Ultrastructural examination of regenerated junctional epithelial cells interfacing surgically placed endosteal dental implants, comprised of alpha‐alumina oxide ceramic in single crystalline form, exhibited an external basal lamina and linear body located between the external surface epithelial cell and the implant. In addition, hemidesmosomes were located at intervals along the outer junctional epithelial plasma membrane. The component substructures of the basal lamina and the hemidesmosomes were similar to those seen interfacing natural teeth. The linear body was an electron‐dense structure between the lamina densa and the inert biomaterial. This study provides ultrastructural evidence for the presence of an attachment complex between gingiva and aluminum oxide implants which is analagous to that seen around natural teeth. These data support the concept that a viable biological seal can develop around endosteal dental implants and provide support for satisfactory clinical service.
The Frenectomy Combined with a Laterally Positioned Pedicle Graft: Functional and Esthetic Considerations
Authors: Miller Preston D.
Published: March 2012

In many cases it is necessary to perform a frenectomy to prevent reopening of a midline diastema following closure by orthodontic therapy. Often the loss of the interdental papilla between the maxillary incisiors during the classic frenectomy creates an unacceptable esthetic result. A surgical technique combining a frenectomy with a laterally positioned pedicle graft is presented. The interdental papilla is left surgically undisturbed if it is of physiologic size. If it is enlarged, gingivoplasty is performed to reduce it to an appropriate size. Closure across the midline by laterally positioning gingiva and healing by primary intention results in attached gingiva across the midline. This attached gingiva may have a bracing effect and thus aid in preventing orthodontic relapse (reopening of the diastema). Twenty‐seven cases were treated. No relapse was found in 24 cases and in 3 cases only minimal relapse was noted (less than 1 mm). The esthetic result is superior to that obtained with the classic frenectomy technique.
Transmission and Colonization of Actinobacillus actinomycetemcomitans in Localized Juvenile Periodontitis Patients
Authors: Christersson Lars A. , Slots Jørgen , Zambon Joseph J. , Genco Robert J.
Published: March 2012

Actinobacillus Actinomycetemcomitans is a Gram‐negative oral microorganism, which has been implicated in the etiology of localized juvenile periodontitis and in severe medical infections such as bacterial endocarditis. This study evaluated the ability of periodontal probes to transmit A actinomycetemcomitans from juvenile periodontitis lesions to healthy gingival sulci in the same patient.

Localized juvenile periodontitis patients exhibiting first molar and incisor alveolar bone loss and with large numbers of A actinomycetemcomitans in deep periodontal pockets were included in this study. A periodontal probe was inserted into periodontal pockets of 6 mm or greater depth. The probe was then placed into a healthy gingival sulcus of 3 mm or less, in the same subject. Fifty‐five transfers by probing were made and A actinomycetemcomitans in both the donor and recipient sites was assessed by a selective culture technique.

The results indicate that periodontal probes can become contaminated with A actinomycetemcomitans from juvenile periodontitis lesions during routine dental examinations and can transfer this microorganism from infected to previously uninfected sites. However, A actinomycetemcomitans inoculated into the healthy gingival sulci did not permanently colonize these sites since the organisms were eliminated within 3 weeks.
Lactate Dehydrogenase, β‐Glucuronidase and Arylsulfatase Activity in Gingival Crevicular Fluid Associated with Experimental Gingivitis in Man
Authors: Lamster Ira B. , Vogel Richard I. , Hartley Linda J. , DeGeorge Carol A. , Gordon Jeffrey M.
Published: March 2012

Experimental gingivitis provides a useful model for studying the initiation of periodontal disease in man. This study evaluated over a 4‐week period the Plaque Index (PLI), Gingival Bleeding Time Index (GBTI), and gingival crevicular fluid (GCF) for resting and flow volume as well as the concentration and total activity of three enzymes in the GCF (lactate dehydrogenase—LDH, β‐glucuronidase—BG and arylsulfatase—AS) from the maxillary right quadrant of eight subjects with healthy gingiva. After rising sharply during the 1st week, the PLI continued to increase during the 2nd week but remained constant during the 3rd and 4th weeks. The GBTI, and the resting and flow GCF volumes, increased steadily throughout the study. LDH concentration in GCF varied minimally during the experiment, while total LDH activity rose slightly over the 4‐week period. BG concentration and total activity in GCF rose steadily from baseline to the 3rd week and then either fell or leveled off during the 4th week. AS concentration in GCF rose from baseline to the 2nd or 3rd week and then fell. AS total activity in GCF rose from baseline to the 2nd week and then remained constant. These data suggest that while clinical signs of inflammation increased over the 4 weeks of the experiment, a homeostatic mechanism in the crevicular environment may control ground substance‐degrading enzyme activity during experimental gingivitis in man.
The Application of a Collagen Stabilizer to the Gingiva of the Beagle Dog
Authors: Ciancio Sebastian G. , Golub Lorne M. , Mather Maryanne L. , Bunnell Helen
Published: March 2012

The objective of this study was to determine the effect of crevicular application of a collagen stabilizer on ligature‐induced periodontal disease in beagle dogs. Fourteen male and female dogs, 15 months of age, were studied. The mandibular first molars and third and fourth premolars were ligated for 6 months and moderate periodontitis resulted. Ligatures were removed for 2 months and then replaced for an additional 3 months to experimentally mimic the episodic changes seen in human periodontal disease. Following this phase, ligatures were removed and the animals were assigned to a placebo or treatment group. Medications were then applied intracrevicularly, three times a week over 5 months using an IMAX irrigator. Clinical indices measured were plaque index (PI), gingival index (GI), gingival crevicular fluid flow (GCF), attachment level (AL), pocket depth (PD) and standardized radiographic analysis of alveolar bone height. While overall changes in PI, GI and GCF were not significant, the results showed that alveolar bone regeneration was increased approximately twice as much in the treatment group as compared to the placebo group, PD improved by 20% vs. 12.5% (P < 0.001) and AL improved by 8.8% vs. 4.5% (P < 0.001). The data were also evaluated in terms of the response in more severe sites as compared to those less severe. The results of these evaluations showed the more severe sites to be significantly more responsive to treatment than the less severe sites. The results suggest that the effect of this new compound is in the area of the periodontal attachment, underlying connective tissue and alveolar bone as evidenced by the greater and consistent changes in the radiographic, pocket depth and attachment level data.