bluuebunny/crossref_metadata_2025 huggingface dataset:
Destructive Periodontal Disease in Healthy Children
Authors: Cogen Ronald B. , Wright J. Timothy , Tate Anita L.
Published: March 2012

This study determined the prevalence of destructive periodontal disease affecting the deciduous dentition among otherwise healthy subjects, who were diagnosed with juvenile Periodontitis (JP) in their permanent dentitions. There were 4,757 subjects in this retrospective, cross‐sectional study. Diagnosis of JP was based on age (≤ 15 years), negative medical history, and radiographic evidence of arc‐shaped alveolar bone loss. The study population was one‐third white and two‐thirds black and the male/female ratio was 1:1, reflecting the general patient population. The prevalence among whites was 0.3%, with a female/male ratio 4:1; whereas among blacks the prevalence was 1.5%, with a female/ male ratio ˜1:1. Among the black JP subjects with radiographs of the mixed dentition, 85.7% presented evidence of bone loss, and of those with radiographs of the deciduous dentition, 71.4% had discernible alveolar bone loss. This study suggests that JP is much more prevalent in blacks and that it does indeed occur in the prepubertal years affecting the deciduous as well as the permanent dentitions in otherwise healthy children. These data imply the importance of including a periodontal evaluation in the examination of children, using the periodontal probe and radiographs sufficient to adequately view the alveolar bone. J Periodontol 1992; 63:761–765.
Salivary and Metabolic Factors Involved in Oral Malodor Formation
Authors: Kleinberg I. , Westbay G.
Published: March 2012

Saliva plays a central role in the formation of oral malodor. Such formation has as its basis bacterial putrefaction, the degradation of proteins, and the resulting amino acids by microorganisms. Saliva provides substrates that are readily oxidized and in the process facilitates oxygen depletion. This favors the reduced conditions conducive to production of odoriferous volatiles. At the same time, saliva is a major source of oxygen for the oral bacteria which generally is inhibitory of their formation. The pH is also critical to malodor development; acidity inhibits, whereas neutrality and alkalinity favor malodor production. Since the pH on oral mucosal surfaces where odor formation occurs is largely determined by the fermentative and putrefactive activities of the adhering bacteria, these acid‐base processes are necessarily of major regulatory importance. Because oral malodor and periodontitis both involve excessive oral putrefaction, a better understanding of putrefaction could lead to more substantive methods of oral malodor treatment than exists today, as well as identifying new approaches to amelioration of the bacterial attack on the soft tissues leading to the destruction associated with periodontal disease. J Periodontol 1992; 63:768–775.
Measurement of Oral Malodor: Current Methods and Future Prospects
Authors: Rosenberg Mel , McCulloch Christopher A. G.
Published: March 2012

Measurement of oral malodor is complicated by a variety of parameters including complexity of gaseous molecular species, sampling difficulties, temporal variations, choice of suitable subject populations, and lack of agreement on reference standards. Since oral malodor is a perceived olfactory stimulus, direct sampling and assessment by human judges may be the most logical measurement approach. However, as with other psychophysical assessments, human malodor measurement by the human nose may vary widely among and between judges, and consequently cannot be confidently reproduced in other laboratories. Such shortcomings have led several investigators to propose quantitative approaches based on measurement of volatile sulfide compounds which are associated with oral malodor. Highly sensitive and discriminatory measurements of volatile sulfides can be made using gas chromatography although for rapid sampling of larger subject populations, portable sulfide monitors may be more appropriate. Future research in this field should consider: 1) improved and simplified instrumentation for more rapid throughput and reliability; 2) development and definition of reference standards for oral malodor assessment; 3) formulation of clinical studies with appropriately sized, well‐defined patient populations; and 4) further development of within mouth, site‐specific measurements. J Periodontol 1992; 63:776–782.
The Distribution and Transmission of Actinobacillus actinomycetemcomitans in Families With Established Adult Periodontitis
Authors: Preus Hans R. , Zambon Joseph J. , Dunford Robert G. , Genco Robert J.
Published: March 2012

The prevalence and genotype distribution of Actinobacillus actinomycetemcomitans strains in families where at least one adult family member (proband) suffered from periodontal disease was investigated to better understand how this periodontal organism is acquired or transmitted. Fifteen probands with severe (established) periodontal disease (EPD) and their 46 immediate family members were sampled for A. actinomycetemcomitans. Among the 15 families, 10 contained at least one additional family member colonized with oral A. actinomycetemcomitans. Genomic DNA from 3 subgingival A. actinomycetemcomitans strains from each of the 10 probands and their 17 family members were amplified and characterized by the polymerase chain reaction (PCR) using a single arbitrary primer known to distinguish A. actinomycetemcomitans strains. The PCR products from each strain were separated by electrophoresis on a 1% submarine agarose gel containing ethidium bromide and visualized by UV light transillumination. The amplification products migrated to form readily distinguishable bands and, since the banding patterns were characteristic of strains of A. actinomycetemcomitans, these patterns were called “amplitypes.” The culture studies showed that 51% of all patients suffering from EPD carried oral A. actinomycetemcomitans. Moreover, 50% of their spouses and 30% of their children harbored the bacterium. Comparison of the PCR‐generated amplitypes showed that 26 out of 27 individuals had strains exhibiting a single amplitype of A. actinomycetemcomitans, the 27th being colonized by 2 different amplitypes. They also showed that in 6 out of 7 families, the husband and wife did not harbor the same A. actinomycetemcomitans amplitype. Furthermore, most often children carried an amplitype identical to one of the parents. However, one of the 10 children harbored two amplitypes each of which was identical to the parents. We propose that A. actinomycetemcomitans is acquired through contact with one of the parents at some time during childhood. J Periodontol 1994;65:2–7.
The Influence of Molar Furcation Involvement and Mobility on Future Clinical Periodontal Attachment Loss
Authors: Wang Hom‐Lay , Burgett Frederick G. , Shyr Yu , Ramfjord Sigurd
Published: March 2012

The purpose of this study was to determine the influence of furcation involvement (FI) and mobility (MO) on change in probing periodontal attachment level (AL) on molar teeth. Twenty‐four patients were selected from The University of Michigan longitudinal periodontal clinical trial. The patients who met the entry criteria received a baseline examination and were treated by periodontal scaling and root planing followed by different periodontal surgical approaches in a split‐mouth design. Patients were placed on a 3‐month interval for maintenance prophylaxis and had yearly periodontal scorings for a period of 8 years. The scorings included determination of AL, FI, MO, and tooth loss (TL). Data for molar teeth from three different time periods (at entry (A) and at 1 (B) and 8 (C) years) were analyzed. The results demonstrated that teeth with FI were 2.54 times more likely to be lost when compared to teeth without FI during the maintenance period. By using paired t test approach to the probing attachment level data, molars with FI had significantly more loss between times B and C but not between A and B or A and C. Teeth with increased MO demonstrated significantly more AL between times A and C and B and C. When the interaction between MO and FI was analyzed, teeth with both FI and MO had significantly more attachment loss during the maintenance period (B to C). No statistically significant difference was found among the three different therapeutic approaches (pocket elimination, curettage, and modified Widman flap) during any of the time periods. From these limited data it was concluded that during periodontal treatment and maintenance, molars with FI had a higher tendency to lose periodontal attachment and be extracted as compared to molars without furcation involvement. The inclusion of MO in the analysis suggests mobile teeth and mobile teeth with FI are at greater risk of AL when compared to teeth without these characteristics. J Periodontol 1994;65:25–29.
Short‐Term Microbiological and Clinical Effects of Subgingival Irrigation With an Antimicrobial Mouthrinse
Authors: Fine James B. , Harper D. Scott , Gordon Jeffrey M. , Hovliaras Christine A. , Charles Christine H.
Published: March 2012

Fifty chronic adult periodontitis patients completed a 6‐week controlled, doubleblind, split mouth clinical study to determine the effects of subgingival irrigation with an antimicrobial mouthrinse on periodontal microflora, supragingival plaque, and gingivitis when used as an adjunct to normal oral hygiene. Qualifying subjects had at least four sites, two on each side of the mouth, with probing depths between 4 and 6 mm, which bled on gentle probing. Following baseline examinations, subjects received a half mouth scaling and prophylaxis and full mouth subgingival irrigation with either the antimicrobial mouthrinse or sterile colored water control professionally delivered. Subjects continued irrigation at home once daily for 42 days with their assigned rinse delivered via a subgingival delivery system. All sites in the mouth were scored at baseline and at day 42 for supragingival plaque, bleeding on probing, and redness. For the four selected periodontitis sites, probing depth and attachment level were measured at baseline and on day 42; additionally, supragingival plaque and gingival redness were scored on days 7 and 21. Subgingival plaque samples for microbiological analysis were harvested from the selected periodontal sites at baseline and on days 7, 21, and 42. Microbiologically, irrigation with the antimicrobial mouthrinse resulted in statistically significant reductions compared to control in putative periodontopathogens, including black pigmenting species, which persisted at 42 days. Clinically, subgingival irrigation with the antimicrobial mouthrinse produced a significant reduction in supragingival plaque (P <0.001), bleeding on probing (P = 0.019), and redness (P = 0.017) compared to the control, whether or not the area irrigated received a prophylaxis. While there were no significant differences between active and control groups in either probing depth or attachment level (P >0.05); this finding was not surprising in view of the small number of periodontitis sites and relatively short study duration. The findings indicate that subgingival delivery of the antimicrobial mouthrinse by means of an oral irrigation device can play a potential role in the management of chronic periodontitis by virtue of its significant effects on the subgingival periodontopathic microflora and supragingival plaque and gingivitis. J Periodontol 1994;65:30–36.
Relationship of Oral Malodor to Periodontitis: Evidence of Independence in Discrete Subpopulations
Authors: Bosy A. , Kulkarni G. V. , Rosenberg M. , McCulloch C.A.G.
Published: March 2012

Associations between oral malodor, measures of periodontal disease, and trypsinlike activity of periodontal pathogens on tongue and teeth were examined in 127 subjects. Volatile sulphur compound (VSC) measurements were made with a portable sulphide monitor; oral malodor was also estimated by organoleptic methods. Measurements repeated one week apart indicated that steady‐state VSC levels (r = 0.72; P = 0.0001) and peak VSC levels (r = 0.63; P = 0.0001) were reproducible but these r values were not significantly different (P >0.1). There was a significant correlation between tongue odor and peak VSC levels (r = 0.40; P = 0.0001) and between tongue odor and whole mouth organoleptic measures (r = 0.55; P = 0.0001). To study the effect of reducing microbial colonization on oral malodor, chlorhexidine gluconate (0.2%) rinsing was prescribed for 7 days. Reductions of VSC levels were significant for both peak (37%) and steady‐state (41%) data (P = 0.0001). Anaerobic periodontal pathogens on the tongue estimated by the proportions of positive BANA tests were reduced 19% (P = 0.001) and this was concomitant with a 40% (P = 0.0001) decrease in organoleptic measurement of the tongue dorsum. Mean pH measurements of the tongue dorsum showed large reductions from 6.9 initially to 6.3 post‐treatment (P = 0.0001). Subjects were divided into periodontitis/no periodontitis based on periodontal inflammation and probing depth (≥5 mm). Of the 37 subjects with periodontitis, 23 had oral malodor whereas 52 out of 90 periodontally healthy subjects exhibited malodor. Chi square analysis comparing halitosis in subjects with and without periodontitis showed no statistically significant association (X2 = 0.208; P 0.65) between these two factors although the intensity of malodor as based on VSC concentration in periodontally healthy subjects was 19% less (mean = 111 ppb) than in subjects with periodontitis (mean = 136 ppb). The odds ratio was 1.2, indicating that oral malodor was not associated with periodontitis. These data indicate that a large proportion of individuals with oral malodor are periodontally healthy and that the mucosal surface of the tongue is a major site of oral malodor production. J Periodontol 1994;65:37–46.
Detection of Porphyromonas gingivalis in Gingival Exudate by a Dipeptide‐Enhanced Trypsin‐Like Activity
Authors: Wikström M. , Potempa J. , Polanowski A. , Travis J. , Renvert S.
Published: March 2012

Porphyromonas gingivalis in subgingival plaque is an important risk factor for future periodontal attachment loss in susceptible adults. The elimination of P. gingivalis is usually concomitant with a healing process. Therefore, it should be valuable to have an easy chairside method to follow the effect of periodontal treatment on P. gingivalis detection as well as on its eventual reappearance during the maintenance period. We have previously reported the stimulation of amidolytic activity of P. gingivalis by the addition of glycyl‐glycine to the assay buffer. In this study we determined the proportions of P. gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Capnocytophaga spp, Camphylobacter rectus, and Eikenella corrodens by cultivation technique and the amidolytic activity, using N‐benzoyl‐L‐argininep‐nitroanilide (BAPNA) as substrate, in gingival exudate before and during a 3‐year treatment and maintenance period. P. gingivalis was the only species yielding a high and persistent correlation to stimulated amidolytic activity (P values ≤0.0001) on both site (r = 0.5) and subject (r = 0.8) level. Testing pure cultures of suggested periodontal pathogens for effect of glycyl‐glycine on amidolytic activity, we found that of P. gingivalis to be 5.9‐fold increased. The amidolytic activity of Treponema denticola was only slightly stimulated (ratio with/without glycyl‐glycine = 1.2) and that of Capnocytophaga slightly inhibited (ratio with/without glycyl‐glycine = 0.8). The outcome of this study has the potential to be used for the development of a simple, rapid, and inexpensive assay for a qualitative and quantitative determination of P. gingivalis in gingival crevicular fluid. J Periodontol 1994;65:47–55.
Characterization of Prevotella intermedia and Prevotella nigrescens Isolates From Periodontic and Endodontic Infections
Authors: Gharbia Saheer E. , Haapasalo Markus , Shah Haroun N. , Kotiranta Anja , Lounatmaa Kari , Pearce Michelle A. , Devine Deirdre A.
Published: March 2012

The occurrence and surface properties of Prevotella intermedia and P. nigrescens in healthy sites and in periodontic and endodontic infections were studied among 73 strains, tentatively identified as P. intermedia. Fifteen strains were from necrotic root canal infections, 41 were from periodontal samples, and 17 isolates were obtained from healthy gingival sites. Identification of isolates as either P. intermedia or P. nigrescens was based on differences in malate and glutamate dehydrogenase electrophoretic mobilities which allowed unambiguous separation of P. intermedia and P. nigrescens. The majority of strains from periodontal samples were P. intermedia (29 of 41 strains). In endodontic samples only 4 out of 15 isolates were P. intermedia, while all except 1 of 17 strains from healthy gingival sites were identified as P. nigrescens. SDS‐PAGE of whole cell proteins revealed 31 and 38 kDa proteins in P. nigrescens which were not detected in P. intermedia. Surface biotinylation of cells, followed by Western blotting and detection by alkaline phosphatase conjugated extravidin, showed strong staining of the 31 kDa protein in P. nigrescens indicating that this protein is located on the surface of the cell. Corresponding staining was not seen in P. intermedia. Fimbria‐like projections were observed using electron microscopy of negatively‐stained cells of P. nigrescens. The results show that P. intermedia and P. nigrescens may have different site specificities and surface properties and thus emphasize the need for accurate identification of these two species for the evaluation of their role in the pathogenesis of oral infections. J Periodontol 1994;65:56–61.
Cyclosporine A Upregulates Interleukin‐6 Gene Expression in Human Gingiva: Possible Mechanism for Gingival Overgrowth
Authors: Williamson Michael S. , Miller E. Katherine , Plemons Jacqueline , Rees Terry , Iacopino Anthony M.
Published: March 2012

Cyclosporine A (CsA) is a widely used immunosuppressant for transplant patients and is also used for the treatment of a wide variety of systemic diseases with immunologic components. A prominent side effect of CsA administration is gingival overgrowth. It has been postulated that CsA alters fibroblast activity through effects on various cytokines such as the interleukins, however, as yet, data concerning the molecular mechanisms involved in connective tissue proliferation are still preliminary in nature. The purpose of this study was to evaluate interleukin‐6 (IL‐6) gene expression in gingival tissues of patients receiving CsA therapy and exhibiting gingival overgrowth. Radioimmunoassay (RIA) demonstrated a significant difference in tissue levels of IL‐6 as mean ± SEM. IL‐6 content in CsA‐stimulated tissue was 184.3 ±30.2 ng/mg total protein versus 23.3 ± 6.5 ng/mg total protein in control tissue. In situ hybridization indicated that overgrown gingival tissues from patients taking CsA had a significantly higher content of IL‐6 mRNA when compared to control tissues. Expressing IL‐6 mRNA levels as silver grains/cell, CsA‐stimulated tissue had 166.9 ± 12.0 grains of IL‐6 mRNA/cell while control tissue had 12.8 ± 3.0 grains of IL‐6 mRNA/cell. These results demonstrate that CsA therapy results in increased levels of IL‐6 protein and IL‐6 mRNA in overgrown human gingival tissues. This is the first report of CsA‐upregulated IL‐6 gene expression in vivo, and may explain in part the molecular mechanisms responsible for CsA‐induced gingival overgrowth. J Periodontol 1994;65:895–903.
Efficacy of Mouthrinses in Inhibiting the Development of Supragingival Plaque Over a 4‐Day Period of No Oral Hygiene
Authors: Moran John , Addy Martin , Kohut Bruce , Hovliaras Christine A. , Newcombe Robert G.
Published: March 2012

This study was a first stage evaluation of the plaque inhibitory properties of an experimental cetylpyridinium chloride (CPC)/essential oil mouthrinse. The study was a formulation, not ingredient, evaluation and comparisons were made with established mouthrinse products. The 5 rinses tested were: the experimental formulation; a triclosan/copolymer prebrushing mouthrinse; two negative control rinses, which differed only in color; and as a positive control, a 0.2% chlorhexidine mouthrinse. The study used a 5 cell, 4‐day plaque regrowth, double‐blind crossover design in which 15 subjects participated. Allocation of mouthrinse sequences was accomplished using 3 replicates of a 5 × 5 Latin square, incorporating balance for carryover. On Day 1, subjects received a scaling and polishing to reduce plaque, ceased toothcleaning, and commenced rinsing twice daily, under supervision, with the randomly assigned rinse. Rinsing time for the experimental and one negative control rinse was 30 seconds and for the other rinses was 60 seconds. On Day 5, plaque was scored by both index and area. Differences in plaque regrowth between the rinse groups were highly significant. The order of efficacy from the most effective was: chlorhexidine rinse (positive control); experimental CPC/essential oil rinse; triclosan/copolymer rinse; and the negative control rinses. From the calculated confidence intervals each rinse differed significantly from each other rinse, except for the two negative control rinses which were comparable to each other. Proportionately, the CPC/essential oil rinse was positioned 30 to 50% between the triclosan/copolymer rinse and the chlorhexidine (positive control). These findings suggest that the CPC/phenolic rinse would seem worthy of further evaluation for adjunctive benefits to oral hygiene. J Periodontol 1994;65:904–907
Comparison of a Conventional Probe With Electronic and Manual Pressure‐Regulated Probes
Authors: Perry Dorothy A. , Taggart Edward J. , Leung Angela , Newbrun Ernest
Published: March 2012

We compared the accuracy, consistency, time, comfort, and cost of probing with a conventional hand probe (CP) with 3‐mm banded markings, a manual pressure‐regulated probe (MP), and two electronic probes (IP and FP). Twenty (20) examiners used all four probes on a test block to determine accuracy; measurements compared favorably to the reference block. Two calibrated examiners probed the Ramfjord teeth of 10 periodontal patients on maintenance regimens, six sites per tooth (n = 708), with all four probes; measurements were repeated after one week. Wilcoxon signed‐rank test showed the CP measured more deeply (P <0.0001) than MP, FP, and IP with mean differences of 0.40, 0.67, and 0.58 respectively. MP measured more deeply (P <0.001) than FP and IP, with mean differences of 0.27 and 0.18 mm. There was no difference between FP and IP. Time (min:sec) required by one examiner to perform full mouth probing on six subjects (minimum of 26 teeth each) was CP = 3:59; MP = 4:18; FP = 6:16; and IP = 7:23. Subjects rated FP and IP as slightly more uncomfortable than CP or MP. Cost per 1,000 uses was computed based on available data. The IP and FP took longer to perform and cost more per procedure than did the CP and MP. Spearman rank‐order correlation revealed that only probe depths measured by CP and MP were well correlated (rs = 0.67). Although some statistically significant differences were found between probes, no differences were considered to be of clinical significance when probing periodontally healthy or maintenance patients. Electronic probes were more expensive per use and more time‐consuming than hand probes. J Periodontol 1994;65:908–913.
Subepithelial Connective Tissue Grafts in the Treatment of Gingival Recessions. A Comparative Study of 2 Procedures
Authors: Bouchard Philippe , Etienne Daniel , Ouhayoun Jean‐Pierre , Nilvéus Rolf
Published: March 2012

Thirty (30) Class I and Class II recessions in 30 subjects were treated with a subepithelial connective tissue graft procedure. In one group (15 sites), the surgery was carried out in a traditional fashion: the epithelial collar of the graft was preserved and left exposed (CTG group). In the second group (15 sites), the epithelial collar of the graft was removed and the recession areas were conditioned with citric acid. The graft was then sutured and completely immersed under the facial flap which was coronally repositioned (CR group). Clinical assessments included probing depth, probing attachment level, surface area of the recession, and gingival width. These measurements were taken at baseline and at 6 months. In addition, an esthetic evaluation was done. The differences between treatments were not statistically significant except for the augmentation of gingiva (P ≤0.05). Based on the midfacial measurements taken in the central area of the recession, the mean percentage of root coverage was 69.2%. In the CR group, 3 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 65.5%. In the CTG group, 5 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 94.4%. The mean surface area of root exposure was reduced from 13.82 mm2 and 13.67 mm2 to 2.15 mm2 and 2.34 mm2 for the CR group and the CTG group, respectively. One‐hundred percent (100%) of good‐to‐moderate esthetic results were found by a panel of independent examiners; there was tendency toward better results in the CR group. The results of this study indicate that partial success could be expected with subepithelial connective tissue grafting in Class I or Class II recession therapy. It is suggested that the CR group procedure gives better esthetic results than the CTG group procedure. However, when larger augmentation with keratinized tissue is needed, the CTG group procedure is preferred. J Periodontol 1994;65:929–936.
Clinical Use of a Bioresorbable Matrix Barrier in Guided Tissue Regeneration Therapy. Case Series
Authors: Laurell Lars , Falk Hanne , Fornell Jan , Johard Gunnar , Gottlow Jan
Published: March 2012

In this case series study 19 Class II furcations and 47 intrabony defects in 59 patients were treated according to the principles of guided tissue regeneration using a bioresorbable matrix barrier. Gingival condition and device exposure were assessed at 2 weeks, and 1, 3, 6, and 12 months after surgery. The effect of therapy was evaluated by assessing probing depths (PD), probing attachment level (PAL), and the position of the gingival margin prior to surgery and 12 months after surgery. Mild clinical signs of inflammation in the soft tissue covering the device was found adjacent to 3 defects only and limited to the first month of healing. Device exposure occurred at 10 out of the 66 defects. At the furcation defects, the mean PD reduction amounted to 3.7 mm (P ≤0.001). Mean gain PAL vertical was 3.4 mm and PAL horizontal 3.3 mm (P ≤0.001), resulting in complete closure of 9 out of the 19 defects. Mean gingival recession was 0.2 mm. At the intrabony defects mean PD reduction was 5.4 mm and mean gain of PAL 4.9 mm (P ≤0.001). Gingival recession averaged 0.5 mm (P ≤0.05). It was concluded that the use of the matrix barrier in GTR therapy resulted in 1) reduced probing depths; 2) pronounced gain of clinical attachment; and 3) a very low incidence of gingival pathology, gingival recession, and device exposure. J Periodontol 1994;65:967–975
Synthetic Bioabsorbable Barrier for Regeneration in Human Periodontal Defects
Authors: Caton J. , Greenstein G. , Zappa U.
Published: March 2012

Guided tissue regeneration (GTR) may result in the formation of new bone, cementum, and periodontal ligament. The purpose of this study was to assess the efficacy of a resorbable synthetic material, which has been used extensively in general surgery for wound support, to promote GTR. Forty healthy patients with adult periodontitis, each having a Class II furcation defect, participated in the study. After initial therapy, mucoperiosteal flaps were elevated and furcations debrided with hand and rotary instruments. In 20 patients the molar Class II furcation defects were treated with a GTR procedure using the resorbable synthetic material (experimental), and 20 patients received a mucoperiosteal flap debridement procedure without barrier placement (control). Probing depth and attachment level measurements were taken immediately before surgery, at 6 weeks, and 2, 3, 4, 5, and 6 months after surgery. All areas healed uneventfully. Comparison of clinical attachment level measurements indicated significantly greater gain of attachment at sites receiving barriers. Fifteen of 20 Class II furcations in the synthetic barrier group, but only one of 20 in the control group, were converted to Class I defects. Barriers were still clinically detectable at 4 weeks, but were absent at 6 weeks. The synthetic barriers enhanced gain of clinical attachment in human Class II furcation defects. J Periodontol 1994; 65:1037–1045.
Comparative Detection Frequency of 6 Putative Periodontal Pathogens in Sudanese and Norwegian Adult Periodontitis Patients
Authors: Ali Raouf Wahab , Bakken Vidar , Nilsen Rune , Skaug Nils
Published: March 2012

Twenty‐five Sudanese and 18 Norwegian adult periodontitis patients were selected to participate in this study. The purpose was to compare cultivation results of Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, and Capnocytophaga species as well as various enteric rods in both populations. In addition, DNA probe analysis was used to identify P. gingivalis, P. intermedia, A. actinomycetemcomitans, F. nucleatum, and Bacteroides forsythus in the Sudanese patients and results were compared with those obtained by cultivation. The paper point technique was used to sample 99 sites in the Sudanese group (4 paper points/site) and 119 sites in the Norwegian patients (3 paper points/site). In the Sudanese subjects, the fourth paper point was used for the DNA probe analysis. The chi‐square test and the Wilcoxon signed rank test were used to test for statistically significant differences between Sudanese and Norwegian cultivation results as well as between cultivation and DNA results in the Sudanese group. Cultivation results indicated that the Sudanese subjects had significantly lower prevalence of P. gingivalis, P. intermedia, and F. nucleatum (P < 0.01), significantly higher prevalence of Capnocytophaga species (P < 0.05), and similar prevalence of A. actinomycetemcomitans. Almost all Sudanese subjects tested positive for various enteric rods, while none of the Norwegians did so. The extent to which unrestricted use of antibiotics and transport media influenced the levels of enteric species is not known, however. In the Sudanese group, DNA results showed higher levels of P. gingivalis and P. intermedia (P < 0.01), and F. nucleatum (P < 0.05), while lower levels of A. actinomycetemcomitans (P < 0.05), as compared to cultivation results. B. forsythus was detected by DNA probe analysis in 96% of the Sudanese patients (57.6% of sites). Except for the high levels of enteric rods in the Sudanese samples, the present investigation demonstrated that both patient populations harbored the species monitored in levels similar to those commonly perceived among adult periodontitis patients in the West. J Periodontol 1994; 65:1046–1052.
Microbial Associations of 4 Putative Periodontal Pathogens in Sudanese Adult Periodontitis Patients Determined by DNA Probe Analysis
Authors: Ali Raouf Wahab , Skaug Nils , Nilsen Rune , Bakken Vidar
Published: March 2012

The few previous cultivation studies on the in vivo associations between various periodontal microbial species have shown several positive and negative associations. The present investigation utilized DNA probe analysis to examine possible in vivo associations between the periodontal pathogens Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, and Bacteroides forsythus in subgingival plaque samples obtained from 25 Sudanese untreated adult periodontitis patients. The standard paper point technique was used to sample 99 sites with a mean probing depth of 6.8 mm (range 6.0 to 10.0). Microbial associations were determined by detecting the effect of the presence or absence of one species (effector) on the occurrence of the other 3 species (target). The Wilcoxon signed rank test was used to examine variations in occurrence of each target bacteria in the presence or absence of the effector. In addition, the Spearman's rank correlation test was used to assess the relationship between the level of each bacteria to that of the other 3. Results showed bacterial associations with the following effectoron‐target effects: F. nucleatum (P <0.01 Wilcoxon; P <0.001 Spearman) >> P. gingivalis (P <0.01 Wilcoxon; P <0.001 Spearman), and B. forsythus (P <0.05 Wilcoxon; P <0.001 Spearman) > P. intermedia (P <0.01 Spearman). The study demonstrated positive associations between the 4 species investigated, while no neutral or negative associations were revealed. The most striking finding was the effect exerted by F. nucleatum on the colonization of P. intermedia; P. intermedia was never detected in a site unless F. nucleatum was also present. J Periodontol 1994; 65:1053–1057.
Expanded Polytetrafluoroethylene Titanium‐Reinforced Membranes for Regeneration of Mucogingival Recession Defects. A 12‐Case Report
Authors: Tinti Carlo , Vincenzi G. Paolo
Published: March 2012

The regeneration of tissue to treat mucogingival recession defects is well established but these defects pose additional challenges for the clinician in the creation and maintenance of a space under the guiding membrane. We used titanium‐reinforced membranes of expanded polytetrafluoroethylene (ePTFE) to facilitate the creation and maintenance of such spaces in 12 patients with mucogingival recession defects. The membranes were judged according to their ease of handling and placement and the regenerative results; the patients were evaluated for gingival recession and the quantity of attached gingiva before and for as long as 15 months after treatment. At 15 months, the average gingival recession was 1.4 mm (pretreatment = 5.3 mm), and the attached gingiva measured 3.3 mm (pretreatment = 1.4 mm). Titanium‐reinforced ePTFE membranes result in a simpler, faster, and more predictable surgical procedure. Comparison of titanium‐reinforced ePTFE membranes to other available procedures awaits assessment in clinical trials. J Periodontol 1994; 65:1088–1094.
Cystinosis and Gingival Hyperplasia: Demonstration of Cystine Crystals in Gingival Tissue and Unusual Aspects of Management
Authors: Heller Allen N. , Heller Debra S. , Schwimmer Alan , Gordon Ronald E. , Cambria Robert J.
Published: March 2012

A patient with nephropathic cystinosis developed gingival hyperplasia secondary to cyclosporine‐A therapy for his renal allograft. The typical crystals described on electron microscopic examination of other organs of patients with cystinosis were seen in the resected gingiva of this patient. These crystals have not been previously described in this location. Unusual aspects of the management of this patient are discussed. J Periodontol 1994;65:1139–1141.
Non‐Human Primate Models for Testing the Efficacy and Safety of Periodontal Regeneration Procedures
Authors: Caton Jack , Mota Luis , Gandini Liliana , Laskaris Bill
Published: March 2012

Experimentally‐produced defects in the non‐human primate are preferred for testing the efficacy and safety of periodontal regenerative therapies. These animals closely resemble the human in dental anatomy and periodontal wound healing physiology. Defects can be produced which do not display spontaneous regeneration and which are contralaterally identical. Thus, within animals, untreated controls can be obtained to indicate the level of supporting tissues prior to therapy. The use of non‐human primate models is recommended for science transfer experiments involving invasive surgery and the testing of potentially harmful new devices and pharmaceuticals. J Periodontol 1994; 65:1143–1150.
Comparison of Canine and Non‐Human Primate Animal Models for Periodontal Regenerative Therapy: Results Following a Single Administration of PDGF/IGF‐I
Authors: Giannobile William V. , Finkelman Richard D. , Lynch Samuel E.
Published: March 2012

Two commonly used animal models for evaluating putative periodontal regenerative therapies are the beagle dog model with natural periodontal disease and the non‐human primate with ligature‐induced attachment loss. The host response, microbiology, and skeletal rates of remodeling of these two models are summarized. In addition, the results of experiments comparing the healing response to periodontal surgery with and without concurrent use of the combination of platelet‐derived growth factor (PDGF) and insulinlike growth factor‐I (IGF‐I) in these models are presented. At 1 month, PDGF/IGF‐I administration resulted in a 64.1% and 51.4% increase in new attachment formation in the non‐human primate and canine, respectively, while controls (surgery plus placebo) demonstrated 34.1% and 8.6% increases in new attachment formation in the non‐human primate and canine models, respectively. Further, application of PDGF/IGF‐I stimulated 21.6% and 65% osseous defect fill in the non‐human primate and canine, respectively, while controls demonstrated 8.5% and 14.5% osseous defect fill in the non‐human primate and canine, respectively. The osseous response in the canine appears greater than that of the non‐human primate, and the new attachment formation was more substantial in the non‐human primate than the canine. However, in general these data demonstrate a high degree of consistency in the effects of PDGF/IGF‐I in promoting periodontal regeneration. Positive results in these two models–the dog with natural periodontal disease and the non‐human primate with ligature‐induced attachment loss–justify human clinical trial testing of a putative regenerative therapy. J Periodontol 1994;65:1158–1168.
Probing Velocity: Novel Approach for Assessment of Inflamed Periodontal Attachment
Authors: Tessier J.‐F. , Kulkarni G. V. , Ellen R.P. , McCulloch C.A.G.
Published: March 2012

Little is known about the biophysical characteristics of the dento‐gingival junction in response to the development or resolution of inflammation. The Toronto automated periodontal probe (TAPP) provides an estimate of the biophysical integrity of the dentogingival junction by measuring intrapocket probing velocity. Presence or absence of a plateau in displacement versus time plots were used to perform dichotomous analyses as a function of established parameters of inflammation. Plateaus were operationally defined as a 3 standard deviation reduction in the slope of the displacement versus time plot (probing velocity) and hence the plateau represents an increased resistance of the probe tip at the dento‐gingival junction. The aim of the study was to measure the relationship between post‐treatment reductions of gingival inflammation and the probability of plateau formation as measured by the TAPP. Twenty‐nine subjects exhibiting gingival inflammation were provided with periodontal therapy consisting of subgingival scaling and root planing. Over a 2‐month sampling period, 6 sites from each subject were monitored and these sites exhibited wide variations of inflammation. Logistic regression revealed a significant relationship between the probability of plateau formation and treatment (P = 0.002), plaque index (P = 0.002), the increased severity levels of gingival index (P >0.05), or bleeding index (P >0.05). The probability of plateau formation decreased with higher levels of crevicular fluid flow but there was no dependence of plateau formation on probing depth (P >0.55). These data indicate a direct relationship between improved measures of clinical health and increased resistance to probe penetration near the base of the pocket. The improved clinical health is reflected by the increased probability of plateau formation in the terminal segment of the probing velocity plot. We conclude that the TAPP can detect gain of biophysical integrity at the dento‐gingival junction that is induced by non‐surgical periodontal therapy. J Periodontol 1994;65:103–108.
Chlorhexidine Use After Two Decades of Over‐the‐Counter Availability
Authors: Albandar Jasim M. , Gjermo Per , Preus Hans R.
Published: March 2012

Chlorhexidine (CHX) is a compound with plaque‐inhibiting effects and available only by prescription in the United States. In Norway, however, CHX has been dispensed over‐the‐counter for over 20 years, and this study was undertaken to evaluate dentists' perceptions regarding its indications, usefulness, and side effects. A written questionnaire was sent to a sample of 10% of dentists registered in Norway, 78% of whom (354) responded. Additionally, representatives from 2% of all dental practices in Norway were contacted by telephone. Fourteen percent (14%) of the respondents reported that they never recommended CHX to their patients. Among those recommending the compound, 85% used it frequently after surgical periodontal procedures; 74% when treating acute gingivitis; 57% following oral surgery in general; and 35% during non‐surgical periodontal therapy. It was used also as an adjunct to other treatment routines. Seventy‐three percent (73%) reported frequent use of CHX when treating stomatitis and 54% in herpes simplex infections. As to side effects, 77% of the dentists indicated that staining of teeth, restorations, and the tongue was a major concern to patients; 12% reported inconveniences due to the bitter taste; and 6% reported other disturbances such as dryness of the mouth and development of oral ulcerations. The majority (94%) of the dentists recommended mouth rinsing, whereas 6% recommended a gel form. Only 4% of the dentists recommended rinsing with a patient‐diluted 0.1% concentration, whereas 96% recommended the standard 0.2% formulation; 88% recommended using CHX mouthwash twice a day or more often. It is concluded that CHX is used frequently in Norwegian dental practices and that its use profile is diverse, though mainly as an anti‐plaque compound over a limited period of time when the use of other mechanical measures is not feasible or sufficient. J Periodontol 1994;65:109–112.
Priming Effect of Porphyromonas gingivalis Lipopolysaccharide on Superoxide Production by Neutrophils From Healthy and Rapidly Progressive Periodontitis Subjects
Authors: Shapira Lior , Gordon Barbara , Warbington Martha , Van Dyke Thomas E.
Published: March 2012

Pre‐incubation of neutrophils from rapidly progressive periodontitis (RPP) patients with lipopolysaccharide (LPS) extracted from Porphyromonas gingivalis was found to prime the neutrophils for enhanced FMLP‐stimulated superoxide production in a dosedependent manner. The priming effect of P. gingivalis LPS on neutrophils from control subjects was scanty or without effect at all. Inclusion of human serum in the experimental priming conditions increased the control and RPP neutrophil response by 2 to 3 fold. Blocking of the CD14 receptor on the neutrophil surface with monoclonal antibody eliminated the priming effect. Furthermore, incubation of control neutrophils with P. gingivalis LPS in the presence of serum from RPP patients generated a higher response as compared to incubation with control serum. The data suggest that neutrophil priming described in RPP patients is dependent on a serum factor which alters the neutrophil response to priming agents such as LPS. J Periodontol 1994;65:129–133.
Superficial Cemental Curettage: Its Efficacy in Promoting Improved Cellular Attachment on Human Root Surfaces Previously Damaged by Periodontitis
Authors: Fukazawa Eisuke , Nishimura Kazuaki
Published: March 2012

This study was designed primarily to determine whether or not gingival fibroblasts attach to curetted cementai surfaces in periodontally‐involved human teeth. Ten periodontally‐involved human teeth were used. The superficial cementum from 5 teeth was removed by light mechanical curettage while no root treatment was performed on the remaining 5 teeth. Subsequently, the roots of all teeth were cut longitudinally to create 800 μm thick sections (slabs). Prepared slabs were then placed in 35 mm culture dishes, seeded with human gingival fibroblasts (HGF), and after 4 weeks processed for transmission electron microscopy (TEM). TEM results revealed flattened HGF on the noncuretted cemental surfaces that failed to attach. Fibrillar material was not seen between the HGF and cemental surfaces. In contrast, the HGF that grew on previously curetted cementum exhibited typical morphology of healthy, functional fibroblasts. Newly synthesized fibrillar material and collagen fibrils were noted, and both were apparently oriented towards the curetted cemental surface. Results strongly suggest that improved cellular attachment can be promoted on areas of root surface previously damaged by periodontitis if superficial cementum is first removed by mechanical curettage. J Periodontol 1994;65:168–176.
Oral Sebaceous Retention Phenomenon
Authors: Koutlas Ioannis G. , Yaholnitsky Bruce
Published: March 2012

An unusual lesion associated with obstruction of ectopic sebaceous glands of the retromolar mucosa is presented. Histologically, this was associated with mucus‐producing and respiratory metaplasia of the sebaceous ducts that also demonstrated microcyst formation. Sebaceous glands were hyperplastic. A review of the literature did not reveal a similar published example. J Periodontol 1994;65:186–188.
Role of Cytokine in the Induction of Adhesion Molecules on Cultured Human Gingival Fibroblasts
Authors: Takahashi Keiso , Takigawa Masayuki , Takashiba Shogo , Nagai Atsushi , Miyamoto Manabu , Kurihara Hidemi , Murayama Yoji
Published: March 2012

This study was undertaken in an effort to understand the role of cytokines on human gingival fibroblasts and T lymphocyte trafficing into inflamed gingival tissue. Using flow cytometry we examined gingival fibroblasts to determine the level of cell surface expression and the percentage of cells positive for intercellular adhesion molecule 1 (ICAM‐1), the HLA‐DR antigen, lymphocyte function‐associated antigen 3 (LFA‐3), and the CD44 molecule, which are involved in antigen presentation. The following cytokines were used: interleukin‐1β (IL‐1β), tumor necrosis factor‐α (TNF‐γ), interferon‐γ (IFN‐γ), IL‐6, and IL‐8. The levels of ICAM‐1 expression were enhanced in a dose‐ and time‐dependent manner by IL‐1β, TNF‐α, or IFN‐γ, but not by IL‐6 or IL‐8. HLA‐DR surface expression was induced only by IFN‐γ in a dose‐ and time‐dependent manner, but not by the other cytokines tested. In contrast, the expression of LFA‐3 and the CD44 molecule could be detected without the stimulation of any cytokine, but the levels of their expression were not significantly changed by any cytokines. The enhanced ICAM‐1 expression by cytokines was reduced in a time‐dependent manner following the removal of cytokines from the reaction mixture, while IFN‐γ‐induced HLA‐DR expression was maintained even 7 days after the removal of IFN‐γ. These data support an interactive role for inflammatory cytokines and the expression of adhesion molecules on gingival fibroblasts in the pathogenesis of gingival inflammation in periodontal disease. J Periodontol 1994;65:230–235.