bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic control of serum IgE levels: a study of low molecular weight protein tyrosine phosphatase
Authors: Bottini N , Otsu A , Borgiani P , Saccucci P , Stefanini L , Greco E , Fontana L , Hopkins JM , Mao X‐Q
Published: December 2004

Protein tyrosine phosphatases (PTPases) have recently been recognized as important modulators of various signal transduction pathways in immune cells. Genetic polymorphisms have been described in genes codifying for members of this family of enzymes, and the genetics of PTPases is predicted to play an important role in the etiology of immune diseases and of their clinical variability. The low molecular weight protein tyrosine phosphatase (ACP1 or LMPTP) is one of the few PTPases with a known genetic polymorphism, and has been proposed to be associated with atopic dermatitis in a small sample from an Italian population. In this paper we describe the association of the ACP1 polymorphism with total IgE levels in two independent samples from English and Italian populations. In both the samples the mean value of serum IgE is lower among subjects carrying the BC genotype than in other ACP1 genotypes. The BC genotype is associated with the highest total ACP1 enzymatic activity. Our data suggest that one or both of the ACP1 isoforms exert an inhibitory role on some signal transduction pathway relevant for IgE hyperproduction.
Identification of a novel BMPR1A germline mutation in a Korean juvenile polyposis patient without SMAD4 mutation
Authors: Kim I‐J , Park J‐H , Kang HC , Kim K‐H , Kim J‐H , Ku J‐L , Kang S‐B , Park SY , Lee J‐S , Park J‐G
Published: December 2004

Juvenile polyposis (JP) is characterized by the development of multiple hamartomatous polyps and is inherited as an autosomal dominant trait. Germline mutations of the SMAD4 gene have been reported in JP. We have previously identified three SMAD4 germline mutations in five Korean JP patients. Recently, germline mutations of the BMPR1A (ALK3) gene were reported in JP cases without SMAD4 mutations. In order to determine whether BMPR1A could be involved in the development of JP, we screened all five patients using denaturing high‐performance liquid chromatography (DHPLC) analysis. We found that one patient had a BMPR1A germline mutation without a SMAD4 mutation. This patient harbored a novel missense mutation (M470T) in exon 10. After close clinico‐pathological examination, one patient who was previously diagnosed to have JP was excluded from the JP group. In total, all four Korean JP patients had either the SMAD4 or the BMPR1A mutation, with three having SMAD4 germline mutations and one carrying a BMPR1A germline mutation.
Cystic fibrosis mutation frequencies in an Irish population
Authors: Devaney J , Glennon M , Farrell G , Ruttledge M , Smith T , Houghton JA , Maher M
Published: December 2004

The incidence of cystic fibrosis (CF) at birth in Ireland is 1/1461. Neonate CF genetic testing is not routinely performed in Ireland. Currently, screening is only carried out where there is clinical evidence or a family history to suggest disease. Here we report the frequencies of common CF mutations occurring in an Irish population composed of samples collected from western, mid‐western and southern regions of Ireland. Rarer CF mutations were also identified in a selected number of CF patients. In addition, a number of polymorphisms were identified, some of which are reported to be functionally and phenotypically important.
The PPAR‐gamma P12A polymorphism modulates the relationship between dietary fat intake and components of the metabolic syndrome: results from the Québec Family Study
Authors: Robitaille J , Després J‐P , Pérusse L , Vohl M‐C
Published: December 2004

The metabolic syndrome is a complex disorder characterized by an atherogenic dyslipidemia resulting from the interaction between genetic and nutritional factors. The objective of this study was to examine in a cohort of 720 adults participating in the Québec Family Study (QFS) whether dietary fat interacts with the P12A polymorphism in the gene encoding the peroxisome proliferator‐activated receptor‐gamma (PPAR‐γ), a nuclear factor that regulates lipid and glucose homeostasis. Carriers of the A12 allele had a higher body mass index (BMI), waist circumference, fat mass as well as subcutaneous adipose tissue and visceral adipose tissue (VAT) areas both assessed by computed tomography than P12/P12 homozygotes. Total fat and saturated fat intakes estimated from a 3‐day food record were significantly correlated with several components of the metabolic syndrome in P12/P12 homozygotes. None of these expected associations were observed among carriers of the A12 allele. Furthermore, in a model including the PPAR‐γ P12A polymorphism, fat intake, age and gender, PPAR‐γ P12A and its interaction with fat intake were associated with BMI and waist circumference. Similar results were obtained when saturated fat intake replaced total fat intake into the model. When the two genotype groups were further classified into quartiles of total fat or saturated fat intake and their characteristics compared, an increase in fat intake was associated with an increase in waist circumference in P12/P12 homozygotes but not in A12 carriers. There was no difference in the waist circumference in carriers of the A12 allele whether the fat or the saturated fat intake was high or low. These results suggest that the PPAR‐γ P12A polymorphism can modulate the association between dietary fat intake and components of the metabolic syndrome.
Two novel mutations in the α‐galactosidase A gene in Chinese patients with Fabry disease
Authors: Yang C‐C , Lai L‐W , Whitehair O , Hwu W‐L , Chiang S‐C , Lien Y‐HH
Published: December 2004

Fabry disease is an X‐linked disorder caused by a deficiency of the lysosomal α‐galactosidase A [EC 3.2.1.22]. The molecular diagnosis of Fabry disease is important for genotype/phenotype correlation, pre‐natal or early diagnosis, and detection of carrier status. Although more than 200 genotypes of the α‐galactosidase A gene have been identified, mutation data on the Chinese population is sparse. We recently identified two unrelated Chinese families with Fabry disease. Mutation analysis was performed by polymerase chain reaction (PCR) sequencing of the seven exons and adjacent introns of the α‐galactosidase A gene. Two novel mutations were identified: in family I, a C‐to‐A transversion resulted in an early termination at amino acid 222 (Y222X), while in family II, an A‐to‐G transition resulted in a substitution of alanine for threonine at amino acid 410 (T410A). Carrier status was identified in all four females in the two families. The genotype Y222X is associated with classic Fabry disease, with unexpectedly rapid deterioration of visual acuity, while T410A is associated with a milder Fabry disease, with ventricular hypertrophy and neuropathic pain.
Cerebro–oculo–facial–lymphatic syndrome
Authors: Milunsky JM , Capin DM
Published: December 2004

We describe a boy whose prime features are severe‐to‐profound mental retardation, intractable complex seizures, lissencephaly, facial dysmorphism, and lymphatic abnormalities. To our knowledge, this is the fourth reported case of this syndrome. We propose the syndromic appellation of cerebro–oculo–facial–lymphatic syndrome, suggest cardinal diagnostic features, and discuss several possible overlapping syndromic diagnoses.
Bilateral simultaneous augmentation of the maxillary sinus floor with particulated mandible. Report of a technique and preliminary results
Authors: Cordaro Luca
Published: December 2004

Abstract: This paper describes a surgical technique that permits the achievement of bilateral simultaneous augmentation of the maxillary sinus floor with the use of autologous bone harvested from the mandibular symphysis alone. Out of a group of 26 partially edentulous patients consecutively treated for sinus augmentation in an 18‐month period, eight needed a bilateral procedure and were treated with the same surgical protocol. None of the patients had residual molar teeth, crestal bone height was reduced to 4 mm or less. Bone was harvested from the chin in blocks with a trephine bur, 11 or 9 mm in diameter, it was then particulated with a bone mill. Sinus augmentation and implant placement were done simultaneously in both sides of the maxilla. Implant‐supported fixed partial dentures were inserted 6 months after the procedure. 44 ITI solid screw implants were placed in the grafted sinuses with a mean of 2.75 implants on each side. Mean follow‐up was 19 months. In all patients needing a bilateral sinus lift, the procedure could be successfully completed. All implants were stable at abutment connection. All implants are stable at the latest follow‐up, and all prosthesis are still working. In all implants, a clear bone‐to‐implant contact was visible. No peri‐implant radiolucency has been noticed so far. It is concluded that bilateral augmentation of maxillary sinus floor with particulated mandible associated with simultaneous ITI implant insertion is feasible. It is a safe and effective procedure that can be accomplished in an out‐patient environment with only minor discomfort for the patient.
The Harvest Smart PRePTM system versus the Friadent‐Schütze platelet‐rich plasma kit
Authors: Weibrich Gernot , Kleis Wilfried K. G. , Buch Rainer , Hitzler Walter E. , Hafner Gerd
Published: December 2004

Abstract: An important reason to improve methods for isolating platelet‐rich plasma (PRP) is the potential use of autogenous platelet growth factors. In addition to the Curasan PRP kit (Curasan, Kleinostheim, Germany) and the platelet concentrated collection system (PCCSTM) system, two new methods for the preparation of PRP by the surgeon are now available. This study compared the suitability of these new methods for the preparation of PRP. Whole blood was drawn from 54 healthy donors (33 men and 21 women) aged 23–79 years (38.0 ± 17.7 years). PRP was prepared from each donor's blood using both the Smart PRePTM system (Harvest Technologies Corporation, Munich, Germany) and the Friadent‐Schütze method (PRP kit; Friadent‐Schütze, Vienna, Austria). The platelet count in donor whole blood was 276 810 ± 59 440 /μl. Platelet counts differed significantly between the Smart PRP preparation (1227 890 ± 312 440 platelets/μl) and the Friadent‐Schütze PRP preparation (1440 500 ± 501 700 platelets/μl) (sign test, P < 0.001). The Smart PRePTM system had a significantly higher collection efficiency (63.4 ± 7.9%) than the Friadent‐Schütze kit (49.6 ± 13.6%) (sign test, P < 0.001). The leukocyte contents in the two platelet concentrates were similar (Smart PRePTM, 19 261 ± 8082 platelets/μl; Friadent‐Schütze, 21 691 ± 16 430). Transforming growth factor (TGF)‐β1 and platelet‐derived growth factor (PDGF)‐AB were higher in the Friadent‐Schütze PRP (TGF‐β1, 196.8 ± 109.6 ng/ml; PDGF‐AB, 251.6 ± 115.4 ng/ml) than in the Smart PRePTM (TGF‐β1, 77.2 ± 54.8 ng/ml; PDGF‐AB, 208 ± 85.2 ng/ml). The sign test indicated significant differences between the two methods in the concentrations of TGF‐β1 (P < 0.001) and PDGF‐AB (P < 0.01). Insulin‐like growth factor (IGF)‐1 levels in the two PRP preparations were similar (Friadent‐Schütze PRP, 72.8 ± 22.3 ng/ml; Smart PRePTM, 91.4 ± 21.3 ng/ml). The Smart PRePTM system was superior with respect to ease of handling and preparation time. It also had a significantly higher platelet collection efficiency than the Friadent‐Schütze PRePTM kit. The Friadent‐Schütze PRP kit offers a slight advantage in the resulting PRP platelet concentration. However, this is easily compensated for in the Smart PRePTM system by reducing the volume of the resulting PRP.
Prediction of marginal bone loss and tooth loss – a prospective study over 20 years
Authors: Jansson Leif , Lavstedt Stig , Zimmerman Mikael
Published: December 2004

Aim: The purpose of the study was to investigate the influence of potential risk predictors/risk factors on the longitudinal marginal bone loss and tooth loss over 20 years.

Material and Methods: A clinical and radiographic investigation of a sample of 513 individuals was performed in 1970 and 1990. Stepwise multiple regression analyses were adopted to calculate the influence of the potential risk predictors/risk factors on the longitudinal marginal bone loss and tooth loss.

Results: Russell's Periodontal Index in 1970 and smoking were significantly and positively correlated to longitudinal bone loss. Russell's Periodontal Index, marginal bone loss and Plaque Index at baseline were positively and significantly correlated to the longitudinal tooth loss, whilst age, the number of missing teeth in 1970 and the number of school years showed a significant negative correlation to number of teeth lost between 1970 and 1990.

Conclusions: Smoking was found to be a significant risk factor in marginal bone loss, while plaque was a risk factor in tooth loss. However, the regression models explained a low percentage of the total variance, especially for marginal bone loss.
Powder emission rates of four air polishing devices
Authors: Petersilka Gregor J. , Schenck Ulf , Flemmig Thomas F.
Published: December 2004

Objectives:  Although highly effective in plaque and stain removal, the use of air polishing devices (APDs) on denuded root surfaces may lead to clinically relevant loss of tooth substance. As the amount of powder emitted by an APD may have a significant impact on the safety and efficacy of the instruments, the purpose of the study was to quantify the amount of powder emitted by APDs depending on their powder filling status and powder setting.

Methods: Four different APDs were filled to maximum level and the cumulative amount of powder emitted, depending on instrument settings and filling status, was quantified during 15 subsequent 120‐s periods of use. Differences in powder emission were analyzed using anova repeated measures.

Results: Exact powder dosage was possible in one APD only (Dentsply Prophyjet®) where emission rates also remained constant over the first five periods assessed. In the three other APDs assessed (EMS Air‐Flow®, Satellec Air‐Max®, KaVo Prophyflex II®) powder emission depended on the amount of powder present in the powder chamber and declined with ongoing use. Changes in powder setting had a significant impact on powder emission in all APDs assessed, apart from the KaVo Prophyflex II® unit.

Conclusions: Powder emission of APDs may vary greatly depending on the amount of powder present in the powder bowl. Therefore, instrument powder setting may not be a reliable parameter for safety and efficacy adjustments. This should be considered in clinical applications as well as in future research.
In vitro antimicrobial susceptibility of oral strains of Actinobacillus actinomycetemcomitans to seven antibiotics
Authors: Müller H.‐P. , Holderrieth S. , Burkhardt U. , Höffler U.
Published: December 2004

Background/aims: Periodontal infections with Actinobacillus actinomycetemcomitans seem to be refractory to conventional therapy. The aim of the present study was to test the in vitro susceptibilities of A. actinomycetemcomitans strains to a panel of seven orally administrable antibiotics.

Methods: A total of 60 isolates of A. actinomycetemcomitans recovered from 43 individuals with gingivitis or periodontitis were tested. In addition, laboratory strains UP‐6 and JP2 were analysed. The E‐test was employed in order to determine minimal inhibitory concentrations (MIC) of antibiotics ampicillin/sulbactam, roxithromycin, azithromycin, doxycycline, metronidazole, ciprofloxacin, and moxifloxacin.

Results: A. actinomycetemcomitans was highly susceptible to both fluoro‐quinolones (MIC90 of 0.006 µg/mL of ciprofloxacin and 0.032 µg/mL of moxifloxacin). Good susceptibilities were found for ampicillin/sulbactam and doxycycline (MIC90 of 0.75 µg/mL and 1 µg/mL, respectively), and moderate susceptibilities for azithromycin (MIC90 of 3 µg/mL). Most strains were resistant to metronidazole and roxithromycin. Cluster analysis revealed two larger clusters of A. actinomycetemcomitans strains with the smaller cluster assembling isolates with significantly higher MICs of most antibiotics.

Conclusions: Due to reported favourable pharmacokinetics, the fluoro‐quinolone moxifloxacin appeared to be a promising candidate for adjunctive systemic antibiotic therapy in periodontal infections with A. actinomycetemcomitans.
Cytokine levels in crevicular fluid are less responsive to orthodontic force in adults than in juveniles
Authors: Ren Yijin , Maltha Jaap C. , Van′t Hof Martin A. , Von den Hoff Johannes W. , Kuijpers‐Jagtman Anne Marie , Zhang Ding
Published: December 2004

Objectives: Bone remodelling during orthodontic tooth movement is related to the expression of mediators in gingival crevicular fluid (GCF). No information is available concerning the effect of age on the levels of these mediators in GCF. The purpose of this study was to quantify three mediators (prostaglandin E2, interleukin‐6 and granulocyte‐Macrophage Colony‐Stimulating Factor) in GCF during orthodontic tooth movement in juveniles and adults.

Material and methods: A total of 43 juvenile patients (mean age 11 ± 0.7 year), and 41 adult patients (mean age 24 ± 1.6 year) took part in the study. One of the lateral incisors of each patient was tipped labially, the other served as control. GCF samples were taken before force activation (t0) and 24 h later (t24). Mediator levels were determined by radioimmunoassay (RIA).

Results:PGE2concentrations were significantly elevated at t24in juveniles and adults, while concentrations of IL‐6 and GM‐CSF were significantly elevated only in juveniles. Total amounts of all three mediators in GCF significantly increased at t24in both groups.

Conclusions: In early tooth movement, mediator levels in juveniles are more responsive than levels in adults, which agrees with the finding that the initial tooth movement in juveniles is faster than in adults and starts without delay.
Effects of smoking on periodontal tissues
Authors:   Gloria Calsina, Ramón José‐María , Echeverría José‐Javier
Published: December 2004

Background/Aims: Most studies about the association between tobacco and periodontal disease have shown that tobacco negatively affects periodontal tissues, although some authors have failed to demonstrate such association. Very few studies have tried to find out whether the effect of tobacco on periodontal tissues was similar for women and men. The aims of this investigation were to confirm the possible relationship between tobacco consumption and periodontitis, to study the correlation between intensity of smoking and disease severity, and to investigate any differences between genders related to the effects of tobacco consumption in periodontal health.

Material and methods: In this case‐control study, 240 dental patients were selected according to previously defined criteria and were divided in two groups according to their periodontal status. Patients with established periodontitis constituted the case group. The remaining patients constituted the control group. Smoking status, probing depth, gingival recession, clinical attachment level, tooth mobility, periodontal bleeding index and plaque index were determined for each participant. Generated data were processed for statistical analysis using multiple comparisons, covariance analysis and logistic regression analysis.

Results: Logistic regression analysis showed that smokers had 2.7 times and former smokers 2.3 times greater probabilities to have established periodontal disease than non‐smokers, independent of age, sex and plaque index. Among cases, probing depth, gingival recession and clinical attachment level were greater in smokers than in former smokers or non‐smokers, whereas plaque index did not show differences. Bleeding on probing was less evident in smokers than in non‐smokers. There was a dose–effect relationship between cigarette consumption and the probability of having advanced periodontal disease. The association between tobacco smoking and periodontal disease was more evident after 10 years of smoking, independent of age, gender and plaque index. Finally, it was observed that tobacco affected periodontal tissues more severely in men than in women.

Conclusions: Smoking is a risk factor strongly associated with periodontitis. The effects of smoking on periodontal tissues depend on the number of cigarettes smoked daily and the duration of the habit. The effect of tobacco on periodontal tissues seems to be more pronounced in men than in women.
Epidemiologic risk factors for periodontal attachment loss among adults in the United States
Authors: Hyman Jeffrey J. , Reid Britt C.
Published: December 2004

Objectives:  The objective of this study was to identify variables related to periodontal loss of attachment (LOA).

Materials and Methods:  The study population consisted of a nationally representative sample of 12,325 US adults who participated in the National Health and Nutrition Examination Survey III. The analyses used survey multinomial logistic regression to account for the complex survey design.

Results:  The adjusted odds ratio for a mean LOA of 3 mm or more associated with current smoking was 18.55 (95% CI 9.44–36.45) among 20–49‐year olds. Among those aged 50 years or more, the odds ratio for a mean LOA of 4 mm or more was 25.64 (13.04–50.40). Prior smoking, untreated decayed surfaces (on both person and site levels), and male gender were also associated with LOA. There was no excess risk observed among non‐Hispanic blacks or Mexican‐Americans. The adjusted population attributable fractions due to current smoking were 60% for persons aged 20–49 with the worst 10% of LOA (1.58 mm or more), and 47% for those aged 50 plus (LOA of 3.39 mm or more).

Conclusion:  These results support earlier findings regarding the central role of cigarette smoking in the etiology of periodontal loss of attachment, a role due in large part to the substantial relationship between smoking and severe periodontal disease.
HHV‐6, HHV‐7, HHV‐8 in gingival biopsies from chronic adult periodontitis patients
Authors: Cassai Enrico , Galvan Monica , Trombelli Leonardo , Rotola Antonella
Published: December 2004

Background: Recent reports have suggested that various herpesviruses may be involved in the occurrence and progression of different forms of periodontal disease.

Objective: The objective of the present study was to investigate the presence of the novel herpesviruses HHV‐6, HHV‐7 and HHV‐8 in gingival biopsies from patients affected by chronic adult periodontitis. As control, gingival biopsies from periodontally healthy subjects were analysed.

Materials and methods: Gingival biopsies were harvested from 23 volunteers: 13 patients affected by chronic adult periodontitis (CAP) and 10 periodontally healthy subjects. Each CAP patient contributed two biopsies involving the epithelium and connective tissue facing the sulcus/periodontal pockets: one biopsy from a site having a probing pocket depth (PPD) 5 mm and presenting with bleeding upon probing (affected site) at the time of biopsy collection, and the other biopsy from a site with PPD3 mm and without bleeding on probing (nonaffected site). After DNA extraction, nested PCR was used in herpesvirus identification.

Results: HHV‐6 DNA sequences were detected in one non‐affected site (8%) and no affected sites (0%) of CAP patients. One biopsy (10%) in healthy subjects revealed HHV‐6 positivity. Tissue specimens in 10/13 CAP patients (77%) and 7/10 healthy subjects (70%) contained HHV‐7 DNA. HHV‐7 prevalence in affected and nonaffected sites of CAP patients was 77% and 54%, respectively. HHV‐8 was detected in 7.7% of CAP patients and 0% of healthy subjects.

Conclusions: Gingival tissue may act as a reservoir for HHV‐7. A high prevalence of HHV‐7 was detected in both periodontally diseased and healthy individuals. The prevalence of HHV‐6 and ‐8 was similarly low in both groups. Our data do not support an association of investigated herpesvirus species with destructive periodontal disease.
Subgingival plaque removal in buccal and lingual sites using a novel low abrasive air‐polishing powder
Authors: Petersilka G.J. , Steinmann D. , Häberlein I. , Heinecke A. , Flemmig T.F.
Published: December 2004

Aim of the Study: This study was aimed at assessing the efficacy of subgingival plaque removal in buccal and lingual sites during supportive periodontal therapy (SPT) using a novel low abrasive air‐polishing powder.

Material and Methods: In 27 SPT patients, subgingival debridement was performed using the novel air‐polishing powder (test) and hand instruments (positive control) in a randomized split mouth design. Before and immediately after treatment, subgingival plaque samples were taken from two teeth with pockets of 3–5 mm depth in both groups. To assess the influence of plaque sampling on the microflora, samples were also taken twice from two untreated teeth (negative control). The mean reduction in total colony forming units (CFU) was assessed by anaerobic culture. The patients’ perception of treatment was assessed by a visual analog score (VAS). Therapy and plaque sampling were repeated after a 3‐month interval.

Results: Test treatment resulted in a significantly greater reduction in mean CFU than positive control treatment (log 1.7±0.98 and log 0.61±0.79 respectively; p<0.05). Following both treatments, the CFU reduction was significantly greater compared to negative control treatment (log 0.06±0.49; p<0.05). In addition, test treatment was perceived as significantly more pleasant than hand instrumentation (p<0.05).

Conclusion: The novel low abrasive air‐polishing powder is superior to curettes in removing subgingival plaque from pockets of 3–5 mm depth in supportive periodontal therapy and offers greater patient comfort.
Longitudinal study on the distribution of proximal sites showing significant bone loss
Authors: Laurell Lars , Romao Cristina , Hugoson Anders
Published: December 2004

Background, aims: In 1973, a random sample of 574 dentate individuals aged 15, 20, 30, 40, 50, and 60 years in the city of Jönköping, Sweden, were examined clinically and radiographically to assess oral health and overall treatment needs. Periodontal examination included registration of plaque, gingivitis, probing depths at four aspects of each tooth, and interproximal bone height measurements on full‐mouth intraoral radiographs. In 1990, 17 years later, the same individuals were invited to participate in a new investigation. Of these, 433 (75%) agreed to participate in the investigation and were re‐examined (Hugoson & Laurell 2000). The proximal alveolar bone height at all interproximal sites was measured and expressed as per cent of tooth length. Only teeth that were present in both 1973 and 1990 were included in the assessment of changes in bone score. From the age of 30 years, about 80% of the population had one or more sites with a bone loss of 2–3 mm or more. Seventeen per cent of the individuals had more than six such sites, indicating destructive periodontal disease. Bone loss occurred at sites both with and without previous bone loss. The present study was undertaken to test the hypothesis that sites with a bone loss of 10% or more of the tooth length (2–3 mm) during the 17 years were randomly distributed in the dentition.

Material and methods: Of the 13,197 sites examined in individuals 20–60 years at baseline, 1201 sites (9.0%) in 998 teeth with a bone loss corresponding to 10% or more of the tooth length were found and included in the analysis. A probability test for binomial distribution was used to test the null hypothesis that all teeth had the same risk of losing bone regardless of its position in the dentition. The valid risk for each tooth was 3.571% and the null hypothesis was rejected at the 95% confidence interval.

Results: Although all tooth types were affected by tooth loss, some teeth, namely 17, 16, 42, 41, and 31, showed a higher incidence of sites losing bone, whereas 46, 45, 44, and 36 had a lower incidence. Loser sites in smokers appeared more at random.

Conclusion: Sites that will develop periodontal break‐down over time may appear at random, although with higher risk at maxillary molars and lower incisors. For the early detection of destructive periodontitis, periodontal examination that includes all teeth should be made routine in every dental check‐up.
Antiplaque and antigingivitis effectiveness of a hexetidine mouthwash
Authors: Sharma N. C. , Galustians H. J. , Qaqish J. , Charles C. H. , Vincent J. W. , McGuire J. A.
Published: December 2004

Objective: To assess the antiplaque/antigingivitis efficacy of a hexetidine‐containing mouthwash.

Methods: This examiner‐blind, parallel group, controlled clinical study examined the effectiveness of a hexetidine (0.1%) mouthwash both in inhibiting the development of supragingival plaque and in reducing gingivitis. One hundred and thirty‐four adult subjects completed the 2‐week experimental gingivitis model study. Following baseline examinations, which included plaque index, modified gingival index and gingival bleeding index, subjects received a full dental prophylaxis. Subjects were randomly assigned to one of three mouthwashes (hexetidine 0.1%, chlorhexidine 0.12% (positive control) or a 5% hydroalcohol negative control) and commenced three times daily supervised rinsing as their sole method of oral hygiene. All indices were rescored after 2 weeks.

Results: Compared to the negative control group, the hexetidine group demonstrated a statistically significant inhibition and reduction of supragingival plaque and gingival inflammation with reductions of 6.3%, 33.5% and 56% for gingivitis, plaque and gingival bleeding, respectively. The results of the chlorhexidine group were used to validate the study.

Conclusion: The study confirms the efficacy of a hexetidine rinse in reducing supragingival plaque and gingival inflammation.
Guided tissue regeneration using a polylactic acid barrier
Authors: Ehmke B. , Rüdiger S. G. , Hommens A. , Karch H. , Flemmig T. F.
Published: December 2004

Objectives:  The purpose of this study was to determine the relative impact of various predictors responsible for the variability in treatment outcome after guided tissue regeneration (GTR) in intraosseous periodontal defects.

Patients and methods:  30 patients with chronic periodontitis and at least one intraosseous periodontal lesion (≥4 mm) were enrolled. Following full‐mouth scaling, GTR using polylactic acid membranes was performed at one site in each patient. Main periodontal pathogens, defect morphology, membrane exposure and smoking habit were assessed as predictor variables. Alveolar bone level change served as the primary outcome variable in a multiple regression analysis.

Results:  After 12 months, the 29 patients completing the study showed alveolar bone changes ranging from 4 mm bone gain to 1 mm bone loss (mean: 1.6±0.4 mm gain). Active smoking (β‐weight:‐0.49, P=0.003) and persistence of subgingival infection with P. gingivalis (P.g.) (β‐weight:‐0.25, P=0.11) were associated with poor treatment outcome. Deep initial intraosseous defects (β‐weight: 0.32, P=0.045) were associated with favorable treatment outcome, and membrane exposure had no impact on bone gain.

Conclusion:  Active smoking was the strongest predictor variable negatively affecting alveolar bone gain following GTR in the treatment of periodontal defects. It was followed by a positive influence of a deeper intraosseous defect and by a negative effect by persistent subgingival infection of P. gingivalis. The relative impact of these factors may be useful in assessing the prosgnosis of GTR in intraosseous periodontal defects.
Systemic disorders in patients with periodontal disease
Authors: Lagervall Maria , Jansson Leif , Bergström Jan
Published: December 2004

Background, aims: Over the past 10 years several studies have been published pointing towards a relationship between periodontal disease and various systemic disorders or diseases. The purpose of this retrospective study was to investigate the occurrence of self‐reported systemic disorders in patients referred to a specialist clinic for periodontal treatment and to explore possible relationships between general health and periodontal disease severity in this population.

Material and Methods: Data were collected from the dental records and the health questionnaires of 1006 subjects. Stepwise multiple linear regression analyses were adopted to calculate correlations between systemic disorders as independent variables and number of remaining teeth and the relative frequency of periodontal pockets of 5 mm or more, respectively, as the dependent variable.

Results: The number of remaining teeth was significantly and positively correlated to the presence of cardiovascular disease, diabetes and rheumatoid disease after adjustment for age, sex and smoking. The relative frequency of diseased sites, however, was not significantly correlated to any one of the investigated systemic health disorders.

Conclusion: No significant associations between investigated systemic disorders and periodontal disease severity were found if the relative frequency of deep periodontal pockets was used as the clinical parameter for periodontal disease severity. However, cardiovascular disease, diabetes and rheumatoid disease were found to be significantly correlated to number of lost teeth, which may represent one aspect of periodontal health. This result held true in nonsmokers only.
Fcγ receptor polymorphisms in relation to periodontitis
Authors: Loos B. G. , Leppers‐Van de Straat F. G. J. , Van de Winkel J. G. J. , Van der Velden U.
Published: December 2004

Objectives: Evidence suggests functional relevance for polymorphisms in FcγR in relation to inflammatory and infectious diseases. The present aim was to investigate genetic polymorphisms in three FcγR in relation to susceptibility and severity of periodontitis.

Material and Methods: The study population consisted of 68 periodontitis patients and 61 controls (Northern European Caucasian background, mean ages 44 and 42 years, respectively). Among the patients, 12 subjects were diagnosed with aggressive periodontitis (AgP) and 56 individuals were diagnosed with chronic periodontitis (CP). Radiographic bone levels were scored for all teeth in the patients. Subjects were typed for the following genes (alleles): FcγRIIa (R131 or H131), FcγRIIIa (V158 or F158) and FcγRIIIb (NA1 or NA2).

Results: Hardy–Weinberg equilibrium criteria were fulfilled for the different genotypes at the three genes investigated. The frequency of the FcγRIIIa‐V158 allele in the patient population (53%) was higher than in the control group (39%) (OR 1.73 [1.06–2.85], p=0.034). The V158 carriage rate in AgP was even higher (63%). The frequency of the FcγRIIa‐H131 allele in the total periodontitis population was 58%; for AgP this was 79%, compared with 51% in the control population (OR 3.68 [1.29–10.5], p=0.013). Also, the frequency of the FcγRIIa‐H/H131 genotype was significantly higher in AgP patients than in controls (OR 9.07 [1.29–63.56], p=0.026, adjusted for smoking status and other potential confounders). Moreover, patients with the FcγRIIa‐H/H131 genotype had more severe radiographic bone loss than patients with the other FcγRIIa genotypes.

Conclusion: The current study of relative small sample size suggests that the FcγRIIa‐H/H131 genotype may be a putative susceptibility and severity factor, and the FcγRIIIa‐V158 allele a putative susceptibility factor for periodontitis in Northern European Caucasians. These results need further verification and the biological importance of these findings needs further investigation.
Gingival and other oral manifestations in measles virus infection
Authors: Katz Joseph , Guelmann Marcio , Stavropolous Franci , Heft Marc
Published: December 2004

Background: Measles is a highly contagious, viral infectious disease affecting mainly children and young adults. It is characterized by high fever, maculopapular rash, keratoconjunctivitis and pathognomonic oral Koplik's spots.

Methods: During an outbreak of measles among soldiers in the Israeli military, patients were referred to one medical center where they were also examined for oral signs and symptoms of their illness.

Results: We present a case of measles infection with distinct oral findings. These included Koplik's spots, various forms of ulcerations of the free mucosa, ‐like gingivitis and pericoronitis. All oral lesions resolved after cessation of systemic illness.

Conclusions: The measles virus is associated with a transient inhibition of the host response. Immunosuppression may create the necessary condition for the proliferation of pathobacteria associated with the observed pericoronitis and the other gingival lesions.
C‐1 esterase inhibitor dysfunction localised to the periodontal tissues: clues to the role of stress in the pathogenesis of chronic periodontitis?
Authors: Roberts A. , Shah M. , Chapple I. L. C.
Published: December 2004

Background: C1‐esterase inhibitor (C1eIn) is an important modulator of complement activation via the classical pathway. Deficiencies or dysfunction involving this inhibitor underlie the condition of angioneurotic oedema.

Aim:

The purpose of this report is to describe a female patient who presented at the age of 24 years with an apparently aggressive form of periodontitis and severe oedema, localised to the free gingival tissues. After 21 years of repeated surgical reduction of the gingiva, a diagnosis of C1eIn dysfunction was made.

Methods:

Exhaustive serological investigations were performed along with histopathology.

Results:

All investigations were unremarkable, until the function of the C1eIn molecule was investigated. These demonstrated a functional activity of only 29% and a raised C1q at 157 mg/l. Subsequent repeated investigation with careful specimen handling demonstrated undetectable levels of C1eIn and normal C1q. A diagnosis of C1eIn dysfunction was made, although at present it is unclear whether this represents an unusual variant of hereditary dysfunctional C1eIn deficiency. The patient was managed by various means, including steriodal and non‐steroidal drugs, the latter forming part of her maintenance regime.

Conclusions:

To our knowledge, this is the first case of angio‐oedema localised to the free gingiva. The role of stress in the acute exacerbations of oedema and bone loss is discussed along with the diagnostic pitfalls associated with this case.
Interactions between the gingiva and the margin of restorations
Authors: Padbury Allan , Eber Robert , Wang Hom‐Lay
Published: December 2004

An adequate understanding of the relationship between periodontal tissues and restorative dentistry is paramount to ensure adequate form, function, esthetics, and comfort of the dentition. While most clinicians are aware of this important relationship, uncertainty remains regarding specific concepts such as the biologic width and indications and applications for surgical crown lengthening. This review discusses the concept of the biologic width and its relationship to periodontal health and restorative dentistry. The importance of restorative margin location, materials, and contours related to periodontal health is also addressed. The rationale and indications for surgical crown lengthening are elaborated. Particular surgical principles of crown lengthening are examined in detail.
Eruption cyst formation associated with cyclosporin A
Authors: Kuczek A. , Beikler T. , Herbst H. , Flemmig T. F.
Published: December 2004

Background: Cyclosporin A (CyA) is a potent immunomodulatory agent with a wide range of applications. Despite its therapeutic value, multiple adverse effects of CyA have been identified. This case report describes eruption cyst formation as a possible adverse effect of CyA administration during tooth eruption in a boy treated with CyA as a consequence of a cardiac transplantation. The clinical diagnosis of eruption cyst was confirmed by histopathological examination.

Treatment: The periodontal treatment consisted of supragingival and subgingival scaling, followed by surgical removal of the tissues overlying the crowns of the teeth associated with eruption cysts, and flap surgery in the region of gingival overgrowth. The patient was then placed on quarterly periodontal supportive therapy and his immunosuppressive medication was switched from CyA to tacrolimus.

Results: Twenty months after therapy, neither new cyst formation nor recurrence of gingival overgrowth was registered.

Conclusion: Formation of an eruption cyst may be an adverse effect of CyA in children with erupting teeth.
Comparison of infrabony defects treated with enamel matrix derivative versus guided tissue regeneration with a nonresorbable membrane
Authors: Silvestri Maurizio , Sartori Stefano , Rasperini Giulio , Ricci Giano , Rota Chiara , Cattaneo Vitaliano
Published: December 2004

Aim:

The purpose of the present multicenter clinical trial was to compare the efficacy of two different procedures in the treatment of infrabony defects: guided tissue regeneration (GTR) with nonresorbable membranes and enamel matrix derivative (EMD).

Material and methods: Six centers participated in this study. Ninety‐eight patients with an interproximal infrabony defect were selected. All patients were treated with an initial phase of scaling and root planing, and at the study's baseline the selected defects presented a value of probing depth (PD) ≥6 mm with an infrabony component ≥4 mm. Forty‐nine patients were treated with GTR procedures (using ePTFE membranes (Gore‐Tex W.L. Gore and Associates, Flagstaff, AZ, USA)) and forty‐nine with EMDs (Emdogain® (Û Biora AB Malm, Sweden)). The efficacy of each treatment modality was investigated through covariance analysis.

Results: The patients were reevaluated at one year postop. Probing attachment level (PAL) gain and PD reduction were analyzed. In the Emdogain® group the PAL before surgery (PAL 0) and the PD before surgery (PD 0) were respectively 9.9±1.4 and 8.5±1.6 mm. The PAL gain and the PD reduction at 1 year postsurgery were respectively 4.1±1.8 and 5.3±1.9 mm. The group of patients treated with membranes showed that PAL 0 and PD 0 were respectively 8.9±1.9 and 8.1±1.9. The PAL gain was 4.3±1.9 mm and the PD reduction was 5.6±1.5 mm. The mean PAL gain expressed by percentage (PAL gain/PAL 0) for the group treated with EMD was 41%, while it was 48% for the group treated with GTR. Results from our analysis suggest that there is no statistically significant difference between GTR and EMD treatments in terms of PAL gain, PD reduction and recession variation. Applying the regression model to a group of patients with a PAL 0 ≥8 mm, we observed a better clinical outcome in terms of PAL gain (difference of 0.3 mm) in patients treated with the GTR procedure compared to those treated with EMD. Covariance analysis showed a strong correlation in both groups of patients between PAL gain and full mouth bleeding score, and between PAL gain and defect morphology and depth.
Association of the−1087 IL 10 gene polymorphism with severe chronic periodontitis in Swedish Caucasians
Authors: Berglundh Tord , Donati Mauro , Hahn‐Zoric Mirjana , Hanson Lars‐Å. , Padyukov Leonid
Published: December 2004

Background: Severe forms of periodontitis are suggested to have a genetic basis.

Objective: The aim of the present investigation was to study association of an IL10 gene polymorphism (G to A transition at the –1087 position) with severe chronic periodontitis.

Materials & methods: Two groups of Swedish Caucasian subjects were included. One group consisted of 60 patients (aged 36–74 years; mean 54.5±8.5) with severe and generalized chronic periodontitis. The patients exhibited bone loss >50% at all teeth. Thirty‐nine periodontally healthy subjects between 35–78 years of age (mean 51.0±10.9) were also recruited. DNA was isolated from peripheral blood cells and genotyping was performed by combination of PCR with restriction endonuclease mapping.

Results: The proportion of subjects that exhibited the GG genotype was significantly larger in the group with severe periodontitis than in the periodontally healthy group. The difference regarding the occurrence of the GG genotype between the two groups was more conspicuous in non‐smokers and yielded an odds ratio of 6.1. The G allele carriage in non‐smokers was >90 % in the periodontitis group and was significantly higher than in the healthy controls.

Conclusion: It is suggested that the −1087 IL10 polymorphism in Caucasian subjects of a north European origin is associated with severe chronic periodontitis.
Hyperaemic response to cigarette smoking in healthy gingiva
Authors: Mavropoulos Antonios , Aars Harald , Brodin Pål
Published: December 2004

Background and aim: Cigarette smoking is currently considered as a risk factor for periodontal disease. Controversy exists as to whether the vasoconstrictive property of nicotine is one of the pathogenic mechanisms. To this end we tested the hypothesis that cigarette smoking is causing vasoconstriction in the healthy human gingiva.

Materials and Methods: Gingival blood flow was continuously measured with laser Doppler flowmetry in healthy (n=13) casual consumers of tobacco. Simultaneously, recordings were made of skin blood flow in the forehead and the thumb as well as heart rate (HR) and blood pressure (BP). In another session infraorbital nerve block anaesthesia (INB) with 1.0 ml of Carbocain® without vasoconstrictive additives was used to identify nervously mediated vascular responses to cigarette smoking (n=8).

Results: Cigarette smoking induced a modest hyperaemic response in the gingiva that was lower than the relative increases in BP and HR, and the calculated gingival vascular conductance decreased. In the forehead, flow responses were similar to those in the gingiva, while in the thumb a powerful vasoconstriction was observed. During the later part of the 10‐min recovery period, BP and HR tended to decrease while blood flow in the gingiva and forehead remained high. INB potentiated the hyperaemic response to cigarette smoking in gingiva.

Conclusions: The present results help to shed some light on the understanding of the vasoactive mechanisms induced by cigarette smoking, and to support the hypothesis that cigarette smoking causes nervously mediated vasoconstriction in the healthy human gingiva. However, the degree of vasoconstriction was far less than in the thumb skin, and in our subjects was overcome by the evoked rise in arterial perfusion pressure. As a consequence, gingival blood flow increased during smoking. It is speculated that small repeated vasoconstrictive attacks due to cigarette smoking may in the long run contribute to gingival vascular dysfunction and periodontal disease.