bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Two Sonic and Two Ultrasonic Sealer Tips in Furcations
Authors: Patterson Mary , David Eick J. , Eberhart Adele B , Gross Karen , Killoy William J.
Published: March 2012

This study compared the effectiveness of two sonic and two ultrasonic sealer tips on artificial calculus removal from the furcations of mandibular first and second molars. Twenty‐four extracted mandibular molars were cleaned and randomly assigned to one of four treatment groups. Teeth were split buccal lingually, artificial calculus was placed in the furcation areas, and the teeth were photographed with a stereo camera. Teeth were reconnected with bonding material and mounted in a typodont with simulated gingiva and attached to a dental chair. Teeth were instrumented with either a Cavitron TFI10 tip, Cavitron EWPP tip, Titan–S Universal tip, or Titan‐S Sickle tip by a licensed dental hygienist until each tooth was judged calculus free to the touch with a CH3 explorer. Time for each instrumentation period was recorded. Following instrumentation, the teeth were again split and photographed. Stereophotogrammetry was used to produce tracings of the teeth with initial calculus and remaining calculus. Pre‐instrumentation and post‐instrumentation amounts of calculus on the surface area were computed using the Bloquant system. A two factor analysis of variance was conducted followed with a Newman–Keuls Multiple Comparison Technique to test for within and between differences. Significant differences (P ≤ 0.01) were found between pre‐ and post‐amounts of calculus for all tips. No significant differences (P ≤ 0.05) were found between the four instrument tips with respect to percentage of furcation surface with calculus remaining. No differences were found between tips with regard to the time required to clean the test surfaces.
Periodontitis in a Patient with Chronic Neutropenia
Authors: Carrassi Antonio , Abati Silvio , Santarelli Giorgio , Vogel Giorgio
Published: March 2012

The aim of this investigation was to obtain information about the composition and the morphology of the microorganisms that inhabit the root surface of a patient with chronic neutropenia and severe and progressive Periodontitis. In addition, gingival biopsies were studied by both scanning and transmission electron microscopy (SEM and TEM) to look for bacteria within the gingiva. Dark field microscopy (DFM) revealed 50% spirochetes, 30% motile rods, and 20% coccoid forms. Fourteen extracted teeth studied by SEM showed that the distribution of different bacterial morphotypes varies along the root surface and spirochetes are the prevailing bacteria on the most apically located plaque. TEM analyses of gingival tissue revealed no bacterial invasion within the gingiva. This study suggests that spirochetes may play an important role in the etiology of Periodontitis associated with chronic neutropenia. In spite of neutropenic status, there was no bacterial invasion into the gingiva, suggesting that host reaction to dental plaque has not been abolished in this condition.
The Development During Pregnancy of Pyogenic Granulomas Superimposed Upon a Congenital Hemangioma:
Authors: Tervahartiala Barbara , Ainamo Jukka
Published: March 2012

A case of a 25–year old female school teacher with pyogenic granulomas of the gingiva developing during her first pregnancy in the area of a congenital hemangioma is described. The recurrence of the pyogenic granulomas of the gingiva during the second pregnancy could be successfully prevented by scaling and root planing prior to and bi‐weekly professional tooth cleaning during pregnancy period. Hormonal changes during pregnancy were in this case found not to influence the development of gingival pyogenic granulomas during maintenance of optimal dental hygiene.
An Estimate of Periodontal Treatment Needs in the U.S. Based on Epidemiologic Data
Authors: Oliver R. C. , Brown L. J. , Löe H.
Published: March 2012

It has generally been assumed, based on previous epidemiologic and utilization studies as well as the increasing elderly population, that there would be an increasing need for periodontal treatment. Analysis of a more recent household epidemiologic survey conducted in 1981 indicates that the need for treatment of Periodontitis is less than previous estimates. These epidemiologic data have been translated into treatment needs through a series of conversion rules derived from previous studies and current patterns of treatment, and applied to the 1985 U.S. population. The total periodontal services needed for scaling, surgery, and prophylaxes would require 120 to 133 million hours and $5 to $6 billion annually if the total population were treated for Periodontitis over a 4‐year period. Only 11% of the total hours needed would be for scaling and surgery whereas 89% would be needed for prophylaxes. Expenditures for periodontal treatment total approximately 10% of the amount being spent on dental care in 1985. On the basis of these data, it seems unlikely that there will be a substantial increase in the need for periodontal treatment in a growing and aging U.S. population. These figures represent the upper limits of treatment need and are reduced by factoring in current utilization of periodontal treatment.
Effect on Periodontal Status of Rotary Electric Toothbrushes vs. Manual Toothbrushes During Periodontal Maintenance
Authors: Boyd R. L. , Murray P. , Robertson P. B.
Published: March 2012

The purpose of this study was to compare the Rotadent rotary electric toothbrush with conventional toothbrushing for its effectiveness in controlling supragingival plaque and gingival inflammation in periodontal maintenance patients. Forty subjects who had received periodontal treatment, including periodontal surgery, for moderate to advanced Periodontitis and were on a 3‐month periodontal maintenance were divided into two equal groups matched for age and sex. One group used conventional toothbrushing, dental floss, and toothpicks and the other used only the rotary electric toothbrush for a 12‐month study period. Single‐blind clinical assessments (Plaque Index, Gingival Index, bleeding tendency, pocket depth, and loss of attachment) were made at baseline and at 3, 6, 9, and 12 months after baseline. Subgingival debridement was performed 1 week after the baseline assessment and the 6‐ and 12‐month examinations. Plaque removal was reinforced at 3‐month intervals. Both groups had significantly improved scores (P < 0.01) for Gingival Index and bleeding tendency during the 12‐month period, but no differences were found between the groups at any examination. These results indicate that the rotary electric toothbrush is as effective for plaque removal and control of gingival inflammation as a combination of conventional toothbrushing, flossing, and toothpicks for patients in periodontal maintenance.
Effects of Penicillin and Erythromycin on the Clinical Parameters of the Periodontium
Authors: Helovuo Hilkka , Paunio Keijo
Published: March 2012

The clinical effects of systemic penicillin and Erythromycin on the periodontium were investigated. There are only a few studies of the effects of these antibiotics on clinical periodontal parameters. Of the 72 subjects in the study, 24 belonged to the penicillin group, 21 to the erythromycin group and 27 to the control group. Plaque and gingival indices, tooth mobility, and probing depths of gingival pockets were recorded before the drug treatment and again 1, 2, 3, 4, and 12 weeks later. Dental calculus was recorded before the drag treatment. Radiographs were taken. Both antibiotics decreased plaque, and erythromycin also decreased gingivitis. In the penicillin group 10 of the 24 patients developed abscesses during the study, and the studied clinical parameters worsened. These patients had more severe Periodontitis initially than the persons with no acute reaction. The clinical changes had returned to the baseline level by 12 weeks after the antibiotic treatments. There were no significant or lasting effects of antibiotic treatment alone in patients with overt Periodontitis.
The Effectiveness of a Counter‐Rotary Action Powered Toothbrush and Conventional Toothbrush on Plaque Removal and Gingival Bleeding
Authors: Killoy William J. , Love John W. , Love Jerry , Fedi Peter F. , Tira Daniel E.
Published: March 2012

Initial investigations have demonstrated the effectiveness of a new contra‐rotary powered electric toothbrush in removing plaque supragingivally, subgingivally, and interproximally following a single use. The purpose of this study was to evaluate the effectiveness of a counter–rotary toothbrush following 1) one time instruction, 2) reinstruction and 1 week practice; and 3) a third instruction and 3 weeks of practice and home use. Twentyfour patients were studied; 12 using the counter‐rotary toothbrush and 12 using a conventional toothbrush. Using O'Leary and Turesky plaque indices, both brushes significantly reduced supragingival plaque from baseline at all intervals. The counter‐rotary brush, however, was more efficient than the conventional brush at all intervals (P < 0.01). Using a Surface Area Plaque Index, both brushes significantly reduced supragingival plaque from baseline at all intervals but there were no significant differences between brushes. A timed bleeding index showed significant reduction in gingival bleeding following 28 days of brushing with both brushes. Again, the counter‐rotary toothbrush was superior to the conventional toothbrush (P < 0.01).
Effect of Various Graft Materials with Tetracycline in Localized Juvenile Periodontitis
Authors: Evans Gerald H. , Yukna Raymond A. , Sepe Walter W. , Mabry Thomas W. , Mayer Elizabeth T.
Published: March 2012

Ten patients with bilateral, posterior osseous defects associated with localized juvenile Periodontitis (LJP) completed the study. Following the initial therapy, osseous defects were surgically debrided and grafted with a 4:1 volume ratio combination of either Synthograft/ tetracycline (b‐TCP/TTC), Periograf/tetracycline (HA/TTC) or freeze‐dried bone allograft/ tetracycline (FDBA/TTC). Graft materials were selected randomly for each half mouth following defect debridement, with a different material used on the opposite side for that patient. Immediately following each surgery, patients were placed on doxycycline 100 mg/ day for 10 days. Direct re‐entry evaluation of 51 osseous defects demonstrated no significant differences among the graft materials regarding hard tissue or soft tissue changes, except for greater percent defect fill for HA/TTC compared to b‐TCP/TTC. Significant decreases in defect depth and pocket depth were achieved with each graft material. No adverse reactions to the use of any of the graft materials in combination with local and systemic tetracycline were found. The results indicate all three graft materials used in conjunction with TTC are acceptable and beneficial for the treatment and repair of osseous defects associated with localized juvenile Periodontitis. {J Periodontol 1989;60:491–497)
Gingival Resistance to Probing Forces
Authors: Garnick J. J. , Keagle J. G. , Searle J. R. , King G. E. , Thompson W. O.
Published: March 2012

This study was undertaken to determine the effect of gingival inflammation and probing pressure on probe tip placement in relation to the base of the gingival crevice and the most coronal connective tissue attachment fibers. Nine young male beagle dogs were divided into three groups as determined by clinical status of the gingiva following implementation of a protocol designed to produce gingival health and disease. An electromechanical device was used to advance 0.6 mm diameter probes into the facial gingival crevices of selected teeth and to obtain force‐displacement curves. The instrument stopped the probe at pressures of either 80, 160, 320, 640, 1280, or 2560 kPa which were randomly allocated to 12 test teeth in each dog. After the probe came to rest, it was attached to the tooth. When all 12 probes were attached, the animal was sacrificed. Blocks consisting of gingiva, probe, and tooth were processed to obtain two buccolingual sections, one containing the probe and the other immediately adjacent to it. Clinical and histometric measurements were performed and the data evaluated. Although three groups of animals were discernable by clinical criteria, only two groups, health and disease, could be formulated based on the degree of histologic inflammation. The histologic grouping was used in data analysis. Histometric distances from the cemento‐enamel junction to the base of the crevice (cJ), to most coronal connective tissue attachment (cC) and to the probe tip (cP) all increased with change from health to disease. However, changes in health/disease did not influence differences between distances (cP‐cJ,cP‐cC). It was therefore concluded that inflammation was not a factor in probe tip position relative either to the base of the crevice or to the most coronal connective tissue attachment. However, pressure was a significant factor. Therefore, the pressures at which cP = cJ and cP = cC were computed. Placement of a probe at the base of the crevice required an estimated 474 kPa or a force of. 17 N using a probe of 0.6 mm in diameter. The pressure required to place the probe at the most coronal connective tissue attachment was estimated at 1927 kPa or a force of.69 N using a probe of similar diameter. (J Periodontol 1989;60:498– 505.)
In vitro Activity of a Chlorhexidine–Containing Mouthwash Against Subgingival Bacteria
Authors: Wade W. G. , Addy M.
Published: March 2012

Three hundred and fifteen subgingival isolates were tested for their susceptibility to a mouthwash containing 0.2% Chlorhexidine. The majority of strains tested were susceptible at high dilution although some strains of S. mitior, S. sanguis, and Capnocytophaga were relatively resistant. It was concluded that, on the basis of these in vitro results, the mouthwash should have potential for subgingival use in the treatment of chronic Periodontitis. (J Periodontol 1989;60:521–525.)
Bacterial Penetration of Gingiva in the Adult Beagle Dog With Periodontitis
Authors: Silverstein L.H. , Schuster G. S. , Garnick J.J. , Singh B.
Published: March 2012

Invasion of gingival tissues by bacteria is thought to be a major factor in development of periodontal lesions. Morphologic studies have revealed bacteria within the pocket epithelium, gingival connective tissues, alveolar bone, and oral epithelium. The current studies are intended to determine whether they are present in healthy and diseased tissues and to identify the microbial source. Five beagle dogs with naturally occurring periodontitis were fed a soft diet. Two quadrants of the dentition of each dog were cleaned regularly and health maintained while others were allowed to develop further disease. After 4 weeks, samples of gingiva were removed both prior to and after the animals were sacrificed by perfusion fixation attempting not to introduce microorganisms. The identical samples were examined by light and scanning electron microscopy for numbers and location of organisms. Their numbers were greater in diseased than in healthy tissues. Furthermore, the quantity was greater in samples taken prior to perfusion fixation than after such treatment, especially in the oral epithelium. The results suggest that normally there are some microorganisms present within the periodontal tissues and that their numbers are greater in diseased tissues. However, the data also indicated that significant numbers may be introduced into the tissues during sampling of unfixed tissues. J Periodontol 1990;61:35–41.
Furcation Defects in Dogs Treated by Guided Tissue Regeneration (GTR)
Authors: Caffesse Raul G. , Dominguez Liza E. , Nasjleti Carlos E. , Castelli Walter A. , Morrison Edith C. , Smith Billy A.
Published: March 2012

This study evaluated the effects of guided tissue regeneration (GTR) in the treatment of Class II furcation defects in beagle dogs. Gore‐Tex periodontal material was used, and the amount of furcation fill and the surface area corresponding to new connective tissue attachment and new bone were evaluated. If present, epithelium was also evaluated. Six female dogs with naturally‐occurring periodontitis were given thorough root debridement. Four weeks later mucoperiosteal flaps were raised, involving the mandibular 2nd, 3rd, and 4th premolar and 1st molar teeth. After debridement, notches were placed on the roots at the level of furcal alveolar bone. Gore‐Tex material was adapted to the furcation and secured with sutures on two teeth of each quadrant. The flaps were sutured tightly, making sure the margin of the material was covered. Teeth receiving only surgery acted as controls. Gore‐Tex material was removed 1 month following surgery. All dogs were sacrificed by exsanguination at 3 months. Mesiodistal sections were evaluated by descriptive histology. Surface area determination of the furcal tissues was carried out using a microscope attached to a computerized digitizer. Approximately 10 serial sections per tooth were evaluated. Mean values for each dog were obtained for experimental and control teeth and analyzed using paired t‐tests (N = 6) to see whether different treatments had any effect on the parameters tested. Different degrees of fill were seen with epithelium, new connective tissue, and bone. Statistically, GTR gave significantly better results in the amount of connective tissue and bone fill achieved. J Periodontol 1990;61:45–50.
The Effectiveness of Subgingival Scaling and Root Planing II. Clinical Responses Related to Residual Calculus
Authors: Sherman P.R. , Hutchens L.H. , Jewson L.G.
Published: March 2012

This study related 3‐month clinical changes following scaling and root planing to the presence or absence of calculus on the root surfaces detected after extraction. Seven patients provided 646 sites evaluated for plaque, bleeding upon probing (BOP), probing pocket depth (PPD), and probing attachment level (PAL) at baseline and monthly following instrumentation. The teeth were extracted and evaluated for the presence and the percent surface area of calculus. Diagnostic sensitivity and predictability values for initial and residual PPDs, loss of PAL, and BOP in detecting residual calculus were determined. Calculus was found on 376 surfaces with a mean percent surface area of 3.13%. Predictability values were similar for all PPD ranges, while sensitivity decreased with increasing PPD. Probing attachment level changes were found to be unrelated to the presence or the amount of residual calculus. Bleeding upon probing had high levels of predictability, but sensitivity values were low. None of the clinical parameters evaluated in this study provided both a high level of predictability and sensitivity in detecting residual calculus. J Periodontol 1990;61:9–15.
Actinobacillus actinomycetemcomitans in Families Afflicted With Periodontitis
Authors: Gunsolley John C. , Ranney Richard R. , Zambon Joseph J. , Burmeister John A. , Schenkein Harvey A.
Published: March 2012

The purpose of this study was to determine the prevalence of Actinobacillus actinomycetemcomitans (Aa) in individuals from families where at least one individual has an early onset form of periodontitis. Twenty‐three families with 73 subjects were evaluated in this study. Forty‐seven early onset periodontitis subjects outside the 23 families were also studied. Prevalence of detection of Aa in family members ranged from 49% to 66% among groups constituted by clinical findings indicative of no loss of attachment, adult periodontitis, generalized severe juvenile periodontitis, or localized juvenile periodontitis. Whether the data were analyzed by subject or by site, no statistical differences could be found in prevalence (proportion of positive samples) among those clinical groups. The only significant difference was that localized juvenile periodontitis subjects had higher concentrations of Aa in their Aa‐positive sites than did the other clinical groups. The prevalence of Aa‐positive sites in subjects without attachment loss, but who are members of families in which early onset periodontitis is represented, was much higher than in other reports where periodontally healthy subjects were not related to early onset periodontitis cases. This suggests that Aa may be transmitted among members of families in which one or more members has an early onset form of periodontitis. J Periodontol 1990; 61:643‐648.
Repair Potential in Localized Juvenile Periodontitis. A Case in Point
Authors: Mattout Paul , Moskow Bernard S. , Fourel Jean
Published: March 2012

An aggressive form of localized juvenile periodontitis (LJP) in a 12‐year old West African female is reported. The case was treated with scaling, root planing, debridement, and tetracycline therapy, which resulted in complete resolution of the disease, including elimination of periodontal inflammation, regeneration of lost periodontal structures, and spontaneous repositioning of teeth that had pathologically migrated. A hopelessly involved mandibular right first molar was successfully replaced by an incompletely developed maxillary third molar tooth bud whose roots and pulp structure continued to develop after autotransplantation. It is suggested, that LJP can be successfully treated without periodontal surgery and that the potential for repair in LJP cases is apparently greater than what one can anticipate in adult forms of periodontitis. J Periodontol 1990; 61:653–660.
Clinical and Microbiological Effects of Subgingival and Gingival Marginal Irrigation With Chlorhexidine Gluconate
Authors: Jolkovsky David L. , Waki Marc Y. , Newman Michael G. , Otomo‐Corgel Joan , Madison Miles , Flemmig Thomas F. , Nachnani Sushma , Nowzari Hessam
Published: March 2012

Recent interest in the local delivery of antimicrobial and anti‐inflammatory agents has stimulated interest in the efficacy of various treatment regimens. Chlorhexidine gluconate (CHX) delivered daily by home‐applied marginal irrigation as a 0.04% solution in combination with a single professional irrigation of 0.12% CHX was tested over a 3month period. Sixty periodontal maintenance patients each having at least 2 pockets ≥ 4 mm probing depth, and bleeding on probing were assigned to either Group 1: one professional subgingival 0.12% CHX (Peridex) irrigation (Perio Pik) followed by adjunctive daily home marginal 0.04% CHX irrigation (Pik Pocket); Group 2: one professional subgingival 0.12% CHX irrigation followed by adjunctive daily home marginal water irrigation; Group 3: one professional subgingival water irrigation followed by adjunctive daily home marginal water irrigation; or Group 4: control. At baseline and 3 month visits, subgingival plaque samples were taken from 2 sites per patient. Cultural microbiological analysis was performed using non‐selective and selective media. Plaque Index, Gingival Index, pocket probing depths, and gingival recession were assessed. Scaling and root planing (supportive periodontal treatment) was provided for each patient followed by subgingival irrigation as outlined above. At 3 months the Gingival Index and pocket probing depths were both significantly reduced (P <.05) in all irrigation groups compared to baseline. There were no significant changes in clinical parameters in the control group from baseline to 3 months. In Group 1 the GI was significantly reduced (P <.05) compared to Group 4 at 3 months. W. recta and black‐pigmented Bacteroides sp were significantly reduced in Group 1 at 3 months compared to baseline. The findings suggest that it is possible to achieve beneficial clinical and microbiological effects from adjunctive professional 0.12% CHX and home 0.04% CHX subgingival irrigations in periodontal maintenance patients receiving supportive periodontal treatment. J Periodontol 1990; 61:663–669.
Reliability of Crevicular Fluid Measurements Taken in the Presence of Supragingival Plaque
Authors: Stoller Norman H. , Karras Donna C. , Johnson Lonnie R.
Published: March 2012

The measurement of gingival crevicular fluid (GCF) is commonly used in clinical studies to quantitate the severity of gingival inflammation. This study examined the influence of the presence of supragingival plaque on GCF readings. Bilateral pairs of maxillary premolars received replicate GCF measurements. One of the teeth was randomly selected to be the test tooth. Supragingival plaque was removed from the test tooth between the first and second GCF measurements. Plaque was not removed from the control tooth. The crevicular fluid was collected on filter paper strips which were placed just subgingivally. The quantity of crevicular fluid was determined with the aid of the Periotron 6000. The mean difference between the first and second GCF measurement for the control teeth was –1.5 ± 5.7 (± SD). This change was not significant (P = 0.21). The mean difference between the first and second GCF measurements for the experimental teeth (—21.3 ± 16.5) was significant (P ≤.001). The mean difference between the control and the experimental GCF differences were found to be highly significant (P ≤.001). The data indicate that the presence of supragingival plaque can significantly elevate the GCF measurements when determined with the Periotron 6000. J Periodontol 1990; 61:670–673.
Studies of the Subgingival Microflora in Patients With Acquired Immunodeficiency Syndrome
Authors: Zambon Joseph J. , Reynolds Homer S. , Genco Robert J.
Published: March 2012

Two unique forms of periodontal disease, HIV‐gingivitis and HIV‐periodontitis, have been described in patients with Acquired Immunodeficiency Syndrome (AIDS). In order to determine the bacterial species associated with periodontitis in AIDS patients, the predominant cultivable microflora was examined in 21 subgingival plaque samples from 11 AIDS patients with periodontitis. The presence of putative periodontal pathogens including Actinobacillus actinomycetemcomitans, Bacteroides intermedias, Porphyromonas gingivalis (formerly B. gingivalis), and Wolinella recta was examined by immunofluorescence in 128 subgingival dental plaque samples from 50 AIDS patients including 32 patients with periodontitis. Of 666 bacterial strains isolated from the 21 subgingival plaque samples, Streptococcus sanguis II was the most frequently recovered species comprising 18.5% of the total number of isolates followed by Lactobacillus acidophilus (12.2%), Porphyromonas gingivalis (12%), Fusobacterium nucleatum (11.4%), Staphylococcus epidermidis (8.7%), Actinomyces naeslundii (7.5%), and Actinomyces viscosus (4.7%). Fusobacterium nucleatum was the most prevalent species and was found in 76% of the sites and 91% of the patients. Enteric species including Enterococcus avium and Enterococcus faecalis, Clostridium clostridiiforme and Clostridium diffide as well as Klebsiella pneumoniae also were recovered. Immunofluorescence assays detected similar carriage rates of A. actinomycetemcomitans, B. intermedius, and P. gingivalis in both gingivitis patients and periodontitis patients, while four times more periodontitis patients demonstrated W. recta. Subgingival yeast was a frequent finding in these AIDS patients, present in 62% of the subjects and 55% of the sites. This study indicates that subgingival plaque in AIDS patients with periodontitis can harbor high proportions of the same periodontal pathogens as are associated with periodontitis in non‐HIV infected subjects as well as high proportions of opportunistic pathogens. J Periodontal 1990;61:699–704.
Gingival Manifestations of Wegener's Granulomatosis
Authors: Cohen Robert E. , Cardoza Thomas T. , Drinnan Alan J. , Aguirre Alfredo , Neiders Mirdza E.
Published: March 2012

Localized wegener's granulomatosis is characterized by necrotizing granulomatous disease affecting the upper and lower respiratory tracts, mucosa, and skin. Without treatment, disseminated necrotizing vasculitis and focal necrotizing glomerulonephritis usually follow. Although oral lesions are relatively common, they have been infrequently described and have rarely been reported as the sole manifestation of this disease. In this report, we present two cases of early Wegener's granulomatosis which featured hyperplastic gingival lesions as the initial presenting lesion. Clinical findings and histological evaluation of tissue obtained from the gingival lesion following incisional and excisional biopsies supported the diagnosis of Wegener's granulomatosis. These cases illustrate that less‐frequently occurring entities should be considered in the differential diagnosis of localized gingival lesions which fail to respond to conventional therapy. J Periodontol 1990; 61:705–709.
Oral Manifestation of Immunoproliferative Small Intestinal Disease. A Case Report
Authors: Bartold P. Mark , Henning Frederick R.
Published: March 2012

A patient with a previous medical history of immunoproliferative small intestinal disease (IPSID) presented with persistent red and ulcerated lesions on her attached gingiva. Despite the obvious long standing gingival inflammation, minimal destruction of alveolar bone had occurred. Following failure of the tissues to respond to routine periodontal therapy, a gingival biopsy was taken. Histological assessment of the specimen revealed several features in common with the intestinal lesions seen in IPSID. In particular, a large plasma cell infiltrate subjacent to the gingival epithelium was noted. There was a marked loss of normal connective tissue morphology and evidence of epithelial degeneration. Treatment has since consisted of palliative measures only. While this is a relatively rare condition, it (as well as other disorders of the immune system) provides a useful insight into the role that the immune system plays in the inflammatory periodontal diseases. J Periodontol 1990; 61:710–713.
Increase of Interproximal Bone Density After Subgingival Instrumentation: A Quantitative Radiographical Study
Authors: Dubrez B. , Graf J.M. , Vuagnat P. , Cimasoni G.
Published: March 2012

Ten interproximal sites, with periodontal pockets deeper than 5 mm and showing loss of bone on standard dental radiographs, were treated by subgingival instrumentation in 10 patients properly motivated and given thorough hygiene instructions. The index of gingival inflammation, the plaque index, the degree of mobility, the depth of the pockets, and the loss of attachment were measured before starting the treatment, and 2 months, 6 months, and 1 year after treatment. Standardized reproducible radiographs of the 10 sites were taken by using a recently developed paralleling instrument before treatment, immediately after and 2 months, 6 months, and 1 year afterwards. The density of the interdental bone was measured on the radiographs by a computer assisted densitometric technique at three levels of the interdental septum: the most occlusal or “superficial” level; the “deep” level, arbitrarily chosen 1.5 mm below; and the “control” level, in a much deeper area of interproximal bone. As further control, the density of the superficial crestal bone was also followed in 5 healthy untreated sites from 5 of the patients. As expected, a significant improvement of the clinical parameters was observed during the year following therapy. The results of the radiographical analysis showed statistically significant increases of both the superficial and deep average densities of interproximal bone at 6 months and 1 year after treatment. The superficial bone density was, on the average, 13% higher at 6 months and 16% higher at 1 year, as compared to that measured immediately after treatment. The improved bone density observed at 1 year could be predicted from the decrease in pocket depths measured clinically at 2 and 6 months and, with a high degree of statistical significance, from the gain of attachment measured at 6 months. J Periodontol 1990; 61:725–731.
Early‐Onset Periodontitis: Radiographic Patterns of Alveolar Bone Loss in 55 Cases From a Selected Malaysian Population
Authors: Yusof Zainal A.
Published: March 2012

The objective of this report was to determine the radiographic patterns of alveolar bone loss in early‐onset periodontitis (EOP) cases in a selected Malaysian population. The radiographs of 55 cases of EOP patients were examined and the radiographic patterns were classified as follows: Type I: bone destruction on first molars and/or incisors only; Type II: bone destruction on first molars and/or incisors and several additional teeth (< 14 teeth); Type III: generalized bone destruction (> 14 teeth), but with involvement noticeably more extensive on the first molars and/or incisors; Type IV: generalized bone destruction (> 14 teeth), but with no more bone loss on the first molars and/or incisors than on other involved teeth. Sex, age, and missing teeth were also recorded. Out of 55 cases, 47 cases, 22 males and 25 females, were classified into the types mentioned above; the remaining 8 cases were excluded due to too many missing teeth. It was found that 7 (14.9%) were Type I; 12 (25.5%) were Type II; 7 (14.9%) were Type III; and 21 (44.7%) were Type IV. There was a predominance of first molar/incisor involvement in Types I, II, and III with the maxillary first molars most frequently involved followed by the mandibular central incisors. Type I occurred in the younger age group and Types II, III, and IV mainly in the older age group. It was concluded that EOP in this patient sample resembled that of western society. J Periodontol 1990; 61:751–754.
Characterization of Fibroblasts Derived From Human Periodontal Ligament and Gingiva
Authors: Mariotti Angelo , Cochran David L.
Published: March 2012

Growth characteristics and macromolecular synthesis of fibroblasts derived from human periodontal ligament (PDLF) and gingiva (GF) have been compared in cell culture. Cells were isolated from expiants and plated at 500,000 cells/100 mm culture dish (day 0) with daily changes of culture medium. DNA histograms were obtained by flow microfluorimetric analysis to confirm the growth state of the cell cultures. Human PDLF cultures became confluent at day 6 as determined by cell number and cell cycle analysis while GF were confluent by day 4. Initially, DNA content of logarithmically growing cells was significantly greater in GF cultures; however, when confluent, DNA content and cell number was greater in PDLF cultures. Total protein content in GF was slightly greater than PDLF until day 7 but this difference was not significant. Analysis of collagen and noncollagen protein synthesis revealed a greater trend in noncollagen protein synthesis in the GF cultures compared to PDLF cultures. Analysis of glycosaminoglycans in the culture medium of GF and PDLF revealed similar distributions of components. In the cellular fraction, GF had greater amounts of hyaluronic acid and heparin and lesser amounts of chondroitin sulfates A and C than PDLF cultures. The results indicate that the growth characteristics of PDLF and GF, although similar in many respects, do exhibit specific differences in proliferative rates and macromolecular synthesis. The differences observed in these parameters may be important during in vivo events, such as guided tissue regeneration, where significant functional differences are observed between gingival connective tissue and periodontal ligament connective tissue. J Periodontol 1990; 61:103–111.
Supragingival Irrigation with 0.06% Chlorhexidine in Naturally Occurring Gingivitis I. 6 Month Clinical Observations
Authors: Flemmig Thomas F. , Newman Michael G. , Doherty Frances M. , Grossman Eli , Meckel Alfred H. , Bakdash M. Bashar
Published: March 2012

The purpose of this study was to assess the efficacy of supragingival irrigation with 0.06% Chlorhexidine gluconate (CHX) on naturally occurring gingivitis. The relative benefit of CHX irrigation in comparison with CHX rinsing, water irrigation, and normal oral hygiene was evaluated. In a blind, placebo‐controlled 6‐month study 222 patients were assigned to one of four groups: Group 1: Once daily irrigation with 300 ml water followed by irrigation with 200 ml 0.06% Chlorhexidine gluconate (experimental); Group 2: Twice daily rinsing with 15 ml 0.12% Chlorhexidine (positive control); Group 3: Once daily irrigation with 500 ml water (irrigation control) and Group 4: Sodium fluoride dentifrice for normal oral hygiene only (negative control). All groups used the same sodium fluoride dentifrice for tooth brushing. At baseline, 3 months, and 6 months patients were examined for Gingival Index (GI), Bleeding on Probing (BOP), Plaque Index (PLI), Pocket probing depth (PD), Calculus Index (CI), and stain. After the baseline visit all patients received a supra‐ and subgingival oral prophylaxis. At 6 months GI and BOP were significantly (P≤0.05) reduced by adjunctive CHX irrigation (42.5% and 35.4%, respectively), CHX rinse (24.1% and 15.0%), and water irrigation (23.1% and 24.0%) compared to tooth brushing alone. Plaque was significantly (P≤0.05) reduced only by CHX irrigation (53.2%) and CHX rinse (43.3%) while calculus and staining were significantly (P≤0.05) increased in the two Chlorhexidine groups (276.4% (irrigation) and 273.2% (rinse)). Although significant (P≤0.05), pocket probing depth reduction was minimal after CHX irrigation (4.6%). This study demonstrated an enhanced effect of Chlorhexidine on gingivitis when used with this oral irrigator and treatment regimen. Irrigation with water had less than Chlorhexidine irrigation, but significant clinical benefits. Irrigation may increase the access of solutions beneath the gingival margin resulting in improved tissue health. J Periodontol 1990;61:112–117.
Responses of Four Tooth and Site Groupings to Periodontal Therapy
Authors: Kaldahl Wayne B. , Kalkwarf Kenneth L. , Patil Kashinath D. , Molvar Michael P.
Published: March 2012

The responses of four tooth/site groupings to periodontal therapy were evaluated. Eighty‐two patients with periodontitis were treated in a split mouth design with coronal scaling, root planing, modified Widman surgery, and flap with osseous resectional surgery. Patients were evaluated prior to therapy, 4 weeks post‐Phase I therapy, 10 weeks post‐Phase II therapy, and at yearly intervals during 2 years of maintenance therapy. The tooth/site groupings evaluated were: 1) interproximal sites of single rooted teeth (T1), 2) facial and lingual sites of single rooted teeth (T2), 3) nonfurcation sites of molar teeth (T3), and 4) furcation sites of molar teeth (T4). Following 2 years of maintenance, no clinically significant differences in probing depth reduction or probing attachment loss were present between the four tooth/site groupings in 1 mm to 4 mm sites. T2 had the greatest decrease of probing depth in 5 mm to 6 mm sites followed by T1, T3 and T4. T1 and T2 showed a greater gain of probing attachment followed by T3 and then T4. T1 and T2 had the greatest decrease of probing followed by T3 which was greater than T4 in ≥ 7 mm sites. T4 had significantly less probing attachment gain than the other groups. There was a trend for T1 and T2 to have less gingival bleeding post‐therapy and for T2 to have less plaque accumulation than the other groups at both pre‐ and post‐therapy examinations. J Periodontol 1990; 61:173–179.
Multi‐Center Clinical Evaluation of a Chairside Method for Detecting Certain Periodontopathic Bacteria in Periodontal Disease
Authors: Loesche W.J. , Bretz W.A. , Lopatin D. , Stoll J. , Rau CF. , Hillenburg K.L. , Killoy W.J. , Drisko C.L. , Williams R. , Weber H.P. , Clark W. , Magnusson I. , Walker C. , Hujoel P.P
Published: March 2012

The association of bacteroides gingivalis, Bacteroides forsythus, Treponema denticola, and Actinobacillus actinomycetemcomitans among others with periodontal disease offers the opportunity for the development of diagnostic tests that are based upon the detection and/or quantification of one or more of these organisms or their by‐products in the plaque. Three of the putative periodontal pathogens namely, T. denticola, B. gingivalis, and B. forsythus, can hydrolyze the synthetic trypsin substrate, N‐benzoyl‐DL‐arginine‐2‐naphthylamide (BANA) forming a color reaction. The present investigation evaluated a commercially developed solid state assay for BANA hydrolysis that can be read after 15 minutes incubation at chairside. A total of 702 subgingival plaque samples were collected from 117 patients seen at four university dental clinics and placed on reagent cards. The color development on the cards was compared to the presence of T. denticola and B. gingivalis in the plaque, and with the clinical appearance of the sampled sites. This multi‐center study demonstrated that antibodies to B. gingivalis and T. denticola could detect these organisms by an ELISA in the majority of the subgingival plaque samples. Comparable information could be obtained when the same plaques were evaluated by the reagent card format for BANA hydrolysis. The ELISA and reagent card were comparable in their ability to distinguish between clinically healthy and diseased sites. Both diagnostic procedures detected the periodontopathogens in plaques from sites that were judged clinically healthy. The reagent card test has certain clinical advantages over the ELISA in that it is simple, can be performed quickly at chairside, and provides valuable information as to the pathogenicity of the microflora at discrete oral sites. Such information may be used in the detection of patients or intraoral sites at risk for periodontal disease. J Periodontol 1990;61:189‐196.
Statistical Properties of Some Clinical Measures of Gingivitis and Periodontitis
Authors: Fleiss Joseph L. , Turgeon Livia , Chilton Neal W. , Listgarten Max A.
Published: March 2012

Various statistical properties of the plaque index, the gingival index, and the wholemouth averages of pocket depth and attachment level measurements were examined using data from a 4‐year randomized trial of 80 patients with a history of treated periodontal disease. Departures from normality were assessed by the median of the standardized distribution, by the coefficients of skewness and kurtosis, and by the Kolmogorov goodness‐of‐fit test. The relative precisions of probing pocket depth and of attachment level were measured, as were correlations between repeated measurements over time for the four clinical measures. The distribution of the plaque index was far from normal, but the distribution of its logarithm was more nearly normal. The distributions of the other clinical measures were effectively normal to varying degrees of approximation. With only rare exceptions, correlations between repeated measurements on the same clinical variable remained relatively constant no matter how far apart in time the measurements were made, at least up to 4 years. The whole‐mouth mean of the attachment level measurements seemed to be relatively more precise than the whole‐mouth mean of the pocket depth measurements. J Periodontol 1990;61:201–205.
Common Problems With Statistical Aspects of Periodontal Research Papers
Authors: Emrich Lawrence J.
Published: March 2012

Enormous advances have been made over the past decade concerning the proper use of statistical techniques in reporting periodontal research. However, numerous articles still appear which use inappropriate or less than optimal statistical methods. This paper describes the most common problems encountered in a recent review of the literature, and presents suggestions which will hopefully improve the quality of statistical information reported in future research articles. J Periodontol 1990;61:206–208.
Analgesic Efficacy of Flurbiprofen as Compared to Acetaminophen and Placebo After Periodontal Surgery
Authors: Gallardo Fernando , Rossi Enrique
Published: March 2012

The purpose of the present investigation was to compare the analgesic efficacy of flurbiprofen, a nonsteroidal anti‐inflammatory drug, which is a phenyl propionic acid derivative, with acetaminophen and placebo in 63 adult outpatients with moderate to severe dental pain following periodontal surgery. After surgery was completed under local anesthesia, the patients received under double‐blind conditions an envelope containing four tablets of either flurbiprofen 100 mg, acetaminophen 500 mg, or placebo and they were instructed to take one tablet every 6 hours when postoperative pain reached moderate to severe intensity. To determine analgesic efficacy and patients recorded pain intensity on a scale of 0 to 3. Patients were allowed to remedicate after 1 hour if pain was not reduced. Flurbiprofen was shown to possess an adequate analgesic effect superior to either placebo (P < 0.005) or acetaminophen (P < 0.01) in the parameters studied. Our results seem to further support earlier data obtained with the drug in dental patients with postoperative pain after the surgical removal of impacted third molars; therefore, it is concluded that flurbiprofen used as directed is a new alternative for the proper.treatment of pain following periodontal surgery. J Periodontol 1990;61:224‐227.
The Use of Desmopressin in the Management of Two Patients with von Willebrand's Disease Undergoing Periodontal Surgery. 2 Case Reports
Authors: Petrover Michael G. , Cohen Charles I.
Published: March 2012

Von Willebrand's disease is a genetic bleeding disorder characterized by either a reduced plasma concentration of von Willebrand's factor (vWF) or a qualitative deficiency in that vWF which is produced. Previous therapy consisted of injecting concentrates of vWF manufactured from the pooled plasma of multiple donors. With the increased incidence and risk of serum borne transmission of such diseases as hepatitis and AIDS, the advantages of an alternative mode of therapy was obvious. In the course of using 1desamino‐8‐D‐argenine (desmopressin or DDAVP, a synthetic analogue of 8‐argenine Vasopressin, a hormone secreted in the posterior pituitary gland) in the treatment of diabetes insipidis, it was discovered that this drug causes the release of bound vWF into the plasma. The elevation lasts for several hours and is effective in producing hemostasis in some types of mild to moderate von Willebrand's disease. In 1984, desmopressin was approved for this usage in the United States. This paper discusses the use of DDAVP in the management of von Willebrand's disease and present two case reports of patients with von Willebrand's disease and in need of periodontal surgery. J Periodontol 1990;61:239‐242.
Parietal Lobe Abscess After Routine Periodontal Recall Therapy. Report of a Case
Authors: Andersen W. Clark , Horton Harold L.
Published: March 2012

This paper reports on a case of a 70‐year‐old physician diagnosed with a parietal lobe abscess following such treatment. After stereotactic biopsy and drainage and a 6– week course of intravenous antibiotic treatment, the patient recovered with minimal neurologic deficits. Although brain abscesses are not commonly encountered in practice, clinicians must be aware of the potential virulence of the anerobic components of the periodontal pocket and the possibility of resulting systemic infection, which can produce a life‐threatening situation. J Periodontol 1990; 61:243–247.