bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of local delivery of PDGF‐BB on attachment of human periodontal ligament fibroblasts to periodontitis‐affected root surfaces – in vitro
Authors: Gamal Ahmed Y. , Mailhot Jason M.
Published: March 2003

Background/aims: The purpose of this study was to determine at what concentration does platelet‐derived growth factor‐BB (PDGF‐BB) provide for optimal stimulation of human periodontal ligament fibroblasts (PDL) to adhere to periodontitis affected root surfaces.

Method: 80 root dentine specimens were prepared from extracted periodontally diseased teeth obtained from patients ranging in age between 35 to 60 years. The root dentine specimens were associated with the subgingival area opposing the periodontal pocket for each extracted tooth. 10 healthy root dentine specimens were obtained from teeth extracted for orthodontic reasons and served as controls. The specimens were distributed into 9 groups (10 specimens in each). In group 1, PDL fibroblasts were cultured on the specimen surface of a diseased treated control. In group 2, PDL fibroblasts were cultured on the specimen surface of a healthy control. In groups 3 to 9, PDL fibroblasts were cultured on a pretreated specimen surface with concentrations ranging from 5, 10, 20, 50, 100, 200 and 300 ng/ml PDGF‐BB, respectively. After 24 h incubation, the media were removed, specimens were fixed, processed for SEM viewing and photographed at 750 ×. Fibroblast adherence was measured by counting number of cells within a standard test area and cell morphology was scored.

Results: Findings suggest dentine specimens pretreated with 5, 10 and 20 ng/ml PDGF‐BB were not significantly different in number of adherent cells from the diseased treated control. However, at concentrations of 50, 100, 200 and 300

ng/ml, a highly significant increase in number of adherent fibroblasts was detected when compared to the diseased treated control. At these concentrations, the cell morphology was comparable to that of the healthy control.

Conclusions: PDGF‐BB in concentrations equal to or greater than 50 ng/ml demonstrates a significant stimulation of PDL cells adherence to periodontal diseased root surfaces. Since the higher concentrations resulted in similar effects as obtained by 50 ng/ml, it may therefore be considered that this concentration provides for optimal stimulation of human periodontal ligament fibroblasts (PDL) to adhere to periodontitis‐affected root surfaces.
Recombinant human bone morphogenetic protein‐7 in maxillary sinus floor elevation surgery in 3 patients compared to autogenous bone grafts
Authors: Van Den Bergh J. P. A. , Ten Bruggenkate C. M. , Groeneveld H. H. J. , Burger E. H. , Tuinzing D. B.
Published: March 2003

Background/Aims: This pilot study was designed to determine the clinical bone formation ability of a human recombinant DNA bone morphogenetic protein‐7, also referred to as Osteogenic Protein‐1 [OP‐1] combined with a collagen carrier, implanted in the maxillary sinus of 3 patients. The results were compared with a group of 3 patients treated with sinus floor elevation and autogenous bonegrafts.

Methods: 6 consecutive patients, 4 female and 2 male, between 48 and 57 years of age were treated by means of sinus floor elevation for insufficient bone height in the posterior maxilla for implant surgery. 3 patients, 2 female and 1 male, were treated with OP‐1 attached to a collagen device. In these patients, 4 maxillary sinus grafting procedures according to Tatum's method were carried out. 1 g of collagen carrier containing 2.5 mg rhOP‐1 mixed with 3 ml of saline was placed between the bony floor and the elevated mucosal lining of the most caudal part of the maxillary sinus, in order to increase the vertical bone dimension to place dental implants of a sufficient length. The 3 other patients, also 2 female and 1 male, with a total of 5 sinus sites, were treated with sinus floor elevation and autogenous iliac crest bonegrafts. After 6 months, during dental implant preparation, bone cores were taken for histology. Thus, clinical, radiological and histological results of the 2 groups of 3 patients were compared.

Results: 6 months after sinus grafting with OP‐1, in 1 male, well‐vascularized bonelike tissue of good quality was observed clinically. This could be confirmed by histology. In the second, female, patient no bone formation was observed at all. A cyst‐like granular tissue mass, without purulent content, was removed. In the 3rd, female, patient, who received bilateral sinus grafts, some bonelike formation was seen, however it showed flexible tissue which led to the decision that at 6 months after the sinus grafting, the implant placement had to be postponed. In all 5 autogenous grafted sinuses a bone appearance similar to normal maxillary bone was observed clinically as well as histologically and dental implants could be placed six months after sinus floor elevation surgery.

Conclusions: These findings indicate that the OP‐1 device has the potential for initiating bone formation in the human maxillary sinus within 6 months after

a sinus floor elevation operation. However, the various findings in these 3 patients indicate that the behaviour of the material is at this moment insufficiently predictable, in this indication area. Further investigation is indicated before OP‐1 can be successfully used instead of the “gold standard” autogenous bone graft.
Classifications of oral lesions in HIV infection
Authors: Narani Nazanin , B. Epstein Joel
Published: March 2003

Background: Manifestations of immunosuppression may take the form of opportunistic infection, and neoplasia. While this paper has focused on gingival and periodontal manifestations, these tissues cannot be evaluated in isolation. The presence of involvement of other oral tissues such as the cheek or tongue with manifestations associated with HIV such as hairy leukoplakia, Kaposi’s sarcoma at these sites, and candidiasis in addition to periodontal manifestations may further increase the clincial suspicion of underlying immunosuppression and/or progression of the immunosuppressive state.

Discussion: The periodontist plays an essential rôle in identifying the periodontal status of an individual and has an important rôle to play in early recognition of signs and symptoms of HIV disease or progression of the medical condition.

Conclusion: Only through such recognition can appropriate definitive diagnostic testing be conducted, and appropriate therapeutic intervention for the oral condition and the systemic condition be considered.
Periodontal status and serum antibody titers for Porphyromonas gingivalis fimbriae in a rural population in Japan
Authors: Furuichi Y. , Ito H.‐O. , Izumi Y. , Matsuyama T. , Yotsumoto Y. , Mishige Y. , Kojima M. , Yamashita K. , Inoue M.
Published: March 2003

Background, aims: The present study was undertaken to assess the periodontal status of a rural Japanese population and to study the correlation between the periodontal status and the serum antibody titers for Porphyromonas gingivalis (Pg) fimbriae.

Method: A total of 236 individuals were examined for their periodontal conditions by the use of the community periodontal index for treatment needs (CPITN), and serum antibody titers for Pg fimbriae in their peripheral blood samples were evaluated using the enzyme‐linked immunosorbent assay.

Results: There was a substantially larger proportion of edentulous subjects in the age group older than 60 years. The remaining teeth were 24.1, 23.2, 11.1 and 10.1 per person in the 40–49, 50–59, 60–69 and 70 age groups, respectively. The % of sextants with a CPITN code of missing sextant (MS) increased towards elderly and reached >60% in the age group of 70 years, as the % of the CPITN 2, 1 or 0 sextant decreased. The % of CPITN 4 and 3 sextants did not differ between different age groups and were about 6–8% and 15–20%, respectively. The % of CPITN 1 or 0 sextants was higher in female subjects than in male subjects in the 60–69 and 70 age groups, while the % of CPITN 4 or 3 sextants was higher in male subjects than in female subjects in all age groups. There was no significant difference between various age groups in the mean serum antibody titers for Pg fimbriae. The mean anti‐Pg fimbriae antibody titers was significantly higher for the subjects with a maximum CPITN code 4 (max.‐CPITN 4 subject) than for the subjects with lower maximum CPITN codes. The antibody titers varied extensively among the max.‐CPITN 4 or 3 subjects, but not among the max.‐CPITN 2/1/0 or MS subjects.

Conclusions: The present study demonstrated that tooth loss is a remarkable event in elderly subjects and that oral prophylaxis and mechanical debridement should be mandatory in the population examined. It was also demonstrated that the serum antibody titers against Pg fimbriae could be useful for screening individuals with moderate to severe periodontitis.
Concentration of interleukin‐1β and neutrophil elastase activity in gingival crevicular fluid during experimental gingivitis
Authors: Gonzáles J. R. , Herrmann J. M. , Boedeker R. H. , Francz P. I. , Biesalski H. , Meyle J.
Published: March 2003

Background, aim: The aim of the present study was to measure interleukin‐1β concentrations and neutrophil elastase activity in gingival crevicular fluid (GCF) during experimental gingivitis in humans.

Material and Methods: 12 healthy young men participated. After prophylaxis, they performed optimal hygiene to reach plaque and gingivitis indices of or approaching zero. All oral hygiene measures were then ceased for a period of 18 days. The Quigley‐Hein plaque index (PLI) and Saxer & Mühlemann papillary bleeding index (PBI) were assessed. GCF samples were taken from the mesiobuccal site of two contralateral teeth in the upper jaw by means of periopapers at baseline and on days 3, 7, 14 and 18. After measuring the gingival crevicular fluid volume (GCFV) with the Periotron 8000, the samples were analyzed in our laboratory for the detection of IL‐1β concentration by ELISA.

Results: PLI and PBI showed a reduction prior to baseline reaching almost zero, both increasing from day 0 to day 18 (PLI=from 0.1 to 2.9, PBI=from 0 to 2.0). IL‐1β concentration increased from 229.25 ng/ml (day 0) to 526.13 ng/ml (day 18). Clinical data and IL‐1β concentrations were correlated with elastase activity (EA). No significant correlation could be demonstrated between the clinical parameters assessed and IL‐1β or EA (Spearman rank correlation coefficient). A correlation between GCFV and PBI from day 0 to day 18 could be demonstrated.

Conclusion: Overall, both IL‐1β and EA showed an increase from baseline throughout the whole study.
Evaluation of the effect of tooth vitality on regenerative outcomes in infrabony defects
Authors: Cortellini Pierpaolo , Tonetti Maurizio S.
Published: March 2003

Background, aims: This investigation was designed to evaluate the null hypothesis of no differences in GTR outcomes in intrabony defects at vital and successfully root‐canal‐treated teeth.

Method: 208 consecutive patients with one intrabony defect each were enrolled. Based on tooth vitality, the treated population was divided at baseline into 2 groups: one with 41 non‐vital teeth and the other with 167 vital teeth. The 2 groups were similar in terms of patient and defect characteristics.

Results: A slight unbalance in terms of depth of the intrabony component was observed in the non‐vital group compared to the vital group (6.9±2.1 mm versus 6.2±2.3 mm, p=0.08). All defects were treated with GTR therapy. At 1 year, the non‐vital and the vital groups showed a clinical attachment level (CAL) gain of 4.9±2.2 mm and of 4.2±2 mm, respectively. The difference was statistically significant (p=0.03). To correct for the baseline unbalance in defect depth, data were expressed as a % of clinical attachment level gains with respect to the original intrabony depth of the defect. % CAL gains were 72.8±42.2% and 73±26.4% for vital and non‐vital teeth, respectively: the difference was not statistically significant (p=0.48). Average residual pocket depths were 2.8±1 mm in the vital and 2.8±0.9 mm in the non‐vital group. Tooth vitality was assessed at baseline, at 1‐year and at follow‐up (5.4±2.8 years after surgery): all teeth vital at baseline were still vital at follow‐up with the exception of 2 teeth that received endodontic treatment for reconstructive reasons and for caries. At follow‐up visit, the difference in CAL with respect to 1‐year measurements was −0.9±0.8 mm in the vital group and −0.7±0.8 mm in the non‐vital group, indicating stability of the regenerated attachment at the majority of sites.

Conclusions: Data from this study demonstrate that root canal treatment does not negatively affect the healing response of deep intrabony defects treated with GTR therapy; furthermore GTR therapy in deep intrabony defects does not negatively influence tooth vitality.
Tacrolimus is not associated with gingival overgrowth in renal transplant patients
Authors: James Jacqueline A. , Jamal Sundos , Hull Peter S. , Macfarlane Tatiana V. , Campbell Babatunde A. , Johnson Robert W. G. , Short Colin D.
Published: March 2003

Background: Cyclosporin A is used extensively to prevent the rejection of allogenic renal transplants. However, it is associated with a variety of undesirable side effects including gingival overgrowth. Tacrolimus (FK506), has been marketed as an effective alternative immunosuppressant to cyclosporin A and recent subjective reports suggest patients taking it complain infrequently of gingival problems. This clinical investigation was undertaken to confirm whether or not tacrolimus adversely affected the gingival health of renal transplant recipients.

Methods: Renal transplant patients (RTPs) under the care of the Renal Transplantation Service at the Manchester Royal Infirmary, who had received a renal allograft at least 18 months earlier, were recruited for this study. All but one of the RTPs had been taking tacrolimus since transplantation. The other had commenced tacrolimus therapy two months after receiving her allograft. A hospital based control group was recruited from non transplanted individuals attending the Turner Dental School, Manchester. Each patient underwent a detailed dental assessment and had dental impressions taken. The extent of gingival overgrowth was determined from plaster models.

Results: 25 renal transplant recipients and 26 control patients were included in the study. None of the individuals in either the tacrolimus or control groups had clinically significant overgrowth. The patients in the tacrolimus group with the highest overgrowth scores were those also taking calcium antagonists as treatment for hypertension.

Conclusion: This study demonstrates that tacrolimus has no adverse effects on the gingival tissues and thus has potential as an alternative immunosuppressant for individuals susceptible to developing cyclosporin A‐induced gingival overgrowth.
The gingival inflammatory infiltrate in cardiac patients treated with calcium antagonists*
Authors: Bullón Pedro , Machuca Guillermo , Armas José R. , Rojas José L. , Jiménez Gema
Published: March 2003

Objectives: To analyse the periodontal inflammatory infiltrates in patients with cardiac disease, some of these patients were treated with calcium antagonists (nifedipine and diltiazem) and some were not, to compare them with a healthy control group, and to evaluate the changes in the inflammatory infiltrate after periodontal treatment.

Material and methods: A “healthy group” (HG, n=12), a “cardiac group” (CG, n=12) without treatment with calcium antagonists, a “nifedipine group” (NG, n=18) and a “diltiazem group” (DG, n=13) were analysed. Biopsies were taken from a zone 2–3 mm below the upper part of the interproximal papillae 12–13 and 33–32 before causal periodontal treatment and after 1 year. Using haematoxylin‐eosin staining, the plasma cells (P), lymphocytes (L), histiocytes (H) and polymorphonuclear cells (PMN) were counted. T and B lymphocytes were evaluated using the monoclonal antibodies anti‐CD20 and anti‐CD45RO. Statistical tests used: χ2 for study of the sample composition; ANOVA for comparison between groups; Student t‐test and Wilcoxon test for comparison between visits; post‐hoc test Bonferroni.

Results: When the cells were compared statistically, differences were stablished for L at the first visit (p<0.00001) and at the last visit (p<0.02), for the B lymphocytes (first visit p<0.0021, last visit p<0.022) and for the T lymphocytes (first visit p<0.0042, last visit p<0.0021). Between the 2 visits, HG showed significant reductions for P (p<0.01), L (p<0.045) and H (p<0.033); and the NG for L (p<0.0001). Lymphocytes showed differences in the NG with respect to the B lymphocytes (p<0.008).

Conclusions: Nifedipine affects the inflammatory infiltrate with a greater number of lymphocytes (especially B) and these cells fell significantly in number after periodontal treatment.
Comparison of ready‐to‐use EMDOGAIN®‐gel and EMDOGAIN® in patients with chronic adult periodontitis
Authors: Bratthall G. , Lindberg P. , Havemose‐Poulsen A. , Holmstrup P. , Bay L. , Söderholm G. , Norderyd O. , Andersson B. , Rickardsson B. , Hallström H. , Kullendorff B. , Sköld Bell H.
Published: March 2003

Objectives: The aim of this multicenter trial was to compare the clinical and radiographical outcome of a ready‐to‐use Emdogain®‐gel (test) with the marketed Emdogain® (control).

Methods: Subjects with bilateral infrabony defects 4 mm deep and 2 mm wide according to radiographs were selected. 88 subjects with probing pocket depth (PPD) 6 mm 1 month after supervised oral hygiene and scaling participated. At baseline plaque index, bleeding on probing, PPD and probing attachment level were recorded and reproducible radiographs for computer‐based bone level measurements were taken. In each subject, 1 tooth was randomly treated with the test and 1 tooth with the control gel. Examinations were repeated 8 and 16 months post‐operatively.

Results: After 16 months, the mean test PPD was 4.1 mm and the mean control PPD 4.2 mm. The mean gain of attachment was 2.7 mm for test and 2.9 mm for the control sites, and the radiographic measurements demonstrated a mean gain of 1 mm for both test and control sites.

Conclusion: This series of cases demonstrated a statistically significant reduction of pocket depths and gain of attachment and bone after 8 and 16 months with no difference between the 2 preparations.
Application of an adjusted χ2 statistic to site‐specific data in observational dental studies
Authors: Ahn Chul , Jung Sin‐Ho , Donner Allan
Published: March 2003

Background: When a binary response is observed on teeth from each subject belonging to 2 or more exposure groups, application of the usual Pearson χ2 tests is invalid, since such responses within the same subject are not independent. Consequently, special statistical methods are needed to control for the correlation among teeth (sites) within the same subject. A simple adjustment to the Pearson χ2 statistic has been proposed for comparing proportions in site‐specific data. However, the required assumptions for this statistic have not yet been thoroughly addressed. These assumptions are guaranteed to hold in experimental comparisons, but may be violated in some observational studies.

Method: We investigate the conditions under which the adjusted χ2 statistic is valid and examine the performance of the adjusted χ2 statistic when these conditions are violated.

Results: Our simulation study shows that the adjusted χ2 statistic generally produces good empirical type I errors under the assumption of a common intracluster correlation coefficient. Even if the intracluster correlations are different, the adjusted statistic performs well when the groups have equal numbers of clusters (subjects).

Conclusion: The discussion is illustrated using an observational study of caries on the roots of teeth.
A laser Doppler study of gingival blood flow variations following periosteal stimulation
Authors: Ambrosini Pascal , Cherene Sabine , Miller Neal , Weissenbach Michel , Penaud Jacques
Published: March 2003

Objectives: Evaluation of the modifications occurring in human gingival blood flow following periosteal stimulation.

Material and methods: Laser Doppler was used to measure the gingival blood flow (GBF). The reproducibility of the technique was validated by comparing measures made at intervals of 1 week. Sensitivity was verified by recording GBF before and after injection of an anesthesic containing a vasoconstrictor. Finally, 12 patients were subjected to GBF measurements before and 8 days after periosteal stimulation prior to gingival grafting.

Results: The laser Doppler accurately measured GBF. Measurements made at day 0 and day 7 were not statistically different (p=0.60). After injection of an anesthesic solution containing vasoconstrictor, the laser Doppler recorded a sharp decrease of the GBF (p=0.04). The patient that underwent periosteal stimulation showed statistically significant increases (p=0.02) in GBF before and 1 week post‐stimulation.

Conclusion: Periosteal stimulation induces significant increases in the GBF after 1 week.
White blood cell count in generalized aggressive periodontitis after non‐surgical therapy
Authors: Christan Claudia , Dietrich Thomas , Hägewald Stefan , Kage Andreas , Bernimoulin Jean‐Pierre
Published: March 2003

Background: Periodontal bacteria are known to invade the systemic circulation. Chronic low‐level bacteremia and a systemic inflammatory response have been suggested as a pathogenetic link between periodontal disease and atherosclerosis. The purpose of this study was to examine the systemic effect of a non‐surgical therapy on white blood cell count (WBC count) and differential blood count in smoking and non‐smoking generalized aggressive periodontitis (GAP) patients.

Methods: 27 adult periodontitis patients (13 smokers and 14 non‐smokers) with previously untreated GAP were subjected to 3 sessions of oral hygiene procedure. Afterwards, the patients were treated by scaling and root planing under local anaesthesia. Periodontal examinations were performed after supragingival pretreatment and three months after subgingival therapy. Pocket probing depth (PPD) and relative attachment level (RAL) were measured with Florida probe and disc probe. Accompanying clinical evaluation venous blood samples were taken to analyse the WBC counts and differential blood counts. For statistical analysis non‐parametric tests were utilized.

Results: No clinical or demographic differences were found between smokers (n=13) and non‐smokers (n=14). PPD, bleeding on probing (BoP) and suppuration improved significantly after therapy both in smokers and non‐smokers. Following periodontal treatment WBC counts, neutrophil and platelet counts decreased significantly in non‐smokers (p≤0.004), while in smokers only platelet counts were significantly reduced (p=0.006). Non‐smokers showed a significantly higher reduction of WBC counts (p=0.005) and neutrophils (p=0.001) compared to smokers.

Conclusion: The results indicate that a therapeutical intervention may have a systemic effect on the blood count in GAP patients. This effect seems to differ between smokers and non‐smokers.
Metastatic breast carcinoma mimicking periodontal disease on radiographs
Authors: Ögˇütcen‐Toller M. , Metin M. , Yıldız L.
Published: March 2003

Background: Tumors can metastasize to the jaws, oral soft tissues, or salivary glands. Metastasis from distant organs and tissues to the jaws or oral cavity is considered rare.

Results: The mandible is the most common site of metastasis of the oral and maxillofacial region. Radiographically, there is usually an area of radiolucency with hazy outline. Such lesions are manifested as radiopaque or sclerotic areas.

Conclusions: Radiographic view of a tumor in the present case mimicked a periodontal lesion with an osteolytic area around the roots.
Adjunctive effects to non‐surgical periodontal therapy of systemic metronidazole and amoxycillin alone and combined
Authors: Rooney J. , Wade W. G. , Sprague S. V. , Newcombe R. G. , Addy M.
Published: March 2003

Background and aim: Several studies have reported adjunctive benefits to scaling and root planing (SRP) of systemic amoxycillin and metronidazole in the treatment of periodontal diseases. To date no comparisons have been made of these antimicrobials alone or in combination. The aim of this study was to compare the adjunctive benefits to SRP of amoxycillin and metronidazole alone and combined.

Methods: 66 subjects <46 years of age with advanced chronic periodontal disease participated in this randomised, double blind, 4 parallel treatment group designed study. All subjects received quadrant SRP and then were prescribed amoxycillin capsules (250 mg) and metronidazole tablets (200 mg) (AM) or lactate capsules and metronidazole (PM) or amoxycillin and calcium lactate tablets (AP) or lactate and calcium lactate (PP). All medication was 3 of each per day for 7 days. Subgingival plaque samples were obtained and probing depth (PD), loss of attachment (LOA), bleeding on probing (BOP), suppuration (SUPP) and plaque (DEP) were recorded pre‐treatment, 1, 3 and 6 months post‐treatment.

Results: Final group sizes were: AM=15, PM=16, AP=16 and PP=15. PD improved in all groups. Treatment effects were highly significantly different and always greatest in the AM and least in the PP groups. Benefits of PM and AP over PP were also noted. LOA improved in all groups and showed the same highly significant treatment differences, again favouring AM. BOP improved in all groups, particularly in AM compared to the other groups. SUPP improved in all groups and was virtually eradicated in AM with differences among treatments highly significant. DEP changed little in any group and there were no significant differences among groups. Microbiological data showed significant differences in favour of AM compared to PP and PM for total aerobes and anaerobes at 1 month. P. intermedia counts were always lower in active groups compared to PP and reached significance for AM and AP at 1 month and AM and PM at 3 months.

Conclusion: The significant differences among treatment groups and the overall trend in the data, in line with other studies, support the considerable adjunctive benefits to SRP of amoxycillin and metronidazole combined in the treatment of advanced chronic periodontal disease.
Expression of endothelial adhesion molecules in the alveolar ridge mucosa, gingiva and periimplant mucosa
Authors: Zitzmann N. U. , Berglundh T. , Marinello C. P. , Lindhe J.
Published: March 2003

Objectives: The purpose of this study was to analyze the expression of adhesion molecules on endothelial cells in the alveolar ridge mucosa, the gingiva and the periimplant mucosa in humans.

Material and methods: Twelve partially edentulous subjects were included in the study. In each subject, one soft tissue biopsy was harvested from the edentulous alveolar ridge mucosa, one from a tooth site and one from an implant site. After 3 weeks of undisturbed plaque accumulation, an additional biopsy was obtained from one tooth and one implant site in each subject. The tissue samples were snap frozen and prepared for immunohistochemical analysis.

Results: In the alveolar ridge mucosa, smaller proportions of endothelial cells expressing ICAM‐1, ELAM‐1 and VCAM‐1 were observed than in the gingiva. ELAM‐1‐positive cells occurred in lower numbers than in periimplant mucosa. After 21 days of plaque accumulation, ELAM‐1 was increased in tooth sites, but decreased in periimplant mucosa.

Conclusion: The results of the present study indicated that the proportions of activated endothelial cells and the extravasation of leukocytes is larger in gingiva and periimplant mucosa than in alveolar ridge mucosa. This might be due to the less permeable keratinized epithelial layer in the edentulous ridge mucosa, which offers proper protection against microbial pathogens. The greater expression of endothelial cell adhesion molecules during experimental gingivitis, compared to periimplant mucositis, may reflect its longer history of repeated antigenic assaults.
Gingival eruption cysts induced by cyclosporine administration to neonatal dogs
Authors: O'Hara Amanda J. , Collins Teresa , Howell John MC. C.
Published: March 2003

Objectives: The purpose of this paper is to report the development of extensive, gingival eruption cyst formation in neonatal dogs during chronic administration of cyclosporine, which regressed after treatment ceased.

Materials and methods: As part of an investigation of the efficacy of adenoviral‐mediated gene therapy in a canine model of Duchenne Muscular Dystrophy (DMD), 26 Golden retriever pups were given intramuscular injections of adenoviral gene constructs (at 2–5 days old) either with (15 pups) or without (9 pups) concomitant immunosuppression using oral cyclosporine (from 1 to 3 days old).

Results: The daily administration of cyclosporine to Golden Retriever pups from 1 to 3 days of age resulted in the formation of eruption cysts over the incisors after approximately 3 weeks of treatment. The gingiva over the remaining teeth became swollen. However unlike the incisors, part of the crown erupted through the gingiva. Continuous treatment for 60–90 days was associated with persistence and expansion of the cysts over the incisor teeth. The cysts resolved within 1 month if cyclosporine administration was discontinued. Movement of incisors within the jaws was not appreciably affected when compared with age‐matched controls.

Conclusion: Chronic cyclosporine administration to neonatal dogs induces the formation of eruption cysts over the incisors, which is reversible once treatment is discontinued and does not affect intraosseous eruption.
Serum IgG to heat shock proteins and Porphyromonas gingivalis antigens in diabetic patients with periodontitis
Authors: Sims Tom J. , Lernmark Ake , Mancl Lloyd A. , Schifferle Robert E. , Page Roy C. , Persson G. Rutger
Published: March 2003

Background: Past studies have reported a correlation between the presence and severity of periodontitis and serum antibody titers to species‐specific antigens of Porphyromonas gingivalis or to cross‐reactive antigens, such as lipopolysaccharide (LPS) and heat shock proteins (HSP), shared between P. gingivalis and other bacteria. Our recent study of periodontal treatment outcome in insulin‐dependent (type 1) diabetes mellitus patients with severe periodontitis (IDDMI/periodontitis) resulted in two key findings:

1. serum glutamic acid decarboxylase autoantibody (GAD65 Ab) levels were significantly associated with periodontal pocket depth change (PDC) and 2. serum IgG titers to P. gingivalis cells were positively associated with GAD65 Ab level in seropositive (GAD65 Ab +) patients.

We have therefore hypothesized that profiles of serum autoantibody levels and IgG titers, to P. gingivalis‐specific antigens may be useful in assessing risk for refractory periodontitis in such patients.

Aim: To determine whether PDC resulting from non‐surgical periodontal treatment can be predicted using profiles of baseline IgG titers to P. gingivalisspecific antigens, human HSP, and GAD65.

Methods: PDC was assessed two months after non‐surgical periodontal treatment of 7 GAD65 Ab + and 11 GAD65 AbIDDM/periodontitis patients. Pretreatment titers to GAD65, recombinant human heat shock proteins (HSP90, HSP70, and HSP60), and various P. gingivalis antigens were measured using radioligand precipitation or enzyme‐linked immunosorbent (ELISA) assays and compared to the same measurements for 154 recent‐onset IDDM patients and 46 non‐diabetic controls.

Results: Median titers (ELISA units) to HSP90 and HSP70 were significantly higher than non‐diabetic controls for GAD65 Ab + (p°= 0.002) and GAD65 Ab‐ (p = 0.034) IDDM/periodontitis patients, respectively. Multivariate regression analysis indicated significant partial correlation of PDC with log‐transformed titers to HSP90 (r = − 0.62, p = 0.008), HSP70 (r = + 0.62, p = 0.009), GAD65 (r = − 0.60, p = 0.01) and P. gingivalis LPS (r = − 0.5 1, p = 0.04). Furthermore, hierarchical clustering of baseline profiles of log‐transformed HSP90, HSP70, and GAD65 Ab titers sorted patients into two distinct clusters with significantly different median PDC (1.45 min, n = 10 vs. 0.65 min, n = 8; p = 0.016, Mann–Whitney).

Conclusion: Pretreatment profiles of serum antibody titers to HSP90, HSP70, GAD65, and P. gingivalis LPS may be useful for predicting which patients with IDDM/periodontitis will have a poor response to non‐surgical periodontal therapy.
Toothbrushing promotes gingival fibroblast proliferation more effectively than removal of dental plaque
Authors: Horiuchi Masazumi , Yamamoto Tatsuo , Tomofuji Takaaki , Ishikawa Akira , Morita Manabu , Watanabe Tatsuo
Published: March 2003

Objectives: Removal of dental plaque is an essential element of periodontal treatment. However, there have also been studies of the effects of the mechanical stimulation provided by toothbrushing on gingival host‐defense mechanisms. The aim of the study was to evaluate the effects of toothbrushing on gingival fibroblast proliferation in dogs over time, compared to effects of plaque removal without brushing.

Methods: The mouths of six mongrel dogs were divided into four quadrants: two for daily toothbrushing, and two for daily plaque removal with a curette. After 1, 3 and 5 weeks of treatment, histometrical analyses were performed to assess inflammatory cell infiltration, proliferating cell nuclear antigen (PCNA)‐positive fibroblasts, procollagen type I‐positive fibroblasts in the subepithelial connective tissue of junctional epithelium.

Results: Toothbrushing increased the number of PCNA‐positive fibroblasts in the first week, increased the number of type I procollagen‐positive fibroblasts at the fifth week, and reduced inflammatory cell infiltration at the third week.

Conclusion: These findings suggest that mechanically stimulated fibroblasts begin proliferating within a week, and this cell division results in an increased number of fibroblasts at the third week. It takes 5 weeks before differences in collagen synthesis between brushing and plaque removal areas are detectable.
A clinical evaluation of a novel data logger to determine compliance with the use of powered toothbrushes
Authors: McCracken G. I. , Janssen J. , Steen N. , DeJager M. , Heasman P. A.
Published: March 2003

Objectives: The pimary objective of this study was to evaluate the viability of an electronic data logger to record the brushing episodes of patients receiving standardised oral hygiene instructions. The secondary objective was to estimate the compliance of a group of patients diagnosed with chronic periodontal disease with brushing time instructions for the daily use of a powered toothbrush over a 2‐month period.

Material and methods:  17 modified Philips Jordan Sensiflex 2000 powered toothbrushes (PTBs) were provided to patients (32–67 years) attending for non‐surgical management of chronic periodontal disease. The PTBs incorporated an electronic data logger which recorded, for each individual brushing event: the length of time the brush was used (identifying the brushing speed setting); the maximum, minimum and average current during operation; and the time spent charging in between two consecutive brushing events. The patients were given detailed instructions with the PTB and were told to use it for 2 min each morning and 2 min in the evening. The patients returned for non‐surgical management over two visits prior to reinforcement of the oral hygiene instructions 1 month after PTB allocation. Subjects were asked to complete a simple brushing diary to record their use of the toothbrush on a daily basis. After 2 months of using the PTBs at home, the brushes and diaries were collected and the data downloaded from the data loggers.

Results: Of the 17 data loggers allocated, two recorded no information and two subjects did not return for the follow‐up appointments. The data from the remaining 13 data loggers were evaluated for level of compliance. An event of brushing between 120 and 130 s was considered to be compliant, one of between 90 and 120 or 130–150 s was partially compliant and brushing for < 90 s or > 150 s was recorded as non‐compliant. Percentage compliance for all the events (2087 recordings) was 34%, partial‐ and non‐compliance were calculated as: 18%; 48% of events, respectively.

Conclusion: This data logger has provided previously unrecorded data on the brushing times for a group of patients using a powered toothbrush at home during non‐surgical management of chronic periodontal disease. The data suggested that almost half (48%) of the brushing events recorded by the data loggers were greater than 30 s above or below the instructed brushing time.
Association of interleukin‐1 receptor antagonist gene polymorphisms with early onset periodontitis in Japanese
Authors: Tai Hideaki , Endo Motohiro , Shimada Yasuko , Gou Emire , Orima Kazuko , Kobayashi Tetsuo , Yamazaki Kazuhisa , Yoshie Hiromasa
Published: March 2003

Background/Aims: Early onset periodontitis (EOP), newly ‘aggressive periodontitis’, is considered to have genetic basis, which have not been clearly defined. The interleukin‐1 (IL‐1) gene cluster polymorphism as one of genetic factors may influence the expression of several chronic inflammatory diseases. The aim of this study is to investigate the frequency of single nucleotide polymorphisms (SNPs) in the genes encoding IL‐1α, IL‐1β and a variable number of tandem repeat (VNTR) polymorphisms in the IL‐1 receptor antagonist gene (IL‐1RN) in 47 generalized EOP (G‐EOP) patients and 97 periodontally healthy controls.

Material and methods: All subjects were of Japanese descent and systemically healthy. They were identified according to established clinical criteria. SNPs in the IL‐1α (+ 4845) and IL‐1β (− 511, + 3954) genes were analyzed by amplifying the polymorphic region using polymerase chain reaction (PCR), followed by restriction‐enzyme digestion and agarose gel electrophoresis. IL‐1RN (VNTR) polymorphisms were then detected by PCR amplification and fragment size analysis.

Results: There was no significant difference in the IL‐α (+ 4845) and IL‐1β (− 511, + 3954) genotypes and allele frequencies between G‐EOP patients and healthy controls. However, the frequency of IL‐1RN (VNTR) polymorphic alleles was found to be significantly increased in G‐EOP patients (χ2 test, P = 0.007; odds ratio = 3.40). Additionally, the carriage rate of IL‐1RN (VNTR) polymorphisms was significantly higher in G‐EOP patients than in healthy controls (χ2 test, P = 0.005; odds ratio = 3.81).

Conclusion: These findings suggest that IL‐1RN (VNTR) polymorphisms are associated with G‐EOP in Japanese.
Labial piercing resulting in gingival recession. A case series
Authors: Sardella Andrea , Pedrinazzi Massimo , Bez Cristina , Lodi Giovanni , Carrassi Antonio
Published: March 2003

Several complications of oral piercing have been recently reported in the medical and dental literature. Even though few people have had problems related to oral piercing, dentists should familiarise themselves with the potential associated oral and dental problems. We present three cases of young people with gingival recession in the mandibular incisor area related to labial piercing. The clinical examination and the dental history of the three cases revealed the relationship between the gingival recession and the presence of labial piercing. In particular, a stud in the lower lip was held in place by a metal disk on the inner labial mucosa in each case. The metal disk was in close proximity to the mandibular front teeth and it would appear that it was responsible for local trauma and recession. This case series reinforces previously reported concerns regarding the practice of piercing and the role of the dentist, both in advising patients with oral or facial piercing and in the treatment of related oral, gingival and dental problems.
Analysis of two common α1‐antitrypsin deficiency alleles (PI*Z and PI*S) in subjects with periodontitis
Authors: Scott D. A. , Von Ahsen N. , Palmer R. M. , Wilson R. F.
Published: March 2003

Background: πα1‐Antitrypsin deficiency is a genetically determined condition resulting in predisposition to certain inflammatory diseases due to a protease: antiprotease imbalance that is exacerbated by tobacco smoking. Limited evidence suggests that there may be a significant enrichment of mild α1‐antitrypsin deficiency phenotypes in subjects with chronic inflammatory periodontal disease.

Objective: To examine the prevalence of two common α1‐antitrypsin deficiency alleles (PI*Z and PI*S) in a UK population of subjects with periodontitis.

Subjects and methods: The prevalence of PI*M, PI*S and PI*Z allele combinations was determined in 31 subjects with periodontitis and compared with 31 healthy control subjects matched for smoking status, ethnicity, age and gender. α1‐Antitrypsin genotyping was performed by multiplex real‐time fluorescence polymerase chain reaction (PCR) using DNA extracted from whole blood.

Results: There was no difference in the proportion of any α1‐antitrypsin genotype found in the diseased and control populations.

Conclusions: We did not find evidence to support an association between mutant PI* alleles and periodontitis in a small, controlled study. Larger studies will be required to clarify the relationship between α1‐antitrypsin genotype and susceptibility to inflammatory periodontal disease.
Caries prevalence and distribution in 20–80‐year‐olds in Jönköping, Sweden, in 1973, 1983, and 1993
Authors: Hugoson Anders , Koch Göran , Slotte Christer , Bergendal Tom , Thorstensson Björn , Thorstensson Helene
Published: March 2003

Abstract – In 1973, a cross‐sectional study on oral health status was performed on 1000 individuals in the age groups 3–70 years in Jönköping, Sweden. In 1983 and 1993, new cross‐sectional studies were carried out in the age groups 3–80 years. The aim of the present study was to analyze caries prevalence and distribution in the three investigations 1973, 1983, and 1993 in the age groups 20–80 years. In the younger age groups (20–40 years), a larger proportion of individuals with good oral health was found in 1993 than in 1973 or 1983. A steady increase in the number of teeth in the age groups 40–80 years could be found, which was also reflected in the increasing number of decayed and filled tooth surfaces (DFS) in the same age groups. A marked decrease in proximal DFS in 20–50‐year‐olds in 1993 compared to 1973 and 1983 was found. However, a rather large and unchanging group of individuals suffering from severe caries was also observed. This situation demands an individualized caries treatment strategy based on risk assessment.
Socioeconomic factors that affect international caries levels
Authors: Diehnelt Dawn E. , Kiyak H. Asuman
Published: March 2003

Abstract – Health policy makers have examined the impact of economic policies and a nation’s social development on the health of its population. Objectives: The purpose of this research was to investigate the association between health care expenditures, socioeconomic factors, and caries levels in 109 countries representing an array of social and economic conditions, and to determine how such factors are related to caries experience at different levels of economic development. Methods: Countries were divided into established market economies and three groups of developing nations, based on their GNP (high, medium, low income). Total health expenditures as percent GDP and as US dollars per capita, public expenditures and aid flow as percent of total health expenditures, dentists per 100 000 population, per capita sugar consumption, and urbanization of the population were compared among these countries. Correlations between these variables, and decayed, missing and filled teeth (DMFT) of 12‐year‐olds in these countries were assessed. Results: The highest correlations were found between DMFT and public expenditures, sugar consumption, and urbanization. Highly significant differences emerged across nation groups by stages of development on several variables. Conclusions: The findings suggest that it is important to consider the stage of development of a given country when planning caries prevention policies and programs. Such a contextual approach is more likely to be successful in reducing caries levels.
Response to direct and indirect recruitment for a randomised dental clinical trial in a multicultural population of elders
Authors: MacEntee Michael I. , Wyatt Christopher , Kiyak H. Asuman , Hujoel Philippe P. , Persson Rigmor E. , Persson G. Rutger , Powell L. Virginia
Published: March 2003

Objectives: Recruitment for randomised clinical trials and community‐based studies has received little attention in the dental literature. The goal of this study was to report on our experiences with direct and indirect recruitment methods for a trial to prevent tooth loss in elders.

Methods: A direct approach, consisting of an introductory lecture with the help of a local contact person in each of the nine community centres, resulted in 208 recruits mostly from minority non‐English speaking communities (52%), whereas the other 192 recruits who responded to newspaper announcements (48%) were, in large part, from the English‐speaking community.

Results: The response suggests that a more direct and culturally specific approach is more productive when recruiting elders from ethnic minority groups, whereas elders from the dominant culture can be recruited indirectly and for about half the financial cost through newspaper announcements.

Conclusion: We conclude, therefore, that both direct and indirect methods are needed to recruit a multiethnic sample of subjects for a trial.
Plaque minerals in the prediction of caries activity
Authors: Pearce Euan I. F. , Dong Yan‐Mei , Yue Lin , Gao Xue‐Jun , Purdie Gordon L. , Wang Jia‐De
Published: March 2003

Background/Aims: Attempts to identify subjects who will develop caries lesions in future years have been only moderately successful, suggesting that one or more important risk factors are being overlooked. The aim of this study was to validate the use of plaque calcium, phosphate and fluoride concentrations as significant risk factors in caries. Methods: DMFS and DMFT rates were measured three times over 2 years in a group of rural Chinese schoolchildren initially aged 12 years and not living in a high‐fluoride area. At the baseline and year 1 examinations, dental plaque was accumulated for 3 days and, after collection, was analysed for Ca, P and F. Plaque scores, dental health behaviour and parents' occupation data were also recorded. Results: The mean DMFS increment over 2 years was 1.14 with a range of −2 to +9. Regression analysis taking all factors into account identified only plaque Ca concentration, baseline DMFS score and toothbrushing frequency as significant factors in identifying high‐risk individuals. Plaque Ca also showed predictive ability on its own. For example, when high caries was defined as 3+ new DMFS and a Ca cut‐off value of 200 nmol/mg dry wt was selected, sensitivity was 0.84 and specificity 0.38. However, with this cut‐off value the percentage predicted to have high caries risk was unrealistically high at 66%. As in several other studies, baseline caries score was a useful predictor of future caries. Conclusion: Low plaque Ca concentration showed a modest ability to predict future caries, and since it is implicated directly in the chain of events leading to caries, its use in caries prediction should be considered further. Plaque P and F showed no predictive ability in this study.