bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Comparison of Hydroxyapatite‐Coated Titanium Dental Implants Placed in Fresh Extraction Sockets and Healed Sites
Authors: Yukna Raymond A.
Published: March 2012

The placement of hydroxyapatite‐coated dental implants in fresh extraction sockets was compared to placement in adjacent healed sites in 14 patients. Systematic sequential documentation was obtained regarding periodontal health, radiographic bone levels, and implant stability at the time of implant placement, at uncovering, and from 8 to 24 months (mean 16 months) after loading and restoration delivery. There were no significant differences in any clinical parameter between those implants placed in fresh extraction sockets and those placed in healed areas. Periodontal health, maintenance of crestal bone levels, and implant stability were excellent for implants placed in both types of recipient sites. The results of this study suggest that hydroxyapatite‐coated dental implants can be successfully placed in fresh extraction sockets utilizing otherwise standard implant placement techniques, and that they appear to clinically perform equally well in fresh sockets and healed sites. J Periodontol 1991; 62:468–472.
Errors in Measuring Parameters Associated With Periodontal Health and Disease
Authors: Kingman A. , Löe H. , Ånerud Å. , Boysen H.
Published: March 2012

The intra‐examiner reliability for the Plaque Index (PlI), Calculus Index (CI), Gingival Index (GI), and periodontal loss of attachment (LA) was evaluated in 2 different physical and clinical environments. Examiner reliability for each index was consistently better when clinical evaluations were performed in an office setting on subjects who had low levels of periodontal disease than under more difficult field conditions evaluating subjects with higher disease levels. In an office environment intra‐examiner reliabilities were very good for subject‐based averages (intraclass r's were 0.85, 0.83, 0.81, and 0.78 for GI, PlI, LA, and CI, respectively); they were moderate to good for site‐based scores (kappas were 0.63, 0.54, and 0.47 for CI, GI, and PlI). Under field conditions reliabilities ranged from excellent to fair for subject‐based averages (intraclass r's of 0.98, 0.86, 0.76, and 0.33 for LA, CI, GI, and PlI, respectively); for site‐based scores they ranged from moderate to fair (kappas of 0.50, 0.49, and 0.21 for GI, CI, and P1I, respectively). Small but significant systematic errors were detected under field conditions for the PlI and CI, and for the PlI in the office environment as well. The results observed suggest that the examination process can affect the clinical status of the surface or site when replicate assessments of plaque and calculus are conducted within a 24‐hour period. Our results also confirm that measurement error standard deviation for loss of attachment evaluated with a periodontal probe can be maintained at 0.13 mm for whole‐mouth means and 0.54 mm for individual sites, even when examining subjects with substantial periodontal disease under field conditions. J Periodontol 1991; 62:477–486.
The Penetration of Lavage Solution into the Periodontal Pocket During Ultrasonic Instrumentation
Authors: Nosal Gregory , Scheidt Michael J. , O'Neal Robert , Van Dyke Thomas E.
Published: March 2012

The purpose of this study was to evaluate the penetration depth of the water coolant for medicament lavage of an ultrasonic device into the periodontal pocket. Patients having teeth previously planned for extraction, and exhibiting probing depths 3 mm or greater were used in this study. A reference notch was placed on the tooth at the level of the gingival margin and the probing attachment level (PAL) was measured from the base of the notch to the base of the pocket. The ultrasonic device, with an EWPP tip and equipped with a reservoir of erythrocin dye colored coolant, was activated and moved in a vertical direction from the gingival margin to the apical extent of the pocket. The tooth was extracted and the penetration depth (PD) of the dye‐colored water spray was measured from the reference notch to the apical limit of the stained subgingival plaque. The tooth was counter stained with methylene blue to determine the coronal extent of the connective tissue attachment. Pearsons' Product Moment Correlation Coefficient for the PAL and PD was calculated. Dye‐stained root surface was observed along the full extent of the probe tip's penetration path. The dispersion of the dye‐colored stain was localized to the area of the ultrasonic probe with very little lateral dispersion. The ultrasonic instrument may be an effective system to mechanically remove plaque and calculus at the same time as delivering a chemotherapeutic agent. The limited dispersion of the liquid dye would indicate that chemical plaque control with this delivery system is dependent upon thorough debridement with the instrument such that all affected surfaces are instrumented. J Periodontol 1991; 62:554–557.
Gingival Crevicular Fluid Concentration and Side Effects of Minocycline: A Comparison of Two Dose Regimens
Authors: Freeman Eric , Ellen Richard P. , Thompson Gordon , Weinberg Sandra E. , Song Meja , Lazarus Randi H.
Published: March 2012

The purpose of this study was to conduct a direct comparison of two dose regimens of minocycline to determine 1) whether they achieved crevicular fluid concentrations in a therapeutic range; and 2) the frequency of side effects. In a double‐blind design, 30 patients divided into 2 groups were given either 100 mg minocycline or 200 mg minocycline per day for an 8‐day period. The concentration of minocycline in the gingival crevicular fluid (GCF) at 8 days was 4.77 μg/ml for the 100 mg a day group and 5.97 μg/ml for the 200 mg a day group and at 15 days was 4.30 μg/ml for the 100 mg a day group and 4.17 μg/ml for the 200 mg a day group. There was no significant difference in the antibiotic concentration in the gingival crevicular fluid between the 2 groups. Reported adverse experiences to the minocycline were greater in the 200 mg a day group. Short‐term changes in periodontal health as measured by plaque index, gingival index, pocket depth, and bleeding upon probing showed improvements in all parameters over the 15 day period. There were no significant differences in these parameters between the 100 mg a day and 200 mg a day group. At 8 days reduced levels of Porphyromonas gingivalis and Prevotella intermedia were achieved but they were not eliminated from infected subgingival sites in either group. Achieving bacteriostatic concentrations of GCF, fewer side effects, and the potential for better compliance suggests that a single daily dose of 100 mg minocycline should now be investigated for its efficacy in managing periodontal infections manifesting as Periodontitis. J Periodontol 1992;63:13–18.
A Comparison of Two Techniques for Attaining Root Coverage
Authors: Laney James B. , Saunders Victor G. , Garnick Jerry J.
Published: March 2012

This study compared the relative success of soft tissue coverage of denuded roots by two surgical procedures: Autogenous free gingival graft (FGG) and a 2‐stage coronallypositioned flap (CPF). Eight patients who had bilateral areas of gingival recession were selected. The areas of recession treated were Class I or II according to Miller's classification and caused either an esthetic problem or root sensitivity. The defects were randomly assigned to surgical procedures in each subject. In the FGG, the root surfaces were root planed, conditioned with a saturated citric acid solution, and an adjacent recipient site was prepared surgically. A thick palatal graft was then sutured to the recipient site. In the CPF, an initial autogenous free gingival graft was surgically placed in a recipient site just apical to the root recession. After 1 month of healing, the gingiva was coronally positioned to the level of the CEJ. Standardized photographs were obtained presurgically, at 2 weeks, and at 1 and 3 months. Reduction of areas of exposed root surface and distances from CEJ to gingival margin were computed. Data analysis did not demonstrate a significant difference in success between FGG and CPF at 3 months. Maximum decrease of exposed root surfaces occurred at 2 weeks postsurgically with both procedures and then some recession of each type of graft occurred. The mean distance of the exposed root surfaces decreased from 2.136 mm to 1.301 mm and from 2.187 mm to 1.400 from baseline to 3 months for the FGG and CPF respectively. The area of root exposure was reduced from 6.692 mm2 to 3.705 mm2 and from 6.949 mm2 to 3.841 mm2 for the FFG and CPF respectively. Thus, the null hypothesis was accepted in that there were no differences in root surface coverage by CPF and FGG procedures. J Periodontol 1992; 63:19–23.
Day‐Long Reduction of Oral Malodor by a Two‐Phase Oil:Water Mouthrinse as Compared to Chlorhexidine and Placebo Rinses
Authors: Rosenberg Mel , Gelernter Ilana , Barki Mira , Bar‐Ness Ronit
Published: March 2012

Few scientific investigations have addressed the ability of mouthrinses to reduce oral malodor for periods longer than 3 hours. In the present report, we have employed simple, recently described techniques to assess the day‐long reduction in oral malodor of a novel 2‐phase oil:water mouthrinse (TPM), as compared to a corresponding placebo rinse, and to a commercial 0.2% chlorhexidine mouthrinse. Sixty dental students were divided randomly into 3 groups, and instructed to use one of the rinses prior to bedtime and the following morning. Measurements carried out in the late afternoon, about 8 to 10 hours following rinsing, were compared with baseline measurements carried out in the late afternoon of the previous day. Volatile sulphide levels were measured using a portable industrial sulphide monitor. Microbial levels were estimated using a simple rinsing technique employing sterilized milk. These quantitative techniques were corroborated by organoleptic (hedonic) ratings of a single odor judge. Both TPM and Chlorhexidine brought about significant decreases in volatile sulphides (P < 0.05) as compared to the placebo group. These results were corroborated by the organoleptic data. Similarly, both chlorhexidine and TPM were highly effective in reducing microbial levels as measured by the rinsing technique, in comparison to the placebo group. Chlorhexidine appeared to be more effective than TPM in all measurement categories, although only in the case of microbial activity was there a significant (P < 0.05) difference between the two groups. The data showing daylong reduction of malodorous sulphides and microbial levels by TPM extend previous in vitro studies demonstrating its potent microbial desorption properties, and provide the first evidence for its potential clinical efficacy. J Periodontol 1992;63:39–43.
Dentifrice Abrasivity and Cervical Dentinal Hypersensitivity. Results 12 Weeks Following Cessation of 8 Weeks' Supervised Use
Authors: Gillam D.G. , Newman H.N. , Bulman J.S. , Davies E.H.
Published: March 2012

Following an 8‐week controlled investigation of 2 strontium chloride hexahydrate dentifrices (SCH) of differing abrasivity, 2 groups of 20 subjects each, with cervical dentinal hypersensitivity, were re‐examined at 20 weeks; that is, 12 weeks after the active period. The examination procedures were conducted in the same manner as in the main clinical trial. Sensitivity levels were assessed by 2 instrument methods: tactile (Yeaple probe), and cold air (dental air syringe), and by subjective perception of pain by means of a Visual Analogue Scale. The results from these methods of assessment demonstrated that 12 weeks following the cessation of 8 weeks' controlled use of standard and low abrasive SCH dentifrices, sensitivity levels reversed only slightly in both groups and, overall, sensitivity remained significantly lower than at baseline. The abrasivity of the dentifrice did not affect the desensitivity activity. J Periodontol 1992; 63:7–12.
The Effect of Titanium Implant Abutment Surface Irregularities on Plaque Accumulation In Vivo
Authors: McCollum Judith , O'Neal Robert B. , Brennan William A. , Van Dyke Thomas E. , Horner Jack A.
Published: March 2012

The purpose of this study was 2‐fold to: 1) evaluate in vitro the surface texture of titanium implant abutments after exposure to plastic sealers, an air‐powder abrasive system, rubber cup polishing with flour of pumice, and untreated control abutments; and 2) compare plaque accumulation in humans on abutments treated with the above methods. In part I, 5.5 mm abutments were instrumented for 30 seconds per 90° segment with the respective methods. The surface character was compared to untreated controls using SEM at 260X magnification. The control abutments revealed prominent milling marks and small pits; plastic sealers slightly smoothed the milling marks and created microscratches; the air‐powder abrasive largely obliterated the milling marks and caused some surface pitting; the rubber cup with flour of pumice removed the milling marks and created a smooth swirl pattern. None of the instrumentation appeared to roughen the surface. In the clinical experiment (part II), four abutments, one of each type, were placed in 12 patients for a period of 7 days, during which the patients performed no oral hygiene. At the end of 7 days, the abutments were retrieved and processed for SEM. A digitizer and software program were used to determine the percent of total abutment surface area covered by plaque. The demarcation of supragingival and subgingival plaque was well delineated. The total mean percent surface area of plaque ranged from 52.06% for the air‐powder abrasive to 55.29% for the plastic sealers. All abutments collected plaque, but no single treatment yielded a surface with significantly different amounts of plaque accumulation. For maintenance and prophylaxis, any of these methods may be used without damaging the abutment surface or enhancing plaque accumulation. The rubber cup with flour of pumice provides the smoothest polished abutment surface when used with light intermittent pressure. Heavy pressure with the rubber cup on an abutment may gouge the surface or round the abutment–prosthesis interface. J Periodontol 1992; 63:802– 805.
Effect of Subgingival Irrigation With Chlorhexidine During Ultrasonic Scaling
Authors: Chapple Iain L. C. , Walmsley A. Damien , Saxby Michael S. , Moscrop Helen
Published: March 2012

This study examines the effect of a Chlorhexidine irrigant during ultrasonic scaling and root planing and compares clinical results with those obtained using a water irrigant. The irrigant was delivered either through a conventional or a recently‐introduced ultrasonic sealer, which allows the irrigant solution to be passed through the inside of the sealer tip. The study utilizes a split‐mouth design and contrasts the effectiveness of both instruments in improving periodontal health, as measured by standard clinical indices. A preliminary investigation of patient tolerance to treatment performed throughout the clinical trial was also undertaken. Statistical analysis at the 3 and 6 month post‐treatment stage revealed no significant differences between the 4 experimental groups in respect of probing attachment levels (P>0.5), bleeding index (P>0.1), or plaque index (F>0.05). Clinical attachment gain assessed by probing ranged from 0.6 to 0.9 mm. Chlorhexidine increased patient tolerance in 77% of cases and the new model ultrasonic sealer was favored over the traditional model in 70% of cases. The magnitude of the tolerance differences was however not statistically significant. The possible potential of the new sealer and of Chlorhexidine as an irrigant to reduce patient discomfort is worthy of further investigation than was possible in this study. J Periodontol 1992; 63:812–816.
Efficacy of Preprocedural Rinsing With an Antiseptic in Reducing Viable Bacteria in Dental Aerosols
Authors: Fine Daniel H. , Mendieta Carlos , Barnett Michael L. , Furgang David , Meyers Ronnie , Olshan Arnold , Vincent Jack
Published: March 2012

This double‐blind, controlled, cross‐over, clinical study evaluated the effect of preprocedural rinsing with an antiseptic mouthrinse on the level of recoverable viable bacteria in an aerosol generated during a typical dental procedure. Eighteen subjects participated. Following 24 hours of abstention from all oral hygiene procedures, subjects received a 10‐minute ultrasonic scaling of a randomly selected one‐half of their mouth which served as the unrinsed control. They were then randomly assigned either antiseptic mouthwash or a control rinse and rinsed with 20 ml for 30 seconds, after which the remaining half mouth (experimental side) was scaled ultrasonically for 10 minutes. During each 10‐minute scaling period aerosolized bacteria were collected on a sterile filter using a modified vacuum air‐sampling device. Microbes captured on the sterile filter were quantitated by overlaying the filters onto trypticase soy agar, incubating the filters aerobically at 37°C for 24 to 72 hours, and counting the resulting colony forming units (CFU). Preliminary experiments had confirmed that neither the collection method nor residual antiseptic mouthwash in the aerosol adversely affected the number of viable bacteria recovered from the filter. Rinsing with the antiseptic mouthwash produced a 94.1% reduction in recoverable CFUs compared to the non‐rinsed control, while the control rinse produced a 33.9% reduction. The difference between the mouthwash and control was statistically significant (P <.001). This study indicates that preprocedural rinsing with an antiseptic mouthwash can significantly reduce the microbial content of aerosols generated during ultrasonic scaling and may have potential in‐office use as part of an infection control regimen. J Periodontol 1992; 63:821–824.
Effects of a Bisphosphonate on Experimental Periodontitis in Monkeys
Authors: Brunsvold Michael A. , Chaves Eros S. , Kornman Kenneth S. , Aufdemorte Thomas B. , Wood Robert
Published: March 2012

Bisphosphonates have been shown to increase bone mass in estrogen‐deficient patients by inhibiting osteoclast activity. The purpose of this study was to measure clinical and radiographic effects of a bisphosphonate on periodontitis development in monkeys. Twenty‐seven (27) adult cynomolgus monkeys were studied. After quarantine, baseline data were obtained including plaque index, gingival index, clinical probing depth measurements, and intraoral radiographs. Standardized radiographs were analyzed for quantitative changes in bone density using a computer assisted densitometric (CADIA) system. Animals were divided into 3 groups to receive 1 of the 3 treatment agents; these agents consisted of two levels of the test drug (alendronate) and a saline placebo. Agents were injected in the saphenous vein of the lower leg every 2 weeks for 16 weeks. One week after the initiation of treatment agent injections, mandibular right molars and premolars were ligated with 3–0 silk sutures to induce periodontitis. Ligated teeth were also inoculated with Porphyromonas gingivalti to insure a significant etiologic challenge. Nonligated homologous teeth served as controls. Clinical measurements and radiographs were repeated at 8 and 16 weeks after ligation. The bisphosphonate at a concentration of 0.05 mg/kg significantly retarded the progression of periodontitis as measured by bone density changes. The higher level dose of the test drug did not differ from placebo with respect to loss of bone density. Clinical indices were not affected significantly by the test drugs. Drugs that alter bone metabolism may offer a new approach to the treatment of periodontal disease. J Periodontol 1992; 63:825–830.
Dental Implants: A Review
Authors: Meffert Roland M. , Langer Burton , Fritz Michael E.
Published: March 2012

The present article is a review presenting an update on the field of dental implants since the World Workshop in Clinical Periodontics in July 1989. Areas that are discussed include following: 1. Biomaterials and the implant interface, and the interaction of these with the environment. 2. Periodontal considerations including data supporting a perimucosal seal of implant to soft tissue and discussion of the endosseous interface between the bone and the implant. 3. Newer techniques of diagnostic imaging and their determination of bone types are related to the future practice of dental implants. 4. Implant selection and the surgical techniques involved in implant placement. 5. Current ideas of implant prosthodontics, implant maintenance, and the treatment of implant failures. 6. Finally, the use of dental implants in the United States and Sweden. J Periodontol 1992; 63:859–870.
In Vitro Effects of Citric Acid Application Techniques on Dentin Surfaces
Authors: Wen C. Rosa , Caffesse Raul G. , Morrison Edith C. , Nasjleti Carlos E. , Parikh Udayan K.
Published: March 2012

The present study evaluated the in vitro effects of different application techniques of citric acid on dentin root surfaces. Ten freshly extracted, periodontally involved teeth were obtained and 4 dentin slabs, approximately 4 × 6 × 2 mm, were obtained from the roots of each tooth, for a total of 40 slabs. These slabs were identified by tooth and preserved in 1:1 anhydrous glycerol/absolute alcohol solution. Citric acid pH 1 was applied to 32 of the slabs for 5 minutes with one of 4 different techniques: 1) immersion; 2) placed with a saturated cotton pellet with no rubbing; 3) placed and burnished with a saturated cotton pellet; or 4) applied with a camel hair brush. The remaining 8 dentin slabs were used as negative control specimens, root‐planed and non‐acid treated. Following the various treatments, the slabs were fixed, dehydrated, critical point dried, and coated for scanning electron microscopic (SEM) evaluation. Scanning photomicrographs were obtained at 2,000, 6,000, and 40,000 magnifications. The surface characteristics of the treated dentin slabs were evaluated descriptively regarding the degree of fiber exposure; the number of exposed tubules and the surface area occupied by tubule orifices were also measured. Friedman's 2‐way analysis for block designs was employed. Results demonstrated that root‐planed, non‐acid treated specimens had an amorphous, irregular surface which corresponded to a smear layer. Corresponding views of instrumented surfaces which had been treated with citric acid by immersion, placed with a cotton pellet, or applied with a camel hair brush exhibited funnel‐shaped orifices of dentinal tubules and intertubular zones with exposed connective tissue fibers, mat‐like morphology. In contrast, slabs treated with the burnishing technique showed wide surface variations. Surface tufting with widened tubular opening was observed on 2 of the 8 treated slabs. Surface smearing with complete obturation of tubules was present in the remaining 6 slabs. According to the results of the present study, if maximum exposure of intertubular fibrils and dentinal openings is beneficial in periodontal regenerative procedure, it may be undesirable to apply citric acid using excessive pressure. J Periodontol 1992; 63:883– 889.
The Effect of Insulin‐Like Growth Factor‐I and Human Growth Hormone on Periodontal Ligament Fibroblast Morphology, Growth Pattern, DNA Synthesis, and Receptor Binding
Authors: Blom Søren , Holmstrup Palle , Dabelsteen Erik
Published: March 2012

Repopulation of the detached root surface by cells from the periodontal ligament (PDL) is a prerequisite for new attachment formation. Stimulation of PDL‐cell growth may therefore serve as an essential method to enhance formation of new attachment. Studies have demonstrated that insulin‐like growth factor‐I (IGF‐I) has a mitogenic effect on fibroblasts originating from various connective tissues and cell‐lines. Further, human growth hormone (hGH) is known to regulate the plasma concentration of IGF‐I and to mediate cellular biological effects. In the present study we examined the effect of IGF‐I and hGH on morphology, growth pattern, and DNA synthesis. The expression of IGF‐I and hGH receptors on the surface of cultured PDL fibroblasts is also described. A primary fibroblastic cell line was established from rat PDL tissue, and blind, photographic recordings of morphology and growth pattern, as well as incorporation of [3H]thymidine in cellular DNA, was carried out in the presence and absence of IGF‐I and hGH. The presence of specific membrane receptors was investigated by binding of [125I]IGF‐I and [125I]hGH. The analysis of photographs showed that IGF‐I and hGH had no effect on morphology and growth pattern. Incorporation of 3H‐thymidine, however, was increased in a dose‐dependent manner by IGF‐I, whereas hGH alone or in combination with IGF‐I produced no dosedependent response. Maximum effect (% of control) on DNA synthesis was 176% for IGFI and 91% for hGH. The mitogenic effect of IGF‐I was not enhanced in the presence of hGH, on the contrary, incorporation of [3H]‐thymidine was perhaps slightly depressed by all tested concentrations of hGH. [125I]IGF‐I was displaced in a concentration‐dependent manner by unlabeled IGF‐I, whereas no specific binding was found for [125I]hGH. Maximum specific binding was 5.8% of added IGF‐I, and half maximal binding was found at a concentration of 10 to 100 ng/ml IGF‐I. This study demonstrates that IGF‐I can stimulate the DNA synthesis of PDL fibroblasts, likely via binding to high affinity cell surface receptors. The effect of IGF‐I was not enhanced by hGH and no effects on the morphology or growth pattern were observed. J Periodontol 1992; 63:960–968.
HIV Inactivation in a Bone Allograft
Authors: Mellonig James T. , Prewett Annamarie B. , Moyer Mary Pat
Published: March 2012

The use of exclusionary techniques in the procurement of donors for bone allografts greatly reduces chances for disease transmission. Furthermore, treatment of HIV with either chemical agents or strong acids will effectively inactivate the AIDS virus. These data are taken as indirect proof that the risk of obtaining AIDS from a freeze‐dried bone allograft is highly remote. The purpose of this study is to obtain direct evidence that the processing of a demineralized freeze‐dried bone allograft would render the allograft safe for human use. In Part I, human cortical bone was obtained from a cadaveric source and tested to be free of HIV contamination. The bone was spiked with 5.26 × 109 viral particles. This corresponded to 148 μg of total viral protein. In Part II, cortical bone was procured from a donor who died of AIDS. In both Parts I and II, the cortical bone was ground to yield particle sizes of 90 to 500 μm. Test samples were treated with a virucidal agent and demineralized in HCl. Control samples were left untreated. All samples were cocultivated with stimulated peripheral blood lymphocytes and assayed for p24 core protein, reverse transcriptase, and viral gag gene by polymerase chain reaction (PCR). In Part I, the HIV spiking experiment, untreated virus infected paniculate bone was positive for HIV replication. Treated samples were negative when assayed for HIV. Bone samples in Part II, HIV infected bone, were positive by PCR. Replication of viable HIV could not be demonstrated after treatment. It was concluded that demineralization and treatment with a virucidal agent inactivates HIV in spiked and infected bom. J Periodontol 1992; 63:979–983.
Principles and Pitfalls of Clinical Trials Design
Authors: Jeffcoat M.K.
Published: March 2012

Periodontitis and gingivitis trials can involve many complex experimental designs. The selection of a specific design and the details of the protocol can influence the magnitude of any effect observed, the generalizability of the results, and the clinical significance of the findings. The purpose of this paper is to review selected aspects of clinical trials including the overall clinical experimental design, controls, outcomes, sample size, and patient selection. Particular emphasis will be placed on Periodontitis trials. J Periodontol 1992; 63:1045–1051.
Bacterial Concentration Fluorescence Immunoassay (BCFIA) for the Detection of Periodontopathogens in Plaque
Authors: Wolff Larry F. , Anderson LuAnn , Sandberg Gregory P. , Reither Lowell , Binsfeld Christine A. , Corinaldesi Giuseppe , Shelburne Charles E.
Published: March 2012

A bacterial concentration fluorescence immunoassay (BCFIA) was developed to rapidly detect periodontopathic bacteria in human plaque samples. The BCFIA utilized fluorescent‐tagged monoclonal antibodies (MAbs) directed against the lipopolysaccharide of selected Gram‐negative bacteria. Microorganisms identified in plaque using the BCFIA included Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum. The immunoassay procedure involved combining a patient's plaque sample with a species‐specific fluorescein isothiocyanate‐labeled MAb and then incubating the mixture in a specialized microtiter plate allowing the MAb to bind to its homologous bacteria. Bound and unbound fluorescent‐tagged MAbs were separated by filtration and total bound bacterial fluorescence was determined with a fluorimeter. The relative number of a bacterial species in a given plaque sample was estimated by reference to a standard curve carried through the BCFIA. The BCFIA had a lower detection limit of near 104 specific bacterial cells in a mixed bacterial preparation or plaque sample. When compared to cultivable flora procedures in detecting the 4 periodontopathogens, the BCFIA had high levels of statistical sensitivity, 97% to 100%, while statistical specificity ranged between 57% and 92%. There was a 71% to 82% agreement between BCFIA and DNA probe methodology in detecting periodontopathogens in plaque. The BCFIA, when compared to cultivable flora, offers the advantage of evaluating both live and dead bacterial cells in plaque. This may in part, if not fully, explain the lower specificity values of the BCFIA when compared to cultivable flora. Screening plaque samples for periodontopathic bacteria is considerably faster and results in a greater frequency of detection with BCFIA than cultivable flora based methods. J Periodontol 1992; 63:1093–1101.
The Host Response in Gingival Crevicular Fluid: Potential Applications in Periodontitis Clinical Trials
Authors: Lamster Ira B.
Published: March 2012

Traditional clinical variables of periodontal pathology have only limited value as indicators for future disease progression in patients with adult periodontitis. Consequently, other aspects of the periodontal lesion are being examined for their diagnostic utility. Analysis of the host response in gingival crevicular fluid (GCF) is among the most intensely studied of these new diagnostic approaches. Specific indicators of the humoral immune response, cellular immune response, and acute inflammatory response have been identified in GCF. The relationship of indicators of the humoral immune response to active periodontal disease is equivocal. Specific indicators of the cellular immune response in GCF may ultimately prove to be important diagnostically, but the relationship of any specific marker to active periodontal disease has not been reported. In contrast, the acute inflammatory response in GCF has been extensively studied and a number of factors appear to be associated with an increased risk for future disease progression. Indicators of enhanced polymorphonuclear leukocyte activity, (lysosomal β‐glucuronidase, lysosomal collagenase), Prostaglandin E2, and an indicator of acute tissue destruction (the cytoplasmic enzymes aspartate aminotransferase) have been associated with the occurrence of clinical attachment loss. An example of the application of a GCF marker in a periodontitis clinical trial is provided by describing the relationship of lysosomal βglucuronidase in GCF at baseline and 2 weeks following root planing and scaling to the occurrence of disease activity during the following 6 months. Persistently elevated levels of this enzyme were related to clinical attachment loss. The positive, negative, and total predictive values for β‐glucuronidase as an identifier of clinical attachment loss were 86%, 71%, and 76%, respectively. The accumulated evidence suggests that inclusion of a GCF‐based determination of the acute inflammatory response in periodontitis clinical trials is justified. The information obtained may provide both a quantitative assessment of the host response and a measure of how effective the therapy is in reducing the risk of future clinical attachment loss. J Periodontol 1992; 63:1117–1123.
Effect of X‐Ray Angulation on Radiographic Periodontal Ligament Space Width
Authors: Tibbetts J. , Allen K. , Hausmann E.
Published: March 2012

The aim of this study was to set up a model for quantitating a change in radiographic PDL width on variation of x‐ray angulation within anticipated clinical limits. Four incisor and 4 molar sites of 6 human skulls were radiographed at varying angulation. Horizontal angulation changes were made over a 12° range, in 3° increments. Vertical angulation change was in one 10° increment. Baseline radiographs were taken with the x‐ray beam perpendicular to a buccal tooth surface in a horizontal direction and perpendicular or 10° off the perpendicular in a vertical direction. The radiographs were converted to digitized images and PDL width measurements made utilizing a mouse‐driven computer program. The mean PDL width differences between all possible horizontal and vertical combinations (n = 45) were compared with the mean of those obtained from differences observed in PDL width measurements on replicate baseline radiographs. Mean PDL width differences for incisor locations were statistically different from the mean baseline PDL width difference; posterior PDL width difference showed no statistical variation from the mean baseline PDL width difference. For radiographs taken within the range expected under clinical conditions, a significant change in PDL width may be observed in incisor locations. Posterior sites may not exhibit this significant change due to the anatomy of the region which may reduce the clarity of the radiographic image. J Periodontol 63; 1992:114– 117.
A 10‐Year Longitudinal Study of Untreated Mucogingival Defects
Authors: Freedman Arnold L. , Salkin Leslie M. , Stein Marc D. , Green Kevan
Published: March 2012

A study was conducted to observe the changes in areas with untreated mucogingival defects over a 10‐year period. The results in this group after 4 years were previously published. Upon entering dental school, a group of 39 freshman dental students were assessed for plaque index, gingival index, probing depth, and width of keratinized gingiva in 112 sites of inadequate keratinized gingiva. Eighteen of the original 39 participants were reassessed for the same parameters in 64 sites after 10 years. The results revealed that 22 sites showed a slight increase in keratinized gingiva, 32 were unchanged, and 10 sites showed a slight decrease in keratinized gingiva. The mean width of keratinized gingiva at the beginning of the study was 1.73 ± 0.542 mm and was 2.01 ± 0.864 mm after 10 years. This represented a small, but statistically insignificant, increase in the width of keratinized gingiva. The Plaque Index and Gingival Index of this group at baseline and at 10 years indicated a high level of oral hygiene and gingival health. It was concluded that in the absence of gingival inflammation, areas with small amounts of keratinized gingiva may remain stable over long periods of time. J Periodontol 1992; 63:71–72
Serial Doxycycline and Metronidazole in Prevention of Recurrent Periodontitis in High‐Risk Patients
Authors: Aitken S. , Birek P. , Kulkarni G.V. , Lee W.L. , McCulloch C.A.G.
Published: March 2012

The efficacy of Metronidazole and doxycycline in preventing recurrent Periodontitis was studied in 23 patients. After treatment in the previous 7 months with either bimonthly scaling and 3 weeks of systemic doxycycline (11 subjects) or scaling and placebo (12 subjects), patients were monitored for recurrent Periodontitis and were scaled every 2 months. When either a periodontal abscess or > 2 mm loss of gingival attachment was observed, metronidazole was administered (250 mg every 8 hours) for 10 days. In the placebo plus metronidazole group, 5 patients (42%) exhibited recurrent Periodontitis after the metronidazole regimen compared with only one (9%) in the doxycycline plus metronidazole group (P < 0.096). Subgingival plaque samples at study and healthy control sites were screened for the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Eikenella corrodens, and Fusobacterium nucleatum by immunofluorescence and for spirochetes using Ryu's stain. Presence/absence analysis of the sum of scores of the 6 individual pathogens demonstrated large reductions (P < 0.005) in the frequency of detection of pathogens in the former doxycycline compared with the placebo plus metronidazole group at both study and control sites before and one month after metronidazole. By 7 months after metronidazole, there was no detectable difference between groups. These results indicate that prevention of recurrent Periodontitis with metronidazole may be enhanced by previous treatment with doxycycline. J Periodontol 1992; 63:87‐92.
The Effect of Hygiene Instruments on Dentin Surfaces: Scanning Electron Microscopic Observations
Authors: Gantes Bernard G. , Nilvéus Rolf , Lie Tryggve , Leknes Knut N.
Published: March 2012

The present study consists of two separate parts. The first section is an in vitro evaluation of the relative abrasiveness of some hygiene instrumentations commonly used during maintenance therapy. In the second section, one of the instruments, a recently developed plastic tip for use on a sonic sealer, was examined for its ability to remove dental plaque from root surface specimens instead for 5 weeks in the oral cavities of dogs. The in vitro study was performed on recently obtained dentin specimens where a ridge had been machined parallel to the long axis of the tooth. The sonic sealer fitted with the plastic tip gave considerably less removal of dentin and a smoother dentin surface than the curet, the rubber cup with polishing paste, or the sonic sealer with an ordinary metal tip. These findings further demonstrated that the plastic tip was able to efficiently remove 5‐week old dental plaque from experimental root surface areas within a time frame of 5 seconds. The new plastic tip may be valuable in maintenance therapy giving less risks for iatrogenic effects on the root surfaces than other debridement methods. J Periodontol 1992; 63:151‐157.
Effects of Sodium Meclofenamate on Postoperative Pain Following Periodontal Surgery
Authors: Gallardo F. , Rossi E.
Published: March 2012

The analgesic activity of single doses of meclofenamate (100 mg) was compared to aspirin (500 mg) and to placebo on 99 outpatients with moderate to severe pain following periodontal surgery under double‐blind conditions. Pain intensity differences scores (PID) at the first, second, and third hour after the ingestion of the first capsule of each medication were used to determine the analgesic efficacy of the studied drugs. Kruskal Wallis test followed by the Mann‐Whitney rank sum test were used in the statistical analysis of results. Meclofenamate was statistically superior to placebo and superior to aspirin in the second hour of evaluation, while aspirin was not superior to placebo during the 3‐hour period of pain evaluation. It is concluded that meclofenamate is a non‐steroidal antiinflammatory drug with interesting analgesic properties which can be used as directed as an alternative to aspirin or acetaminophen for the control of postoperative pain following periodontal surgery. J Periodontol 1992;63:166–168.
Re‐Interpretation of the Evidence for X‐Linked Dominant Inheritance of Juvenile Periodontitis
Authors: Hart Thomas C. , Marazita Mary L. , Schenkein Harvey A. , Diehl Scott R.
Published: March 2012

Several studies have provided evidence supporting the inheritance of juvenile periodontitis (JP) in a Mendelian fashion, and both X‐linked and autosomal modes of transmission have been proposed. Re‐examination of the evidence for the X‐linked dominant hypothesis reveals that two assumptions were crucial in favoring the X‐linked rather than an autosomal hypothesis of JP transmission. The first assumption was that females are more likely than males to have JP by ratios of approximately 2.5:1. The second key observation was the reported lack of father to son transmission of the trait. However, the data that these assumptions were based on may be interpreted differently. Although the number of females reported to be affected by JP is greater than the number of affected males, this is probably a reflection of the greater number of females incorporated into these studies. When the proportions of affected males and females are examined, rather than total numbers of affected individuals, the proportion of affected males and females is similar. Additionally, the reported lack of father to son transmission for JP appears to be the result of incomplete family data. The female ascertainment bias inherent in many JP studies, compounded by the lack of male participation in such studies, appears to have resulted in the perception of a lack of male to male transmission of JP. This lack of observed father to son transmission of JP in incomplete data sets has been regarded as proof of no male to male transmission for the trait. Studies of more complete family data, however, do document father to son transmission of JP. When these data are reinterpreted in light of these findings, the preponderance of evidence appears to support autosomal transmission of juvenile periodontitis. J Periodontol 1992; 63:169–173.
Freeze‐Dried, Cross‐Linked Bovine Type I Collagen: Analysis of Properties
Authors: Hyder P. R. , Dowell P. , Singh G. , Dolby A. E.
Published: March 2012

This study was undertaken to assess the physical and biological properties of freeze‐dried cross‐linked bovine type I collagen and to assess its potential for use in the guided tissue regeneration method of treatment of periodontal disease in human adult subjects. The modulus of elasticity, swelling ratio, and biodegradation rate were investigated. The collagen sponge was implanted subdermally into Sprague‐Dawley rats and a histological study carried out at 2, 7, 21, 35, and 49 days post implantation. Growth of human gingival and periodontal ligament derived fibroblasts on collagen sponge was assessed, as well as the effect of bovine collagen supernatants upon gingival and periodontal fibroblast cultures. The physical properties of the collagen sponge were consistent with good handling qualities and, therefore, it was appropriate for use at a surgical site. The histological study demonstrated a reduction in thickness of the collagen at 21 days; at 35 days there was a hazy appearance of the collagen remnants; and at 49 days the graft material had been completely replaced with fibrous tissues. The in vitro response of human gingival and periodontal fibroblasts to bovine collagen showed that, after 21 days, confluent fibroblast growth was observed around and underneath the sponge. The effect of bovine collagen supernatants upon fibroblasts demonstrated an apparent proliferative effect of the supernatant with both gingival and periodontal ligament fibroblasts. However, the non‐parametric Friedman test revealed no significant differences between dilutions or time points. The overall findings provide encouraging evidence of the safety of freeze‐dried cross‐linked bovine collagen sponge in the surgical treatment of periodontal disease. Clinical studies are needed using matched sites in a randomized way with the clinical assessor being blind to the operating code to determine its potential usefulness and efficiency. J Periodontol 1992; 63:182–186.
The Occurrence of Periodontitis‐Related Microorganisms in Relation to Titanium Implants
Authors: Ong E.S.‐M. , Newman H.N. , Wilson M. , Bulman J.S.
Published: March 2012

The peri‐implant space was examined for the presence of periodontitis‐related microorganisms in 19 patients. All patients had been fitted with osseointegrated titanium implants which were clinically sound at the time of examination and all had been prescribed daily 0.2% Chlorhexidine mouthrinse. In 17 patients, two contralateral fixtures in patients were selected, the remaining 2 patients had only one fixture, and associated mucosal clinical variables assessed for plaque accumulation, gingival inflammation, bleeding tendency, and probing depth. The bacteriological composition of submucosal plaque samples was investigated using non‐selective media and selective media for Actinobacillus actimomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi). The peri‐implant tissues were healthy. Twenty‐two of 37 sites had a greater proportion of anaerobes than aerobes. Aa was detected at one site. Pg was not cultivated, and Pi was present in 7 of 37 sites, comprising between 0.4% and 60.9% of the total anaerobic viable counts. Since the presence of any of these organisms may play a contributory role to the loss of the fixture, it is recommended that the submucosal plaque of implants be monitored regularly for the presence of these periodontitis‐associated species. J Periodontol 1992;63:200–205.
Tooth Morphology Following Root Resection Procedures in Maxillary First Molars
Authors: Majzoub Zeina , Kon Simao
Published: March 2012

The disto‐buccal root is the most commonly resected root in maxillary molars. This root resection procedure results in a unique environment dictated by the contours of the remaining roots and the residual furcation between them. Tooth morphology was evaluated in 50 extracted maxillary first molars after disto‐buccal root resection. The following measurements were studied: 1) The maximum concavity (D) on the distal aspect of the resected molar; 2) the minimum mesio‐distal dimension (d) of tooth structure between the two remaining roots; 3) the width (s) of the residual interradicular septum; and 4) the distance (p) from the pulp chamber floor to the root separation on the distal aspect of the resected molar. The mean measurements were (D) = 2.47 mm, (d) = 3.67 mm, (s) = 3.33 mm and (p) = 2.70 mm. The value of (p) was equal to or less than 3 mm in 86% of the teeth; this means that the distance from the finish line to the interradicular osseous peak is less than 2.04 mm (average biologic width), if the finish line is placed on solid tooth structure about 1 mm below the pulp floor. Six percent of the resected molars had an overall topography easily amenable to periodontal maintenance and restorative procedures with (D) < 2 mm, (d) > 3 mm, (s) > 3 mm, and (p) > 3 mm. Poor root anatomy of the remaining roots after removal of the disto‐buccal root in maxillary first molars may be considered as a contraindication for root resection procedures. Unfortunately, this poor topography can be ascertained only during the surgery and after removal of the disto‐buccal root. J Periodontol 1992; 63:290–296.
Radiographic Methods for the Detection of Progressive Alveolar Bone Loss
Authors: Jeffcoat Marjorie K.
Published: March 2012

Intraoral transmission radiographs have been the primary diagnostic method for the assessment of bone support as well as for the detection and measurement of osseous changes due to periodontitis. The purpose of the present paper is three‐fold. The first is to review radiographic techniques for the assessment of periodontal disease progression, presenting the strengths and weaknesses of each method while placing special emphasis on digital subtraction radiography. The second purpose is to present data from a recent study that compared the ability of digital subtraction radiography and automated attachment level probing to detect the same active sites. Thirty periodontitis patients and eight control patients were studied over a 6‐month period. The results indicate that when these two sensitive methods for the assessment of progressive periodontitis were used there was concordance between the presence or absence of probing attachment loss and bone loss in 82.1% of the sites. The final goal of this paper is to present future directions for the quantitative analysis of digital radiographic images. J Periodontol 1992; 63:367– 372.