bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of the Carbon Dioxide Laser in Retarding Epithelial Migration: A Pilot Histological Human Study Utilizing Case Reports
Authors: Israel Michael , Rossmann Jeffrey A. , Froum Stuart J.
Published: March 2012

Predictable regeneration of tooth‐supporting tissues lost to periodontal disease is the aim of periodontal therapy. Often the result of conventional treatment is healing with a long junctional epithelium along the root surface and little regeneration of the complete attachment apparatus. The purpose of this pilot study was to evaluate whether de‐epithelialization with a CO2 laser at the time of flap surgery and at 10‐day intervals over the first 30 days of healing has the potential to enhance the formation of a connective tissue attachment. Six mandibular incisors in two patients were selected for the study. Each patient received oral hygiene instruction and initial therapy prior to surgery. The teeth were splinted together, open flap debridement was performed on all teeth, a notch was placed on the roots at the height of the crest of the alveolar bone, and the flaps were sutured in place. The test side received controlled de‐epithelialization of the outer (oral) gingiva with the carbon dioxide laser, and the inner gingival flap. The de‐epithelialization was repeated on the test side at 10, 20, and 30 days postsurgically. Controls received open debridement only. Block sections were taken at 90 days and processed for histologic analysis. The results showed that for both patients, junctional epithelium (JE) was formed on both test and control teeth. In all control teeth, the JE extended the entire length of the root to the base of the reference notch. On the test side (laser treated) in one patient, the notch was filled with connective tissue and limited repair cementum. This finding was not seen in any control teeth. This is the first reported observation of human histologic evaluation utilizing the CO2 laser for de‐epithelialization and may warrant further study. J Periodontol 1995;66:197–204.
Vascular Changes Following Mucoperiosteal Flap Surgery: A Fluorescein Angiography Study in Dogs
Authors: McLean Thomas N. , Smith Billy A. , Morrison Edith C. , Nasjleti Carlos E. , Caffesse Raul G.
Published: March 2012

This study was undertaken to determine the vascular changes which occur following mucoperiosteal flap surgery where two different suturing techniques were employed. In four healthy adult mongrel dogs, buccal and lingual full‐thickness envelope flaps were reflected in the mandibular quadrants following intracrevicular incisions from the first premolar to the first molar. The flaps were immediately readapted and primary closure was achieved by the horizontal mattress suturing technique in one quadrant and the direct interrupted suturing technique in the contralateral quadrant of each dog. A simple photographic system was developed for recording the in vivo gingival circulation depicted by fluorescein angiography just prior to surgery and then after surgery on days 1, 3, 7, 10, 14, and 21. The flaps were divided into three interproximal and two mid‐buccal sites for analysis and the intracapillary and diffusion extent of dye fluorescence was accurately quantified by computerized planimetry. As healing progressed, longitudinal changes relative to presurgical baseline were analyzed by paired t‐test. Cross‐sectional comparisons utilizing Student t‐test allowed for evaluating differences between the two suturing techniques as well as differences between interproximal versus mid‐buccal sites at each postsurgical day. It was found that the simple act of raising a mucoperiosteal envelope flap initiates significant vascular trauma. Statistically significant reductions in flap circulation relative to presurgical baseline lasted for at least 3 days but persisted for 7 days at the interproximal sites. Flap diffusion (extravascular leakage) recovered sooner and extended over a significantly greater area of the flap than did intracapillary flap circulation during the early period of healing. No significant differences appeared between the two suturing techniques compared, although both may have exerted a local negative influence on the circulation until they were removed. J Periodontol 1995; 66:205–210.
Alendronate Treatment of Naturally‐Occurring Periodontitis in Beagle Dogs
Authors: Reddy Michael S. , Weatherford Thomas W. , Smith C. Anne , West Brian D. , Jeffcoat Marjorie K. , Jacks Thomas M.
Published: March 2012

The treatment of periodontal disease has been largely directed at the microbiological etiology. The prevention of bone loss by modulating the host response to the bacteria may be a useful adjunctive method in the management of periodontitis. Alendronate, an amino bisphosphonate, may inhibit bone loss in osteolytic diseases by altering osteoclast activity. The objective of this double‐blind study was to evaluate alendronate inhibition of alveolar bone loss in the naturally occurring beagle dog model of periodontitis. Sixteen 7 to 9 year old beagles with moderate‐to‐severe periodontitis were studied for 6 months. The dogs were stratified into two groups based on initial periodontal severity. One group received 3.0 mg/kg alendronate weekly orally and the other group received a placebo. Silk ligatures were placed on the study teeth for the first 3 months of the study to exacerbate the periodontal destruction. Clinical data were collected for attachment level, gingival index, plaque index, and mobility at baseline and one‐month intervals. Intraoral radiographs were made at baseline and at 3 and 6 months. The mandibles were processed for histolology at month 6. The radiographs were analyzed by digital image analysis of the subtracted images. A statistically significant difference in bone mass (P <0.001) was observed between the alendronate and placebo groups. The bisphosphonate had no effect on the clinical parameters of gingival inflammation or plaque. A trend toward decreased attachment loss and mobility was observed in favor of the alendronate group. A significant difference in bone density (P <0.05) was found by histomorphometric analysis. Bisphosphonate treatment may be beneficial in the management of alveolar bone destruction associated with periodontal destruction. J Periodontol 1995; 66:211–217.
Prostaglandin E2 Regulates Gingival Mononuclear Cell Immunoglobulin Production
Authors: Harrell John C. , Stein Sidney H.
Published: March 2012

Histological studies have revealed elevated levels of T and B lymphocytes in inflamed gingival tissue. Functional analysis of these B cells has determined that they are spontaneously secreting large amounts of Immunoglobulin. Several components of bacterial plaque which accumulate during the onset of periodontal disease induce polyclonal B cell activation, and are most likely responsible for the “hyperactive” state of these gingival B lymphocytes. In addition to this exaggerated humoral response, increased levels of inflammatory mediators, such as Prostaglandin (PG) E2, have been implicated in the pathogenesis of disease. Therefore, the purpose of this study was to determine if PGE2 could regulate Immunoglobulin production within inflamed gingival tissue. Specimens were harvested during routine surgery of patients with chronic adult periodontitis. Utilizing an ELISA, elevated levels of IgG were detected in the supernatant of cultured gingival mononuclear cells. Inclusion of indomethacin, which inhibits arachidonic acid metabolites such as PGE2, caused a decrease in IgG levels. PGE2 exerted a biphasic effect upon IgG production, with high doses diminishing and low doses increasing IgG levels. From a clinical perspective, these results suggest that elevated levels of PGE2 associated with inflammation will attenuate an IgG response and, as PGE2 production wanes, the local humoral response will rebound. Interestingly, the combination of low dose PGE2 and IL‐4 induced a synergistic rise in IgG production. These findings support the theory that local PGE2 levels can regulate Immunoglobulin production and potentiate cytokine induced class switching within gingival tissue. J Periodontol 1995; 66:222–227.
Factitious Injury of the Oral Mucosa: A Case Series
Authors: Kotansky K. , Goldberg M. , Tenenbaum H.C. , Mock D.
Published: March 2012

Gingival and oral mucosal tissues can be the site of a number of mucocutaneous and ulcerative conditions. Generally, these are not difficult to identify on the basis of clinical characteristics, and diagnosis can be aided by the use of routine histopathological and immunopathological techniques as well as other laboratory investigations. Self‐induced or factitious injury (FI) of the oral mucosal tissues may present a confusing clinical picture, and be diagnosed erroneously as a mucocutaneous disorder in spite of the absence of appropriate pathological and immunopathological findings, or a failure to respond to routine treatment. A case series is presented here outlining 4 cases of FI which presented initially as mucocutaneous disease. These cases were investigated to rule out systemic or local causes, in order to establish a diagnosis of FT Treatment of these conditions was facilitated with placebo or sham procedures which were designed primarily to cover the lesions. In most cases, the self injurious behavior could be linked to secondary gain. J Periodontol 1995;66:241–245.
Caries Lesions and Dental Restorations as Predisposing Factors in the Progression of Periodontal Diseases in Adolescents. A 3‐Year Longitudinal Study
Authors: Albandar Jasim M. , Buischi Yvonne A.P. , Axelsson Per
Published: March 2012

The present study used a novel approach to assess the relationship between untreated caries lesions and defective and non‐defective dental restorations and the incidence of gingival inflammation and the progression of chronic inflammatory periodontal diseases at the approximal surfaces of posterior teeth and at the adjacent surface of the neighboring tooth in adolescents over a period of 3 years. Two hundred‐twenty‐seven (227) 13‐yearold schoolchildren were examined clinically and radiographically at baseline and annually at three subsequent occasions. At each site the alveolar bone height and presence of gingival bleeding were assessed. Incipient caries lesions, manifest caries, and defective and nondefective restorations were identified at the same site and also at the adjacent approximal tooth surface at all examinations, both clinically and radiographically. The data were analyzed by the multi‐level logistic regression and variance components analyses. On average, 32, 8.5, 7, and 10% of the sites, respectively, were diagnosed as having incipient caries, manifest caries, and defective and non‐defective restorations. There was a significant association between the presence of untreated manifest caries lesions, non‐defective and defective dental restorations, and the progression of periodontal support loss. Also there was an association between presence of defective restorations and manifest caries and the incidence of gingival inflammation. Consistently, factors detected at the involved site and at the adjacent site had significant effects. The present study indicates that untreated cavities and dental restorations are predisposing factors with a significant negative effect on periodontal health in adolescents. Young individuals having multiple sites with such local factors are to be considered at risk of developing destructive periodontal lesions and should be treated accordingly. J Periodontol 1995; 66:249–254.
Collagen Formation at the Tooth‐Cell Interface: Comparative Ultrastructural Study on the Effect of Partial Demineralization of Cementum With Dentin
Authors: Higashi Tomie , Onzuka Tomoko , Satoh Gen , Yoshino Hiroshi , Okamoto Hiroshi
Published: March 2012

In order to compare the effect of partial demineralization with root planing and partial demineralization of cementum with that of dentin on healing, the ultrastructural morphology of the interface between the layer of human periodontal ligament‐derived, fibroblast‐like cells (HPF) and the treated root surface was studied in an in vitro culture system. Sixty (60) pairs made from transversally‐cut root slices, 500 μm thick, were obtained from extracted human periodontally diseased teeth. Thirty (30) pairs of the root slices were preliminarily root planed (RP). The remaining half were root planed and then partially demineralized in a solution of citric acid (RP+CA). The opposite surface of paired slices was made uniform by using either cementum or dentin. Consequently, all root slices were classified into four experimental groups: RP‐cementum and RP‐cementum pairs (group 1), RP‐dentin and RP‐dentin pairs (group 2), RP+CA‐cementum and RP+CA‐cementum pairs (group 3), and RP+CA‐dentin and RP+CA‐dentin pairs (group 4). Each pair of root slices was placed on the floor of a 35‐mm culture dish. HPF were seeded at a concentration of 4×105 cells/dish. Co‐cultures of HPF and the root slices were examined using phase contrast and electron microscope after 4, 6, and 10 weeks. Electron‐dense material covered non‐demineralized root surfaces and the lining cells in accumulating cell layers were oriented parallel to the root surface and attached to the material in groups 1 and 2. In groups 3 and 4, the underlying cells in several accumulating cell layers were oriented approximately perpendicular to the lower aspect of the vertical surface of the root slice. The underlying continuous cells were separated from the demineralized root surface by newly synthesized collagen fibrils after 6 to 10 weeks. The features of cell attachment and formation of collagen fibrils on the surface of cementum did not differ from those on the dentinal surface in both RP and RP+CA groups. J Periodontol 1995; 66:267–273.
Modulation by Progesterone of Interleukin‐6 Production by Gingival Fibroblasts
Authors: Lapp Carol A. , Thomas Michael E. , Lewis Jill B.
Published: March 2012

The gingivitis associated with pregnancy has been attributed to increased concentrations of circulating estrogen and/or progesterone. However, the mechanism by which these steroids increase gingival inflammation is not known. Interleukin‐6 (IL‐6), a pleiotropic cytokine produced by many cell types including human gingival fibroblasts (hGF), is secreted in response to inflammatory challenges such as bacterial lipopolysaccharide and interleukin‐1 (IL‐1). This study tested the hypothesis that progesterone could modulate the local production of IL‐6 by hGF. The effects of progesterone on IL‐6 production were measured in vitro in serum‐free, phenol red‐free medium to eliminate possible effects of such medium additives. The concentration of IL‐6 secreted into supernatant medium after a 24 hour challenge with IL‐1β was estimated by radioimmunoassay. Total RNA from steroid‐treated hGF was probed for IL‐6 mRNA. In serum‐free medium, progesterone dose‐dependently and significantly (P <0.05) inhibited IL‐6 production by hGF, as did the glucocorticoids hydrocortisone (HC) and dexamethasone. At progesterone concentrations common in late pregnancy, IL‐6 production was reduced to levels 40 to 50% of control. In addition, mRNA was significantly down‐regulated by progesterone and HC, at both basal levels and after IL‐1β challenge. These results suggest that high levels of progesterone during pregnancy affect the development of localized inflammation by down‐regulation of IL‐6 production, rendering the gingiva less efficient at resisting the inflammatory challenges produced by bacteria. J Periodontol 1995; 66:279–284.
Longitudinal Assessment of Early Onset Periodontitis
Authors: Gunsolley J.C. , Califano J.V. , Koertge T.E. , Burmeister J.A. , Cooper L.C. , Schenkein H.A.
Published: March 2012

The purpose of this study was to determine the clinical course of early onset periodontitis and to investigate factors which may influence its clinical course. For the past 15 years we have been conducting a study of families with early onset periodontitis, and have examined 142 localized juvenile periodontitis and 185 severe generalized early onset periodontitis patients. In order to study the clinical course of early onset periodontitis we recalled our subject population to determine their periodontal status. Forty (40) patients with localized early onset periodontitis (LJP) and 48 with generalized early onset periodontitis (SP) were re‐examined. The time since the most recent visit for LJP patients was approximately 3 years and for SP patients almost 4 years. LJP patients who received periodontal therapy on the average gained periodontal attachment. In contrast, LJP patients who did not receive therapy lost periodontal attachment. SP patients lost periodontal attachment regardless of whether or not they had periodontal therapy. SP patients also lost an average of one tooth during the approximately 4 years of observation. LJP patients lost very few teeth with only 4 teeth being lost in 40 patients. The results of this study suggest that localized juvenile periodontitis is a stable disease in most individuals. In contrast, patients with severe generalized early onset periodontitis continued to lose both periodontal attachment and teeth. J Periodontol 1995; 66:321–328.
A Comparison of Topical Ketorolac, Systemic Flurbiprofen, and Placebo for the Inhibition of Bone Loss in Adult Periodontitis
Authors: Jeffcoat M.K. , Reddy M.S. , Haigh S. , Buchanan W. , Doyle M.J. , Meredith M.P. , Nelson S.L. , Goodale M.B. , Wehmeyer K.R.
Published: March 2012

Systemic non‐steroidal anti‐inflammatory drugs (NSAIDs) have been shown to reduce alveolar bone loss in periodontitis. This study assesses the efficacy of a topical NSAID rinse, containing ketorolac tromethamine as the active agent. Adult periodontitis patients (n = 55) were studied in this 6‐month randomized, double blind, parallel, placebo and positive‐controlled study. Each patient had a least 3 sites at high risk for bone loss as assessed by low dose bone scan. Groups, balanced for gender, were assigned to one of three regimens: bid ketorolac rinse (0.1%) with placebo capsule; 50 mg bid flurbiprofen capsule (positive control) with placebo rinse; or bid placebo rinse and capsule. Prophylaxes were provided every 3 months. Monthly examinations assessed safety, gingival condition, and gingival crevicular fluid PGE2. Standardized radiographs were taken at baseline and at 3 and 6 months for digital subtraction radiography. A significant loss in bone height was observed during the study period in the placebo group (‐0.63±0.11; P <0.001), but not in the flurbiprofen (‐0.10±0.12; P = 0.40) or ketorolac rinse (+0.20±0.11 mm; P = 0.07) groups. Nested ANOVA revealed that ketorolac and flurbiprofen groups had less bone loss (P <0.01) and reduced gingival crevicular fluid PGE2 levels (P <0.03) compared to placebo. ANOVA suggests (P = 0.06) that ketorolac rinse preserved more alveolar bone than systemic flurbiprofen at the dose regimens utilized. These data indicate that ketorolac rinse may be beneficial in the treatment of adult periodontitis. J Periodontol 1995; 66:329–338.
Protective Immunity to Porphyromonas gingivalis Infection in a Murine Model
Authors: Bird Philip S. , Gemmell Erica , Polak Boris , Paton Robert G. , Sosroseno Wihas , Seymour Gregory J.
Published: March 2012

The mouse abscess model has been used extensively to demonstrate protection after challenge with periodontopathic organisms. In the present study, an outer membrane (OM) preparation of P. gingivalis ATCC 33277 was used to immunize BALB/c mice prior to challenge with live P. gingivalis organisms. This OM preparation, particularly at the highest dose level of 100 μg/immunization, was able to induce high levels of specific antibody and subsequent protective immunity. Protection in all immunized mice was noted by the rapid healing of the primary lesions, a low incidence of secondary lesions, and, in the highest dose group, an absence of septicemia. Non‐immunized animals demonstrated a slower development as well as healing of primary lesions, with higher numbers and larger sizes of secondary lesions. Weight loss and behavior patterns such as hunched bodies, ruffled hair, and stiffness of the hind legs were particularly noted in this group. Depletion of CD4 T cells in mice prior to immunization with 100 μg P. gingivalis OM resulted in significantly depressed serum levels of anti‐P. gingivalis antibody and an increase in the physical signs of disease compared with both the immunized and control groups. Western blot analysis demonstrated three antigen bands (63.3, 50.1, and 45.1) recognized by all immunized groups and also the control non‐immunized group, although the latter recognition occurred only after challenge. A further antigen band of 36.1 kDa was recognized by sera from the highest dose group only. This study has demonstrated the ability of P. gingivalis OM to provide protection against challenge with live P. gingivalis organisms. The increased physical signs of disease seen in the CD4 depleted animals compared with the control group not only illustrate the protective role of serum antibody, but also suggest a possible role for T cell mechanisms in control of the lesion locally. The ability of specific OM antigens to provide similar protective immunity remains to be ascertained. J Periodontol 1995; 66:351–362.
Loss of Periodontal Attachment in HIV‐Seropositive Military Personnel
Authors: Tomar Scott L. , Swango Philip A. , Kleinman Dushanka V. , Burt Brian A.
Published: March 2012

The cross‐sectional relationship between severe loss of periodontal attachment (LPA) and worsening immune status due to HIV infection was evaluated in 474 HIVinfected subjects (416 men, 58 women) aged 18 to 49 years who had been classified at stages 1 through 6 of the Walter Reed Army Institute of Research (WR) Staging Classification System. LPA was measured at four sites per tooth using a manual probe; severe LPA was defined as ≥ 1 site/subject exhibiting ≥ 5 mm LPA. Severe LPA was found in 94 (20%) of the subjects. Modeling with multiple logistic regression analysis revealed that WR stage and peripheral CD4+ lymphocyte cell counts were not significant independent predictors of severe LPA. Severe LPA was more common in subjects at WR stage 5 or 6 who exhibited oral candidiasis (OC), a marker of immune system damage, than in persons at those WR stages without OC (odds ratio = 7.85; 95% confidence interval (CI) = 1.94–31.81). After the analysis controlled for WR stage, younger subjects receiving AZT had greater odds of severe LPA than sameage subjects not taking the drug (e.g., odds ratio for subjects aged 30 years = 2.59; 95% CI = 1.22, 5.49). Other significant predictors in the model included male sex; retired military status; cigarette smoking; and presence of cratered, ulcerated, or necrotic interdental papillae. HIV‐associated immune deficiency may be associated with localized severe LPA, but this may be an indirect association due to medication use, opportunistic infection, or other factors not captured by the WR staging system or peripheral CD4+ cell counts. Comparison with the estimated prevalence of HIV‐associated periodontitis (HIV‐P) in this population suggests that infected persons may experience severe LPA that does not necessarily have the clinical presentation of HIVP. J Periodontol 1995;66:421–428.
The Functional Interaction of EGF and PDGF With Bradykinin in the Proliferation of Human Gingival Fibroblasts
Authors: McAllister Bradley S. , Leeb‐Lundberg Fredrik , Mellonig James T. , Olson Merle S.
Published: March 2012

Epidermal growth factor (EGF) and platelet‐derived growth factor (PDGF)‐BB are both involved in periodontal wound healing. Each of these growth factors exerts a positive proliferative effect on cells of the periodontium in vitro. However, in vivo the peptide bradykinin is one of a complex array of mediators present in addition to these growth factors. The purposes of this investigation were to: 1) evaluate bradykinin interactions with EGF and PDGF‐BB altering cell proliferation in cultured human gingival fibroblasts (HGF), periodontal ligament cells (HPDL), and cells derived from alveolar bone (HOB); and 2) determine at the signal transduction level the mechanism of interaction between EGF and bradykinin in HGF. EGF and PDGF‐BB stimulated DNA synthesis in a concentration‐dependent manner, as measured by [3H] thymidine incorporation. Bradykinin alone did not alter significantly basal DNA synthesis values; however, bradykinin in combination with EGF reduced DNA synthesis to nearly basal levels and bradykinin in combination with PDGF reduced the DNA synthesis over 50%. Examination of the interactions between bradykinin and EGF signal transduction pathways revealed that PGE2, release was increased in the presence of bradykinin and EGF (167 ± 33% to 317 ± 29%). The bradykinin‐stimulated PGE2 release was completely abolished by indomethacin. Indomethacin also was found to block the bradykinin inhibition of EGF‐induced DNA synthesis. Additional evidence supporting a mechanism involving PGE2, in the bradykinin inhibition of growth factor‐stimulated DNA synthesis was that EGF‐induced DNA synthesis was inhibited by exogenously added PGE2 but not by endothelin, Vasopressin, or des‐Arg9 bradykinin. Forskolin and dibutyryl cAMP also were found to inhibit EGF‐induced DNA synthesis, suggesting that cAMP was involved in the mechanism of inhibition. In conclusion, the present study demonstrates that both EGF‐ and PDGF‐BB‐induced proliferative responses are inhibited by bradykinin in cells of the periodontium. The signaling mechanism of the bradykinin inhibition of EGF appears to be mediated by PGE2 through a cAMPdependent pathway in HGFs. J Periodontol 1995;66:429–437.
Effects of Toothbrushing Prior and/or Subsequent to Dietary Acid Application on Smear Layer Formation and the Patency of Dentinal Tubules: An SEM Study
Authors: McAndrew Robert , Kourkouta Styliani
Published: March 2012

Dentine sensitivity is a quite common condition, associated with open dentinal tubules patent all the way to the pulp. The purpose of this in vitro study was to assess the effects of toothbrushing preceded and/or followed by dietary acid application on the patency of dentinal tubules. Dentine sections were prepared from recently extracted human molars and, after removal of the smear layer, were treated as follows: 1) toothbrushing alone; 2) toothbrushing followed by exposure to orange juice; and 3) toothbrushing subsequent to orange juice exposure. All specimens were observed in the scanning electron microscope (SEM) at a standard magnification and the patency of the dentinal tubules estimated. Results showed that toothbrushing alone was the most effective in occluding the tubules, followed by toothbrushing subsequent to dietary acid application, and then by toothbrushing prior to dietary acid application. From the results of this study it may be that in cases of dentine sensitivity toothbrushing should not precede or follow dietary acid application but be separate from mealtimes. Clinical research is required to confirm the findings of this in vitro study. J Periodontol 1995; 66:443–448.
Periodontal Status and Selected Cultivable Anaerobic Microflora of Insulin‐Dependent Juvenile Diabetics
Authors: Sbordone Ludovico , Ramaglia Luca , Barone Antonio , Ciaglia Renato Nicodemo , Tenore Alfred , Iacono Vincent J.
Published: March 2012

The periodontal status and subgingival microflora of insulin‐dependent juvenile diabetic (JD) patients (n = 16, mean age = 11.3) were compared with that of their non‐diabetic cohabiting healthy siblings (HS, n = 16, mean age = 13.2). JD patients were monitored every 3 months for levels of glycosylated hemoglobin (HbAlc) and clinical and microbial parameters were measured 6 weeks before drawing blood for levels of HbAlc (M% = 8.76). Clinical indices, measured for the entire permanent dentition, included: probing depth (PD), attachment level (AL), sulcus bleeding index (SBI), and plaque index (PI). Subgingival plaque samples were obtained at 2 sites from each subject; whenever possible, the site with the deepest probing depth and the mesial aspect of the maxillary right first molar were used. Microbial analyses were determined by cultural characteristics and biochemical tests. No significant differences were detected in any of the clinical indices for the entire dentition. The mean AL for JD sites was 2.32 ± 0.83 mm and for HS sites was 2.2 ± 0.85 mm. Mean percentage of total cultivable anaerobic microflora included Capnocytophaga spp. (JD, 13.21%; HS, 11%) and Porphyromonas gingivalis (JD, 5.1%; HS, 7.9%). Differences between the two groups were not statistically significant. When cluster analysis was performed on sampled sites, one cluster group in JD patients showed significantly elevated P. gingivalis and lower Capnocytophaga spp. levels as compared to the overall mean. The clinical parameters of this cluster were characterized by statistically significant greater loss of attachment and probing depth. These data would suggest few differences between JD patients and their HS in this population. J Periodontol 1995;66:452–461.
Occurrence of Certain Bacterial Species and Morphotypes in Juvenile Periodontitis in Chile
Authors: López Néstor J. , Mellado Juan C. , Giglio María S. , Leighton Gloria X.
Published: March 2012

The occurrence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Eikenella corrodens, Fusobacterium nucleatum, Campylobacter rectus, Capnocytophaga species, and certain bacterial morphotypes was determined in 18 affected and 18 unaffected sites in 10 localized juvenile periodontitis (LJP) patients, and in 10 affected and 10 unaffected sites in 5 generalized juvenile periodontitis (GJP) patients. The subgingival proportion of the 7 bacterial species was determined by selective and nonselective culturing. The results showed that when considering the pure prevalence of bacteria (> 0%) there were significant differences (P < 0.05) in the subgingival plaque microflora of the affected sites versus those of the unaffected sites for P. gingivalis, A. actinomycetemcomitans, P. intermedia, E. corrodens, C. rectus, and F. nucelatum in LJP, and for P. gingivalis, P. intermedia, and F. nucleatum in GJP. The mean proportions of cocci, motile rods and spirochetes were also significantly different (P < 0.05) in affected sites compared to unaffected sites. Capnocytophaga sp, F. nucleatum, P. intermedia, and E. corrodens were found in more than 75% of affected sites in LJP. When taking the approach that an organism, to be associated with periodontal disease, has to be detected above a certain minimum threshold, the results indicated that bacteria most frequently associated with LJP and GJP in Chile are P. gingivalis (66% of LJP and 80% of GJP affected sites), and A. actinomycetemcomitans (44% of LJP and 50% in GJP affected sites). Different bacterial species may be judged to be important in the disease process depending upon whether a pure bacterial prevalence, or a prevalence above a certain detection level, is considered. J Periodontol 1995;66:559–567.
The Influence of the Design of Two Different Bioresorbable Barriers on the Results of Guided Tissue Regeneration Therapy. An Intra‐Individual Comparative Study in the Monkey
Authors: Lundgren Dan , Laurell Lars , Gottlow Jan , Rylander Harald , Mathisen Torbjörn , Nyman Sture , Rask Madelene
Published: March 2012

The aim of the present study was to compare two bioresorbable. barriers to evaluate whether differences in design influence the result of guided tissue regeneration (GTR) therapy. Twenty‐four (24) plaque exposed, recession type defects in 4 monkeys were treated. Contralateral defects were randomized for test or control treatment. During a healing period of 6 weeks, gingival recession resulting in device exposure occurred at 3 test and 10 control sites. One control barrier was exfoliated. Histologically, 9 of the 12 test barriers were completely integrated with the surrounding tissues. At 3 test sites, epithelium had migrated apically outside the barrier to a level not exceeding one‐third of the height of the device. Seven of the 11 control barriers were enclosed by dentogingival epithelium. The adjacent connective tissue exhibited local inflammatory cell infiltrates (ICT). At the remaining 4 control sites, the epithelial downgrowth as well as the adjacent ICT areas were limited to the coronal Vi of the device. New attachment; i.e., new cementum with inserting collagen fibers, averaged 2.2 mm and 0.8 mm at the test and control sites respectively (P < 0.01). Based on the results of the present study, it was concluded that a bioresorbable GTR device, designed to prevent epithelial downgrowth along the barrier surface, has a higher potential to promote new attachment formation than a device which does not have this property. J Periodontol 1995; 66:605–612.
The Effect of Initial Periodontal Therapy on Salivary Platelet‐Activating Factor Levels in Chronic Adult Periodontitis
Authors: Rasch Mark S. , Mealey Brian L. , Prihoda Thomas J. , Woodard Donna S. , McManusm Linda M.
Published: March 2012

Platelet‐activating factor (PAF), a potent phospholipid inflammatory mediator, is increased in the mixed saliva of subjects with periodontal disease and correlates with the extent of oral inflammation. The present study was designed to provide a longitudinal evaluation of the effect of initial periodontal therapy (home care instruction, prophylaxis, and scaling/root planing) on salivary PAF levels in chronic adult periodontitis patients (n = 15). Mixed saliva was collected prior to, during, and after initial therapy and was utilized to assess PAF levels after lipid extraction and fractionation as well as to histologically assess the number of polymorphonuclear leukocytes (PMN). PAF activity was determined in bioassay relative to authentic PAF (1O‐hexadecyl‐2‐acetyl‐sn‐glycero‐3‐phosphocholine; 16:0‐alkyl‐PAF). Initial salivary PAF levels (12.1 ± 2.8 pmole equivalents of 16:0‐alkyl‐PAF/ml saliva; mean ± SE) decreased following supragingival plaque control (9.6 ± 2.4) and were further reduced following scaling and root planing (5.7 ± 1.4). In parallel, salivary PMN levels were significantly reduced and clinical estimates of periodontal disease were significantly improved; i.e., there was a decrease in the percentage of sites with both bleeding on probing (from 46.1 ± 4.6% of sites at pretreatment to 25.9 ± 2.6% after scaling and root planing) and probing depths ≥ 4 mm (from 16.7 ± 1.9% of sites to 10.3 ± 1.2%). Thus, initial periodontal therapy reduced salivary PAF levels in concert with improvements in clinical estimates of marginal and submarginal periodontal inflammation suggesting that PAF may participate in inflammatory events during periodontal tissue injury and disease. J Periodontol 1995;66:613–623.
Gingival Interleukin‐6 Concentration Following Phase I Therapy
Authors: Guillot John L. , Pollock Steven M. , Johnson Roger B.
Published: March 2012

There is little information available on the effects of periodontal therapy on tissue levels of interleukin‐6 (IL‐6). This study compares IL‐6 concentrations in gingiva and gingival crevicular fluid (GCF) from patients requiring surgical procedures following Phase I periodontal therapy. Sites requiring surgery due to “unresolved” intrabony pockets were compared to sites not requiring surgery (“resolved”) in each patient. Resolved sites had minimal histologic evidence of chronic inflammation and IL‐6 accumulation; unresolved sites contained a substantial number of chronic inflammatory cells and IL‐6 was widely distributed. IL‐6 levels in GCF were ‐significantly greater at resolved than at unresolved gingival sites (P < 0.001); however, IL‐6 tissue levels were significantly greater at unresolved than in resolved gingival sites (P < 0.01). These results suggest that IL‐6 levels were elevated in gingival connective tissue adjacent to intrabony pockets which had not been resolved following Phase I therapy. Thus, intrabony pocket resolution may be affected by accumulation of IL‐6 in the adjacent gingival connective tissue, which may result from increased rates of synthesis or reduced rates of release from gingiva into the GCF. J Periodontol 1995;66:667–672.
Evaluation of Periodontal Treatments Using Controlled‐Release Tetracycline Fibers: Clinical Response
Authors: Drisko Connie L. , Cobb Charles M. , Killoy William J. , Michalowicz Bryan S. , Pihlstrom Bruce L. , Lowenguth Roxanne A. , Caton Jack G. , Encarnacion Myriam , Knowles Mark , Goodson J. Max
Published: March 2012

The purpose of this investigation was to evaluate the clinical efficacy of controlledrelease tetracycline fiber therapy in adult periodontitis patients. One hundred‐twentytwo (122) adult patients from 3 dental centers were enrolled at baseline for this study. Each patient provided at least one site in each of four quadrants that was ≥ 5 mm and bled on probing. One or two such sites were selected as test sites and were randomly assigned to receive one of four treatments: scaling and root planing (S), scaling and root planing plus tetracycline fiber for 10 days (SF), fiber therapy alone for 10 days (F), or two 10‐day serial fiber applications (FF). After treatment, no periodontal maintenance or supportive care was provided until the end of this 12month study. Probing depth (PD), clinical attachment level (CAL), plaque, and bleeding on probing (BOP) were measured at baseline and at 1, 3, 6, 9, and 12 months following treatment. Repeated PD and CAL measurements were taken at three locations within each site and averaged for each site. One hundred‐sixteen (116) subjects completed the study. All treatments resulted in similar improvements in clinical parameters compared to baseline and were equally effective in the treatment of periodontitis as measured by probing depth reduction, clinical attachment level gain, and reduction of bleeding on probing. The clinical response, established primarily by 3 months following therapy, was generally sustained in all treatment groups for 12 months without the benefit of supportive maintenance therapy. J Periodontol 1995;66:692–699.
The Origin of Fibroblasts and Their Role in the Early Stages of Horizontal Furcation Defect Healing in the Beagle Dog
Authors: Herr Yeek , Matsuura Masahiro , Lin Wen‐Lang , Genco Robert J. , Cho Moon‐Il
Published: March 2012

The origin of fibroblasts, their proliferative activity and roles in the early stages of periodontal repair were investigated in order to better understand the periodontal healing process in furcation defects of the beagle dog after guided tissue regenerative therapy. Newly divided cells were identified by immunolocalization. of bromodeoxyuridine (BrdU) injected 1 hour prior to sacrificing the animals. At 1 and 2 weeks after creation of the defects, the lesions were occupied primarily by granulation tissue. Under this condition, periodontal ligaments (PDL) fibroblasts in a coronal portion of the remaining PDL close to wounds proliferated actively, migrated along the root surface and formed fibrous connective tissue on the surface. Similarly, the fibroblasts adjacent to the bone surface also showed proliferative activity and engaged in active formation of fibrous connective tissue on the bone surface. The majority of labeled cells in both areas were located in the extravascular area. At 3 and 4 weeks, the defects were filled with an increased amount of new connective tissue and bone. The labeled fibroblasts were preferentially found in the most coronal portion of connective tissue formed on the root surface that was in direct contact with inflamed tissue, and the collagen fibers projected into granulation tissue. In areas of active bone formation, numerous labeled fibroblasts were located in connective tissue adjacent to the newlyformed bone. However, fibroblasts in the endosteum of new bone were rarely labeled. These results indicate that fibroblasts involved in periodontal repair originate primarily from both the remaining PDL and alveolar bone, and actively engage in fibrous connective tissue formation in the early stages of periodontal repair. The ability of PDL fibroblasts to proliferate, migrate, and form connective tissue on the root surfaces in the early repair stages appears to play a crucial role in the formation of the PDL and cementum, and consequently, in periodontal regeneration in the absence of root resorption and ankylosis. As the formation of new connective tissue and bone continues, the precursor cells for fibroblasts and osteoblasts are supplied locally through the continued divisions of the fibroblastic cells in association with the newly‐formed connective tissue. Paravascular and endosteal cells appear to be minor contributors to new cell population during furcation defect repair in the beagle dog. J Periodontol 1995; 66:716–730.
Primary Extramedullary Plasmacytoma in Cyclosporine‐Induced Gingival Overgrowth. A Case Report
Authors: Pan Whei‐Lin , Chan Chiu‐Po , Huang Chiu‐Ching , Lai Ming‐Kuen , Ju Yuh‐Ren , Hsueh Chuen
Published: March 2012

An unusual solitary extramedullary plasmacytoma developed in the gingiva of a 28 year‐old male renal transplant patient with cyclosporine (CyA)‐induced gingival overgrowth. On initial presentation, there was no suspicion of a tumor within the lesion. One year later, however, the lesion had increased progressively in size, and its surface was ulcerated. At this time, the lesion was excised by gingivectomy, and histopathological examination revealed plasmacytoma. CyA was discontinued and the patient has been closely observed for 4 years with no recurrence of the gingival lesion. J Periodontol 1995;66:804–807.
Periodontal Status of Diabetic and Non‐Diabetic Men: Effects of Smoking, Glycemic Control, and Socioeconomic Factors
Authors: Bridges Raymond B. , Anderson James W. , Saxe Stanley R. , Gregory Kevin , Bridges Susan R.
Published: March 2012

Periodontal disease is more prevalent and more severe in diabetic than in nondiabetic individuals but the magnitude of this increase is still being debated. This prospective, cross‐sectional study compared the periodontal status of 118 diabetic men and 115 age‐matched non‐diabetic men. Plaque and gingival indices, bleeding scores, probing depth, losa of attachment, and number of missing teeth were measured in a blinded manner. Smoking status, glycemic control, socioeconomic status, and previous dental care were also assessed. These parameters were significantly higher in diabetic than non‐diabetic men: plaque index, P < 0.0001; gingival index, P < 0.0002; bleeding score, P < 0.0001; probing depth, P = 0.0059; loss of attachment, P < 0.0001; and missing teeth, P < 0.005. These parameters were significantly higher in smokers than non‐smokers: gingival index, probing depth, and loss of attachment. The duration of diabetes was not significantly related to the periodontal measures. Glycemic control as assessed by fasting plasma glucose and glycohemoglobin values was not significantly correlated to periodontal status. These studies indicate, for this study group, that diabetes significantly affects all measured parameters of periodontal status. J Periodontol 1996;67:1185–1192.
Bacterial Colonization of Bioabsorbable Barrier Material and Periodontal Regeneration
Authors: De Sanctis M. , Zucchelli G. , Clauser C.
Published: March 2012

The objective of the study was to evaluate bacterial colonization of the toothfacing surface of bioabsorbable membranes and to determine its effect on the clinical outcome of membrane supported reconstructive periodontal surgery. Twenty systemically healthy subjects affected by chronic adult periodontitis were enrolled in the study. One non‐furcation tooth site perpatient, associated with an angular bony defect and a probing attachment loss of > 5 mm, was selected to be treated by means of a guided tissue regeneration procedure using a polyglicolactic membrane. Antibiotics (amoxicillin/clavulanate potassium 1 g per day) for 2 weeks were prescribed, in addition to the use of chlorhexidine for post‐surgical plaque control. All patients were recalled once a week for 5 weeks for professional tooth cleaning. At 5 weeks sites with clinically exposed membranes underwent a second surgery to harvest residual barrier material which was analyzed by scanning electronic microscopic (SEM) for bacterial colonization. Sites with no membrane exposure at 5 weeks were allowed to heal without any other surgical intervention. Professional tooth cleaning and reinforcement of self‐performed oral hygiene measures were given at 1 month intervals for the duration of the study. For each treated site the difference in probing attachment loss between baseline examination and a follow‐up examination made 6 months after the second surgery was calculated. Gain of probing attachment was statistically (P < 0.001) greater in sites with no membrane exposure when compared to sites with partially exposed barrier material (4.2 ± 0.5 vs. 3.3 ± 0.6). The results of SEM analysis revealed that bacterial colonization was evident in all the microscopic fields of the exposed areas of the membranes. In the mid‐part of the membranes 16 out of 39 microscopic fields (41%) demonstrated microbial colonization, while no bacteria‐positive field was observed in the most apical portion of the membranes. Regression analysis indicated that gain in probing attachment level was negatively correlated to microbial colonization of the mid‐part of the membranes. It was suggested the midportion of the tooth‐facing surface of polyglicolactic membrane is a critical area for the healing process since its bacterial colonization was detrimental to the outcome of the GTR surgery. J Periodontol 1996;67:1193–1200.
In Vitro Comparison of Aged and Young Osteogenic and Hemopoietic Bone Marrow Stem Cells and Their Derivative Colonies
Authors: Dodson Stephanie A. , Bernard George W. , Kenney E. Barrie , Carranza Fermin A.
Published: March 2012

The purpose of this in vitro study was to determine whether there were differences in the number and size of osteogenic and hemopoietic colonies derived from bone marrow stem cells of aged and young adult male Sprague‐Dawley rats. Using a Ficoll‐Paque gradient, stem cells were harvested from aged male rats 18 to 22 months old and young adult males 55 days of age. Single cell suspensions from the red marrow of the long bones were cultured 14 days in vitro and subsequent colonies were assessed by light microscopy for number and size. A computerized histomorphometric linear measuring system was utilized to assess colony area in square millimeters. The results clearly show that young animals have a statistically significant increased cellular potential for osteogenic and hemopoietic colony formation. Cultures from aged animals showed an average formation of 0.45 ± 0.6863 osteogenic colonies while those from younger animals had an average of 3.6 ± 2.3523 osteogenic colonies per 3 million cells plated. Hemopoietic colonies from aged animal cell cultures numbered 5.25 ± 2.2449 while those from the young animals averaged 8.23 ± 3.3601 per 3 million cells plated. The difference in size of the osteogenic and hemopoietic colonies between age groups was not statistically significant. The area of osteogenic colonies derived from aged animals measured 0.1244 ± 0.0891 mm2, while those derived from the young animals averaged 0.1276 ± 0.0518 mm2. Hemopoietic colonies from the aged cells measured 0.0759 ± 0.0514 mm2, while hemopoietic colonies from the young animal cells measured 0.06010 ± 0.0180 mm2. The results of this study may have implications for consideration in the cellular healing aspects of aged versus young individuals. J Periodontol 1996;67:184–196.