bluuebunny/crossref_metadata_2025 huggingface dataset:
Buccal Alveolar Exostoses: Prevalence, Characteristics, and Evidence for Buttressing Bone Formation
Authors: Horning Gregory M. , Cohen Mark E. , Neils Todd A.
Published: February 2005

Background: Buttressing bone formation has been described as the development of thickened or exostotic buccal alveolar bone in response to heavy occlusal forces. Little supporting evidence for this model has been found in previous literature, however, and there is little seen on the prevalence or characteristics of buccal alveolar exostoses.

Methods: A sample of 416 selected teeth and investing bone in 52 modern skeletal specimens at the National Museum of Natural History were examined. Two measures of heavy occlusal function––periodontal ligament (PDL) width and occlusal attrition –were analyzed for their relationship to three parameters of buccal alveolar bone (exostoses, lipping, and overall thickness).

Results: Buccal alveolar bone enlargements were found in 25% of all teeth examined: 18% were expressed as marginal bony lippings and 7% as buccal exostoses. Exostoses were mainly seen around maxillary molars and bicuspids, especially in males, while lippings were seen in molars, bicuspids, and mandibular incisors, with even gender distribution. When findings were controlled for arch and tooth type, no significant correlations were found between wider PDL spaces or occlusal attrition and exostotic, lipped, or thicker alveolar bone.

Conclusions: These results indicate a lack of anatomic evidence for the theory of buttressing bone formation and suggest that other factors may be of greater importance in the etiology of buccal bone enlargements. Incidentally, no correlation was found between widened PDL spaces or severe occlusal attrition and the presence of cervical loss of tooth structure, which casts doubt on the currently popular concept of abfraction. J Periodontol 2000;71:1032‐1042.
Retention of Multi‐Rooted Teeth With Class III Furcation Lesions Utilizing Resins. Report of 17 Cases
Authors: Anderegg Charles R. , Metzler David G.
Published: February 2005

Background: Treatment of periodontally diseased multi‐rooted posterior teeth has conventionally consisted of scaling and root planing, apically positioned flaps, tunneling, root amputation, root resection, guided tissue regeneration, osseous grafting, and combination osseous graft and barrier membrane techniques. Successful treatment has often been directed and measured by how well the clinician obtains sufficient access to facilitate patient hygiene efforts. Longterm success is predicated upon tooth retention and the arrest of further destruction within the furcation area.

Methods: Seventeen adult periodontal patients with Class III furcation defects were evaluated. Using an open flap procedure, a resin‐ionomer was placed into all 3 furcation defects. The patients were placed on quarterly maintenance appointments and the teeth evaluated up to 1 year.

Results: The results revealed that sealing the furcations of multi‐rooted teeth with hopeless prognoses seems to be a viable alternative to accessing the same intraradicular areas for maintenance using more conventional modes of therapy. Sealing further decreases the surface area of the furca and simplifies future maintenance.

Conclusions: The present study showed that teeth with hopeless prognoses might be retained by decreasing probing depths, bleeding upon probing, and mobility when furcation areas are sealed with a resinionomer. J Periodontol 2000;71:1043‐1047.
Metabolic Diseases and Their Possible Link to Risk Indicators of Periodontitis
Authors: Noack Barbara , Jachmann Ingeborg , Roscher Solveig , Sieber Lydia , Kopprasch Steffi , Lück Christian , Hanefeld Markolf , Hoffmann Thomas
Published: February 2005

Background: During the last few years, risk assessment has become one of the main topics of periodontal research. Therefore, the aim of this study was to determine whether a predisposition to metabolic disorders such as diabetes mellitus (in the absence of diagnosed diabetic disease) or hyperlipidemia may be risk indicators for periodontitis.

Methods: One hundred patients ranging in age from 40 to 70 years were examined. The patients were classified as having impaired glucose tolerance (IGT) but no manifest diabetes (56 patients), hyperlipidemia (17 patients, HL), or normal metabolic status (27 control patients). Probing depth (PD), attachment level (AL), plaque index (PI), and gingival bleeding on probing (BOP) were recorded. Serum antibody titers (SAT) to A. actinomycetemcomitans (A.a.), P. intermedia (P.i.), and P. gingivalis (P.g.) were determined by enzyme‐linked immunosorbent assay (ELISA). Pooled subgingival plaque samples were analyzed using indirect immunofluorescence to detect the same organisms. In addition, respiratory burst activity of peripheral polymorphonuclear leukocytes (PMN) was evaluated by chemiluminescence (CL).

Results: No significant differences were observed between the IGT group and normal controls in the following parameters: 1) percentage of sites exhibiting BOP; 2) mean PI; 3) mean PD and AL; 4) percentage of periodontal microorganisms; and 5) increased SAT. The IGT probands exhibited a significantly higher mean serum level of triglycerides, as well as higher formyl‐methionyl‐leucyl‐phenylalanine (FMLP)‐stimulated PMN chemiluminescence than the control group. Patients with hyperlipidemia (HL) showed a significantly higher number of sextants with increased PD (73.4%) than the control group (50.6%). Similar results were obtained when comparing the percentage of all sites with increased PD (HL = 16.7%, control 12.3%). The mean FMLP‐stimulated CL in patients with hyperlipidemia was significantly higher than the control group. When looking at all patients, there was a small but statistically significant correlation between PD and lipid levels. In addition, a significant correlation was observed between lipid serum levels and the FMLP‐stimulated chemiluminescence.

Conclusions: These findings suggest that abnormal glucose tolerance, which is a predisposing factor for diabetes mellitus, does not appear to be a risk indicator for periodontal disease. On the other hand, impaired lipid metabolism does seem to be a risk indicator for periodontitis. J Periodontol 2000;71:898‐903.
Guided Tissue Regeneration Associated With Bovine‐Derived Anorganic Bone in Mandibular Class II Furcation Defects. 6‐Month Results at Re‐Entry
Authors: Simonpietri‐C Jeannette J. , Novaes Arthur B. , Batista Eraldo L. , Feres Filho Eduardo J.
Published: February 2005

Background: The use of graft materials with guided tissue regeneration (GTR) in Class II furcation defects is aimed at improving the outcome of the regenerative technique. In this regard, however, there are a limited number of studies discussing the results obtained when GTR and graft materials are used in the treatment of Class II furcation defects. Furthermore, most studies employ either allogeneic or autogenous materials. The present trial sought to determine whether the use of a bovine‐derived anorganic bone (ABB) in conjunction with GTR influenced the outcome of mandibular Class II furcation treatment.

Methods: This study included 14 patients who provided 15 pairs of similar periodontal defects. Each defect was randomly assigned to treatment with either a cellulose membrane in combination with bovine‐derived anorganic bone (GTR+ABB) or membrane alone (GTR). Following basic therapy, baseline measurements were recorded including probing depth (PD), clinical attachment level (CAL), and gingival margin position (GMP). Hard tissue measurements were performed during surgery to determine alveolar crestal height (CEJ‐AC), and vertical (VDD) and horizontal defect depth (HDD). Membranes remained in position for at least 4 weeks. After 6 months, all sites were re‐entered and soft and hard tissue measurements were recorded.

Results: Both surgical procedures resulted in statistically significant probing depth reduction and gain in clinical attachment levels, with no significant difference between groups. Gingival recession was more pronounced in the GTR+ABB group (0.87 ± 0.83 mm), but not statistically different from the GTR group (0.46 ± 1.19 mm). Vertical defect resolution was significant in both groups (GTR: 1.60 ± 1.50 mm; GTR+ABB: 1.80 ± 2.11 mm), without differences between groups. Only horizontal furcation resolution (GTR: 2.47 ± 0.99 mm; GTR+ABB: 3.27±1.39 mm) was significantly different between groups (P <0.05).

Conclusions: The use of ABB with GTR techniques improved horizontal defect resolution in mandibular Class II furcation defects, but did not yield superior results regarding soft tissue changes when compared to sites treated with GTR alone. Evaluation of a larger sample could indicate differences and advantages between the evaluated approaches and confirm the real necessity of associating filling materials with GTR. J Periodontol 2000;71:904‐911.
Guided Tissue Regeneration With Bioabsorbable Barriers: Intrabony Defects and Class II Furcations
Authors: Eickholz Peter , Kim Ti‐Sun , Steinbrenner Harald , Dörfer Christof , Holle Rolf
Published: February 2005

Background: The aim of this study was to compare the effects of guided tissue regeneration (GTR) using 2 different bioabsorbable barriers (control: polylactide acetyltributyl citrate; test: polydioxanon). The polydioxanon barrier is an experimental membrane for GTR therapy that consists of a continuous occlusive barrier that has a layer of slings on the side that is meant to face the mucoperiosteal flap.

Methods: In 21 patients with 22 pairs of similar contralateral defects (30 intrabony and 14 Class II furcation lesions), each defect was randomly assigned for treatment with either control (c) or test (t) devices. At baseline and 12 months after surgery, clinical measurements, plaque index (PI) gingival index (GI), probing depth (PD), and vertical and horizontal clinical attachment loss (CAL‐V; CAL‐H) and standardized radiographs were obtained.

Results: Barrier exposure was commonly observed in both groups. Four weeks after surgery 61% of all barriers were exposed to some extent. However, both treatments revealed a significant GI reduction (P <0.005), PD reduction (–3.08 ± 2.29 mm [t]; –3.52 ± 2.67 mm [c]; P <0.001) and CAL‐V gain (2.44 ± 2.29 mm [t], 2.80 mm ± 2.21 [c]; P <0.001) 12 months after surgery in all defects. Within the intrabony defects significant bony fill (2.03 ± 1.70 mm [t]; 1.91 ± 1.20 mm [c]; P = 0.001), and within the furcations a significant but small CAL‐H gain (0.79 ± 0.68 mm [t]; 1.13 ± 1.44 mm [c]; P <0.05), was observed.

Conclusions: Regarding GI and PD reduction as well as CALV and CAL‐H gain, this study failed to reveal statistically significant or clinically relevant differences between test and control 12 months postsurgically. Thus, the use of both bioabsorbable barriers in GTR therapy may be recommended. J Periodontol 2000;71:999‐1008.
2‐Year Observation of Attachment Loss in a Rural Chinese Population
Authors: Suda Reiko , Cao Caifang , Hasegawa Kohji , Yang Shi , Sasa Ryuji , Suzuki Motoyuki
Published: February 2005

Background: Risk indicators for periodontitis seem to vary with study population. The purpose of this study was to determine whether risk indicators of additional attachment loss differ between generations of Chinese villagers in a rural area of China over a 2‐year period.

Methods: The study population consisted of 310 subjects aged 15 to 44. In each subject, 2 quadrants from either the upper or lower jaw were randomly selected and 6 sites on each tooth were examined. Clinical parameters included plaque scoring system (PSS), calculus index (CI), probing depth (PD), attachment level (AL), and sulcus bleeding index (SBI). The second examination was done 2 years after the first.

Results: In the 15‐ to 24‐year‐old age group, mean PSS, CI, and SBI were significantly higher in subjects with additional attachment loss ≥3 mm (AL+) than in those without attachment loss (AL‐). In the 25‐ to 34‐year‐old age group, mean PD was significantly higher in AL+ than in AL‐, and mean PD and AL were significantly higher in AL+ than in AL− in the 35‐ to 44‐year‐old age group. Although the number of subjects with AL+ increased with age, the mean number of sites with AL+ per subject did not differ by generation. In addition, smokers tended to exhibit attachment loss more often than non‐smokers.

Conclusions: The present results suggest that the clinical parameters associated with attachment loss differ between generations and that gingival inflammation is likely associated with the onset of periodontitis more strongly than progression of periodontitis, whereas PD and/or AL are associated with the progression of periodontitis. J Periodontol 2000;71:1067‐1072.
Biological Effects of Cementum and Bone Extracts on Human Periodontal Fibroblasts
Authors: Hou L.‐T. , Liu C. ‐M. , Lei J. ‐Y. , Wong M. ‐Y. , Chen Jin‐Kun
Published: February 2005

Background: Non‐collagenous proteins of mineralized tissues play important roles in bone induction during mineralization and in regulating the activity of many types of mesenchymal cells. This study was conducted to determine the effects of acetic acid extracts of bone and cementum on alkaline phosphatase (ALPase) activity and in vitro mineralization of cultured human periodontal fibroblasts (hPF).

Methods: Alveolar bone and cementum obtained from clinically healthy subjects were extracted by a solution containing 0.5 M acetic acid and enzyme inhibitors. Osteoblastic phenotypes of hPF were assayed by ALPase activity, gene expression of bone marker proteins, and the ability to produce in vitro mineralization in culture media containing 50 µg/ml ascorbic acid, 10 mM sodium β‐glycerophosphate, and 10‐7 M dexamethasone. The effects of cementum and bone extracts on the expression of osteoblastic phenotypes in hPF were also determined.

Results: Many protein components, varying in molecular weight from 10 to 14 to 120 kDa, were detectable in 10% SDS‐PAGE of both cementum and alveolar bone extracts. The hPF cells were found to exhibit a moderate ALPase activity when compared with rat osteosarcoma (ROS) 17/2.8 cells under the same experimental conditions. Gene expression for ALPase, osteocalcin bone sialoprotein, osteopontin, and BMP‐7 at mRNA message was detected by RT‐PCR in hPF and ROS 17/2.8 cells. The confluent hPF and ROS 17/2.8 cells showed evidence of calcium deposition in the extracellular milieu at 30 and 15 to 30 days' cultures, respectively, under a mineralization medium. The hPF appeared to form mineralized foci with morphological characteristics different from the mineralized nodules produced by ROS 17/2.8 cells. The addition of low concentrations (5 µg/ml) of either cementum or bone extract produced an increase in the size and number of mineralization spots, as well as greater ALPase activity in both hPF and ROS 17/2.8 cultures during the observation periods.

Conclusions: These results suggest that hPF possess certain mineralizing phenotypes, and that acetic acid extracts of bone and cementum contain components capable of stimulating osteogenic differentiation of hPF. J Periodontol 2000;71:1100‐1109.
Neutrophils Die in the Gingival Crevice, Periodontal Pocket, and Oral Cavity by Necrosis and Not Apoptosis
Authors: Crawford John M. , Wilton James M.A. , Richardson Peggy
Published: February 2005

Background: Neutrophils play important roles in the homeostasis of periodontal tissues. However, remarkably little is known about how these cells live and die in the gingival crevice and periodontal pocket. We have examined whether subgingival neutrophils die by necrosis or apoptosis and have begun to study the mechanisms controlling the functional lifespan of these cells.

Methods: Neutrophils collected from clinically healthy gingival crevices, periodontal pockets, and the oral cavity (saliva) were examined with Hoechst dye 33342, propidium iodide/eithidium bromide, and FITC‐annexin V to identify live, dead, and apoptotic cells. Blood neutrophils were cultured for 17 to 20 hours in the presence or absence of gingival crevice washings (GC‐w) to study the effect of GC‐w on neutrophil apoptosis. In addition, endotoxin was removed from GC‐w by affinity resin to investigate the contribution of LPS to the inhibitory effect of GCw on blood neutrophils.

Results: The percentage of dead neutrophils in all subgingival sites and in all oral samples far exceeded the percentage of apoptotic neutrophils. In all 3 locations, approximately 30% of neutrophils were dead, whereas less than 1% of neutrophils were apoptotic. We conclude that the majority of neutrophils which lose their viability within gingival crevices, periodontal pockets and the oral cavity die by necrosis and not by apoptosis. Washings obtained from clinically healthy gingival crevices (GC‐w) variably, but significantly, delayed apoptosis of peripheral blood neutrophils (mean suppression 45.7% ± SD 22.3). Removal of endotoxin from GC‐w significantly reduced this inhibitory effect.

Conclusions: Our findings provide insights into the mechanisms of neutrophil death and the control of the functional lifespan of neutrophils in gingival crevices and periodontal pockets and therefore into the pathogenesis of periodontal diseases. J Periodontol 2000;71:1121‐1129.
The Influence of Genetic Variation on the Splenic T Cell Cytokine and Specific Serum Antibody Responses to Porphyromonas gingivalis in Mice
Authors: Gemmell Erica , Winning Tracey A. , Grieco Dorothy A. , Bird Philip S. , Seymour Gregory J.
Published: February 2005

Background: T cell cytokine profiles in the spleens and anti‐Porphyromonas gingivalis antibodies in the sera of P. gingivalis‐immunized BALB/c (H‐2d), CBA/CaH (H‐2k), C57BL6 (H‐2b), and DBA/2J (H‐2d, C5 deficient) mice were examined.

Methods: Mice were immunized either by intraperitoneal injections of P. gingivalis outer membrane antigens and Freund's incomplete adjuvant weekly for 3 weeks or sham‐immunized with PBS and adjuvant, followed by subcutaneous challenge with live organisms 1 week after the final immunization. Spleens were excised and blood samples collected by heart puncture at 0 and 7 days after challenge. Splenic CD4 and CD8 cells were stained for intracytoplasmic interleukin (IL)‐4, interferon (IF)‐gamma, and IL‐10 and levels of anti‐P. gingivalis antibodies in the serum samples determined by ELISA.

Results: Lesion sizes in immunized BALB/c mice remained stable for the 7‐day experimental period. Immunized CBA/CaH and C57BL6 mice exhibited large lesions at day 1 reducing by day 7 particularly in the latter strain. Lesions in immunized DBA/2J mice were still larger than the other strains at day 7. With the exception of DBA/2J mice, sham‐immunized mice demonstrated lesions which did not show signs of healing by day 7. T cell cytokine responses in sham‐immunized mice at day 0 were low, increasing to a variable degree by day 7 after challenge in the 4 strains. Immunized BALB/c mice demonstrated intermediate T cell responses while generally exhibiting a stronger IFN‐gamma response than IL‐4 or IL‐10. Immunized CBA/CaH and C57BL6 mice showed weak T cell cytokine responses while immunized DBA/2J displayed the strongest T cell responses particularly in regard to IL‐4 positive cells. Sham‐immunized mice had low levels of serum anti‐P. gingivalis antibody levels at day 0 with levels increasing significantly by day 7 after challenge. Antibody levels in immunized mice seemed to correlate with lesion sizes. Immunized C57BL6 mice had the highest antibody levels followed by CBA/CaH, BALB/c with DBA/2J exhibiting low levels. The T cell and B cell antibody responses in each strain appeared to exhibit an inverse relationship.

Conclusions: This study has shown that genetic differences at the level of H‐2 haplotype induce variations in the local and T and B cell responses to P. gingivalis antigens. The responses of DBA/2J mice which have the same haplotype as BALB/c mice suggest that factors other than H‐2 haplotype such as the C5 deficiency may influence this immune response. The significance of the specific antibody and T cell responses and of their inverse relationship to susceptibility to periodontal disease remains to be determined. J Periodontol 2000;71:1130‐1138.
A spartate Aminotransferase Activity in Crevicular Fluid From Dental Impiants
Authors: Paolantonio Michele , Di Placido Giacinto , Tumini Vincenzo , Di Stilio Mauro , Contento Alessandro , Spoto Giuseppe
Published: February 2005

Background:Aspartate aminotransferase (AST) is an enzyme normally confined to the cytoplasm of cells, but released to the exracellular environment upon cell death. Its levels are associated with the severity of experimental gingivitis and the loss of periodontal attachement. The aim of the present study was to investigate the presence and activity levels of AST in peri‐implant crevic‐ular fluid (PCF) healthy and diseased endosseous implants in order to assess if AST in PCF can be further studied as a possible objective diognostic aid in oral implantology.

Methods: Eighty‐one fitures from 81 systemically healthy subject were divide into 3 groups, 27 healthy implants (HI), 27 implants with mucositis (MI) and 27 implants affected by periimplantities (PI)according to well‐defined clinical and radiographic criteria. PCF was collected by the insertion of a # 40 standardized ‐ point to the base of the crevice or pocket for 30 seconds. AST activity was determined spectrophotometrically at 25′ C. The results were expressed as AST Units/ml in PCF.

Results: An AST activity was detected in each sample from HI, MI and PI. The mean AST activity in HI was 0.26 f 0.16 U/ml; in MI, 0.38 ± 0.27u/ml; in PI, 0.62 k 0.29 U/ml. ANOVA showed that the deference among HI, MI, and PI was statistically significant at P <0.01level. Post‐hoc tests demonstrated that a significant difference in AST activity existed between HI/PI (t = 5.14; P <0.01) and MI/PI (t = 3.09; P <0.01). No statistically significant difference was fond between HI/MI (t = 1.07; P>0.1) AST activity was significantly (P <1) associated with probing depth (r = 0.55), the amount of bone loss (r = 0.60) and bleeding on probing (r = 0.67). When the threshold for a positive AST test was set ≥0.4 U/ml, a sensitivity = 0.81 and a specificity = 0.74 were found in the detection of peri‐implantitis; the positive predictive value was 61% and the negative predictive value was 88%.

Conclusions: within the limits of this study, our results may suggest the PCF analysis could be further investigated in longitudi‐nal studies as a suitable diagnostic strategy in the evaluation of dental implants. J Periodontol2000;71:1151‐1157.
Effects of Bisphosphonate on Matrix Metalloproteinase Enzymes in Human Periodontal Ligament Cells
Authors: Nakaya H. , Osawa G. , Iwasaki N. , Cochran D.L. , Kamoi K. , Oates T.W.
Published: February 2005

Background: The host response is a critical component in the pathogenesis of periodontitis. In fact, the clinical benefits associated with regulating the host response have been demonstrated in studies using several different classes of drugs. Biophosphates are one host‐modulating class of drugs that has demonstrated this ability. These drugs are clinically effective at reducing bone resorption and have shown the ability to inhibit host degradative enzymes, specifically the matrix metalloproteinases (MMPs). Therefore, the purpose of this study was to investigate the regulatory effects of a bisphosphonate, tiludronate, on MMP levels and activity in human periodontal cells.

Methods: MMP‐1 and MMP‐3 were assessed in cultured human periodontal ligament cells treated with a bisphosphonate, tiludronate. Reverse transcription‐polymerase chain reaction was used to identify mRNA levels for both enzymes, and also for tissue inhibitors (TIMP‐1). Enzyme immunoassay (EIA) and immunocytochemistry were used to assess MMP proteins in these cell cultures. Enzyme activity was assessed using FITCconjugated substrates and quantitated using spectrophotofluorometry.

Results: Tiludronate significantly inhibited both MMP‐1 and MMP‐3 activity in a concentration‐dependent manner. A maximal reduction in activity of 35% was achieved for each of the enzymes at a 10‐4 M concentration. Tiludronate did not have a significant effect on the mRNA levels for MMP‐1, MMP‐3, or TIMP‐1. Similarly, there were no effects noted for either MMP‐1 or MMP‐3 on the protein level.

Conclusions: This study demonstrates an inhibitory effect of tiludronate on the activity of both MMP‐1 and MMP‐3. These effects appear to occur without altering either mRNA or protein levels for these enzymes, supporting a possible mechanism of action that involves the ability of bisphosphonates to chelate cations from the MMPs. Furthermore, these results support the continued investigation of these drugs as potential therapeutic agents in periodontal disease. J Periodontol 2000;71:1158‐1166.
Induction of Experimental Periodontitis in Mice With Porphyromonas gingivalis‐ Adhered Ligatures
Authors: Kimura Shigenobu , Nagai Atsushi , Onitsuka Tokuya , Koga Toshiya , Fujiwara Taku , Kaya Hidehiro , Hamada Shigeyuki
Published: February 2005

Background: Little information is available on the colonization of periodontopathic bacteria and alveolar bone loss in a mouse system, because of the difficulty in establishing bacteria in the oral cavity. The aim of this study was to establish experimental periodontitis in mice by applying a Porphyromonas gingivalis‐adhered ligature onto the molars.

Methods: Specific pathogen‐free C3H/HeN mice were divided into 3 groups: 80 infected, 80 sham‐infected, and 48 non‐treated control mice. Sterile silk ligatures were preincubated with and without P. gingivalis 381 in vitro and then physically tied on the right maxillary first molar of infected and sham‐infected mice, respectively. Ten mice from the infected and sham‐infected groups and 6 from the control group were sacrificed at 2‐week intervals for up to 15 weeks after infection.

Results: Plaque samples were collected at the time of sacrifice and alveolar bone loss was examined. The results indicated that P. gingivalis was recovered from the plaque samples in 95% of the infected mice after 1 week and then gradually dropped to 58% after 15 weeks of infection, whereas P. gingivalis was not isolated in either sham‐infected or control mice throughout the experimental period. The infected mice showed significant P. gingivalis‐induced bone loss at the sites where the ligature was tied weeks 13 to 15. A linear regression analysis revealed a significant positive correlation between the number of P. gingivalis recovered and alveolar bone loss at 15 weeks after infection (P <0.01).

Conclusions: The use of a P. gingivalis‐adhered ligature supported a long‐lasting infection of P. gingivalis in mice, resulting in P. gingivalis‐induced alveolar bone breakdown. J Periodontol 2000;71:1167‐1173.
Peripheral Ameloblastoma: A Report of 2 Cases
Authors: Orsini Giovanna , Fioroni Massimiliano , Rubini Corrado , Piattelli Adriano
Published: February 2005

Peripheral ameloblastoma (PA) is a rare odontogenic tumor most common in elderly patients. They are usually solitary; red or pink granular, nodular, or papillary lesions; up to 1.5 cm in diameter; and either not resorb bone or produce a shallow erosion. Peripheral ameloblastoma should be included in the differential diagnosis of soft tissue lumps on the gingiva or edentulous alveolus. J Periodontol 2000;71:1174‐1176.
Peripheral Clear Cell Calcifying Epithelial Odontogenic Tumor. Report of a Case
Authors: Orsini Giovanna , Favia Gianfranco , Piattelli Adriano
Published: February 2005

Calcifying epithelial odontogenic tumor (CEOT) is an uncommon, locally aggressive odontogenic tumor representing less than 1% of all odontogenic tumors. Clear cells have been described in CEOT, ameloblastomas, calcifying odontogenic cysts, lateral periodontal, and gingival cysts. It is not yet clear if the clear cell variants of the odontogenic tumors have a different biologic behavior, even if it seems that these tumors are more aggressive with an higher recurrence rate. The authors present a case of a peripheral clear cell CEOT (CCCEOT). It is a rare lesion with only 9 cases reported in the literature. The lesion was removed by excision and no recurrence was found after a 4‐year follow‐up. J Periodontol 2000;71:1177‐1180.
Severe Gingival Recession in Trisomy 18 Primary Dentition. A Clinicopathologic Case Report of Self‐Inflicted Injury Associated With Mental Retardation
Authors: Tatakis Dimitris N. , Todd Milledge J.
Published: February 2005

This clinicopathologic case report documents severe gingival recession in the primary dentition of a trisomy 18 patient. Primary molar and canine teeth exhibited recession extending beyond the midpoint of the buccal aspect of the root, occasionally reaching the root apex. Radiographic examination revealed taurodontism in both primary and permanent teeth. Clinical and histopathologic findings, along with case history, eliminated the possibility of prepubertal periodontitis and suggested a diagnosis of self‐inflicted injury associated with mental retardation. Histologic examination of the primary teeth revealed normal cementum and dentin structure. Taurodontism, histologic structure of the dentition, and severe attachment loss in the primary dentition have not been described previously in trisomy 18. J Periodontol 2000;71:1181‐1186.
Ability of Deproteinized Cancellous Bovine Bone to Induce New Bone Formation
Authors: Schwartz Z. , Weesner T. , Van Dijk S. , Cochran D.L. , Mellonig J.T. , Lohmann C.H. , Carnes D.L. , Goldstein M. , Dean D.D. , Boyan B.D.
Published: February 2005

Background: Preclinical and clinical studies indicate that deproteinized cancellous bovine bone is osteoconductive and may be osteopromotive. Previous studies using commercial preparations failed to demonstrate the presence of protein, implicating bone‐mineral composition and 3‐dimensional structure as reasons for clinical success; however, these studies did not examine whether osteoinductive factors might be present in close association with the mineral phase.

Methods: Deproteinized cancellous bovine bone was decalcified and any protein present released by chaotropic solvents using the protocol described for purification of bone morphogenetic proteins (BMPs). Three extracts were obtained and tested for their ability to support osteoinduction in the calf muscle of nude mice.

Results: Protein content averaged 11 µg/g based on absorbance at 280 nm using bovine serum albumin as a standard. All extracts contained material that stained positively with silver stain after sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS‐PAGE). Western blots of these gels indicated the presence of transforming growth factor‐beta (TGF‐β) and BMP‐2. All 3 extracts were osteoinductive in the nude mouse model when combined with inactive DFDBA, and bone formation was comparable to that induced by active DFDBA. Deproteinized cancellous bovine bone by itself was not osteoinductive in the nude mouse, but in a clinical case, exhibited osteoclastic resorption with adjacent new bone formation.

Conclusions: The results suggest that small amounts of protein are present in deproteinized cancellous bovine bone in close association with the mineral phase. Some of the extracted material has osteoinductive potential and may contain growth factors. This may explain the osteopromotive ability of deproteinized cancellous bovine bone clinically. J Periodontol 2000;7I:l258‐1269.
In Vitro Wound Healing Responses to Enamel Matrix Derivative
Authors: Hoang A.M. , Oates T.W. , Cochran D.L.
Published: February 2005

Background: Enamel matrix derivative (EMD) contains a variety of hydrophobic enamel matrix proteins and is extracted from developing embryonal enamel of porcine origin. EMD has been associated with the formation of acellular cementum and it has been found to stimulate periodontal regeneration. The present study was established to investigate the influence of EMD on human periodontal ligament (PDL) cells, gingival fibroblasts (GF), and osteosarcoma (MG‐63) cells on wound‐fill rates using an in vitro wound model.

Methods: Wounds were created by making 3 mm incisions in cell monolayers across the length of tissue culture plates. The wounded PDL, GF, and MG‐63 cell monolayers were treated with media containing EMD over a concentration range of 5 to 100 µg/ml, platelet‐derived growth factor (PDGF‐BB) at 20 ng/ml as a positive control and insulin‐like growth factor (IGFI) at 100 ng/ml as a negative control. PDL cell wounded monolayers also were treated in EMD coated tissue culture plates. After an incubation period (up to 9 days), the cells were fixed and stained and cellular fill was measured across the width of the wound by computer‐assisted histomorphometry.

Results: When PDL, GF, and MG‐63 cells were exposed to EMD in culture medium, an enhanced wound‐fill was observed for all cells compared to untreated conditions. At early time points, PDL wound‐fill rates in the presence of EMD were statistically greater than the rates of GF and MG‐63 treated with EMD (P <0.001). There were no significant differences in wound‐fill rates of PDL cells treated with EMD in medium versus EMD coated on culture plates. At days 3 and 6 post‐wounding, PDL cells showed a significantly greater response to EMD than to PDGF‐BB (P <0.001). EMD also had a greater effect on GF wound‐fill rates than PDGF‐BB at days 6 and 9. MG‐63 cells were less responsive to PDGF‐BB and EMD than PDL cells and GF. All 3 cell types treated with IGF‐I showed no significant increase of wound‐fill rates.

Conclusion: The present data support the concept that clinical application of enamel matrix derivative may enhance periodontal wound regeneration by specifically modifying periodontal ligament cell proliferation and migration. J Periodontol 2000;71:1270‐1277.
Porcine Fetal Enamel Matrix Derivative Enhances Bone Formation Induced by Demineralized Freeze Dried Bone Allograft In Vivo
Authors: Boyan B.D. , Weesner T.C. , Lohmann C.H. , Andreacchio D. , Carnes D.L. , Dean D.D. , Cochran D.L. , Schwartz Z.
Published: February 2005

Background: Embryonic enamel matrix proteins are involved in the formation of acellular cementum during development of the periodontal attachment apparatus, suggesting that these proteins might be used clinically to promote periodontal regeneration. At present, it is unknown if these proteins are osteoinductive, osteoconductive, or osteopromotive. To address this question, we examined the ability of a commercially prepared embryonic porcine enamel matrix derivative to induce new bone formation in nude mouse calf muscle, or to enhance the bone induction ability of a demineralized freeze‐dried bone allograft (DFDBA).

Methods: Porcine fetal enamel matrix derivative (EMD) was implanted bilaterally in the calf muscle of 4 male Nu/Nu mice per treatment group (N = 8 implants): 2 mg EMD alone; 4 mg EMD alone; inactive human DFDBA alone; inactive DFDBA + 2 mg EMD; inactive DFDBA + 4 mg EMD; active DFDBA alone; active DFDBA + 2 mg EMD; and active DFDBA + 4 mg EMD. Implants were harvested after 56 days and examined histologically for bone induction using a semi‐quantitative score and histomorphometrically for area of new bone, cortical bone, bone marrow, and residual DFDBA.

Results: Implants containing inactive DFDBA, 2 mg EMD, 4 mg EMD, and inactive DFDBA + 2 or 4 mg EMD did not induce new bone. Active DFDBA and active DFDBA + 2 mg EMD induced new bone to a similar extent. In contrast, active DFDBA + 4 mg EMD resulted in enhanced bone induction, area of new bone, and cortical bone. Residual DFDBA was also increased in this group.

Conclusions: EMD is not osteoinductive. However, it is osteopromotive, due in part to its osteoconductive properties, but a threshold concentration is required. J Periodontol 2000;71:1278‐1286.
Porcine Fetal Enamel Matrix Derivative Stimulates Proliferation But Not Differentiation of Pre‐Osteoblastic 2T9 Cells, Inhibits Proliferation and Stimulates Differentiation of Osteoblast‐Like MG63 Cells, and Increases Proliferation and Differentiation of Normal Human Osteoblast NHOst Cells
Authors: Schwartz Z. , Carnes D.L. , Pulliam R. , Lohmann C.H. , Sylvia V.L. , Liu Y. , Dean D.D. , Cochran D.L. , Boyan B.D.
Published: February 2005

Background: Embryonic enamel matrix proteins are hypothesized to be involved in the formation of acellular cementum during tooth development, suggesting that these proteins can be used to regenerate periodontal tissues. Enamel matrix protein derived from embryonic porcine tooth germs is used clinically, but the mechanisms by which it promotes the formation of cementum, periodontal ligament, and bone are not well understood.

Methods: This study examined the response of osteoblasts at 3 stages of osteogenic maturation to porcine fetal enamel matrix derivative (EMD). Proliferation (cell number and [3H]‐thymidine incorporation), differentiation (alkaline phosphatase and osteocalcin), matrix synthesis ([35S]‐sulfate incorporation; percentage of collagen production), and local factor production (prostaglandin E2 [PGE2] and transforming growth factor beta 1 [TGF‐β1]) were measured in cultures of 2T9 cells (pre‐osteoblasts which exhibit osteogenesis in response to bone morphogenetic protein‐2 [BMP‐2]), MG63 human osteoblast‐like osteosarcoma cells, and normal human osteoblasts (NHOst cells).

Results: EMD regulated osteoblast proliferation and differentiation, but the effects were cell‐specific. In 2T9 cell cultures, EMD increased proliferation but had no effect on alkaline phosphatase‐specific activity. EMD decreased proliferation of MG63 cells and increased cellular alkaline phosphatase and osteocalcin production. There was no effect on collagen synthesis, proteoglycan sulfation, or PGE2 production; however, TGF‐β1 content of the conditioned media was increased. There was a 60‐fold increase in cell number in third passage NHOst cells cultured for 35 days in the presence of EMD. EMD also caused a biphasic increase in alkaline phosphatase that was maximal at day 14.

Conclusions: EMD affects early states of osteoblastic maturation by stimulating proliferation, but as cells mature in the lineage, EMD enhances differentiation. J Periodontol 2000;71:1287‐1296.
Acellular Dermal Matrix Allografts to Achieve Increased Attached Gingiva. Part 1. A Clinical Study
Authors: Wei Pein‐Chi , Laurell Lars , Geivelis Milton , Lingen Mark W. , Maddalozzo Donna
Published: February 2005

Background: Freeze‐dried acellular dermal matrix (ADM) allograft, originally used for full‐thickness burn wounds, was recently introduced as an alternative to the autogenous free gingival graft (FGG) in achieving increased attached keratinized tissue. The aim of part 1 of this study was to investigate the clinical efficacy of the ADM allograft for this particular purpose.

Methods: Twelve patients, 7 males and 5 females, with attached gingiva ≤1 mm on the facial aspect of mandibular anterior teeth demonstrating a tendency of progressive marginal tissue recession, were randomly assigned to either test or control treatment. Six patients received ADM graft (test) and 6 patients received an autogenous FGG harvested from the hard palate (control). Clinical variables including plaque index (PI), gingival index (GI), probing depth (PD), attached tissue width (AT), and gingival recession (GR) were recorded immediately before surgery and at the 6‐month postoperative visit. Patients were seen at 2, 4, 6, 8, and 12 weeks to monitor wound healing and oral hygiene performance (PI and GI). Graft width was also measured, in corono‐apical direction, on individually involved teeth during the surgery.

Results: When values between baseline and 6 months were compared in both groups, there was no statistically significant difference in changes of PI, GI, PD, and GR (P >0.05) with the exception of PD in the FGG group (1.01 ± 0.03 versus 1.27 ± 0.20 mm, P = 0.042). There was a statistically significant (P <0.05) increase in AT in both groups. Although the ADM group received wider grafts than the FGG group (8.81 ± 0.46 versus 6.70 ± 0.89 mm), the AT gain was significantly smaller (2.59 ± 0.92 versus 5.57 ± 0.44 mm) and the graft shrinkage significantly greater (71 ± 10% versus 16 ± 12%) in the ADM group than in the FGG group (P <0.01).

Conclusions: The results of this study suggest that in procedures aiming at increasing the width of attached gingiva: 1) the ADM allograft was less effective and less predictable than the autogenous FGG in terms of increasing attached keratinized tissue due to considerable shrinkage and inconsistent quality of the attached tissue gained and 2) the esthetic results using the ADM allograft might be better than those using the autogenous FGG. J Periodontol 2000;71:1297‐1305.
Identification of Periodontal Disease‐Associated Bacteria in the “Plaque‐Free Zone”
Authors: Noiri Yuichiro , Ebisu Shigeyuki
Published: February 2005

Background: Subgingival plaque bacteria live within a biofilm covered with glycocalyx, and little is known of the bacterial species associated with biofilm formation at the bottom of human periodontal pockets, the so‐called “plaque‐free zone”(PFZ).

Methods: Seventy‐seven extracted teeth from 56 patients with severe advanced adult periodontitis were examined. Porphyromonas gingivalis, Campylobacter rectus, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Treponema denticola, Prevotella nigrescens, and Actinomyces viscosus were examined by scanning immunoelectron microscopic techniques, using both secondary and back‐scattered imaging, with rabbit antibodies specific for each bacteria.

Results: Secondary electron images showed that rods, filaments, and spirochete‐shaped bacteria formed small aggregates in the PFZ. Some of the bacteria were covered with an amorphous film‐like structure. By back‐scattered electron imaging, positive reactions with anti‐P. gingivalis were found in 8 of 13 samples examined, and film‐like structures coated several cells of 6 positive samples examined. Labeled cells with anti‐C. rectus, anti‐T. denticola and anti‐P. nigrescens were detected in 3 of 11, 5 of 10, and 1 of 8 samples examined. A. viscosus were found in 6 of 11 of the samples. A. viscosus tended to overlay the amorphous capsula and aggregate. F. nucleatum and A. actinomycetemcomitans were not detected in any samples examined.

Conclusions: These findings indicated that P. gingivalis, C. rectus, T. denticola, P. nigrescens, and A. viscosus were present in the PFZ, and that some specified bacteria were possibly related to plaque‐biofilm formation of subgingival plaque. J Periodontol 2000;71:1319‐1326.
The Deceptive Nature of Root Coverage Results
Authors: Greenwell Henry , Bissada Nabil F. , Henderson Robin D. , Dodge John R.
Published: February 2005

Background: The purposes of this article are to: 1) propose a new method of reporting root coverage data; 2) compare existing root coverage techniques using the proposed data analysis method; and 3) discuss additional refinements to root coverage data analysis. Past studies have equated percent defect coverage with root coverage. This gives deceptive information about the magnitude of the residual recession defect. Defect coverage of 67% could actually amount to 92% root coverage.

Methods: The use of mean root lengths will permit the determination of true root coverage data. This should be reported in addition to defect coverage data. Also including frequency data will provide a better assessment of the predictability of the surgical techniques.

Results: A comparison table of root coverage studies demonstrates that the connective tissue graft is the most effective and predictable method that has been tested.

Conclusions: Further refinements to data analysis may help researchers identify the determinants of predictable root coverage. J Periodontol 2000;71:1327‐1337.
Gingival Recession Treatment Using a Bilayer Collagen Membrane
Authors: Burns William T. , Peacock Mark E. , Cuenin Michael F. , Hokett Steven D.
Published: February 2005

Traditional periodontal plastic surgery techniques for the management of gingival recession have typically used soft tissue grafts to obtain defect coverage with great clinical success. Clinicians using guided tissue regeneration (GTR) techniques are also enjoying significant success in periodontal plastic surgery procedures. GTR therapy utilizing bioabsorbable membranes offers the advantages of preventing a donor site surgery and a second surgical procedure for barrier removal. A new bioabsorbable bilayer collagen membrane that readily adapts to bone and tooth surfaces by a gel formation of collagen fibers and blood may be stabilized without sutures prior to soft tissue closure. This bioabsorbable membrane has been shown to be effective in guided bone regeneration procedures and in treating periodontal defects. This case demonstrates the treatment of gingival recession with a novel collagen bilayer membrane. J Periodontol 2000;71:1348‐1352.
Ridge Preservation Utilizing an Acellular Dermal Allograft and Demineralized Freeze‐Dried Bone Allograft: Part I. A Report of 2 Cases
Authors: Fowler Edward B. , Breault Lawrence G. , Rebitski George
Published: February 2005

Alveolar ridge deformities are usually the result of trauma, periodontal disease, surgical insult, or developmental defects. Preventing ridge collapse with the extraction of maxillary anterior teeth is vital to an esthetic restorative result. Several techniques are available to prevent ridge collapse. In these case presentations, ridge preservation was achieved utilizing an acellular dermal matrix as a barrier membrane with a demineralized freeze‐dried bone allograft. This report demonstrated an acceptable esthetic result with no loss of ridge height or width. Soft tissue dimensions were also preserved. The two graft materials were well accepted by the body and healing was rapid and without significant discomfort. The technique illustrated provides the surgeon with another option to prevent ridge collapse and ultimately improve esthetics. J Periodontol 2000;71:1353‐1359.
Patterns of Tooth Wear Associated With Methamphetamine Use
Authors: Richards John R. , Brofeldt B. Tomas
Published: February 2005

Background: Methamphetamine (MAP) abuse is a significant worldwide problem. This prospective study was conducted to determine if MAP users had distinct patterns of tooth wear.

Methods: Methamphetamine users were identified and interviewed about their duration and preferred route of MAP use. Study participants were interviewed in the emergency department of a large urban university hospital serving a geographic area with a high rate of illicit MAP production and consumption. Tooth wear was documented for each study participant and scored using a previously validated index and demographic information was obtained using a questionnaire.

Results: Forty‐three MAP patients were interviewed. Preferred route of administration was injection (37%) followed by snorting (33%). Patients who preferentially snorted MAP had significantly higher tooth wear in the anterior maxillary teeth than patients who injected, smoked, or ingested MAP (P = 0.005).

Conclusion: Patients who use MAP have distinct patterns of wear based on route of administration. This difference may be explained anatomically. J Periodontol 2000;71:1371‐1374.