bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Preoperative Diflunisal for Postoperative Pain Following Periodontal Surgery
Authors: Minutello James S. , Newell Donald H. , Thrash William J. , Terezhalmy Geza T.
Published: March 2012

The effectiveness of diflunisal as a preoperative medication to reduce pain following periodontal surgery was evaluated. Fifty patients were divided into two groups in a doubleblind random manner: Group one received preoperative difunisal and Group two received preoperative placebo. The preoperative diflunisal group reported significantly less discomfort (P < 0.05) than the preoperative placebo group and used rescue medication significantly less often (P < 0.01). Therapeutic doses of diflunisal, given presurgically, are significantly more effective than placebo in limiting postoperative pain associated with periodontal surgery.
Solitary Eosinophilic Granuloma (Histiocytosis X) of the Gingiva
Authors: Finney Debra S. , Rees Terry D. , Wright John M. , Blanton Patricia L.
Published: March 2012

Two cases are reported in which the patients presented with solitary ulcers on the gingiva. The lesions were excised and examined histologically. A connective tissue infiltrate of large mononuclear cells was identified with immunohistochemical staining as Langerhans cells and a diagnosis of histiocytosis X was made. Further medical evaluation revealed no other lesions in one of the patients but did locate an infiltrate in the right mastoid of the other patient. Solitary lesions of histiocytosis in oral mucosa are extremely rare. The manifestations of the disease, pathogenesis, and treatment are discussed.
Severe Localized Destruction of the Periodontium Secondary to Subgingival Displacement of an Elastic Band
Authors: Marino Valerie A. , Fry Hiram R. , Behrents Rolf G.
Published: March 2012

A seven‐year‐old male with localized severe periodontal destruction at the maxillary central incisior region presented for treatment. There was a history of acute trauma, but local factors were inconsistent with the clinical picture. Initial treatment consisting of palliative nonsurgical debridement coupled with systemic tetracycline resulted in a more chronic lesion with progressive bone loss. Surgical entry revealed an elastic band close to the apices of the central incisors. Removal of the etiologic agent has resulted in increased radiographic bone density and decreased probing depths. Periodontal lesions induced by elastic bands are difficult to diagnose but have several features in common that may aid in rapid diagnosis and treatment.
Microbiologic Assessments to Enhance Periodontal Diagnosis
Authors: Greenstein Gary
Published: March 2012

Associations between microbes and progressive periodontal lesions provide the biologic rationale for using specific organisms as bacteriologie markers for disease activity. Rapid, specific and relatively inexpensive laboratory tests to identify bacteria have facilitated increased testing by clinicians. However, assays must be interpreted with regard to current concepts of etiology and pathogenesis of periodontal diseases. This paper addresses commonly used microbiologie assays and their shortcomings.
Use of Antimicrobial Containing Acrylic Strips in the Treatment of Chronic Periodontal Disease
Authors: Addy M. , Hassan H. , Moran J. , Wade W. , Newcombe R.
Published: March 2012

Local antimicrobial therapy has been considered for use in the treatment of chronic periodontal disease. This study evaluated Chlorhexidine, metronidazole, and tetracycline delivered into periodontal pockets in an acrylic resin vehicle and compared the results with root planed and untreated sites over a three‐month follow‐up period. One site per patient where pocketing ≥6 mm associated with a single rooted tooth was randomly allocated to one of the five possible regimens. Baseline and follow‐up measurements included probing depth, loss of attachment, bleeding on probing, crevicular fluid flow, and dark‐field microscopy of a subgingival plaque sample. Intratreatment evaluations revealed no significant changes in any parameter for untreated sites. Significant improvements in many parameters occurred with all four therapies although the magnitude and duration were greater in metronidazole and root planing groups. The more important intertreatment comparisons indicated that most treatments produced significant benefits compared with the control group; however, again these were greater with metronidazole and root planing. Furthermore, significantly greater effects were noted for metronidazole and root planing compared with tetracycline and more particularly Chlorhexidine. It is concluded that some locally delivered antimicrobials alone may be useful in the treatment of chronic periodontal disease. However, at this time local antimicrobial therapy should be considered as adjunctive to conventional debridement techniques.
Ultrastructural Changes of Subepithelial Capillaries Following Graft Epithelialization
Authors: Nobuto Takahiro , Imai Hisao , Yamaoka Akira
Published: March 2012

This study investigated architectural changes in the nourishment‐providing capillaries beneath the epithelium that accompany graft epithelialization. A total of 77 mongrel dogs underwent free gingival autografts involving the maxillary canine and its attached gingiva. Comparative investigations relating the architectural transformations and endothelial permeability of the capillaries were made histopathologically, with graft epithelialization as an indicator.

Microscopic findings revealed that the subepithelial capillaries transformed from loop structure into glomus‐like structures. The endothelium changed ultrastructurally from the continuous type to the fenestrated. This occurred during the most active graft epithelialization phase. By the time the epithelium of the graft had matured, the fenestrated microvascular structure reverted to the continuous type and changed from a glomus‐like structure to a network capillary system. However, by the 84th postoperative day, the subepithelial capillaries, still exhibiting network structure, had not yet returned to the loop structure indigenous to the gingiva.

Observations indicated that transformation of the structure of the nourishment‐providing capillaries was attendant to and simultaneous with the changes brought about by graft epithelialization.
New Attachment Achieved by Guided Tissue Regeneration in Beagle Dogs
Authors: Caffesse R. G. , Smith B. A. , Castelli W. A. , Nasjleti C. E.
Published: March 2012

This study tested the effects of using a Gore‐Tex periodontal material on new connective tissue attachment in beagle dogs with natural Periodontitis. Seven female beagle dogs with advanced Periodontitis were selected and given thorough root debridement. Under general anesthesia four weeks later, mucoperiosteal flaps were raised involving all mandibular premolars and first molars. Gore‐Tex periodontal material was adapted to all premolare, and the flaps were sutured tightly, keeping the material covered. The first molars acted as controls, receiving only surgery. Some material was removed in one month, while other materials were removed eight to 10 weeks after surgery. All dogs were sacrificed at three months. After processing, descriptive histology and histometrics were carried out, evaluating new connective tissue attachment, bone response and epithelial downgrowth.

Results were statistically analyzed, using paired t tests. They showed new connective tissue attachment with cementum deposition in areas where the material was used. Also, the epithelial downgrowth was reduced in these areas. In the controls, minimal connective tissue attachment was found, with the area healing by a long junctional epithelium. Statistical analysis showed significant differences (P < 0.05) favoring experimental areas both in the increase of new connective tissue attachment and in the decrease of epithelial downgrowth. No differences were found between areas where the material was removed in one month or left longer in place. No difference in bone response was found. Gore‐Tex material was effective in blocking gingival epithelial downgrowth and connective tissue proliferation, promoting new attachment according to the principle of “guided tissue regeneration.”
Pemphigus Vulgaris Presenting as a Gingival Lesion
Authors: Barnett Michael L.
Published: March 2012

A 26‐year‐old Hispanic male presented with a nonspecific gingival lesion initially presumed to be of infectious etiology. During continued follow‐up over several weeks, the lesion evolved into one typical of desquamative gingivitis. Direct immunofluorescent testing and routine histopathology resulted in a diagnosis of pemphigus vulgaris, which was confirmed by indirect immunofluorescence. Although it is unusual for pemphigus vulgaris to present with the gingiva as the sole primary site of involvement, this case serves to enhance our awareness of the gingiva as a site at which systemic disease can be manifested.
Facial Radicular Groove in a Maxillary Central Incisor
Authors: Kozlovsky Avital , Tal Haim , Yechezkiely Niza , Mozes Ofer
Published: March 2012

A facial radicular groove may occur in central maxillary incisors and act as a funnel for accumulating plaque and calculus. Since it is inaccessible to routine oral hygiene efforts of the patient and to treatment manipulations of the dentist, this anomaly predisposes the tooth to localized periodontal disease. Conservative or surgical treatment of such teeth should restore periodontal health by creating an environment more favorable for plaque control.
Chemotaxis of Gingival Neutrophils: Scanning Electron Microscopy
Authors: Farber Paul A.
Published: March 2012

Gingival neutrophils, tested in the chemotaxis–under–agarose assay, were examined with the scanning electron microscope. Non–motile cells were round with narrow surface ridges. In response to the chemoattractant, zymosan–activated serum, the cells elongated and became polarized with an anterior lamellipodium and a posterior uropod. Cells flattened as they emigrated beneath the agarose. These studies show that gingival crevicular neutrophils from healthy subjects are capable of responding vigorously to external stimuli and hence may participate in the pathophysiology of periodontal disease. {J Periodontol 1989;60:540– 543)
Occurrence of Gingival Recession in Adults
Authors: Vehkalahti Miira
Published: March 2012

The occurrence of gingival recession was investigated in adults by age and gender and in relation to their dental status and frequency of toothbrushing. A total of 258 dentate subjects were clinically examined. Their mean age was 46 years and they had an average of 19.4 natural teeth. Gingival recession was recorded as present if any root surface was clearly visible without retraction of the gingival tissue. Recession was found on at least one tooth surface in 68% of subjects. Mean number of surfaces with recession was 7.2 for women and 10.4 for men. Subjects with gingival recession had fewer natural teeth than did those without recession. The two groups did not differ from each other in the number of filled teeth and decayed teeth. Mandibular teeth had more surfaces with recession than did maxillary ones. Sites of recession occurred quite symmetrically. Frequent toothbrushers had, both in the maxilla and mandible, more surfaces with recession than had those brushing their teeth infrequently. Frequent toothbrushing had a greater association with recession among women and in the youngest age group. J Periodontol 1989;60:599–603.
The Hard Evidence of Alveolar Bone Loss in Early Hominids of Southern Africa
Authors: Ripamonti Ugo
Published: March 2012

Since the discovery at Taung of the first early hominid specimen to be recovered in Africa, designated as Australopithecus africaines1, the South African Pliocene and earliest Pleistocene deposits of the Blaauwbank Valley (Sterkfontein, Swartkrans, Kromdraai) in the Transvaal and of Makapansgat in the northern Transvaal, have yielded the most spectacular fossilized hominid remains of the genus Australopithecus and associated fauna, together with some intriguing and fascinating specimens of the genus Homo.
Detachment of Oral Bacteria from Saliva—Coated Hydroxyapatite by Human Polymorphonuclear Leukocytes
Authors: Erard Jean‐Claude , Miyasaki Kenneth T. , Wolinsky Lawrence E.
Published: March 2012

Human polymorphonuclear leukocytes (PMN) demonstrated the ability to detach Actinomyces viscosus, A. naeslundii and Streptococcus sanguis from saliva‐coated hydroxyapatite beads (SHA). Between 60 to 80% of bacteria were detached within 1 hour at PMNto‐bacteria ratios between 1:10 to 1:22. Detachment was enhanced by treating bacteria with fresh but not heat‐inactivated normal human serum. Detachment of serum‐treated A. viscosus was inhibited by cytochalasin B, L–l–tosylamide–2–phenylethylchloromethyl ketone (TPCK), and deoxyglucose but not colchicine, phenylmethylsulfonyl fluoride (PMSF), N‐carbobenzoxy‐L‐phenylalanine chloromethyl ketone (ZPCK), and sodium azide. In the absence of serum treatment, the detachment of A. viscosus was insensitive to lactose, galactose, and mannose. We conclude that PMN can efficiently detach bacteria from SHA, this detachment is enhanced by serum, and this enhancement is probably dependent upon complement. Additionally, detachment of A. viscosus bound to SHA by PMN (1) does not appear to involve bacterial lectin activity, (2) seems to be dependent upon glycolytic metabolism, microfilament formation, and the activity of a TPCK‐sensitive serine protease, and (3) is not sensitive to inhibitors of tubulin polymerization or heme‐protein activity.
Focal Dermal Hypoplasia
Authors: Greer Robert O. , Reissner Marc W.
Published: March 2012

Focal dermal hypoplasia syndrome (fdh) is a congenital disorder of mesodermal derivation with some ectodermal participation. The disorder, first described in 1962, is characterized by tenacious defects consisting of thinning of the skin; herniations of adipose tissue; abnormal skin pigmentation and other skeletal, dental, ocular, hair, and nail abnormalities. a rare instance of focal dermal hypoplasia syndrome is reported as characterized by papillary gingival hyperplasia. Differential diagnostic guidelines that separate focal dermal hypoplasia from a host of other skin and mucous membrane disorders are discussed along with therapeutic modalities and the possible relationship of human papillomavirus to focal dermal hypoplasia syndrome.
A Supernumerary Tooth Located at the Facial of a Mandibular Lateral Incisor:
Authors: Krayer Joe W.
Published: March 2012

A report of a supernumerary tooth located at the facial of a mandibular lateral incisor tooth, a heretofore unreported location, is presented.
A Clinical Comparison of Antibacterial Mouthrinses:
Authors: Grossman E. , Meckel A. H. , Isaacs R. L. , Ferretti G. A. , Sturzenberger O. P. , Bollmer B. W. , Moore D. J. , Lijana R. C. , Manhart M. D.
Published: March 2012

this study compared the clinical efficacy of three mouthrinses containing either 0.12% Chlorhexidine, phenolic compounds, or sanguinarine, which were used unsupervised, in a placebo–controlled, double–blind study of 6 months' duration. The study was conducted according to ADA clinical guidelines for evaluation of antigingivitis agents and was completed by 481 adults. Following baseline exams and a prophylaxis, subjects were randomly divided into treatment groups matched for age, gender, and gingivitis severity, and were instructed to use the rinses in accordance with manufacturer's directions. Followup examinations evaluated supragingival plaque, gingivitis, and gingival bleeding. Compared to placebo at 6 months, the group rinsing with 0.12% Chlorhexidine had significantly less gingivitis (31% reduction), gingival bleeding (39% reduction), and plaque (49% reduction) and was significantly better than any of the other treatment groups (P < 0.05). Both the phenolic and sanguinarine groups showed moderate, yet significant, reductions in plaque compared to placebo (24% and 12% respectively) yet were significantly less effective than the 0.12% Chlorhexidine rinse (P < 0.05). However, neither the phenolic nor sanguinarine rinses were significantly different than placebo in their effects on gingivitis or gingival bleeding. These results support previous published results on the superiority of 0.12% Chlorhexidine when used in conjunction with professional care and as an adjunct to routine oral hygiene practices.
Clinical and Microbiological Characteristics of Treated Periodontitis Patients on Maintenance Care
Authors: Listgarten M. A. , Slots J. , Rosenberg J. , Nitkin L. , Sullivan P. , Oler J.
Published: March 2012

A population of 98 adults previously treated for moderate to advanced adult Periodontitis and currently maintained in a recall program for at least one year were recruited for this study. The ultimate purpose of the study is to determine whether the presence of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, and Bactewides intermedius in selected periodontal sites can predict the future clinical course of these patients, particularly with respect to disease recurrence. This report presents the clinical design of the study which allows comparisons between sites positive and negative for these species in infected patients, and between sites in infected patients and comparable sites in non‐infected patients. In addition, some base line clinical and microbiological data for these patients are presented. The distribution of P1I and GI scores tended to be highest for molars, with the remaining teeth having similar scores. Probing depth measurements were greater for mesio‐distal than oro‐vestibular recordings. A bilaterally symmetrical pattern of increasing probing depth was noted from the midline distally on mesio‐distal as well as oro‐vestibular surfaces. Sites positive for the target organisms listed above tended to have greater probing depths (mean: 4.14 ± 0.1 mm) than non‐infected sites in the same patients (mean: 3.76 ± 0.1 mm) or comparable sites in non‐infected patients (mean: 3.54 ± 0.1 mm).
Tooth Loss in Patients With Moderate Periodontitis After Treatment and Long–Term Maintenance Care
Authors: Wood Walter R. , Greco George W. , McFall Walter T.
Published: March 2012

Records of 63 patients diagnosed as having moderate Periodontitis who had been treated and maintained by scaling and root planing for 10 years or longer (mean 13.6 years, range 10 to 34 years) in dental school clinics were reviewed for tooth loss. The patients averaged 45 years of age (range 24 to 67 years) at the initial appointment, and 41 were female. Record audit determined type of periodontal treatment, total tooth loss, periodontally related tooth loss, loss of teeth with furcation invasion, plaque scores, and maintenance interval. Results of therapy were evaluated by groups on the basis of number of teeth lost. At the completion of active periodontal therapy 1,607 teeth were present in the patients. During the maintenance period, 115 teeth (7.1 %) were lost and of these 88 (5.0%) were lost due to periodontal reasons. Maxillary and mandibular molar teeth, particularly maxillary second molars, were the teeth lost most frequently to periodontal disease. Of the 164 teeth initially indicated as having furcation invasion, 23% were subsequently lost. This retrospective study confirms the low rate of tooth mortality occurring when patients with periodontal disease are treated and kept on a maintenance program. Canines were the teeth least frequently lost. (J Periodontol 1989;60:516–520).
Total Hemolytic Complement (CH50) and Its Fractions (C3 and C4) in the Sera of Diabetic Patients With Periodontitis
Authors: Anil S. , Remani P. , Vijayakumar T. , Joseph Preethi A.
Published: March 2012

The total hemolytic complement activity (CH50) and its fractions C3 and C4 were determined in 50 patients with Type II or non‐insulin dependent diabetes mellitus (NIDDM) and 50 nondiabetic patients with periodontitis. The values were compared with those of 50 age and sex matched controls. An elevation of CH50 was observed in both the diabetic and nondiabetic patients, compared to controls. The diabetic patients with periodontitis showed a significantly higher complement activity compared to nondiabetic patients with periodontitis. The C3 and C4 values were significantly elevated in both diabetic and nondiabetic patients when compared with the control group. The elevation being more pronounced in diabetic groups. J Periodontol 1990;61:27–29.
A Mineral‐Related Feature of Young Plaque Characteristic to Periodontitis‐Affected Adults
Authors: Sewón Liisi , Söderling Eva , Karjalainen Sára
Published: March 2012

The calcium concentration of 3‐day‐old total supragingival plaque in periodontitisaffected adults (n = 12) and their age and sex‐matched periodontitis‐free pairs was compared. The young plaque of the periodontitis‐affected adults contained more calcium per protein (P < 0.025, sign test) than that of the periodontitis‐free pairs. The findings of the present study may suggest that high Ca‐content of supragingival plaque is connected to the development of adult periodontitis. J Periodontol 1990;61:42–44.
Microbiology in Diagnosis and Treatment of Severe Periodontitis. A Report of Four Cases
Authors: Goené R.J. , Winkel E. G. , Abbas F. , Rodenburg J.P. , van Winkelhoff A.J. , de Graaff J.
Published: March 2012

The purpose of this report is to illustrate the use of microbiology in the diagnosis and treatment in four cases of severe adult periodontitis. All four patients were subgingivally infected with Actinobacillus actinomycetemcomitans which was the basis for an adjunct minocycline therapy. Scaling and root planing plus minocycline were not able to establish a clinically stable periodontal condition. A. actinomycetemcomitans was not eliminated from the pockets in any of the patients. Good clinical and microbiological results were obtained after continuous conventional treatment with an adjunct therapy of metronidazole plus amoxycillin. With a 7 day course of this antibiotic therapy, the pockets of all four patients became free of A. actinomycetemcomitans and were still negative on repeated sampling on recall visits. Microbiological monitoring of severe periodontitis in adults seems to be a valuable adjunct to clinical examination. Furthermore, effective antibiotic therapy in A. actinomycetemcomitans‐associated periodontitis appears of paramount importance in obtaining a stable periodontal situation. J. Periodontol 1990;61:61–64.
Production of Immunoglobulins in Gingival Tissue Explant Cultures From Juvenile Periodontitis Patients
Authors: Hall Eric R. , Falkler William A. , Suzuki Jon B.
Published: March 2012

B lymphocytes and plasma cells are histologically observed in granulomatous periodontal tissues of juvenile periodontitis (JP) patients. Local immune processes may participate in protective or immunopathologic roles in the pathogenesis of this disease. An in vitro expiant culture system was utilized to demonstrate the production of Immunoglobulins by diseased JP tissues. Immunodiffusion studies using goat anti‐human gamma, alpha, or mu chain serum revealed IgG to be the major Immunoglobulin present in 92% of the day 1 supernatant fluids (SF) of the 47 JP gingival tissue expiant cultures. IgA was present in 15% of the SF; however, no IgM was detected. Staph Protein A isolated 14C‐labeled IgG from the SF, when allowed to react with goat anti‐human gamma chain serum, formed lines of precipitation. Positive autoradiographs confirmed the biosynthesis of IgG by the expiant cultures. The in vitro gingival tissue expiant culture system described provides a useful model for the study of localized Immunoglobulins produced by diseased tissues of JP patients. J Periodontol 1990;61:603–608.
HTR Polymer Grafts in Human Periodontal Osseous Defects. I. 6‐Month Clinical Results
Authors: Yukna Raymond A.
Published: March 2012

htr polymer was evaluated as a grafting material in periodontal osseous defects in 21 adult patients. Following initial preparation and pre‐surgical documentation with standardized measurements, radiographs, and photographs, vertical osseous defects were treated with surgical open flap debridement alone (DEBR) or with DEBR plus placement of HTR polymer graft material. Patients were followed with frequent recalls until surgical re‐entry at about 6 months for documentation and any needed remedial therapy. Re‐entry data show that use of HTR polymer grafts resulted in significantly better mean defect fill of 2.2 mm (60.8%) compared to 1.0 mm (32.2%) with DEBR alone (P <.001). Other hard tissue findings such as residual defect depth, crestal resorption, and percent defect resolution showed similar clinically superior results with the use of HTR polymer. Soft tissue findings showed significant differences in favor of HTR for decrease in probing depth and gain in clinical attachment. These results are similar to those reported with other graft materials. Over a 6‐month period, HTR polymer was found to show promise for the repair of periodontal osseous defects. J Periodontol 1990;61:633–642.
Oxidized Cellulose Mesh Used as a Biodegradable Barrier Membrane in the Technique of Guided Tissue Regeneration. A Case Report
Authors: Galgut Peter N.
Published: March 2012

In this case study oxidized cellulose mesh was shown to have potential for use as a biodegradable barrier membrane for regenerative procedures in furcation areas and interdental infrabony defects. The material was customized so as to protrude coronally to the soft tissue flaps and interdentally after surgery. The material resorbed and normal healing took place with crevicular depths less than 2 mm by 1 month postoperatively. By 6 months postoperatively, 2 of the sites showed crevice depths of 3 mm. Initially there was negligible recession, except in one site, but by 6 months after surgery some recession of the tissues had occurred, and the furcation regions remained resistant to probing. It is, therefore, concluded that this material may have the potential for use as a biodegradable membrane in the technique of guided tissue regeneration. J Periodontol 1990; 61:766–768.
Morphologic and Histochemical Characteristics of the Dental Cuticle in Teeth Affected by Prepubertal Periodontitis
Authors: López Néstor J. , Gigoux Carlos , Canales María L.
Published: March 2012

A study was undertaken to determine the nature and composition of the cuticle found in teeth with generalized prepubertal periodontitis (PP). This was accomplished by using histological and histochemical methods on decalcified specimens. Forty‐six permanent teeth which were extracted from three prepubertal periondontitis patients (siblings) were used. Nineteen of the 46 teeth were obtained with the facial or interdental gingiva. As a control, 20 healthy teeth extracted from 10 children for orthodontics reasons, and 22 teeth affected by terminal adult periodontitis (AP), were used. All the teeth with PP showed a thick coat covering the root surface from the cemento‐enamel junction to the junctional epithelium. In some teeth the cuticle extended a few μm coronally to the cemento‐enamel junction. The cuticle had a thickness which varied between 10 to 80 μm. It usually presented a very regular surface in the coronal portion of the root, and showed laminations suggesting appositional growth. In the middle and apical portions of the root exposed to the pocket, the cuticle was lobular with a very irregular surface and was covered with a thick microbial plaque. The staining reactions indicated that the cuticle was made of proteins probably derived from the inflammatory exudate. None of the healthy teeth examined nor those affected by AP showed a cuticle similar to those with PP. The cuticle formed on the teeth with PP appears to be an abnormal structure of proteinaceous nature, characteristic of these teeth, and may possibly play a role in the pathogenesis of the disease. J Periodontol 1990:61:95–102.
A Contemporary Perspective on Techniques for the Clinical Assessment of Alveolar Bone
Authors: Hausmann Ernest
Published: March 2012

Radiographic techniques, traditional ones as well as newer ones under development, for clinically assessing alveolar bone are critically assessed. Traditional intraoral radiography is reexamined, in particular with regard to the accuracy with which the alveolar crest is seen. Evidence is presented for a more accurate representation of the aveolar crest on bitewings rather than periapical films. Application in periodontics of newer radiographic techniques, subtraction radiography, and single and dual photon aborptiometry presently under clinical development are discussed in regard to their potential and limitations. Similarly, radiopharmaceuticals to evaluate the metabolic status of alveolar bone are discussed as well as the potential for using analyses of gingival crevice fluid as a window for assessment of alveolar crest metabolism. J Periodontol 1990;61:149‐156.
Sorption of Fibronectin to Human Root Surfaces In Vitro
Authors: Mendieta C. , Caravana C. , Fine D.H.
Published: March 2012

The purpose of this study was to determine the conditions that favor the sorption and retention of human plasma fibronectin to cementum. Rectangular root segments prepared from teeth extracted for orthodontic reasons were mounted on a capillary pipette and immersed in solutions of 125I fibronectin for assay of cementum sorption under various conditions. Kinetic studies showed sorption to be rapid, with 77% of the maximum fibronectin sorption occurring within 1 minute. Fibronectin sorption was reduced when added in conjunction with serum and was inhibited by monovalent ions (such as sodium), but enhanced in the presence of divalent cations (such as calcium). Exposure of cementum to serum partially blocked subsequent sorption of fibronectin, while cementum bound fibronectin was eluted by subsequent exposure to serum. Treatment of cementum with citric acid pH 1.1 (4 minutes) followed by 5% sodium hypochlorite (5 minutes) caused a significant increase in fibronectin sorption with maximum retention upon subsequent exposure to serum (P <0.05). Fibronectin sorption to cementum was: rapid, electrostatic in nature, competitive, reversible, Ca++ ‐facilitated, and maximized by prior treatment of the root with citric acid and sodium hypochlorite. It is concluded that sorption of fibronectin to cementum can be achieved for clinical gain; however, conditions of application can significantly influence both accumulation and subsequent release of root sorbed material. J Periodontol 1990; 61:254–260.
Osseo‐Integrated Implant Treatment of a Patient With Rapidly Progressive Periodontitis. A Case Report
Authors: Malmstrom Hans S. , Fritz Michael E. , Timmis David P. , Van Dyke Thomas E.
Published: March 2012

The case report presented describes placement of osseointegrated fixtures in a patient with a probable history of rapidly progressive periodontitis. A 12‐year history is presented. The post‐operative sequelae of placing fixtures in a fully edentulous maxilla and partially edentulous mandible were the worst seen by the Implant Team at Emory University. The hypothesis presented is that patients with aggressive forms of periodontal disease should be subjected to appropriate mechanical and antimicrobial therapy to produce a healthy oral flora before any implants are placed. J Periodontol 1990;61:300– 304.
A Case of Ameloblastoma Presenting as an Exophytic Gingival Lesion
Authors: Stevenson Alastair R. L. , Austin Bruce W.
Published: March 2012

Ameloblastomas are predominantly benign, intra‐osseous odontogenic tumors and mucosal involvement is a rare secondary phenomenon, occurring only after a long period of intra‐osseous growth and bone expansion. A case is reported of an intra‐osseous multicystic (solid) ameloblastoma which presented as an exophytic gingival lesion in the left mandibular third molar region. A classification of exophytic gingival lesions is presented and the clinical features and management of ameloblastomas discussed. J Periodontol 1990;60:378‐381.
Microscopic Characterization of Root Surface‐Associated Microbial Plaque in Localized Juvenile Periodontitis
Authors: Douglass Kelly D. , Cobb Charles M. , Berkstein Sergio , Killoy William J.
Published: March 2012

The purpose of this investigation was to characterize by scanning electron microscopy, the microbial morphotypes associated with the roots of teeth from patients exhibiting localized juvenile periodontitis (LJP). Eighteen teeth were examined from 10 adolescent patients who satisfied the standard clinical diagnostic criteria for LJP. The microscopic evaluation was facilitated by dividing that portion of the root exposed to the periodontal pocket into coronal, middle, and apical one‐thirds. Controls consisted of an equal number of teeth matched as to pocket depth and anatomical type obtained from patients exhibiting adult periodontitis (AP). All specimens were coded and examiners were unaware of their origins. Results of the SEM evaluation revealed little difference in microbial morphotypes comprising the root associated plaque in the coronal one‐third of LJP specimens when compared to the AP controls. The dominant microbial morphotypes were cocci, short and long rods, filamentous microorganisms, and spirochetes. However, microbial plaque located in the middle and apical one‐third root zones of LJP specimens was distinctly different than that of AP specimens. In the deeper pocket zones the dominant microbial morphotypes in LJP specimens were limited to cocci, short rods, coccobacilli, and various sized spirochetes. In contrast, AP specimens exhibited a collection of microbial morphotypes consisting of cocci, short rods, long rods, filamentous organisms and spirochetes. Calculus was found on the root surfaces of all specimens regardless of disease category although, as a group, the LJP specimens featured lesser amounts. Although areas of root resorption were common in both LJP and AP groups, they were more frequently observed in LJP specimens, likely associated with the generally less confluent deposits of calculus and plaque. J Periodontol 1990; 61:475–484.
Microbiological and Immunological Aspects of Experimental Periodontal Disease in Rats: A Review Article
Authors: Klausen Bjarne
Published: March 2012

Animal models in which microbiological and immunological aspects of periodontal disease can be studied prospectively seem well warranted. The rat bears much resemblance to man with respect to periodontal anatomy, development and composition of dental plaque, histopathology of periodontal lesions, and basic immunobiology. Furthermore, reproducible methods are available for assessment of periodontal disease in rats, and detectable periodontal destruction can be induced in a few weeks in these animals without traumatizing periodontal tissues with ligatures. Experimental periodontitis studies in germ‐free rats have confirmed the pathogenicity of several suspected periodontal pathogens (Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Capnocytophaga sputigena, Eikenella corrodens, and Fusobacterium nucleatum). The studies also suggest that the number of periodontal pathogens may be higher than generally believed, since species like Streptococcus sobrinus and Actinomyces viscosus are associated with periodontal bone loss in rats. Studies in rats with congenital or induced immune defects indicate that generalized or selective immunosuppression at the time of infection with periodontal pathogens may aggravate periodontal disease. Studies in immunized rats indicate that periodontal disease can be prevented by immunization against periodontal pathogens. However, it is also possible by immunization to induce periodontal destruction; i.e., the immune system has a destructive potential which should not be overlooked. In the future, the rat model may prove valuable for initial screening of antigen preparations and immunization regimens in the search for a periodontitis vaccine. J Periodontol 1991;62:59–73.
Histologic Evaluation of Combining Tetracycline and Allogeneic Freeze‐Dried Bone on Bone Regeneration in Experimental Defects in Baboons
Authors: Drury Gerald I. , Yukna Raymond A.
Published: March 2012

Tetracyclines (TTC) have been used both systemically and locally during periodontal bone grafting procedures, but previous work regarding the effect of TTC on new bone formation has been contradictory. The purpose of this study was to determine if the use of locally applied TTC in combination with freeze‐dried bone allografts (FDBA) would enhance bone regeneration in an experimental alveolar bone osseous defect grafting system. Pre‐weighed freeze‐dried bone allograft particles (300‐500 μ diameter) were placed in nylon mesh chambers (250 μ pore size) and rehydrated with either 10 μg/ml aqueous TTC or sterile distilled water. Empty chambers were used as further controls. The chambers were placed in the posterior mandible of baboons in surgically created windows. After 3 and 5 weeks, the chambers were retrieved, processed histologically, and analyzed histometrically for new bone formation. The TTC‐rehydrated FDBA demonstrated much greater (> 5 x) new bone formation than the water rehydrated FDBA. These results strongly suggest that locally‐applied TTC in combination with FDBA enhances new bone formation in experimental alveolar bone defects. J Periodontol 1991; 62:652–658.
Guided Tissue Regeneration for Implants Placed Into Extraction Sockets: A Study in Dogs
Authors: Becker William , Becker Burton E. , Handelsman Mark , Ochsenbein Clifford , Albrektsson Tomas
Published: March 2012

Twelve 10 mm implants were placed into immediate extraction sockets in dogs. Six implants were isolated with PTFE membranes and 6 sites served as controls. Standardized clinical measurements were taken at test and control sites. At 18 weeks the dogs were anesthetized and flaps were laid for the purpose of obtaining clinical measurements. The average gain of bone around augmented implants was 2.6 mm, while control sites had an average bone gain of 1.0 mm. Ridge width adjacent to augmented sites increased by 1.2 mm and control sites had an increased width of 0.6 mm. Histologic evaluation of test and control specimens showed greater bone formation around augmented implants. Implants augmented with PTFE membranes had clinically significant amounts of bone regeneration when compared with controls. J Periodontol 1991; 62:703–709.
The Gingival Immune Response to Actinobacillus actinomycetemcomitans in Juvenile Periodontitis
Authors: Hall Eric R. , Falkler William A. , Martin Stephen A. , Suzuki Jon B.
Published: March 2012

The established and advanced lesions of juvenile periodontitis‐localized form (JP) are predominated by B‐lymphocytes and plasma cells. Local immune processes may participate in protective or immunopathologic roles in the pathogenesis of this disease. Actinobacillus actinomycetemcomitans (A.a.) is implicated as a primary etiologic agent in JP. An in vitro gingival explant culture system was utilized to study the specificity of Immunoglobulins produced by diseased JP tissues. A dot‐immunobinding assay demonstrated that 46% of the supernatant fluids (SF) from expiant cultures of diseased tissues (n = 39) were positive for the presence of antibody to A.a. Y4, while 61% of autologous JP sera (n = 39) tested positive. For rapidly progressive (RP) and adult periodontitis (AP) SF, 50% and 40% were positive for A.a. Y4, respectively. Seventeen percent of SF from healthy tissue were positive for A.a. Y4. There was no significant difference between JP SF reactivities to A.a. Y4 when compared to reactivities of SF from AP and RP patients. Only 10% of JP SF were positive for Porphyromonas asaccharolytica, a non‐oral control microorganism. The de novo biosynthesis of antibody in JP tissue, reactive with A.a. Y4, was demonstrated with Staph Protein A isolated 14C‐labeled IgG (SPAG) and the use of a dot‐immunobinding assay and autoradiography. The in vitro gingival tissue expiant culture system described provides a useful model for the study of the synthesis and specificity of localized Immunoglobulins produced by diseased tissues of JP patients. J Periodontol 1991; 62:792–798.
Discriminating Power of Five Plaque Indices
Authors: Quirynen Marc , Dekeyser Christel , van Steenberghe Daniel
Published: March 2012

Since plaque plays a major role in the development of periodontal inflammation, special attention is paid to its composition and quantity. Several indices have been designed for the quantification of the supragingival plaque. The aim of the present study was to compare the utility and discriminating power of five such plaque indices. In 14 subjects, three teeth were selected randomly on which the undisturbed plaque formation was studied over a period of 96 hours. This examination was performed twice, the first time after induction of gingivitis and a second time starting with a healthy gingiva. It is known that in the presence of gingival inflammation, the plaque growth rate slightly increases. Plaque formation was estimated at several visits with the following indices: Harrap index, Quigley and Hein index, Navy index modified by Clemmer and Barbano, Navy index modified by Hancock and Wirthlin, and a planimetrical plaque scoring system. The path of the plaque growth curve was found to depend on the selected plaque index, going from an exponential curve (planimetry) over an sigmoidal curve (Harrap index, Navy index modified by Hancock and Wirthlin) to a nearly linear relation (Quigley and Hein, Navy index modified by Clemmer and Barbano). By comparing the plaque scores on patients with healthy gingiva with those from patients with inflamed gingiva, it was found that the planimetrical plaque index had a clearly higher discriminating power. It was concluded that the choice of an index for the measurement of the plaque extension depends on the goals of the study. J Periodontol 1991; 62:100–105.
The Effects of Erythrosine on Alveolar Bone and Gingival Connective Tissue in Dogs
Authors: Rapley John W. , Brunsvold Michael A.
Published: March 2012

This study was conducted to determine if erythrosine had any effect when placed in contact with alveolar bone and gingival connective tissue in dogs in conjunction with a periodontal surgical procedure. Periodontal surgery was performed on 15 dogs, with a mucoperiosteal flap affording access for introduction of erythrosine (test) or saline (control) solutions, and subsequent flap replacement. The dogs were sacrificed at 2, 7, 10, 14, 21, and 28 days. Autopsy specimens were prepared, stained, sectioned, and examined by light microscopy. The general amount, degree, and type of inflammatory infiltrate was evaluated and recorded. Erythrosine had no apparent effect on the clinical healing time, alveolar bone, or gingival connective tissue in regard to the general degree, type, and location of the inflammation infiltrate based on postsurgical observations. J Periodontol 1991; 62:132–134.
Binding, Uptake, and Release of Nicotine by Human Gingival Fibroblasts
Authors: Hanes Philip J. , Schuster George S. , Lubas Scott
Published: March 2012

Previous studies of the effects of nicotine on fibroblasts have reported an altered morphology and attachment of fibroblasts to substrates and disturbances in protein synthesis and secretion. This altered functional and attachment response may be associated with changes in the cell membrane resulting from binding of the nicotine, or to disturbances in cell metabolism as a result of high intracellular levels of nicotine. The purpose of the present study, therefore, was to 1) determine whether gingival fibroblasts bound nicotine and if any binding observed was specific or non‐specific in nature; 2) determine whether gingival fibroblasts internalized nicotine, and if so, at what rate; 3) determine whether gingival fibroblasts also released nicotine back into the extracellular environment; and 4) if gingival fibroblasts release nicotine intact or as a metabolite. Cultures of gingival fibroblasts were prepared from gingival connective tissue biopsies. Binding was evaluated at 4° C using a mixture of 3H‐nicotine and unlabeled nicotine. Specific binding was calculated as the difference between 3H‐nicotine bound in the presence and absence of unlabeled nicotine. The cells bound 1.44 (± 0.42) pmols/106 cells in the presence of unlabeled nicotine and 1.66 (± 0.55) pmols/106 cells in the absence of unlabeled nicotine. The difference was not significant. Uptake of nicotine was measured at 37° C after treating cells with 3H‐nicotine for time periods up to 4 hours. Uptake in pmols/106 cells was 4.90 (± 0.34) at 15 minutes, 8.30 (± 0.75) at 30 minutes, 12.28 (± 2.62) at 1 hour and 26.31 (± 1.15) at 4 hours. The efflux or release of nicotine was evaluated after treating cells with 3H‐nicotine for 4 hours and then measuring the amount of 3H‐nicotine released into fresh non‐radioactive medium over a 2‐hour period by direct scintillation counting of aliquots of medium and by chromatographic analysis of medium samples. Cells released nicotine back into the medium at a rate much slower than the rate of uptake, and the majority of nicotine released by the cells over the 2‐hour period was in the form of nicotine rather than a metabolite. At earlier time points, a greater percentage of the 3H isotope separated chromatographically before 3H‐nicotine, suggesting an association of the nicotine with intracellular vesicles or other intracellular components. The results of this study suggest that, although nicotine does bind to gingival fibroblasts, this binding is non‐specific, and that the uptake of nicotine by these cells is continuous over 4 hours, providing high intracellular levels. In addition, gingival fibroblasts also release nicotine, apparently unmetabolized, back into the medium. However, an apparent association of the nicotine with intracellular components seems to result in the development of high intracellular levels of nicotine which may interfere with normal cellular functions. J Periodontol 1991; 62:147‐152.
Clinical Effects of Closed Root Planing Compared to Papilla Reflection and Fiber Optic Augmentation
Authors: Reinhardt Richard A. , Johnson Georgia K. , DuBois Linda M.
Published: March 2012

Mini‐surgical approaches in 4 to 7 mm probing depths have been shown to facilitate improved deposit removal as compared to closed instrumentation. At the same time this treatment is less traumatic than more extensive flap reflection for root planing. The purpose of this study was to compare the clinical effects of closed root planing (C/SCRP) to those of root planing augmented by papilla reflection and fiber optic illumination (PR/ SCRP) over a 6‐month period. Fourteen patients with moderate/advanced adult periodontitis received each therapy in 2 experimental periodontitis sites (PS = ≥ 5 mm probing depth and > 5 mm attachment loss) and one non‐periodontitis site (NPS = ≤ 3 mm probing depth and no recession). Presence of supragingival plaque, bleeding on probing, probing depths, and clinical attachment levels were measured before treatment and 6, 12, and 24 weeks posttreatment. Mean supragingival plaque levels were high and did not vary significantly over the course of the study, but bleeding on probing was significantly reduced in PS following both C/SCRP and PR/SCRP (P ≤ 0.0001). Mean probing depths were significantly reduced after 6 months (P ≤ 0.01) in NPS‐PR/SCRP from 2.8 ± 0.1 to 2.0 ± 0.2 mm, in PS‐C/SCRP from 5.5 ± 0.2 to 4.5 ± 0.4 mm, and in PS‐PR/SCRP from 5.8 ± 0.2 to 3.2 ± 0.1 mm. In periodontitis sites, PR/SCRP demonstrated greater probing depth reductions than C/SCRP at all time periods (P ≤ 0.004). PS attachment levels also improved following C/SCRP and PR/SCRP at all postoperative times (P ≤ 0.01). PR/SCRP appears to provide better short‐term mean probing depth reduction (2.6 mm) than C/SCRP (1.0 mm), presumably due to apical positioning of the papillae and periodontal repair following improved access for root planing. J Periodontol 1991; 62:317–321.