bluuebunny/crossref_metadata_2025 huggingface dataset:
Healing after Application of Tissue‐Adhesive Material to Denuded and Citric Acid‐Treated Root Surfaces
Authors: Caton J. G. , Polson A. M. , Prato G. Pini , Bartolucci E. G. , Clauser C.
Published: March 2012

This study was undertaken to evaluate the effects of a commercially available tissue adhesive upon healing of the coronal periodontium. In four squirrel monkeys, 24 teeth were extracted, and the coronal third of the roots planed free of fibers and cementum. Eight teeth were replanted without further alteration and eight were coated with tissue adhesive prior to replantation. In the remaining eight teeth, the planed surface was decalcified, coated with tissue adhesive and replanted. Histological observations were made at 1 and 7 days after replantation. In the teeth replanted after root planing alone and root planing plus tissue adhesive, epithelium migrated apically and was within the ligament space lining the denuded root at 7 days. In contrast, those teeth which were decalcified prior to application of tissue adhesive demonstrated fiber attachment to the planed root surface and little or no epithelial downgrowth.
Oral Leiomyomas: Review of the Literature and Report of a Case of Palatal Angioleiomyoma
Authors: Svane Todd J. , Smith Brian R. , Cosentino B. J. , Cundiff E. James , Ceravolo Joseph J.
Published: March 2012

A rare case of angioleimyoma of the palate is reported. A review of the literature shows that of a total of 116 previously reported cases of oral leiorayomas, only 19 were palatal angioleiomyomas.
Mucosal Induction of Systemic T Cell Tolerance by Fusobacterium nucleatum
Authors: Keys J. M. , Lupton I. M. , Gemmell E. , Bird P. S. , Seymour G. J.
Published: March 2012

The present study was undertaken to determine if mucosal presentation of the periodontopathic bacterium Fusobacterium nucleatum could induce systemic tolerance. Two separate protocols of mucosal priming were carried out. In the first, mice were gastrically intubated on 2 consecutive days; this was repeated 5 days later. In the second protocol, mice were similarly primed but received another priming dose after a further 7 days. Positive control mice were similarly primed with sheep red blood cells (SRBC) while negative control animals were sham‐primed with saline. Following mucosal priming, mice were systemically sensitized with the respective antigen and then subsequently challenged in the left hind footpad. The right footpad was challenged with saline and served as a negative control. Serum antibody levels were measured using enzyme‐linked immunoabsorbent assay (ELISA) and haemagglutination assays.

Mucosal priming with F. nucleatum was found to suppress the local delayed type hypersensitivity reaction as determined by footpad measurements. Sham‐priming did not suppress the local response. On the other hand, the levels of serum antibodies were not influenced by mucosal priming. These results suggest that under the experimental conditions used, mucosal presentation of F. nucleatum can induce a degree of split tolerance in which T cell responses are suppressed while B cell responses remain intact. The implication of this finding to human periodontal disease is yet to be determined.
A Comparison of Alveolar Bone in Young and Aged Mice
Authors: Barnett Nancy A. , Rowe Dorothy J.
Published: March 2012

To study the relationship between aging and alveolar bone lOSS, the periodontia of young (12‐week‐old) and aged (94‐week‐old) C57B1/6 Nia mice were compared, giving special attention to the alveolar bone. The tibiae were also examined to distinguish local from systemic bone changes.

The mean area of interproximal bone between the first and second mandibular molars was significantly less in the aged mice than in the young mice. While there was no difference in the distance from the cementoenamel junction (CEJ) to the alveolar crest, the width of the interproximal bone was narrower in the aged animals. The cross‐sectional width of the tibia was also reduced in the aged mice, although the total bony area remained constant. In both groups of animals, the distance from the apical extent of the inflammatory infiltrate to the alveolar crest was similar suggesting that alveolar bone loss was not related to inflammation. Other histologic features observed in the teeth of the aged mice, which may have influenced the amount of alveolar bone, were mesial tilting and distal drifting, occlusal wear, and passive eruption. These findings suggest that the greater bone loss in the aged mice may be more related to the aging process and to the functional changes of tooth movement associated with aging than to periodontal disease.
Atypical Localized Juvenile Periodontitis: A Case Report and Review of Current Treatment Considerations
Authors: Sterrett John D.
Published: March 2012

An atypical case of localized juvenile periodontitis is presented. The case exhibits a unique distribution of osseous defects, an unusually high dental lesion incidence, and an atypical Gram‐staining and morphologic subgingival microflora. Past and current treatment regimens are reviewed. Based on our current understanding of the pathogenesis of juvenile periodontitis and the therapeutic effects of antibiotic and surgical treatment, a temporal treatment regimen is proposed which would overlap instead of superimpose effective stages of therapy.
Subgingival Microflora and Periodontal Conditions in Healthy Teenagers
Authors: Asikainen Sirkka , Alaluusua Satu , Kari Kirsti , Kleemola‐Kujala Eija
Published: March 2012

The composition of subgingival flora was correlated with clinical periodontal conditions in 100 teenagers aged 12 to 17 years. The Community Periodontal Index of Treatment Needs (CPITN) was used for the clinical examination. Subgingival bacterial samples were taken from the mesial surface of each first molar, two samples for dark‐field microscopy and two samples for Actinobacillus actinomycetemcomitans (A.a.) cultivation.

Fifty‐nine subjects had at least three healthy sextants. Score 1 was the highest CPITN recording in 61 subjects and Score 2 in 30 subjects. None had scores 3 or 4. In dark‐field microscopy, cocci predominated in most samples. Straight rods, fusiforms and motile rods correlated negatively to the number of healthy sextants per subject. Straight rods and fusiforms showed a positive correlation to gingival bleeding tendency at the sampled site. A.a. was isolated in four subjects.

Motile microorganisms and A.a. were detected rarely in subjects with good periodontal conditions.
The Effects of a Dentifrice Containing Zinc Citrate and 2,4,4' Trichloro‐2'‐Hydroxydiphenyl Ether
Authors: Saxton C.A.
Published: March 2012

The effects of a dentifrice which contained 1% zinc citrate and 0.5% of a nonionic antimicrobial agent, 2,4,4' trichloro‐2'‐hydroxydiphenyl ether on plaque and gingival health have been investigated. In a 4‐day nonbrushing study in which dentifrices were used as slurries, this dentifrice inhibited plaque accumulation significantly more than dentifrices which contained either zinc citrate or Triclosan separately.

In a 28‐day double‐blind cross‐over study, a significant reduction in plaque accumulation and improvement in gingival health was demonstrated for the test dentifrice compared to the placebo. The effect was demonstrated with a group of well motivated volunteers who had a good standard of oral health. Analysis of the data suggested that the benefit might be extended to a less motivated population.
Effect of Lyophilized Autologous Plasma on Periodontal Healing of Replanted Teeth
Authors: Nasjleti Carlos E. , Caffesse Raul G. , Castelli Walter A. , Lopatin Dennis E. , Kowalski Charles J.
Published: March 2012

The purpose of this histologic and autoradiographic study of replanted teeth was (1) to evaluate the beneficial effect, if any, of lyophilized autologous plasma (LAP) application on periodontal healing and (2) to re‐examine rates of repair in different areas of the associated periodontium following replantation. Maxillary and mandibular incisors and premolars of three rhesus monkeys were used. Teeth were extracted with forceps and placed in sterile physiologic saline. After 5 minutes each tooth was returned to its socket and immobilized by interproximal acid‐etch splints. Splints were removed after 1 week. Of the 48 replants performed, 24 (controls) were replanted as described. Of the 24 experimental teeth, during the 5 minute interval between tooth extraction and replantation, the root surface and the inner socket walls were bathed with 1 ml of the reconstituted LAP‐saline solution (800 mg/ ml). Replants and animal sacrifice were scheduled to provide observations at 1, 3, 7, 14, 28 and 45 days following replantation. One hour prior to sacrifice, each monkey received an intravenous injection of tritiated thymidine, 1 μCi/gm body weight. Tissue specimens were processed for evaluation following standard procedures. Eight replanted teeth were available for evaluation for each of the six time‐points. Four teeth were treated with LAP and four without it. Histologically, tissue sections were examined for (1) epithelial proliferation and attachment, (2) periodontal fibers organization and maturation, (3) inflammatory cell types, (4) presence or absence of cementum resorption and dentoalveolar ankylosis and (5) degree of vascularity of the tissues. For autoradiographic evaluation, the periodontium associated with the replanted tooth was divided into nine spatial cell compartments. In each compartment, labeled tissue cells, epithelial or connective, were counted and recorded. Differences between the control (untreated) replanted teeth and the LAP‐treated teeth, at each timepoint and within each compartment, were analyzed for significance using the paired t‐test. The findings of this study indicate that LAP use enhanced healing by (1) early replacement of the fibrin clot, (2) increased connective tissue cell proliferation, (3) reduction of the inflammatory response and (4) inhibition of root cementum resorption. Periodontal healing and repair occurred more rapidly in the supracrestal or transseptal connective tissue region than within the periodontal membrane space.
Infantile Agranulocytosis with Survival into Adolescence: Periodontal Manifestations and Laboratory Findings
Authors: Lamster Ira B. , Oshrain Richard L. , Harper D. Scott
Published: March 2012

A case of infantile agranulocytosis with survival into adolescence is presented. The polymorphonuclear leukocyte is considered an important source of lysosomal enzymes in gingival crevicular fluid, and evaluation of connective tissue‐degrading enzymes in the fluid was performed. The activity of β‐glucuronidase, a ground substance‐degrading enzyme that may serve as a marker for polymorphonuclear leukocytes, was markedly reduced in the fluid compared to samples from systemically healthy adults with periodontitis. The activities of the ground substance‐degrading enzyme arylsulfatase, and collagenase, were in the lownormal range. The plaque microbiology, as characterized by dark‐field microscopy and selective culturing, was consistent with advanced periodontitis. A review of the medical history revealed a series of bacterial infections since infancy. Improvement in the systemic health of the patient occurred at about the age of 15, and the intake of antibiotics to control infections was correspondingly reduced after this time. An exacerbation of the patient's periodontal disease, as evaluated by loss of alveolar bone on radiographs, occurred 1 to 2 years later. The progression of periodontal disease observed in this patient was apparently associated with the withdrawal of antibiotics administered for control of systemic (nonoral) infections.
Cell Proliferation after Flap Surgery, Root Conditioning and Fibronectin Application
Authors: Caffesse R. G. , Smith B. A. , Nasjleti C. E. , Lopatin D. E.
Published: March 2012

This study evaluated the effects of citric acid demineralization and autologous fibronectin application on cell proliferation after mucoperiosteal flap surgery. Three adult rhesus monkeys were used. After flaps were raised, the roots were surgically exposed and planed. Surfaces on the experimental sides were decalcified with citric acid, and after thorough rinsing, the inner aspect of the flaps and the roots were bathed with 1 ml of autologous plasma fibronectin in normal saline (400 μgm/ml) and the flaps sutured. Contralateral teeth, acting as controls, were treated only with the surgical procedure. One hour prior to sacrifice, the animals were injected with an intravenous injection of tritiated thymidine (1 μCi/gm body weight). Surgeries were staggered to produce the following time periods: 3, 7, 15, 21 and 28 days. After processing, autoradiographs were obtained for evaluation, and labeled cells were counted in five compartments at 400 ×: (1) oral epithelium, (2) crevicular area, (3) supracrestal connective tissue, (4) coronal periodontal membrane and (5) coronal bone marrow. Forty tissue sections per procedure (20 slides per tooth) were counted and means obtained for the three monkeys. Differences between experimental and control values were statistically evaluated for each component, at each time interval, using pairwise t tests. Fibronectin‐treated areas showed significantly increased cellular proliferation (P < 0.01) during the first 2 weeks, affecting mainly all the supracrestal tissues. Histologically, the establishment of a well‐organized fibrinous clot at 3 days was noted in these areas. Results show a faster healing after surgery with the use of citric acid and fibronectin. It was concluded that citric acid followed by fibronectin enhanced cellular proliferation.
Effect of Citric Acid and Various Concentrations of Fibronectin on Healing Following Periodontal Flap Surgery in Dogs
Authors: Smith B. A. , Smith J. S. , Caffesse R. G. , Nasjleti C. E. , Lopatin D. E. , Kowalski C. J.
Published: March 2012

The purpose of this histologic and histometric study was to examine the effect of citric acid and increasing concentrations of fibronectin on new connective tissue attachment following periodontal flap surgery. Full thickness, mucoperiosteal flaps were elevated in six healthy mongrel dogs. Two to 3 mm of alveolar bone were removed along the buccal aspect of the teeth in the mandible and into the interproximal areas of each surgical site. Cementum was removed from the exposed root surfaces and reference notches were inscribed into the roots at the margin of the recontoured bone. Citric acid, pH 1.0, was applied to the instrumented root surfaces for 3 minutes and rinsed with sterile saline. Both the root surfaces and the inner surface of the flap were then bathed in either sterile saline or increasing concentrations (0.38, 0.75 and 1.5 mg/ml saline) or exogenous fibronectin. All the flaps were returned to their original preoperative positions, secured using figure 8 sutures with 4– 0 braided silk and allowed to heal. Two dogs per time‐point were sacrificed at 1, 2 and 6 weeks after surgery. Block specimens of the surgical sites were demineralized and serial sections prepared for histologic and histometric evaluations. Histologically, tissue sections were examined for: (1) epithelial proliferation and attachment, (2) periodontal fiber organization and maturation, (3) inflammatory cell types, (4) presence or absence of new cementum deposition and (5) degree of vascularity of the tissues. Histometric measurements were taken: (1) from the root surface notch to the apical extent of the junctional epithelium and (2) from the apical extent of the junctional epithelium to the free gingival margin. The four treatment modalities were compared by the use of repeated measurement analysis of variance. When significant differences were found, the Newman‐Keuls procedure was used to make individual comparisons between each pair of mean values. Results of the study demonstrated a significant increase in new connective tissue attachment in all surgical sites where exogenous fibronectin had been added, but there was no obvious advantage in increasing the concentration of fibronectin above the plasma level (0.38 mg/ml).
Histologic and Clinical Responses to Porous Hydroxylapatite Implants in Human Periodontal Defects
Authors: Stahl S. S. , Froum S. J.
Published: March 2012

Twelve intrabony periodontal lesions in three volunteers received surgical debridement followed by site implantation of porous hydroxylapatite implants. These patients were followed over a total of a 1‐year observation period. Blocks of treated sites were surgically removed at 3 months, 6 months and 12 months after implantation.

Clinical observation indicated a reduction in pocket depth consisting of both recession and clinical gain of attachment. No ill effects were observed. Histologic examination of the treated sites showed ossification of the implant pores and the implant periphery as early as 3 months after implantation, which became pronounced 12 months after placement. At times, peripheral ossification linked with eresiai osseous seams. This ossification occurred in the presence of an adjacent root covering, long junctional epithelium, and thus there was no new attachment. On the other hand, this graft material offers the potential of increasing new bone mass within a human intrabony lesion.
Significance of the Width of Keratinized Gingiva on the Periodontal Status of Teeth with Submarginal Restorations
Authors: Stetler Kathy J. , Bissada Nabil F.
Published: March 2012

The purpose of this clinical study was to evaluate the periodontal condition of teeth having submarginal restorations associated with either narrow or wide zones of keratinized gingiva.

Fifty‐eight teeth in 26 individuals were selected and then divided into two groups according to the width of the keratinized gingiva at the midfacial aspect of the tested tooth. Group I consisted of 30 teeth with ≥2.0 mm, and Group II consisted of 28 teeth with <2.0 mm of keratinized gingiva. Each group was equally subdivided into subgroup “A” having teeth with a full coverage, subgingival type of restoration for at least 2 years, and subgroup “B” representing contralateral homologous teeth, in the same individual, with no subgingival restoration. Clinical examination of individual teeth included determination of plaque and gingival indices, gingival fluid, probing depth, bleeding tendency and bone level. Data were subjected to statistical analysis using the Student t test and a two‐way analysis of variance to determine any significant differences in variables between teeth with and without subgingival restorations, in narrow and wide zones of keratinized gingiva. The findings were: (1) teeth with subgingival restorations and narrow zones of keratinized gingiva showed statistically significant higher gingival scores than teeth having submarginal restorations with wide zones of keratinized gingiva. (2) Teeth without subgingival restorations showed no statistical difference between narrow and wide zones of keratinized gingiva (P > 0.05).
Clinical Effectiveness of a Dentifrice Containing Fluoride and a Citrate Buffer System for Treatment of Dentinal Sensitivity
Authors: McFall Walter T. , Hamrick Steven W.
Published: March 2012

Four test dentifrices were evaluated in a double‐blind investigation to determine their effect on dentinal sensitivity in 87 adult human participants. Baseline data were obtained by patient questionnaire, dental examination and by soliciting subjective responses to controlled osmotic, thermal and tactile stimuli. The four dentifrices were: (1) a placebo dentifrice, (2) a fluoride dentifrice containing 0.1% fluoride, (3) a 2% citrate buffered dentifrice in a pluronic gel and (4) a dentifrice containing 0.1% fluoride and 2% citrate buffer in a pluronic gel. Precipitated silica provided the abrasive for all dentifrices. Dentrifices were supplied to participants on a random basis, and participants were instructed to brush twice daily for 8 weeks. Responses to the three stimuli as accomplished at baseline were obtained at 2, 4 and 8 weeks on 81 participants. A statistically significant stimulus reduction was found between treatment groups to thermal stimulus at the 2‐month interval (P = 0.048) and to the tactile stimulus at 2 weeks (P = 0.019). Both the citrate dentifrice and the citrate/fluoride dentifrices demonstrated significant efficiency in reducing sensitivity.
Human Intraosseous Healing Responses to the Placement of Tricalcium Phosphate Ceramic Implants
Authors: Froum S. , Stahl S.S.
Published: March 2012

Five intrabony lesions in a 40‐year‐old healthy, white female patient suffering with severe periodontitis were removed en bloc, 13 to 18 months after flap debridement and graft placement. At the time of debridement, the position of the gingival margin and the most apically located calculus were notched in the root to serve as reference points. All lesions received tricalcium phosphate ceramic implants, and the lesions healed uneventfully. The sites were professionally cleaned frequently during the experimental period. At the time of block removal, clinical measurements demonstrated gingival recession (average = 2.6 mm) and a gain in clinical closure (average = 2.3 mm).

Histologic evaluation of step serial sections of these blocks showed limited presence of graft particles. The particles were surrounded by dense connective tissue. They did not induce inflammation, nor did they appear to enhance osteogenesis or cementogenesis. Closure of lesions was essentially done by a long junctional epithelium adhesion and limited evidence of new connective tissue—root attachment. In the 18‐month specimen, active root resorption was seen immediately apical to the junctional epithelium at a site demonstrating significant inflammation in some sections. Fibrils apparently arising from the resorbing dentinal wall were seen in these sections. Serial sections of this site showed cellular cementum and functional fiber attachment at the resorption sites. These variations in resorption/repair/ regeneration within the same surgical site were seen 18 months postsurgery and thus may reflect local tissue responses to inflammatory fluctuations rather than surgical sequellae.
Adenomatoid Hyperplasia of Mucous Salivary Glands
Authors: Brown Frederic H. , Houston Glen D. , Lubow Richard M. , Sagan Mitchell A.
Published: March 2012

Adenomatoid hyperplasia of the mucous salivary glands is an uncommon benign tumor of the oral cavity. Two cases of palatal involvement are presented. Since clinical differentiation between benign and malignant growth of the palate cannot be established, microscopic examination is necessary. The palate is the most common location of this lesion, and as such it is useful for the periodontist to be aware of this tumor.
Mucoperiosteal Flaps with and without Removal of the Pocket Epithelium
Authors: Smith Billy A. , Echeverri Mauricio , Caffesse Raul G.
Published: March 2012

The purpose of this study was to clinically evaluate the need for elimination of the pocket epithelium during mucoperiosteal flap surgery aimed at reattachment or readaptation. A split mouth design was used in 13 patients with two bicuspids and two molars included in each quadrant. Two surgical techniques were compared. One of the quadrants received a modified Widman flap with removal of the pocket epithelium, while the contralateral side received a crevicular flap without removing the pocket epithelium.

One month after the hygienic phase was completed, the following measurements were taken: Gingival Index, Plaque Index, gingival crevicular fluid flow, mobility, furcation involvement, level of attachment, pocket depth and gingival recession. In addition to these measurements, which were taken immediately prior to the surgery (baseline), 1‐ and 3‐month postsurgical measurements were also taken. Gingival recession was recorded immediately after the flaps were replaced and sutured. All data were analyzed statistically using paired t test and sign test.

The biometrie results showed that without the removal of the pocket epithelium, good clinical results relative to gain in clinical attachment levels and reduction in probing depth were achieved. Greater gingival recession occurred on the crevicular flap side postsurgically when compared to the modified Widman flap. The other clinical parameters remained the same at the three time intervals. This was true within each technique and when both techniques were compared.
The Effects of Antiformin‐Citric Acid Chemical Curettage on the Microbial Flora of the Periodontal Pocket
Authors: Forgast Lorraine B. , Gound Sherry
Published: March 2012

This study investigated the hypothesis that antiformin‐citric acid chemical curettage combined with scaling and root planing (SRP/AF) would significantly reduce pathogenic bacteria of the periodontal pocket when compared to scaling and root planing alone (SRP). Ten patients with moderate periodontitis participated. Four pockets per patient, one in each posterior sextant, were chosen. Pocket depths, attachment levels, and gingival index (GI) were measured. Bacterial samples were examined under dark‐field microscope for: (1) spirochetes, (2) motile rods, and (3) all others. A randomized four‐sextant treatment design was used. One sextant received no treatment, a second received SRP, and the two remaining sextants received identical treatments of SRP/AF. Of these two sextants, one was sampled at baseline and 12 weeks only in order to serve as an additional control. The remaining sextants were sampled at 1,4, 8, and 12 weeks. Both SRP and SRP/AF significantly reduced the percentage of spirochetes and motile rods. A significant reduction in GI and pocket depths was also noted. Attachment level showed no significant change. Results of both treatment groups showed no significant differences among any of the parameters. A comparison of the two SRP/AF groups indicated no significant difference among clinical or bacterial parameters due to sampling.
Calculus Removal by Scaling/Root Planing with and without Surgical Access
Authors: Buchanan Sally A. , Robertson Paul B.
Published: March 2012

We assessed the presence and extent of calculus on subgingival root surfaces of teeth that received scaling and root planing (S/RP) alone, S/RP with modified Widman flap, or no treatment. After extraction, each surface was examined to determine the pocket depth (PD), area of root surface exposed to the pocket (A), and amount of pocket area showing retained calculus (C). Calculus‐positive teeth (CPT) and surfaces (CPS) and percentage of pocket area occupied by calculus (C/A) were derived for each group. In general, CPT and CPS were significantly lower after S/RP with flap (37% and 14%, respectively) than after S/RP alone (62% and 24%). The advantage of S/RP with flap was greatest for facial and lingual surfaces and for anterior and premolar teeth. In both treatment groups CPS were similar over a pocket depth range of 0 to 6 mm. But in deeper pockets, CPS in teeth treated by S/RP with flap remained constant at 17% while after S/RP alone CPS increased linearly to approximately 45% at >8 mm. The mean C/A was essentially equal in both treatment groups (11%) and was not related to pocket depth.
A Longitudinal Study of Untreated Mucogingival Defects
Authors: Salkin Leslie M. , Freedman Arnold L. , Stein Marc D. , Bassiouny Mohammed A.
Published: March 2012

A study was conducted to observe the changes in areas with untreated mucogingival defects over a 4‐year period. Upon entering dental school, a group of freshman students were assessed for Plaque Index, Gingival Index, probing depth, and width of keratinized gingiva. These same students were reassessed for the same parameters at the end of their senior year.

Of the 112 sites in 39 individuals, 33 sites revealed a slight increase in keratinized gingiva, 69 sites were unchanged, and 10 sites showed a slight decrease. These changes were minimal and not statistically significant. The Plaque Index, Gingival Index, and probing depth mean values showed a small but statistically significant improvement.

In this group of students with a high degree of oral hygiene, areas with inadequate zones of attached gingiva were able to be maintained without further recession and without surgery.
The Treatment of Desquamative Gingival Lesions
Authors: Nisengard R. J. , Rogers R. S.
Published: March 2012

The treatment of desquamative gingival lesions is dependent on the correct diagnosis of the underlying disease, which is frequently dermatologic. This is determined by clinical observations, as well as by histologic and immunologic examination of gingival biopsy specimens. The recommended treatment of desquamative lesions caused by lichen planus, cicatricial pemphigoid (benign mucous membrane pemphigoid), pemphigus, and psoriasis, the most common dermatoses causing gingival lesions, is summarized on the basis of 62 cases and reports in the literature.
Periodontal Status and Bruxism
Authors: Hanamura Hiroyuki , Houston Frank , Rylander Harald , Carlsson Gunnar E. , Haraldson Torgny , Nyman Sture
Published: March 2012

This study investigated a possible association between bruxism and severity of periodontal disease. Subjects consisted of 51 patients (mean age 47.3 years) referred to the Department of Periodontology for treatment of moderate to severe periodontal disease (Perio‐group) and 40 patients (mean age 48.9 years) referred to the Department of Stomatognathic Physiology for treatment of symptoms related to bruxism (Bruxism‐group). Examination of the two groups included measurements of the alveolar bone height, probing attachment level, tooth mobility, and attrition of teeth. A questionnaire was also used to gain information on the patient's awareness of bruxism and tooth mobility.

Awareness of clenching and/or grinding was reported by 57% of patients in the Bruxismgroup and 24% of patients in the Perio‐group. The perio‐patients reported significantly higher frequency of tooth mobility than did the bruxism‐patients. Alveolar bone loss, attachment loss, and tooth mobility were significantly more pronounced in the Perio‐group than in the Bruxism‐group. The Bruxism‐group showed a higher frequency of tooth attrition than the Perio‐group. Periodontal disease and bruxism seldom occurred in the same individual, and the results indicate that the two phenomena are in general not closely associated.
Ultrastructural and Morphometric Analyses of Human Cementoblasts and Periodontal Fibroblasts
Authors: Yamasaki A. , Rose G. G. , Pinero G. J. , Manan C. J.
Published: March 2012

In order to elucidate the cytological characteristics of human cementoblasts which distinguish them from periodontal fibroblasts, the periodontal ligament and gingival connective tissue attached to 37 extracted teeth from 27 patients (ages 10‐67) were analyzed by electron microscopy coupled with a morphometric procedure. The cementoblasts largely consisted of either immature or resting types of collagen‐producing cells (CPC), both of which were poor in the rough endoplasmic reticulum and Golgi complex; these organelles were well‐developed in the relatively less common active cementoblasts. The cementoblasts consistently revealed a higher mean‐volume‐density per tissue unit than the fibroblasts and sometimes were grouped into clusters with the formation of junctional apparatuses. The relative volume of glycogen particles per cytoplasm was significantly higher in the cementoblasts, whereas the rough endoplasmic reticulum was higher in the fibroblasts. From the present study, it is suggested that the cementoblasts are functionally less active CPC than the periodontal fibroblasts.
Differences in Periodontal Disease‐Associated Microorganisms of Subgingival Plaque in Prepubertal, Pubertal and Postpubertal Children
Authors: Wojcicki Christopher J. , Harper D. Scott , Robinson Peter J.
Published: March 2012

It is generally accepted that normal prepubertal children do not develop periodontitis, and that the severity of gingivitis in prepubertal children is usually less than that observed in children after puberty. One possible explanation is that the bacteria associated with periodontal diseases cannot become established in great numbers prior to puberty. Studies by Kornman and Loesche and others suggest that levels of black pigmented Bacteroides, especially B. intermedius, increase with increased levels of gonadotrophic hormones in pregnant women. Delaney and Kornman have found that there is a similar increase in levels of black pigmented Bacteroides with puberty. The present study involved cultural and microscopic characterization of the subgingival plaque flora of prepubertal, circumpubertal and postpubertal children with similar Silness and Löe plaque index scores. Puberty was confirmed through examination of wrist radiographs. Populations of black pigmented Bacteroides were very low in prepubescent children and were much higher in circumpubertal and postpubertal children. However, B. intermedius predominated only in circumpubertal plaques. Levels of total motile bacteria increased at each age level, but levels of spirochetes above 2% were observed only in the postpubertal group. These results support those of previous investigators who postulated a relationship between hormone levels and black pigmented Bacteroides levels in subgingival plaque and suggest that differences in the subgingival environment profoundly influence the proportions of suspected periodontopathic species in plaque.
Tooth Loss in Maintenance Patients in a Private Periodontal Practice
Authors: Wilson Thomas G. , Glover Mark E. , Malik Arvinder K. , Schoen Janice A. , Dorsett Dovalee
Published: March 2012

A group of 162 maintenance patients, previously studied for compliance to suggested maintenance schedules, were surveyed for tooth loss over a 5‐year period. The group was divided into those who complied to suggested maintenance schedules and those whose compliance was erratic. It was found that none of the patients who had complied to suggested maintenance schedules lost any teeth. In the erratic group, where all tooth loss occurred, it was found that the more often a patient presented for maintenance, the less likely he was to lose teeth. These findings are discussed in relation to current studies on efficacy of various therapies for periodontal diseases.
Salt and Peroxide Compared with Conventional Oral Hygiene: I. Clinical Results
Authors: Pihlstrom Bruce L. , Wolff Larry F. , Bakdash M. Bashar , Schaffer Erwin M. , Jensen James R. , Aeppli Dorothee M. , Bandt Carl L.
Published: March 2012

The purposes of this 2‐year longitudinal study were to: 1) compare the clinical effectiveness of patient applied sodium bicarbonate, hydrogen peroxide, and sodium chloride (S/P) to the use of conventional oral hygiene methods and 2) to investigate the motivational effect of using phase‐contrast microscopy in teaching effective oral hygiene. Initially, 972 subjects were screened for signs of periodontitis. From these, 347 with early to moderate periodontitis were selected and each was randomly assigned to one of four home treatment regimens after scaling and root planing. The four treatment regimens included: 1) conventional oral hygiene procedures, 2) conventional oral hygiene procedures plus phase‐contrast demonstration of subgingival microbial forms for oral hygiene motivation, 3) S/P oral hygiene, and 4) S/P oral hygiene plus phase‐contrast demonstration of subgingival microbial forms for oral hygiene motivation. Plaque, bleeding, gingival inflammation, probing depth, and clinical attachment level were recorded at baseline, 8, 16, and 24 months. Subjects were recalled for reinforcement of oral hygiene and periodontal prophylaxis at various intervals. Data were analyzed based on disease severity, location of index sites and compliance. The results indicated that both conventional oral hygiene procedures and the S/P regimen were effective in reducing clinical signs of disease when combined with professional care. There were no differences between the two regimens in clinical effectiveness and trends favoring microscopic viewing of subgingival plaque for motivational purposes were not statistically significant.
Relationship of Serum Antibody to Attachment Level Patterns in Young Adults with Juvenile Periodontitis or Generalized Severe Periodontitis
Authors: Gunsolley J. C. , Burmeister J. A. , Tew J. G. , Best A. M. , Ranney R. R.
Published: March 2012

The goal of this study was to relate attachment loss patterns in early onset periodontitis subjects (juvenile periodontitis n = 47 and severe (generalized) periodontitis n = 52) with antibody reactivities to 25 bacterial strains which were suspected periodontal pathogens. The 25 antibody reactivities were screened by correlation analysis. Eleven strains were found to be significantly related to attachment loss. Using these 11 reactivities, stepwise multiple linear regression with plaque and age as covariates was used to further relate the reactivities within each subject group. Plaque was significantly related to the number of teeth with slight, moderate, or severe attachment loss. A significant inverse relationship was found between antibody reactivity with Haemophilus actinomycetemcomitans Y4 and the number of teeth having slight or moderate attachment loss. Similarly a significant inverse relationship between antibody reactivity with Bacteroides gingivalis and the number of teeth having moderate or severe attachment loss was found. The inverse relationship between the two antibody reactivities and attachment loss patterns were independent of the positive relationship of plaque. These relationships suggest that the failure to mount a substantial antibody response to these organisms leads to greater and more widespread periodontal disease in early onset periodontitis subjects.
Extracellular Matrices and Polypeptide Growth Factors as Mediators of Functions of Cells of the Periodontium
Authors: Terranova Victor P. , Wikesjö Ulf M.E.
Published: March 2012

This is a review of the interactions between cells and their extracellular matrices and Polypeptide growth factors. The review not only attempts to provide a basic understanding of the functions of extracellular matrices and Polypeptide growth factors but, in addition, suggests the role these biological molecules may play in periodontal regeneration. It is conceivable that future periodontal therapy will include the treatment of a scaled root with biological response modifiers to predictably attain a true new connective tissue attachment.
Growth Inhibitory Effects of Endotoxins from Bacteroides gingivalis and intermedius on Human Gingival Fibroblasts in Vitro
Authors: Layman Don L. , Diedrich Dana L.
Published: March 2012

Purified endotoxin or lipopolysaccharide from Bacteroides gingivalis and Bacteroides inlermedius caused a similar dose‐dependent inhibition of growth of cultured human gingival fibroblasts as determined by 3H‐thymidine incorporation and direct cell count. Approximately 200 μg/ml endotoxin caused a 50% reduction in 3H‐thymidine uptake of logarithmically growing cells. Inhibition of growth was similar in cultures of fibroblasts derived from either healthy or diseased human gingiva. When examining the change in cell number with time of exposure in culture, the rate of proliferation was significantly suppressed during the logarithmic phase of growth. However, the cells recovered so that the rate of proliferation, although reduced, was sufficient to produce a cell density similar to the control cells with prolonged culture. The endotoxins were characterized by sodium dodecyl sulfate‐polyacrylamide gel electrophoresis. The profiles of the Bacteroides endotoxins were different. B. gingivalis endotoxin showed a wide range of distinct bands indicating a heterogeneous distribution of molecular species. Endotoxin from B. intermedius exhibited a few discrete low molecular weight bands, but the majority of the lipopolysaccharides electrophoresed as a diffuse band of high molecular weight material. The apparent heterogeneity of the two Bacteroides endotoxins and the similarity in growth inhibitory capacity suggest that growth inhibitory effects of these substances cannot be attributed to any Polysaccharide species of endotoxin.
A Comparison of Three Delivery Methods of Chlorhexidine in Handicapped Children: I. Effects on Plaque, Gingivitis, and Toothstaining
Authors: Francis J. R. , Hunter Bruce , Addy Martin
Published: March 2012

In handicapped groups, the maintenance of oral hygiene can be a major problem, and chemical plaque control offers many advantages. This study compared the effectiveness of Chlorhexidine gluconate, delivered as a 0.2% mouthrinse, a 0.2% spray, and a 1% gel in trays, in controlling dental plaque and gingival bleeding in a group of 49 spastic children. All three delivery methods produced an improvement in plaque and gingival bleeding scores. However, the gel was significantly more effective than either the mouthwash or the spray. There was no significant difference between delivery methods in the amount of tooth staining.
Rate of Removal of Root Structure by the Use of the Prophy‐Jet Device
Authors: Galloway S. E. , Pashley D. H.
Published: March 2012

The effects of a constant blast from the Prophy‐Jet directed at enamel, dentin, and cementum over 5‐, 10‐, 15‐, 20‐, 30‐, 40‐, 50‐ and 60‐second periods were evaluated to determine what effects the spray had on tooth structure. There was no visible effect on enamel when the spray was directed at the surface for as long as 60 seconds. It was shown, however, that as little as 5 seconds of continuous spray caused a substantial loss of structure when the spray was directed at dentin and cementum. This structural loss was linearly related to the amount of time the area was subjected to the spray. Substitution of flour of pumice for the Prophy‐Jet powder resulted in approximately the same rate of loss of root structure. The results suggest that the manufacturers should provide more explicit warnings regarding the abrasiveness of the device on exposed dentin and cementum areas.
The Effect of Storage Media on the Proliferation of Periodontal Ligament Fibroblasts
Authors: Lauer Hans‐Christoph , Müller Johann , Gross Josef , Horster Michael F.
Published: March 2012

The effect of storage media, which are routinely used in replantation, upon the proliferative capacity of periodontal ligament fibroblasts, was compared with the effect of a tissue culture medium. The periodontal tissue was obtained from mandibular central incisors of White New Zealand rabbits. The experiments were performed in fibroblasts derived during second subculture. The storage media were physiologic salt solution, Ringer's solution and Rivanol; the tissue culture medium was α‐minimum essential medium without nucleosides. The incubation period was 1 hour. [3H]‐thymidine incorporation and cell counts were taken to indicate changes in the proliferative capacity of the fibroblasts. The tissue culture experiments showed that the proliferative ability of the periodontal ligament fibroblasts was dependent upon the composition of the storage medium. Physiologic salt solution, Ringer's solution and Rivanol were unable to maintain the metabolism of the fibroblasts. μ‐MEM medium, however, was capable of stimulating proliferation of the periodontal ligament fibroblasts.
Periodontium Destruction Associated with Oncology Therapy
Authors: Wright William E.
Published: March 2012

Radiation treatment to the head and neck and cytotoxic chemotherapy can produce deleterious side effects to the periodontium that are generally transient in nature, reversible, and do not result in permanently visible defects. However, combinations of the malignant disease itself, the direct and indirect effects of medical therapy and associated oral infections, along with local trauma can lead to periodontal tissue destruction with resulting permanent architectural defects. Five case reports illustrate destructive alterations of the periodontium that were associated with oncology therapy. Proposed guidelines for periodontal treatment of compromised individuals undergoing oncology therapies are suggested.
Prevalence of Medical Problems in Periodontal Patients Obtained from Three Different Populations
Authors: Nery E. B. , Meister F. , Ellinger R. F. , Eslami A. , McNamara T. J.
Published: March 2012

Data from three different sources of periodontal patients were collected and examined to find if there was a significant difference between these groups relative to the prevalence of medical problems. Data were evaluated to show if age and sex were significantly related to the existence of medical problems and to determine which problems were the most prevalent. A total of 581 periodontal patients' records were obtained. Results of the evaluation showed that the private office group had 27.6% medical problems, the academic dental center had 46.3%, and the hospital dental clinic had 74.1%. Cardiovascular disease was the most prevalent medical problem in all groups and orthopedic disease or injury was second. Within each group, sex was not significantly related to the presence of a medical problem. Age was a highly significant factor, with the prevalence of medical problems increasing with advancing age.
Phenotypic and Functional Analysis of T Cells Extracted from Chronically Inflamed Human Periodontal Tissues
Authors: Cole Karen L. , Seymour G. J. , Powell R. N.
Published: March 2012

T‐cell subsets extracted from chronically inflamed periodontal tissues were identified using monoclonal antibodies, and their functional activity was analysed using the autologous mixed lymphocyte reaction (AMLR). Tissue was obtained from a total of 33 adult periodontitis (AP) patients and 6 normal/marginal gingivitis (N/MG) patients. All AP patients had received repeated oral hygiene instruction and root planing prior to the surgery, and the majority (30 out of 33) had at least one site with >6 mm loss of attachment from the cementoenamel junction within the surgical field. The N/MG patients had no loss of attachment, and probing depths were less than 3 mm. Single cell suspensions were obtained following collagenase digestion (90 minutes at 37°C) and mechanical disruption of the tissue. T‐cell subsets were identified using an indirect immunofluorescence assay on cells obtained from 19 AP patients and the 6 N/MG patients. The mean (±standard error) helpensuppressor (T4:T8) ratio for the AP patients was found to be 0.94 ± 0.48 compared with 1.65 ± 0.16 for the N/MG group and 1.51 ± 0.12 for peripheral blood controls. HLA‐DR positive macrophages were identified and were found to include both acid Phosphatase (AcP) positive and adenosine triphosphatase (ATPase) positive populations.

Functional analysis was carried out using cells extracted from the remaining 14 AP patients. Cells from six of these 14 patients were found to be capable of spontaneous proliferation. Co‐culture experiments using autologous T and non‐T populations revealed that cells from only four patients were able to respond in an AMLR while those from only one of the 14 patients were able to stimulate the AMLR. This inability to undergo spontaneous proliferation or to respond in an AMLR may be a functional reflection of the depressed T4:T8 ratio. The inability to stimulate peripheral blood T cells may reflect either a local antigen‐presenting defect or an abnormality of peripheral blood T cells. Nevertheless, these results illustrate a possible immunoregulatory defect in adult periodontitis.
Human Leukocyte Antigen (HLA) DR4
Authors: Katz Joseph , Goultschin Josef , Benoliel Rafael , Brautban Chaim
Published: March 2012

The relationship between human leukocyte antigens (HLA) determinants and periodontitis has been examined by several authors without showing any particular pattern. However, no study has investigated the HLA‐D determinants, which are generally associated with immune disorders, and rapidly progressive periodontitis (RPP).

The HLA profile of 10 RPP patients was compared with that of a healthy control population (n = 120). Although no significant difference was found for HLA‐A, HLA‐B, and HLA‐C, HLA‐DR4 of the HLA‐D group was found in 80% of patients but only in 38.3% of controls. A high frequency of HLA‐DR4 has been reported in rheumatoid arthritis (RA) patients. This finding may be significant in light of previous reports highlighting similarities between RA and periodontal disease.