bluuebunny/crossref_metadata_2025 huggingface dataset:
Alveolar Bone Remodeling Following Osseous Surgery: A Clinical Study
Authors: Moghaddas Hamid , Stahl S. Sigmund
Published: March 2012

Remodeling of the alveolar bone crest was monitored following periodontal surgery including osseous recontouring at 26 sites in 17 patients, aged 23 to 60 years, with advanced periodontitis. Comparison of measurements obtained at initial surgery with those noted at re‐entry showed a reduction in crest height 3 months postsurgery at all sites tested: A) At the interradicular sites a mean reduction of 0.38 mm; B) at the radicular sites a mean reduction of 0.84 mm; and C) at the furcation sites a mean reduction of 0.79 mm. A reduction in crest height was also noted 6 months postsurgery at all sites tested: A) At the interradicular sites a mean reduction of 0.23 mm; B) at the radicular sites a mean reduction of 0.55 mm; and C) at the furcation sites a mean reduction of 0.88 mm. The mean bone loss at different surfaces in both 3 month and 6 month groups was statistically significant when compared with zero loss, using the t test. Within the limits of this clinical study, it can be concluded that crestal resorption, albeit limited in extent, was the usual remodeling response following osseous recontouring.
Histologic Study of the Effects of Occlusal Hypofunction Following Antagonist Tooth Extraction in the Rat
Authors: Levy Gerard G. , Mailland Michel L.
Published: March 2012

A histologic study was done to observe the influence of occlusal hypofunction on periodontal tissues and the physiologic drift process, and to elucidate the origin of periodontal ligament narrowing. Twenty‐four Wistar rats were used. Hypofunction was induced by extracting the right maxillary molars. Histologic observations were reported on the right lower jaws which were fixed, decalcified, sectioned and stained according to classical histologic methods. Two groups of five animals each were used for a complementary study using sequential fluorescent labeling in order to evaluate the bone formation rate. After 15 days of hypofunction, the periodontal ligament was obviously narrowed and its structure was disorganized. Woven‐bone formation was noted at the top of the interradicular septa, at the bottom of the sockets and along their modeling sides. At 30 days and at intervals up to 3 months, the periodontal ligament remained disorganized and narrowed. The newly‐formed bone was engaged in a maturation process. Nevertheless, osteoporosis was also observed at the inferior part of the interradicular septa. Fluorescent labeling confirmed the histologic findings and showed that the induced bone formation is related to periodontal ligament narrowing and the supra‐eruption process.
Metastatic Renal Cell Carcinoma in the Gingiva Mimicking a Hyperplastic Lesion: Case Report
Authors: Buchner A. , Begleiter A.
Published: March 2012

An unusual case of metastatic renal cell carcinoma in the gingiva, without roentgenographic evidence of underlying bone involvement, is described. The tumor had the clinical appearance of a pyogenic granuloma and peripheral giant cell granuloma. Histologic sections and the pertinent history revealed the tumor to be a metastatic renal cell carcinoma. Review of the literature reveals that metastatic lesions to the gingiva are rare, but when they occur they tend to mimic clinically the common localized hyperplastic lesions of the gingiva.
Periodontal Splinting With Wire and Composite Resin: A Revised Approach
Authors: Greenfield David S. , Nathanson Dan
Published: March 2012

A method for periodontal splinting of anterior teeth with wire and composite resins is described. The method combines the use of a double wire reinforcement, shallow tooth preparation, and acid etching to obtain good strength and sealing properties. The sequence of steps was exclusively designed to suit the properties of composite resins. The technique has the advantages of conservatism and simplicity, good esthetics and strength that surpasses that of conventional wire and acrylic or composite splints.
Postsurgical Bone Loss Following Root Planing by Ultrasonic and Hand Instruments
Authors: Glick David H. , Freeman Eric
Published: March 2012

The ultrasonic sealer is currently used to plane the roots in periodontal surgery. The purpose of this study was to provide experimental evidence in support of, or against, the use of the ultrasonic sealer for root planing in periodontal surgical procedures. A notch was made through the enamel of each canine of nine adult cats. Full thickness mucoperiosteal flaps were elevated on each canine. Using hand curettes, soft tissue tags were removed from each tooth. At the maxillary right canines and mandibular left canines the roots were planed using the ultrasonic sealer, while at the maxillary left canines and mandibular right canines the roots were planed using hand curettes. A caliper was used to measure the distance from the notch to the crest of the alveolar process at each tooth. The mucoperiosteal flaps were repositioned and secured with cyanoacrylate cement. Three months postoperatively all 36 sites were reoperated and the distance from the notch of each canine to the crest of its alveolar process was measured using the caliper. The same caliper was used for all sites and the same investigator made all the measurements. Analysis of the results showed that all canines lost alveolar bone as a result of the surgical procedure, however, there was no statistical significance between the amount of bone lost on the canines where root planing was carried out by the ultrasonic sealer and the canines where the roots were planed with hand curettes. These findings support the use of the ultrasonic sealer for the planing of roots following elevation of mucoperiosteal flaps and confirm its value in the practice of periodontal surgical procedures.
Modified Distal Wedge Procedure
Authors: Pollack Ralph P.
Published: March 2012

A modified distal wedge procedure has been developed for use adjacent to edentulous areas. The purpose of this procedure is to eliminate pockets, yet retain keratinized tissue. Ease of flap design, the creation of access to the underlying osseous structures, and ease of closure are demonstrated by illustrations and Kodachromes.
Intravenous Conscious Sedation in the Periodontal Patient
Authors: Hillman James D. , McFall Walter T. , Gregg John M.
Published: March 2012

Intravenous diazepam was evaluated as a preoperative medication prior to periodontal surgery. Ten patients were subjected to two separately scheduled surgical episodes. During one procedure, a placebo was administered via an intravenous drip and during the other procedure, diazepam was titrated until Verrill's sign was reached. Vital signs, skin temperature, galvanic skin response, and serum cortisol were monitored and analyzed during both procedures. Vital functions were more stable in diazepam‐sedated patients than in the placebo group. This was manifested by less increase in systolic blood pressure, respiration and heart rate. The galvanic skin resistance was increased and serum cortisol values decreased throughout the sedation phase, suggesting a reduced sympathetic arousal. This study indicates that intravenous diazepam sedation enhances patient comfort and improves physiologic safety during periodontal surgery.
The Effect of Female Sex Hormones on Subgingival Plaque
Authors: Jensen J. , Liljemark W. , Bloomquist C.
Published: March 2012

The periodontal status of three groups of women; pregnant, taking oral contraceptives, and nonpregnant, were evaluated clinically and microbiologically for changes in their gingiva and any corresponding changes in the subgingival microbial plaque, specifically the percentage of Fusobacterium species and Bacteroides species. Overall, the women had relatively good gingival health. However, statistically significant increased scores were observed in the Gingival Index and the gingival crevicular fluid flow in the pregnant group compared with the nonpregnant group. The most dramatic microbial changes were the increased proportions of Bacteroides species both in the pregnant group and the group taking oral contraceptives over the nonpregnant group. Increased female sex hormones substituting for the napthaquinone requirement of certain Bacteroides were most likely responsible for this increase. No statistically significant clinical difference was noted between the group taking oral contraceptives and the nonpregnant group, although a 16‐fold increase in Bacteroides species was observed in the group taking oral contraceptives.
Immunologic Tolerance to Collagen and Glycosaminoglycan Components of Scleral Allografts in Humans: Evidence for T Cell Suppression
Authors: Felts Chuck , Engel David , Ammons William , Narayanan A. Sampath
Published: March 2012

Unfractionated peripheral blood lymphocytes (PBL) and the T and B cell fractions of PBL from four patients who had received scleral allografts, and fractions from four control subjects were tested in vitro for proliferative responsiveness to collagen and glycosaminoglycan‐enriched extracts of allogeneic sclera. None of the unfractionated lymphocyte cultures (patients and controls) were responsive to the scleral extracts. However, B‐enriched lymphocyte cultures from one patient and two control subjects did respond to the scleral extracts, although there was considerable individual variation in the magnitudes of these responses (stimulation indices ranging from 1.5 to 11.5). In contrast, the DNA‐synthesis response of T cells to scleral extracts was strongly suppressed. Furthermore, T cells pre‐exposed for 24 hours to scleral collagen were capable of suppressing B‐cell responsiveness to mitogens in autologous mixed lymphocyte cultures. Our findings confirm the lack of apparent adverse immunologic responsiveness to scleral allografts in humans as reported by others. It is possible that immunological tolerance to the scleral allografts is due to a suppressor T‐cell mechanism which is triggered by scleral collagen.
The Influence of Oral Contraceptive Therapy on the Periodontium—Duration of Drug Therapy
Authors: Pankhurst C. L. , Waite I. M. , Hicks K. A. , Allen Y. , Harkness R. D.
Published: March 2012

The participants in this study were 151 women; 49 of these had been taking oral contraceptives for over 5 years, 63 had been taking oral contraceptives for less than 5 years, and 39 formed the control group. It was found that there was a statistically significant increase in gingival inflammation related to the duration of drug therapy. There were no significant differences in level of attachment between the groups of subjects.
Disruption of Complement‐Mediated Reactions by Insoluble Dentifrice Ingredients
Authors: Boackle Robert J. , Draughn Robert A. , Vesely Jana
Published: March 2012

It has been strongly suggested that the complement system plays a critical role in the pathological processes occurring in periodontal disease. Because individuals with this common disease are often instructed to brush their teeth more often and for longer periods of time, several commercial toothpastes were tested for their effects on complement‐mediated reactions. In this study, six of the nine toothpastes tested activated the classical complement pathway, leading to C3 cleavage, as determined by crossed immunoelectrophoresis. The activating ingredients were contained in the insoluble fraction of the toothpastes. Of the toothpaste abrasives, Ca++ pyrophosphate was determined to have C3‐converting activity. One of the toothpastes, which contains a particular type of amorphous silica abrasive, appeared to bind both native C3 and its conversion products. In general, disruption of complement‐mediated functions in affected tissues could alter local immunological responses and interfere with healing. The in vitro studies described here suggest a need for clinical studies to ascertain the in vivo influences of dentifrice ingredients on complement‐mediated reactions in periodontal disease.
Detachment of Endothelial Cells by Polymorphonuclear Leukocytes in Vitro: Potentiation by Antibody Coating and Prevention by Inflammatory Exudate
Authors: Cogen Ronald B. , Taubman Sheldon B. , Tuddenham Edward G. D.
Published: March 2012

A widely advocated hypothesis suggests that polymorphonuclear leukocytes release enzymes at sites of inflammation which in turn cause tissue damage, especially vasculitis. To test this we isolated and grew human endothelial cells and labelled them with chromium‐51. Polymorphonuclear leukocytes were separated from whole blood and added to the labelled endothelial cells. Upon incubation with the polymorphonuclear leukocytes the endothelial cells rapidly detached but were not lysed. Detachment was prevented by the addition of small amounts of inflammatory exudate. Prior coating of endothelial cells with a specific antibody accelerated detachment of the cells by polymorphonuclear leukocytes but this was still prevented by addition of inflammatory exudate in low concentration. In a separate experiment extracellular basement membrane synthesized in vitro by endothelial cells was labelled by incubating the cells with 14C‐proline. Polymorphonuclear leukocytes caused release of 14C but this was again prevented by addition of either inflammatory exudate or serum. We conclude that polymorphonuclear leukocytes alone could cause vascular intimal damage in vivo if inhibitors, which are present in serum and inflammatory exudate, are excluded or overwhelmed.
Chemical Treatment of Diseased Root Surfaces in Vitro,
Authors: Wirthlin M. R. , Hancock E. B.
Published: March 2012

Untreated periodontally‐involved extracted human teeth were cleaned of plaque and calculus and then treated with chemicals having the potential to dissociate or degrade endotoxin. The count of attached gingival fibroblast cells after 48‐hours of culturing was used as a measure of the biocompatibility of the diseased root surface. Paired specimens compared to their phosphate‐buffered saline controls demonstrated no significant differences for the use of sodium lauryl sulfate and EDTA, plasma protein fraction, immune serum globulin, citric acid, or sodium deoxycholate followed by immune serum globulin.
An Evaluation of Root Resections: A Ten‐Year Study
Authors: Langer Burton , Stein Stephen D. , Wagenberg Barry
Published: March 2012

A study was undertaken to evaluate the long term results of root resections. Records of 100 patients who had undergone root resections 10 years prior to the study were reviewed. Although the immediate postoperative results were gratifying, they were not always lasting. Eighty‐four per cent of the failures occurred after 5 years. Most failures were in the mandibular arch and derived from reasons other than inflammatory periodontal disease. Suggestions are made as to how to improve the prognosis of resected teeth.
Topography of Root Surfaces Treated in Vitro With Citric Acid, Elastase and Hyaluronidase: A Scanning Electron Microscopy Study. Part II
Authors: Daryabegi Parviz , Pameijer Cornelis H. , Ruben Morris P.
Published: March 2012

Sixteen extracted human teeth were separated into two groups, root planed, and treated with either elastase or hyaluronidase following acid demineralization. The duration of enzyme application varied from 5 to 20 minutes. From scanning electron micrographs the following was concluded: (1) The cemental collagen network is composed of previously described extrinsic and intrinsic fiber systems. (2) Root planing, using tactile sense as the final criteria, does not always result in complete elimination of contaminants. (3) Citric acid (pH = 1), applied for 3 to 4 minutes, is an effective means of exposing cemental collagen. (4) Qualitatively, the enzyme treatment subsequent to acid demineralization seemed to result in more effective exposure of the collagen mantle of cementum. (5) Further definitive research must be done to determine, both the usefulness of enzymatic treatment in vitro and in vivo and the optimum enzyme concentrations and duration of application.
Relationships Between Epithelium and Connective Tissue in Inflamed Gingiva
Authors: Polson A. M. , Greenstein G. , Caton J.
Published: March 2012

Since chronic inflammation has been associated with degenerative and proliferative responses in connective tissue and epithelium, it was decided to investigate quantitatively the proportions of epithelium and connective tissue in inflamed gingiva. Forty‐five midfacial gingival sites were assessed prior to biopsy for the presence or absence of bleeding after probing using a controlled insertion force of 25 g. In order to delineate the corresponding area for histologic analysis, a reference incision was made on the facial surface of the gingiva which demarcated the depth and mesio‐distal extent of the area probed. Step‐serial bucco‐lingual sections were morphometrically analyzed to determine the percentages of epithelium, inflamed, and noninflamed connective tissues coronal to the reference incision. The data was compared with respect to the presence or absence of bleeding after probing. Specimens which bled after probing had significantly less epithelium and more connective tissue. The increase in overall connective tissue was due to a significant increase in the inflamed component, and it appeared that the decrease in epithelium corresponded to the increase in inflamed connective tissue. The findings of diminished epithelium overlying inflamed connective tissue reinforces the concept that connective tissue status is important for determining structure and function of epithelium.
Mucous Extravasation Phenomenon of the Hard Palate Following Periodontal Surgery
Authors: Curtis James W. , Hutchinson Rowland A.
Published: March 2012

postoperative complications following free mucosal autografts are few and of minor consequence. This is a case report of a recurrent palatal swelling occurring 6 weeks to 3 months postoperatively following removal of palatal tissue for a free mucosal autografi. Excision and histologic examination of the recurrent swelling confirmed the clinical diagnosis of mucocele or mucous extravasation phenomenon.
The Relationship Between Gingival Tissue Temperatures and Various Indicators of Gingival Inflammation
Authors: Holthuis A. F. , Gelskey S. C. , Chebib F. S.
Published: March 2012

In periodontics there is a need for objective measurements in monitoring disease processes and in assessing the effectiveness of treatment. The purpose of this study was to compare gingival temperatures with indicators of gingival inflammation in order to examine the application of temperature as a diagnostic aid. In six patients the temperature of interproximal sulcular tissue was measured and compared with bleeding upon probing, crevicular fluid flow, pocket depth, plaque accumulation and calculus formation. The results show significantly higher temperatures with bleeding upon probing and with the presence of dental plaque and calculus. Temperature increase correlated with increase in crevicular fluid flow, but a relationship to pocket depth is not clear. The thermocouple microprobe is a very sensitive instrument. The method used is noninvasive, safe and efficient. It can be concluded from our data that differences in gingival temperature reflect not only a regional tissue variability but also can indicate an inflammatory state.
Oral Hygiene for the Partially Edentulous
Authors: Bassiouny M. A. , Grant A. A.
Published: March 2012

The effectiveness of a proximal brush on the interdental hygiene for partially edentulous individuals was investigated. Nineteen partially edentulous adults participated in a crossover study. Three groups were instructed to use the toothbrush alone or a toothbrush combined with either toothpicks or proximal brush. The effectiveness of the cleansing devices was measured by the amount of plaque remaining on the examined surfaces. The results indicated that the cleaning efficiency of the proximal brush is greater than that of the toothpicks on the proximal surfaces of teeth adjacent to edentulous areas. On the other hand, the toothpicks were more effective on the proximal surfaces of teeth in contact.
The Effect of Intrasulcular Brushing on Sulcular Epithelial Permeability
Authors: Vogel Richard I. , Alfano Michael J. , Manhold John H.
Published: March 2012

The purpose of the present study was to determine the effect of intrasulcular toothbrushing on permeability of the sulcular epithelium. Twenty‐four dental students were divided into two groups of 12 each. On day 0, subjects in Group I began having the buccal aspects of the maxillary right first and second molars brushed for 30 seconds daily for 49 days by an examiner using an intrasulcular technique while subjects in Group II had the same teeth brushed with an extrasulcular technique. On day 49, clinical evaluation of inflammation was performed and biopsies were taken to evaluate gingival inflammation, sulcular epithelial keratinization and permeability of the sulcular epithelium in vitro using a microperfusion technique. Results indicate that subjects in both groups had attained equally high levels of gingival health. The intrasulcular group demonstrated a significantly higher degree of sulcular epithelial keratinization. However, no relationship was found between the degree of sulcular epithelial keratinization and sulcular epithelial permeability. Thus, the benefits derived from intrasulcular brushing and increasing sulcular epithelial keratinization are questionable.
Temporal Analysis of Nocturnal Bruxism During EMG Feedback
Authors: Rugh John D. , Johnson Rodney W.
Published: March 2012

Several studies have demonstrated that nocturnal bruxism and related symptoms can be relieved through nocturnal electromyogram (EMG) feedback. The effects, however, are not always long lasting and the mechanism of suppression is not understood. It was the object of this study to examine more closely the manner in which nocturnal feedback works in suppressing bruxism. Chart recordings were made of nocturnal masseter EMG activity in five bruxist subjects. Baseline recordings were made in the subject's home followed by 10 or more nights of feedback treatment. Treatment involved sounding a 300 mW tone when EMG activity exceeded about 20 μV for more than 1 second. All subjects showed a decrease in the duration of bruxism. The decrease in bruxism was due to a reduction in the duration of bruxism episodes rather than a change in the number of episodes, i.e. rather than reducing the probability of an event starting, nocturnal feedback appears to simply suppress the activity once it is initiated. This provides little evidence of learning.
Changes of the Marginal Periodontium as a Result of Labial Tooth Movement in Monkeys
Authors: Steiner G. G. , Pearson J. K. , Ainamo J.
Published: March 2012

Tooth position has been suggested to be an important factor in gingival recession. Due to conflicting reports in the literature, this study was undertaken to examine the effects of labial tooth movement on changes in the marginal periodontium. Orthodontic tooth movement was performed in five monkeys (Macaca nemistrina). Oral health was established and exploratory surgery was performed to assess the level of the connective tissue attachment and marginal bone. Measurements of the gingival margin and mucogingival junction were taken and orthodontic forces were applied. The central incisors were moved labially a mean distance of 3.05 mm. Posttherapy measurements were performed to assess the change which occurred as a result of tooth movement. Significant recession of the gingival margin, connective tissue level and marginal bone was found.
Activated Macrophages in Human Periodontitis
Authors: Charon Jaques , Toto P. D. , Gargiulo A. W.
Published: March 2012

Fifteen patients, eight males and seven females, ranging from 30 to 88 years of age with advanced periodontal disease were selected for this study. Biopsies and blood samples were taken of both normal and inflamed gingival tissues, and processed for detection of nonspecific esterase and acid phosphatase activity in monocytes and macrophages. Activated macrophages, as indicated by their intense reaction to acid phosphatase and nonspecific esterase, were found in the gingival epithelium, lamina propria, perivascular tissues and in the blood vessels in human chronic periodontitis. Blood smears of monocytes showed variability of stain intensity suggesting that their activation occurred in blood vessels where they marginate and emigrate into the perivascular tissues in chronic periodontitis. They then appear as macrophages that migrate through the connective tissue, penetrate the basement membrane and continue through the epithelium. The nonspecific esterase stain identified T‐cells, by a singular dot‐like granule, and plasma cells by multiple granules in the cyotplasm. Lymphocytes containing multiple cytoplasmic nonspecific esterase positive granules commonly were found only in the perivascular connective tissue and may represent B‐cell differentiation to plasma cells. The plasma cell predominance, the presence of T‐cells and activated macrophages indicated both humoral and cell‐mediated responses are operative in human chronic periodontitis.
Associations Between Crestal Lamina Dura and Periodontal Status
Authors: Greenstein G. , Polson A. , Iker H. , Meitner S.
Published: March 2012

The purpose of the present study was to investigate associations between radiographic crestal lamina dura and the clinical periodontal status of the corresponding interdental area. The population consisted of 90 individuals (53 females and 37 males), ages 21 to 45 years (mean 31 years), who underwent a comprehensive periodontal examination. Buccal and lingual to the contact point at each interdental area four different clinical criteria were scored as being present or absent: (i) visual inflammation, (ii) bleeding after probing with 25 gm force, (iii) pocket depth greater than 3 mm after probing with 50 gm force, (iv) loss of connective tissue attachment. Bite‐wing and full‐mouth periapical radiographs were taken and processed using standardized techniques. Each interdental crestal area on the radiographs was examined and scored for presence or absence of an intact lamina dura. Statistical analyses were undertaken using correlated means to compare the presence or absence of lamina dura with the individual and simultaneous clinical criteria. No significant differences were obtained between any of the comparisons and, in addition, there was no correlation between lamina dura images on periapical and bite‐wing radiographs. The results indicated that crestal lamina dura on radiographs did not appear to be related to the presence or absence of clinical inflammation, bleeding upon probing, periodontal pockets or loss of attachment.
Interproximal and Buccal Cell Populations Apical to the Sulcus Before and During Experimental Periodontitis in Squirrel Monkeys,
Authors: Adams R. A. , Zander H. A. , Polson A. M.
Published: March 2012

The purpose of this investigation was to study inflammatory cell populations apical to the buccal and interproximal gingival sulcus during destructive experimental marginal periodontitis in squirrel monkeys. Specimens were obtained of the clinically healthy periodontium, and (after 2 and 10 weeks) of experimental periodontitis induced by the placement of plaqueretentive silk ligatures at the gingival margin. Cell populations were characterized and quantitated in a standard area of connective tissue immediately subjacent to the most apical cells of the junctional epithelium in buccal and interproximal locations. Comparisons of periodontitis cell populations showed there were no differences between the regions in relation to either total numbers of cells, or in the percentages of inflammatory cell types. The inflammatory cells consisted primarily of granulocytes and macrophages, with only small percentages of lymphoid and plasma cells. Mechanisms and consequences of these cell types relative to periodontal tissue destruction are discussed.
Histologic Characteristics Associated With Bleeding After Probing and Visual Signs of Inflammation
Authors: Greenstein G. , Caton J. , Polson A. M.
Published: March 2012

This study was designed to characterize histologically the gingival lesion associated with visual signs of inflammation and bleeding after probing. Sixty midfacial gingival sites in 26 persons were evaluated for visual presence or absence of inflammation and bleeding after probing using a controlled insertion pressure of 25 gm. In order to delineate the area for histologic analysis, a reference incision was made on the facial surface of the gingiva which corresponded to the depth and mesio‐distal extent of the area probed and evaluated for signs of inflammation. Gingival biopsy specimens were morphometrically analyzed to determine the percentages of cell rich—collagen poor connective tissue and blood vessel lumens. Histometric data were grouped and compared with respect to the presence or absence of inflammation and bleeding. Specimens associated visually with inflammation had significantly greater percentages of both cell rich—collagen poor connective tissue and blood vessel lumens. Bleeding upon probing was associated with a significantly greater percentage of cell rich— collagen poor connective tissue without an increase of blood vessel lumens. It was concluded that both observed signs of inflammation and bleeding after probing can be used to detect inflammatory lesions in the gingiva. However, in areas inaccessible for evaluation of inflammation, bleeding determinations using controlled insertion pressures provided an objective diagnostic method for detecting the presence of an inflammatory lesion.
The Composition of the Subgingival Microbiota After Periodontal Therapy
Authors: Rosenberg Edwin S. , Evian Cyril I. , Listgarten Max A.
Published: March 2012

The purpose of the study was to determine the composition of the microbiota in periodontally diseased pockets by dark field microscopy prior to treatment, after scaling and root planing, and after periodontal surgery. Eighteen patients with untreated chronic periodontitis were selected. Preoperative or baseline clinical data included Plaque Index (PlI), Gingival Index (GI) and Probing Depth (PD). Subgingival microbial debris from the surface with the deepest probing depth in each of the six sextants was collected and the pooled microbial sample was examined by differential dark‐field microscopy. The relative proportions of bacterial forms were classified into four groups: coccoid cells, motile rods, spirochetes and others. The patients were instructed in oral hygiene and received several sessions of scaling and root planing, some of these in conjunction with occlusal therapy. The clinical and microbial status was reevaluated prior to the surgical treatment phase. At least 6 weeks after the last surgical intervention aimed at facilitating access for debridement and pocket reduction, the clinical data and microbial composition were recorded again. The results indicated a significant increase in the mean percentage of coccoid cells and a significant decrease in the proportions of spirochetes and motile rods from baseline to postinitial therapy and from postinitial therapy to postsurgery. Some differences were noted between subjects in their response to therapy. Although 16 of 18 cases showed a decrease in the percentages of spirochetes and motile rods as a result of therapy, two patients showed an increase in the proportions of spirochetes and motile organisms and a decrease in the proportion of coccoid cells. These microbial changes were accompanied by a deterioration of the clinical status of these patients. In general, GI and P1I scores and PD measurements varied directly with the proportions of spirochetes or motile rods, and inversely with the proportion of coccoid cells. The greatest clinical improvement with respect to P1I and GI scores and PD occurred between baseline and the completion of initial therapy. Relatively little if any change in these clinical parameters was detectable in the interval betweens the completion of initial therapy and the postsurgical phase, despite the continued shift in bacterial composition from a flora associated with diseased sites toward one associated with periodontally healthy sites.
A Comparison of a Composite Restorative Material and Wire Ligation as Methods of Stabilizing Excessively Mobile Mandibular Anterior Teeth
Authors: Stoller Norman H. , Green Paul A.
Published: March 2012

Eighteen patients with mobile mandibular anterior teeth were randomly assigned to one of two treatment groups in order to determine the relative effectiveness of two modalities of temporary stabilization. The two groups were well matched for initial horizontal tooth mobility, age and sex. Patients in Group I had their teeth stabilized in the conventional fashion with extracoronal wire ligation. The Group II subjects' mandibular anterior teeth were acid‐etched and then had composite restorative material applied to the lingual, facial and interproximal surfaces. Horizontal tooth mobility utilizing the periodontometer was recorded prior to, immediately after, and then at 1, 3, 6 and 12 months poststabilization. Löe's Gingival Index and the Silness and Löe Plaque Index were recorded for the same time periods. All subjects were instructed in oral hygiene techniques appropriate for splinted teeth. The mobility scores for both Group I and II dropped to significantly lower levels immediately after the splints were placed and then remained relatively unchanged for the next 12 months. There were no statistically significant changes in the gingival or plaque indices throughout the study. Three splints required repairs or adjustments in Group I subjects. Six fractures occurred in Group II subjects.
Dentin Matrix Gelatin (DMG) as a Possible “Universal” Grafting Material in Periodontics
Authors: Gould T. R. L. , Westbury L. , Tillman J.
Published: March 2012

The ideal of periodontal surgery is the total regeneration of the lost periodontal complex. A promising new osseous grafting material is Dental Matrix Gelatin (DMG). DMG was prepared by a method similar to that of Conover and Urist (1979). This consisted of sequential extraction in 1:1 chloroform‐methanol, 25°C for 1 hour; 0.6 N HCl, 2°C for 24 hours with constant agitation; 2 M CaCl2, 2°C for 1 hour; 0.5 M EDTA pH 7.4, 2°C for 1 hour; washed in distilled water 1 hour. Twelve rats were anesthetized, had heads shaved, midline flaps reflected, and 2 mm holes drilled through the right and left parietal bones. This type of osseous defect normally heals only by fibrous scarring and has been used to define osteoinductive materials. The DMG was cut into pieces about 1 mm square and placed into the right side defect while the left side remained open as a control. The animals were sacrificed on a schedule of two rats every 2 weeks until the 10th week when four rats were killed. The results showed complete osseous closure of the DMG site while the control healed by fibrous scarring. DMG seems to have strong osteoinductive power, and used allogenically has great potential as a commercially viable implant material.
Oral Hygiene and Maintenance of Periodontal Support
Authors: Ramfjord S. P. , Morrison E. C. , Burgett F. G. , Nissle R. R. , Shick R. A. , Zann G. J. , Knowles J. W.
Published: March 2012

The role of personal plaque control in periodontal maintenance care was studied in 78 patients who had undergone periodontal therapy and were on 3‐month recall for prophylaxis over 8 years. Variations in pocket depth and attachment levels were related to individuals with plaque scores above and below the median. The results also were analyzed by comparing the 25% of the sample having the lowest plaque scores with the 25% having the highest scores over 7 years of maintenance care. Students t test was used. It was found that personal oral hygiene as expressed in plaque scores was not critical for maintenance of post‐treatment pocket depth and attachment levels in patients with professional tooth cleaning every 3 months. The initial post‐treatment reductions in pocket depth and variations in attachment levels were more favorable in patients with good than with poor oral hygiene, but, these differences were not significant after 3 to 4 years of maintenance care.
Electron‐Dense Deposits Following Gold Therapy in Experimental Periodontitis in Cats
Authors: Freeman Eric , Biggar Michael R.
Published: March 2012

Electron microscopic examination of inflamed gingival connective tissue of ligature‐induced periodontitis in the cat following a therapeutic to high regime of parentally administered soluble gold, revealed electron‐dense material characteristic of gold deposits within phagolysosomes of macrophages, and to a lesser extent, endothelial cells and fibroblasts. Since gold salts can alter some of the events that may occur in periodontal breakdown, chrysotherapy may have a beneficial effect on the pathogenesis and progression of experimental periodontitis in the ligature‐induced model of periodontal disease.
Immunological Response to Herpes Simplex Virus in Human Gingival Fluid
Authors: Zakay‐Rones Zichria , Hochman Nira , Rones Yeushoa
Published: March 2012

Antibodies to herpes simplex virus were found by immunofluorescence in the gingival fluid of patients suffering from recurrent oral herpetic infections. The type of antibodies was modulated by the clinical state of the patient. IgG antibodies were found before infection and secretory IgA antibodies during the convalescent stage; in the acute stage no antibodies were detectable.
Bacterial Variability Within Diseased Periodontal Sites
Authors: Evian Cyril I. , Rosenberg Edwin S. , Listgarten Max A.
Published: March 2012

The purpose of this study was to examine the variability in bacterial proportions between individual periodontal sites in patients with chronic periodontitis by means of differential dark‐field microscopy. Fourteen patients with untreated, moderate to advanced disease were included. Probing depth, plaque and gingival index scores were recorded for each patient. Microbial samples were collected from the tooth surface with the greatest probing depth in each sextant and examined individually by dark‐field microscopy. The results indicated that proportions of spirochetes and motile rods at any given probing depth varied considerably, ranging from those expected at healthy sites to those expected at diseased sites. In accordance with previous studies, mean percentages of spirochetes tended to vary directly with increased PD, PlI and GI scores, while mean percentages of coccoid cells tended to follow a reverse pattern. However, no significant correlations could be demonstrated when measurements from individual sites were analyzed. Most of the variance in the data was due to differences between subjects rather than differences between sites. It is postulated that the large variance between subjects and sites is due in part to the cyclical nature of the disease and to the lack of synchrony between remissions and exacerbations at different sites and in different patients.
Root Surface Demineralization in Periodontal Therapy: Subject Review
Authors: Nightingale Scott H. , Sheridan Phillip J.
Published: March 2012

The literature of root surface demineralization in periodontal therapy is reviewed. Root surface alterations in periodontal disease and root surface preparation are also discussed.
Progressive Replacement of Epithelial Attachment by a Connective Tissue Junction After Experimental Periodontal Surgery in Rats
Authors: Listgarten M. A. , Rosenberg S. , Lerner S.
Published: March 2012

The purpose of this study was to test the hypothesis that the long junctional epithelium formed during the early stages of periodontal wound healing can become replaced, at least in part, by a connective tissue attachment. A surgical wound was created on the mesial surface of the left maxillary first molar of 4‐month‐old rats and the mesial root surface curetted free of soft tissue and cementum. The contralateral molar served as an unoperated control. Groups of five to eight animals were killed at intervals of 10 days, 3 and 6 weeks, and 3, 6 and 12 months after surgery. The histometric data demonstrated a progressive apical recession of the entire gingival unit on the unoperated control side during the experimental period. On the operated side, the junctional epithelium became reestablished by migration of epithelium from the wound edge along the cut gingival surface facing the tooth, until contact was established near the apical border of the instrumented root surface. Coronal migration of the epithelium from that level accounted for most of the lengthening of the junctional epithelium observed in 3 weeks. During the balance of the experimental period the junctional epithelium did not change in length significantly. However, the entire epithelial attachment was displaced coronally, primarily at the expense of sulcus depth which decreased with time, and by replacement of the apical portion of the junctional epithelium by a connective tissue junction of increasing dimension. These findings challenge the widely held belief that, once established, the dentoepithelial junction cannot be replaced by a connective tissue attachment.
The Development and in Vitro Evaluation of Acrylic Strips and Dialysis Tubing for Local Drug Delivery
Authors: Addy M. , Rawle L. , Handley R. , Newman H. N. , Coventry J. F.
Published: March 2012

This study reports on the development of drug containing acrylic strips for delivering antimicrobial agents and compares the in vitro release pattern with dialysis tubing. Polyethylmethacrylic strips of suitable dimensions containing 10 to 50% Chlorhexidine acetate, 40% metronidazole and 40% tetracycline were prepared. Daily release of the incorporated drugs into 1 ml aliquote was measured spectrophotometrically over a 14 day period. Similarly the release of chlorhexidine gluconate from various lengths of patent and heat sealed dialysis tubing was recorded for 4 days. At 30%, 40% and 50% admixtures the acrylic strips released chlorhexidine up to the 14 day period and a parallel bioassay confirmed the maintenance of antibacterial activity to this time. At the same admixture the release of metronidazole was greater than chlorhexidine and tetracycline. All drugs were released at high levels on day 1 followed by a marked fall in release by day 2 and progressive fall thereafter. The release from tubing was almost total within 24 hours and was independent of sealing the ends. The strips appear to have potential for prolonged drug delivery to periodontal pockets. Preliminaty clinical use revealed no patient acceptability problems and alterations in subgingival flora were produced.
Incidence and Extent of Venous Sequelae With Intravenous Diazepam Utilizing a Standardized Conscious Sedation Technique
Authors: Glaser Jeff W. , Blanton Patricia L. , Thrash William J.
Published: March 2012

Twenty‐four periodontal patients volunteered for a study designed to investigate the incidence of venous sequelae with Injectable Valium administered by a standardized conscious sedation technique. Sedative doses were injected into veins on the dorsum of the hand utilizing a continuous infusion drip of 5% dextrose in water. Postoperative evaluation extended over 12 weeks. Ultrasonic tests for thrombosis were performed with a Doppler Flowmeter. Independent variables considered included age, vein size, volume of drug, volume of intravenous solution, pain upon injection and initial venous flow velocity. Sixteen subjects (66.67%) experienced some form of venous sequelae. Thirteen sequelae advanced to thrombophlebitis. Those subjects who demonstrated no complications had significantly higher initial venous flow than those with complications. Those subjects with resolution of complications demonstrated a significantly greater initial venous flow than those without resolution of complications. Clinical variables of pain on injection, vein diameter, dose of diazepam and volume of infusion solution did not significantly differ across groups. However, those subjects with no complications were significantly older than those with complications. It is recommended that the larger veins of the forearm and antecubital fossa, with greater mean velocities of venous flow, be preferred for intravenous diazepam administration to attempt to decrease the nature and incidence of thrombophlebitis.
Blastogenic Responses by Lymphocytes from Periodontally Healthy Populations Induced by Periodontitis‐Associated Bacteria
Authors: Donaldson Stephen L. , Ranney Richard R. , Burmeister John A. , Tew John G.
Published: March 2012

Studies of blastogenic responsiveness induced in peripheral blood lymphocytes (PBL) from periodontally healthy subjects by periodontal bacteria have conflicted. This study was undertaken to examine the blastogenic response of periodontally healthy subjects under experimental conditions which provide improved control of laboratory variables. By using cryopreserved PBL the responses of all subjects in an experiment were determined on the same day under identical conditions. The periodontally healthy populations consisted of subjects of the same age range and sex matched to three distinct groups of periodontally diseased subjects (i.e., juvenile (JP), severe (SP), and moderate (MP) periodontitis). The bacterial stimulants tested were chosen on the basis of known association with and isolation from persons fitting the disease classifications. If PBL response differences between periodontally healthy and diseased subjects exist they should be most obvious in response to predominant organisms associated with the disease states. PBL cultures were harvested after a 4 hour pulse with 3H‐thymidine on days 4 and 6 of culture. Three separate experiments were conducted comparing one healthy group and one diseased group. In all three experiments subjects in the healthy group responded as frequently as did those in the diseased group, the dose‐response distribution was indistinguishable, and the magnitude of the responses was not substantially different between groups. These results suggest nonspecific activation as the major determinant in the blastogenic response, rather than specific sensitization occurring during initiation or progression of periodontitis.
A Scanning Electron Microscopic Study of Leukocytes and Their Interaction with Bacteria in Human Periodontitis
Authors: Saglie R. , Newman M. G. , Carranza F. A.
Published: March 2012

Shape, size, topographical relationships, surface morphology, phagocytosis and locomotion were used to identify and study leukocytes in human cases of periodontitis. These cells were described in the following locations: in peripheral blood vessels adjacent to the pocket epithelium; gingival connective tissue; basement lamina; sectioned pocket epithelium; surface of pocket epithelium; junctional epithelium; and cementum surface. The interaction of leukocytes and bacteria was documented in the phases of recognition, attachment and engulfment of bacteria. Morphologic data suggesting the process of degranulation was also presented.