bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Clinical Evaluation of a Root Coverage Procedure Using a Collagen Barrier Membrane
Authors: Shieh An‐Tay , Wang Hom‐Lay , O'Neal Robert , Glickman Gerald N. , MacNeil R. Lamont
Published: March 2012

The use of guided tissue regeneration (GTR) procedures in the treatment of gingival recession has shown promising results and is gaining clinical acceptance. The purpose of this study was to assess the use of a bioabsorbable collagen membrane as a barrier device in root coverage treatment of gingival recession defects. The study consisted of 10 patients with 10 defects of either Miller Class I or II description and gingival recession ≥2.5 mm. Clinical measurements taken at baseline included plaque index (PI) and gingival index (GI), clinical attachment level (CAL) measured with an automated probe and reference Stent, recession depth (RD); mean = 3.19 ± 0.26 mm), recession width (RW; 3.95 ± 0.41 mm), probing depth (PD; 2.3 ± 0.2 mm), and width of keratinized tissue (KT; 2.4 ± 0.3 mm); measurements were repeated at 1, 2, and 4 weeks and 3 and 6 months post‐treatment. During the surgical procedure, a mucoperiosteal flap was elevated and the respective root thoroughly planed. The collagen membrane was cut to cover the defect and surrounding bone, positioned over the root, and secured with 5‐0 gut interdental sutures. The flap was coronally positioned to cover the membrane and sutured with 5‐0 silk. Data were analyzed using the Student paired t‐test to compare pre‐ and postsurgery measurements. The nonparametric Wilcoxon matched pairs test was used to analyze the significance of PI and GI at different time intervals. A statistically significant (P < 0.01) reduction in RD (−1.66 ± 0.25 mm) was observed at 6 months, representing 51.6% total attainable root coverage. Clinically, a statistically significant mean gain of 1.34 ± 0.47 mm CAL and 0.90 ± 0.32 mm KT was observed at 6 months. No statistical differences were found in PD and RW between baseline and 6 months postoperatively. PI and GI remained low and showed no statistically significant change (P < 0.05) throughout the study period. Results from this study suggest that a collagen membrane can be used successfully as a barrier device in GTR‐based root coverage procedures. J Periodontol 1997;68:770–778.
A Comparative Study of Root Coverage Obtained With Guided Tissue Regeneration Utilizing a Bioabsorbable Membrane Versus the Connective Tissue With Partial‐Thickness Double Pedicle Graft
Authors: Harris Randall J.
Published: March 2012

Obtaining predictable root coverage has become an important part of periodontal therapy. The purpose of this study was to compare two techniques of obtaining root coverage. The two techniques were the connective tissue with partial‐thickness double pedicle graft and guided tissue regeneration with a bioabsorbable polylactic acid softened with citric acid ester membrane. The connective tissue with partial‐thickness double pedicle graft had a mean root coverage of 97.1%, and the guided tissue regeneration procedure produced a mean root coverage of 75.1%. This difference was not statistically significant. Additionally, it was the goal of this study to determine if the thickness of the tissue near the defect was a factor in root coverage. Thickness of the tissue was not a factor with the connective tissue with partial‐thickness double pedicle graft. The thin areas had a mean root coverage of 100%, while the others had a mean root coverage of 95.9%. This difference was not statistically significant; however, the thickness of the tissue was a factor in root coverage success in the guided tissue regeneration procedure. The thin areas treated with guided tissue regeneration had a mean root coverage of 26.7%, while the others had a mean root coverage of 95.9%. This difference was statistically significant. The results of this study demonstrate that root coverage is possible with both procedures. However, when the tissue in the area of the defect is relatively thin, the connective tissue with partial‐thickness double pedicle graft will produce greater root coverage. When treating defects with tissue that is not thin, similar amounts of root coverage can be obtained with both procedures. J Periodontol 1997;68:779–790.
Periodontal Status of HIV‐1 and HIV‐2 Seropositive and HIV Seronegative Female Commercial Sex Workers in Senegal
Authors: Ndiaye Charlotte F. , Critchlow Cathy W. , Leggott Penelope J. , Kiviat Nancy B. , Ndoye Ibra , Robertson Paul B. , Georgas Kostantinos N.
Published: March 2012

Comprehensive studies of 92 commercial sex workers in Senegal, Africa included an oral examination in which we obtained measurements of decayed, missing, and filled (DMF) teeth; plaque index; gingival index; recession; probing depth (PD); clinical attachment loss (CAL); and the presence of HIV‐associated periodontal lesions, under conditions wherein the examiner was unaware of the subject's HIV status. Twenty‐seven subjects (29%) were HIV seropositive, 19 of whom were positive for HIV‐1, 7 positive for HIV‐2, and 1 positive for both. Most subjects were not taking any medications and previous dental care was limited. HIV‐seronegative and HIV‐seropositive subjects were similar in mean age, number of DMF teeth, percentage of sites with visible plaque, and number of sites with recession. However, the frequency of sites with gingival bleeding, with PD ≥ 6 mm, and with CAL ≤ 6 mm was significantly greater in seropositive than seronegative subjects. No differences were observed between HIV‐1 and HIV‐2 positive subjects. About 26% of HIV‐seropositive subjects and about 5% of the seronegative subjects exhibited at least one site with concurrent PD ≥ 6 mm and CAL ≥ 6 mm. HIV‐associated periodontal lesions were seen in 3 HIV‐seropositive subjects (2 linear gingival erythema, 1 necrotizing periodontitis). One HIV‐seronegative subject exhibited necrotizing gingivitis. In this population with multiple risks to oral health, both HIV‐1 and HIV‐2 infections were associated with a significantly increased prevalence of periodontal disease. J Periodontol 1997;68:827–831.
CD30+ Lymphocytes in Chronic Gingivitis From HIV‐Positive Patients: A Pilot Study
Authors: Gomez Ricardo Santiago , de Souza Paulo Eduardo Alencar , da Costa José Eustáquio , Araújo Ney Soares
Published: March 2012

Th2 type lymphocytes are characterized by high expression of CD30 glycoprotein. Increased serum levels of CD30 and Th2 IL‐4 producing T‐cells are found during AIDS progression. Since HIV‐positive patients are more susceptible to periodontal disease, quantitative analysis of positive cells for the CD30 receptor in chronic gingivitis of both HIV‐infected and non‐infected patients (NSG) would help to clarify the immunoregulation of HIV‐associated periodontal diseases. The purpose of this study was to evaluate CD30+ lymphocytes in gingival biopsies from sites exhibiting chronic gingivitis on HIV‐positive patients (CG‐HIV) and NSG. A biotin‐streptavidin amplified system was used for identification of the CD30 receptor. The results demonstrated increased proportions of Th2 cells in CG‐HIV as compared to NSG. Additional studies are necessary to understand the importance of these cells to the biological activity or inactivity of the disease. J Periodontol 1997;68:881–883.
Local Delivery of an Amino Bisphosphonate Prevents the Resorptive Phase of Alveolar Bone Following Mucoperiosteal Flap Surgery in Rats
Authors: Yaffe A. , Iztkovich M. , Earon Y. , Alt I. , Lilov R. , Binderman I.
Published: March 2012

Mucoperiosteal flaps are used to access the bone and root surface in a wide range of periodontal procedures and in implant surgery. We have demonstrated that the mucoperiosteal surgical flap of the rat mandible produces a transient burst of alveolar bone resorption similar to the clinical observations in humans. This resorptive activity, when coupled with local irritation factors, may cause confined alveolar bone loss. Recently, we have demonstrated that an amino bisphosphonate, which is used in preventing systemic bone resorption in osteoporosis and other bone diseases, reduces alveolar bone resorption in the rat model when administered systemically. In this study we evaluated the effect of local delivery of the amino bisphosphonate on bone resorption associated with mucoperiosteal flaps. Following mucoperiosteal flap elevation in the premolar and molar region of the rat mandible, a surgical pellet soaked with amino bisphosphonate was locally applied on the exposed bone surface and covered by flap. The results show that local delivery of amino bisphosphonate reduces significantly alveolar bone resorption activated by mucoperiosteal flap surgery. This study suggests that local application of amino bisphosphonate can be used as an adjunct in therapy for reducing bone resorption following surgery. J Periodontol 1997;68:884–889.
Effects of Expanded Polytetrafluoroethylene and Polylactic Acid Barriers on Healthy Sites
Authors: Trejo P.M. , Weltman R. , Caffesse R.G.
Published: March 2012

The configuration of the barrier devices to treat interproximal defects by guided tissue regeneration (GTR) necessitates inclusion of healthy adjacent teeth to secure the barriers in place. The purpose of this study was to evaluate the effects of expanded polytetrafluoroethylene (ePTFE) and polylactic acid (PLA) barrier devices on probing depth (PD), clinical attachment level (CAL), and eresiai bone height in healthy sites. The study included 30 patients who were in an earlier study which compared the effects of GTR utilizing an ePTFE or a PLA barrier in intrabony defects. Thirty defects were randomly assigned to receive either a PLA (test) or an ePTFE barrier (control) after open flap debridement. The sites in this investigation included those healthy sites in the immediately adjacent non‐affected teeth covered by the barriers. CAL and PD were measured at baseline and 12 months. Intrasurgical crestal bone height was recorded at the time of barrier placement and at a 12‐month re‐entry. Two‐sample t‐test comparisons of PD and CAL measurements between barrier device covered sites at baseline (PD: ePTFE, 2.32±0.51; PLA, 2.59±0.74; CAL: ePTFE, 2.71 ±0.66; PLA, 2.59±0.65 mm), and at one year (PD: ePTFE, 2.14±0.37; PLA, 2.07±0.56; CAL: ePTFE, 3.14±1.05; PLA, 2.75±0.73 mm) were not statistically different (P > 0.05). Paired t‐test was utilized to compare changes in PD, CAL, and crestal bone height from baseline to 12 months. A statistically significant reduction in PD was found in the PLA group (Δ = −0.52, P = 0.01) while no significant change was found in the ePTFE group (Δ=−0.18, P = 0.18). Change in CAL was statistically significant in the ePTFE group (Δ = 0.43, P = 0.02) while no significant change was found in the PLA group (Δ = 0.16, P = 0.39). Crestal bone height changes from baseline to 12 months were statistically different for both groups (ePTFE, Δ = 0.8 mm, P = 0.001; PLA, Δ = 0.6 mm, P = 0.001). These resorptive changes, when compared between treatment groups were not statistically different (P > 0.05). In conclusion, the placement of ePTFE or PLA barriers on healthy sites resulted in probing depth reductions and loss of attachment of 0.5 mm or less. Additionally, both groups exhibited less than 1.0 mm of crestal bone resorption. J Periodontol 1998;69:14–18.
The Expression of Collagen I and XII mRNAs in Porphyromonas gingivalis‐Induced Periodontitis in Rats: The Effect of Doxycycline and Chemically Modified Tetracycline
Authors: Karimbux Nadeem Y. , Ramamurthy Nangavaran S. , Golub Lorne M. , Nishimura Ichiro
Published: March 2012

Tissue remodeling is a dynamic state in which a balance is achieved between the proteolytic breakdown and synthesis of the extracellular matrix. Type I collagen is a major component of the gingival connective tissue (GCT) and the periodontal ligament (PDL) throughout development, while type XII collagen has been found in the mature forms of these tissues. The purpose of this study was to investigate the effects of periodontitis on the expression of type I and XII collagen and subsequently to investigate the effects of doxycycline (DOXY) and chemically modified nonantimicrobial tetracycline (CMT‐1) on the expression of these molecules in this model. Adult barrier‐raised male Sprague‐Dawley rats were inoculated with Porphyromonas gingivalis obtained from humans to create the experimental periodontitis. The animals with the P. gingivalis‐induced periodontitis were then split into the following groups: Group A served as infected untreated controls (PGI group); group B was treated with doxycycline (DOXY group); and group C was treated with chemically modified tetracy cline‐1 (CMT‐1 group). Group D contained uninfected animals that served as uninfected controls (NIC group). The expression of type I and XII collagen mRNAs was examined by in situ hybridization in each group, with the co‐expression of these molecules representing mature and functional gingival connective tissue. In the NIC group, cells hybridized with digoxygenine‐labeled cDNA probes encoding rat α2(I) or α1(XII) collagens were found distributed uniformly throughout the periodontal connective tissue. The PGI group showed little hybridization in the areas of infection, while both the DOXY and CMT‐1 groups showed co‐expression of the α2(I) and α1(XII) probes in the GCT and coronal part of the PDL. This study demonstrates that doxycycline and CMT‐1 moderate or reduce the inhibitory effects of periodontal infection on the expression of type I and type XII collagen mRNAs. These results suggest that doxycycline and a form of non‐antimicrobial tetracycline, chemically modified tetracycline‐1, can reduce periodontal destruction by reversing the inhibitory effect of periodontal infection on collagen synthesis. J Periodontol 1998;69:34–40.
Long‐Term Maintenance of Alveolar Bone Gain After Implantation of Autolyzed, Antigen‐Extracted, Allogenic Bone in Periodontal Intraosseous Defects
Authors: Flemmig Thomas F. , Ehmke Benjamin , Bolz Katja , Kübler Norbert R. , Karch Helge , Reuther Jürgen F. , Klaiber Bernd
Published: March 2012

This randomized controlled trial assessed the long‐term maintenance of alveolar bone gain after implantation of autolyzed, antigen‐extracted, allogenic (AAA) bone. AAA bone is a demineralized freeze‐dried bone allograft processed after previously described methods. In each of 14 patients, AAA bone was implanted into the intraosseous defect of 1 tooth (test); a second tooth with an intraosseous defect was treated by modified Widman flap surgery alone (control). All patients were offered supportive periodontal therapy at 3‐ to 6‐month intervals following treatment. Clinical measurements were taken prior to surgery, 6 months, and 3 years following surgery. Of the 14 patients enrolled, 11 patients completed the 6‐month and 8 patients the 3‐year examination. In test teeth, bone gain was significantly greater compared to control teeth at 6 months (2.2±0.5 mm and 1.2±0.5 mm, respectively) and 3 years (2.3±0.7 mm and 1.1±0.8 mm, respectively) (P < 0.05). Also, more probing attachment was gained in test compared to control teeth at 3 years (2.0±0.7 mm and 0.8±0.5 mm, respectively; P < 0.05). At 3 years, Porphyromonas gingivalis was detected in 3 test and 2 control teeth by Polymerase chain reaction, whereas no Actinobacillus actinomycetemcomitans was found. Due to the low detection frequency, there was no clear correlation between the maintenance of alveolar bone during supportive periodontal therapy and subgingival infection with P. gingivalis. The data indicated that alveolar bone gain after implantation of AAA bone may be maintained over a minimum of 3 years in patients receiving periodontal supportive therapy. J Periodontol 1998;69:47–53.
Non‐Insulin Dependent Diabetes Mellitus and Alveolar Bone Loss Progression Over 2 Years
Authors: Taylor George W. , Burt Brian A. , Becker Mark P. , Genco Robert J. , Shlossman Marc , Knowler William C. , Pettitt David J.
Published: March 2012

This study tested the hypothesis that persons with non‐insulin dependent diabetes mellitus (NIDDM) have greater risk of more severe alveolar bone loss progression over a 2‐year period than those without NIDDM. Data from the longitudinal study of the oral health of residents of the Gila River Indian Community were analyzed for 362 subjects, aged 15 to 57, 338 of whom had less than 25% radiographic bone loss at baseline, and who did not develop NIDDM nor lose any teeth during the 2‐year study period. The other 24 subjects had NIDDM at baseline, but met the other selection criteria. Bone scores (Scale 0–4) from panoramic radiographs corresponded to bone loss of 0%, l%–24%, 25%–49%, 50%–74%, or 75% and greater. Change in bone score category was computed as the change in worst bone score (WBS) reading after 2 years. Age, calculus, NIDDM status, time to follow‐up examination, and baseline WBS were explanatory variables in regression models for ordinal categorical response variables. NIDDM was positively associated with the probability of a change in bone score when the covariates were controlled. The cumulative odds ratio for NIDDM at each threshold of the ordered response was 4.23 (95% C.I. = 1.80, 9.92). In addition to being associated with the incidence of alveolar bone loss (as demonstrated in previous studies), these results suggest an NIDDM‐associated increased rate of alveolar bone loss progression. J Periodontol 1998;69:76—83.
Immunocytochemical Discrimination Between Early and Late S Phase: A New Approach to the Study of Gingival Epithelium Proliferation in Rats
Authors: Breschi Lorenzo , Mazzoni Giovanni , Baratta Brunella , Galanzi Angela , Strocchi Paola , Falconi Mirella , Centurione Maria Antonietta , Ferrari Carlo , Rizzoli Riccardo
Published: March 2012

The renewal of the free gingival margin epithelium in rats was studied evaluating 5‐bromodeoxyuridine (BrdU) incorporation in proliferating cells by means of an immunocytochemical method. We found a close correspondence between light and electron microscopy patterns of BrdU incorporation at a nuclear level. BrdU was localized in the inner interchromatin regions in cells starting DNA synthesis, while it was localized in the peripheral heterochromatin domains in cells terminating the S phase. This possibility of discriminating cells in early S phase from cells in late S is able to provide far more information as to the time at which a labeled cell starts proliferation than that obtainable with 3H‐thymidine autoradiography. This, in turn, permits detection of cells that start proliferation in a wide period of time by means of a single BrdU administration. Rats treated at 7 a.m. demonstrated higher proliferation than rats treated at 7 p.m., supporting the existence of circadian variations in the epithelial renewal. Proliferative events take place by consecutive activation of at least three replication waves, producing clusters of labeled cells which could be observed in rats sacrificed at 10 a.m. In rats treated once with BrdU at 7 a.m., the clusters were localized in both the basal and suprabasal layer of the epithelium; in rats further injected with BrdU at the same time, the clusters increased in size, progressively extending throughout the epithelium. In this way, the renewal of the free gingival margin epithelium does not proceed randomly, but by consecutive activation of discrete units or clusters of basal cells, which then extend to the upper layers. This can be followed at a morphological level as a progression of labeled cells, which move from the basal layer to the epithelium surface in approximately 82–85 hours. J Periodontol 1998;69:84–91.
Association of Oxygen Tension in Human Periodontal Pockets With Gingival Inflammation
Authors: Tanaka Muneo , Hanioka Takashi , Takaya Keiko , Shizukuishi Satoshi
Published: March 2012

The objective of this study was to investigate the association of the oxygen tension in the periodontal pockets with clinical parameters of gingival inflammation of the maxillary anterior teeth of 32 patients. The pocket oxygen tension (pO2) was measured by a polarographic method with electronic compensation for temperature change. The oxygen saturation of hemoglobin (So2) in the gingiva was determined with tissue reflectance spectrophotometry. Gingival crevicular fluid flow (GCF) was measured with electronic impedance. No significant association was found between pocket pO2 and the modified gingival index, the plaque index, and GCF. Pocket pO2 showed significant correlation with probing depth (r = −0.57, P = 0.0005). Significant correlation was observed between pocket pO2 and gingival So2 (r = 0.69, P < 0.0001). When all variables were entered into a multiple regression model, only gingival So2 had a significant independent effect on the pocket pO2 (P = 0.0005). These results indicate that the oxygen sufficiency in the gingiva has a significant independent influence on the pocket oxygen tension. These studies provide the basis for understanding the oxygen tension in the periodontal pocket, which likely is a major determinant of the subgingival microflora. The studies may also lead to the development of methods for diagnosing and monitoring periodontal diseases. J Periodontol 1998;69:1127–1130.
Neutrophil Migration Into the Gingival Sulcus Is Associated With Transepithelial Gradients of Interleukin‐8 and ICAM‐1
Authors: Tonetti Maurizio S. , Imboden Martin A. , Lang Niklaus P.
Published: March 2012

The expression of adhesion molecules and the local production of chemotactic cytokines within the epithelium are considered to be key events in neutrophil (PMN) migration at sites of mucosal infections. In their journey toward the gingival sulcus, PMNs have been shown to selectively migrate through the junctional epithelium. Little, however, is known about the molecular mechanisms involved in this key process aimed at the control of subgingival bacterial plaque. This investigation describes the expression of IL‐8 mRNA‐positive cells and the establishment of a gradient of intercellular adhesion molecule‐1 (ICAM‐1) receptors within the junctional epithelium of clinically healthy gingiva. Expression of ICAM‐1 and IL‐8 was topographically associated with the area of PMN migration; i.e., the junctional epithelium. Levels of ICAM‐1 expression increased from the basal cells toward the surface of the junctional epithelium and thus toward areas exposed to bacterial challenges. IL‐8 mRNA‐positive cells were also present at highest density in the most superficial junctional epithelial layers. The combination of the haptotactic stimuli, resulting from the interaction of the PMN's β2 integrin receptors with the gradient of ICAM‐1 expression, and the location of IL‐8 mRNA‐positive cells, consistent with the establishment of a discrete PMN chemotactic source, may play an important physiologic role in efficiently routing PMNs to the gingival sulcus. This process contributes to the maintenance of a local host‐parasite equilibrium and to the limitation of PMN‐associated tissue damage. J Periodontol 1998;69:1139–1147.
Local Metronidazole Application in Maintenance Patients. Clinical and Microbiological Evaluation
Authors: Rudhart A. , Purucker P. , Kage A. , Hopfenmüller W. , Bernimoulin J.‐P.
Published: March 2012

The purpose of this investigation was to evaluate the clinical and microbiological effect of local antibiotic therapy in comparison with subgingival scaling and root planing in a randomized semi‐masked study. Forty‐six recall patients who completed systematic periodontal therapy 6 to 24 months prior to the study were enrolled. The inclusion requirements were at least one site with probing depth ≥5 mm in each quadrant, no scaling, and no antibiotic therapy during the last 6 months. After randomization each patient received 2 different treatments: in 2 quadrants metronidazole 25% dental gel was applied subgingivally to the pockets at day 0 and day 7; scaling and root planing was carried out in the 2 other quadrants, one at day 0 and in the remaining quadrant at day 7. Subgingival microbiological samples were taken from each patient before treatment and on days 21, 91, and 175 after the treatment. The analyses were carried out by indirect immunofluorescence assay. At all treated sites probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded on days 0, 21, 91, and 175. Both treatments resulted in PD reduction and CAL gain. PD reduction was statistically significant (P < 0.01) for both treatment modalities after 6 months. The CAL gain was not significant for either treatment. There was no statistical significance between scaling and antibiotic therapy. Treponema denticola, Porphyromonas gingivalis, and Prevotella intermedia were significantly reduced after therapy; however, there were no statistically significant differences between treatments. If Actinobacillus actinomycetemcomitans was present before therapy, it was also present after treatment in both groups. The conclusion is that, in recall patients, local application of metronidazole and scaling and root planing showed similar clinical and microbiological effects without statistically significant differences. J Periodontol 1998;69:1148–1154.
Analysis of Gingival Crevicular Fluid Intracytoplasmic Enzyme Activity in Patients With Adult Periodontitis and Rapidly Progressive Periodontitis. A Longitudinal Study Model With Periodontal Treatment
Authors: Atici Kübra , Yamalik Nermin , Eratalay Kenan , Etikán Ílker
Published: March 2012

In the present study, the activity of 3 functionally related enzymes, creatine Kinase (CK), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) levels in the rest and flow gingival crevicular fluid (rGCF, fGCF) from patients with rapidly progressive periodontitis (RPP) and adult periodontitis (AP) were determined before and after periodontal treatment, including maintenance. When rGCF and fGCF mean enzyme levels were compared, rGCF was found to contain approximately twice as much enzyme levels than fGCF throughout the study. The findings of the present study revealed that both the rGCF and fGCF samples also contained higher CK, LDH, and AST levels than serum samples. Baseline clinical parameters and GCF enzyme levels presented a significant decline throughout the non‐surgical and surgical treatment phases in both patient groups, with surgical treatment being more effective. Despite clinical stability, in the AP group levels of LDH and AST showed a tendency to increase in the third month, while enzyme levels still continued to decrease in the RPP group, who received additional antibiotics during the surgical phase. These findings suggest that GCF intracytoplasmic enzyme profile is related with periodontal status and successful periodontal treatment, in addition to clinical improvement, has a significant effect on this profile. Analysis of biochemical events, more specifically intracytoplasmic enzyme levels in GCF, are likely to offer a sensitive measure of periodontal pathology which may help in overcoming the existing limitations of clinical parameters. For this purpose, analysis of rGCF intracytoplasmic enzymes seems to be more beneficial. J Periodontol 1998;69:1155–1163.
Gingival Salivary Gland Choristoma. A Case Report
Authors: Ledesma‐Montes Constantino , Fernández‐López Rocóo , Garcés‐Ortíz Maricela , Portilla‐Robertson Javier , Hernández‐Guerrero Juan Carlos
Published: March 2012

Gingival salivary gland choristoma is an extremely rare disturbance of glandular development. A review of the literature disclosed only 5 reported cases of this entity and 7 gingival salivary gland tumors or alterations. We present a case of this condition present in a 43‐year‐old female patient, which was found while reviewing casts for the design of a prosthetic appliance. This case suggests that embryonal pluripotentiality of gingival epithelial cells is retained and that development of salivary glands in gingival tissue is feasible. An additional discussion about its histogenesis is presented. J Periodontol 1998;69:1164–1166.
A Method for Determining Patient Oral Care Skills: The University of Mississippi Oral Hygiene Index
Authors: Silberman Stephen L. , Jeune Ronald C. Le , Serio Francis G. , Devidas Meenakshi , Davidson Lisa , Vernon Karen
Published: March 2012

The plaque control record (O'Leary index) appears to be a commonly used oral hygiene index for assessing oral health skills. This index provides sufficient information for patient education; however, the time involved in data collection reduces its value. Most other indices limit the number of teeth and surfaces and function well for researchers, but are limited for patient education. A new oral hygiene index was developed based on the concepts of the Periodontal Screening and Recording (PSR). The highest score obtained in each buccal and lingual sextant is recorded. In addition, proximal and gingival plaque are noted separately. This study assesses the index for inter‐ and intrarater reliability and validity. Two calibrated hygienists examined 47 patients 3 times. The University of Mississippi Oral Hygiene Index (UM‐OHI) was recorded for times 1 and 3, the O'Leary for time 2. There was a strong positive correlation between scores obtained for both hygienists for each method and repetition. The intrarater reliability was high for the 2 methods and also over time for the UMOHI. Pearson's correlation coefficients ranged from 0.79 to 0.92. Paired t‐tests used to compare scores for the 2 hygienists over time showed significant differences. Despite observer bias, these data seem to indicate that the UM‐OHI has sufficient reliability and validity to be used as a health education teaching tool. J Periodontol 1998;69:1176–1180.
Periodontal Surgery of Vertical Bony Defects With or Without Synthetic Bioabsorbable Barriers. 12‐Month Results
Authors: Eickholz Peter , Lenhard Markus , Benn Douglas K. , Staehle Hans J.
Published: March 2012

The aim of the present study was to clinically and radiographically compare guided tissue regeneration (GTR) therapy with bioabsorbable polyglactin 910 barriers and conventional periodontal surgery in intrabony defects. In 26 patients with advanced periodontitis, 29 teeth exhibiting interproximal intrabony defects were treated; 15 by conventional periodontal surgery (control) and 14 by GTR (test). Before and 12 months after surgery, clinical parameters were assessed and standardized radiographs were taken. On the radiographs the distances from the cemento‐enamel junction (CEJ) to the alveolar crest (AC), and the CEJ to the most apical extension of the bony defect (BD) were measured using a computer‐assisted analyzing device (LMSRT). Twelve months after surgery, 24 patients with 27 lesions were available for examination. For both methods statistically significant (P < 0.001) probing depth (PD) reduction (mean ± standard deviation) of −4.49 ± 1.94 mm (n = 13, test) and −3.22 ± 1.48 mm (n = 14, control), as well as clinical attachment gain (CAL‐V) of 3.41 ± 1.59 mm (test) and 2.07 ± 1.10 mm (control), was observed. Radiographic changes of the distance CEJ to AC of −0.95 ± 1.72 mm (n = 9, test), and −0.98 ± 1.53 mm (n = 11, control) were not significant. A significant bony fill (distance CEJ‐BD) of 1.05 ± 1.22 mm was observed for the test group (P < 0.01); the 0.68 ± 2.04 mm bony gain for the control group was not statistically significant. The PD reduction (P < 0.05) and attachment gain (P < 0.01) in the test group was statistically significantly more favorable than in the control group. Twelve months after surgery, statistically more favorable PD reduction and attachment gain was observed using polyglactin 910 barriers than compared to conventional flap surgery. Hence, the use of bioabsorbable barriers for therapy of intrabony defects may be recommended. J Periodontol 1998;69:1210–1217.
Evaluation of a Diphenylphosphorylazide‐Crosslinked Collagen Membrane for Guided Bone Regeneration in Mandibular Defects in Rats
Authors: Zahedi Shahram , Legrand Roman , Brunel Gérard , Albert Adelin , Dewé Walthére , Coumans Bernard , Bernard Jean‐Pierre
Published: March 2012

In the present study, the potential of a diphenylphosphorylazide‐crosshriked type I bovine collagen membrane was evaluated in the healing of mandibular bone defects applying the biological concept of guided bone regeneration. The experiment was carried out on 25 Wistar rats. After exposing the mandibular ramus bilaterally, 5 mm diameter full‐thickness circular bone defects were surgically created. While the defect on one side was covered by the membrane (experimental), the defect on the other side was left uncovered (control) before closure of the overlying soft tissues. The rats were sacrificed in groups of 5 after 7, 15, 30, 90, and 180 days of healing. Although at early stages of healing similar amounts of bone formation were observed in the experimental and control defects, after 1 month of healing, most of the experimental defects were completely closed with new bone, while in the control defects, only limited amounts of new bone were observed at the rims and in the lingual aspect of the lesions. In the 90‐ and 180–day animals, all experimental defects were completely closed, while in the control defects, no statistically significant increase in bone regeneration was observed. The increase in percentage of bone regeneration in the experimental defects was statistically significant between the 15‐day specimens as compared with the 7‐day specimens (P < 0.01) and likewise between 30‐day and 15‐day specimens (P < 0.001). It can be concluded that a DPPA‐crosslinked collagen membrane yields biocompatibility, ad hoc mechanical hindrance, and handling characteristics suitable for guided bone regeneration applications in this experimental model. J Periodontol 1998;69:1238–1246.
Effects of Porphyromonas gingivalis 2561 Extracts on Osteogenic and Osteoclastic Cell Function in Co‐Culture
Authors: Loomer Peter M. , Ellen Richard P. , Tenenbaum Howard C.
Published: March 2012

This study was undertaken to determine the direct effects of extracts derived from Porphyromonas gingivalis on bone formation and mineral resorption in an osteogenic/osteoclastic cell in vitro co‐culture model. Osteogenic bone marrow derived stromal cells were isolated from 18‐day old embryonic chickens, while osteoclastic cells were isolated from laying white Leghorn hens on calcium deficient diets. Osteoclastic cells (5 × 105) were seeded onto mineral thin films and suspended above osteogenic cells (1 × 104) already plated on the bottoms of tissue culture plate wells. Sonicated P. gingivalis 2561 extracts were prepared from whole bacterial cells and added in varying proportions (0 to 2 μg/ml) to the co‐culture growth medium. These co‐cultures, and appropriate mono‐culture controls, were incubated for a further 4 days. Parameters of bone forming cell activity including alkaline phosphatase activity, calcium and inorganic phosphate accumulation were performed on the osteogenic cells. Mineral substrate resorption by osteoclastic cells was assessed morphometrically. In their respective mono‐cultures, the addition of P. gingivalis sonicate to the culture medium had no effect on osteoclastic mineral resorption, but significantly inhibited Osteogenesis (up to 45%; P <0.05). In co‐cultures, however, the sonicate induced significant increases in mineral resorption (up to 70%; P <0.05), whereas bone forming cell activity was still inhibited, although to a significantly lesser extent than in mono‐cultures (up to 25%; P <0.05). These results suggest that P. gingivalis sonicate induced up‐regulation of mineral resorption may be mediated via osteogenic cells. J Periodontol 1998;69:1263–1270.
Periodontal Repair in Intrabony Defects Treated With a Calcium Sulfate Implant and Calcium Sulfate Barrier
Authors: Kim Chong‐Kwan , Chai Jung‐Kiu , Cho Kyoo‐Sung , Moon Ik‐Sang , Choi Seong‐Ho , Sottosanti John S. , Wikesjö Ulf M.E.
Published: March 2012

This randomized, controlled, clinical study was designed to evaluate outcome following surgical implantation of an allogeneic, freeze‐dried, demineralized bone matrix‐calcium sulfate (DBM+CS) composite with a CS barrier in intrabony periodontal defects. Twenty‐six patients contributing 26 deep intrabony defects completed the study. Thirteen patients received the DBM+CS implant. Thirteen patients received gingival flap surgery alone (GFS; control). Clinical outcome was assessed at 6 and 12 months postsurgery. At 12 months postsurgery, probing depth (PD) reduction (mean ± SD) for the DBM+CS and GFS group was to 4.3 ± 0.5 and 3.0 ± 1.3 mm; clinical attachment gain was to 2.9 ± 0.8 and 1.7 ± 1.5 mm; and probing bone level gain was to 2.9 ± 1.4 and 1.2 ± 1.2 mm, respectively. There were no apparent differences between evaluations at 6 and 12 months postsurgery. Clinical improvements were significantly different from presurgery for both groups at both observation intervals (P < 0.01). There were no significant differences between groups in PD reduction and clinical attachment gain. Probing bone level gain was significantly greater in the DBM+CS group compared to controls (P < 0.05). In summary, surgical implantation of DBM+CS with a CS barrier resulted in reduced PD and improved attachment levels comparable to that achieved by gingival flap surgery alone. However, gain in probing bone levels in deep intrabony periodontal pockets assessed by clinical parameters was greater than that observed by gingival flap surgery alone. These changes were noted at both 6 and 12 months after surgery. This regenerative technique needs further biologic evaluation before being generally accepted. J Periodontol 1998;69:13171324.
Periodontitis‐Associated Marker Bacteria in an Urban North American Patient Population: Application of a Commercial Immunoassay
Authors: Eggert F.‐Michael , McLeod M. Herbert , Flowerdew Gordon , McIntyre Edward W. , Wasylyk Jason , Koschzeck Lea
Published: March 2012

We used an immunoassay to demonstrate marker organisms (Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans) in 3 private practice populations (F‐ME periodontist, 55 patients; MHM periodontist, 179 patients; and EWM general dentist, 19 patients). Occurrence of the marker organisms involves the whole oral environment, not just individual sites, as shown by close correlation between presence of the marker organisms in 2 independent sites/samples within a single mouth. Presence of the marker P. gingivalis (and P. intermedia) relates closely to periodontal pocketing while presence of A. actinomycetemcomitans does not have this pocket‐associated characteristic. There was no significant relationship between presence of the marker organisms and the number of teeth in a mouth, and in the periodontal practice patients there was no significant effect of gender on occurrence of the marker organisms. A. actinomycetemcomitans and the other 2 markers were found over the entire age range (12 to 75) of our patients. Regular periodontal treatment reduced occurrence of all marker organisms and increased the frequency of marker‐negative patients and sites. Occurrence of the marker organisms above immunoassay threshold levels appears to represent how receptive a patient is to each individual organism. Most patients appear receptive to the presence of P. intermedia whether treated or not. Significantly fewer patients who underwent regular treatment show the presence of P. gingivalis or A. actinomycetemcomitans when compared to untreated patients. Diagnostic application of microbial markers requires ongoing clinical assessment of patients and careful clinical judgment. J Periodontol 1998;69:1382–1391.
The Influence of Endodontic Infection on Periodontal Status in Mandibular Molars
Authors: Jansson Leif E. , Ehnevid Helge
Published: March 2012

The purpose of the study was to investigate the influence of an endodontic infection on periodontal probing depth and presence of furcation involvement in periodontally‐involved mandibular molars. All first and second mandibular molars in 100 patients were selected if at least one was root‐filled or had a possible periapical radiolucency. The sample consisted of patients from a referral population at a periodontal clinic which represented an adult population with a mean age between 50 and 60 years. For mandibular molars with periapical destruction at both roots, mean periodontal probing depth was significantly greater compared to teeth without periapical destruction. Horizontal furcation depths ≥3 mm were significantly more frequent at mandibular molars with periapical destruction. It is suggested that a root canal infection in periodontitis‐involved molars may potentiate periodontitis progression by spreading of endodontic pathogens through patent accessory canals and dentinal tubules. In conclusion, an endodontic infection in mandibular molars was found to be associated with additional attachment loss in the furcation area, and may thus be considered to be one of several risk factors influencing the prognosis of molars in periodontitis‐prone patients. J Periodontol 1998;69:1392–1396.
Sinus Floor Augmentation With Simultaneous Implant Placement in the Severely Atrophic Maxilla
Authors: Peleg Michael , Mazor Ziv , Chaushu Gavriel , Garg Arun K.
Published: March 2012

Dental implant placement associated with augmentation of the sinus floor in the severely atrophie maxilla can be performed in 1‐ or 2‐surgical stages, depending on the height of the residual alveolar bone. A minimum of 4 to 5 mm of residual alveolar bone height is recommended for a 1‐stage surgical procedure. The present study describes a 1‐stage procedure in cases where the residual alveolar bone height in the posterior maxilla was 1 to 2 mm. A total of 55 hydroxyapatite‐coated dental implants were inserted in 20 grafted sinuses of 20 patients. No case presented any difficulty in achieving initial stabilization and parallelism. No perforation of the sinus membrane or clinical complications of the sinuses were evident. Prior to exposure, radiographie evaluation revealed bone consolidation and a close bone‐implant relation. At secondstage surgery, there was no clinical evidence of crestal bone loss around the implants. All implants were clinically osseointegrated. All patients received fixed implant‐supported prosthesis. The mean follow‐up was 26.4 months (range 15 to 39 months). There was no implant loss after loading. The following surgical modifications are essential: a wide lateral window opening, the use of a bone mill to homogenize the bone graft, meticulous condensation, and clinical measurements to ensure implant parallelism. J Periodontol 1998;69:1397–1403.
Factors Affecting Implant Mobility at Placement and Integration of Mobile Implants at Uncovering
Authors: Orenstein Ira H. , Tarnow Dennis P. , Morris Harold F. , Ochi Shigeru
Published: March 2012

This study examined 1) factors that contributed to implant stability at placement and 2) the likelihood for an implant that was mobile at placement to osseointegrate. Eighty‐one (3.1%) of 2,641 implants placed by the Dental Implant Clinical Research Group between 1991 and 1995 were found to be mobile at placement. Seventy‐six (93.8%) of the 81 mobile implants were integrated at uncovering compared to 97.5% for the 2,560 immobile implants. Variables that influenced mobility at placement included patient age, implant design and material, anterior‐posterior jaw location, bone density, and use of a bone tap. Hydroxyapatite (HA)‐coated implants were slightly more likely to be mobile at placement (P = 0.324) than non‐hydroxypatite (HA)coated implants. Of the 54 HA‐coated implants that were mobile at placement, all (100%) integrated, while only 17 (81.5%) of the 22 mobile non‐HA‐coated implants integrated (P = 0.003). Mean electronic mobility testing device values (PTVs) at uncovering for all implants mobile or immobile at placement that integrated were −2.9 and −3.6 respectively. PTVs for HA‐coated implants that were mobile (−3.5 PTV) or immobile (−4.0 PTV) at placement differed by 0.5 PTV, whereas non‐HA‐coated implants exhibited a greater difference of 1.2 PTVs at uncovering. HA‐coated implants, regardless of mobility at placement, integrated more frequently and exhibited greater stability than non HA‐coated implants. J Periodontol 1998;69:1404–1412.
Analysis of Peripheral Blood Leukocytes in Patients With Cyclosporine A‐Induced Gingival Hyperplasia
Authors: Cebeci Írfan , Kantarci Alpdoǧan , Gürel Nuray , Adin Suzan , Tuncer Özen , Çarin Mahmut , Badur Selim , Firatli Erhan
Published: March 2012

Background: Gingival overgrowth is one of the major adverse effects of the immunosuppressive drug cyclosporine A (CsA). Although several studies have attempted to determine the immunological mechanisms of gingival hyperplasia (GO) due to CsA therapy, the pathogenesis remains unclear. In this study, the distribution of the peripheral blood leukocytes in a group of renal transplant patients undergoing CsA therapy was analyzed and possible correlations of periodontal and pharmacological variables to lymphocyte subpopulations, natural killer cells, and monocytes investigated.

Methods: Thirty‐six patients were classified into 2 groups of 18 each according to the degree of gingival overgrowth. The periodontal evaluation included plaque index (PI), gingival index (GI), gingival overgrowth (GO), calculus index (CI), and probing depth (PD). The pharmacological variables of current doses of the therapeutic serum levels of CsA were investigated. The peripheral blood leukocytes were studied by 2color flow cytometric analysis using anti‐human CD2, CD3, CD4, CD8, CD11b, CD11c, CD16, CD19, HLA‐DR, and CD3+HLA‐DR+ monoclonal antibodies.

Results: Statistical evaluation revealed that none of the pharmacological variables varied between the 2 groups. Responders (GO >30%) had significantly higher GI, PD, and GO scores compared to nonresponders (GO ≤30%). Of the immunological parameters studied, only CD2 was higher in the responder group. None of the clinical parameters correlated to the immunological values.

Conclusions: The results of this study may be useful in explaining the underlying mechanisms of drug‐induced gingival overgrowth. Several previously unsuspected cells and accessory activation mechanisms for T lymphocytes could play a role in the pathogenesis. J Periodontol 1998;69:1435–1439.
The Clinical Effects of Nifedipine on Periodontal Status
Authors: Tavassoli Sepideh , Yamalik Nermin , Çaǧlayan Feriha , Çaǧlayan Gürhan , Eratalay Kenan
Published: March 2012

The present study was conducted to determine the clinical effects of nifedipine on the gingiva of 97 patients. Patients were examined for changes in periodontal status and divided into subgroups, based on their age, gender, duration of drug intake, presence/absence of plaque and gingival inflammation, and according to the presence and severity of gingival overgrowth. Gingival overgrowth was noticed in 29% of the patients. Among the recorded parameters, duration of drug intake, presence/severity of gingival inflammation, and gender seemed to have the greatest effect on the development of gingival overgrowth. Patients with higher gingival inflammation scores, those on nifedipine medication for more than 4 years, and males were likely to have an increased tendency for higher incidence and severity of gingival overgrowth. The findings of the present study suggest that nifedipine medication induces gingival overgrowth and that certain local factors are involved in the pafhogenesis of drug‐induced gingival overgrowth. However, individual ability and sensitivity to metabolize the drug and its metabolites also seem to be important etiological factors. J Periodontol 1998;69:108–112.