bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and Laboratory Studies on a Patient With Early Onset Periodontitis and Her Family Members. A Case Report
Authors: Takahashi Keiso , Takigawa Masayuki , Hara Hiroaki , Nagai Atsushi , Takashiba Shogo , Nishimura Fusanori , Chibara Toshihiro , Ohyama Hideki , Satoh Nobuhiko , Kurihara Hidemi , Murayama Yoji
Published: March 2012

Extensive clinical, microbiological, hematological, and immunological studies were performed on a patient with early onset periodontitis (EOP) and two other members of the family. The proband, a 27‐year‐old female, had early onset periodontitis and a high level of serum rheumatoid factors (RF) with no diagnosable medical disease. Her mother had lost all her teeth at the age of 50 because of advanced periodontitis, while her elder sister was unaffected by periodontitis. Neither the proband's periodontally‐affected mother nor her unaffected sister exhibited a detectable level of RF. In this study, we examined: 1) serum Immunoglobulin G (IgG) antibody titers against putative periodontal pathogenic bacteria; 2) peripheral neutrophil functions; 3) phenotypic analyses of peripheral lymphocyte subpopulations; and 4) peripheral lymphocyte functions (T cell proliferative activity, ability of cytokine [interleukin (IL)‐2, tumor necrosis factor‐α, interferon‐γ, IL‐6 and IL‐8] and IgG and IgM productivity). High antibody titers to Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Campylobacter rectus were detected in the sera of the proband, as were high serum antibody titers to P. gingivalis in the mother and to C. rectus in the unaffected sister compared to the non‐periodontitis affected subjects. The proband also showed enhanced neutrophil Chemotaxis; a high percentage of pan‐B cells; and high productivity of IL‐6, IgG, and IgM compared to individuals who were not periodontally affected. The mother showed slightly low helper/induced T cells (Th/i) suppressor/cytotoxic T cells (Ts/c) ratios due to the elevated count of Ts/c, and high IFN‐γ productivity compared to control subjects. We could not identify any common risk factor in this family, but the immunological profiles of this proband might be useful for discussing the relationship between RF and periodontal disease. J Periodontol 1995; 66:403–412.
Papillon‐Lefévre Syndrome: A Review of the Literature and Report of 4 Cases
Authors: Hattab Faiez N. , Rawashdeh Ma'amon A. , Yassin Othman M. , Al‐Momani Aref S. , Al‐Ubosi Mustafa M.
Published: March 2012

This report describes 4 cases of Papillon‐Lefévre syndrome (PLS) affecting 2 Jordanian families with a total of 8 children. In family A, 3 girls out of 6 siblings were affected; and in family B, the eldest of 2 brothers. The patients were between 4½ and 12 years old, and their parents, who are first cousins, were not affected. Diagnosis was determined by history, and clinical, laboratory, and radiographie examinations. All present cases exhibited the typical clinical features of PLS: hyperkeratosis of the palms and soles and the presence of advanced destructive periodontitis resulting in early loss of both the primary and permanent dentitions. In Case 4, cutaneous lesions were noticed at age 6 months and the child was edentulous by the age of 12 years. In all cases, there was a relationship between increased severity of skin lesions and seasonal variations and intensified periodontal destruction. There was an early eruption of the permanent teeth. The teeth were caries‐free with no sign of root resorption. Dentists play a significant role in the diagnosis and management of PLS patients. J Periodontol 1995; 66:413–420.
The Effects of Intracanal Medicaments, Fillers, and Sealers on the Attachment of Human Gingival Fibroblasts to an Exposed Dentin Surface Free of a Smear Layer
Authors: Breault Lawrence G. , Schuster George S. , Billman Michael A. , Hanson Benjamin S. , Kudryk Val L. , Pashley David H. , Runner Royce R. , McPherson James C.
Published: March 2012

To date there has been very little research into the possible effects of endodontic therapy on.regeneration of the lost periodontal attachment. The objective of this study was to examine the effects of endodontic medicaments on fibroblast attachment to dentin surfaces free of a smear layer. Pulp chambers of extracted third molars were filled with one of the following medicaments: gutta‐percha with Roth's zinc oxide and eugenol‐based sealer, warm gutta‐percha with sealer, warm gutta‐percha without sealer, calcium hydroxide, formocresol, cotton pellet, or left empty. A predetermined dentin surface area was then inoculated with human gingival fibroblasts at a concentration of 2 × 104 cells per ml. The cells were allowed to adhere to the dentin surface for either 4 or 24 hours, then cell attachment was quantified using a methyl‐tetrazolium assay. The data were analyzed using a Kruskal‐Wallis one‐way analysis of variance and Dunn's multiple comparison test. It was determined that fibroblast attachment was significantly reduced when exposed to formocresol or warm gutta‐percha without sealer at both the 4 and 24 hour interval (P ≤ 0.05). This suggests that the use of formocresol or warm gutta‐percha without sealer in a root canal may impede periodontal wound healing and regeneration. J Periodontol 1995;66:545–551.
Growth Factor Effects on the Expression of Collagenase and TIMP‐1 in Periodontal Ligament Cells
Authors: Alvares O. , Klebe R. , Grant G. , Cochran D.L.
Published: March 2012

The Fibroblast is a prominent cellular component of the periodontal ligament. It is believed to play an important role in collagen metabolism in health and disease. The turnover of collagen in the periodontal ligament is believed to be controlled by the balance between collagen synthesis and degradation. The family of matrix metalloproteinases and their inhibitors is one of the mechanisms which regulates this balance. The factors that regulate the synthesis of collagenase and its inhibitor, TIMP‐1, by the periodontal ligament cell are poorly understood. The present study was undertaken to assess the effect of interleukin‐1 beta (IL‐1β), platelet‐derived growth factor (PDGF), and transforming growth factor‐β 1 (TGF‐β) on the expression of collagenase (MMP‐1) and TIMP‐1 mRNA in periodontal derived fibroblasts using reverse transcription polymerase chain reaction (RT‐PCR). Early passage periodontal ligament derived fibroblasts were treated with IL‐1 β (10 and 100 pg/ml), two isoforms of PDGF, ‐AA and ‐BB (4 and 20 ng/ml) and TGF‐β (1 and 10 ng/ml). Treatment with growth factors from 2 to 24 hours revealed that the largest effects on MMP‐1 mRNA occurred after 24 hours. IL‐1β induced a 5 to 9 fold increase in MMP‐1 mRNA. The two isoforms of PDGF had less of an effect (3 to 5 fold) on MMP‐1 mRNA whereas TGFβ induced a 25 to 50% decrease in the expression of this message. None of the growth factors had an effect on TIMP‐1 mRNA expression. These findings suggest that of the growth factors examined, IL‐1β exerts the most profound effect on MMP‐1 synthesis at the mRNA level. PDGF isoforms have less of an effect and consistent with other cell types, TGF‐β had an inhibitory effect. Further, IL‐1β, PDGF, and TGF‐β had no effect on TIMP‐1 mRNA level. These results demonstrate that, in human periodontal cells, IL‐1β, PDGF‐AA and ‐BB and TGF‐β differentially and specifically regulate expression of collagenase mRNA but not that of its inhibitor. J Periodontal 1995;66:552–558.
Clinical Comparison of Desired Versus Actual Amount of Surgical Crown Lengthening
Authors: Herrero F. , Scott J.B. , Maropis P.S. , Yukna R.A.
Published: March 2012

The actual length of clinically exposed tooth structure between planned restoration margin and alveolar crest (“biologic width”) obtained during surgical crown elongation procedures was compared to the textbook goal of 3.0 mm. Sixteen (16) patients with 21 teeth requiring surgical crown lengthening for restoration placement participated. Oral hygiene instructions were given and optimal plaque control was mandatory. At each clinician's discretion, surgical techniques consisted of either gingivectomy or an apically positioned flap with and without osseous resection. Utilizing a reference stent, measurements were obtained at the facial, mesial‐facial, lingual, and distal‐lingual of the treated teeth both before and after osseous reduction. Parameters evaluated were gingival margin position, probing depth, mucogingival junction position, alveolar crest location, mobility, plaque index, and gingival index. These measurements were again recorded 8 weeks after surgery with the exception of alveolar crest. Statistical analysis with the paired t‐test and linear correlation showed no significant change from baseline or among operators with varying experience in any of these parameters. Overall the results showed that the default objective of 3 mm between planned restoration margin and alveolar crest was not routinely achieved (mean 2.4 ± 1.4 mm). The post‐treatment distance from the planned restoration margin to the alveolar crest was greatest at the facial aspect of the teeth (mean 2.6 ± 1.2 mm) and least at the distal‐lingual (mean 2.2 ± 1.7 mm). In addition, although more experienced periodontists removed a larger amount of bone, the amount of root surface exposed was still short of the initially desired biologic width. Within the limits of this clinical study a 3 mm biologic width was not routinely achieved during surgical crown elongation. J Periodontol 1995;66:568–571.
Prevalence of Nifedipine‐Induced Gingival Hyperplasia
Authors: Nery Edmundo B. , Edson Robert G. , Lee Kelvin K. , Pruthi Vijay K. , Watson James
Published: March 2012

This study investigated the prevalence of gingival hyperplasia in subjects who were undergoing treatment with a calcium channel blocker, nifedipine, in dentate and edentulous subjects. In addition, the relationship between gingival hyperplasia and 5 other variables (duration of nifedipine intake, dose, age, oral hygiene index, and number of teeth) was investigated. Results of statistical analyses showed overwhelming evidence that the percent of nifedipine subjects with gingival hyperplasia was greater than that of the control subjects (P < 0.05) and that, across treatment group, the percent of dentate subjects with hyperplasia was significantly higher than that for edentulous subjects (P < 0.05). The χ2 test showed a strong univariate relationship between gingival hyperplasia and, separately, oral hygiene and number of teeth. For 24% of the subjects with gingival hyperplasia index (GHI) values of 2 or 3, gingivectomy was performed, and the tissues were prepared for histological examination. Microscopic examination of the biopsy material showed findings similar to those from previously reported cases of nifedipine‐ or phenytoin‐induced hyperplasia. J Periodontol 1995;66:572–578.
Dose‐Dependent Gingival Overgrowth Induced by Cyclosporin in Rats
Authors: Fu Earl , Nieh Shin , Chang Hou‐Li , Wang Shiao‐Long
Published: March 2012

This study evaluated the effect of dosage on severity of cyclosporin‐A (CSA) induced gingival overgrowth. Eighty (80) male Sprague‐Dawley rats were randomly distributed into 4 groups. Rats in each group daily received CSA in mineral oil by gastric feeding at dosages of 0 (control), 3, 10, and 30 mg/kg, respectively, for 6 weeks. Stone models of the mandibular incisal region were obtained biweekly and were used for analysis of the gingival dimensions. Animals were sacrificed at the end of week 6 and tissue sections were processed for histopathologic evaluation. Gingival overgrowth including bucco‐lingual and mesio‐distal width and vertical height were significantly increased with increasing CSA dosage. Furthermore, the gingival dimensions displayed a positive linear relation to dosage and treatment duration. The histopathologic evaluation revealed a granulomatous tissue wedging the tooth‐gingival tissue interface in the 3 mg/kg group. This tissue had reached exuberant size in the 10 and 30 mg/kg groups. In summary, the analysis of gingival dimensions and the histopathologic evaluation shows a dose‐dependent effect on the severity of CSAinduced gingival overgrowth. J Periodontol 1995;66:594–598.
Understanding Diagnostic Testing for Periodontal Diseases
Authors: Greenstein Gary , Lamster Ira
Published: March 2012

Probability computations are used to characterize new periodontal diagnostic tests and are an integral facet of risk assessment for periodontal diseases. However, misinterpretation of these data can result in confusion and erroneous conclusions regarding the relationship of test results to the presence or absence of disease in a subject, or to episodes of periodontal destruction at specific sites. This paper was written to provide clinicians with a primer to help in understanding calculations used to evaluate diagnostic tests and risk assessment. J Periodontol 1995;66:659–666.
Comparative Effectiveness of Various Regenerative Modalities for the Treatment of Localized Juvenile Periodontitis
Authors: DiBattista Peter , Bissada Nabil F. , Ricchetti Paul A.
Published: March 2012

The objective of this study was to assess the effectiveness of surgical debridement versus various guided tissue regeneration techniques for the treatment of localized juvenile periodontitis (LJP). Seven patients, 14 to 18 years old, were selected on the basis of having: 1) vertical bone loss on at least 3 first molars; 2) probing attachment loss ≥ 5 mm; 3) presence of Actinobacillus actinomycetecomitans (Aa) as determined by the DNA probe test; 4) no systemic diseases; and 5) not taken antibiotics for 6 months prior to treatment. Each patient was randomly assigned by first molar involvement to one of four treatment modalities: 1) surgical debridement alone (DEBR); 2) ePTFE membrane alone (G); 3) ePTFE membrane plus root conditioning (G+D); or 4) ePTFE membrane plus root conditioning plus composite graft (G+D+B). Standardized clinical attachment level measurements (CAL) were taken at baseline, 6, 12, and 18 months. Hard tissue measurements were evaluated radiographically (RAD) at baseline, 6, 12, and 18 months, and volumetrically at baseline and 12 months postsurgery. At 12 months re‐entry, all residual defects were re‐treated with a composite graft consisting of calcium sulfate + DFDBA + doxycycline. Results were evaluated 6 months post‐retreatment using CAL and RAD measurements. Statistical analysis of the data showed: 1) a significant gain in clinical attachment as well as increased volumetric bone fill of the defects 12 and 18 months following the various treatment modalities when compared to baseline (P < 0.05); and 2) no statistically significant differences among the tested treatment modalities and surgical debridement alone for all parameters (P > 0.05). It may be concluded that surgical debridement in conjunction with systemic administration of doxycycline is as effective as regenerative techniques in treating patients with LJP. J Periodontol 1995;66:673–678.
Evaluation of Periodontal Treatments Using Controlled‐Release Tetracycline Fibers: Maintenance Response
Authors: Michalowicz Bryan S. , Pihlstrom Bruce L. , Drisko Connie L. , Cobb Charles M. , Killoy William J. , Caton Jack G. , Lowenguth Roxanne A. , Quinones Carlos , Encarnacion Myriam , Knowles Mark , Goodson J. Max
Published: March 2012

The purpose of this investigation was to examine periodontal disease recurrence from 3 to 12 months following various treatments with scaling and root planing and controlled‐release tetracycline fibers. One‐hundred‐twenty‐two (122) adult volunteers with at least one bleeding pocket ≥ 5 mm in each of four quadrants were enrolled in this study. One or two such sites in each quadrant were selected as test sites. Quadrants were randomly assigned to receive one of four treatments: scaling and root planing (S); scaling and root planing plus tetracycline fiber for 10 days (SF); fiber therapy alone for 10 days (F); or fiber therapy alone for 20 days (FF). After treatment, no supportive care was provided during the 12‐month study period. Probing depth (PD), attachment loss (AL), plaque, and bleeding on probing were measured at baseline, and at 1,3, 6, 9, and 12 months after treatment. PD and AL measures were taken at three locations within each site and averaged for each site. Disease recurrence was defined as ≥ 1 mm mean attachment loss at a site during the 3‐ to 12‐month period. Onehundred‐sixteen (116) subjects completed the study. Sites treated with SF experienced significantly (P < 0.05) less disease recurrence (4%) than S, F, or FF (9%, 10%, and 12%, respectively). Results of this study suggest that, compared to S, F, or FF, scaling and root planing in conjunction with tetracycline fiber therapy for 10 days can significantly reduce disease recurrence 3 to 12 months following treatment in the absence of supportive care. J Periodontol 1995;66:708–715.
Eosinophilic Granuloma of the Mandible Involving the Periodontal Tissues. A Case Report
Authors: Piattelli A. , Paolantonio M.
Published: March 2012

This case reports on a 14‐year‐old boy with multiple radiolucent lesions widely distributed in the mandible, particularly in the right side (body‐angle‐ascending ramus). The lesion was first diagnosed as early‐onset periodontitis and treated accordingly. It continued to grow very quickly, however, over a 6‐month period, resulting in involvement of the entire mandible, with complete destruction of the lingual cortical bone, erosion of the external cortex with expansion in the neighboring soft tissues, and with a periosteal reaction in some areas. This case may serve to illustrate the rapid progress of eosinophilic granuloma, the importance and the difficulties of an early diagnosis, and the consequences of late diagnosis and treatment. J Periodontol 1995;66:731–736.
Iatrogenic Gingival Overgrowth in Cardiac Transplantation
Authors: Thomason J. Mark , Seymour Robin A. , Ellis Janice S. , Kelly Peter J. , Parry Gareth , Dark John , Idle Jeffery R.
Published: March 2012

It is well established that both cyclosporin and nifedipine are associated with gingival overgrowth. Although both drugs are widely used in the management of organ transplant patients, there is little information on the prevalence and severity of this unwanted effect in cardiac transplant patients. This study evaluated the gingival health of 94 dentate cardiac transplant patients, all of whom were medicated with cyclosporin as a component of their immunosuppressive therapy. Sixty‐three (63) of the patients were also medicated with nifedipine. Significantly higher gingival overgrowth scores (P < 0.0001) and periodontal probing depths (P = 0.001) were observed in patients medicated with the combination of cyclosporin and nifedipine than those medicated with cyclosporin alone. Likewise, there was a significantly greater need to carry out gingival surgery on patients taking the combination (62%), than those medicated with cyclosporin alone (25.8%) (P = 0.001). Patient's age, sex, duration of therapy, gingival bleeding index, and nifedipine therapy were important determinants for both the expression of gingival overgrowth and the need for surgery. Significant sequestration of nifedipine in the gingival crevicular fluid (GCF) was observed. The concentration of nifedipine in GCF did not relate to either the gingival changes or plasma concentration of the drug. Cardiac transplant patients are at risk of developing gingival overgrowth and approximately 50% require surgical intervention. This risk increases significantly when patients are medicated concomitantly with nifedipine. J Periodontol 1995;66:742–746.
Role of Saliva and Salivary Components as Modulators of Bleaching Agent Toxicity to Human Gingival Fibroblasts In Vitro
Authors: Tipton David A. , Braxton Sonia D. , Dabbous Mustafa Kh.
Published: March 2012

Mild oxygenating agents generating H2O2 are used for effective at‐home tooth bleaching, but can cause gingival ulcers in some patients. There are concerns about the possible pathological effects of relatively long‐term exposure of oral tissues to bleaching agents. Previous work in our laboratory showed that a bleaching agent, which generates ~3% H2O2 from carbamide peroxide, was toxic to human gingival fibroblasts in vitro, but that the toxicity was abolished by treatment with the H2O2destroying enzyme catalase. The purpose of the present study was to determine if whole saliva, the salivary enzyme lactoperoxidase (LP) (which, like catalase, removes H2O2), or salivary mucin protected fibroblasts from bleaching agent toxicity. The cells were exposed to 0.05% agent with or without saliva, LP, mucin or catalase (as a positive control based on our previous study) and assessed for effect on viability/morphology (by microscopic observation), proliferation (by [3H]‐thymidine incorporation), and the production of fibronectin (FN) and type I collagen (by ELISA). While the bleaching agent at 0.05% caused cell death, the cells appeared viable and morphologically normal when treated with the bleaching agent and LP (≥ 0.1 μM), saliva (> 4%), or catalase (> 0.3 μg/ml). There was dose‐dependent protection by saliva, LP, and catalase from agent inhibition of proliferation (P ≤ 0.04) and FN production (P ≤ 0.01). Mucin had statistically insignificant or no protective effect as assessed by the above parameters. Treatment with saliva, LP, mucin, and catalase gave complete or partial protection from agent‐inhibition of collagen production (P ≤ 0.04). The results suggest that the toxicity of the agent is largely due to H2O2, and that it may be reduced or abolished in vivo by enzymes present in saliva and/or the oral tissues which break down H2O2. J Periodontol 1995;66:766–774.
γδ T Lymphocytes in Human Periodontal Disease Tissue
Authors: Gemmell Erica , Seymour Gregory J.
Published: March 2012

Gamma delta T cells have been implicated as playing a role in inflammatory and autoimmune conditions. In this study, a biotin‐streptavidin peroxidase technique was used to determine the presence of T cells expressing αβ and γδ T cell receptors (TCR) in the inflammatory infiltrates of gingival tissue sections from gingivitis and adult periodontitis patients. The lesions were graded 1+ to 3+ according to the size of the infiltrate. αβ+ T cells predominated in all infiltrates with no differences in the mean percent (20 to 30%) according to size of. lesion or to clinical status. A mean percent γδ T cells of 0.42 ± 0.11 and 0.91 ± 0.42 was demonstrated in 1+ infiltrates of gingivitis and adult periodontitis sections respectively. Although the mean percent γδ T cells increased in both gingivitis (2.09 ± 0.54) and adult periodontitis sections (2.25 ± 0.35) with increasing size of infiltrate, this was not statistically significant. However, when the mean proportion of γδ T cells of the total TCR bearing cells was determined, there was a significant 3 to 4 fold increase in adult periodontitis sections from 3.09 ± 1.35 in 1+ lesions to 11.90 ± 2.94 and 8.81 ± 1.45 in 2+ and 3+ lesions respectively. A similar increase of the same magnitude occurred in gingivitis sections from 2.82 ± 0.74 in 1+ lesions to 11.12 ± 4.13 in 2+ lesions, but this was not significant (P = 0.055). There was no correlation between the increase in the proportion of γδ T cells and the T:B cell ratio or the CD4:CD8 ratio in individual lesions. This study has, therefore, demonstrated an increase in the proportion of γδ T cells compared with αβ T cells with increasing size of infiltrate in both gingivitis and periodontitis lesions. J Periodontol 1995;66:780–785.
Hydrogen Peroxide: A Review of Its Use in Dentistry
Authors: Marshall Milton V. , Cancro Lewis P. , Fischman Stuart L.
Published: March 2012

Several dentifrices that contain hydrogen peroxide are currently being marketed. The increased use of bleaching agents containing (or generating) H2O2 prompted this review of the safety of H2O2 when used in oral hygiene. Daily exposure to the low levels of H2O2 present in dentifrices is much lower than that of bleaching agents that contain or produce high levels of H2O2 for an extended period of time. Hydrogen peroxide has been used in dentistry alone or in combination with salts for over 70 years. Studies in which 3% H2O2 or less were used daily for up to 6 years showed occasional transitory irritant effects only in a small number of subjects with preexisting ulceration, or when high levels of salt solutions were concurrently administered. In contrast, bleaching agents that employ or generate high levels of H2O2 or organic peroxides can produce' localized oral toxicity following sustained exposure if mishandled. Potential health concerns related to prolonged hydrogen peroxide use have been raised, based on animal studies. From a single study using the hamster cheek pouch model, 30% H2O2 was referred to as a cocarcinogen in the oral mucosa. This (and later) studies have shown that at 3% or less, no cocarcinogenic activity or adverse effects were observed in the hamster cheek pouch following lengthy exposure to H2O2. In patients, prolonged use of hydrogen peroxide decreased plaque and gingivitis indices. However, therapeutic delivery of H2O2 to prevent periodontal disease required mechanical access to subgingival pockets. Furthermore, wound healing following gingival surgery was enhanced due to the antimicrobial effects of topically administered hydrogen peroxide. For most subjects, beneficial effects were seen with H2O2 levels above 1%. J Periodontol 1995;66:786–796.
Massive Gingival Enlargement and Alveolar Bone Loss: Report of Two Cases
Authors: Schmidt Brian L. , Pogrel M.A. , Perrott David H. , Regezi Joseph A.
Published: March 2012

We present two cases of massive gingival enlargement and osteolysis of alveolar bone in a 30‐year‐old female and a 36‐year‐old male. The etiology could not be established in either case. Histologically, both lesions contained hyperplastic fibrous connective tissue and intense plasma cell infiltrates. Both patients responded well to extensive gingivectomy, extraction of all teeth, and alveoplasty. J Periodontol 1995; 66:811–816.
Influence of Smoking on Long‐Term Clinical Results of Intrabony Defects Treated With Regenerative Therapy
Authors: Rosen Paul S. , Marks Manuel H. , Reynolds Mark A.
Published: March 2012

This retrospective study compares the short‐term (1 year) and long‐term (2 to 5 year) clinical results of regenerative therapy in clinical private practice using a bone allograft for the treatment of intrabony defects in smokers and non‐smokers. A total of 110 intrabony lesions were treated with demineralized freeze‐dried bone allograft (DFDBA) following thorough defect debridement and root preparation in 53 patients (15 cigarette smokers and 38 non‐smokers). Assessments of clinical attachment level (CAL) and probing depth (PD) were recorded at pre‐treatment, 1 year post‐treatment, and 2 to 5 years post‐treatment. At 1 year post‐treatment, significant gains in mean CAL were maintained for both smokers (2.7 mm) and non‐smokers (3.4 mm). Similarly, significant reductions in mean PD were observed for smokers (3.0 mm) and nonsmokers (3.8 mm) at the 1‐year follow‐up. However, when comparing relative improvements in clinical measures, smokers were found to exhibit significantly poorer treatment results (i.e., sites exhibited less CAL gain) at 1 year and 2 to 5 years followup. Relative to pre‐treatment scores, differences in improvements observed for CAL at the 1‐year evaluation (29.2% for smokers and 42.5% for non‐smokers) were sustained in the subgroup of patients at 2 to 5 years follow‐up (31.3% for smokers and 41.8% for non‐smokers). Similar but non‐significant trends were observed for relative reductions in probing depth for smokers and non‐smokers at 1 year (41.9% for smokers and 49.3% for non‐smokers) and 2 to 5 years follow‐up (43.9% for smokers and 48.3% for non‐smokers) for the subgroup of patients followed beyond 1 year. These results suggest that smoking adversely affects treatment outcome, as measured by gains in clinical attachment levels of intrabony defects treated by regenerative therapy using DFDBA. J Periodontol 1996;67:1159–1163.
The Adherence of Periodontopathogens to Periodontal Probes. A Possible Factor in Intra‐Oral Transmission?
Authors: Papaioannou William , Bollen Curd M.L. , Van Eldere Johan , Quirynen Marc
Published: March 2012

Periodontal probes have previously been shown to harbor several bacterial types or species after probing periodontally diseased pockets. This study aims to identify and quantify periodontopathogens that may adhere to a periodontal probe by culturing techniques. It also examines the probe's roughness on its capability to collect bacteria, comparing Merrit‐B probes (with deep indentations) with TPS probes (with smooth surfaces). From the differential phase contrast microscopy findings it was seen that, while paper‐points harbored nearly 50% motile rods or spirochetes, the periodontal probes were just at, or below, the 20% threshold level for pathogenicity (23.6% for the Merrit‐B probe and 11.3% for the TPS probe). The cultural data showed that paperpoints had significantly higher (P < 0.05) numbers of anaerobic bacteria than the 2 probe types, which still harbored up to 107 CFU. No significant differences could be detected between the probes. When specific periodontopathic species were considered, it was seen that for all species, even for Actinobacillus actinomycetemcomitans or Porphyromonas gingivalis, the detection frequency was comparable for the 3 sampling devices. However, the levels of Prevotella intermedia and Campylobacter rectus was significantly higher in samples from paper‐points (P < 0.05), but still their numbers reached even 105 on the probes. Differences among the 2 probe types were again negligible. Periodontal probes harbor relatively high numbers of bacteria found in periodontal pockets and may be able to carry them over to other sites. Further studies are needed to determine if, and to what extent, transmission occurs during periodontal probing. J Periodontol 1996;67:1164–1169.
Osteogenesis Enhanced by Chitosan (Poly‐N‐Acetyl Glucosaminoglycan) In Vitro
Authors: Klokkevold Perry R. , Vandemark Lorese , Kenney E. Barrie , Bernard George W.
Published: March 2012

Chitosan, with a chemical structure similar to hyaluronic acid, has been implicated as a wound healing agent. The purpose of this research was to evaluate the effect of chitosan on Osteoblast differentiation and bone formation in vitro. Mesenchymal stem cells were harvested from fetal Swiss Webster mice calvariae prior to osteoblast differentiation and calcification (12 to 13 days in utero). Stem cells were seeded into 6‐well culture plates at a density of 350,000 cells per well. Using this model, it was possible to quantify the influence of chitosan on osteoprogenitor differentiation and osteogenesis. Experimental wells were pretreated with 200 μl chitosan (2 mg/ml in 0.2% acetic acid vehicle). Control wells were pretreated with 200 μl vehicle (0.2% acetic acid) or remained untreated. Cells were allowed to grow under optimal conditions for 14 days. Cell cultures were fixed with glutaraldehyde and stained with Von Kossa stain to identify bone forming colonies. Positive staining colonies were identified and counted under light microscopy. Histologic cross‐sections of representative positively stained colonies identified osteoblasts and confirmed bone formation. Examination of control wells revealed 3.6 ± 0.6 colonies per well while experimental wells revealed a significantly greater average of 6.2 ± 1.2 colonies per well (P ≤ 0.01). Computer‐assisted image analysis of the average area of bone formed by control colonies was 0.34 ± 0.09 (relative units) while that of experimental colonies was 0.39 ± 0.06 (relative units) per average bone forming colony. The difference in mean size (control versus chitosan bone forming colony) was not statistically significant (P = 0.4691). The results of this in vitro experiment suggest that chitosan potentiates the differentiation of osteoprogenitor cells and may facilitate the formation of bone. J Periodontol 1996;67:1170–1175.
Periodontal Pocket Treatment in Beagle Dogs Using Subgingival Doxycycline From a Biodegradable System. I. Initial Clinical Responses
Authors: Polson Alan M. , Southard G. Lee , Dunn Richard L. , Yewey Gary L. , Godowski Kenneth C. , Polson Anne P. , Fulfs Jon C. , Laster Larry
Published: March 2012

The present study evaluated the clinical response of periodontal pockets in beagle dogs after treatment with a biodegradable delivery system containing 10% doxycycline hyclate (ABDS‐D). Eight adult, female beagle dogs had generalized, severe periodontitis with plaque and calculus‐laden pockets. In each animal, 3 teeth with multiple pocket sites ≥ 4 mm (mean depth = 6.0 mm) associated with attachment loss (mean = 5.4 mm) and which bled on probing (mean score = 2.5) were treated with a single application of either ABDS‐D (experimental group) or the delivery system alone without the doxycycline (control group). Residual polymer was removed at day 7. Bioassay of doxycycline in gingival crevicular fluid associated with presence of ABDS‐D gave mean levels of bioactivity of approximately 250 μg/ml. Levels of bioactive doxycycline were detected for approximately 7 days after ABDS‐D removal. Periodontal maintenance consisted of thrice‐weekly toothbrushing the treated sites. Clinical responses were evaluated at 2 weeks, and at bi‐weekly intervals thereafter for 4 months. Analyses of the data from the control group showed that there was only slight clinical improvement. In contrast, in the experimental group, bleeding on probing and probing depths were significantly reduced from baseline at all post‐treatment time points. At 1 month, mean probing depth reduction was 2.4 mm and this was maintained at 4 months (mean reduction = 2.5 mm). These probing depth reductions occurred primarily through gain of clinical attachment which was 2.0 mm at 4 months. Bleeding had been virtually eliminated (mean = 0.2). It was concluded that, for the beagle dogs with severely infected periodontal pockets in this study, treatment with subgingival doxycycline using the delivery system resulted in substantial improvement in periodontal health. J Periodontol 1996;67:1176–1184.
The Effect of Verapamil on the Prevalence and Severity of Cyclosporine‐Induced Gingival Overgrowth in Renal Allograft Recipients
Authors: Cebeci Irfan , Kantarci Alpdoğgan , Firatli Erhan , Çarin Mahmut , Tuncer Özen
Published: March 2012

Cyclosporine A (CsA) and verapamil are two agents used in renal transplantation, both of which are suspected of inducing gingival overgrowth. This study was conducted to investigate the effect of verapamil on the severity and prevalence of CsA‐induced gingival overgrowth. Fifty‐one (51) renal transplant recipients (total group) of whom 22 were using only CsA (Group A) and 29 of whom were prescribed CsA + verapamil (Group B) were evaluated for various periodontal and pharmacological parameters. No statistically significant differences were found in age, sex, plaque index, gingival index, calculus index, probing depth, CsA oral dose, CsA whole blood level, duration of CsA therapy, azathioprine dose, and prednisolone dose. Although the prevalence of the gingival overgrowth was more pronounced in CsA + verapamil group compared to CsA group (51.72% vs. 40.91%), the difference was not statistically significant. Similarly, the severity of gingival overgrowth, although more manifest in CsA + Verapamil group than CsA patients (34.24% vs. 28.91%), was not significantly different. Gingival overgrowth scores in the main group, CsA, and CsA + verapamil groups were found to be positively correlated to periodontal probing depths (r = 0.60, r = 0.70, r = 0.52, respectively) and the gingival index (r = 0.60, r = 0.70, r = 0.54, respectively). CsA oral dose, whole blood level, and duration of CsA therapy were not found to be correlated with the gingival overgrowth in either group. Likewise, the dose of verapamil and the duration of verapamil therapy were not correlated with the gingival overgrowth in Group B. This study indicates that verapamil, when prescribed as the calcium channel blocker in renal transplant patients, has no augmenting effect on the severity and the prevalence of CsA‐induced gingival overgrowth. J Periodontol 1996;67:1201–1205.
Clinical and Immunological Findings in 2 Siblings With Papillon‐Lefèvre Syndrome
Authors: Firatli Erhan , Gürel Nuray , Efeoglu Ahmet , Badur Selim
Published: March 2012

Rapid and severe destruction of periodontal tissues in early childhood has been reported both in systemically healthy children and in children with systemic disorders. In this study, the clinical and immunological findings of two siblings in a family with Papillon‐Lefèvre syndrome are presented. The peripheral blood lymphocytes were analyzed using a double colored flow cytometry and adequate monoclonal antibodies to CD2, CD3, CD4, CD5, CD8, CD11b, CD16, CD19, and HLA‐DR receptors. CD11b expression was found to be higher in both siblings (35% and 37%). The elevated CDllb expression may be related to a defect in neutrophils. The expression of natural killer cells was found to be higher in one patient but the results were in normal range. The CD2+, CD3+, CD4+, CD5+, CD8+, and CD19+ lymphocytes were in normal range in both patients. We think that the depressed chemotaxis of peripheral neutrophils, and higher expression of HLA‐DR and CD11b molecules in peripheral leukocytes were useful in explaining the pathogenesis of the Papillon‐Lefèvre syndrome. J Periodontol 1996;67:1210–1215.
Migration of Human Gingival Fibroblasts Over Guided Tissue Regeneration Barrier Materials
Authors: Payne Jonathan M. , Cobb Charles M. , Rapley John W. , Killoy William J. , Spencer Paulette
Published: March 2012

The purpose of this investigation was to determine the ability of human gingival fibroblasts, in vitro, to migrate along a chemotactic gradient over 3 different guided tissue regeneration barrier materials; i.e., polytetrafluoroethylene, polylactic acid, and sterile calcium sulfate. Forty petri dishes were divided into 4 equal groups. In each group of 10 dishes, a different barrier material served as the fibroblast substrate with the polystyrene floor of one group of Petri dishes serving as the control. The under agarose technique of measuring cell migration was employed using platelet derived growth factor‐BB homodimer as the chemoattractant and Hanks balanced salt solution to test random migration. In addition, fibroblasts were directly cultured on triplicate sets of barrier materials and the control surface for 24 hours and examined by scanning electron microscopy. Comparative analysis of the fibroblast migration data showed the mean migration distance (adjusted for random migration) for controls to be significantly greater than any of the three barrier materials. Further, the mean migration distance over calcium sulfate was significantly greater when compared to that of the polylactic acid barrier group. All other possible comparisons between groups were not statistically significant. Scanning electron microscopic examination of fibroblasts cultured directly on barrier membranes and compared to controls indicated that the calcium sulfate substrate appeared to facilitate cell attachment and spreading whereas cells on polytetrafluoroethylene and polylactic acid barriers exhibited a morphology not conducive to migration or, in many cases, cell health. Based on these limited in vitro results and, given the 3 barrier materials considered, it would appear that calcium sulfate offers the greater potential for guided tissue regeneration in surgical sites where primary wound closure cannot be obtained. J Periodontol 1996;67:236–244.
Development of an Exostosis Following a Free Gingival Graft: Case Report
Authors: Czuszak Charlene A. , Tolson George E. , Kudryk Val L. , Hanson Benjamin S. , Billman Michael A.
Published: March 2012

A case of an exostosis developing subsequent to the placement of a free gingival graft in the mandibular premolar area is described. J Periodontol 1996;67:250–253.
PDGF‐B Producing Cells and PDGF‐B Gene Expression in Normal Gingiva and Cyclosporine A‐Induced Gingival Overgrowth
Authors: Plemons Jacqueline M. , Dill Russell E. , Rees Terry D. , Dyer Barbara J. , Ng May C. , Iacopino Anthony M.
Published: March 2012

It has been proposed that healthy gingiva is in a continuous state of wound repair. Thus, one might expect to find cells in normal gingiva producing growth factors associated with wound healing such as platelet‐derived growth factor B chain (PDGFB). One might also expect to find increased numbers of these cells or increased amounts of these growth factors in conditions which involve increased tissue volume such as drug‐induced gingival overgrowth (DGO). The purpose of this study was to quantify PDGF‐B gene expression and identify cells producing PDGF‐B in normal gingiva and DGO. Cyclosporine A (CSA) DGO was selected as a prototype of the overgrowth condition. Twelve patients with clinical CSA DGO and 12 patients with no DGO or history of drugs known to cause DGO were selected for study. Frozen sections of gingival specimens from these patients were subjected to in situ hybridization for PDGF‐B mRNA. Positive cells were counted and expressed as mean ± SEM cells/mm2 of lamina propria. Morphometric analysis revealed 6.2 ± 1.9 cells/mm2 for control gingiva and 10.3 ± 3.4 cells/mm2 for CSA DGO samples. There was no statistically significant difference between groups. PDGF‐B gene expression was measured in these cells and expressed as mean ± SEM silver grains/cell. There was a significant upregulation of PDGF‐B gene expression in cells from the CSA DGO group (39.5 ± 14.7 silver grains/cell for normal gingiva vs. 255.3 ± 77.1 silver grains/cell for CSA DGO samples; P < 0.001). The presence of PDGF‐B in these cells was confirmed in all cases by immunocytochemical localization. Additionally, PDGF‐B producing cells were identified as macrophages in sections taken from an additional patient with CSA DGO by double immunofluorescence labeling of the CD51 membrane marker for macrophages and intracellular PDGF‐B. These findings are consistent with the concept that healthy gingiva is in a continuous state of wound repair and support the hypothesis that CSA DGO is associated with enhanced macrophage PDGFB gene expression rather than an increase in the number of PDGF‐B producing macrophages. J Periodontol 1996;67:264–270.
Engineering Specifics of the Periodontal Curet's Cutting Edge
Authors: Balevi Ben
Published: March 2012

Much has been reported on the qualitative, and to some degree, the quantitative effects of wear and sharpening of the periodontal curet's cutting edge. Presented here is an engineering model of the periodontal curet's cutting edge during wear and sharpening, and an estimated life of a typical periodontal curet. Although not confirmed by scientific experiments, this engineering model provides a framework for further scientific analysis. It also gives a clinical appreciation for the longevity of such periodontal instruments. J Periodontol 1996;67:374–378.
A New Monitor With a Zinc‐Oxide Thin Film Semiconductor Sensor for the Measurement of Volatile Sulfur Compounds in Mouth Air
Authors: Shimura M. , Yasuno Y. , Iwakura M. , Shimada Y. , Sakai S. , Suzuki K. , Sakamoto S.
Published: March 2012

Halitosis, defined as unpleasant oral odor, is a concern among the general public. Halitosis is generally diagnosed by organoleptic examination and by gas chromatographic analysis of the main source of halitosis, volatile sulfur compounds, such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. Gas chromatography requires a large‐scale system and a long running time. We investigated the use of a zinc‐oxide thin film semiconductor sensor for measuring trace volatile sulfur compounds in mouth air. Mouth air samples collected in teflon bags from 21 volunteers were analyzed by 3 methods: the monitor analysis, gas chromatography, and organoleptic examination by 3 judges. The readings of the monitor were correlated with the values of the total volatile sulfur compounds measured by gas chromatography (r = 0.75, P < 0.01) and also with the organoleptic scores given by the judges (r = 0.76, P < 0.01). The organoleptic scores were correlated with the gas chromatographic values (r = 0.71, P < 0.01). These results suggest that this new monitor with a zincoxide thin film semiconductor sensor may be used for the diagnosis of halitosis. Its small size and simplicity of handling may enable its use for routine chair‐side study and field surveys of halitosis. J Periodontol 1996;67:396–402.
Host Defensive Functions in a Family Manifesting Early‐Onset Periodontitis
Authors: Arai Hideo , Chihara Toshihiro , Takahashi Keiso , Nagai Atsushi , Akutsu Isao , Takashiba Shogo , Nishimura Fusanori , Kurihara Hidemi , Murayama Yoji
Published: March 2012

Family case studies help us identify host risk factors in periodontal disease. In this study we examine a family consisting of a mother (40 years old, with rapidly progressive periodontitis), her elder daughter (14 years old, with localized juvenile periodontitis), and younger daughter (13 years old, with simple gingivitis). We examined 1) the peripheral neutrophil functions (chemotactic migration, phagocytosis, superoxide production); 2) lymphocyte functions (proliferative activity and cytokine productivity of T cells, immunoglobulin [Ig] M productivity of B cells when stimulated with pokeweed mitogen); 3) phenotypic analyses of peripheral lymphocyte subpopulations; 4) serum IgG antibody titers against periodontopathic bacteria; and 5) serological type of HLA class II. All the subjects exhibited high T4/T8 ratios due to high percentage of CD4‐positive cells, showed high IgG titers to Actinobacillus actinomycetemcomitans, and had a HLA DQwl in common. The mother showed a slight deficiency of neutrophil chemotactic migration to N‐formyl methyonyl leucyl phenylalanin (fMLP), raised interleukin‐2 productivity of T cell, and high levels of IgG titers to Porphyromonus gingivalis and Fusobacterium nucleatum. Both daughters showed weak T cell proliferative response to anti‐CD3 monoclonal antibody and low IgM productivity. Low lymphocyte responsiveness may be involved in the pathogenesis of periodontal disease of these daughters; therefore, the lymphocyte dysfunctions shown should be considered in relation to the progression of periodontal disease. J Periodontol 1996;671:433–442.
The Importance of Regular Dental Treatment in Patients With Cyclic Neutropenia. Follow‐up of 2 Cases
Authors: Pernu Hilkka E. , Pajari Ulla H. , Lanning Marjatta
Published: March 2012

Data on two patients with cyclic neutropenia are presented. They demonstrate that regular tooth care and professional dental treatment can prevent progressive periodontal breakdown but that neglecting oral hygiene soon leads to periodontal pathology. Regular, monthly professional removal of dental plaque and calculus, and rinsing with 0.2% chlorhexidine gluconate during neutropenia help maintain periodontal attachment level. The caries susceptibility and the apical periodontitis in the intact anterior tooth of the female patient indicate the possibility of cyclic neutropenia playing a role in caries and pulpal pathology. J Periodontol 1996;67:454–459.