bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Treatment on Actinobacillus actinomycetemcomitans in Localized Juvenile Periodontitis
Authors: Mandell Robert L. , Tripodi Lynne S. , Savitt Eugene , Goodson J. Max , Socransky Sigmund S.
Published: March 2012

Three treatment regimens including local tetracycline delivery, systemic doxycycline and surgery plus systemic doxycycline were investigated in a localized juvenile periodontitis (LJP) population. Of the investigated treatments only surgery plus systemic doxycycline for 14 days was effective in eliminating or suppressing Actinobacillus actinomycetemcomitans, an organism strongly associated with LJP lesions. While surgery plus antibiotics was the superior treatment, it appears that the possibility of reinfection or incomplete elimination of the organism exists. Careful long‐term follow‐up, including clinical and microbiological monitoring, is highly recommended in this periodontal population.
Acute Necrotizing Ulcerative Gingivitis
Authors: Johnson Bradley D. , Engel David
Published: March 2012

Vincent's original description of the fusiform‐spirochete nature of acute necrotizing ulcerative gingivitis (ANUG) still remains true today, although much additional insight has been gained regarding the etiology, pathogenesis and treatment of the disease. In addition to the historic association of fusiform and spirochete microbes with ANUG, recent findings have also implicated Bacteroides and Selenomonas species. Possible abnormalities in immunological function, such as altered PMN and lymphocyte responsiveness, may be present. Stress, which has long been known to be associated with the disease, appears to play a role through induction of increased cortisol and catecholamine levels. These chemical mediators respectively may compromise the host immune responses and the gingival microcirculation. Cortisol may also serve as a nutrient source for Bacteroides bacteria. Other predisposing factors to ANUG may include smoking and poor oral hygiene. Treatment modalities involve eliminating or reducing the levels of bacterial pathogens by mechanical and antibiotic means, along with attempts at controlling significant psychological and physical precipitating factors.
A Clinical Comparison of the Effect on the Gingiva of the Prophy‐Jet and the Rubber Cup and Paste Techniques
Authors: Mishkin David J. , Engler William O. , Javed Tariq , Darby Towles D. , Cobb Russell L. , Coffman Michael A.
Published: March 2012

This clinical trial compared the effect on the gingiva of the Prophy‐Jet and the rubber cup and paste techniques of stain and supragingival plaque removal. Twenty‐one human subjects with healthy gingiva or slight gingivitis participated. A split mouth design was used. The Prophy‐Jet caused a statistically significant increase (P < 0.05) in gingival irritation immediately posttreatment, but the differences were not deemed clinically significant. There were no statistically significant (P < 0.05) or clinically significant differences in the effect on the gingiva between the two techniques at 7 and 21 days posttreatment.

There was no lasting difference in gingival trauma between the two methods of stain and supragingival plaque removal in subjects with healthy gingiva or slight gingivitis.
Reticular Mandibular Gingival Ridges
Authors: Giunta John L.
Published: March 2012

This paper reports five cases of a heretofore unreported condition of the gingiva named reticular mandibular gingival ridges. Occurring in middle‐aged males, macroscopically, they are bilateral ridges on the mandibular attached gingivae resembling rugae and having a reticular pattern that may be mistaken for lichen planus. Microscopically, they are formed of fibrous tissue with vessels that have a minimal perivascular infiltrate; the epithelium has extension of rete ridges. Of unknown etiology, the condition does not appear to change, is innocuous and does not require treatment.
Clinical and Volumetric Analysis of Three‐Wall Intrabony Defects Following Open Flap Debridement
Authors: Becker William , Becker Burton E. , Berg Lawrence , Samsam Ciamek
Published: March 2012

Fourteen defects were treated with flap debridement procedures using the Prichard principle of epithelial exclusion.5 Six defects were considered to be medium in width (3–4 mm), seven defects were wide (>4 mm), and one defect was narrow (1–2 mm). The parameters studied were changes in gingival and plaque scores, attachment levels, and bone scores. All defects were reentered 9 to 16 months after surgery and changes between the pretreatment and posttreatment bone levels were recorded. The mean gain in probing attachment level was 2.76 mm. The mean amount of defect fill measured from models was 2.56 mm, while the mean defect fill from direct measurements was 3.26 mm. The percentage defect fill measured from study models was 61%. Crestal resorption was 9.7%. The average change in defect volume unadjusted for crestal resorption was 61.8 cu mm. Seven defects had a 50% or greater decrease in defect volume, while seven defects had less than a 50% change. Intrabony defects where calculus is present on the involved tooth surface prior to therapy will repair with substantial amounts of bone as a result of open debridement.
Histologic Observations Following the Placement of Tricalcium Phosphate Implants in Human Intrabony Defects
Authors: Bowers G. M. , Vargo J. W. , Levy B. , Emerson J. R. , Bergquist J. J.
Published: March 2012

Biopsies of soft tissue with visible ceramic particles were removed from the coronal part of grafted sites during reentry surgery. After 1 year there was evidence of osteoid forming alongside and within many of the ceramic particles. Viable fragments of mature bone were also observed separate from the ceramic material.
Chemotaxis of Human Gingival Epithelial Cells to Laminin
Authors: Terranova Victor P. , Lyall Raymond M.
Published: March 2012

Laminin, a large glycoprotein (Mr = 106) and a major component of basement membrane, is shown here to be a potent chemoattractant for human gingival epithelial cells. Laminin stimulated Chemotaxis and chemokinesis of gingival epithelial cells in the modified Boyden chamber assay. This effect appeared to be laminin receptor mediated. Gingival epithelial cells were shown to bind laminin (Kd = 2.0 nm) with 10,000 to 30,000 binding sites per cell. Antilaminin antibody, which inhibited laminin binding, inhibited the chemotactic response of epithelial cells to laminin, while antifibronectin was without effect. Fibronectin was not as potent a chemoattractant as laminin. Other biological response modifiers were also tested; of these, Type IV collagen and epidermal growth factor were active as chemoattractants, although not as effective in inducing Chemotaxis as laminin. The data indicate that laminin and other components of basement membrane may be important in regulating the migration and growth of gingival epithelial cells.
A Simplified Laboratory Procedure to Select an Appropriate Antibiotic for Treatment of Refractory Periodontitis
Authors: Telsey Bernard , Oshrain Herbert I. , Ellison Solon A.
Published: March 2012

The feasibility of using a simplified laboratory procedure to select an appropriate antibiotic for treatment of refractory periodontitis was investigated.

Six different antibiotics were added to commercially available CDC‐agar plates. Plaque samples from periodontal pockets were inoculated onto the plates. The percentage kill was determined by comparing colony counts on the antibiotic‐containing medium with those on the control plates. The three most effective antibiotics were ranked by visual inspection as well as by colony count. It was determined that visual inspection may be used to determine an effective antibiotic.
Root Coverage and Ridge Augmentation in Class IV Recession Using a Coronally Positioned Free Gingival Graft
Authors: Miller Preston D. , Binkley Les H.
Published: March 2012

Although root coverage is not anticipated in Class IV recession, occasionally this can be accomplished if there is an edentulous area adjacent to the tooth to be grafted. This edentulous area allows the surgeon to more intimately adapt the graft to the interproximal surface of the root. A second procedure to coronally position the healed graft may be required. A case demonstrating this technique is presented.
Orientation of Gingival Fibroblasts in Simulated Periodontal Spaces in Vitro
Authors: Aukhil Ikramuddin , Fernyhough Will S.
Published: March 2012

The present study examined the orientation of gingival fibroblasts in simulated periodontal spaces in vitro. Extracted human teeth were root planed followed by root resection and root canal instrumentation. The middle and cervical thirds of each root were cut transversely to create 600‐μm thick sections. Cortical bovine bone was cut, sectioned and contoured to create bone rings 600 μm thick with an internal diameter large enough to accommodate a root slice leaving a circumferential space varying from approximately 0.1 to 1.0 mm. Root slices and bone rings were incubated in a solution of collagenase and hyaluronidase to remove all remaining soft tissue and partially demineralized in EDTA (18%) for 30 minutes. Human gingival fibroblasts (HGF) were plated to confluency in tissue culture dishes. The dentin slices were then gently placed over the HGF monolayer along with bone rings around them to create simulated periodontal spaces. Control root slices were placed without bone rings around them. Cultures were maintained under standard tissue culture conditions. Representative specimens were obtained after 2, 3 and 4 weeks of culture and processed for scanning electron microscopy (SEM).

At 2 weeks, the HGF had formed sheets of cells attached to the periphery of the root slices at one end and to the inner surface of bone rings at the other end. The orientation of cell sheets varied from being perpendicular to the periphery of the slice to oblique. At 3 and 4 weeks, the density and size of cell sheets increased and the orientation was maintained. The control root slices at the different observation periods showed cell attachment around the periphery of root slices but the cell sheets were seen only on isolated spots and were smaller in size compared to the experimentais.

The present findings suggest that the spatial relationship of substrata (root and bone) can influence the orientation of cells. The present in vitro model appears to be suitable to study the development of oriented fibers in simulated periodontal spaces.
Localization of Fibronectin in Gingival Connective Tissue of the Beagle Dog
Authors: Cho Moon‐II , Lee Yu Lin , Garant Philias R.
Published: March 2012

Ferritin and peroxidase‐conjugated antibodies were used in an indirect antibody method to localize fibronectin in gingival connective tissues. Fibronectin was found in the basal lamina beneath the epithelium and endothelium. Collagen fibrils associated with the basement membranes were also heavily coated by fibronectin. Amorphous patches of fibronectin were found adjacent to the plasma membrane of epithelial cells as well as free in the interepithelial spaces.

Fibronectin was present throughout the connective tissue in close association with individual collagen fibrils, apparently serving as an interfibrillar cementing substance. Patches of fibronectin were located at the cell surface of fibroblasts, plasma cells, lymphocytes, endothelial cells, smooth muscle cells, and neutrophils. These amorphous patches were observed to connect adjacent cells across narrow spaces and to connect cells to collagen fibrils.

The heavy labeling for fibronectin visualized by fluorescent microscopy around gingival blood vessels (Cho et al., 1985) can be accounted for by a heavy coating of fibronectin on the collagen fibrils and basal laminas associated with endothelial cells, as well as by the presence of abundant deposits of fibronectin along the cell membranes of endothelial cells and in the intercellular spaces of the vessel wall.
Clinical Oral Medicine: An Exciting Facet of Postdoctoral Periodontic Training
Authors: Hurt William C.
Published: March 2012

This paper briefly reviews the historical relationship between oral medicine and periodontics. The reasons for including structured clinical oral medicine in a postdoctoral program in periodontics are discussed. Problems and solutions to such an integrated program are outlined. Guidelines for broadening the base of the field of periodontics by expanding the specialty more vigorously into the area of clinical oral medicine are provided.
Periodontal Manifestations of Acute Autoimmune Thrombocytopenic Purpura
Authors: Ripamonti Ugo , Petit Jean‐Claude , Penfold Grace , Lemmer John
Published: March 2012

Purpuric hemorrhages are usually the result of thrombocytopenia, but are also seen in vascular disorders such as vitamin C deficiency, Henoch‐Schonlein purpura, and von Willebrand's disease. The progressive purpuric hemorrhages in the oral mucosae and skin in a case of acute autoimmune thrombocytopenic purpura (AITP) in a young adult are described. Localized hemorrhagic periodontal lesions of doubtful interpretation proved to be the first clinical signs of the underlying thrombocytopenia. The diagnosis is confirmed by finding thrombocytopenia with normal or increased numbers of megakaryocytes in the bone marrow. Treatment must be started before the onset of serious complications such as cerebral hemorrhages.
Comparison of Manual and Pressure‐Controlled Periodontal Probing
Authors: Kalkwarf Kenneth L. , Kaldahl Wayne B. , Patil Kashinath D.
Published: March 2012

Over 25,000 sites around natural teeth in three stages of periodontal therapy (prior to instrumentation, following closed subgingival instrumentation and following surgical therapy) were independently probed by two examiners. Examiner A used a conventional periodontal probe with uncontrolled pressure. Examiner B used an identical probe tip mounted in a handle which controlled vertical probing force at 50 g. The pressure‐controlled technique produced significantly deeper clinical probing measurements on the direct facial and lingual aspects of teeth regardless of the stage of periodontal therapy that had been completed. Manual probing obtained deeper measurements on the distal‐lingual aspects of teeth in the posterior regions which had not received surgical therapy. The percentage match between probing depths obtained by the two methods declined as the probing depths increased. Control of vertical force during probing may provide a more objective method of monitoring periodontal status during longitudinal trials.
The Effects of Megadoses of Ascorbic Acid on PMN Chemotaxis and Experimental Gingivitis
Authors: Vogel Richard I. , Lamster Ira B. , Wechsler Stephen A. , Macedo Braz , Hartley Linda J. , Macedo Judy A.
Published: March 2012

A double‐blind study was undertaken to determine the effects of megadose ascorbic acid supplementation on plasma ascorbate levels, polymorphonuclear neutrophil (PMN) Chemotaxis and clinical and biochemical determinations of inflammatory progression in individuals with a mean daily ascorbate intake level of approximately twice the recommended daily allowances. Results indicate that although the group receiving ascorbate supplementation demonstrated a significant increase in plasma levels of the vitamin as compared to a placebo group, no significant differences with respect to PMN Chemotaxis or responses to experimental gingivitis were found between the groups.
The Effect of Controlled Ascorbic Acid Depletion and Supplementation on Periodontal Health
Authors: Leggott P. J. , Robertson P. B. , Rothman D. L. , Murray P. A. , Jacob R. A.
Published: March 2012

To determine if systemic levels of vitamin C influence periodontal health, changes in plaque accumulation, gingival health and periodontal probing depth were measured in healthy subjects housed for 3 months in a nutrition suite that provided controlled periods of ascorbic acid depletion and supplementation.

Eleven healthy, nonsmoking men, aged 19 to 28 years, ate a rotating 7‐day diet adequate in all nutrients except ascorbic acid. This basal diet, which contained less than 5 mg/day ascorbic acid, was supplemented with 60 mg/day ascorbic acid for 2 weeks, 0 mg/day ascorbic acid for 4 weeks, 600 mg/day ascorbic acid for 3 weeks and 0 mg/day ascorbic acid for 4 weeks. Plasma, urine and leukocyte ascorbate levels, Plaque Index, Gingival Index, Bleeding Index and probing depths were monitored throughout the study. A uniform oral hygiene program was maintained in which oral hygiene instructions were reinforced biweekly.

Ascorbate concentrations in body fluids and leukocytes responded rapidly to changes in ascorbic acid intake. No mucosal pathoses or changes in plaque accumulation or probing depths were noted during any of the periods of depletion or supplementation. However, measures of gingival inflammation were directly related to the ascorbic acid status. The results suggest that ascorbic acid may influence early stages of gingivitis, particularly crevicular bleeding.
Flossing Clefts: Clinical and Histologic Observations
Authors: Hallmon William W. , Waldrop Thomas C. , Houston Glen D. , Hawkins Benny F.
Published: March 2012

Clinical and histologic observations of 14 marginal tissue clefts associated with improper floss manipulation are presented. Newly acquired lesions were characteristically inflamed, ulcerated and symptomatic while clefts of chronic duration were asymptomatic and un‐noticed by the patient. Cleft sites exhibiting varying degrees of epithelialization generally presented apical bifurcations suggesting reinjury by the patient during lateral positional shifts of the floss. The terminology „flossing cleft” is suggested by the authors to describe linear or V‐shaped interdental marginal tissue deformities that result from dental floss‐induced injury. While these clefts may serve as a potential source of bacteremia during vigorous flossing and associated oral tissue manipulation, in no instances were they determined to constitute a morphologic impediment to effective plaque control efforts.
Extravascular Clot Formation and Platelet Activation on Variously Treated Root Surfaces
Authors: Steinberg Arnold D. , LeBreton Guy , Willey Ruth , Mukherjee Sabyassachi , Lipowski Jeannette
Published: March 2012

The platelet attachment and activation potential of a variety of treated, human root surfaces was studied employing an established in vitro method for determining thrombogenicity. In addition, scanning electron microscopic observations were made of the morphological appearance of blood components in initial clot formation on root surfaces containing periodontal ligament (PDL). For the platelet study, the crowns were removed from freshly extracted teeth with and without periodontal disease (PD) and the roots were sectioned. The following surface conditions were created: (1) PDL present, (2) PD, (3) PD planed, (4) PD planed and demineralized, (5) Condition 4 treated with collagenase. All conditions were incubated with Indium‐Ill‐labeled platelets with and without the addition of prostacyclin, an inhibitor of platelet activation. It was observed that the greatest number of attached platelets were found in Condition 1, that platelet activation was significantly enhanced in Condition 4 and this effect was reversed by Condition 5. The scanning electron microscopic observations were made on freshly extracted teeth with an intact PDL in which the roots were sectioned and either reinserted immediately into the extraction site or incubated in platelet‐rich plasma. It was seen that platelets were involved early in clotting and activated by this surface. This study suggests the possible use of platelet attachment and activation as an indicator for root surface thrombogenicity and perhaps of the fibrous attachment potential.
Endosseous Dental Implantology from the Periodontist's Viewpoint
Authors: Meffert Roland M.
Published: March 2012

Oral implantology has been a controversial dental therapeutic procedure for many years. Periodontics, as a specialty, did not really get involved until the word, osseointegration, was placed in the implant nomenclature by Dr. Per‐Ingvar Branemark and the attendant success rate for osseointegrated prostheses was presented in a fully documented format.

In March 1985, the definition of the scope of periodontics was provisionally changed by the Executive Council of the American Academy of Periodontology to include the discipline of oral implantology. Requirements for Advanced Specialty Education Programs in Periodontics with an effective date of January 1, 1986, include a statement as to the desirability of including implantology in some form in the postdoctoral curriculum.

Many implant materials and designs are presently being used in endosseous dental implantology; studies are in progress to evaluate the short‐ and long‐term response of hard and soft tissues to these materials. Continuing, nonbiased research is needed to fully understand and use this promising modality.
Leukemic Cell Infiltration of the Gingivae
Authors: Barrett Anthony P.
Published: March 2012

A case of gingival infiltration in terminal acute leukemia is reported, with a discussion of factors contributing to this phenomenon.
Treatment of Localized Juvenile Periodontitis (Periodontosis)
Authors: Krill David B. , Fry Hiram R.
Published: March 2012

Localized juvenile periodontitis is a disease of the adolescent periodontium characterized by rapid alveolar destruction around molar and incisor teeth of the permanent dentition. Early treatment methods were variable and often empirical due to lack of knowledge concerning etiology. Elucidation of factors associated with the disease has led to different therapeutic approaches. A comprehensive review of these modalities is presented.
The Effects of Burnishing NaF/Kaolin/Glycerin Paste on Dentin Permeability
Authors: Pashley D. H. , Leibach J. G. , Homer J. A.
Published: March 2012

The effects on dentin permeability of burnishing NaF, kaolin, or glycerin, alone and in various combinations, were determined using an in vitro system. The results indicate that the important variable was not any of the constituents of the paste but the burnishing process itself. Burnishing dentin creates a partial smear layer on the dentin surface, thereby occluding the orifices of dentinal tubules sufficiently to reduce fluid movement across dentin 50 to 80%.
Periodontal Status of Teeth Facing Extraction Sites Long‐Term after Orthodontic Treatment
Authors: Årtun Jon , Osterberg Stig K.
Published: March 2012

The present study was undertaken to examine the long‐term periodontal status of teeth orthodontically moved into extraction sites. Patients were examined 14 to 34 years after active orthodontic treatment involving extraction of four first premolars. Three groups were established: one with closed tooth contacts and parallel adjacent teeth, one with closed tooth contacts and tipped adjacent teeth, and one with open contacts between adjacent teeth. Within each group accumulation of plaque, gingival health status, probing pocket depth, and probing attachment level of interproximal tooth surfaces, facing extraction sites and adjacent control sites between canine and lateral incisor were compared. Significantly more probing attachment loss was found in extraction sites with open tooth contacts (P < 0.01) and with parallel adjacent teeth and closed tooth contacts (P < 0.05) than in control sites. However, the mean differences were less than 0.5 mm, which may not be considered clinically significant. Tipping of teeth into the extraction sites had no long‐term detrimental effect on the probing attachment level. No differences in accumulation of plaque and in gingival health status were observed.
Measurement of Gingival Crevicular Fluid Conductivity, In Vivo
Authors: Ferris Geraldine , Grow Thomas E. , Low Samuel B. , Ferris Robert T.
Published: March 2012

It has been shown that the ionic concentration of gingival crevicular fluid (GCF) rises with increases in the inflammation of the surrounding tissue. Because measurement of this increase might be useful for clinical assessment of periodontal status and because the sampling of this fluid is difficult in the typical clinical environment, attempts were made to measure the conductivity of GCF in vivo using a fabricated conductivity probe. Preliminary results suggest that statistically significant correlations may exist between certain clinical indices and GCF conductivity. A correlation could be shown when comparing the Gingival Index and the measured conductivity of GCF, but the correlation may be too low to be of biologic relevance, possibly due to the use of pooled samples. The use of an ion‐specific probe and the study of site‐specific periodontal lesions are suggested to develop more definitive data than this pilot study provided.
Root Coverage with the Free Gingival Graft
Authors: Miller Preston D.
Published: March 2012

The free soft tissue autograft when used for increasing the amount of attached gingiva is a relatively simple surgical procedure. The use of the free soft tissue autograft for root coverage, however, is a much more technically demanding procedure requiring the periodontist to consider additional factors. Overlooking or failing to properly address a single one of these factors can result in incomplete coverage. The purpose of this paper is to outline those factors that must be considered when complete root coverage is attempted.
Histologic Study of Healing of Human Periodontal Defects after Placement of Porous Hydroxylapatite Implants
Authors: Carranza F. A. , Kenney E. B. , Lekovic Voja , Talamante Enrique , Valencia Javier , Dimitrijevic B.
Published: March 2012

Two intrabony pockets on teeth that were to be extracted for prosthetic reasons, in two patients, were treated by means of papilla preservation flaps and implantation with porous hydroxylapatite. The teeth, with a portion of their periodontium, were extracted 5 and 6 months after treatment and processed histologically. Both cases showed the implants invaded by connective tissue, which was actively forming bone. There was no inflammatory reaction triggered by the implant material, although there was some recurrence of inflammation in the vicinity of the pocket wall. The junctional epithelium in both cases extended slightly beyond the coronal level of the implant.

One of the cases had an abundant new cementum formation with fibrous tissue next to the implant, that appeared to be a rebuilt attachment of collagen fibers.

Although some multinucleated giant cells were found in the pores and next to the newly formed bone, the implanted material did not appear to be resorbed in the period of time studied.
Compliance
Authors: Wilson Thomas G.
Published: March 2012

This paper begins with a review of the literature on compliance. The medical literature suggests that patients with chronic illnesses tend to comply poorly, especially if the disease is not perceived by the patient as particularly threatening. The dental literature covers two principal areas: compliance with oral hygiene regimens and utilization of dental care by the public. These works show that most patients surveyed do not clean their teeth as they have been instructed, and most do not receive routine dental care. The reasons for this noncompliance are highly variable but include lack of pertinent information, fear, economics, and the patient's perception of lack of compassion on the part of the dental therapist. In periodontics the majority of studies have focused on the effectiveness of patient oral hygiene along with its modification and on maintenance therapy. Other work in the periodontal literature is discussed in light of the widespread noncompliance shown by our patients. A number of studies have been undertaken on how best to improve compliance. In general, it has been found that patients comply better when they are informed and positively reinforced, and when barriers to treatment are reduced. Suggestions are made for improving compliance in the periodontal office and for tailoring therapy to predicted compliance levels.
Relationship between Periodontal Furcation Involvement and Molar Cervical Enamel Projections
Authors: Hou Guey‐Lin , Tsai Chi‐Cheng
Published: March 2012

A total of 78 individuals ages 21 to 61 years with periodontal furcation involvement was examined for the presence of cervical enamel projections on the buccal surfaces of molar teeth. The furcal defects and cervical enamel projections (CEPs) of molars were diagnosed by probing, periapical roentgenographs, flap operation and inspection. Plaque index (PlI) and gingival index (GI) were recorded for the buccal and lingual surfaces of molars examined. The percentage of CEPs in the 78 individuals examined was 67.9%. The prevalence of CEPs in all molars examined was 45.2%. The prevalence of CEPs in molars with and without furcal involvements were 82.5% and 17.5%, respectively. The frequency of CEP in molars occurred in the following order: mandibular first molars, maxillary first molars, mandibular second molars and maxillary second molars. Statistical analyses (Chisquare test) revealed a significant difference between periodontal furcation involvements and the presence of CEPs. Results of this study also indicated that the furcal involvements with CEPs were associated with poor oral hygiene as measured by GI and PlI.
Osteogenic Potential of Nonvital Tissues and Synthetic Implant Materials
Authors: Amler Melvin H.
Published: March 2012

Following the application of various techniques to restore or rebuild alveolar bone with different implants, results are generally unpredictable. In successful cases it is not clear whether the materials are capable of initiating Osteogenesis by metaplastic induction, where endogenous bone formation had failed, or initiating Osteogenesis by stimulating the regeneration of existing vital bone tissue by irritation. In order to discriminate between these two possibilities, 40 Sprague‐Dawley descent rats were implanted with both devitalized tissues and synthetic materials in an area where bone is not usually formed: the anterior eye chamber. The test materials consisted of two devitalized tissues: boiled bone marrow and demineralized dentin, and six synthetic materials: formalin 10% and 40%, formic acid 10% and 88%, plaster of Paris, and ceramic tricalcium phosphate (Durapatite). Test materials were inserted into 59 chambers, but bone was not formed in any of these cases following a three‐week experimental test period. Following implantation of 21 control chambers with viable mature marrow, bone was formed in 5 of 21 cases (24%), following the three‐week test period. These findings appear to indicate that the reported cases where bone regeneration successfully occurred following implantation probably resulted from unpredictable irritational factors upon the existing vital bone tissue rather than by metaplastic induction.
Preliminary Investigation into the Performance of a Sonic Scaler
Authors: Gankerseer E. J. , Walmsley A. D.
Published: March 2012

Recently a number of mechanical scalers, known as air or sonic scalers, have been developed. Preliminary investigations were undertaken to observe the operating characteristics of such a sonic scaler including its oscillatory pattern, and how this was affected by changing the design of the scaling tip, the air pressure, and the application load. The oscillatory pattern exhibited an open elliptical movement that was dependent upon the air pressure input to the instrument. Application of a load to the scaling tip resulted in oscillatory damping that increased with the magnitude of the load. The oscillatory performance of the sonic scaler differed from that observed previously with ultrasonic scalers. Investigators using the sonic scaler should indicate the type of scaling tip, the air pressure input, and the application load used to enable meaningful comparisons to be made between the results of different workers. Clinicians should be aware of its operating characteristics to avoid potential damage to the tooth surface.
Development of Erosive Gingival Lesions after Use of a Home Care Technique
Authors: Herrin John R. , Squier Christopher A. , Rubright William C.
Published: March 2012

The use of a periodontal home care regime has been found to induce erosive gingival lesions in some individuals. The purpose of this study was to determine which of the chemical or physical components of the technique might be responsible for the changes observed. Ten normotensive subjects were assigned to two groups. Group I subjects used a dentifrice consisting either of sodium bicarbonate and 3% hydrogen peroxide or 3% hydrogen peroxide alone; the dentifrice was removed with a 5 m NaCl irrigating solution. Group II subjects used the same dentifrices as Group I subjects, but distilled water was used as irrigant instead of 5 m NaCl. Erosive lesions of gingiva developed in all six subjects in Group I using the soda‐paste dentifrice and 5 m NaCl irrigant; however, no lesions were found in Group II subjects. The use of a saturated NaCl irrigating solution appears to be injurious to gingiva, possibly as a result of the markedly hypertonic solution dehydrating the epithelium.
Gingival Cyst of the Adult
Authors: Shade Ned L. , Carpenter William M. , Delzer Delano D.
Published: March 2012

The gingival cyst of the adult (GCA) constitutes a pathologic developmental process that the dentist must be prepared to diagnose and treat. The GCA has been infrequently reported in the past as a unilateral phenomenon, but this case constitutes the first known report of synchronously occurring, bilateral GCA in the dental literature.
Root Isolation for New Attachment Procedures
Authors: Becker William , Becker Burton E. , Prichard John F. , Caffesse Raul , Rosenberg Edwin , Gian‐Grasso Joseph
Published: March 2012

A surgical and suturing method is described for the subgingival placement of Gore‐tex® periodontal material during new attachment procedures. The periodontal material isolates the root surface from epithelium and gingival connective tissue. Three cases were treated. Clinical new attachment was evident from clinical probings and reentry. The term “open probing new attachment” describes the type of tissue that was evident at reentry after treatment of a Class III furcation. A combination of new bone and “open probing new attachment” was evident after one‐wall defects were treated adjacent to a mandibular cuspid. A two‐wall defect was treated and biopsied three months later. A reference notch was placed 1 mm coronal to the apical aspect of the defect. Histologic examination of the biopsy showed new bone, cementum and periodontal fibers coronal to the notch. Clinical and histologic new attachment was achieved using the technique for root isolation. The long‐term predictability and stability of this type of new attachment is not known at this time.
Plaque Removing Effect of a Convex‐Shaped Brush Compared with a Conventional Flat Brush
Authors: Thevissen E. , Quirynen M. , van Steenberghe D.
Published: March 2012

The plaque‐removing effect of a convex‐shaped multitufted brush was compared with that of a conventional flat multitufted brush. Two groups (five and seven dental students, respectively), well instructed in the modified Bass technique, participated in a blind, splitmouth, crossover study during two consecutive experimental periods of 96 hours of undisturbed plaque growth. After each of these periods, a supervised brushing session was performed, followed by toothpick utilization. Plaque removal was evaluated using the modified Navy Plaque Index (MNPI) and planimetry. A 4% erythrosin solution was used as a disclosing agent.

Planimetrically, the flat Oral B® brush appeared significantly more effective than the convex shaped Ph® brush (P < 0.001). This superiority was even enhanced after the use of toothpicks (P < 0.0005). The differences between the brushes, however, were too small to be detected by the less discriminating MNPI.

Although it has been claimed that the convex brush could assure approximal plaque control, the results indicate that for the convex‐shaped, as well as for the flat brush, an approximal aid is essential for good plaque control. The hypothesis that the design of the convex‐shaped brush could facilitate the modified Bass technique for the average patient could not be proven in this study.
Histologic Evaluation of Periodontal Implants in a Biologically “Closed” Model
Authors: Bye Fred L. , Krause Michael E. , Regezi Joseph A. , Caffesse Raul G.
Published: March 2012

To study the biologic response, three commercial calcium phosphate implant materials (Calcitite®, Periograf®, Synthograft®) were implanted in cuspid root “windows” in four beagle dogs. No implant material was placed in the fourth cuspid window which served as a control. Following mucoperiosteal flap elevation, windows were chiseled in bone to the root surface which allowed implant particles to contact bone, fibrous connective tissue, cementum and dentin without exposure to the oral environment. Animals were sacrificed after 1,3,5 and 6 months.

Histologically, all implant materials were well tolerated. At 1 month, implant particles were surrounded by fibrous tissue. Fibrous tissues filled the control defect. At 3 months, implant sites exhibited partial bony repair with connective tissue surrounding implant particles. A ring of osteoid surrounded Synthograft particles. Control defect repair was complete. At 5 and 6 months, implant sites exhibited advanced, though incomplete, bony repair. New bone encompassed the Synthograft particles. It was concluded: 1) Control sites healed most rapidly. 2) Calcitite and Periograft were well tolerated space occupiers. 3) Synthograft was a nidus for bone deposition.
Reliability of Attachment Level Measurements Using the Cementoenamel Junction and a Plastic Stent
Authors: Clark D. Christopher , Quee T. Chin , Bergeron M. J. , Chan E. C. S. , Lautar‐Lemay C. , de Gruchy K.
Published: March 2012

Repeated measurements of attachment level appear to be important assessments in periodontal clinical trials, yet the lack of reliability for this assessment creates measurement error which in turn demands increased sample sizes or reduces the power of the test. A plastic occlusal stent has been developed as a fixed reference point to assess changes in probing depths over time and thus reflect differences in attachment levels. The advantages of this system over traditional methods have not been measured. The purpose of this study was to determine intra‐ and interexaminer reliability for probing depths from the stent and the CEJ.

Paired measurements of attachment level using the stent produced correlation coefficients for inter‐ and intraexaminer readings of 0.84 and 0.76, respectively. For subgingival cementoenamel (CEJ) measurements, lower coefficients of 0.71 and 0.59 were found for inter‐ and intraexaminer paired readings, respectively. Thus, measurements using the stent appear to be more reliable than subgingival CEJ readings.
The Value of Systemically Administered Metronidazole in the Modified Widman Flap Procedure
Authors: Mahmood M. M. , Dolby A. E.
Published: March 2012

This double‐blind cross‐over study was undertaken to assess the effect of systemically administered metronidazole when used as an adjunct to periodontal surgery for the treatment of moderate and advanced periodontitis. The effect of metronidazole was compared with that of placebo in patients undergoing modified Widman flap procedures in two areas of the same jaw which could be matched for type of tooth and severity of the periodontal disease. Clinical and microbiological parameters were examined prior to surgery and then 7 days, 1 month, and 3 to 6 months, postoperatively. The clinical parameters recorded were pocket depth (PD), Sulcus Bleeding Index (SBI), probing attachment level (PAL), and patients' preference and pain score. Subgingival plaque samples were studied with dark‐field microscopy for differential bacterial count. Pocket depths and SBIs were reduced significantly at all stages, in both groups. Probing attachment levels increased at 7 days, to significant levels only in the metronidazole group, subsequently PALs decreased in both groups with no significant differences between the groups. Although the differential bacterial count altered markedly in both groups at all times, only the straight rod count at 1 month was significantly (P < 0.05) lower in the metronidazole group. Metronidazole with surgery did not exert a significantly greater beneficial effect than placebo with surgery.
Periapical Cemental Dysplasia and Periodontal Disease
Authors: Baden Ernest , Saroff Stephen A.
Published: March 2012

The patient reported here was seen with periapical cementai dysplasia (PCD) superimposed on chronic inflammatory periodontal disease. Various aspects of the diseases and their relationships are reviewed, including the diagnosis of PCD, its significance, and suggestions for therapy.
The “Furcation Arrow”
Authors: Hardekop James D. , Dunlap Robert M. , Ahl Dennis R. , Pelleu George B.
Published: March 2012

When radiographs of maxillary molars are observed, a small, triangular radiographic shadow is sometimes noted over either the mesial or distal roots in the proximal furcation area. This study was undertaken to determine the reliability of using this radiographic image as an aid in diagnosing proximal furcation involvement. Sixty‐six Degree 1, 53 Degree 2 and 43 Degree 3 proximal furcation involvements in maxillary molars in dry skulls were assessed visually with the Nyman and Lindhe classification. An additional 120 uninvolved furcations were included as controls. The involved maxillary molars were radiographed with standard periapical radiographic techniques. Projected radiographs were evaluated independently by six dentists who determined whether there was a triangular radiographic shadow (“furcation arrow”) over the mesial and distal proximal areas. The association of the furcation arrow image with Degree 2 or 3 furcation involvement was significant when compared with uninvolved furcations. The image was equally apparent over mesial or distal furcations and was not affected by the existence of a buccal furcation involvement. The incidence of the image over both uninvolved proximal furcations and proximal furcations with Degree 1 involvement was low and did not differ significantly. Because the furcation arrow seldom appears over uninvolved furcations, the appearance of the image indicates that there is proximal bony furcation involvement. However, absence of the furcation arrow image does not necessarily mean absence of a bony furcation involvement because the arrow was not seen in a large number of furcations with Degree 2 or 3 involvement.
Trypsin‐Like Activity in Subgingival Plaque
Authors: Loesche W. J. , Syed S. A. , Stoll J.
Published: March 2012

Taxonomic screening of subgingival plaque organisms with various enzyme assays have shown that Treponema denticela, Bacteroides gingivalis and an unspeciated Capnocytophaga species possess a trypsin‐like enzyme (TLE) that can be detected by the hydrolysis of N‐benzoyl‐DL‐arginine‐2‐naphthylamide (BANA). As these organisms can be considered to be periodontopathic, it was of interest to determine whether this BANA hydrolyzing enzyme could be detected directly in subgingival plaque samples. Subgingival plaque samples were collected from single sites of known pocket depth, and after dispersal by vortexing, aliquots were incubated overnight with BANA and were counted microscopically. The color reactions were developed with fast garnet, read by the eye and classified as positive (red to red‐orange), negative (yellow) and questionable. In the BANA‐positive plaques, the spirochetes averaged 43% of the microscopic count, whereas in the BANA negative plaques the spirochetes averaged 8% of the microscopic count. The average pocket depth of BANApositive plaques was 6.7 mm, whereas the average pocket depth of BANA‐negative plaques was 4.5 mm. When both of these parameters were combined, the presence of a positive BANA reaction was usually indicative of subgingival plaques containing >34% spirochetes removed from sites that had probing depths of 7 mm or more. Seventy‐one per cent of the plaques removed from untreated periodontal patients were BANA‐positive, while only 8% of the plaques removed from successfully treated patients seen at maintenance recall visits were BANA‐positive.

These data indicate that the ability of subgingival plaque to hydrolyze BANA is a reliable marker for the presence of high proportions of spirochetes in the plaque sample and possibly could be used clinically to identify those sites and/or individuals who might require treatment to reduce this spirochetal overgrowth.
Cyst of the Incisive (Palatine) Papilla
Authors: Brown Frederic H. , Houston Glen D. , Lubow Richard M. , Sagan Mitchell A.
Published: March 2012

Cysts of the incisive papilla are uncommon variants of the nasopalatine duct cysts. They may be symptomatic or asymptomatic and usually are not seen radiographically. This case report presents a flat, darkly pigmented asymptomatic lesion which required differentiation from a possible malignant melanoma. Due to its location in the anterior palate, this lesion is of interest and clinical significance to the periodontist.
Salt and Peroxide Compared with Conventional Oral Hygiene: II. Microbial Results
Authors: Wolff Larry F. , Pihlstrom Bruce L. , Bakdash M. Bashar , Schaffer Erwin M. , Jensen James R. , Aeppli Dorothee M. , Bandt Carl L.
Published: March 2012

This study was designed to investigate the effect of conventional oral hygiene (n = 116 subjects) versus a salt and peroxide oral hygiene regimen (n = 115 subjects) on subgingival microorganisms. Subgingival plaque for microscopic evaluation was obtained from eight index tooth sites in each of 231 adult subjects. Microbial forms were microscopically identified at baseline, 8, 16, and 24 months.

For both oral hygiene groups, cocci were increased (P < 0.05) and motile rods were decreased (P < 0.05) at 8 months and returned to baseline by 16 months. Spirochetes were decreased (P < 0.05) and remained low through 24 months in both oral hygiene groups. The frequency of agreement between clinical (bleeding) and microbial (>15% spirochetes or motile rods or >20% spirochetes + motile rods) criteria for instrumentation was 59.8%. It was also found that fewer total instrumentations for test subjects were observed when microbiological criteria were used as compared with clinical criteria. The greater number of instrumentations based on clinical criteria was highly significant (P < 0.001). A significant change in microbial signs associated with periodontal disease may be obtained with either a conventional oral hygiene or a salt and peroxide oral hygiene home care regimen.