bluuebunny/crossref_metadata_2025 huggingface dataset:
Visualization of the Human Periodontium Using Serial Thin Section Contact Radiography
Authors: Moskow B. S. , Tannenbaum P. , Bloom A.
Published: March 2012

A method is described to produce radiographs of thin sections of human teeth and periodontal structures. These high resolution contact x‐rays allow for visualization of the microscopic details of the mineralized components of these tissues in a dimension heretofore not examined.

Twenty‐five blocks of human jaws containing teeth affected by periodontal disease were obtained from cadavers. Sagittal, transverse and cross‐sectional serial slices were cut using a rotary instrument (1500 rpm) with a water‐cooled 3‐inch jewelers slot saw. Five hundredμm sections were made of jaw specimens containing 2 or 3 teeth. The radiographs were taken with a Faxitron low voltage x‐ray machine on Kodak‐Ortho, Type 3 film. Films were exposed at a distance of 12 inches from the x‐ray source at 35 kVp and 1.0 mA for 3 minutes with the specimen in direct contact with the film.

Spatial representation of the internal structure of the alveolar bone was obtained using this technique and the detailed anatomy of the vascular channels within the cancellous and cortical compartments of the jaws was studied. Mineralization patterns of plaque and calculus, calcifications in the periodontal ligament, pulp calcifications, accessory root canals, caries and detailed structural changes in the enamel and cementum were also viewed on these films with the aid of microscopy. Magnifications of up to 30 times were used without excessive image distortion resulting from film grain.
Root Surface Measurements of the Mandibular First Molar
Authors: Dunlap Robert M. , Gher Marlin E.
Published: March 2012

The root surface area (RSA) per millimeter of root length was determined for 20 extracted mandibular first molars. The molars were cross‐sectioned at 1‐mm increments, and each section photographed, projected and measured with a calibrated opisometer. The RSA and per cent RSA were calculated for each 1 mm of root length (1‐mm section), the root trunk and the individual roots. Also measured was the location of the root separations from the root trunk, the location of the first detectable root concavity, and the prevalence of “intermediate bifurcation ridges” (IBRs). Mean measurements indicated that the greatest RSA per millimeter of root length was 4 to 7 mm apical to the cementoenamel junction (CEJ) in the area of the furcation. Of the total RSA, 48.7% was located in the coronal 6 mm of a root (mean length, 14.4 mm). Root separation occurred 4.0 mm apical to the CEJ with no tooth having a root trunk longer than 6 mm. Buccal and lingual root concavities were first present 0.7 mm and 0.3 mm apical to the CEJ, respectively. Fourteen (70%) of the 20 teeth had IBRs. According to the mean measurements, the mesial root was larger than the distal root by a ratio of 1.0:0.88. Horizontal attachment loss of 6 mm affecting both the buccal and lingual surfaces of the mandibular first molar would have resulted in a through and through (grade 3) furcation involvement of all the teeth studied.
The Colonization and Establishment of Invading Bacteria in Periodontium of Ligature‐Treated Immunosuppressed Rats
Authors: Sanavi F. , Listgarten M. A. , Boyd F. , Sallay K. , Nowotny A.
Published: March 2012

The morphologic features and pattern of bacterial invasion of the periodontal tissue in ligature‐induced periodontal defects of immunosuppressed rats were studied. Silk ligatures were placed circumferentially on the maxillary left second molar of 24 Sprague‐Dawley rats. The treatment group (14 rats) received Cytoxan (75 mg/kg) the day after ligature placement and at Day 4. The control group (10 rats) received no medication. All animals were sacrificed on Day 8 and the maxillae processed for light and electron microscopy. Only ligated sites in immunosuppressed animals exhibited bacterial invasion. Invading bacteria consisted of microcolonies of Gram‐negative and Gram‐positive coccoid cells and rods located near the tissue surface. Each microcolony consisted of morphologically homogeneous microorganisms. The deeper sites revealed a diffuse invasion of Gram‐negative rods which appeared morphologically similar. Other features associated with invasion were complete destruction of epithelial tissue next to the ligature and the lack of inflammatory cells in the gingival region. These findings, when compared to those of other reports of tissue penetration by bacteria, point to the necessity of differentiating between bacterial invasion of gingival tissues, associated with penetration of tissues by proliferating bacteria, and bacterial translocation, a situation in which bacteria are passively carried into the tissues, for example by mechanical manipulation immediately before or during biopsy taking, or possibly during processing for histology.
Pressures Recorded during Periodontal Pocket Irrigation
Authors: Kelly Ann , Resteghini R. , Williams B. , Dolby A. E.
Published: March 2012

Pressures arising during periodontal pocket irrigation with 5 ml and 20 ml disposable plastic syringes, a peristaltic pump and a Waterpik pulsating irrigator were measured with an in‐line transducer and recorder in 11 patients. Three types of needles were used with each device; disposable 15‐gauge straight and angled needles and a 15‐gauge angled reusable needle. Measurements were made with the needle tips just within, and 3 mm into the pocket. With both the 5 ml and 20 ml syringes and all needles, pressures of 100‐ to 500‐mm mercury were recorded. With the peristaltic pump, pressures of 70‐ to 340‐mm mercury were recorded with all needles. The Waterpik apparatus produced pressures of not more than 60‐mm mercury in all cases.
Peripheral Calcifying Odontogenic Cyst (Gorlin Cyst)
Authors: Swan Richard H. , Houston Glen D. , Moore Stephen P.
Published: March 2012

A case report of a rare peripheral calcifying odontogenic cyst is presented. The clinical, radiographic and histopathologic features of the lesion are discussed, along with the etiology, rate of occurrence and diagnosis.
Gingival Fibromatosis with Hypertrichosis
Authors: Horning Gregory M. , Fisher Jon G. , Barker Bruce F. , Killoy William J. , Lowe James W.
Published: March 2012

A case of gingival fibromatosis with hypertrichosis is reported in a 3‐year‐old girl. Partial recurrence was observed 6 months after surgical treatment. Psychological benefits resulting from the cosmetic improvement may outweigh the probability of recurrences in this rare condition.
A Clinical Trial of Phenoxymethyl Penicillin for Adjunctive Treatment of Juvenile Periodontitis
Authors: Kunihira D. M. , Caine. F. A. , Palcanis K. G. , Best A. M. , Ranney R. R.
Published: March 2012

A double‐blind clinical trial of oral penicillin as an adjunct to conventional treatment of localized juvenile periodontitis (JP) was conducted. Sixteen subjects with JP were paired on the basis of general similarity of disease, and within each pair the persons were assigned randomly, one to a placebo group and one to a penicillin group. Neither patients nor therapist/examiner were aware of whether placebo or penicillin was being taken. All subjects received an initial scaling and root planing of all teeth and flap surgery of all affected sites. Every 12 weeks after surgery through Week 62 of the study, root planing and oral hygiene instructions were repeated. Phenoxymethyl penicillin (250 mg qid) or placebo was started the day of surgery and each recall visit and lasted for 10 days. Clinical measurements were made at the beginning of the study and at each recall visit. In both groups there was a significant decrease in plaque scores, gingival inflammation, gingival bleeding and probeable depths for all sites and for affected sites. Similarly there was a significant increase in attachment level and radiographic bone height, and a total elimination of suppuration. The favorable changes were apparent at the first postsurgical recall (Week 26 of the study) and remained essentially the same through Week 62. The magnitude of change in these parameters was similar to that reported by others for treatment regimes including tetracycline therapy. However, there were no differences in any parameters between the placebo and penicillin groups. Half of the subjects (4 in each group) were continued in the study for another 9 months (Week 98). There were still no differences between groups. The data indicated that root planing, flap surgery and maintenance therapy every 3 months provide an effective treatment for juvenile periodontitis, but that treatment results were not enhanced by oral administration of penicillin.
Histologic Evaluation of New Attachment in Humans: A Preliminary Report
Authors: Bowers Gerald M. , Granet Michael , Stevens Mark , Emerson Jane , Corio Russel , Mellonig James , Lewis Stephen B. , Peltzman Barry , Romberg Elaine , Risom Laurel
Published: March 2012

This study was designed to evaluate the potential for regeneration of a new attachment (alveolar bone, cementum and a functional periodontal ligament) in patients whose attachment apparatus had been destroyed by periodontal disease.

In each of the three parts of the investigation, the most apical level of calculus on the root served as a histologic reference point to measure regeneration. In Part I, attempts were made to initiate the formation of a new attachment by surgical debridement, crown removal (coronectomy) and submersion of the vital root below the mucosa. Nonsubmerged, surgically debrided defects served as controls. In Part II, debrided intrabony defects were treated with and without demineralized freeze‐dried bone allograft and the associated vital roots were submerged. Part III evaluated potential for regeneration of a new attachment in nonsubmerged roots with and without the use of demineralized freeze‐dried bone allograft. Gingival grafts were placed over the experimental and control sites in an attempt to retard epithelial migration.

Biopsies were obtained in 6 months and regeneration was evaluated histometrically. Preliminary results in 7 patients and 24 intrabony defects indicate that new attachment is possible on pathologically exposed root surfaces in a submerged environment with and without the incorporation of demineralized freeze‐dried bone allografts. New attachment was observed on pathologically exposed root surfaces in a nonsubmerged environment when intrabony defects were grafted with demineralized freeze‐dried bone allograft. New attachment was not observed on nongrafted. nonsubmerged. defects with and without the placement of gingival grafts over the defects.
Studies of a Family Manifesting Premature Exfoliation of Deciduous Teeth
Authors: Baab David A. , Page Roy C. , Morton Thomas
Published: March 2012

We report observations made on a family in which the children manifested premature exfoliation of the deciduous incisors and canines beginning as early as 1.5 years of age. We observed gingival recession, alveolar bone resorption, tooth loosening and exfoliation without apical root resorption in the absence of clinical signs of inflammation. The children's mother, age 26, had a normal periodontium, but the father, age 30, had periodontitis of moderate severity. Exfoliated deciduous teeth from one of the children were examined histologically and features characteristic for hypophosphatasia were seen. However, localized prepubertal periodontitis could not be ruled out from these data alone. The differential diagnoses for this type of condition are discussed.
An Unusual Presentation of Metastatic Carcinoma Involving the Periodontium
Authors: Allen Carl M. , Duckworth John
Published: March 2012

A case of metastatic nasopharyngeal carcinoma involving the mandibular periodontium of a 36‐year‐old female is presented. The diffuse gingival enlargement from premolar to premolar was quite unusual, and other conditions were considered in the clinical differential diagnosis. Histopathologic evaluation of the gingival lesion showed a poorly differentiated carcinoma which appeared morphologically similar to earlier metastatic lesions of the nasal fossa and brain.
Association between Signs of Trauma from Occlusion and Periodontitis
Authors: Pihlstrom Bruce L. , Anderson Karl A. , Aeppli Dorothy , Schaffer† Erwin M.
Published: March 2012

The purpose of this study was to evaluate the association between signs of trauma from occlusion, severity of periodontitis and radiographic record of bone support. The maxillary first molars of 300 individuals were independently evaluated by two examiners for signs of trauma from occlusion, pattern of occlusal contacts and severity of periodontitis. Each site was also evaluated radiographically by an independent third examiner. The results indicated that: (1) teeth with either bidigital mobility, functional mobility, a widened periodontal ligament space or the presence of radiographically visible calculus had deeper probing depth, more loss of clinical attachment and less radiographic osseous support than teeth without these findings, (2) teeth with occlusal contacts in centric relation, working, nonworking or protrusive positions did not exhibit any greater severity of periodontitis than teeth without these contacts, (3) teeth with both functional mobility and a radiographically widened periodontal ligament space had deeper probing depth, more clinical attachment loss and less radiographic osseous support than teeth without these findings and (4) given equal clinical attachment levels, teeth with evidence of functional mobility and a widened periodontal ligament space had less radiographic osseous support than teeth without these findings.
The Use of Periograf® in Periodontal Defects
Authors: Sapkos Stan W.
Published: March 2012

Hydroxylapatite (Periograf®) was placed into periodontal defects around five teeth scheduled for extraction in two young adult females with excellent plaque control. On the facial surface of one tooth the material was placed in a supracrestal position. Twelve months later the teeth were extracted in block section and were examined microscopically. Hydroxylapatite crystals were seen in the histologic sections with evidence of new bone formation in juxtaposition. The hydroxylapatite was tolerated relatively well by the surrounding tissue. a “cap” of bone was present coronal and facial to those crystals placed in the supracrestal position. In some areas bone was seen attached to the root via a periodontal ligament coronal to the Durapatite crystals. The question of accidental implantation of the material into the adjacent bone versus the actual regeneration of a true new attachment was discussed.
Alveolar Cavitational Osteopathosis: Manifestations of an Infectious Process and Its Implication in the Causation of Chronic Pain
Authors: Ratner Eugene J. , Langer Burton , Evins Mathew L.
Published: March 2012

A recently discovered oral disease process of infectious origin, characterized by nonradiographically detectable, hollow, pathologic, alveolar cavitational lesions of significant size, is described. This oral infectious disease process, termed alveolar cavitational osteopathosis, is causally implicated not only in the genesis of certain craniofacial pain syndromes, among them idiopathic trigeminal neuralgia and atypical facial pain, but also in chronic pain syndromes remote from the craniofacial region including the back, chest, arms, legs and cervical areas.

A diagnostic process is presented which serves to define the locus of nonradiographically detectable alveolar cavitational osteopathosis and correlates a given pathological site to a given area of pain. Comprehensive schematics have been developed defining the pain pathways emanating from the oral cavity and their specific relationship to sites of perceived pain both in the craniofacial region and other areas of the body.

The treatment modality described serves to induce bone growth within the cavitational lesions, resulting in the subsequent eradication of the cavity. The abolition of osteopathosis results in significant or total disappearance of pain symptomatology.
Smoking and Periodontal Disease: A Review of the Literature
Authors: Rivera‐Hidalgo Francisco
Published: March 2012

The literature related to smoking and periodontal disease is reviewed. The effects of smoking on oral hygiene, gingivitis, necrotizing gingivitis, periodontitis, bacteria and the host's response are presented. From this review it is apparent that while the relationship between smoking and periodontal disease needs further study, smoking is detrimental to periodontal health as it worsens the oral hygiene status and depresses the host's defense posture.
Indices Used to Evaluate Signs, Symptoms and Etiologic Factors Associated with Diseases of the Periodontium
Authors: Barnes George P. , Parker Warren A. , Lyon Thayer C. , Fultz R. Paul
Published: March 2012

Oral indices are reviewed and classified. The methods of using indices are discussed and a number of the periodontal indices are compared using a tabular format.
Hospital Periodontics A Survey of Hospital Utilization by American Academy of Periodontology Members
Authors: Hinrichs James E.
Published: March 2012

A survey of American Academy of Periodontology members was conducted to determine: (1) the number of Academy members with hospital staff privileges, (2) the frequency with which Academy members use hospital facilities, and (3) the amount of training Academy members have had in physical evaluation and assessment of medical risk. The results indicate that over half of all Academy members have hospital staff privileges, with the majority of these being active Academy members. One third of the 945 Academy members who perform dentistry in a hospital operating room treat only one to two cases a year. Fewer than one fifth of the questionnaire respondents who perform dentistry in an operating room treat more than 12 cases per year. Approximately 95% of Academy members believe that periodontal training programs should include a course in physical evaluation and assessment of medical risk. The amount of formal training in physical evaluation and assessment of medical risk varies widely among Academy members. Over one third of 1,144 questionnaire respondents have had no formal training in physical evaluation and assessment of medical risk, while fewer than one tenth have had over 80 hours of formal training.
The Effectiveness of the Titan‐S Sonic Sealer Versus Curettes in the Removal of Subgingival Calculus
Authors: Gellin Robert G. , Miller M. Clinton , Javed Tariq , Engler William O. , Mishkin David J.
Published: March 2012

This study evaluated clinically the effectiveness of hand versus sonic subgingival scaling and root planing in the removal of calculus by visually examining the root surface at the time of periodontal flap surgery. Consideration was given to the method of instrumentation, probing depth, number of roots, and type of tooth surface.

Eleven patients with moderate to advanced periodontal disease were evaluated. Four subjects were scaled and root planed with the Titan‐S only, four with curettes only, and three with the Titan‐S + curettes. At reevaluation 3 to 6 weeks after scaling and root planing, the decision to perform periodontal flap surgery was made based upon probing depth, bleeding upon probing, previous access to the root surface, furcation involvement, and the patient's level of oral hygiene. A full thickness mucoperiosteal flap was elevated to gain access to the root surface and measure the distance from the cementoenamel junction to the residual calculus.

A total of 690 surfaces were evaluated surgically. The percentage of surfaces with residual calculus for each method of instrumentation was: Titan‐S only (31.9%), curettes only (26.8%), and Titan‐S + curettes (16.9%). Overall, 15.7% of the surfaces probing 0 to 3 mm, 29.3% of the surfaces probing 4 to 5 mm, and 44.4% of the surfaces probing 6 to 12 mm had residual calculus.

It was concluded that: (1) the combination of the Titan‐S + curettes was more effective than either method used alone; (2) there was no consistent difference between the Titan‐S and curettes; (3) as the probing depth increased, the percentage of surfaces with residual calculus increased; and (4) subgingival calculus removal was more difficult for multiplerooted teeth and for proximal surfaces.
Effects of Hydrogen Peroxide on Oral Carcinogenesis in Hamsters
Authors: Weitzman Sigmund A. , Weitberg Alan B. , Stossel Thomas P. , Schwartz Joel , Shklar Gerald
Published: March 2012

The effects of twice weekly topical applications of hydrogen peroxide on the buccal epithelium of Syrian hamsters were studied. Animals were treated either with hydrogen peroxide alone, with hydrogen peroxide and the carcinogen 9, 10‐dimethyl‐l,2‐benzanthracene (DMBA), or with DMBA alone. In animals treated with 30% H2O2 alone, histopathologic examination after 22 weeks revealed hyperkeratosis and hyperplasia in all animals with hyperchromatic cells and mild dysplasia in four of nine: no tumors were seen. In animals treated with DMBA alone, three of seven (43%) developed epidermoid carcinoma, while six of 11 (55%) of animals treated with DMBA plus 3% hydrogen peroxide and five of five (100%) of animals treated with DMBA plus 30% hydrogen peroxide (P = 0.054) developed carcinoma. Thus, hydrogen peroxide can, by itself, induce pathologic changes frequently associated with preneoplastic lesions; it may also augment carcinogenesis associated with DMBA.
Oral Ulcerations with Use of Hydrogen Peroxide
Authors: Rees Terry D. , Orth Charles F.
Published: March 2012

Hydrogen peroxide has been advocated for many years as an oral rinse useful in control of various oral conditions. Several authorities, however, have suggested that this material may be harmful to oral tissues, especially if the tissues have been previously injured. This article presents two case reports demonstrating harmful oral effects from hydrogen peroxide rinses. The findings suggest that oral hygiene techniques emphasizing the use of 3% hydrogen peroxide in periodontal therapy may require reevaluation.
Antibody to Collagen Type I in Periodontal Disease
Authors: Ftis A. , Singh Gyan , Dolby A. E.
Published: March 2012

Serum antibody levels to human collagen Type I were measured in 97 patients with periodontal disease (Russell Periodontal Index 1.0–7.0) and 57 control subjects (Periodontal Index <1.0) using an enzyme‐linked immunosorbent assay, which had been standardized with antisera prepared against human collagen Type I in rabbits. Absorption studies were used to confirm the specificity of antibodies to human Type I collagen. Levels of antibody to Type I collagen detected in patients were higher (P < 0.001) than in the control subjects.
In Situ Demonstration of Natural Killer (NK) Cells in Human Gingival Tissue
Authors: Wynne Susan E. , Walsh Laurence J. , Seymour Gregory J. , Powell Robin N.
Published: March 2012

Recent studies have raised the possibility that natural killer (NK) cell activity may play a role in tissue destruction in chronic inflammatory periodontal disease (CIPD). This study aimed to locate and identify these cells in healthy and diseased gingival tissue. Leu 4, Leu 7, and Leu 11 monoclonal antibodies were used to characterize lesions of CIPD and to identify NK cells. Gingival tissue from three patient groups was examined. Group 1 subjects participated in a 21‐day experimental gingivitis study. Group 2 subjects were children aged less than 8 years who had gingivitis associated with deciduous teeth. Group 3 consisted of patients with CIPD undergoing periodontal surgery. In group 1, NK cells were absent in health (Day 0) and gradually increased in number with increasing inflammation up to Day 21. The number and distribution of NK cells in Group 2 subjects resembled those seen after a 21‐day experimental gingivitis study. In Group 3 subjects, lesions of CIPD which contained >90% Leu 4+ cells („T cell” lesions) contained few Leu 7+ cells and no Leu 11+ cells. The greatest number of NK cells were found in the „B cell” lesions (<60% Leu 4+ cells). The absence of NK cells in gingival health and their presence in diseased gingiva suggests that these cells are involved in the immune response to the accumulation of plaque.
Neutrophil Function in Localized Juvenile Periodontitis: Phagocytosis, Superoxide Production and Specific Granule Release
Authors: Van Dyke T. E. , Zinney W. , Winkel K. , Taufiq A. , Offenbacher S. , Arnold R. R.
Published: March 2012

Patients with localized juvenile periodontitis (LJP) exhibit defective neutrophil functions to a variety of environmental and host stimuli. It is not clear, however, how many of the measurable functions are defective and whether individual patients exhibit single or multiple dysfunctions. The purpose of this study was to evaluate chemotaxis, phagocytosis, specific granule release and Superoxide production in a group of 23 previously unreported LJP patients. Our results indicate that all 23 of these LJP patients exhibited Chemotaxis depression to N‐formyl‐L‐methionyl‐L‐leucyl‐L‐phenylalanine (FMLP) and endotoxin‐activated serum (EAS). Smaller groups from the 23 chemotactically defective LJP group were used to test other functions due to inability to obtain sufficient quantities of blood. Fourteen of 14 LJP patients tested exhibited defective phagocytosis. Ten LJP patients were evaluated for specific granule release, and 14 LJP patients were evaluated for Superoxide production. Both granule release and Superoxide production were found to be normal in chemotactically defective LJP patients. Since both defective and normal responses noted in the same neutrophil populations are mediated by the same receptor, it is hypothesized that the cellular defect lies in a post receptor pathway.
Guided Tissue Regeneration: An Experimental Procedure in Beagle Dogs
Authors: Aukhil Ikramuddin , Pettersson Ewa , Suggs Cynthia
Published: March 2012

This preliminary study examined the healing following an experimental procedure designed to facilitate coronal migration of progenitor cells from the periodontal ligament circumferentially on roots of premolar teeth in beagle dogs.

Mucoperiosteal flaps were reflected on the buccal and lingual aspects of premolars in six beagle dogs with periodontal disease. Following root preparation, pieces of orthodontic wire were placed interproximally on the crowns to bridge the spaces between teeth. Biobrane, a synthetic membrane bonded to a knitted nylon fabric and coated with collagen, was placed as a physical barrier between the roots and the flaps to be replaced. The membrane extended as a single piece from the cementoenamel junction (CEJ) to overlap the crest of alveolar bone by 3 to 4 mm on both the buccal and lingual surfaces of the three premolars in each quadrant. The membrane was attached to the crowns at the CEJ with resin. The flaps were replaced and sutured. Postoperative care included plaque control and the membranes were removed after 5 weeks. The dogs were sacrificed to provide observation periods of 8 and 16 weeks after placement of membranes.

Histologic examination revealed new connective tissue attachment in the apical part of the 8‐ and 16‐week experimental specimens. Some experimental specimens showed new attachment up to 2.94 mm while others showed a long junctional epithelium (JE). Root resorption was also seen in some specimens.

These preliminary findings suggest that placement of physical barriers between root surface and flaps may be beneficial in facilitating coronal migration of progenitor cells from the periodontal ligament.
Problems in Identifying “Bursts” of Periodontal Attachment Loss
Authors: Ralls Stephen A. , Cohen Mark E.
Published: March 2012

A theory of periodontal attachment loss which postulates discrete bursts of activity has recently been proposed. This paper identifies several problems in the interpretation of the experimental data that have been used to support the burst model. Major obstacles to valid inferences are associated with the following: 1) substantial measurement error, 2) insufficient evidence supporting a dichotomy of disease state and 3) the use of diagnostic decision criteria with undesirable properties. The nature of these problems is discussed from the framework of receiver operating characteristic (ROC) analysis. “Bursts” of attachment loss can be explained, in whole or in part, by these factors in the absence of real change. Types of research evidence that would offer more compelling support for the burst model are identified. The questionable validity of evidence supporting the burst model may impact on both the direction of future research efforts and clinical applications.
Light and Electron Microscopic Study of Cyclosporin A Induced Gingival Hyperplasia
Authors: Deliliers Giorgio Lambertenghi , Santoro Franco , Polli Nicoletta , Bruno Eugenio , Fumagalli Luca , Risciotti Emanuele
Published: March 2012

Four transplant (3 kidney, 1 bone marrow) patients with cyclosporin A (CyA)‐induced gingival hyperplasia are described. Light and electron microscopic findings of gingival biopsies showed in all patients that, in addition to an increase of collagen, CyA induced in the subepithelial space an enormous infiltration of morphologically normal plasma cells in different stages of maturation. These data, together with the reversibility of the lesion upon discontinuation of the drug, suggest that individual hypersensitivity is probably the most acceptable explanation of CyA‐induced gingival hyperplasia. This hypothesis is also discussed in relation to the CyA‐suppression of the functions of some T‐lymphocyte subsets.
Ultrastructure of Regenerated Junctional Epithelium after Surgery of the Rat Molar Gingiva
Authors: Takata Takashi , Nikai Hiromasa , Ljuhin Naokuni , Okamoto Hiroshi
Published: March 2012

To elucidate the ultrastructure of reconstructed dentogingival junction and cytological details of regenerated junctional epithelium (RJE) and to discuss the functional aspects of RJE through comparing its fine structure with normal structure, molar gingivae of 15 Wistar rats were examined by electron microscopy at 6, 8 and 12 weeks after electrosurgical gingivectomy. As early as 6 weeks after surgery, the epithelial architecture of dentogingival junction was reestablished at the light microscopic level, and RJE showed the ultrastructure indistinguishable from that before surgery. The cytoplasmic vacuoles, characteristic of rat JE, displayed the morphology, distribution and intimate relationship with lysosomes, all of which were quite identical to those in controls, and were regarded to represent “phagosomes.” Since various findings specific to JE are apparently reproduced in RJE, it seems that those peculiar structures would be an expression due to the environment rather than to the predetermined nature. RJE also might play a defensive function through the endocyticvacuolar system as suggested for normal JE. The presence of two types of cuticular structures, which were not conspicuous in normal JE, was also revealed between RJE and the tooth.
Chemotherapeutic Agents and Periodontal Therapy: Their Impact on Clinical Practice
Authors: Ciando Sebastian C.
Published: March 2012

This paper reviews developments in chemotherapeutic agents relative to their impact on clinical practice. These agents are discussed in terms of their effect on plaque, gingivitis, periodontitis, hypersensitive dentin and re‐attachment procedures. The paper also provides a perspective on delivery systems.
Bone Formation within Porous Hydroxylapatite Implants in Human Periodontal Defects
Authors: Kenney E. B. , Lekovic V. , Sa Ferreira J. C. , Han T. , Dimitrijevic B. , Carranza F. A.
Published: March 2012

Tissue samples from three subjects who had periodontal defects treated with a porous hydroxylapatite implant were investigated using light microscopy and scanning electron microscopy. The 3‐month specimen showed connective tissue infiltration through the pores and a narrow zone of bone formation present along the walls of the pores. At 4 months, continued evidence of bone deposition was present with osteocytes, osteoblasts and organization of collagen fibers apparent throughout the implant. The 6‐month implant had further evidence of continued bone formation with lamellar bone being the major component within the pores.
Actinobacillus actinomycetemcomitans and Clinical Periodontal Status in Finnish Juvenile Periodontitis Patients
Authors: Asikainen S. , Jousimies‐Somer H. , Kanervo A. , Saxén L.
Published: March 2012

The relationship between the clinical periodontal status and the occurrence of Actinobacillus actinomycetemcomitans (A.a.) in 19 Finnish patients with localized juvenile periodontitis (LJP) was studied. Clinical examination included the Plaque Index, Gingival Index, suppuration, probing depth and bleeding on probing. The subgingival bacterial samples were taken from two diseased periodontal pockets with radiographic bone loss and two periodontal pockets exhibiting no radiographic alveolar bone loss. The results indicate that A.a. was isolated in 17 (89%) patients, in 68% of the diseased and in 32% of the control periodontal sites. Supragingival plaque, marginal gingival inflammation, gingival bleeding on probing, and suppuration were found as frequently in A.a.‐positive as in A.a.‐negative diseased LJP pockets. It was concluded that A.a. was frequently, but not always, detected in diseased LJP lesions. No association was found between the clinical status and the occurrence of A.a.
Ultrastructure of Durapatite‐Periodontal Tissue Interface in Human Intrabony Defects
Authors: Ganeles J. , Listgarten M. A. , Evian C. I.
Published: March 2012

The ultrastructure of the interface between Durapatite (hydroxylapatite) and human periodontal tissues was examined. Durapatite was implanted into the intrabony periodontal defects during periodontal surgery. Reentry procedures were performed after 1 year and the tissues in the defects were biopsied and processed for transmission electron microscopy. Nineteen tissue blocks from four patients were examined, 17 contained Durapatite particles embedded in fibrous tissue and two contained particles encased in bone, all without inflammation.

The fibrous connective tissue consisted of densely packed collagen fibrils surrounding the implant particles. The bone surrounding the Durapatite consisted in one case of relatively mature bone, and in the other of osteoid tissue. A granular, amorphous, collagen‐free, electron‐dense layer was routinely observed between implant and tissue. This layer was thicker in the bone‐encased samples than in those surrounded by fibrous connective tissue. Except for the particle surrounded by mature bone, this layer was continuous with an organic meshwork located on the periphery of the implant spaces. The ultrastructural features of the interface are consistent with the existence of a mucopolysaccharide “bonding zone” described by other investigators. The organic meshwork appears to outline areas similar in size and shape to the individual crystallites of hydroxylapatite. This may indicate that the reactive surface of hydroxylapatite is much larger than merely the exterior surface of the implant, a finding which may explain the apparently good tissue adhesion to the implant.
Non‐Hodgkin's Lymphoma of the Gingiva: Review of the Literature
Authors: Wilson Thomas G. , Wright John M.
Published: March 2012

A case of non‐Hodgkin's lymphoma is presented in which a gingival swelling was the initial manifestation of the disease. The non‐Hodgkin's lymphomas are reviewed, and the management of patients with gingival disease is discussed.
Progressive Changes of Kaposi's Sarcoma of the Gingiva and Palate
Authors: Petit Jean‐Claude , Ripamonti Ugo , Hille Jos
Published: March 2012

As the incidence of acquired immunodeficiency syndrome (AIDS) cases is rapidly increasing, it is expected that the oral lesions of Kaposi's sarcoma (KS) related to AIDS will be encountered more frequently. The progressive changes of KS of the gingiva and palate are described in an AIDS patient who has been monitored for 7 months. In the initial stage, the oral manifestations of KS can be confused with various other lesions. The histopathological appearance includes proliferating slit‐like vascular channels and scattered macrophages containing numerous hyaline, eosinophilic granules. Rapid neoplastic proliferation seems to be related to cyclical episodes of impaired immunity.
Effects of the Inorganic Salts Sodium Chloride, Sodium Bicarbonate, and Magnesium Sulfate upon the Growth and Motility of Treponema vincentii
Authors: Wolinsky L. E. , Lott T.
Published: March 2012

The use of inorganic salt solutions as chemotherapeutic agents in the control of periodontal disease has received considerable attention in the past few years. Although some research has been published on their clinical effectiveness, little is known about their therapeutic activity and bactericidal effects upon oral spirochetes. The present study investigated the effects of varied concentrations of NaCl, NaHCO3, and MgSO4 upon the in vitro growth and motility of Treponema vincentii.

Growth determinations were performed using a turbidiometric analysis at 545 nm. Motility was qualitatively studied by direct examination of 200 treponemes in a wet mount specimen. Samples were taken at 24, 48, 72, and 96 hours following inoculation with the treponemes. Concentrations of 0.5 m NaCl, NaHCO3, or MgSO4 totally inhibited the growth and motility of T. vincentii over a 96‐hour period. Salt concentrations ≤0.10 m had little if any effect upon growth and motility.

The data support the hypothesis that the bactericidal and antimotility effects of these salts are related more to their concentrations than to the presence of a specific inorganic ion. They also suggest that motility may be a valid indicator of bacterial viability.

Before the clinical significance of the results can be ascertained, human studies are needed to establish sulcular salt concentrations which can be achieved with local irrigation and to determine how long bactericidal concentrations can be maintained.
Histological Evaluation of Human Intraosseous Healing Responses to the Placement of Tricalcium Phosphate Ceramic Implants
Authors: Stahl S. S. , Froum S.
Published: March 2012

Eight intrabony lesions in four patients were removed en bloc 3 to 8 months after periodontal flap debridement. At the time of debridement, the position of the gingival margin and the most apically located calculus were notched to serve as reference points. All lesions received “Synthograft®” implants and lesions healed uneventfully. Even though these were severely involved periodontal sites, clinical measurements at time of block removal demonstrated gingival recession (average = 2.9 mm) and a gain in clinical closure (average = 2.6 mm).

Histologically, graft particles were present in each specimen. They were walled off by collagen and did not appear to enhance new attachment nor did they induce an inflammatory infiltrate. Thus, they seemed to act as nonirritating fillers. Microscopically, closure of the lesions demonstrated repair with limited evidence of new connective tissue attachment. Histologic expression of the clinical gain in closure was the result of closure by long epithelial adhesion (long junctional epithelium) and possible linkage of dentinal collagen with gingival fibers at areas of dentinal resorption. These variations in closure were often seen within the same clinical site.
Cell and Fiber Attachment to Demineralized Dentin from Periodontitis‐Affected Root Surfaces
Authors: Polson A. M. , Ladenheim S. , Hanes P. J.
Published: March 2012

This study assessed connective tissue and epithelial responses to dentin specimens obtained from periodontitis‐affected roots of human teeth after surface demineralization. Rectangular dentin specimens with opposite faces of root and pulpal dentin were prepared from beneath root surfaces covered by sheets of calculus. One half of the specimens were treated with citric acid, pH 1, for 3 minutes, while the remainder served as untreated controls. Specimens were implanted vertically into incisional wounds on the dorsal surface of rats with one end of the implant protruding through the skin. Four specimens in each group were available 1, 3, 5 and 10 days after implantation. Histologic and histometric analyses included counts of adhering cells, evaluation of attached connective tissue fiber density and diameter, and assessment of epithelial migration. Analyses within each group comparing root and pulpal surfaces showed no differences between any of the parameters. Comparisons between experimental and control groups showed that demineralized surfaces had a greater number of cells attached, fiber attachment occurred and epithelial downgrowth was inhibited. Surface demineralization of dentin from periodontitis‐affected roots predisposed toward a connective tissue attachment.
Severe Gingival Overgrowth Associated with Cyclosporine Therapy
Authors: Rostock Matt H. , Fry Hiram R. , Turner James E.
Published: March 2012

A case of severe gingival overgrowth secondary to cyclosporine therapy in a 19‐yearold black male who received a liver allograft transplant is reported. Clinical examination revealed a severely overgrown and inflamed gingiva. Surgical excision of the excess tissue was accomplished under general anesthesia. Healing occurred uneventfully, with acceptable contours; however, some regrowth was evident as early as 2 months. Spontaneous repositioning of the teeth was also seen postoperatively. Examination of the excised tissues revealed alternating areas of dense collagen and myxomatous change. An inflammatory infiltrate primarily of plasma cells was present. There was no evidence of an increased number of fibroblasts in the specimens examined.
Juvenile Periodontitis: I. Demonstration of Local Immunoglobulin Synthesis
Authors: Spindler Steven J. , Thompson James J. , Yukna Raymond A. , Costales Aymee D.
Published: March 2012

The purpose of this investigation was to determine the presence and quantity of Immunoglobulin G (IgG) and albumin (ALB) in specified periodontal tissues and serum from patients diagnosed as having juvenile periodontitis (JP), using an immunoelectrophoresis technique and to determine which portion of the lesion generated the greatest local Immunoglobulin production.

Serum and tissue samples were obtained from 19 patients (ages 13–21 years) who were diagnosed as having JP; 18 were female; 16 were black. Normal, diseased, and granulomatous gingival/periodontal tissues were collected during full thickness flap surgery, then minced, homogenized, and centrifuged.

Supernatants containing the gingival/periodontal protein and the serum were electrophoresed against rabbit antihuman IgG and ALB. The relative IgG/ALB ratios in each specimen were plotted against known concentrations of IgG using a least squares analysis to provide evidence for local synthesis.

In comparing mean IgG/ALB ratios for all tissue types, it was noted that normal gingiva did not differ significantly from serum. Diseased and granulomatous tissues, taken together or separately, had significantly higher IgG/ALB ratios than normal gingiva or serum, demonstrating that 73.6% of the IgG present was due to local synthesis. However, the greatest amounts of locally produced IgG were found in the granulomatous tissue from the deepest areas of the defects.
Effects of Subgingival Chlorhexidine Irrigation in Chronic Moderate Periodontitis
Authors: Haskel Elias , Esquenasi Judith , Yussim Leonel
Published: March 2012

The clinical and microbiological effects of once daily subgingival irrigations with 1 ml of 0.2% Chlorhexidine gluconate (CH) during 14 days were evaluated in 23 patients with 4 to 6 mm contralateral pockets. On Days 0, 14 and 28, evaluations were made of the plaque index, the gingival index, gingival bleeding on probing pocket depth and of microbiological variables (phase‐contrast microscopy). Supragingival scaling was carried out but no oral hygiene instructions were given to patients at the start of the trial. Twenty‐three test sites (subgingival CH) and 23 control sites (subgingival distilled water + supragingival CH) were studied.

The clinical results showed a significant reduction of the gingival index (P < 0.05) in the test group with respect to the control group on Day 14. No other clinically significant differences could be observed in the test group with respect to the control group. A significant reduction in the proportions of spirochetes (P < 0.05) and a significant increase in the proportions of cocci (P< 0.005) were observed in the test group on Day 14.

CH irrigation as a subgingival monotherapy yielded transient microbiological and limited clinical effects.
Topical Folinic Acid Therapy in Methotrexate‐Induced Oral Ulceration
Authors: Barrett Anthony P.
Published: March 2012

A case of severe oral ulceration, following administration of combination chemotherapy which included methotrexate, is reported. Topically applied folinic acid was effective in facilitating resolution of the oral lesions.
Bone Loss Following Periodontal Therapy in Subjects without Frequent Periodontal Maintenance
Authors: DeVore C. H. , Duckworth J. E. , Beck F. M. , Hicks M. J. , Brumfield F. W. , Horton J. E.
Published: March 2012

The longitudinal effects of periodontal therapy in patients without a frequent periodontal maintenance program have been minimally documented. In this study we used Duckworth's modification of the Schei Ruler Technique to assess the difference in bone level around individual teeth treated for periodontal disease in subjects receiving infrequent posttherapy maintenance (≤1 time/year). Crestal bone height differences were evaluated using the initial presenting series of long cone parallel radiographs of 23 subjects with their subsequent posttherapy analogous radiographic series taken 5.4 ± 2.9 years later. Bone loss was defined as a reduction in the alveolar crest of greater than 50% of the radiographic crown height which corresponds to approximately 4 mm in posterior and 5 mm in anterior teeth. The loss for each tooth was expressed as a per cent of the measured height of the crown after conversion from millimeters using the mean crown‐root ratio for each tooth.

We found increased alveolar bone loss and tooth loss in subjects examined posttherapy when compared with conditions present when each subject initially presented for periodontal treatment. Our data suggest that molar teeth are more at risk than incisors and cuspids and that a lack of periodontal maintenance care and inadequate plaque control contribute to progressive bone loss following treatment.
Effects of Chlorhexidine Gel in a Group of Maintenance Care Patients with Poor Oral Hygiene
Authors: Lie Tryggve , Enersen Morten
Published: March 2012

An intraindividual double‐blind crossover study was designed in order to see if a 1% Chlorhexidine gel used twice a day could substitute for ordinary toothpaste in a group of maintenance‐care patients with poor oral hygiene. Twenty patients from a student clinic participated, each with a long history of maintenance‐care problems. A 4‐week test period with Chlorhexidine gel or placebo gel was followed by an intermediate period with ordinary toothpaste, and then by another 4‐week test period. Plaque‐covered surfaces (%), bleeding sites (%) and extraneous staining (color slides) were recorded at each sitting. The results demonstrated that brushing with Chlorhexidine gel significantly influenced both the oral hygiene level and the gingival inflammation. The only adverse effect observed was a marked increase in the amount of brown staining, especially on the facial surfaces of the nonsmokers. In this short‐term study, the staining was not considered cosmetically unacceptable by the patients. The total amount of staining was always greater in smokers than in nonsmokers.