bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Titanium Ti‐6Al‐7Nb Alloy With and Without Plasma‐Sprayed Hydroxyapatite Coating on Growth and Viability of Cultured Osteoblast‐Like Cells
Authors: Lavos‐Valereto Ivone de C. , Deboni Maria Cristina Z. , Azambuja Nilton , Marques Márcia M.
Published: February 2005

Background: Osseointegrated dental implants are currently recognized as a standard treatment method in dentistry. Titanium (Ti) and its alloys are the metals of choice for endosseous parts of currently available dental implants. Ti‐6Al‐4V is the most used Ti alloy, however; an improved version, Ti‐6Al‐7Nb, has been recently developed.

Methods: Rat osteoblast‐like cells (osteo‐1 culture) were used to analyze the biocompatibility of Ti‐6Al‐7Nb alloy with and without hydroxyapatite (HA) coating. The cells were grown on culture Petri dishes on the top of either plain Ti‐6Al‐7Nb or HAcoated Ti‐6Al‐7Nb disks. Osteo‐1 cells grown on plain culture dishes were used as controls. Growth and cell viability curves were obtained by scanning electron microscopy. For the growth and viability curves, 104 cells were seeded on 35 mm dishes. Cells from each group were counted, in triplicate at 3, 7, 11, and 15 days after seeding using the Trypan blue dye exclusion assay.

Results: The cells grew as multiple layers on both Ti‐6Al‐7Nb substrates, showing extracellular matrix only when grown on HA‐coated Ti‐6Al‐7Nb disks. The cells grown on HA‐coated Ti‐6Al‐7Nb grew more slowly than the other 2 groups, with significantly smaller cell numbers than control cultures at the end of the experimental time. Additionally, the HA coated Ti‐6Al‐7Nb group presented smaller percentage of cell viability when compared to the control group. However, no significant differences were observed between the Ti groups.

Conclusions: The presence of HA on the Ti‐6Al‐7Nb surface impaired the cell growth and viability of osteo‐1 cells. However, this coating improved the extracellular matrix formation. Thus, our cell viability and structural studies showed that Ti‐6Al‐7Nb with or without HA coating has relevant physical and biological properties as an implant material. J Periodontol 2002;73:900‐905.
Recurrent Recalcitrant Gingival Hyperplasia and Plasminogen Deficiency: A Case Report
Authors: Suresh Lakshmanan , Aguirre Alfredo , Kumar Vijay , Solomon Lynn W. , Sielski Edward A. , Neiders Mirdza E.
Published: February 2005

Background: Recurrent gingival hyperplasia due to plasminogen deficiency is a rare condition due to fibrin deposition in the connective tissue. Only eight cases have previously been reported in the English literature, and all cases were diagnosed before the age of 35 years. This paper presents an older patient with recurrent gingival hyperplasia due to plasminogen deficiency (hypoplasminogenemia).

Methods: A 59‐year‐old woman presented with recurrent gingival swelling of 6 years' duration. Multiple biopsies performed at various time periods were histologically reported to be gingival hyperplasia with chronic inflammation. Routine hematoxylin and eosin (H & E) staining and direct immunofluorescence were performed.

Results: H & E‐stained sections showed subepithelial, eosinophilic, amorphous, acellular deposits. Direct immunofluorescence showed positive staining for fibrin, immunoglobulin (Ig) G, IgA, and IgM. Functional plasminogen and plasminogen activator inhibitor‐1 assays were done and found to be deficient. A diagnosis of gingival hyperplasia due to plasminogen deficiency (hypoplasminogenemia) was rendered.

Conclusions: Recurrent gingival hyperplasia due to plasminogen deficiency (hypoplasminogenemia) is a newly recognized and rare condition. H&E staining, direct immunofluorescence, and assessment of functional plasminogen levels are essential to differentiate this condition from other conditions in which subepithelial, eosinophilic, amorphous materials are deposited. J Periodontol 2003;74:1508‐1513.
Cyclosporin A Induces Proliferation in Human Gingival Fibroblasts via Induction of Transforming Growth Factor‐β1
Authors: Cotrim P. , Martelli‐Junior H. , Graner E. , Sauk J.J. , Coletta R.D.
Published: February 2005

Background: Cyclosporin A (CsA) is a widely used immunosuppressant that causes significant side effects including gingival overgrowth. The pathogenesis of this condition is not fully understood; however, recent studies show that CsA regulates the transcription of several cytokines including transforming growth factor‐beta 1 (TGF‐β1). In this study, we evaluated the effects of CsA and TGF‐β1 on human normal gingival (NG) fibroblast proliferation, and explored a possible autocrine stimulation of TGF‐β1 as a cellular regulator of proliferation induced by CsA in NG fibroblasts.

Methods: NG fibroblast cell lines were incubated with increasing concentrations of CsA or TGF‐β1 and the proliferation index determined by automatic cell counting, BrdU incorporation, PCNA expression, and mitotic potential. To determine the effect of TGF‐β1 on the proliferation rate of NG fibroblasts under CsA treatment, NG fibroblast cultures were simultaneously treated with CsA and antisense oligonucleotides against the translation‐start site of the TGF‐β1 mRNA.

Results: Treatment of NG fibroblasts with CsA or TGF‐β1 significantly stimulated the cell proliferation in a dose‐dependent manner. Furthermore, neutralization of TGF‐β1 production in CsA‐treated NG fibroblasts inhibited CsA's effect on NG fibroblast proliferation, demonstrating an autocrine stimulatory effect of TGF‐β1 in CsA‐treated NG fibroblast proliferation.

Conclusion: The results presented here suggest that CsA stimulatory induction of NG fibroblast proliferation is mediated via TGF‐β1 in an autocrine fashion. J Periodontol 2003;74:1625‐1633.
In Vivo Effectiveness of a Glycerol‐Compounded Demineralized Freeze‐Dried Bone Xenograft in the Rat Calvarium
Authors: Matzenbacher Scott A. , Mailhot Jason M. , McPherson James C. , Cuenin Michael F. , Hokett Steven D. , Sharawy Mohamed , Peacock Mark E.
Published: February 2005

Background: Demineralized freeze‐dried bone (DFDB) is commonly hydrated with sterile water into a paste‐like consistency for improved clinical handling or reconstituted with biodegradable barriers, such as glycerol, to promote handling and wound stability following human periodontal surgery. The purpose of this study was to evaluate the in vivo effects of glycerol‐compounded human DFDB on bone formation in the rat calvarial critical‐sized defect (CSD) model.

Methods: Forty‐eight adult male Harland Sprague‐Dawley rats were assigned to one of four treatment groups: glycerol, DFDB, DFDB plus glycerol, or a non‐grafted control, and placed into 8 mm calvarial CSDs. DFDB (particle size 0.106 to 0.5 mm), glycerol, and their combination were from identical sources. Calvaria were harvested at 8 weeks postsurgery and evaluated histomorphometrically.

Results: A statistically significant increased percentage of total bone fill was detected in the glycerol plus DFDB group and DFDB group as compared to glycerol group or the control. However, no significant difference was noted between the DFDB plus glycerol group and the DFDB group.

Conclusion: The addition of glycerol to DFDB results in comparable osseous regeneration in the rat calvarium defect model versus DFDB alone; however, based upon clinical judgment, handling characteristics of DFDB were greatly improved. J Periodontol 2003;74:1641‐1646.
Attachment of Periodontal Ligament Cells to Chlorhexidine‐Loaded Guided Tissue Regeneration Membranes
Authors: Chen Yen‐Ting , Hung Shan‐Ling , Lin Li‐Wen , Chi Lin‐Yang , Ling Li‐Jane
Published: February 2005

Background: Early exposure of a guided tissue regeneration (GTR) membrane in the oral cavity results in bacterial contamination, which may lead to failure or incomplete regeneration. Incorporation of antimicrobial agents in GTR membranes may be valuable to control membrane‐associated infection during GTR therapy. The purpose of this study was to evaluate whether the incorporation of chlorhexidine into various GTR membranes improves the attachment of periodontal ligament cells in the presence of Actinobacillus actinomycetemcomitans.

Methods: The possible effects of chlorhexidine on the viability of primary human periodontal ligament (PDL) cells were determined using 3‐[4,5‐dimethylthiazol‐2‐yl]‐2,5 diphenyltetrazolium bromide (MTT), which measures cellular metabolic activity. An expanded polytetrafluoroethylene (ePTFE) membrane, glycolide fiber membrane, and collagen membrane were loaded with chlorhexidine and characterized. Attachment of PDL cells to the chlorhexidine‐loaded membranes with or without A. actinomycetemcomitans was examined using scanning electron microscopy (SEM) analysis.

Results: Relative cellular viability of PDL cells was reduced to approximately 50% when 15 µg/ml (0.0015%) of chlorhexidine was used. Chlorhexidine released from the coated GTR membranes inhibited the growth of A. actinomycetemcomitans. At the concentration used in this study, chlorhexidine incorporated into the GTR membranes did not interfere with the attachment of PDL cells. The inhibitory effects of A. actinomycetemcomitans on cellular attachment were reduced using chlorhexidine‐loaded membranes, including ePTFE, glycolide fiber, and collagen membranes.

Conclusions: These results suggest that incorporation of chlorhexidine into GTR membranes is beneficial in reducing bacterial effects on cellular attachment. The future application of chlorhexidine‐loaded membranes during GTR therapy may be of value. J Periodontol 2003;74:1652‐1659.
Oral Kaposi Sarcoma Associated with Severe Alveolar Bone Loss: Case Report and Review of the Literature
Authors: Lausten Leonard L. , Ferguson Brett L. , Barker Bruce F. , Cobb Charles M.
Published: February 2005

Background: In AIDS patients who present with an oral neoplasm, Kaposi sarcoma is the tumor most frequently encountered, comprising 50% to 80% of all tumor occurrences. However, oral Kaposi sarcoma associated with erosion of underlying bone is a relatively rare finding. This report and review of the literature documents a case of AIDS‐related oral Kaposi sarcoma exhibiting severe bilateral erosion of the maxillary alveolar ridges.

Methods: An HIV‐seropositive male with extensive maxillary Kaposi sarcoma and associated bilateral alveolar bone erosion presented for dental evaluation subsequent to radiation therapy. Clinical and radiographic examinations were performed. Medical and dental histories were procured and supplemented with consultations from the patient's primary physician and radiation oncologist. Maxillary edentulation with surgical revision for primary closure was the treatment of choice for management of the dentoalveolar pathology. A maxillary immediate treatment denture was designed to obturate anticipated antral communications with the maxillary sinus.

Results: Surgical and prosthetic treatments were completed, but complicated by an oral‐antral perforation that subsequently healed without complication. Soft tissue biopsies obtained during surgery revealed no evidence of residual Kaposi sarcoma.

Conclusions: Although AIDS‐related oral Kaposi sarcoma is a relatively common finding, erosion of subjacent alveolar bone is uncommon. Treatment of the tumor with subsequent dental reconstruction can be complicated by the severe lack of bone, surgical perforation of the maxillary sinus, and lack of stable teeth to serve as abutments. Significant advances in understanding the pathogenesis of AIDS‐related Kaposi sarcoma have occurred in the last decade. HHV‐8 and various inflammatory cytokines have been implicated in the pathogenesis and are likely to become the primary targets for therapeutic intervention. J Periodontol 2003;74:1668‐1675.
Alveolar Bone Response in an Experimental Model of Renal Failure and Periodontal Disease: A Histomorphometric and Histochemical Study
Authors: Mandalunis Patricia M. , Steimetz Tammy , Castiglione Jorge L. , Ubios Angela M.
Published: February 2005

Background: Chronic destructive periodontal disease is characterized by gingival inflammation, periodontal pocket formation, and bacterial plaque that lead to alveolar bone destruction. Polymorphonuclear neutrophil leukocytes (PMNs) are the first line of defense against infection caused by dental plaque bacteria. Renal patients present functional abnormalities of PMN, including impaired chemotaxis, phagocytosis, and intracellular killing of bacteria. In view of the above, the aim of this work was to evaluate the effect of renal failure on bone damaged by periodontal disease using histomorphometric and histochemical parameters.

Methods: Twenty male Wistar rats weighing 250 g were assigned to one of the following four groups: 1) control (no treatment); 2) renal failure (RF); 3) periodontal disease (PD); and 4) renal failure plus periodontal disease (RF+PD). All the animals were sacrificed 31 days after the onset of the experiment. Mesio‐distally oriented sections of the first lower molar were obtained for histomorphometric and histochemical evaluation.

Results: Total erosion, active erosion, and total number of tartrate‐resistant acid phosphatase‐positive (TRAP+) osteoclasts were found to be increased in the RF+PD group compared with the PD group.

Conclusion: Our results demonstrate increased bone resorption in animals with untreated renal failure and periodontal disease, and thus indicate that the release of different factors by inflammatory cells is magnified, accelerating the progression of the disease in this animal model. J Periodontol 2003;74:1803‐1807.
Aspartate Aminotransferase Activity in Gingival Crevicular Fluid During Orthodontic Treatment. A Controlled Short‐Term Longitudinal Study
Authors: Perinetti Giuseppe , Paolantonio Michele , D'Attilio Michele , D'Archivio Domenico , Dolci Marco , Femminella Beatrice , Festa Felice , Spoto Giuseppe
Published: February 2005

Background: During orthodontic tooth movement, the early response of periodontal tissues to mechanical stress involves an acute inflammatory response, with a sequence characterized by periods of activation, resorption, reversal, and formation in both tension and compression sites. This study used a longitudinal design to examine aspartate aminotransferase (AST) activity in gingival crevicular fluid (GCF) in order to assess whether AST in GCF has potential as a possible diagnostic aid to monitor tooth movement and tissue response during orthodontic treatment.

Methods: Eighteen patients (mean age, 16.1 years) participated in the study. An upper first molar from each patient undergoing treatment for distal movement served as the test tooth (TT), with its contralateral (CC) and antagonist (AC) first molars used as controls. The CC was included in the orthodontic appliance, but was not subjected to the orthodontic force; the AC was free from any orthodontic appliance. The GCF around the experimental teeth was collected from both mesial and distal tooth sites immediately before appliance activation, 1 hour after, and weekly over the following 4 weeks. Clinical gingival condition was evaluated at baseline and at the end of the experimental period. AST activity was determined spectrophotometrically at 30°C, and the results were expressed as total AST activity (mU/sample).

Results: Throughout the experiment, AST levels were significantly elevated in all sites from the TT and CC groups compared to the AC group where, conversely, AST activity remained at the baseline level. However, enzyme levels in the TT group were significantly greater than in the CCs at tension sites on day 14, and in compression sites on days 7 and 14. Moreover, AST activity from the TT group was significantly greater in compression sites than in tension sites on day 7; this was not observed for the CCs.

Conclusions: Our results suggest that AST levels in GCF reflect the biological activity which occurs in the periodontium during controlled occlusal trauma and, therefore, should be further evaluated as a diagnostic tool for monitoring correct orthodontic tooth movement in clinical practice. J Periodontol 2003;74:145‐152.
Histologic Evaluation of Human Intrabony Defects Following Non‐Surgical Periodontal Therapy With and Without Application of an Enamel Matrix Protein Derivative
Authors: Sculean Anton , Windisch Péter , Keglevich Tibor , Gera István
Published: February 2005

Background: Surgical periodontal treatment with enamel matrix protein derivative (EMD) has been shown to promote periodontal regeneration. However, it is not known whether nonsurgical periodontal therapy with additional subgingival application of EMD may also enhance periodontal regeneration. The purpose of this study was to clinically and histologically evaluate healing of human intrabony defects following non‐surgical periodontal treatment with and without application of EMD.

Methods: Sixteen patients, each of whom displayed one advanced intrabony defect around teeth or roots scheduled for extraction, were included in the study. The defects were treated as follows: 1) scaling and root planing with hand instruments and application of EMD; 2) scaling with an ultrasonic instrument and application of EMD; or 3) scaling with an ultrasonic instrument alone. Healing was uneventful in all cases. Six months after surgery, the teeth or roots were extracted together with some of their surrounding soft and hard tissues and processed for histologic evaluation.

Results: Clinical examination revealed a probing depth reduction and a gain of clinical attachment after all 3 treatment modalities. The histological evaluation, however, revealed that healing in all 3 procedures was predominantly characterized by formation of a long junctional epithelium along the instrumented root surface and no predictable regeneration of attachment apparatus.

Conclusion: Within its limits, the present study failed to show periodontal regeneration in advanced human intrabony defects following non‐surgical treatment with subgingival application of EMD. J Periodontol 2003;74:153‐160.
Comparison of 2 Commercially Available Chlorhexidine Mouthrinses
Authors: Keijser Jan A.M. , Verkade Herman , Timmerman Mark F. , Van der Weijden Fridus A.
Published: February 2005

Background: It has been shown that lowering the concentration of chlorhexidine (CHX) in mouthrinses from 0.2% to 0.12% does not adversely affect inhibition of plaque accumulation. The aim of this study was to evaluate the inhibition of plaque growth by 2 commercially available mouthrinses used according to the manufacturers’ instructions, one with a 30‐second and one with a 60‐second rinsing time.

Methods: The clinical investigation was a single‐blind, randomized study involving 80 volunteers (40 female, 40 male; mean age 25.7 years). At the start of the trial, all participants received a dental prophylaxis to remove all plaque deposits. Subjects refrained from all mechanical oral hygiene procedures, but rinsed twice a day with the allocated CHX mouthrinse over a period of 72 hours. The chlorhexidine preparations compared were a 0.12% concentration used at a 15 ml dose for a rinsing time of 30 seconds and a 0.2% concentration used at a dose of 10 ml for 60 seconds. After 72 hours, the plaque index (PI) from all volunteers was recorded at 6 sites per tooth. All participants received a questionnaire to evaluate their perception of the mouthrinses.

Results: After 72 hours, the 15 ml/30 second/0.12% CHX group had a mean whole mouth PI of 1.65 (SD 0.31) compared with a mean PI of 1.60 (SD 0.40) for the 10 ml/60 second/0.2% CHX group. The difference in plaque scores between the groups was not statistically significant. Results from the questionnaire showed no significant difference between the groups for taste perception, duration of taste, alteration in taste, or perceived plaque reduction; however, the panelists preferred the shorter rinsing time of 30 seconds and, for this parameter, the difference was statistically significant (P = 0.048).

Conclusions: The results of this short‐term study showed that there was no statistically significant difference between both commercially available CHX mouthrinses with respect to plaque inhibition, although both differed in concentration and rinsing time. The subject preference phase of the study indicated that the shorter rinsing time of 30 seconds was favored. J Periodontol 2003;74:214‐218.
Analysis of In Situ Proliferative Activity in Oral Gingival Epithelium in Patients With Xerostomia
Authors: Çelenligil‐Nazlıel Haviye , Palalı Ali , Ayhan Ayşe , Ruacan Şevket
Published: February 2005

Background: Sjögren's syndrome is an autoimmune disease characterized by xerostomia and keratoconjunctivitis sicca. The relationship between xero‐stomia and proliferative activity in human gingival epithelium is not known. Proliferating cell nuclear antigen (PCNA) is a nuclear protein associated with the cell cycle. Nuclear PCNA immunoreactivity is found in the proliferative compartment of normal tissues. The aims of this study were to evaluate PCNA expression in oral gingival epithelium of healthy and inflamed gingiva obtained from patients with Sjögren's syndrome, and to compare the results to age‐ and gender‐matched subjects with normal salivary function.

Methods: Eighteen Sjögren's syndrome patients and 28 controls (14 with chronic periodontitis and 14 with no clinical evidence of periodontal disease) were included in the study. Biopsies were obtained from both inflamed and healthy gingiva. The expression of PCNA was evaluated in formalin‐fixed, paraffinembedded gingival samples using an immunoperoxidase technique and PC10 monoclonal antibody to PCNA.

Results: PCNA expression was observed both in the basal and suprabasal layers, and was found to be more prominent in the suprabasal layers. Proliferative index (PI) in inflamed gingiva was significantly lower in the Sjögren's syndrome group. However, no significant difference was observed between the study and control groups with respect to PI in healthy gingiva. In both groups, PI was found to be increased due to inflammation.

Conclusions: Our data indicate that proliferative activity is observed in the suprabasal layers and, less frequently, in the basal layer. Inflammation caused increased proliferative activity. However, this positive effect of inflammation on epithelial cell proliferation decreased significantly with a lack of saliva. Therefore, it appears that saliva‐derived biological mediators may also contribute to increased proliferative activity observed during inflammation. J Periodontol 2003;74:247‐254.
Periodontal Treatment with an Er:YAG Laser or Scaling and Root Planing. A 2‐Year Follow‐Up Split‐Mouth Study
Authors: Schwarz Frank , Sculean Anton , Berakdar Mohammad , Georg Thomas , Reich Elmar , Becker Jürgen
Published: February 2005

Background: Non‐surgical periodontal treatment with an Er:YAG laser has been shown to result in significant clinical attachment level gain; however, clinical results have not been established on a long‐term basis following Er:YAG laser treatment. Therefore, the aim of the present study was to present the 2‐year results following non‐surgical periodontal treatment with an Er:YAG laser or scaling and root planing.

Methods: Twenty patients with moderate to advanced periodontal destruction were treated under local anesthesia, and the quadrants were randomly allocated in a split‐mouth design to either 1) Er:YAG laser (ERL) using an energy level of 160 mJ/pulse and 10 Hz, or 2) scaling and root planing (SRP) using hand instruments. The following clinical parameters were evaluated at baseline and at 1 and 2 years after treatment: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL). Subgingival plaque samples were taken at each appointment and analyzed using dark‐field microscopy for the presence of cocci, non‐motile rods, motile rods, and spirochetes. The primary outcome variable was CAL. No statistically significant differences between the groups were found at baseline. Power analysis to determine superiority of ERL treatment showed that the available sample size would yield 99% power to detect a 1 mm difference.

Results: The sites treated with ERL demonstrated mean CAL change from 6.3 ± 1.1 mm to 4.5 ± 0.4 mm (P<0.001) and to 4.9 ± 0.4 mm (P <0.001) at 1 and 2 years, respectively. No statistically significant differences were found between the CAL mean at 1 and 2 years postoperatively. The sites treated with SRP showed a mean CAL change from 6.5 ± 1.0 mm to 5.6 ± 0.4 mm (P <0.001) and to 5.8 ± 0.4 mm (P <0.001) at 1 and 2 years, respectively. The CAL change between 1 and 2 years did not present statistically significant differences. Both groups showed a significant increase of cocci and non‐motile rods and a decrease in the amount of spirochetes. However, at the 1‐ and 2‐year examination, the statistical analysis showed a significant difference for the CAL (P <0.001, respectively) between the 2 treatment groups.

Conclusion: It was concluded that the CAL gain obtained following nonsurgical periodontal treatment with ERL or SRP can be maintained over 2‐year period. J Periodontol 2003;74:590‐596.
Effect of Recombinant Human Bone Morphogenetic Protein‐2 in Dehiscence Defects with Non‐Submerged Immediate Implants: An Experimental Study in Cynomolgus Monkeys
Authors: Hanisch Oliver , Sorensen Rachel G. , Kinoshita Atsuhiro , Spiekermann Hubertus , Wozney John M. , Wikesjö Ulf M.E.
Published: February 2005

Background: Alveolar ridge aberrations commonly compromise optimal dental implant installation. To offset any variance between an aberrant alveolar ridge and prosthetic designs, bone augmentation procedures become necessary. The objective of this study was to evaluate bone formation and osseointegration at alveolar dehiscence defects following augmentation of the defect site with recombinant human bone morphogenetic protein‐2 (rhBMP‐2) in an absorbable collagen sponge carrier (ACS) at dental implant installation including transmucosal positioning of the dental implant.

Methods: Four adult male Cynomolgus monkeys received dental implants in contralateral extraction socket sites with surgically created 6 × 4 mm buccal dehiscence defects following elevation of mucoperiosteal flaps. Contralateral sites received rhBMP‐2/ACS (rhBMP‐2 at 1.5 mg/ml; 0.1 mg/defect) or served as shamsurgery controls. The flaps were adapted and sutured around the healing abutments leaving the implants in a transmucosal position. The animals were sacrificed at 16 weeks postsurgery and block sections of the implant sites were harvested and prepared for histometric analysis.

Results: One dental implant from each treatment group failed to osseointegrate. Another 3 dental implants (sham‐surgery controls) failed to osseointegrate with newly‐formed bone in the defect area. Thus, 7 of 8 defect sites (4/4 animals) receiving rhBMP‐2/ACS compared to 4 of 8 sites (2/4 animals) receiving shamsurgery exhibited evidence of osseointegration with newly formed bone in the defect area. Mean ± SD defect height amounted to 5.3 ± 0.2 and 5.4 ± 0.1 mm for the rhBMP‐2/ACS and sham‐surgery sites, respectively. Vertical bone gain in rhBMP‐2/ACS treated defects (3.9 ± 0.3 mm) did not differ significantly from that in the sham‐surgery control (3.7 ± 0.4 mm; P >0.05; paired t‐test, N = 4). There were also no significant differences noted for coronal bone‐implant contact (3.0 ± 0.6 versus 3.6 ± 0.5 mm), and bone‐implant contact within the defect site (28.5% ± 15.1% versus 27.4% ± 31.7%) and within resident bone (46.9% ± 26.8% versus 47.8% ± 39.4%) for the rhBMP‐2/ACS and control sites, respectively.

Conclusions: The observations in this study point to a substantial native osteogenic potential of the alveolar process that has previously not been explored and show that surgical reentry observations of new bone formation may not necessarily indicate that osseointegration has occurred. Bone formation in control defects was substantially greater than predicted, limiting the value of adding an osteoinductive biologic construct. J Periodontol 2003;74:648‐657.
Quantitative Evaluation of the Vasculature and Fibronectin Localization in Gingival Connective Tissue of Smokers and Non‐Smokers
Authors: Sönmez Şule , Canda Tülay , Özkara Esra , Ak Dilek
Published: February 2005

Background: It has been shown that tobacco is a significant risk factor for periodontal disease. The reason for decreased gingival bleeding in smokers is not known. The aim of the present study was to demonstrate the localization of fibronectin in the extracellular matrix of the inflamed gingiva of smokers and non‐smokers and to evaluate the chronic effect of smoking on the gingival microvessel number (NVES) and vascular surface density (VSD).

Methods: Seventy‐four (74) adult patients with periodontitis were included in this investigation. Of these patients, 38 were smokers and 36 were non‐smokers. Probing depths (PD), papillary bleeding index (PBI) of both groups, and the smoking habits of the smokers were recorded. Biopsy specimens obtained during periodontal surgery were prepared to evaluate fibronectin distribution and to quantitate the vasculature.

Results: The mean VSD values of smokers and non‐smokers were 6.721 ± 1.845 and 5.721 ± 3.118 (mean ± SD), and the mean NVES of smokers and non‐smokers was 31.582 ± 11.810 and 30.145 ± 15.442, respectively. The difference between the mean PD and PBI values of the 2 groups was not statistically significant. The location of the biopsy specimen, whether in the anterior or posterior area of the mouth, did not lead to any statistically significant differences between the groups. In addition, the number of years smoked and the tobacco brand used did not result in statistically significant differences. The most intense staining of fibronectin was observed beneath the epithelium around the blood vessels of the uppermost region of the connective tissue, showing a fibrillar and diffuse distribution; however, there was no significant difference between smokers and non‐smokers.

Conclusion: The results of the present study indicate that smoking does not affect the vascular surface density, number of vessels per mm2 stroma, or fibronectin distribution in subepithelial gingival connective tissue. J Periodontol 2003;74:822‐830.
Species‐Specific DNA Probe for the Detection of Porphyromonas gingivalis from Adult Chinese Periodontal Patients and Healthy Subjects
Authors: Luchuan‐Liu  , Xiujie‐Wen  , Huixia‐He  , Junnan‐Shi  , Changhua‐Ji
Published: February 2005

Background: It has been reported that Porphyromonas gingivalis is closely associated with chronic periodontitis and its detection has been recommended as a routine marker for periodontal diagnosis. The purpose of this study was to evaluate the sensitivity and specificity of a DNA probe to detect P. gingivalis in adult Chinese periodontitis patients as well as to find a rapid and convenient method to detect P. gingivalis in clinical practice.

Methods: A total of 26 bacterial strains (20 reference strains and 6 clinical isolates) were collected, of which 5 were P. gingivalis and 21 were heterologous species. A DNA fragment of 542 bp, which encodes the fimbriae subunit protein (fimA) of P. gingivalis, was obtained by polymerase chain reaction (PCR) and molecular cloning techniques and used to construct the DNA probe, labeled with 32P or with digoxigenin. The constructed DNA probe was used to detect P. gingivalis in specimens collected from the periodontal pockets of 100 patients clinically confirmed with chronic periodontitis. One hundred periodontally healthy persons served as a control group.

Results: Positive reactions were seen in all 5 strains of P. gingivalis while no visible reaction was found in other species. The DNA probe was capable of detecting as few as 100 P. gingivalis cells in samples. A significant difference in the positive rates of P. gingivalis between the periodontitis patients and the control group was found (P <0.01). In addition, the amount of detected P. gingivalis was positively correlated with the extent of tooth mobility, depth of periodontal pockets, and patient age (P <0.01).

Conclusion: The DNA probe is specific and sensitive for the detection of P. gingivalis in chronic periodontitis specimens and may be a suitable method for the clinical diagnosis of chronic periodontitis. J Periodontol 2003;74:1000‐1006.
Periodontal Repair in Dogs: A Bioabsorbable Calcium Carbonate Coral Implant Enhances Space Provision for Alveolar Bone Regeneration in Conjunction with Guided Tissue Regeneration
Authors: Wikesjö Ulf M.E. , Lim Won Hee , Razi Saghi S. , Sigurdsson Thorarinn J. , Lee Michael B. , Tatakis Dimitris N. , Hardwick W. Ross
Published: February 2005

Background: collapse or compression of a barrier device into a periodontal defect or onto the root surface compromises outcomes following guided tissue regeneration (GTR). Bone biomaterials have been suggested to support regeneration of alveolar bone and to improve space provision with GTR devices. The objective of this study was to evaluate space provision, alveolar bone, and cementum regeneration following use of a bioabsorbable, calcium carbonate biomaterial in conjunction with GTR.

Methods: Routine, critical size, 5 to 6 mm, supraalveolar, periodontal defects were created in 5 young adult beagle dogs. Alternate jaw quadrants in consecutive animals received GTR and the coral biomaterial (cGTR) or GTR alone. The animals were euthanized 4 weeks postsurgery and tissue blocks processed for histometric analysis.

Results: The coral implant particles were surrounded by newly‐formed bone or immersed in connective tissue and appeared to resorb and be replaced by bone. There was limited, if any, appreciable cementum regeneration. Space provision was enhanced in cGTR compared to GTR sites (6.1 ± 1.6 versus 2.4 ± 0.8 mm2; P <0.05). Bone regeneration (height) was significantly increased in cGTR compared to GTR sites averaging 1.9 ± 0.6 and 1.2 ± 0.6 mm, respectively (P<0.05). Bone regeneration (area) was 2‐fold greater in cGTR sites compared to the GTR control (3.3 ± 1.8 versus 1.4 ± 0.5 mm2), however the difference was not statistically significant (P >0.05).

Conclusions: The coral implant significantly enhanced space provision for GTR while alveolar bone formation appeared to be enhanced by its use. Increased healing intervals are needed to fully understand the biologic value of the coral implant a s an adjunct to GTR. J Periodontol2003;74:957‐964.
Qualitative and Quantitative Expression of Bovine Bone Mineral in Experimental Bone Defects. Part 1: Description of a Dog Model and Histological Observations
Authors: Artzi Zvi , Givol Navot , Rohrer Michael D. , Nemcovsky Carlos E. , Prasad Hari S. , Tal Haim
Published: February 2005

Background: The purpose of this study was to evaluate histologically the contribution of inorganic bovine bone biomaterial in a new experimental bone defect in dogs at different healing periods and to examine newly formed bone around the grafted mineral particles and their relationship in membrane‐protected (test) and non‐protected intrabony (control) defects.

Methods: Four round intrabony defects, 5 × 4 mm were made bilaterally (at different times) on the lateral bony mandibular angle in eight dogs. Two defects were filled with bovine bone mineral (BBM) particles and two remained non‐grafted but were blood clotted. A collagen membrane covered each defect type (n = 4). This procedure was repeated on the contralateral side at a different given time to obtain two different healing periods in each dog. Thus, four specimens were obtained at 3, 6, 12, and 24 months postoperatively for each healing period. The non‐decalcification method (Donath technique) with Stevenel's blue and van Gieson's picro fuchsin staining was used for histological examination.

Results: Newly formed bone was observed at all examined defect types. The BBM particles were clearly evident regardless of the healing period. At 3 and 6 months, newly formed bone, woven in nature, was incorporated with the grafted particles. High cellular bone with occasional osteoclasts was noted towards the surface of the mineral particles. No substantial difference was observed between the protected and the non‐protected defects except for higher ossified centers around the membrane‐protected defects. At the nongrafted sites, the membrane‐protected defect showed newly formed bone near the bony walls, and particularly under the membrane, establishing a bony bridge over the defect at the healing periods. The non‐grafted unprotected defect (control) showed bone formation only at the base and close to the bony walls leaving a healed concave configuration. At 1 and 2 years, the grafted sites showed full bone healing configuration. However, the grafted particles still dominated the previous defect area and were completely surrounded by the newly formed bone. Osteons and lamellar bone arrangement were established but the bone was still highly cellular and osteoclasts could still be identified. The non‐grafted membrane‐protected sites showed excellent bone healing although areas of non‐mineralized soft tissue were often seen. The control sites healed but still presented with a concave surface configuration.

Conclusions: BBM biomaterial is a highly osteoconductive material. In a 4‐wall bony defect, newly formed bone was well evident in establishing excellent bone healing configuration with or without a regenerative biological barrier. The grafted material dominated the experimental sites with no substantial resorption at any healing period up to 2 years observation. J Periodontol 2003;74:1143‐l1152.
Lifestyle and Psychosocial Factors Associated with Chronic Periodontitis in Taiwanese Adults
Authors: Teng Hsiu‐Chen , Lee Chien‐Hung , Hung Hsin‐Chia , Tsai Chi‐Cheng , Chang Yong‐Yuan , Yang Yi‐Hsin Connie , Lu Chun‐Tai , Yen Yea‐Yin , Wu Yi‐Min
Published: February 2005

Background: The development of chronic periodontitis (CP) is a multifactorial process and variation in severity cannot be explained by just a few risk factors. The aims of this study were: 1) to explore the lifestyle and psychosocial factors of CP patients and 2) to estimate the proportion of total CP cases attributable to one or more risk factors considered.

Methods: A case‐control study of 250 cases of CP patients and 250 controls were matched by age (within 3 years) and gender. Complete dental examinations were performed based on the clinical criteria for CP for both groups. Structured questionnaires were conducted to collect lifestyle and psychosocial factors. Multivariate logistic regression was applied to assess the association between risk factors and chronic periodontitis.

Results: Conditional multivariable logistic regression analysis showed that toothbrushing frequency (odds ratio [OR]: 5.77, if rarely; OR: 3.50, if once a day), mental illness (OR: 5.32, if Chinese Health Questionnaire scores were ≥6), and smoking (OR: 3.93, if pack years smoked was >21) are significantly and independently associated with chronic periodontitis. In addition, all these variables reﬂected a dose‐response effect (P trend = <0.001, 0.004, and 0.005, respectively).

Conclusions: For Taiwanese adults, 36.10% of CP cases were presumably attributable to toothbrushing frequency, mental illness, and smoking. These three factors should be the first priorities in establishing a preventive program to improve the periodontal health status. J Periodontol 2003;74:1169‐1175.
Antimicrobial Periodontal Treatment Decreases Serum C‐Reactive Protein, Tumor Necrosis Factor‐Alpha, But Not Adiponectin Levels in Patients with Chronic Periodontitis
Authors: Iwamoto Yoshihiro , Nishimura Fusanori , Soga Yoshihiko , Takeuchi Kazu , Kurihara Mikinao , Takashiba Shogo , Murayama Yoji
Published: February 2005

Background: Elevated levels of C‐reactive protein (CRP) and decreased plasma adiponectin are associated with increased risk of atherosclerosis. Furthermore, recent observations suggested that adiponectin and tumor necrosis factor‐α(TNF‐α) suppressed each other's production. Since periodontal disease has been suggested to act as a risk factor for atherosclerosis, we examined the effects of antimicrobial periodontal treatment on CRP, adiponectin, and TNF‐α levels.

Methods: Fifteen chronic periodontitis patients with various systemic conditions at high risk for atherosclerosis were enrolled in the study. Patients were non‐surgically treated with topical application of antibiotics and mechanical debridement of calculus once a week for 1 month. Before and after therapy, CRP, adiponectin, and TNF‐α levels were measured.

Results: Both CRP and TNF‐α levels were signifi‐ cantly decreased after treatment (P <0.01 and P <0.03, respectively), while adiponectin levels did not change significantly.

Conclusions: Periodontal treatment is effective in reducing CRP and TNF‐α, while adiponectin does not appear to be influenced by periodontal treatment. Elevated levels of CRP and TNF‐α may be associated with increased risk for future development of atherosclerosis in periodontitis patients. J Periodontol 2003; 74:1231‐1236.
Relationship Between Transmission of Porphyromonas gingivalis and fimA Type in Spouses
Authors: Asano Hiroyuki , Ishihara Kazuyuki , Nakagawa Taneaki , Yamada Satoru , Okuda Katsuji
Published: February 2005

Background:Porphyromonas gingivalis is one of the major microbial pathogens associated with chronic periodontitis. To eradicate such pathogens by periodontal therapy, it is essential to clarify the source of infection. Recent findings suggest that the genotype of the fimbriae is one of the important factors in infection by P. gingivalis. The objectives of the present study were to investigate the transmission of P. gingivalis between spouses and to determine the relationship between P. gingivalisfimA type and colonization.

Methods: A total of 14 couples were selected to investigate the transmission of P. gingivalis and its association with the fimA types. To examine the distribution of fimA type in the general population, 32 subgingival plaque samples from 47 patients with periodontitis were also tested. The transmission of P. gingivalis strains was determined by using pulsed field gel electrophoresis (PFGE). P. gingivalis strains isolated from the couples and subgingival dental plaque samples were studied for fimA classification.

Methods: A total of 14 couples were selected to investigate the transmission of P. gingivalis and its association with the fimA types. To examine the distribution of fimA type in the general population, 32 subgingival plaque samples from 47 patients with periodontitis were also tested. The transmission of P. gingivalis strains was determined by using pulsed field gel electrophoresis (PFGE). P. gingivalis strains isolated from the couples and subgingival dental plaque samples were studied for fimA classification.

Conclusion: This study suggests that fimA type II, even though widely distributed in patients with periodontitis, may be an important factor in the transmission of P. gingivalis between spouses. J Periodontol 2003;74:1355‐1360.
Cigarette Smoking, Periodontal Disease, and Chronic Obstructive Pulmonary Disease
Authors: Hyman Jeffrey J. , Reid Britt C.
Published: February 2005

Background: Cigarette smoking is a significant risk factor for both chronic obstructive pulmonary disease (COPD) and periodontal disease. The goal of this study was to better understand the role of smoking in a possible relationship between periodontal disease and COPD.

Methods: The study population consisted of 7,625 participants in the Third National Health and Nutrition Examination Survey (NHANES III) during 1988‐1994 who were aged 30 years or older when examined and who received a spirometric examination. The data analysis employed logistic regression models and accounted for the complex sampling design used in NHANES III.

Results: After adjustment for potential confounders, there was no statistically significant association between periodontal disease and COPD among former or non‐smokers. Current smokers with ≥4 mm mean loss of attachment had an odds ratio of 3.71 (95% confidence interval: 1.74, 7.89).

Conclusions: These results suggest that cigarette smoking may be a cofactor in the relationship between periodontal disease and chronic obstructive pulmonary disease. The key role played by smoking in the etiology of both periodontal disease and chronic obstructive pulmonary disease suggests that much of the observed increase in risk may actually reflect the exposure to smoking. Additional research into smoking‐related effect modification is needed to clarify the role of periodontal disease in the etiology of smoking‐related systemic diseases. J Periodontol 2004;75:9‐15.
Influence of Age on Combined Effects of Cyclosporin and Nifedipine on Rat Alveolar Bone
Authors: Spolidorio L.C. , Spolidorio D.M. , Nassar P.O. , Nassar C.A. , Holzhausen M. , Almeida O.P.
Published: February 2005

Background: There is some evidence showing that cyclosporin A (CsA) and nifedipine (NIF) affect bone metabolism. The purpose of this work was to study the effects of CsA and NIF, given alone or concurrently, on alveolar bone of rats of different ages.

Methods: Rats 15, 30, 60, and 90 days old were treated daily with 10 mg/kg body weight of CsA subcutaneously injected and/or 50 mg/kg body weight of NIF/day given orally for 60 days. Alveolar bone of the first lower molars was morphologically and stereologically evaluated in serial 5 µm bucco‐lingual paraffin sections, stained with hematoxylin and eosin. Serum calcium and alkaline phosphatase levels were measured in all animals at the end of the experimental period.

Results: Rats treated with CsA or NIF alone or CsA and NIF concurrently showed decreased alveolar bone density. CsA was more effective than NIF. A significant decrease in serum calcium was found only in animals treated with CsA or CsA/NIF. The results were similar regardless of age.

Conclusions: These results indicate that the decrease in the alveolar bone volume in rats caused by CsA and NIF alone or concurrently is not age dependent. Furthermore, NIF (50 mg/kg) did not further increase the loss of alveolar bone volume induced by CsA (10 mg/kg). J Periodontol 2004;75:268‐272.
Comparison of Probes for Microbial Contamination Following Use in Periodontal Pockets of Various Depths
Authors: Holt Lorie A. , Williams Karen B. , Cobb Charles M. , Keselyak Nancy T. , Jamison Connie L. , Brand Valerie S.
Published: February 2005

Background: It has been speculated that periodontal probes can transmit periodontal pathogens from site to site. The purpose of this study was to evaluate the potential for bacterial transmission as a function of periodontal probe design.

Methods: Four different periodontal probes were used to measure probing depths ranging from 0 to 3 mm and ≥4 mm. Following measurement of each pocket, probes were transported to a laboratory and cultured on blood agar, and colony forming units (CFUs) were determined for total aerobic, anaerobic, and darkpigmented colonies (DPCs). Eight randomly selected probe tips, representing each probe type and probing depth category, were selected for examination by scanning electron microscopy (SEM) to determine distribution and morphotypes of adhering microbes.

Results: Results showed no statistically significant main effect for probes with respect to CFUs. However, there was a statistically significant increase in CFUs for deeper pockets when compared to pockets 0 to 3 mm. SEM observations were consistent among groups, regardless of probe design or probing depth. All probes exhibited a rough surface texture. Microbes were observed as single organisms or in aggregates and were adherent along the entire length of the probe up to the maximum probing depth.

Conclusions: There was no difference in CFUs obtained as a function of periodontal probes. The rough surfaces of the probes used in this study likely promoted bacterial adherence through two different mechanisms: through scraping of the pocket walls by the roughened surfaces of the probe and by the high surfacefree energy of the metal probes, facilitating bacterial adherence. J Periodontol 2004;75:353‐359.