bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Platelet‐Derived Growth Factor‐BB on Periodontal Cells in an In Vitro Wound Model
Authors: Mumford John H. , Carnes David L. , Cochran David L. , Oates Thomas W.
Published: February 2005

Background: Platelet‐derived growth factor (PDGF‐BB) has been shown to enhance periodontal regeneration. Principles of guided tissue regeneration dictate that one of the goals of therapy is to modulate the wound healing processes to favor repopulation of the wound with cells derived from the periodontal ligament rather than from the gingival tissues. Using an in vitro wound model, gingival fibroblasts (GF) have been shown to fill a wound space significantly faster than periodontal ligament cells (PDL). There are no data reported directly comparing the response of these 2 cell types to PDGF‐BB within such a wound model. Therefore, the aims of this research were: 1) to characterize both the proliferative and wound fill (WF) effects of PDGF‐BB within an in vitro model and 2) to compare specific growth factor effects between GF and PDL.

Methods: Primary cultures of both human PDL and GF were derived from explanted tissues and passaged to 12‐well tissue culture plates. Triplicate cultures of both cell types were grown to confluence and in vitro wounds were mechanically created, removing a 3 mm wide band of the cell layer across the diameter of the wells. The wells were then incubated for 2, 6, and 9 days in media containing 0.1% fetal bovine serum (FBS) and 1 of 5 concentrations of PDGF‐BB. At each time point, cells were pulsed with 5‐bromo, 2‐deoxyuridine (BrdU) fixed, and nuclei were stained to measure BrdU incorporation (as a measure for proliferation). Cells were counter‐stained with cytoplasmic stain to measure cell number. Quantitative analyses within the wound boundaries, marginally (area of interest [AOI] 1) and centrally (AOI 2), were accomplished using computer‐assisted histomorphometry.

Results: PDL exhibited a significantly greater proliferative response to PDGF‐BB in both AOI when compared to GF (P <0.0001). The PDL exhibited increased levels of proliferation at concentrations of PDGF‐BB greater than or equal to 10 ng/ml. By contrast, GF displayed no increase in proliferation in response to stimulation with PDGF‐BB at any of the concentrations tested when compared to negative controls. The wound fill (WF) responses to PDGF‐BB were similar between PDL and GF, with both cell types responding in an all or none fashion when measured at day 2, and in a concentration‐dependent manner at later time points. The only significant difference in WF between PDL and GF occurred in AOI 2 in negative control medium (0 ng/ml of PDGF‐BB), with GFs having greater (P <0.01) levels of WF over the 9 days.

Conclusion: The findings from this study demonstrate differing effects of PDGF‐BB on the proliferation of PDL and GF in this in vitro model. These results suggest that there may be cell‐specific differences critical to periodontal wound healing that may be exploited in the development of new therapies. J Periodontol 2001;72:331‐340.
Relationship of Periodontopathic Bacteria With Early‐Onset Periodontitis in Down's Syndrome
Authors: Amano Atsuo , Kishima Tetsuhiko , Akiyama Shigehisa , Nakagawa Ichiro , Hamada Shigeyuki , Morisaki Ichijiro
Published: February 2005

Background: Down's syndrome (DS) patients often develop severe early‐onset marginal periodontitis in early adulthood; however, there is little information available on the microbiology of DS periodontitis.

Methods: Subgingival plaque specimens were taken from 67 DS young adults and 41 age‐matched systemically healthy individuals with mental disabilities (MD). The prevalence of 10 possible periodontopathic bacterial species, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Treponema denticola, Prevotella intermedia, Prevotella nigrescens, Capnocytophaga ochracea, Capnocytophaga sputigena, Campylobacter rectus, and Eikonella corrodens, were investigated in their subgingival plaque samples using a polymerase chain reaction method. The detection of P. gingivalis fimA genotypes was also performed in P. gingivalis‐positive samples.

Results: Although DS subjects generally develop an earlier and more extensive periodontal breakdown than those with MD, no significant differences were observed in the bacterial profiles. The profiles of subjects with periodontitis were significant in DS, but not in MD. The prevalence of P. gingivalis, B. forsythus, and P. intermedia were significant in the DS periodontitis group, compared to DS gingivitis group. Moreover, the occurrence of P. gingivalis with the type II fimA gene was significantly related to periodontitis in both DS and MD, with odds ratios of 6.32 and 12.03, respectively.

Conclusions: These results suggest that early‐onset periodontitis in DS is mainly due to the more susceptible host for the causative microbial agents including P. gingivalis with type II fimA. J Periodontol 2001;72:368‐373.
Identification and Consequences of Distinct Löe‐Silness Gingival Index Examiner Styles for the Clinical Assessment of Gingivitis
Authors: McClanahan Stephen F. , Bartizek Robert D. , Biesbrock Aaron R.
Published: February 2005

Background: In clinical studies, gingivitis is most frequently assessed by the Löe‐Silness gingival index (GI). The objective of this work was to develop an understanding of how clinicians experienced with GI differ with respect to how they apply GI and to assess the impact of different examination styles on statistical outcomes and magnitude of treatment differences.

Methods: A method was developed to mathematically relate the average GI score and degree of bleeding observed for a subject. Graphical analyses were used to profile examiner styles with respect to using the GI index. A prospective single‐center, examiner‐blind study comparing the effects of a staggered prophylaxis on gingivitis was then conducted, where a difference in gingivitis was created between two balanced groups by providing subjects a prophylaxis at two staggered time points. Subjects were assigned to one of two cohorts; within each cohort, group 1 subjects received a dental prophylaxis following the baseline examination and group 2 subjects received a dental prophylaxis 8 weeks later. Five to 7 days after the group 2 prophylaxis, all subjects were examined for GI. Twelve experienced clinicians participated.

Results: Retrospective analyses indicated the presence of distinct examiner styles which are based on the frequency that a given GI score (0, 1, 2, or 3) is measured by a clinician. In the prospective study, all 12 examiners observed statistically significant differences between the prophylaxis treatment groups at the final visit for both mean number of bleeding sites and mean GI; the magnitude ranged from 21.5% to 84.6% for mean number of bleeding sites and 9.4% to 39.2% for mean GI. There were 4 distinct styles employed by these experienced clinicians.

Conclusions: Varying examiner styles impact the structure of resulting data. Importantly, the implementation of arbitrary thresholds (e.g., 20%) regarding percent treatment differences between groups as a guideline for judging the clinical significance is scientifically unsupported. A more scientific criterion in the field of gingivitis clinical testing would be the independent demonstration of statistical superiority compared to a negative control and/or a demonstration of similar or superior efficacy to clinically proven positive controls. In addition, interexaminer calibration is a mechanism that can be utilized to minimize the impact of different examiner styles in clinical settings involving more than one examiner. J Periodontol 2001;72:383‐392.
Cyclooxygenase‐2 Is Upregulated in Inflamed Gingival Tissues
Authors: Morton Rakhi Sinha , Dongari‐Bagtzoglou Anna I.
Published: February 2005

Background: Increased release of prostaglandins (PG) within periodontal tissues is considered to play a pathogenetic role during periodontal disease progression. The rate‐limiting step in the formation of PG from arachidonic acid is catalyzed by cyclooxygenase (COX). Currently there are 2 known isoforms of the enzyme. COX‐1 is constitutively expressed in various tissues whereas COX‐2 is an inducible enzyme believed to be responsible for PG synthesis at sites of inflammation. The purpose of this study was to compare COX‐2 expression in inflamed and healthy human gingiva and further explore some of the pathogenetic mechanisms which may lead to elevated COX‐2 expression in vivo.

Methods: Thirty‐two gingival biopsies were obtained during routine oral surgical procedures and were processed histologically using hematoxylin and eosin to determine the degree of inflammation. Of these biopsies, 7 with low and 7 with high histological levels of inflammation were further processed immunohistochemically in order to assess the levels of COX‐2 expression in situ. To explore some potential mechanisms of COX‐2 upregulation, gingival connective tissue primary cell cultures were established and challenged with periodontal bacteria or proinflammatory cytokines in vitro. The levels of COX‐2 expression were analyzed by Western blot of cell lysates. COX‐2 activity was assessed by quantifying prostaglandin E2 (PGE2) levels in culture supernatants by competitive EIA.

Results: We have shown by immunohistochemistry that COX‐2 expression was significantly higher (P <0.01) in tissues with higher levels of inflammatory infiltrates. Expression of COX‐2 was detected in gingival epithelium, endothelial cells as well as cells with fibroblast morphology. In vitro studies indicated that gingival fibroblasts (GF) did not express COX‐2 constitutively. However, when these cells were challenged with interleukin (IL)‐1β or bacterial cells (A. actinomycetemcomitans JP2 or B. forsythus ATCC 43037), COX‐2 expression as well as COX‐2 activity were upregulated. COX‐2 expression was upregulated as early as 2 hours post IL‐1β challenge and was accompanied by a sustained PGE2 release in the culture supernatants. Cyclosporin A (CsA) did not inhibit COX‐2 expression induced by bacterial challenge. In contrast, NS‐398, a selective inhibitor of COX‐2 activity, almost completely abolished PGE2 synthesis by these cells in response to bacterial or cytokine challenge.

Conclusions: We conclude that COX‐2 expression is significantly upregulated in inflamed periodontal tissues. Both inflammatory cytokines such as IL‐1β and bacterial constituents may be responsible for the enhanced COX‐2 expression and PGE2 synthesis in vivo. J Periodontol 2001;72:461‐469.
Predictable Multiple Site Root Coverage Using an Acellular Dermal Matrix Allograft
Authors: Henderson Robin D. , Greenwell Henry , Drisko Connie , Regennitter Fred J. , Lamb James W. , Mehlbauer Michael J. , Goldsmith Linda J. , Rebitski George
Published: February 2005

Background: The primary aim of this randomized, controlled, blinded clinical investigation was to determine if orientation of an acellular dermal matrix (ADM) allograft, basement membrane side against the tooth or connective tissue side against the tooth, affected the percent root coverage. Additional aims were to: 1) compare results of this study with results obtained from other root coverage studies; 2) determine if multiple additional sites could be successfully covered with the same surgery; 3) determine the effect of the procedure on keratinized tissue; and 4) evaluate the amount of creeping attachment obtained.

Methods: Ten patients with 2 Miller Class I or II buccal recession defects ≥3 mm were treated with a coronally positioned flap plus ADM and followed for 12 months. Test sites received ADM with the basement membrane side against the root (AB), while the control sites received the connective tissue side against the root (AC). Multiple additional recession sites were treated with the same flap procedure.

Results: Mean baseline recession for the AB sites was 4.2 mm and for the AC sites, 3.7 mm. Mean root coverage of 95% was obtained for both AB and AC sites. Sixty‐eight additional Class I or II AB and AC sites obtained about 93% root coverage. The mean increase in keratinized tissue for both treatments was 0.80 mm. No additional root coverage was gained due to creeping attachment between 2 and 12 months.

Conclusions: Treatment with ADM was an effective and predictable procedure for root coverage. The orientation of the material did not affect the treatment outcome for any of the parameters tested. J Periodontol 2001;72:571‐582.
Combination Use of Bovine Porous Bone Mineral, Enamel Matrix Proteins, and a Bioabsorbable Membrane in Intrabony Periodontal Defects in Humans
Authors: Lekovic Vojislav , Camargo Paulo M. , Weinlaender Michael , Kenney E. Barrie , Vasilic Nikola
Published: February 2005

Background: The purpose of this study was to evaluate the effectiveness of a combination of enamel matrix proteins (EMP), bovine porous bone mineral (BPBM), and a bioabsorbable membrane for guided tissue regeneration (GTR) as regenerative therapy for intrabony defects in humans and compare it to an open flap debridement (OFD) technique.

Methods: Using a split‐mouth design, 18 pairs of intrabony defects were treated and surgically reentered 6 months after the initial surgery. Experimental sites were treated with EMP, grafted with BPBM, and received a collagen/polylactic acid membrane for GTR. Control sites were treated with OFD. The primary outcomes evaluated in the study included probing depth resolution, clinical attachment gain, and bony defect fill.

Results: Preoperative probing depths, attachment levels, and intraoperative bone measurements were similar for the experimental and control groups. Postsurgical measurements taken at 6 months revealed a significantly greater reduction in probing depth in the experimental group (4.95 ± 1.52 mm on buccal sites and 4.74 ± 1.47 mm on lingual sites) when compared to the control group (2.83 ± 0.83 mm on buccal sites and 2.90 ± 0.91 mm on lingual sites). The experimental sites also presented with significantly more attachment gain (3.89 ± 1.16 mm on buccal sites and 3.78 ± 1.14 mm on lingual sites) than the control sites (1.52 ± 0.83 mm on buccal sites and 1.48 ± 0.78 mm on lingual sites). Surgical reentry of the treated defects revealed a significantly greater amount of defect fill in favor of the experimental group (4.76 ± 1.36 mm on buccal sites and 4.81 ± 1.37 mm on lingual sites) as compared to the control group (1.78 ± 0.92 mm on buccal sites and 1.67 ± 0.90 mm on lingual sites).

Conclusions: The results of this study indicate that a combination technique including BPBM, EMP, and GTR results in better clinical resolution of intrabony defects than treatment with OFD. Differences observed were both statistically and clinically significant. The exact role of each of the 3 technique components in achieving the clinical improvement observed in this study remains to be determined. J Periodontol 2001;72:583‐589.
Expression of Cytokines and Inducible Nitric Oxide Synthase in Inflamed Gingival Tissue
Authors: Hirose Michiko , Ishihara Kazuyuki , Saito Atsushi , Nakagawa Taneaki , Yamada Satoru , Okuda Katsuji
Published: February 2005

Background: Periodontopathic bacteria induce inflammation of periodontal tissues. The cytokines and nitric oxide released in periodontal lesions have been reported to play a protective role in bacterial infection and to relate to the process of inflammation. To clarify the relationship between colonization of periodontopathic bacteria and cytokines, we evaluated profiles of inflammatory cytokines, chemokine, anti‐inflammatory cytokines, and inducible nitric oxide synthase (iNOS) and colonization by Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans, which are major pathogens of periodontitis.

Methods: mRNA expression of cytokines and iNOS in inflamed and healthy gingival tissue was determined using reverse transcription‐polymerase chain reaction (RT‐PCR), and the relationship between their profiles and the detection of specific bacteria was analyzed.

Results: The relative expression of interleukin (IL)‐6 and iNOS mRNAs in periodontal lesions was significantly higher than those in healthy individuals. IL‐6 mRNA expression was also significantly higher at bleeding on probing (BOP)‐positive sites than at BOP‐negative sites. The expressions of IL‐1α and IL‐8 increased, but IL‐10 expression decreased at sites where A. actinomycetemcomitans was detected. We found no correlation between the expression of cytokine and iNOS mRNA and infection by P. gingivalis.

Conclusions: The expression of IL‐6 may reflect inflammation in gingival tissue, and iNOS may be involved in the inflammatory process in periodontitis. The presence of A. actinomycetemcomitans or P. gingivalis might relate to the different cytokine profiles of IL‐1α, IL‐8, and IL‐10. J Periodontol 2001;72:590‐597
Human Fibroblasts Ubiquitously Express Glutamic Acid Decarboxylase 65 (GAD 65): Possible Effects of Connective Tissue Inflammation on GAD Antibody Titer
Authors: Kono Takayuki , Nishimura Fusanori , Sugimoto Hikaru , Sikata Kenichi , Makino Hirofumi , Murayama Yoji
Published: February 2005

Background: Type 1 diabetes is caused by a destruction of pancreatic β cells due to autoimmunity. Autoantibody against glutamic acid decarboxylase (GAD) 65 expressed in pancreatic β cells is widely used as a predictive marker for pancreatic destruction. In this study, we hypothesized that if certain cells in periodontal tissues could express GAD, then it may influence GAD antibody titer.

Methods: We used: 1) reverse transcription‐polymerase chain reaction (PCR) analysis to detect GAD 65 mRNA in various cells; 2) nucleotide sequencing analysis to confirm that amplified PCR product is the gene encoding GAD; and 3) Western blotting to determine the expression of GAD 65 protein in human gingival fibroblasts. Immunohistochemical staining of GAD 65 protein in normal and inflamed gingiva was performed to examine the potential influence of periodontal inflammation on GAD 65 expression. GAD antibody titer in sera of periodontal patients as well as healthy subjects was measured to determine if periodontal patients could develop autoantibody against GAD 65.

Results: Cultured human gingival, periodontal, and dermal fibroblasts and mesangial cells expressed GAD mRNA. Nucleotide sequencing analyses confirmed the amplified PCR product as GAD 65. Western immunoblotting analyses and immunohistochemical staining revealed that the GAD 65 protein was expressed in vitro and in vivo. The expression of GAD 65 in inflamed tissue was higher than that in normal tissues. Two of 62 periodontal patients without diabetes showed an increased antibody titer against GAD 65, while none of the systemically healthy subjects showed an increased antibody titer against this antigen.

Conclusions: We concluded that periodontal inflammation may result in higher levels of GAD and influence GAD antibody titer, and, hence, affect diabetic diagnosis based upon GAD antibody production. J Periodontol 2001;72:598‐604.
Prevalence and Risk of Gingival Enlargement in Patients Treated With Nifedipine
Authors: Miranda Jaume , Brunet Lluís , Roset Pere , Berini Leonardo , Farré Magí , Mendieta Carlos
Published: February 2005

Background: Gingival enlargement is a known side effect of nifedipine use. This study was conducted to determine the prevalence and risk factors for gingival enlargement in nifedipinetreated patients.

Methods: A cross‐sectional study was conducted in a primary care center. Data from 65 patients taking nifedipine were compared with 147 controls who had never received the drug. All patients were examined for the presence of gingival enlargement using 2 different indices: vertical gingival overgrowth index (GO) in 6 points around each tooth, and horizontal MB index in the interdental area. Gingival index, plaque index, and probing depth were also evaluated.

Results: The prevalence of gingival enlargement was significantly higher in nifedipine‐treated cases than in controls (GO index, 33.8% versus 4.1%; MB index, 50.8% versus 7.5%, respectively). Higher gingival and plaque indices were observed in patients taking nifedipine. Among the possible risk factors, only the gingival index showed a significant association with gingival enlargement. The risk (odds ratio [OR]) of gingival enlargement associated with nifedipine therapy was 10.6 (3.8‐29.1) for the GO index and 14.4 (6‐34.6) for the MB index. Gingival index‐adjusted ORs were 9.6 (3.3‐28.1) and 9.7 (3.9‐23.3), respectively. In the subset of high nifedipine exposure patients, the odds ratio for gingival enlargement increased to 17.4 (5.3‐56.3) for the GO index and 23.6 (7.7‐72.3) for the MB index. The concordance between GO and MB indices showed a kappa value of 0.689 in controls and 0.642 in patients treated with nifedipine.

Conclusions: Patients taking nifedipine are at high risk for gingival enlargement, and gingivitis acts as a predisposing factor. J Periodontol 2001;72:605‐611.
Naturally Occurring Periodontal Bone Loss in the Wild Deer Mouse, Genus Peromyscus
Authors: Wiebe Colin B. , Adkins Christine A. , Putnins Edward E. , Hakkinen Lari , Larjava Hannu S.
Published: February 2005

Background: Historically, animal models for the study of periodontal diseases have incorporated surgically created defects, plaque retentive ligatures, as well as soft and high‐sucrose diets which may not accurately reflect progression of the natural disease. Spontaneous periodontal disease is seen in a few animal species, but these are often expensive to maintain and are unsuitable for manipulation using advanced molecular biology techniques. Mice are inexpensive, easy to maintain, and are routinely used for transgenic experiments and are therefore an optimal animal for research purposes. However, it is commonly accepted that mice do not spontaneously develop periodontal disease. The purpose of this study was to determine if a mouse population that exhibits periodontal breakdown in the wild could be found, allowing for genetic manipulation of naturally occurring periodontal disease.

Methods: We examined over 2,500 dry skulls of several Peromyscus species from various locations and habitats on the west coast of North America for periodontal bone loss in the molars, using furcation involvement as an indicator of disease severity. Alveolar bone loss was classified as Grade I) horizontal component of bone loss in the furcations; II) through‐andthrough furcations; and III) through‐and‐through furcations with alveolar bone loss into the apical third of the root.

Results: The proportions of individual mice experiencing bone loss were 3.8% for Class I‐III involvement, 1.3% for Class II‐III involvement, and 0.5% for Class III alone. Three subspecies of P. keeni and one subspecies of P. maniculatus had periodontal disease prevalences in 7% to 13.5% of their samples. Mice from isolated islands had 1.8‐ to 4.7‐fold higher disease prevalence than those located on the mainland, with even greater prevalence on small islands. No statistically significant differences between genders were found.

Conclusions: It appears that periodontal disease is far more common in this mouse genus than previously believed. Some of the subspecies demonstrated severe periodontal disease at a prevalence comparable to that found in humans. J Periodontol 2001;72:620‐625.
Adhesion of Porphyromonas gingivalis Strains to Cultured Epithelial Cells From Patients With a History of Chronic Adult Periodontitis or From Patients Less Susceptible to Periodontitis
Authors: Quirynen M. , Papaioannou W. , van Steenbergen T.J.M. , Dierickx K. , Cassiman J.J. , van Steenberghe D.
Published: February 2005

Background: The present study aimed to explain the interindividual variation in periodontitis susceptibility by differences in the initial adhesion rate of Porphyromonas gingivalis to the pocket epithelium of these individuals, and/or by inter‐P. gingivalis strain differences in association capacity (adhesion and internalization).

Methods: Adhesion assays were performed on epithelial monolayers (cultured in vitro from pocket epithelium belonging to patients who were less or more susceptible to chronic adult periodontitis) using 11 genetically different clinical strains of P. gingivalis

Results: Both the disease category (less susceptible versus susceptible) and the interstrain variation were found to have a significant effect (both P <0.05) on the initial bacterial association. The chronic adult periodontitis group showed significantly more association of P. gingivalis when compared to less susceptible patients (4.2 × 106 versus 3.5 × 106). Also, the interstrain variation was significant, with strains Pg 4 and 5 representing the least and best associating bacteria (1.8 × 106 colony forming units for Pg 4, 9 × 106 for Pg 5).

Conclusions: These results indicate that periodontitis susceptibility is influenced by both the interindividual differences in pocket epithelium (allowing more adhesion of P. gingivalis) or by the strain type by which the patient is infected (intra‐species differences in adhesion capacity). J Periodontol 2001;72:626‐633.
Gliding Capacity of Different Dental Flosses
Authors: Dörfer Christof E. , Wündrich Dominik , Jörg Staehle Hans , Pioch Thomas
Published: February 2005

Background: One of the major concerns with the use of dental floss is the passage of the proximal contact, which might be influenced by the material characteristics of the floss. The aim of this study was to compare the gliding capacities of different flosses with major differences in structure and experimental behavior in vivo.

Methods: In a clinical, single‐blind, crossover study of 27 subjects, the forces necessary for passing all 14 proximal contacts between the first premolars were measured using 2 polytetrafluoroethylene (PTFE)‐based flosses, 2 nylon‐based flosses, and 1 nylon‐based tape. The flosses were fixed in a special holder with strain gauges, which allowed registration of the maximum forces at insertion into and removal from the interdental area.

Results: In most contacts, the PTFE flosses needed less force compared to the nylon flosses. The range between the flosses was higher in the mandible compared to the maxilla and increased from the mesially located contacts to the more distally located contacts. The nylon tape required higher forces at insertion for all maxillary contacts. All other flosses proved to be equivalent at these contacts.

Conclusions: PTFE flosses are superior to nylon flosses in terms of passing stronger proximal contacts in both directions. Due to gliding differences between different types of floss, the selection of a floss has the potential of compensating intra‐ and interindividual variation in contact strengths. J Periodontol 2001;72:672‐678.
Human Papillomavirus Infection in Cyclosporin‐Induced Gingival Overgrowth in Renal Allograft Recipients
Authors: Bustos Dolores A. , Grenón Miriam S. , Benitez Mónica , de Boccardo Graciela , Pavan Jorge V. , Gendelman Héctor
Published: February 2005

Background: Host immunity plays an important role in the development of human papillomavirus (HPV)‐associated disease. The HPV infection in oral cyclosporin‐induced gingival overgrowth in renal transplant recipients has not been investigated previously. The aim of this study was to establish the HPV infection of cyclosporin‐induced gingival hyperplasia in renal transplant recipients through morphological changes and use of the in situ hybridization technique.

Methods: We examined 13 renal transplant recipient biopsies with gingival overgrowth lesions and 4 healthy mucosa samples of these patients. The histopathological diagnoses were established on the basis of widely accepted criteria, and the pathologist was not aware of the HPV result. An in situ molecular hybridization was carried out under low stringent conditions to detect HPV species with mixed biotin‐labeled probes of HPV 6 and HPV 11, and under high stringent conditions with HPV 6, HPV 11, HPV 16, and HPV 18 probes for HPV typing.

Results: The HPV prevalence among the 13 samples studied was 92.31% (12/13), of which 4 tested positive for HPV 6‐11 and 1 for HPV 16. The 4 biopsies of normal mucosa from gingival overgrowth patients were also reactive for HPV DNA. In 11/12 (91.7%) HPV‐positive cases, koilocytotic atypia was found.

Conclusions: The suppression of T‐cell function by cyclosporin therapy can result in an increase of HPV infection, adding to the proliferative activity of cyclosporin in the oral mucosa. J Periodontol 2001;72:741‐744.
Coronally Advanced Flap Procedure: Is the Interdental Papilla a Prognostic Factor for Root Coverage?
Authors: Saletta Daniele , Prato Giovanpaolo Pini , Pagliaro Umberto , Baldi Carlo , Mauri Mauro , Nieri Michele
Published: February 2005

Background: This study was designed to verify if the dimension of the interdental papilla may be a prognostic factor for the clinical outcome of the coronally advanced flap (CAF) in the treatment of gingival recessions.

Methods: Thirty‐three Miller Class I recessions were treated in 33 patients using the CAF procedure. Two types of measurements were performed: 1) clinical measurements (probing depth, recession depth, width of keratinized tissue, clinical attachment level) were recorded at baseline and 3 months after surgery and 2) all recessions were photographed and transformed into computer images. A specific software allowed recording of both linear and square measurements. The following digital measurements were recorded at baseline: 1) base, height, and area of the mesial and distal papillae adjacent to the involved tooth and 2) width/depth of the recession and the area of the exposed root surface of the involved tooth. The residual recession area, if any, was recorded 3 months after surgery. The digital measurements of the height and of the area of the papilla were used in statistical analysis (multiple linear regression and logistic regression) to evaluate a possible correlation with root coverage (mm2) and/or with complete root coverage.

Results: Root coverage was not significantly correlated to the papilla area (P = 0.3692) or to papilla height (P = 0.0968). The complete root coverage was not correlated to the papilla area (P = 0.3181), but it was correlated to papilla height (P = 0.0499).

Conclusions: This study indicates that the root coverage following CAF procedure is not significantly correlated to papilla dimension. However, complete root coverage is significantly more frequent in sites with lower height of the adjacent papilla. J Periodontol 2001;72:760‐766.
Successful Periodontal Maintenance of a Case With Papillon‐Lefévre Syndrome: 12‐Year Follow‐Up and Review of the Literature
Authors: Wiebe Colin B. , Häkkinen Lari , Putnins Edward E. , Walsh Priscilla , Larjava Hannu S.
Published: February 2005

Background: Various approaches to treating the periodontal condition associated with Papillon‐Lefévre syndrome have been reported. These include oral hygiene instruction, use of mouthrinses, frequent debridement, multiple antibiotic regimens, periodontal surgery, extraction of hopeless teeth, and extraction of all deciduous teeth. Because Papillon‐Lefévre syndrome is rare, most publications are case reports, and very few document long‐term successful treatment of the periodontal condition.

Methods: In 1986, a 3.5‐year‐old Indo‐Canadian male was diagnosed with Papillon‐Lefévre syndrome and began periodontal treatment. Initial therapy consisted of debridement every 3 weeks, a 0.12% chlorhexidine mouthrinse, 2 regimens of metronidazole, and oral hygiene instruction for his parents. After 10 months it became apparent that the treatment was having little beneficial effect, since the periodontal destruction continued and teeth 51 and 61 exfoliated. At age 4, all remaining deciduous teeth were extracted and complete dentures inserted for the following 2‐year edentulous period; then a 3‐month maintenance schedule was maintained.

Results: The patient is now 17 years old and all his adult teeth are present with the exception of the third molars. His oral hygiene varies between moderate and good, with his most recent plaque score at 80% effectiveness. There are no probing depths greater than 4 mm, with the exception of the distal of the lower second molars where opercula are present.

Conclusions: Extraction of all the deciduous teeth followed by a period of edentulousness may partially explain the fact that there has been no recurrent attachment loss in the permanent teeth up to age 17. Other explanations are discussed as part of the literature review of Papillon‐Lefévre syndrome. J Periodontol 2001;72:824‐830.
Effects of Furcation Involvements on Periodontal Status and Healing in Adjacent Proximal Sites
Authors: Ehnevid Helge , Jansson Leif E.
Published: February 2005

Background: In a recent study it was found that following non‐surgical treatment, probing depth (PD) reduction in proximal sites is significantly less in the presence of a vertical destruction in the adjacent site of the neighboring tooth. The present investigation was undertaken to study whether the presence of a proximal furcation involvement also influences the periodontal conditions in the adjacent site of the neighboring tooth.

Methods: The investigation was conducted as a retrospective study on a consecutive referral population based on full‐mouth oral radiographic examinations and PD and plaque score registrations. The statistical analyses were performed on a final sample of 136 patients, with 153 (periodontal status) and 123 (periodontal healing) second maxillary premolars with an adjacent first maxillary molar.

Results: Baseline pockets were significantly deeper, relative radiographic attachment levels significantly reduced, and periodontal PD significantly less reduced after non‐surgical treatment in the distal sites of second maxillary premolars adjacent to first maxillary molars with a mesial furcation involvement of degree ≥2, compared to distal sites adjacent to first maxillary molars with a mesial furcation involvement of degree ≤1.

Conclusions: Periodontal status and healing after non‐surgical treatment in proximal sites are negatively influenced by the presence of a deep furcation involvement in the adjacent site in the same proximal space. The presence of a deep proximal furcation involvement should consequently be considered a risk factor for the adjacent site of the neighboring tooth. J Periodontol 2001;72:871‐876.
Interleukin‐1β and Thiobarbituric Acid Reactive Substance (TBARS) Levels After Phase I Periodontal Therapy in Patients With Chronic Periodontitis
Authors: Tüter Gülay , Kurtiş Bülent , Serdar Muhittin
Published: February 2005

Background: Interleukin‐1β (IL‐1β), a potent stimulator of bone resorption, has been implicated in the pathogenesis of periodontal tissue destruction. There is also a clearly defined and substantial role for free radicals or reactive oxygen species in periodontal destruction. The thiobarbituric acid reactive substances (TBARS) is a commonly applied test to measure free radical activity. The aims of this study were to investigate the amount of crevicular IL‐1β, tissue TBARS levels, and the clinical status of patients with advanced chronic periodontitis and the effect of phase I periodontal therapy on these clinical parameters and measurements.

Methods: Twenty‐five chronic periodontitis and 25 healthy control (C) patients were selected for the study. Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were recorded from each sampling area. Gingival crevicular fluid (GCF) sampling and clinical index scores were recorded at the initial examination (IE) and 6 weeks after phase I periodontal therapy (APT). Assays for GCF IL‐1β were carried out by enzyme‐linked immunosorbent assay (ELISA). Gingival tissue samples were obtained from sites requiring periodontal flap surgery due to unresolved pockets to determine the tissue TBARS levels. The pairedsamples t test was used to compare the IL‐1β levels and clinical parameters between IE and APT. The independent‐samples t test was used to determine the significance of all parameters between IE and C, and between APT and C. The correlation among the IL‐1β levels, clinical parameters, and tissue TBARS levels was analyzed using the Pearson correlation.

Results: The concentration of IL‐1β levels was not statistically different among IE, APT, and C groups, but the total amount of IL‐1β levels was statistically different among the 3 groups. While the levels of IL‐1β and the clinical parameters were reduced following phase I periodontal treatment, pretreatment IL‐1β, post‐treatment IL‐1β, and TBARS levels were statistically higher in IE and APT groups than C specimens. Tissue TBARS levels in the APT group were statistically greater than controls. No correlations were noted between tissue TBARS levels and clinical parameters in the APT group. A positive statistical correlation was detected between the total IL‐1β and TBARS levels in the APT group.

Conclusion: These data suggest that the levels of crevicular IL‐1β and gingival tissue TBARS are closely associated with periodontal status. This relationship may be valuable in treating and monitoring periodontal disease progression. J Periodontol 2001;72:883‐888.
Clinical Periodontal Findings and Microflora Profiles in Children With Chronic Neutropenia Under Supervised Oral Hygiene
Authors: Okada Mitsugi , Kobayashi Masao , Hino Takamune , Kurihara Hidemi , Miura Kazuo
Published: February 2005

Background: This is the first known case report that used a polymerase chain reaction (PCR)‐based method to help identify the oral microflora in patients with chronic neutropenia. In this study, we report clinical periodontal findings and microflora profiles of 2 children, 1 with severe congenital neutropenia (SCN, Kostmann type) and 1 with cyclic neutropenia (CN).

Methods: The SCN patient had severe gingivitis, whereas the patient with CN had mild gingivitis in the gingival margins. Monthly oral cleaning instruction and review were performed without subsequent periodontal therapy. Oral hygiene conditions remained satisfactory and visible plaque was scarce, despite the persistence of mild gingivitis. Under supervised oral hygiene, we examined the presence of periodontal pathogens from patient plaque samples.

Results: By a PCR‐based method, Prevotella nigrescens, Bacteroides forsythus, Campylobacter rectus, and Capnocytophaga gingivalis were detected in the SCN patient and P. intermedia, C. rectus, C. gingivalis, and C. sputigena in the CN patient, suggesting the existence of periodontal pathogens. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and C. ochracea were not found in either patient.

Conclusions: Use of 1% povidone iodine solution and local antibiotic application under supervised oral hygiene were helpful to improve gingival conditions in patients with chronic neutropenia. J Periodontol 2001;72:945‐952.
The Natural History of Periodontal Disease in Man. Risk Factors for Progression of Attachment Loss in Individuals Receiving No Oral Health Care
Authors: Neely Anthony L. , Holford Theodore R. , Löe Harald , Ånerud Åge , Boysen Hans
Published: February 2005

Background: Few investigations have reported on risk factors for periodontal attachment loss over time in subjects with no home or professional dental care. The purpose of this report was to identify potential risk factors for progression of periodontal attachment loss among male Sri Lankan tea laborers who participated in a 20‐year investigation of the natural history of periodontal disease.

Methods: Data for this report were obtained from the 154 subjects who participated in the 1970 baseline and the final 1990 examinations and included data from their interim examinations performed in 1971, 1973, 1977, 1982, and 1985. Oral health assessments included: 1) attachment levels in millimeters on mesial and mesio‐buccal surfaces of all but third molar teeth; 2) plaque index (PI); 3) gingival index (GI); 4) calculus index (CI); 5) caries index (DMFS); and 6) presence or absence of teeth. Other variables included age, history of smoking, and/or use of betel nut. Statistical analyses used multivariate repeated measures analysis of variance (ANOVA).

Results: The final adjusted model indicated that attachment loss increased significantly with age (X2 = 74.0; df = 1), GI (X2 = 45.5; df = 1), CI (X2 = 52.7; df = 1) and follow‐up time (X2 = 219.8; df = 6, P <0.0001 for all variables).

Conclusions: Age, GI, CI, and time were significantly associated with mean attachment loss over 20 years. Neither PI, history of smoking, or history of betel nut use were significantly associated with attachment loss over time. J Periodontol 2001;72:1006‐1015.
Regulation of Cytokine Production in Human Gingival Fibroblasts Following Treatment With Nicotine and Lipopolysaccharide
Authors: Wendell Kevin J. , Stein Sidney H.
Published: February 2005

Background: Patients who smoke are at increased risk for chronic periodontitis (CP). Most studies suggest that the microbial flora in these patients is similar to that found in non‐smoking CP patients. Thus, the increased risk for development of CP is not dependent on an altered microbial profile, but rather to some change in the host response to these periopathogens. There is evidence that human gingival fibroblasts (HGF) derived from diseased sites produce greater amounts of interleukin (IL)‐6 and IL‐8 in vitro than cells derived from healthy sites. This suggests that HGF subpopulations may be selected based upon the inflammatory milieu in which they reside. The hypothesis to be tested was that the combination of nicotine and lipopolysaccharide (LPS) could regulate HGF inflammatory mediator production.

Methods: HGF cell cultures were established from explants derived from 10 patients with CP. HGF cell cultures were stimulated with 1mM, 1µM, or 1ηM nicotine ± Escherichia coli or Porphyromonas gingivalis LPS. At 12, 24, or 48‐hour time points, the cells were counted and the supernatant was collected for subsequent IL‐6 and IL‐8 determination in an enzyme‐linked immunosorbent assay.

Results: At the 24‐hour time point, 1ηM nicotine stimulated IL‐6 production compared to control (P = 0.02). E. coli LPS alone caused a 3‐ to 4‐fold increase in IL‐6 and IL‐8 production, whereas P. gingivalis LPS did not augment IL‐6 or IL‐8. A synergistic effect upregulating IL‐6 was observed with combined treatment of 1mM nicotine and E. coli LPS or P. gingivalis LPS at the 24‐hour time point (P < 0.0005 and P = 0.002, respectively). Similar effects were seen when IL‐8 production was evaluated following HGF stimulation with high doses of nicotine and E. coli LPS or P. gingivalis LPS.

Conclusions: These results demonstrate that nicotine by itself can stimulate HGF IL‐6 and IL‐8 production. Moreover, the combination of high doses of nicotine and either E. coli or P. gingivalis LPS can synergistically upregulate cytokine production. These findings support the hypothesis that a proinflammatory fibroblast phenotype may be elicited in an environment enriched with bacterial LPS and nicotine. J Periodontol 2001;72:1038‐1044.
Nifedipine Induces Gingival Overgrowth in Rats Through a Reduction in Collagen Phagocytosis by Gingival Fibroblasts
Authors: Kataoka Masatoshi , Shimizu Yasuki , Kunikiyo Kenji , Asahara Yoji , Azuma Hideki , Sawa Takamasa , Kido Jun‐ichi , Nagata Toshihiko
Published: February 2005

Background: Nifedipine is used as a long‐acting vasodilator, and a primary side effect is the induction of gingival overgrowth, which is characterized by an accumulation of collagenous components within the gingival connective tissue. To elucidate the mechanisms of nifedipine‐induced gingival overgrowth, we investigated the effect of nifedipine on Type I collagen metabolism in the gingiva of rats.

Methods: Twenty‐day‐old rats were fed a powdered diet containing or lacking nifedipine for 3 to 55 days. Immunohistochemical analysis with anti‐Type I collagen antibody was employed to examine the density of Type I collagen in the gingival connective tissue. Total RNAs were isolated from mandibular molar gingiva on days 0, 3, 15, 30, and 55, and reverse transcription polymerase chain reaction was performed to investigate the mRNA levels of Type I collgen. In addition, we performed a flow cytometric analysis with collagencoated latex beads and cultured fibroblasts derived from rat gingiva to measure collagen phagocytosis.

Results: Immunohistochemical analysis revealed that Type I collagen was more prevalent in the connective tissue of nifedipine‐treated gingiva than in controls on day 55. In the nifedipine‐treated group, the expression of Type I collagen mRNA gradually decreased to 1.5% on day 55 compared to day 0. In the control group, Type I collagen mRNA also decreased to 32%; however, mRNA expression was significantly lower in the nifedipine‐treated group than in the controls. When the rate of phagocytic cells derived from nifedipine‐treated gingiva and controls was represented as the mean ± SE of the percentage from 3 different experiments, the values were as follows: on day 15, 13.5 ± 2.1% and 15.0 ± 1.5%; on day 30, 12.2 ± 4.3% and 34.5 ± 6.7% in the nifedipine‐treated and the control group, respectively, indicating that phagocytic cells were considerably fewer in the nifedipine‐treated gingiva on day 30. This finding demonstrates that the decrease in phagocytosis caused by nifedipine appeared before the detection of severe macroscopic gingival overgrowth.

Conclusion: These findings suggest that the decrease in collagen degradation due to lower phagocytosis is closely associated with the increase in Type I collagen accumulation in nifedipine‐treated rat gingiva. J Periodontol 2001;72:1078‐1083.
Oral Focal Mucinosis of the Gingiva: Case Report
Authors: Iezzi Giovanna , Rubini Corrado , Fioroni Massimiliano , Piattelli Adriano
Published: February 2005

Background: Oral focal mucinosis is a rare disease of unknown etiology, where the connective tissue undergoes a focal myxoid degeneration.

Methods: We describe a 48‐year‐old patient who was referred for a firm, tender mass located on the gingiva of the left central mandibular incisor. The first clinical impression at examination was that of a periodontal abscess.

Results: The lesion underwent a biopsy, and the final microscopic diagnosis was oral focal mucinosis.

Conclusions: It must be stressed that in most focal gingival lesions, a preoperative diagnosis can be almost impossible. J Periodontol 2001;72:1100‐1102.
Patient Preference for Light‐Cured Composite Bite Splint Compared to Heat‐Cured Acrylic Bite Splint
Authors: Leib Alden M.
Published: February 2005

Background: Heat‐cured acrylic has been the most commonly used material for construction of bite splints. Although effective, its processing involves several steps and is time consuming. Furthermore, acrylic splints distort easily if not kept in water when not worn for long periods of time. A newly developed light‐cured composite material is now being used for bite splint fabrication. The composite material offers benefits in ease and speed of construction, has minimal warping and distortion, and has proven patient acceptance. The aim of this study was to determine if patient satisfaction with the composite splint was as good as, or preferential to, the acrylic splint.

Methods: Both a composite and an acrylic bite splint were fabricated for each of 10 patients. The splints were worn alternately on a nightly basis and were adjusted as needed after the first week. After 3 weeks, each patient completed a questionnaire regarding the properties of each splint and any preferences they had in reference to fit, comfort, and other parameters of satisfaction.

Results: All of the patients were able to wear at least one of the splints comfortably. All 10 preferred the composite splint over the acrylic splint, agreeing that it felt more natural and was more comfortable to wear.

Conclusions: The light‐cured composite bite splint is preferable from the patient's perspective to the heatcured acrylic bite splint. The composite splint is rapidly constructed on the original model, easily seated, and comfortably worn. Other properties of composite material also make it preferable for longterm use. Future studies are necessary to evaluate the functional differences between the composite and acrylic splint. J Periodontol 2001;72:1108‐1112.