bluuebunny/crossref_metadata_2025 huggingface dataset:
Certain Bacterial Species and Morphotypes in Localized Juvenile Periodontitis and in Matched Controls
Authors: Asikainen Sirkka , Jousimies‐Somer Hannele , Kanervo Arja , Summanen Paula
Published: March 2012

Subgingival microflora in localized juvenile periodontitis (LJP) was examined by culture of certain bacterial species and by direct dark‐field microscopy in affected and unaffected periodontal pockets of 11 patients and in their age‐ and sex‐matched controls. Only Actinobacillus actinomycetemcomitans (A.a.) correlated to periodontal destruction and occurred most frequently at the affected LJP sites. A.a., Bacteroides intermedius and Fusobacterium nucleatum were isolated in proportions >5% of the flora at the affected LJP sites, but various Actinomyces spp. at the unaffected and control sites. The proportions of straight rods, fusiforms and small spirochetes correlated to gingival bleeding tendency and were higher at the affected LJP sites than at the control sites. Certain nonpigmented Bacteroides spp. and Eikenella corrodens were never isolated when only cocci were seen at dark‐field microscopy. The more complex the flora, the more frequently B. intermedius occurred. The results support a significant role for A.a. in LJP and indicate that certain bacterial species appear to prefer occurring in the complex composition of subgingival microflora.
The Effect of Periodontal Bone Loss on Bite Force Discrimination
Authors: Williams W. N. , Low S. B. , Cooper W. R. , Cornell C. E.
Published: March 2012

This study compared bite force discrimination between 14 treated periodontal patients with significant bone resorption and 14 control subjects who were free of periodontal disease. Bite force was measured using a strain gauge scale which permitted subjects to visually monitor when their bite force equaled a preset resistance. A bite force of 500 gm was selected as the standard. Subjects were presented with a series of paired resistance settings, one at a time, the first of each pair being the standard and the second being the comparator setting of some predetermined different amount. This procedure was continued until the subject's difference limen (DL) value, the threshold of discrimination between two bite forces, was established. The periodontal patients required an average of 334 additional grams of resistance over the standard before they could detect a difference, whereas the control subjects required only 201 additional grams. These group means were significantly different (P < 0.01). The results of this study suggest that the periodontal ligament provides sensory feedback relative to bite force discrimination.
Microvascularization of Gingival Wound Healing Using Corrosion Casts
Authors: Nobuto Takahiro , Tokioka Takao , Limai Hisao , Suwa Fumihiko , Ohta Yoshikuni , Yamaoka Akira
Published: March 2012

The healing process in a wound induced by removal of 6 × 6 mm of gingiva and periosteum from the maxillary attached gingiva of 48 adult mongrel dogs was observed to investigate the potential blood supply for grafts placed on denuded bone. Three‐dimensional observations were performed over 12 weeks by scanning electron microscopy (SEM) following the manufacture of corrosion capillary casts by acrylic resin injection. Revascularization in the gingival wound was mainly through formation of new capillaries from those existing below the surrounding epithelium with little new capillary formation from the Volkmann canals. Moreover, the periodontium contributed greatly to the vascularization, which was fastest from the gingival margin. Further, simplification of new capillary loops was also fastest from this direction. Regeneration of the periosteum and periosteal vascular plexus was slow, taking about twice the time of connective tissue and capillaries below the epithelium. The results indicated that blood supply to grafts on denuded bone in the early postgraft period would mainly be provided by capillaries below the epithelium surrounding the recipient bed.
A Biochemical Approach to Periodontal Regeneration
Authors: Terranova Victor P. , Hic Susanne , Franzetti Louis , Lyall Raymond M. , Wikesjö Ulf M. E.
Published: March 2012

Recent investigations on regeneration of the periodontium have attempted to define factors involved in the formation of a new connective tissue attachment. One essential biological event involved in tissue regeneration is directed cell migration (Chemotaxis). Extracellular matrix proteins have been shown to influence Chemotaxis, cell proliferation and differentiation. Recently, the extracellular matrix proteins, fibronectin (FN) and laminin (LM), and the Polypeptide, endothelial cell growth factor (ECGF), have been shown to stimulate a variety of biological processes.

Current assay systems which attempt to define cell migration are the Boyden chamber assay and a random cell migration assay. Neither assay system adequately defines in vivo cell migration.

Here we present a new in vitro assay system that tests the capacity of several biological response modifiers applied on dentin to stimulate a chemotactic and proliferative response from various cell types. The assay system consists of two types of assays. Assay I measures the chemotactic activity of test substances bound to dentin. In this assay cells must actively move through a filter (Nuclepore®) towards a factor bound to dentin. Assay II examines the ability of dentin‐bound biological response modifiers to stimulate directed movement and proliferation of cells on dentin surfaces. We report that periodontal ligament (PDL) cells migrate towards FN and ECGF; that PDL cell migration is enhanced when dentin is preconditioned with tetracycline HCl; that PDL cells have an increased proliferative response when dentin is conditioned with both FN and ECGF; that gingival epithelial cells have increased migratory and proliferative responses when LM is used to condition dentin; and that there is a reciprocal utilization of biological response modifiers by gingival epithelial cells and PDL cells.
The Use of Ultrasound for the Determination of Periodontal Bone Morphology
Authors: Palou Miguel E. , McQuade Michael J. , Rossmann Jeffrey A.
Published: March 2012

The purpose of this study was to assess the value of ultrasound in the measurement of periodontal bone morphology. Four patients scheduled for periodontal surgery were selected for the study. The Ocu‐Scan 400 machine was used and adjusted according to the manufacturer's instructions. Teeth involved in the study were measured on the facial aspect at three different points: mesial, midfacial and distal (except one tooth measured only at the mesial point). Two different presurgical measurements were made with the use of ultrasound. The distance between the gingival margin and the crest of alveolar bone was measured during the surgical procedure. No correlation could be made between the different measurements obtained. From the results the following was concluded: (1) measurement of alveolar bone topography with the presently available ultrasound probe is not accurate, and (2) ultrasound measurement is a fast and painless procedure.
Radiographic Evaluation of Juvenile Periodontitis (Periodontosis)
Authors: Bial John J. , Mellonig James T.
Published: March 2012

Of 49,380 male naval recruits who were screened for juvenile periodontitis (JP), 270 were clinically diagnosed as having the disease. Full‐mouth radiographs identified 182 of these 270 patients as having JP with extensive bone loss on permanent first molars and/or incisors. These 182 patients, 137 (75.3%) of whom were black, were further classified into Type I: bone loss involving first molars and/or incisors and up to two additional teeth; Type II: involvement of first molars/incisors and several additional teeth; and Type III: generalized involvement (more than 14 teeth) but with bone loss notably more extensive on the first molars and/or incisors. Of the 182 patients, 129 (70.9%) were Type I; 43 (23.6%) were Type II, and 10 (5.5%) were Type III. The molars were involved more frequently than the incisors; more than one molar was always involved, with or without incisor involvement. Most cases had minimal or no radiographic caries, and 46% had demonstrable calculus. Of the remaining 88 cases from the 270 with the initial diagnosis of JP, 63 demonstrated severe bone loss on more than 14 teeth, with many of the teeth being involved to the same degree. These cases were termed rapidly progressive periodontitis. Six of the 88 cases had bone loss on only one tooth surface of the dentition. These cases were termed acute localized destruction of alveolar bone. The status of the other 19 cases could not be determined.
Supragingival Root Surface Removal during Maintenance Procedures Utilizing an Air‐Powder Abrasive System or Hand Scaling
Authors: Berkstein Sergio , Reiff Richard L. , McKinney James F. , Killoy William J.
Published: March 2012

The purpose of this study was to determine the amount of root surface removal in vitro using an air‐powder abrasive system or sharp curet on root surfaces simulating the cumulative effects of an every 3‐month periodontal maintenance regimen over a 3‐year period and to compare the amount of time spent in the utilization of each instrument. Fifty extracted teeth with fully formed roots were cleaned and mounted in one of 10 different artificial alveolar arches. Each arch contained one central incisor, one lateral incisor, one canine, one first and one second premolar. The buccal and mesial tooth root diameters were measured initially and after each treatment with a digital point micrometer. All teeth were stained with coffee and repositioned in their artificial alveolae and treated by the air‐powder abrasive system or curet until all visible stain was removed. Time required for removal of stain in both treatment groups was recorded. Both groups were restained, retreated, and retimed 12 times to reproduce a 3‐month maintenance interval for 3 years. The average root structure removed by the air‐powder abrasive system following each treatment was 10.68 μm while the curet removed an average of 27.09 μm. Stain was removed 3.15 times faster by the airpowder abrasive system than with a curet.
Circadian Rhythms of Gingival Epithelium in Young Mice
Authors: Sandhu H. S. , Tonna E. A. , Singh I. J.
Published: March 2012

Five‐week‐old Brookhaven National Laboratory (BNL), Swiss‐albino male mice were maintained on a 12‐hour light/dark cycle and were subcutaneously injected with 3Hthymidine (1 μCi/gm body weight) one hour prior to sacrifice. Twenty‐four mice (three at each time‐period) were killed at 3 hour intervals for 24 hours. Autoradiographs were prepared from 5‐μm thick paraffin embedded decalcified sections of maxillary first molars and surrounding tissues. Labeling index was determined over the cells of the basal layer of the gingival epithelium. Crevicular and crestal gingival epithelium revealed a circadian rhythmic pattern in DNA synthesis in which two peaks were evident. Peak labeling of 5‐week‐old mouse gingiva exhibited a higher value than previously reported for nontraumatized gingiva. Rodents are nocturnal, as was peak activity, but a second peak is also evident in the light period. Consequently, not all peaks are synonymous with the period of animal activity and feeding. The observed continuous high labeling indices represent a significant potential of gingival epithelium to replenish its cells in response to physiological wear and tear.
In Vitro Evaluation of Extracts of Mineralized Tissues for Their Application in Attachment of Fibrous Tissue
Authors: Somerman Martha J. , Perez‐Mera Maria , Merkhofer Richard M. , Foster Ruth A.
Published: March 2012

A primary objective in the treatment of periodontal diseases is attachment of fibrous tissue to root surfaces. An in vitro method was used to evaluate agents for their potential in enhancing this attachment process. Guanidine EDTA protein extracts of alveolar bone, cementum, and dentin in culture media were added to petri dishes and incubated at 37°C for 1 hour. Human gingival fibroblasts were added to the dishes and incubated for an additional 90 minutes. Following incubation, cells attaching to the dish were quantified electronically, using a Coulter Counter. Extracts of alveolar bone and cementum enhanced cell attachment while dentin extract had no effect. These results indicate that both cementum and bone contain attachment proteins which could prove beneficial for attachment of fibrous tissue to root surfaces.
The Concentration of Lipopolysaccharide on Individual Root Surfaces at Varying Times Following in Vivo Root Planing
Authors: McCoy Sandra A. , Creamer Howard R. , Kawanami Masamitsu , Adams Donald F.
Published: March 2012

Material with endotoxin activity has been detected in extracts prepared from pooled, periodontally involved teeth, and it has been shown that root planing in vivo reduces the level of such material. However, questions concerning the concentration of endotoxin on the diseased surfaces of individual teeth and questions concerning how rapidly individual root planed tooth surfaces retoxify in vivo have not been addressed previously. Citric acid extracts were prepared from individual, periodontally diseased teeth that had been extracted either from the oral cavity without prior root planing or at varying times up to 12 weeks following root planing. Using a chromogenic Limulus Amebocyte Lysate (LAL) assay, we were able to quantitate the amount of endotoxin associated with diseased root surfaces of individual teeth. We concluded that the extracted material contained endotoxin since it activated LAL and since the LAL‐activation was heat‐stable, acid‐stable and neutralizeable by polymyxin B. The levels of endotoxin found on the root surfaces of these individual, periodontally involved teeth at varying times following in vivo root planing support the following conclusions: (1) the concentration of endotoxin present on diseased root surfaces is markedly reduced, but not eliminated, by in vivo root planing, (2) significant retoxification of root planed surfaces occurs within a relatively short time period after root planing and (3) biological responses to such toxification conceivably may lead to subsequent phases having reduced levels of endotoxin.
Human Fibrin Glue Versus Sutures in Periodontal Surgery
Authors: Pini Prato Giovan Paolo , Coltellini Pierpaolo , Agudio Giancarlo , Clauser Carlo
Published: March 2012

A fibrin‐sealing system consisting of symmetrical flap and graft procedures versus silk sutures in a split‐mouth clinical trial was tested in 51 patients. Clinical parameters and operative times were recorded and compared. In clinical use, the fibrin glue provided quick hemostasis and adequate tissue adhesion on the whole inner surface of grafts or flaps. Its use saved remarkable amounts of time and made it easier to fix tissues in difficult areas. The time saved ranged from 3 to 19.5 minutes per procedure, and 1 to 8.5 minutes per tooth. The convenience of the fibrin glue was especially appreciated in pedicle flap procedures.
A Comparison of Three Delivery Methods of Chlorhexidine in Handicapped Children: II. Parent and House‐Parent Preferences
Authors: Francis J. R. , Addy Martin , Hunter Bruce
Published: March 2012

As part of a study of Chlorhexidine used for plaque control in handicapped children, preferences and difficulties with the three delivery methods were evaluated by questionnaire. The delivery methods were a 0.2% mouthwash, 0.2% spray, and 1% gel in trays. Responses from parents and house parents revealed the least preference for, and most difficulties with, the gel in trays. The spray was the most popular and 96% of the respondents would be prepared to use this indefinitely as a method of oral hygiene. The most effective method was the gel in trays, but results of the questionnaire suggested that the respondents would be unwilling to use it for prolonged periods. The importance of user acceptance and compliance to the long‐term success of oral hygiene methods was evident.
Within‐Mouth Correlations and Reliabilities for Probing Depth and Attachment Level
Authors: Fleiss Joseph L. , Park Molly H. , Chilton Neal W.
Published: March 2012

Replicate measurements of probing depth and attachment level were made by three examiners on the six Ramfjord teeth of 34 patients. Within‐mouth correlations were high for single measurements, and yet higher for means across replicate measurements. Interand intra‐examiner variability were both found to be low relative to between‐patient variability. Conclusions are that the low within‐mouth correlations reported by others may be the result of poor reliability, and that it is inappropriate to take the individual site as the unit of statistical analysis in clinical studies of periodontitis.
Efficacy of Strontium Chloride in Dental Hypersensitivity
Authors: Minkoff Sidney , Axelrod Sol
Published: March 2012

Controlled stimuli were used to evaluate a commercially available dentifrice containing 10% strontium chloride hexahydrate for efficacy in alleviating the symptoms of uncomplicated dentinal hypersensitivity. Sixty‐one subjects with hypersensitivity were included in the 12‐week, double‐blind, parallel, comparative (placebo) study. Levels of hypersensitivity in affected teeth were assessed by three methods: thermally controlled cold air stimulus, tactile stimulus with an electronic pressure sensitive probe, and subjective response. The results from all three methods of assessment indicated that the strontium chloride dentifrice, in comparison with a placebo, reduced dentinal hypersensitivity to a significantly greater degree. This therapeutic response to the active agent was apparent within 2 weeks and increased continuously thereafter for the length of the study. One can conclude that the regular at‐home use of a dentifrice containing 10% strontium chloride hexahydrate is an effective means for reducing the discomfort and pain engendered by thermal and tactile stimuli in patients with dentinal hypersensitivity.
Tissue Localization of Actinobacillus actinomycetemcomitans in Human Periodontitis
Authors: Christersson Lars A. , Albini Boris , Zambon Joseph J. , Wikesjö Ulf M.E. , Genco Robert J.
Published: March 2012

Invasion of periodontal tissues by different bacterial morphotypes has been reported in human periodontitis; however, limited information is available as to prevalence, localization and the bacterial species involved. The present study determined prevalence and gingival localization of Actinobacillus (Haemophilus) actinomycetemcomitans in periodontal lesions of juvenile periodontitis patients.

Thirty‐five gingival biopsies were obtained from 12 juvenile periodontitis patients at the time of periodontal therapy. One additional control biopsy was obtained from each of two adult periodontally healthy subjects, one adult periodontitis patient and one periodontally healthy monkey (Macaca fosibolius). The biopsies were carefully processed to avoid mechanical introduction of bacteria into the tissues and were examined using light and electron microscopy. Rabbit antisera specific for the three A. actinomycetemcomitans serotypes were used for immunofluorescence microscopic localization of A. actinomycetemcomitans antigens in the gingival sections.

Immunofluorescence microscopy showed A. actinomycetemcomitans specific antigens in the gingival tissues of 11 of the 12 juvenile patients examined. None of the control specimens showed evidence of A. actinomycetemcomitans antigens in the gingival connective tissue. One specimen from a periodontally healthy subject and the monkey biopsy, however, showed A. actinomycetemcomitans antigens in bacterial plaque on the surface of the crevicular epithelium.

Transmission electron microscopic examination showed microcolonies of small gramnegative rods in the connective tissue, as well as single bacterial cells between collagen fibers and in areas of cell debris. In addition to these extracellular bacterial cells, evidence of bacterial cells was also found within gingival connective tissue phagocytic cells.

The data from the present study suggest that the gingival tissue in juvenile periodontitis lesions harbors A. actinomycetemcomitans.
Lysosomal and Cytoplasmic Enzyme Activity, Crevicular Fluid Volume, and Clinical Parameters Characterizing Gingival Sites with Shallow to Intermediate Probing Depths
Authors: Lamster Ira B. , Harper D. Scott , Fiorello Laura A. , Oshrain Richard L. , Celenti Romanita S. , Gordon Jeffrey M.
Published: March 2012

The biochemical analysis of gingival crevicular fluid (GCF) may offer a sensitive means of determining periodontal disease activity, including the transition of gingivitis to periodontitis. To continue our evaluation of the relationship between clinical and GCF parameters, 552 sites with shallow to intermediate (2.0–5.0 mm) probing depths (PD) were examined. The data were collected at baseline from 33 periodontitis patients participating in a longitudinal trial examining the relationship of changes in GCF biochemistry to attachment loss. Mesiobuccal sites were scored for dichotomous measures of bleeding on probing, gingival redness, suppuration, and plaque accumulation. In addition, GCF was collected using filter paper strips inserted into the sulcus for 30 seconds, eluted in buffer and assayed for activity of the enzymes β‐glucuronidase (BG), arylsulfatase (AS), and lactate dehydrogenase (LDH), markers for ground substance‐degradation and cellular necrosis, respectively. Clinical and GCF parameters were evaluated by increasing PD. Plaque accumulation and bleeding on probing increased with increasing PD, although there was considerable overlap across groups. Suppuration was present in only a very small number of sites and the proportion of sites displaying gingival redness was not related to PD. GCF volume was grouped in 0.25‐μl increments, revealing a progressive shift with increasing PD toward a normal distribution around the median range of 0.51 to 0.75 μl at 5.0 mm. Mean enzyme activities of BG, and to a lesser extent AS and LDH increased sharply from 2.0 to 3.0 mm, were relatively stable from 3.5 to 4.5 mm, and were significantly higher in 5.0 mm than 4.5 mm sites. Lysosomal enzyme activity in GCF was more closely related to bleeding on probing than was cytoplasmic enzyme activity or GCF volume. GCF volume was more closely related to AS activity in the sample than to BG or LDH activity. These data suggest the discriminatory power of GCF analysis. Furthermore, evaluation of lysosomal enzyme activity in GCF may be a more sensitive indicator of tissue status than traditional clinical indices.
Gingival Hyperplasia Caused by Nifedipine
Authors: Barak Shlomo , Engelberg Isaac S. , Hiss Jehuda
Published: March 2012

Thirty‐four cardiac patients, treated with nifedipine (Adalat, Procardia) during a period of 1 year or more, developed slight to severe gingival epithelial hyperplasia, and five cases presented nodular overgrowth of the gingiva. In terms of histopathologic and clinical morphology, nifedipine‐induced gingival hyperplasia is similar to that known to be caused by Phenytoin (Dilantin). Both drugs have the ability to alter calcium metabolism. We believe that the hyperplastic condition is related to calcium imbalance.
A Comparison of Mandibular Lingual Surgical Flaps with and without a Vertical Releasing Incision
Authors: Lynch Thomas J. , Ficara Anthony J. , Ekvall William M. , Raulin Leslie A. , Rossmann Jeffrey A. , Scheidt Michael J.
Published: March 2012

The purpose of this study was to evaluate the short‐term postoperative pain for surgical flaps with mandibular lingual vertical releasing incisions (ML‐VRI) compared with envelope flaps and to observe the postoperative clinical healing of ML‐VRI. Using a split mouth design, 12 adult periodontal patients received bilateral posterior mandibular surgery with an envelope flap on one side and a flap with an ML‐VRI on the contralateral side. Surgical procedures were performed at separate appointments, varied in order, and performed an equal number of times on the right and left sides. Postoperative pain was scored by the patients, and scores for each technique were compared using an analysis of variance and covariance with repeated measures. Photographs were used to assess postoperative clinical healing of ML‐VRI with various degrees of initial closure. Results indicated no significant statistical difference (P > 0.05) between pain levels for the two surgical techniques. There was complete clinical healing despite variations in the degree of closure of ML‐VRI.

The findings of this study support the use of ML‐VRI. They are indicated in areas with flat contours or with slight ledges and inferior concavities. ML‐VRI are contraindicated in areas with prominent ledges and inferior concavities and in areas with exostoses. Suturing the vertical incision is unnecessary and may be detrimental to the tissues. A “step down” incision that preserves attachment levels in nondiseased sites is discussed.
Microbiological and Immunological Studies of Adult Periodontitis in Patients with Noninsulin‐Dependent Diabetes Mellitus
Authors: Zambon Joseph J. , Reynolds Homer , Fisher John G. , Shlossman Marc , Dunford Robert , Genco Robert J.
Published: March 2012

The subgingival microflora and serum antibody response was examined in Periodontitis patients with noninsulin‐dependent diabetes mellitus (NIDDM), impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). The predominant cultivable microflora was determined for subgingival plaque sampled from two deep periodontal pockets in each of eight adult Periodontitis patients with NIDDM. Indirect immunofluorescence for Bactewides intermedius, Bacteroides gingivalis, and Haemophilus actinomycetemcomitans was used to examine these same samples as well as 186 additional subgingival plaque samples from 47 patients with moderate to severe generalized Periodontitis including 25 subjects with NIDDM, six subjects with IGT, and 16 subjects with NGT. Serum antibody levels to 13 microorganisms including seven oral bacterial species and one nonoral control species were measured by enzyme‐linked immunosorbent assays (ELISA) in 377 subjects including 84 normal subjects without periodontal disease, 112 normal subjects with Periodontitis, 19 periodontally normal subjects with IGT, 65 Periodontitis patients with IGT, 15 periodontally normal subjects with NIDDM, and 82 Periodontitis patients with NIDDM.

Three hundred eighty‐two bacterial isolates were recovered from the eight patients. B. intermedius was the most frequently isolated microorganism constituting 16% of the total isolates followed by Wolinella recta and B. gingivalis, which each accounted for 13% of the total. Streptococcus sanguis was the most prevalent microorganism, which was found in 75% of the sites. Subgingival plaque samples examined by immunofluorescence demonstrate a high prevalence of black‐pigmented Bacteroides and suggest that the proportion of B. gingivalis but not B. intermedius is higher in NIDDM with Periodontitis than in other groups. Serological studies of B. gingivalis from patients with NIDDM indicate that these isolates comprise a serogroup distinct from those found in adult Periodontitis patients without diabetes. Serum IgG antibody levels were significantly elevated in nondiabetic, IGT, and NIDDM patients with Periodontitis toward both B. gingivalis strains tested. Nondiabetic Periodontitis patients had significantly elevated levels of serum IgG toward B. intermedius strain 9336 while Periodontitis patients with IGT had significantly elevated antibody levels to B. intermedius strain 25261.

Microbiologic and immunologic data from the present study suggests that B. intermedius. W. recta, and B. gingivalis are important in the etiology of Periodontitis in adult patients with NIDDM.
Effect of Periodontal Therapy on Alveolar Bone as Measured by Subtraction Radiography
Authors: Schmidt Edgar F. , Webber Richard L. , Ruttimann Urs E. , Loesche Walter J.
Published: March 2012

Changes in the periodontal alveolar bone are often evaluated by comparing a series of radiographs taken over time. This investigation used a technique that allowed the image registration to be geometrically standardized each time a radiograph was taken. Radiographs of 24 patients from an ongoing double‐blind, clinical study using metronidazole were obtained: (1) before any treatment, (2) at the completion of scaling and root planing and surgery (when performed) and (3) during the maintenance phase. One hundred six (106) paired comparisons were analyzed by subtraction radiography using a computerized system. Of these, 95 (89%) exhibited a minimal degree of geometric distortion and could be successfully substracted. Most areas (67%) showed no change in bone structure following periodontal treatment. Bone gain was noted in 12% of the sites examined, while bone loss was seen in 21% of the sites. This bone loss was statistically associated with sites that had received some form of surgical treatment.
In Situ Lymphocyte Subpopulations from Active versus Stable Periodontal Sites
Authors: Reinhardt Richard A. , Bolton Ronald W. , McDonald Thomas L. , DuBois Linda M. , Kaidahl Wayne B.
Published: March 2012

The purpose of this study was to evaluate lymphocyte subset densities and distributions within gingival biopsies from active sites (>2 mm clinical attachment loss within three months of biopsy) versus clinically similar but stable or healthy sites. Small interproximal gingival biopsies representing at least one of each of the above categories were obtained from each of 20 periodontal maintenance patients. Serial cryostat sections displaying a cross section of the gingiva were labeled with monoclonal antibodies for (1) pan T cells, (2) T cytotoxic/suppressor cells, (3) T helper/inducer cells and (4) pan B cells and were developed using an avidin‐biotin‐peroxidase system. Lymphocyte populations were enumerated in repeatable fields from the sulcular, middle and oral one‐third of each section. Relative proportions of the same lymphocyte subsets were analyzed in peripheral blood samples from the same patients using direct immunofluorescence.

Pan B cells were significantly more prevalent in infiltrates from active sites than in stable (P < 0.05) or healthy (P < 0.01) sites. The T/B cell ratio was also significantly lower in active than stable biopsies (P < 0.05), and in active biopsies versus blood (P < 0.05). The T helper/T suppressor cell ratio did not vary significantly between blood and any gingival tissue disease group or location, but a trend toward lower relative numbers of T helper cells in the sulcular infiltrates of active sites was noted. These results support the premise that active periodontal sites display elevated B cell populations and abnormal immune regulation possibly involving the T helper cell subset.
In Situ Correlative Immuno‐Identification of Mononuclear Infiltrates and Invasive Bacteria in Diseased Gingiva
Authors: Saglie F. R. , Pertuiset J. , Rezende M. T. , Nestor M. , Marfany A. , Cheng J.
Published: March 2012

The purpose of this study was to identify and quantify mononuclear cells and invasive bacteria in consecutive histological sections in diseased gingiva. Gingival biopsies were obtained from sites displaying evidences of severe Periodontitis (pocket depth >5 mm, bleeding on probing) in six patients. Specimens were frozen and serially sectioned at 8 fim in a cryostat. Monoclonal antibodies (mAb) directed against membrane markers of mononuclear infiltrate cells and rabbit polyclonal sera against specific bacteria shown to be invasive in association with an immunoperoxidase technique and specific point quantification were used. The mAb panel included Leu 1 (Pan T), Leu 2a (T suppressor/cytotoxic), Leu 3a (T helper/inducer), Leu 6 (Langerhans/dendritic), Leu 7 (NK/K), Leu M3 (monocyte/macrophage), and B7 (B cell). This methodology allows for in situ per cent quantification of mononuclear cell subsets along with identification and quantification of invasive bacteria in the same gingival tissue site. This may be a practical approach to establish the relationship between bacterial invasion and cellular immune response by the host. This technique enabled the characterization of the mononuclear infiltrate in relationship to specifically identified invasive bacteria in diseased gingiva.
Tissue Interactions with Dentin Specimens after Demineralization Using Tetracycline
Authors: Frantz Bryan , Polson Alan
Published: March 2012

Greater cell attachment to demineralized dentin has been associated with subsequent development of a fiber attachment system. The purpose of this study was to evaluate tissue interactions to dentin demineralized with different concentrations of tetracycline solution. Dentin specimens were obtained from beneath root surfaces covered by periodontal ligament. Each rectangular specimen had a face of root surface dentin and an opposite surface of pulpal dentin. Experimental specimens were treated with a tetracycline solution of either 200 mg/cc or 100 mg/cc for five minutes. The remaining group of specimens served as untreated controls. Specimens were implanted transcutaneously into incisional wounds on the dorsal surface of rats with one end protruding through the skin. Four specimens in each group were available for examination one and ten days after implantation. Histologie and histometric analysis of both root and pulpal surface of implants included counts of adhering cells, assessment of implant length within the connective tissue, and evaluation of connective tissue fiber relationships. In each group, specimens became severely extruded between days one and ten, the number of attached cells decreased, and a fiber attachment system did not develop. Tetracycline‐treated surfaces had greater numbers of attached cells at both time points compared to untreated controls. No differences were discernible relating to different tetracycline concentrations. It was concluded that tetracycline‐demineralized dentin provided a substrate that increased cell attachment; however, this enhanced response did not result in a connective tissue attachment.
Evaluation of Root‐Resected Teeth
Authors: Bühler Hans
Published: March 2012

There are only a few long‐term investigations on root‐resected teeth in the literature. This article is a 10‐year review of 28 root‐resection cases, which mainly had been used as bridge abutments. The periodontal, prosthetic, and endodontic problems were evaluated. After 10 years a total failure rate of 32% was observed. The analysis of the failure causes revealed that endodontic–not periodontal–complications were predominating. The study also includes a comparison of root‐resected teeth restored with root screws and composite cores versus those which had been restored with cast gold dowels, showing that both types of reconstruction had the same durability concerning the risk of root fractures or loss of retention.
Diplomate of the American Board of Periodontology: Is It in Your Future?
Authors: Vandersall David C.
Published: March 2012

Periodontists who become diplomates of the American Board of Periodontology do so for many reasons. The intent of this paper is to explore the motivational factors of a select group of periodontists who have become diplomates. A survey questionnaire was mailed to 129 diplomates (1980–1984) asking them the question: “What motivated you to obtain diplomatic status in the American Board of Periodontology?” The answers from 95 diplomates were as varied as the individual respondents, but the principal motive was “personal achievement.” This interaalization for the need to become a diplomate was dominant over all external influences. Calculations made since January 1979 and the comments from the participants in this study strongly suggest that additional enticements must be forthcoming to draw more periodontists into diplomate status.
Pigmentation of the Jawbones and Teeth Secondary to Minocycline Hydrochloride Therapy
Authors: Cale Anne E. , Freedman Paul D. , Lumerman Harry
Published: March 2012

Oral pigmentation due to minocycline hydrochloride (Minocin®) therapy is an unusual and infrequently reported side effect of the drug. This report describes a patient on long‐term minocycline therapy who presented with gingival pigmentation. Upon surgical exploration, the gingiva was noted to be normal in color, but the underlying bone was deeply pigmented. Via fluorescent microscopy, minocycline deposition within the alveolar bone was demonstrated.
Fibrolipoma of the Gingiva
Authors: Graham Gar S. , Brannon Robert B. , Houston Glen D.
Published: March 2012

A case of gingival fibrolipoma is described. The lesion presented as a tumor‐like mass with a broad base arising from the attached gingiva adjacent to the mandibular left first bicuspid. Microscopic evaluation of the lesion revealed an admixture of mature adipose tissue and fibrous connective tissue. Fibrolipomas are an infrequent variant of lipomas. A review of the literature indicates that a gingival location for such lesions is rare.
Root Curettage and Gingival Repair in Periodontitis
Authors: Biagini G. , Checchi L. , Miccoli M. C. , Vasi V. , Castaldini C.
Published: March 2012

Twelve patients, aged 35 to 60, having adult Periodontitis were treated with scaling and root planing performed with ultrasonic and hand sealers. Biopsies were taken, gingival crevicular fluid and clinical parameters were analyzed at different times, and the healing process was monitored. Findings showed a clear correlation between the amount of crevicular fluid and the histological inflammatory pattern, whereas no relationship between crevicular fluid and gingival pocket depth was apparent. In this study, no differences were found in the histological features of the repair process triggered by either type of sealer.
Effect of Personal Oral Hygiene on Bleeding Interdental Gingiva
Authors: Bouwsma Otis , Caton Jack , Poison Alan , Espeland Mark
Published: March 2012

A previous study demonstrated that the combination of subgingival scaling and improved oral hygiene resulted in a reduction of clinical and histological signs of interdental gingival inflammation, changes that were associated with a cessation of interdental gingival bleeding. The present study compared, histologically, the interdental tissues of bleeding sites with sites that initially bled but had been converted to nonbleeding by an oral hygiene program alone. Morphometric analysis of interdental gingiva demonstrated that conversion from bleeding to nonbleeding was associated with a significant reduction in the inflamed connective tissue component. This study showed that an oral hygiene program consisting of toothbrushing and interdental cleaning could significantly reduce interdental inflammation, and that bleeding determinations monitored the effects of this therapy.
Assessment of Stress during Periodontal Surgery with Intravenous Sedation and with Local Anesthesia Only
Authors: Shepherd Stephen R. , Sims Thomas N. , Johnson Bruce W. , Hershman Jerome M.
Published: March 2012

Ten patients with moderate to advanced periodontal disease were subjected to two similar periodontal surgical procedures. Each patient received either intravenous conscious sedation with local anesthesia or local anesthesia only. The stress‐reducing effects of a conscious sedation regimen consisting of pentobarbital, meperidine, and diazepam were evaluated in these patients. Stress was evaluated by monitoring changes in serum cortisol, human growth hormone, and vital signs. Blood samples were obtained at 15‐ to 30‐minute intervals throughout each procedure and were evaluated for serum cortisol and growth hormone. The conscious sedation group had significantly lower serum cortisol levels and lower systolic blood pressure, indicating that the patients having periodontal surgery with conscious sedation experienced reduced stress. Physiologic stability was maintained for each patient, indicating that this conscious sedation regimen can be used to reduce measurable parameters of stress that patients develop during periodontal surgery.
Testing Reliability of Plaque and Gingival Indices
Authors: Nordstrom Nancy K. , Paikoff Edward L. , Uldricks Janet , Solt Charles , Burch James , Beck Frank M.
Published: March 2012

This investigation was undertaken to compare two methods of interexaminer and intraexaminer reliability in the evaluation of Plaque and Gingival Indices prior to a study of toothbrushing. Inter‐/intraexaminer reliabilities were compared using a projected slide series consisting of 40 slides of clinical examples of gingival inflammation and plaque accumulation. Time between assessments was three weeks. Using the slide technique, intraexaminer reliability was established for: (1) Gingival Indices and (2) Plaque Indices. Interexaminer reliability was also established for Gingival Indices. Interexaminer reliability could not be established for Plaque Indices on the first assessment but was established on the postassessment. Intraexaminer reliability was also determined through clinical examinations of patients. A third clinician was used to manipulate the tissue while investigators evaluated bleeding on provocation and plaque accumulation. Significant results were established for the Gingival Indices and Plaque Indices. Results of this investigation suggest that significant inter‐/intraexaminer reliabilities may be obtained for gingival indices using the slide technique. In addition, the clinic technique appeared useful for assessing interexaminer reliability for Gingival Indices. Plaque Indices using the slide technique required more practice than those using the clinic technique.
Subcutaneous Facial Emphysema Secondary to Use of the Cavi‐Jet
Authors: Finlayson Richard S. , Stevens Fredric D.
Published: March 2012

A case of subcutaneous facial emphysema secondary to use of the Cavi‐Jet air polishing system is reported. Air pressure of the Cavi‐Jet may exceed that of other dental instruments such as the air/water syringe or air turbine handpiece. Inadvertent angulation of the nozzle tip into a severe periodontal pocket precipitated this condition, which resolved with no serious sequelae. No treatment other than prophylactic antibiotics was prescribed.
The Effect of Nicotine on the Attachment of Human Fibroblasts to Glass and Human Root Surfaces in Vitro
Authors: Raulin L. A. , McPherson J. C. , McQuade M. J. , Hanson B. S.
Published: March 2012

This study examined the effect of nicotine on fibroblast attachment to glass and nondiseased human root surfaces. Human foreskin fibroblasts (HFF) were trypsinized, suspended in RPMI 1640 medium, and incubated with autoclaved human root sections and nicotine concentrations of zero (control), 25, 50, 100, 200, or 400 ng/ml. The root sections were examined for fibroblast attachment at 24, 48, and 72 hours by light microscopy and scanning electron microscopy (SEM). Additional trypsinized HFF were incubated on glass surfaces with the same concentrations of nicotine and examined at one week by light microscopy. HFF attached and grew on glass and root surfaces at all concentrations of nicotine. Controls on glass surfaces exhibited a normal monolayer of long spindle‐shaped fibroblasts with a parallel alignment and minimal overlapping. Nicotine‐treated HFF exhibited a haphazard arrangement with cell overlapping and vacuolization of the cytoplasm. Under SEM, the controls had smooth surfaces and appeared firmly attached to the root surface via (1) microvilli and filopodia on the cell boundaries and (2) short, branched, thinto‐medium width cytoplasmic processes with microvilli and filopodia on their boundaries. Few microvilli were noted on the control cell surfaces. HFF exposed to nicotine had microvilli and filopodia on the cell surfaces and long thin and long broad cytoplasmic processes with many microvilli and filopodia that projected away from the root surface. These findings suggest that the nature of fibroblast attachment to glass and root surfaces is altered by nicotine. A similar disturbance in fibroblast attachment may occur in humans who use nicotine‐containing products, making them more susceptible to destruction of the periodontium and less responsive to new attachment after periodontal therapy.
Comparison of Cultural Methods and DNA Probe Analyses for the Detection of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, and Bacteroides intermedius in Subgingival Plaque Samples
Authors: Savitt E. D. , Strzempko M. N. , Vaccaro K. K. , Peros W. J. , French C. K.
Published: March 2012

The purpose of this study was to compare DNA probe analyses to cultural methods for detecting three periodontal pathogens, Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, and Bacteroides intermedius, in human subgingival plaque. Subgingival sites from patients diagnosed as either healthy or showing evidence of gingivitis or juvenile or adult Periodontitis were sampled using two paper points. The number of these pathogens from one paper point was determined using microbiologic media and speciated by biochemical tests. Results were then compared to bacterial numbers obtained from the other paper point using species‐specific DNA probes. In 60 samples from the disease group, DNA probe analysis demonstrated 100% effectiveness in detecting A. actinomycetemcomitans and B. intermedius and 91% effectiveness in detecting B. gingivalis at culture positive levels (≥103 cells). In addition, probe assays frequently identified these pathogens in samples that were culture negative. Probe analysis revealed a better correlation between presence of a pathogen and clinical evidence of disease on an individual patient basis. In contrast, most samples taken from sites of healthy individuals showed undetectable levels of all three pathogens as determined by both techniques. These results suggest that DNA probe technology is at least equivalent and often superior to cultural methods for detecting A actinomycetemcomitans, B. gingivalis, and B. intermedius in human subgingival plaque samples.
Presence of Periodontal Data in Patient Records of General Practitioners
Authors: McFall Walter T. , Bader James D. , Rozier R. Gary , Ramsey Dianne
Published: March 2012

It has been reported that little diagnostic information concerning periodontal conditions is entered in patient records of general practitioners, but actual rates for such chart entries are unknown. Records of regular patients, seen at least annually, were randomly selected from the offices of 36 general practitioners in two North Carolina counties. In each office 80 records were selected for audit. After adjustment, the final sample consisted of 2488 audited records. Entries noting the presence or absence of 14 diagnostic conditions were identified for the five previous years and for the patient's most recent examination. The presence of a periodontal diagnosis or periodontal treatment plan was noted. The number of radiographie sets exposed in the previous five years and the age of the most recent set were determined for complete series/panoramic films and for bitewings. Across practices, the most frequent notations (20.5% within the past five years) concerned the presence of probing depths and calculus. Gingival bleeding (13%) and plaque (12%) were noted less frequently. A periodontal diagnosis was recorded in only 16.3% of the records. Annualized rates for radiographic sets were 0.09 for complete series/panoramic films and 0.50 for bitewings. These data suggest that, except for radiographs, the majority of patient records do not contain sufficient diagnostic information to describe patients' periodontal health.