bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Nonlymphocytic Leukemia, Monocytic Variant
Authors: Appel Billy N. , Miggantz Richard J.
Published: March 2012

This report documents a case of a patient presenting unusual oral features of one of the rarer variants of acute nonlymphocytic leukemia, a malignancy whose oral manifestations may be the first indication of the presence of an underlying blood dyscrasia. The findings at the initial appointment and the patient's progress for the following 13 months until his death are presented.

Initial suspicion of the clinical symptoms and an immediate, subsequent hospital hematology report established the diagnosis. The histologic features of a gingival biopsy taken during the oral examination were strongly suggestive of leukemia. Since the leukemias may imitate other oral conditions, especially various diseases of the periodontium, it is of paramount importance that the dental clinician recognize their clinical manifestations. As future treatment modalities improve, the dental clinician is seeing more leukemic patients in remission as well as more cases that have relapsed.
Treatment of Endodontically and Periodontally Involved Teeth
Authors: Barkhordar Rahmat A.
Published: March 2012

Treatment of endodontically and periodontally involved teeth requires accurate diagnosis to determine the primary cause. The case presented involves a deep periodontal pocket associated with a necrotic tooth. The cause was diagnosed as being primarily endodontic and regeneration of the attachment apparatus occurred after endodontic therapy.
Ultrastructural Observations on Bacterial Invasion in Cementum and Radicular Dentin of Periodontally Diseased Human Teeth
Authors: Adriaens Patrick A. , Edwards Chris A. , De Boever Jan A. , Loesche Walter J.
Published: March 2012

In this study the bacterial invasion in root cementum and radicular dentin of periodontally diseased, caries‐free human teeth was examined. In addition, structural changes in these tissues, which could be related to the bacterial invasion, were reported. Twenty‐one caries‐free human teeth with extensive periodontal attachment loss were studied by light and scanning electron microscopy. At the base of the gingival pocket, bacteria were found in the spaces between remnants of Sharpey's fibers and their point of insertion in the cementum. In teeth that had been scaled and root planed, most of the root cementum had been removed. Bacterial invasion was found in the remaining root cementum. The invasion seemed to start as a localized process, often involving only one bacterium. In other areas bacteria were present in lacunar defects in the cementum. These lacunae extended into the radicular dentin. In 11 teeth bacteria had invaded the dentinal tubules. Most bacteria were located in the outer 300 μm of the dentinal tubules, although occasionally they were found in deeper parts. In two of the nontreated teeth, bacteria were detected on the pulpal wall. No correlation was found between the presence of bacterial invasion and the absence of radicular cementum. No bacteria were found in the portion of the root located apically to the epithelial attachment. These data are in agreement with our results from cultural studies of the bacterial flora in these structures. It was also demonstrated that in spite of meticulous scaling and root planing and personal oral hygiene, bacterial plaque remained present on radicular surfaces. Both the invaded dentinal tubules and the lacunae could act as bacterial reservoirs from which recolonization of treated root surfaces occurs. From these reservoirs bacteria could also induce pulpal pathoses. Since these bacterial reservoirs are not eliminated by conventional mechanical periodontal treatment, it seems appropriate to combine mechanical periodontal therapy with the use of chemotherapeutic agents.
Detection and Distribution of Actinobacillus actinomycetemcomitans in the Primary Dentition
Authors: Alaluusua Satu , Asikainen Sirkka
Published: March 2012

The occurrence of Actinobacillus actinomycetemcomitans (A.a.) in plaque samples from the primary dentition was studied in 55 healthy Finnish children from four to seven years of age.

A.a. was isolated in seven (13%) children, four boys and three girls. A further examination of the distribution and infection level of A.a. in the oral cavity of five of the A a.‐positive children revealed that A.a. was found in 26 of 45 plaque samples (7–10 samples from each child) and in all samples obtained from the dorsum of the tongue. The individual detection rates of A.a. were 3/7, 5/10, 6/10, 6/10 and 6/8 of the dental sites examined. A.a. occurred in 9/10 of the second primary molars, 8/10 of the first primary molars, 5/10 of the cuspids, 4/8 of the upper incisors and in none of the lower incisors examined. The proportions of A.a. within the dentition had a wide range. In 58% of the A.a‐positive samples, the proportions were less than 1%, and none exceeded 10% of the flora. Gingival bleeding after sampling with floss occurred more than twice as frequently in the A.a.‐positive as in the A.a.‐negative sites (16%/42%).

The results indicate that A.a. was a rather frequent member of the oral flora in the children with primary teeth. The primary molars and the dorsum of the tongue seemed to be preferred sites for A.a. More than one site should be sampled to determine the infection level of A.a. within the dentition.
Growth and Migration of Gingival Epithelial Cells on Mineralized and Partially Demineralized Root Surfaces in an in Vitro System
Authors: Pitaru S. , Hekmati M. , Soldinger M. , Savion N.
Published: March 2012

The capacity of epithelial cells to migrate and grow from gingival explants cultured on mineralized and partially demineralized root surfaces in an in vitro system was assessed. Explants of attached gingiva were obtained from mongrel dogs, cut into rectangular pieces (1x2 mm) and cultured either on mineralized or partially demineralized cementum in a defined culture medium containing transferrin, insulin, epidermal growth factor, cortisone, high density lipoprotein and selenium. After seven days of culture, the specimens were prepared for scanning electron microscopic examination. The amount of epithelial outgrowth from each explant was assessed by measuring the distances between the four aspects of the rectangular expiant and the furthest epithelial cell located opposite to each of these aspects. The mean value obtained for epithelial outgrowth of explants grown on mineralized cementum was six times higher than that for explants cultured on partially demineralized cementum. These results indicate that partially demineralized cementum does not support epithelial growth and migration in vitro.
The Effect of Cyclosporin A (CsA) Treatment on Gingival Tissue of Patients with Behçet's Disease
Authors: Pisanty S. , Shoshan S. , Chajek T. , Maftsir G. , Sacks B. , BenEzra D.
Published: March 2012

Gingival biopsies were obtained at various intervals for a period of two years from 12 patients suffering from Behçet's disease who were under a clinical trial of cyclosporin A (CsA) treatment. The levels of nondialyzable hydroxyproline (Hypro) were determined in the medium of the cultured tissues. Histologic examinations were also performed every three months. Correlations between the CsA blood levels and the levels of nondialyzable Hypro indicated a reciprocal relationship, especially at blood levels of CsA higher than 600 ng/ml.

Histologic examination of gingival sections from CsA‐treated patients showed swelling of the epithelial cells, formation of perinuclear clear zones, widening of intercellular gaps and formation of several basal cell layers. In addition, foci of PAS‐positive material were found in both the epithelium and stroma.

It is assumed that the gingival enlargement observed in the CsA‐treated patients was not due to an increase in tissue collagen but rather to an increase in epithelium combined with an accumulation of noncollagenous extracellular matrix material.
The Gingival Effects of Dental Airpolishing as Evaluated by Scanning Electron Microscopy
Authors: Kontturi‐Närhi Vuokko , Markkanen Seppo , Markkanen Helena
Published: March 2012

An air‐powder abrasive system was tested among 20 volunteers, who had healthy gingiva or slight gingivitis, but no periodontal pockets. Impressions of randomly selected areas (n = 103) were taken before and after airpolishing and positive replicas were prepared for scanning electron microscopy (SEM). Gingival bleeding increased statistically significantly (p < 0.001) during the treatment. Also gingival erosive changes were increased when using airpolishing technique (p < 0.001). The erosive changes observed by SEM and the subjective symptoms during and after the operation positively correlated to the presence of gingival inflammation (p < 0.001). It can be concluded that also the negative aspects of the airpolishing technique should be taken into consideration, especially when operating near the gingival margin.
IgG Subclasses in Gingival Crevicular Fluid from Active versus Stable Periodontal Sites
Authors: Reinhardt Richard A. , McDonald Thomas L. , Bolton Ronald W. , DuBois Linda M. , Kaldahl Wayne B.
Published: March 2012

Since IgG subclasses are common Immunoglobulins associated with the periodontium and have different biological characteristics, these subclasses were measured in gingival crevicular fluid (GCF) from periodontally active (≥2 mm clinical attachment loss within three months of sample) versus clinically similar but stable or healthy sites. A sandwich enzyme‐linked immunosorbent assay (ELISA) using monoclonal antibodies was performed to quantitate IgG subclass and albumin concentrations in serum and interproximal GCF samples from at least one each of the three disease categories from each of 20 periodontal maintenance patients. Although much variability existed among sites, mean IgG1 (p < 0.05) and IgG4 (p < 0.01) concentrations were higher in GCF from active Periodontitis areas than stable sites, even though both had similar clinical characteristics. When IgG subclass concentrations were adjusted per mg albumin, both IgG1 and IgG4 levels in GCF from active sites were still significantly elevated over stable areas (p < 0.05). Mean adjusted concentrations in GCF were generally greater than in serum, especially for IgG4 (active site GCF:serum = 24.2:1). GCF IgG4 concentrations may be useful as an indicator of the immunopathological changes which occur in active Periodontitis.
Clinical and Laboratory Characterization of Early Onset Periodontitis
Authors: Astemborski J. A. , Boughman J. A. , Myrick P. O. , Goodman S. B. , Wooten R. K. , Agarwal S. , Vincent J. W. , Suzuki J. B.
Published: March 2012

Clinical and laboratory data were compared in 72 patients with localized Periodontitis (LP) and 103 patients with generalized Periodontitis (GP). Significantly more LP than GP cases had decreased neutrophil Chemotaxis (CTX), and were seropositive for Actinobacillus actinomycetemcomitans (Aa). Significantly, more GP cases were seropositive for Bacteroides gingivalis (Bg). All clinical indices were similar on affected teeth in LP and GP, but the attachment loss was greater on clinically unaffected teeth in GP when compared with LP. LP cases with CTX defects had a significantly lower mean age, were more often seropositive for Aa antibodies, and were more often female than LP patients with normal CTX. Significantly more GP cases with CTX defects were seropositive for Aa antibody. GP patients with normal CTX had a higher plaque index on both affected and unaffected teeth than did GP patients with a CTX defect. Our data suggest that Chemotaxis and/or specific bacteria may be contributory, but not always necessary, factors in these disorders. The overlap in clinical and laboratory profiles of LP and GP continues to cloud the distinction of these early onset forms of Periodontitis. {J Periodontol 1989;60:557–563)
Clinical Enhancement of Post‐Periodontal Surgical Therapy by a 0.12% Chlorhexidine Gluconate Mouthrinse
Authors: Sanz M. , Newman M. G. , Anderson L. , Matoska W. , Otomo—Corgel J. , Saltini C.
Published: March 2012

Previous studies have demonstrated the potential beneficial effects of post‐surgical rinsing with 0.2% Chlorhexidine. In the present investigation a new chlorhexidine formulation (Peridex) (CHx) and concentration (0.12%) was evaluated clinically to determine if similar effects could be detected from the use of the new product and treatment regimen. A double blind, randomized, placebo–controlled study was carried out in 40 patients during a 6 week period. Patients who had moderate periodontitis (AAP Class III) received osseous periodontal surgery in one quadrant. Each surgical site received periodontal dressing and patients were given a placebo or CHx mouthrinse to be used twice each day. Compared to placebo, CHx significantly reduced plaque at all examinations (54.4% reduction over placebo at 6 weeks, P < 0.05). Visible plaque (PlI > 2) in the CHx group was reduced by 99% over the placebo group at 6 weeks and at 4 weeks post‐surgical, gingival inflammation scores were significantly lower in the CHx group (17% reduction over the placebo at 4 weeks, P < 0.05). Gingival bleeding scores (GI > 2) were significantly lower in the CHx group at 4 and 6 weeks (41 % and 40% reduction over the placebo group, P < 0.05). Probing pocket depth and attachment level changes were not significantly different between both groups. Epithelialization rates and pain assessment demonstrated consistently better results in the CHx group, although differences were not statistically significant. Use of 0.12% chlorhexidine immediately following periodontal surgery, for 6 weeks, has been shown to be a clinically effective adjunct providing enhancement of the post–surgical management of periodontal surgical patients. (J Periodontol 1989;60:570–576)
Effect of 0.12% Chlorhexidine on Bacterial Recolonization Following Periodontal Surgery
Authors: Newman M. G. , Sanz M. , Nachnani S. , Saltini C. , Anderson L.
Published: March 2012

Bacterial plaque accumulation following periodontal surgery has been directly associated with delayed and altered surgical wound healing. Successful antimicrobial treatment following periodontal surgery depends upon the elimination and suppression of wound associated microorganisms. Highly effective antimicrobials should also prevent recolonization of periodontopathogens. In this investigation, the antimicrobial effect of a 0.12% Chlorhexidine gluconate mouthrinse (Peridex) on bacterial recolonization after periodontal surgery was determined. A double–blind, randomized, placebo‐controlled study was carried out on 40 patients for 6 weeks. Patients with moderate Periodontitis (AAP Class III) underwent osseous periodontal flap surgery in one quadrant. Subgingival and marginal plaque samples from the surgery area were taken prior to surgery and 2 and 6 weeks postoperatively. General descriptive bacteriological cultural analysis and assays for specific microbial populations were carried out. During the 6 weeks of mouthrinse use, patients using Chlorhexidine had significant reductions over placebo (P < 0.05) in the number of total Gram–positive facultative cocci, streptococci (85.8%); Gram–positive facultative rods, primarily Actinomyces (91.7%); Capnocytophaga (97.6%) and Gram–negative anaerobic rods (94.5%). Few black pigmented Bacteriodes or Actinobacillus actinomycetemcomitans were found prior to surgery or any time postoperatively. In the Chlorhexidine group, 6 weeks post surgery, streptococci were the predominant bacterial group in the sampled plaque. Quantitatively, the distribution of bacteria, after 2 and 6 weeks of mouthrinse use, was consistent with a young, less mature plaque. A previous study demonstrated that this plaque was associated with clinical health. (J Periodontol 1989; 60:577–581)
Prevalence of Periodontal Breakdown in Adolescents and Presence of Actinobacillus actinomycetemcomitans in Subjects With Attachment Loss
Authors: Van der Veiden U. , Abbas F. , Van Steenbergen T. J. M. , De Zoete O. J. , Hesse M. , De Ruyter C. , De Laat V. H. M. , De Graaff J.
Published: March 2012

The present investigation was carried out to study the prevalence and clinical appearance of destructive periodontal disease in a school population of 15– to 16–year old adolescents in Amsterdam. In addition the prevalence of Actinobacillus actinomycetemcomitans was studied in those subjects showing attachment loss. Attachment loss was diagnosed in 230 of the 4565 subjects participating which is about 5% of the population studied. Within this population males were more frequently affected than females (P = 0.008). Extensive periodontal destruction was found in 16 subjects (0.3%). In this group a female/ male ratio was found of 1.3:1. As a result of the epidemiological survey, 105 subjects with attachment loss volunteered for further investigation. The results showed that presence of plaque, redness and swelling of the gingiva, and bleeding on probing were general phenomena. In addition, the bleeding/plaque ratio, as determined for each subject at sites without attachment loss, increased with the severity of periodontal disease as expressed by the number of sites with attachment loss (P = 0.0038) as well as by the amount of destruction at these sites (P = 0.002). A. actinomycetemcomitans could be identified in 18 of the 105 subjects with attachment loss. Analysis showed that A. actinomycetemcomitans was more frequently isolated in subjects with moderate to severe periodontal breakdown than in subjects with mild breakdown (P < 0.02). When estimating the percentage of juvenile Periodontitis patients on the basis of the classically accepted criteria, it seems likely that between 0.1% to 0.2% of the population in Amsterdam is suffering from this disease entity. {J Periodontol 1989;60:604–610.)
Human Freeze–Dried Dura Mater Allografts as a Periodontal Biological Bandage
Authors: Zaner David J. , Yukna Raymond A. , Malinin Theodore I.
Published: March 2012

Freeze–dried dura mater allografts (FDDMA) were used as a biologic bandage covering periodontal osseous defects which were grafted with autogenous bone particles. Seven consenting adult patients having multiple one–, two–, and wide three–wall periodontal osseous defects participated in the study. Four to 6 weeks following initial preparation, all defects were treated by full thickness flap surgery, debridement of defects, root planing, intramarrow penetration as needed, and autogenous bone grafts that filled the defects. Randomly selected grafted defects in each patient were then covered with FDDMA (experimental) or by the host flap (RF) (control). Periodontal dressing and systemic tetracycline (250 mg q.i.d.) were used for 7 days. Frequent maintenance was performed until re– evaluation at 6 months postsurgically. Soft tissue results showed no significant differences in initial probing pocket depths, recession, or gain of probing attachment. There was a significantly greater amount of probing pocket depth reduction and significantly shallower residual pockets when FDDMA was used. Hard tissue findings indicated that there were no significant differences in initial defect depth, amount of crestal resorption, or amount or percent of defect fill with either treatment. There were significant differences in the percent of defect resolution and the depth of the residual defect in favor of the FDDMA treatment. None of the FDDMA sites were felt to need a secondary surgery to correct residual defects or residual pockets. This study suggests that FDDMA may be beneficial as a “biologic bandage” to cover periodontal osseous defects that were filled with autogenous bone grafts. The trends in this study suggest that FDDMA may be very useful in periodontal regeneration procedures. (J Periodontol 1989;60:617–623)
Caries on Root Surfaces Exposed Following Gingivectomy in Conventional Rats Infected With Streptococcus Sobrinus and Actinomyces Viscosus
Authors: Firestone A. R. , Graves C. N. , Feagin F. F.
Published: March 2012

To study the ability of bacteria associated with coronal caries to initiate root surface caries, a rat model was used. Root surfaces were exposed by gingivectomy in rats fed a caries–promoting diet and orally inoculated with either Actinomyces viscosus M–100, Streptococcus sobrinus (mutans) 6715, or both. A fourth group received a diet containing antibiotics. The animals were sacrificed 64 days following the gingivectomy performed on the right molar quadrants. Gingivectomy significantly increased exposed lingual root length and root caries incidence. There were no caries on non–gingivectomy root surfaces. Root surface caries incidence in the groups inoculated with A. viscosus and A. viscosus plus S. sobrinus did not differ. For both these groups, root caries incidence was significantly greater than that for the group inoculated with S. sobrinus alone. Root caries incidence in this latter group did not differ from that in the control group (J Periodontol 1989;60:624–627).
Computer–Based Thermal Imaging of Human Gingiva: Preliminary Investigation
Authors: Barnett M. L. , Gilman R. M. , Charles C. H. , Bartels L. L.
Published: March 2012

Computer–based thermal imaging techniques were used to compare the rewarming rates of normal and inflamed human gingiva following cooling. A Modified Gingival Index (MGI) score, gingival crevicular fluid (GCF) measurement, and clinical photograph were obtained from a maxillary or mandibular anterior facial region in 20 subjects, aged 25 to 44. Baseline thermograms of the marginal/papillary (M/P) and adjacent attached gingiva (AG) were recorded following an acclimatization period with the patient seated and chin resting on a positioning apparatus. The tissue was then cooled with a gentle stream of air and thermograms were recorded at 10 second intervals for 3 minutes as the tissue rewarmed. Rewarming slopes were calculated based on these thermograms. Correlation coefficients were calculated for MGI with GCF, as well as for both MGI and GCF with AG and M/P rewarming slopes. Mean baseline (SE) temperatures (°F) for AG were 75.9 (0.9), 78.0 (0.6), and 80.3 (1.3) for normal, mildly inflamed, and moderately–severely inflamed gingivae, respectively; corresponding mean (SE) temperature differences (°F) between AG and M/P were 0.5 (0.2), 0.9 (0.2), and 1.4 (0.3). Intragroup mean M/P temperatures were less than mean AG temperatures, with the mean regional differences increasing with greater severity of inflammation. Rewarming rates also increased as inflammation became more severe, with the rewarming slopes of both the AG and M/P having statistically significant correlations with the MGI and the GCF. The correlation between MGI and GCF was also statistically significant. This study suggests that computer–based thermal imaging techniques can detect both static and dynamic temperature differences between normal gingiva and gingivae with increasing severities of inflammation. This indicates the feasibility of further developing these objective noninvasive methods for use in studies of gingival pathology and in clinical trials (J Periodontol 1989;60:628–633).
The Effect of 1% Metronidazole Gel in Routine Maintenance of Persistent Furcation Involvement in Human Beings
Authors: Needleman Ian G. , Watts Trevor L. P.
Published: March 2012

The aim of this study was to test adjunctive insertion of 1% metronidazole gel into furcation areas during periodontal maintenance. Ten patients were selected with paired, contralateral, Class II or III furcation involvements that also bled on constant force probing. Bleeding on probing (BOP) and gingival crevicular fluid (GCF) were measured as experimental variables. Plaque was assessed by dark‐field microscopy (DFM). Following routine subgingival maintenance of these sites, a syringe was used to insert metronidazole or placebo gels into the furcations. Sites were re‐examined 1 and 3 months after baseline. There was little change in either BOP or GCF. Marked longitudinal changes were found by DFM for both experimental and control sites. Experimental sites were not significantly different when compared with controls at the 5% level of probability. (Journal of Periodontology, 1989;60:699–703)
Antibodies to Bacteroides gingivalis in Patients with Treated and Untreated Periodontal Disease
Authors: Murray P. A. , Burstein D. A. , Winkler J. R.
Published: March 2012

It is proposed that the development of periodontal disease is associated with rising levels of serum and gingival crevice fluid (GCF) IgG antibodies to specific organisms, while treatment of periodontal disease is associated with a decline in specific IgG antibodies. This study examined the immune response to Bacteroides gingivalis, a suspected periodontal pathogen, in serum and GCF of patients with adult Periodontitis. Three groups of subjects were studied: (1) patients with untreated adult Periodontitis, (2) patients with treated adult Periodontitis, and (3) patients with gingivitis (controls). An enzyme‐linked immunosorbent assay was employed using whole formalinized B. gingivalis (ATCC 33277) as antigen. Results showed that the untreated adult Periodontitis patients had a humoral immune response to B. gingivalis, producing significantly higher serum levels of IgG antibody to that organism than did patients with treated adult Periodontitis (p ≤ 0.01) or gingivitis (p ≤ 0.005). The untreated patients also demonstrated a local immune response to B. gingivalis in that their GCF levels of IgG antibody to that organism were also significantly higher than levels in treated adult Periodontitis patients (p ≤ 0.005) and gingivitis patients (p ≤ 0.001). These results are consistent with reports by other investigators. However, ratios of GCF antibody to serum antibody in the untreated adult Periodontitis group were not significantly higher than ratios in the other two groups. This suggests that the local immune response to B. gingivalis, as measured by GCF levels of IgG antibody to that organism, may be the result of leakage of serum into the GCF and not a site‐specific response to infection. Additionally, we have described a Western blot technique which showed that IgG antibody in serum recognizes several antigens sites of B. gingivalis.
Effects of Potassium Oxalate on Dentin Hypersensitivity in Vivo
Authors: Muzzin Kathleen Brough , Johnson Renee
Published: March 2012

This study compared 30% dipotassium Oxalate (DO) and 3% monohydrogen‐monopotassium Oxalate (MO) on the reduction of dentin hypersensitivity in vivo. Four treatments were utilized: (1) distilled water followed by 30% DO; (2) distilled water followed by 3% MO; (3) 30% DO followed by 3% MO and (4) distilled water only. Treatments were randomly assigned so that each of the 17 participants received all four treatments, one per tooth tested. Response to cold at baseline and immediately, 1 week, 2 weeks, and 4 weeks posttreatment was measured. Testing began with water at 20° C and decreased at 5° C intervals until a positive response was obtained or until 0° C was reached. No differences were found for time when compared across treatments. When treatments were compared across time, significant reductions occurred in immediate and 4 week posttreatment measurements for treatment 2. In addition, highly significant reductions occurred in 1 week and 2 week posttreatment measurements for treatment 3. Results suggest a decrease in dentin hypersensitivity following the application of 3% MO alone, and 30% DO followed by 3% MO.
Correlations Among Gingival Indices:
Authors: Lobene Ralph R. , Mankodi Suru M. , Ciancio Sebastian G. , Lamm Richard A. , Charles Christine H. , Ross Norton M.
Published: March 2012

Using an experimental gingivitis model, 99 subjects completed a 3‐week study to determine the correlations between a visual index of gingivitis, the Modified Gingival Index (MGI), and the Gingival Index (GI), the Interdental Bleeding Index (IBI), and the Papillary Bleeding Index (PBI).

Following a baseline examination consisting of the MGI and either the GI, IBI, or PBI, each subject received a full mouth scaling and rubber cup polishing to render the teeth plaque and calculus free. Subjects then rinsed twice daily for 30 seconds with 20 ml of either an active antimicrobial or control mouthrinse for 3 weeks while abstaining from all other oral hygiene.

The MGI correlated significantly with the GI, IBI, and PBI, both at baseline and at 3 weeks for all subjects.
Cotinine in Saliva and Gingival Crevicular Fluid of Smokers With Periodontal Disease
Authors: McGuire James R. , McQuade Michael J. , Rossmann Jeffrey A. , Garnick Jerry J. , Sutherland Donald E. , Scheidt Michael J. , Van Dyke Thomas E.
Published: March 2012

A study was undertaken to determine the presence of cotinine, a metabolite of nicotine, in the saliva and gingival crevicular fluid of smokers with periodontal disease. Saliva and crevicular fluid samples were obtained from 16 habitual cigarette smokers and analyzed by High Performance Liquid Chromatography (HPLC) for the presence of cotinine. Thirteen non–smokers with periodontal disease served as controls. There was no evidence of cotinine (within our detection levels) in either the saliva or crevicular fluid of any of the non–smokers. Cotinine, in a wide range of concentrations, was detected in the saliva and crevicular fluid in all of the 16 cigarette smokers. The presence of a nicotine metabolite in the saliva and gingival crevicular fluid reflects the extent of the systemic distribution of nicotine in smokers. The vasoactive properties of nicotine are well known and may possibly affect the pathogenesis of periodontal disease.
Cell and Fiber Attachment to Demineralized Cementum From Normal Root Surfaces
Authors: Hanes P. J. , Polson A. M.
Published: March 2012

The purpose of this study was to assess connective tissue and epithelial responses to cementum (from normal human root surfaces covered by periodontal ligament) after surface demineralization with citric acid. Each rectangular specimen had a face of cementum and an opposite surface composed of pulpal dentin. One half of the specimens were treated with citric acid (experimental group), while the remainder served as untreated control specimens. Specimens were implanted vertically into incisional wounds on the dorsal surface of rats with one end of the implant protruding through the skin. Four specimens in each group were available for examination 1, 3, 5, and 10 days after implantation. Histologie and histometric analyses of the implants included counts of adhering cells, evaluation of attached connective tissue fiber density and diameter, and assessment of epithelial migration. At day 1, a distinct lighter staining zone was present on the surface of both cementum and dentin in the experimental group which corresponded to a zone of surface demineralization produced by the acid treatment. Histometric comparisons between experimental and control groups at 10 days showed a greater number of cells attached to demineralized cementum surfaces. Also, a connective tissue fiber attachment system had developed on these experimental surfaces, but which differed morphologically from periodontal ligament fiber attachment to normal cementum. It was concluded that citric acid treatment can surface demineralize cementum from normal roots, and that the surface demineralization of this cementum facilitated a cell and fiber attachment to the cementum surface.
Relationship Between the Radiographic Periodontal Defect Angle and Healing After Treatment
Authors: Steffensen Bjorn , Weber Hans‐Peter
Published: March 2012

This study radio‐graphically evaluated the correlation between the changes in alveolar bone level occurring in bony defects after periodontal therapy and the corresponding pretreatment defect angles. The defect angle was defined by the bony defect surface and the root surface. The changes were determined from identically exposed and processed radiographs obtained just prior to surgery and 15 to 18 months later.

The defect angle was clearly correlated to the radiographie changes in alveolar bone level. Most defects with an angle less than 45° showed a gain of bone while defects with the largest defect angles showed a loss. In addition, defects on root surfaces without furcations showed better healing than defects associated with furcations.
Effect of Low–Protein Diet on Alveolar Bone Loss in Streptozotocin–Induced Diabetic Rats
Authors: Johnson R. B. , Thliveris J. A.
Published: March 2012

The present study demonstrated that hyperglycemic diabetic rats fed a low–protein (8%) diet maintained an alveolar bone height similar to controls; in contrast, those fed a standard protein diet (24%) had reduced alveolar bone height (P < 0.05). Euglycemic diabetic and untreated control rats fed low‐protein diets did not have significant differences in alveolar bone height compared to those fed standard protein diets. There was no evidence of gingival or periodontal inflammation or osteoclastic bone resorption at the alveolar crest in any animal studied. Thus, (1) hyperglycemic diabetic rats have significant alveolar bone loss in the absence of periodontal inflammation (P < 0.001) and (2) this bone loss can be alleviated by diet (P < 0.05). This data, taken together with previous studies on the effects of lowprotein diet on the kidney, suggest that relieving the protein load on the diabetic kidney in poorly controlled diabetics is beneficial to the longevity of that organ, as well as the preservation of alveolar bone surrounding the teeth.
Periodontitis in Sheep: A Model for Human Periodontal Disease
Authors: Ismaiel M. O. , Greenman J. , Morgan K. , Glover M. G. , Rees A. S. , Scully C.
Published: March 2012

The use of sheep as a suitable animal model of destructive forms of human periodontal disease has been assessed from comparative radiological, histological, and serological investigations of sheep with and without periodontal disease. The results showed that, in sheep with priodontitis, bone resorption, collagen breakdown, degradation of blood capillary vessel walls, cellular infiltration of plasma cells, lymphocytes, and epithelial infiltration were significantly greater than in sheep without Periodontitis, and the features are similar to those in rapidly destructive forms of periodontal disease in man. The levels of serum IgG antibody reactive against B. gingivalis antigens (measured by ELISA) were significantly higher in sheep with Periodontitis than those without, similar to the association reported in some types of human periodontal diseases. These findings suggest that Periodontitis in sheep could represent a suitable animal experimental model for certain types of rapidly destructive human periodontal diseases.
The Effect of a New Electric Toothbrush on Supragingival Plaque and Gingivitis
Authors: Baab David A. , Johnson Robert H.
Published: March 2012

This study tested the effectiveness of a rechargeable electric toothbrush, Interplak, in removing supragingival plaque and resolving gingivitis. Forty adults with gingivitis were randomly assigned to either a “manual” or “electric” group. Detailed oral hygiene instructions were given and a blind examiner assessed plaque scores before and after brushing, toothbrush abrasion, and gingival inflammation at baseline, 1, 2, and 4 weeks. Subjects using the electric brush had significantly lower (P < 0.05) mean plaque and gingival inflammation scores. The electric group's plaque scores fell from 77% at baseline to 28% (before brushing) and 14% (after brushing) at 4 weeks; the manual group's dropped from 75% to 50% and 30% (before and after brushing, respectively). The mean G.I. for the electric group fell from 1.65 at baseline to 1.28 at 4 weeks, while the manual group's scores decreased from 1.65 to 1.43. The results suggest that the electric brush removed supragingival plaque and resolved gingivitis better than the manual brush over a 28–day period. However, a telephone survey conducted 6 months later indicated that most subjects were not using the device twice a day as they had during the study.
Effectiveness of Sodium Fluoride on Tooth Hypersensitivity With and Without Iontophoresis
Authors: Kern David A. , McQuade Michael J. , Scheidt Michael J. , Hanson Benjamin , Van Dyke Thomas E.
Published: March 2012

The purpose of this study was to assess the short and long term reduction of dentinal hypersensitivity by a single application of sodium fluoride with and without iontophoresis. Two teeth in each of 16 patients were blindly evaluated before and after treatment, and at 1, 3, and 6 months. A blast of air and tactile pressure were used to assess pain. Results indicate that there is significant, immediate reduction in dentinal hypersensitivity with the use of iontophoresis that is lost with time. The use of sodium fluoride alone had no effect. Sodium fluoride with iontophoresis was demonstrated to have an immediate post treatment effect (P <.001) that lasted through the 3–month observation period. The data suggest that iontophoresis may be a useful adjunct to sensitivity therapy and that an immediate therapeutic effect may be achieved. The efficacy of the use of sodium fluoride alone is obscured by the natural reduction of root sensitivity observed with time.
Scaling and Root Planing Efficacy in Multirooted Teeth
Authors: Fleischer Howard C. , Mellonig James T. , Brayer William K. , Gray Jonathan L. , Barnett Joseph D.
Published: March 2012

The effect of operator experience level and root surface access on instrumentation of multirooted teeth was investigated. Fifty molars designated for extraction were randomly distributed among four operators of two different experience levels for scaling and root planing with or without surgical access. Following treatment the teeth were extracted and scored in a blind manner for residual calculus. Teeth were sectioned to allow assessment of the furcal aspects. Results show that operators of both experience levels obtained calculus– free root surfaces significantly more often with flap access than with a non–surgical approach. Additionally, operators with more experience achieved calculus–free root surfaces significantly more often than operators of lesser experience with both an open and closed procedure. However, when furcation aspects alone were assessed, it was found that the more experienced operators obtained a calculus–free surface only 68% of the time with an open approach. Results suggest that, although both surgical access and a more experienced operator significantly enhance calculus removal in molars with furcation invasion, total calculus removal in furcations utilizing conventional instrumentation may be limited.
Effect of Periodontal Dressings on Human Gingival Fibroblasts In vitro
Authors: Eber Robert M. , Shuler Charles F. , Buchanan William , Beck Frank M. , Horton John E.
Published: March 2012

In vitro cytotoxicity studies of periodontal dressings have not generally produced a result consistent with in vivo observations. These prior in vitro studies have not used human intraoral cell lines. We tested the effects of two eugenol containing and two non–eugenol periodontal dressings on cultured human gingival fibroblasts (HGF) (ATCC #1292). Replicate HGF cultures grown in microtiter plates were exposed to stock, 1:4 and 1:16 dilutions of extracts made from each of the four periodontal dressings. The HGF cultures were pulse labelled with tritiated thymidine (3HTdR) after 24, 48, and 72 hours. Incorporations of the labelled thymidine were measured using liquid scintillation counting and expressed as counts per minute. The results showed that undiluted extracts from all four periodontal dressings totally inhibited 3HTdR uptake (P < 0.05). The 1:4 dilution of eugenol dressings inhibited 3HTdR uptake significantly more than non–eugenol dressings (P < 0.05). Interestingly, at 72 hours the 1:16 dilution of the non–eugenol dressings caused significantly increased 3HTdR uptake which was not observed with the eugenol dressings. The present results suggest that the use of a human fibroblastic cell line for testing the effects of periodontal dressings may provide information about the relative biological effects of these dressings. Using this cell line, we have found that eugenol dressings inhibit fibroblast proliferation to a greater extent than non–eugenol dressings.
Proximal Bone Loss Adjacent to Periodontally “Hopeless” Teeth With and Without Extraction
Authors: Machtei Eli E. , Zubrey Yuval , Yehuda Amos Ben , Soskolne W. Aubrey
Published: March 2012

Extraction of teeth with severe attachment loss (“hopeless” teeth) is common practice in the dental office. Recent evidence questions the validity of this approach. The purpose of the present study was to examine the alveolar bone changes adjacent to “hopeless” teeth with and without extraction. A total of 145 teeth from 129 patients were included in this retrospective study. Teeth were defined as “hopeless” when Class III furcation involvement was present, or when alveolar bone loss exceeded 50%. Patients were pooled into two groups: A, 82 “hopeless” teeth (71 patients) that were retained throughout the experimental period, and B, 63 “hopeless” teeth (58 patients) that were extracted. The average observation period was 4 years with a minimum of 2 years. Alveolar bone changes were measured as a percentage of the anatomic root (radiographie apex‐CEJ) using a Schei ruler. Results revealed significantly greater bone loss adjacent to teeth flanking retained “hopeless” teeth, 3.12% per year, at a rate 10 times that of the 0.23% annual bone loss in teeth flanking “hopeless” teeth that were extracted (P < 0.0001). This study confirms that without periodontal treatment, the retention of teeth with severe periodontal breakdown has a negative effect on the adjacent teeth. {J Periodontol 1989;60:512–515)
Morphotypes of the Subgingival Microflora in Diabetic Adolescents in Finland
Authors: Sandholm Leena , Swanljung Outi , Rytömaa Inkeri , Kaprio Eero A. , Mäenpää Jorma
Published: March 2012

The morphotypes of the subgingival microflora from 85 12 to 18–year–old Finnish adolescents with insulin–dependent diabetes mellitus (IDDM) were studied in Gram– and Rhodes–stained smears. A comparison was made with subgingival plaque samples from paired age– and sex–matched healthy controls. Significant differences were found in the distribution of the morphotypes. The microflora in the IDDM patient group contained significantly lower proportions of Gram–positive and Gram–negative cocci and total Gram– positive bacteria and higher proportions of Gram–negative rods, fusiforms, and total Gram– negative bacteria. In the Rhodes–stained samples, the patients had more straight and curved rods and less fusiforms than the controls. The proportions of spirochetes and flagellated bacteria were almost identical in both groups. The clinical periodontal status of the subjects had been reported in a separate study. In spite of similar Plaque Index scores, the patients had more gingivitis than the controls. This finding may be explained by the distribution of morphotypes: more Gram–negative rods and total Gram–negative bacteria (periodontally more pathogenic forms) in the diabetic patients. {J Periodontol 1989;60:526–528).
Periodontal Conditions Following Treatment With Distally Extending Cantilever Bridges or Removable Partial Dentures in Elderly Patients. A 5‐Year Study
Authors: Isidor Flemming , Budtz‐Jørgensen Ejvind
Published: March 2012

The aim of the present study was to evaluate the periodontal conditions following treatment with distally extending cantilever bridges or removable partial dentures (RPDs) in elderly patients. All participants had a complete denture in the maxilla and moderateto‐advanced bone loss around the teeth present in the mandible. After undergoing periodontal treatment, 27 patients were treated with distally extending cantilever bridges and 25 patients with a RPD. During the first 2 years following prosthetic treatment, the patients were recalled twice a year and during the last 3 years once a year for oral prophylaxis and assessment of the periodontal status. The patients treated with a RPD showed higher mean Plaque and Gingival Indexes than the patients treated with cantilever bridges. No change in probing pocket depths was observed in either group, and only a small decrease in radiographic alveolar bone height was revealed. In conclusion, only minor changes in the periodontal conditions were recorded during the 5 years of observation after treatment with cantilever bridges or RPDs. J Periodontol 1990;61:21–26.
The Effectiveness of Subgingival Scaling and Root Planing I. Clinical Detection of Residual Calculus
Authors: Sherman P.R. , Hutchens L.H. , Jewson L. G. , Moriarty J.M. , Greco G. W. , McFall W. T.
Published: March 2012

This study evaluated the ability of clinicians to detect residual calculus following subgingival scaling and root planing and compared the clinical detection to the microscopic presence and surface area occupied by calculus found on teeth extracted after instrumentation. Interexaminer and intraexaminer reproducibility in clinically detecting subgingival calculus was also determined. One hundred one extracted teeth with 476 instrumented tooth surfaces were evaluated stereomicroscopically for the presence of calculus and the percent surface area with calculus was determined by computerized imaging analysis; 57% of all surfaces had residual microscopic calculus and the mean percent calculus per surface area was 3.1% (0 to 31.9%). Shallow sites had greater surface area of calculus than moderate and deep sites. The difference was not significant. The interexaminer and intraexaminer clinical agreement in detecting calculus was low. There was a high false negative response (77.4% of the surfaces with microscopic calculus were clinically scored as being free of calculus) and a low false positive response (11.8% of the surfaces microscopically free of calculus were clinically determined to have calculus). This study indicates the difficulties in clinically determining the thoroughness of subgingival instrumentation. J Periodontol 1990; 61:3‐8.
Periodontal Disease Morbidity Quantification. II. Validation of Alveolar Bone Loss Measurements and Vertical Defect Diagnosis From Digital Bite‐Wing Images
Authors: Hildebolt Charles F. , Vannier Michael W. , Shrout,‡ Michael K. , Pilgram Thomas K. , Province Michael , Vahey Edward P. , Rietz Douglas W.
Published: March 2012

Quantitative alveolar bone loss evaluation by digital processing of dental radiographs was performed. More than 20 contrast and edge enhancement techniques were applied to bite‐wing radiographs of adult molar teeth and the results subjectively evaluated. Wallis space variant image enhancement was selected as the most promising candidate for improved visualization of the cemento‐enamel junctions and alveolar crests. Seventy‐three skulls were radiographed, the films digitized, and enhancement performed on the digital images. Alveolar bone loss measurements from skulls (truth) were compared with those from the original radiographs, unprocessed digital images, and enhanced digital images. The average intraclass correlation coefficient for two observers was 0.83 for radiographs, 0.86 for digital images, and 0.91 for enhanced images. The intraclass correlation coefficient between the 2 sets of dry skull measurements made by two additional observers was 0.88. Means and 95% confidence limits were determined for differences between measurements from dry skulls and radiograph‐based images. In the worst case for measurements from enhanced images, the mean difference from truth was ‐0.40 mm with a 95% confidence interval from ‐0.54 to ‐0.25 mm. Receiver operating characteristic (ROC) analysis was used to determine the utility of radiographbased images for the diagnosis of vertical defects. The ability of two observers to diagnose vertical defects on dry skulls was also tested. All methods of vertical defect diagnosis, including the identification of vertical defects on dry skulls, had relatively low diagnostic performance. Image processing technology has considerable potential in periodontal disease studies for quantitative evaluations of alveolar bone height. The diagnosis of vertical defects using current definitions and techniques is problematic, with considerable room for improvement. J Periodontol 1990; 61:623–632.