bluuebunny/crossref_metadata_2025 huggingface dataset:
Occurrence of Porphyromonas gingivalis, Bacteroides forsythus, and Treponema denticola in Periodontally Healthy and Diseased Subjects as Determined by an ELISA Technique
Authors: Di Murro Carlo , Paolantonio Michele , Pedrazzoli Vinicio , Lopatin Dennis E. , Cattabriga Marcello
Published: March 2012

The aim of this study was to assess, by means of an ELISA technique, the occurrence of 3 putative periodontopathogens, Porphyromonas gingivalis, Bacteroides forsythus, and Treponema denticola, in 3 clinically‐defined adult periodontal conditions. Thirty systemically‐healthy subjects were selected and grouped into 3 categories according to their periodontal health: 1) 10 periodontitis subjects (PS), having moderate adult chronic periodontitis; 2) 10 untreated gingivitis subjects (UGS), exhibiting no signs of periodontal destruction but presenting with clinical signs of mild gingivitis; and, 3) 10 treated gingivitis subjects (TGS), having the same clinical status as UGS, but who received a thorough prophylaxis treatment within the past 7 to 14 days prior to the baseline examination. A total of 60 samples were collected subgingivally from the six Ramfjord teeth per subject in each group and ELISA analysis was carried out to give a semiquantitative estimate of P. gingivalis, B. forsythus, and T. denticola. The immunologic detection method suggested the presence of antigens of P. gingivalis, B. forsythus, and T. denticola in subjects from each of the 3 groups. When a global analysis for the 3 disease groups was performed at one time, statistically significant differences were found among the ELISA scores of the 3 bacterial species. For example, comparisons of the ELISA scores showed that the concentrations of P. gingivalis differed significantly when comparing TGS to UGS and PS, but not when examining UGS/PS. The ELISA scores for B. forsythus were significantly different between TGS and PS. Mean concentrations of T. denticola were significantly different when comparing PS to TGS or UGS, whereas no difference was found between the latter categories. Within the limited scope of this study, the concentration of antigens detectable from putative periodontopathogens like P. gingivalis, B. forsythus, and T. denticola differed among the 3 diseased groups, with periodontitis subjects often showing the greatest level of antigens. Thus, it is reasonable to expect that, when using sensitive immunological detection methods, antigens of suspected periodontal pathogens can be found irrespective of the individual's clinical status. However, while detectable in the periodontal sites, the concentrations of these microorganisms are most likely to be above the threshold necessary to induce clinically‐significant disease. Studies with larger sample size and standardized antigens are necessary to determine if the groups we found not to differ, were, in fact, different. J Periodontol 1997;68:18–23.
Sustained Local Delivery of Chlorhexidine in the Treatment of Periodontitis: A Multi‐Center Study
Authors: Soskolne W.A. , Heasman P.A. , Stabholz A. , Smart G.J. , Palmer M. , Flashner M. , Newman H.N.
Published: March 2012

The safety and efficacy of a degradable, subgingivally placed drag delivery system containing 2.5 mg Chlorhexidine (CHX) were evaluated in a randomized, blinded, multi‐center study of 118 patients with moderate periodontitis. A split‐mouth design was used to compare the treatment outcomes of scaling and root planing (SRP) alone with the combined use of SRP and the CHX in pockets with probing depths of 5 to 8 mm. The two maxillary quadrants were used for the two treatment arms of the study. Scaling and root planing was performed at baseline only, while the CHX was inserted both at baseline and at 3 months. Clinical and safety measurements including probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) as well as gingivitis, plaque, and staining indices were recorded at baseline, and at 1, 3, and 6 months. The average PD reduction in the CHX‐treated sites was significantly greater than in the sites receiving SRP alone at both 3 and 6 months with a mean difference of 0.42 mm (P ≥ 0.01) at 6 months. The reduction in CAL at the treated sites was greater than at the SRP sites, although the difference was statistically significant at the 6‐month visit only. An analysis of patients with initial probing depths of 7 to 8 mm (n = 56) revealed a significantly greater reduction in PD and CAL in those pockets treated with CHX compared to SRP at both 3 and 6 months. The mean differences between test and control sites at 6 months were 0.71 mm and 0.56 mm PD and CAL respectively. J Periodontol 1997;68:32–38.
The Vasculature in Chronic Adult Periodontitis: A Qualitative and Quantitative Study
Authors: Bonakdar M.P.S. , Barber P.M. , Newman H.N.
Published: March 2012

Blood vessel features in periodontal pocket soft tissues may be significant in the pathogenesis and progression of chronic periodontitis. The aim of this study was to make a quantitative histological assessment of the vasculature in soft tissue biopsies from patients with chronic adult periodontitis and patients with healthy periodontal tissues. We have also investigated changes in tissue morphology at both the histological and ultrastructural level. Twelve interdental biopsies were obtained, 6 from chronic adult periodontitis patients and 6 from healthy volunteers. The specimens were sliced, fixed in 3% glutaraldehyde, postfixed in 1% buffered osmium tetroxide, dehydrated, and embedded in araldite. One μm semithin sections were differentially stained with a dichromatic technique. The number of blood vessels (BV) for sub‐epithelial, superficial and deep connective tissue layers were then assessed. Only in the sub‐epithelial connective tissue layer was there a significant increase in the number of blood vessels (95% Confidence interval [CI]) in the chronic adult periodontitis specimens when compared to healthy specimens. The results of this study seem to indicate that a dichromatic staining technique facilitates the identification and quantification of blood vessels in epoxy resin embedded specimens at light microscope level, and that there is an increase in the number of blood vessels in the chronic adult periodontitis lesions. J Periodontol 1997;68:50–58.
Experimental Peri‐Implant Tissue Breakdown Around Hydroxyapatite‐Coated Implants
Authors: Hanisch Oliver , Cortella Carlo Alberto , Boskovic Milos M. , James Robert A. , Slots Jørgen , Wikesjö Ulf M.E.
Published: March 2012

This study monitored experimental peri‐implant tissue breakdown around hydroxyapatite (HA)‐coated titanium dental implants. Thirty‐two HA‐coated cylindrical implants, in groups of two, were bilaterally inserted in the posterior maxilla and mandible in 4 Macaca mulatta monkeys. Two months after healing‐abutment connection, a 2‐month plaque control program was initiated. Clinical and radiographic recordings and peri‐implant submucosal microbial samples were then obtained (baseline). Cotton ligatures were next placed around the healing‐abutments and plaque control measures were abandoned. Clinical and radiographic recordings were repeated at 5 and 10 months post‐baseline. Microbial samples were repeated at 10 months post‐baseline, and ligatures were removed. Clinical, radiographic, and microbial examinations were again repeated at 11 months post‐baseline. Mean modified plaque index (mPI; P < 0.01), gingival index (Gl; P < 0.01), and bleeding on probing (BOP; P < 0.05) scores increased over the plaque accumulation period. The mPI, and GI scores decreased after ligature removal (P < 0.001). Mean probing depth (PD) and clinical attachment level (AL) increased between baseline and the 5‐ and 10‐month examinations (ΔPD 3.0 mm; Δ 2.7 mm; P < 0.05). PD values were reduced following ligature removal (P < 0.05). AL values and BP scores remained unchanged. A significant negative correlation was found between induced defect depth and width of keratinized mucosa at baseline (P = 0.03). At baseline, the submucosal microbiota was dominated by coccoid cells. Following ligature placement, the microbiota included a large proportion of Gram‐negative anaerobic rods, predominantly Porphyromonas gingivalis, Bacteroides forsythus, and Fusobacterium species as well as beta‐hemolytic streptococci. Ligature removal had a limited effect on the composition of the submucosal microbiota. This non‐human primate study indicates that ligature‐enhanced plaque accumulation is a precursor of progressive peri‐implant tissue breakdown around HA‐coated implants. The associated microbiota resembles that of peri‐implantitis and destructive periodontal disease in humans. This preclinical model may be useful to study modalities aimed at arresting peri‐implant tissue breakdown and at regeneration of bone in peri‐implantitis defects. J Periodontol 1997;68:59–66.
Pathologic Migration of Anterior Teeth in Patients With Moderate to Severe Periodontitis
Authors: Towfighi Pedram P. , Brunsvold Michael A. , Storey Arthur T. , Arnold Ralph M. , Willman Donald E. , McMahan C. Alex
Published: March 2012

The purpose of this study was to determine the prevalence of pathologic migration of anterior teeth in patients with moderate to severe periodontitis. The correlation between pathologic migration of anterior teeth and attachment loss (AL) was investigated, and an attempt was made to identify the most common early form of pathologic migration. Prevalence of tooth migration was studied in a group of 343 patients with moderate to severe periodontitis before treatment. The presence of pathologic migration was determined from the chief complaint and patient awareness of tooth movement in the last 5 years. Forty‐four patients (age range 18 to 69; mean = 48.75) with 75 pairs of migrated and non‐migrated teeth were studied further to determine if there is a correlation between severity of periodontal AL and pathologic migration. Migrated teeth were compared to control contralateral teeth that did not have migration. In addition, tooth mobility of the anterior teeth on 36 of the 44 patients was measured using the mobility meter. It was anticipated that tooth mobility would follow the same pattern as AL in relation to pathologic migration. The type and severity of displacement was recorded for each tooth affected by migration. The types of pathologic migration recorded were diastema, extrusion, rotation, facial flaring, and drifting into edentulous spaces. Pathologic migration prevalence was 30.03%±2.5 (103/343 subjects). The mean AL of migrated teeth (4.79 ± 0.28 mm) was significantly greater (P < 0.0001) than control teeth (3.21 ± 0.18 mm). The numeric values (called PTV) of migrated teeth (17.6 ± 1.5) were significantly greater (P < 0.0001) than control teeth (9.4 ± 1.1). It was difficult to identify a primary form of displacement, as most patients demonstrated a combination of movements. The percentage of the 44 patients who presented with a specific type of movement was: facial flaring (90.9 ± 4.4%), diastema (88.6 ± 4.8%), rotation (72.7 ± 6.8%), extrusion (68.2 ± 7.1%), and tipping (13.6 ± 5.2%). The results of this study confirms clinical impressions that periodontal disease destruction of the attachment apparatus plays a major role in the etiology of pathologic migration. J Periodontol 1997;68:967–972.
Putative Periodontal Pathogens in Subgingival Plaque of Young Adults With and Without Early‐Onset Periodontitis
Authors: Albandar Jasim M. , Brown L. Jackson , Löe Harald
Published: March 2012

This study assessed the associations between putative periodontal pathogens and early‐onset periodontitis (EOP) in a population of 248 subjects, 13 to 19 years of age at baseline, derived from a representative sample of U.S. young adults. The subjects were selected based on the presence or absence of attachment loss at baseline. The attachment level was assessed clinically at baseline and at a 6‐year follow‐up examination, and the presence of 7 bacterial species was assessed at follow‐up using DNA probes. The individuals were classified into generalized, localized, incidental EOP, and no‐periodontitis groups based on the extent and severity of attachment loss; and classified as having rapid, moderate, slow, and no progression based on the rate of periodontal progression during the 6 preceding years. In the EOP groups there were significantly higher percentages of individuals with detectable levels of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus, and Treponema denticola. In addition, the EOP group had significantly higher levels of these 5 microorganisms compared to the no‐periodontitis group. There were also higher percentages of individuals with these species and higher levels of bacteria in the group showing disease progression than the group without progression. In a descending order of importance, P. gingivalis, T. denticola, and P. intermedia were the microorganisms significantly associated with the generalized and/or rapidly progressing disease. F. nucleatum and C. rectus were also associated with EOP, but to a lesser degree. In the present population Actinobacillus actinomycetemcomitans was not significantly associated with EOP, though it was recovered more often from subjects with localized EOP. Eikenella corrodens was present equally in subjects with and without disease. The results show that several bacterial species are associated with EOP, and that P. gingivalis and T. denticola are of particular importance and may play a significant role in the more severe and progressive forms of EOP. J Periodontol 1997;68:973–981.
Integrated Connective Tissue in Bioabsorbable Barrier Material and Periodontal Regeneration
Authors: Zucchelli G. , De Sanctis M. , Clauser C.
Published: March 2012

The objective of this study was to evaluate the relationship between integrated connective tissue (ICT), that is, the presence of connective tissue into the membrane structure, and the clinical outcome of membrane‐supported periodontal surgery. Twenty‐six systemically healthy subjects affected by chronic adult periodontitis were enrolled in the study. One tooth site per patient, associated with an angular bony defect and an attachment loss of >7 mm, was selected to be treated by means of a guided tissue regeneration procedure using a bioabsorbable membrane. Barrier material was surgically removed after 4 weeks for SEM analysis. For each treated site, the difference in clinical attachment loss, probing depth, and gingival recession between the baseline examination and follow‐up 6 months after the second surgery was calculated. Gain of attachment was statistically (P < 0.001) greater in sites with no membrane exposure when compared to sites with exposed barrier material (5.5 ± 1.0 vs. 4.0 ± 0.6), while further gingival recession was greater (3.0 ± 0.9 vs. 2.1 ± 0.5) in sites with clinically exposed membranes. The results of SEM analysis revealed that when connective tissue structures were observed on membrane surfaces, no bacteria could be detected; conversely, areas heavily colonized by bacteria did not show the presence of connective tissue. Regression analysis indicated that integrated connective tissue on the external layer of the barrier material was positively correlated with the amount of attachment gain and negatively with the amount of gingival recession. Bacterial colonization of the membrane was negatively correlated with attachment gain and positively with gingival recession. It was concluded that connective tissue integration is an important biological phenomenon in preventing membrane exposure and bacterial plaque colonization and thus in enhancing the clinical outcome following guided tissue regeneration surgery. J Periodontol 1997;68:996–1004.
Development and Characterization of a Transformed Human Periodontal Ligament Cell Line
Authors: Hoang A.M. , Chen D. , Oates T.W. , Jiang C. , Harris S.E. , Cochran D.L.
Published: March 2012

Periodontal ligament (pdl) cells are thought to be important for establishing and maintaining a stable interface between bone and teeth. In addition, PDL cells are thought to play critical roles in both the pathogenesis of periodontal disease and the regeneration of periodontal ligament tissues. The purpose of this study was to develop a continuous or stable human PDL cell line as an in vitro model for the investigation of cellular mechanisms involved in periodontal regeneration and destruction. Human PDL cells, derived from a primary cell culture, were transfected with simian virus 40 (SV40) T antigen‐containing virus with a neomycin resistance gene. The transformed cells expressed the SV40 T antigen mRNA as assayed by reverse transcription polymerase chain reaction (RT‐PCR). This cell line was also characterized for morphological changes and growth characteristics compared to primary PDL cell cultures. The transformed cells were shown to form a multilayer pattern and distinct colonies on tissue culture surfaces. However, no colony formation was found in soft agar. The transformed PDL cell line was found to have a greater rate of proliferation in 10% fetal bovine serum than primary culture, and continued to proliferate in low serum concentrations capable of producing quiescence in primary cells. Interleukin‐1β (IL1β) was shown to produce a 7‐fold elevation in collagenase (MMP‐1) mRNA levels, consistent with primary PDL cells. In addition, IL‐1β was shown to produce a decrease in alkaline Phosphatase activity in a concentration‐dependent manner. The transformed cell line has been maintained for over 30 generations of cell culture. In conclusion, a stable human PDL cell line has been established to serve as a model for future in vitro investigations into periodontal pathogenic mechanisms and to evaluate therapies directed at the regeneration of periodontal ligament. J Periodontol 1997;68:1054–1062.
Comparative In Vitro Effectiveness of Closed Root Debridement With Fine Instruments on Specific Areas of Mandibular First Molar Furcations. I. Root Trunk and Furcation Entrance
Authors: Otero‐Cagide Francisco J. , Long Barbara A.
Published: March 2012

The purpose of this study was to compare curets with a small blade to slim ultrasonic inserts on their efficacy in removing artificial deposits from the root trunk and furcation entrance areas of mandibular molars using an in vitro model simulating a clinically closed root debridement approach. The study was conducted on 100 artificial mandibular first molars (50 right side and 50 left side) with anatomical roots. Root trunks, furcation entrances, and furcation areas of each molar were colored by a coat of black model paint. The teeth were fixed in a custom acrylic model and maintained in a firm position by modified acrylic occlusal splints. The root areas were covered with a heavy rubber dam imitating gingival tissue. The model was attached to a mannequin and mounted on a dental chair. Fifty molars (25 right, 25 left) were instrumented with the experimental curets and an equivalent number of molars with the ultrasonic inserts. The instrumentation was carried out by one experienced operator, spending 4 minutes on each molar. The instrumented areas were individually analyzed to determine the percentage of deposits remaining, using a computerized imaging routine system. One‐way analysis of variance was conducted to test for differences between both types of instruments. Results revealed that the curets were significantly more efficient (P < 0.01) than the ultrasonic inserts in removing paint from both root trunks and furcation entrances. These findings should be corroborated in a clinical study to determine the potential value of the instruments tested during initial therapy or supportive care of involved mandibular furcations. J Periodontol 1997;68:1093–1097.
Comparative In Vitro Effectiveness of Closed Root Debridement With Fine Instruments on Specific Areas of Mandibular First Molar Furcations. II. Furcation Area
Authors: Otero‐Cagide Francisco J. , Long Barbara A.
Published: March 2012

The purpose of this study was to demonstrate the extent of deposits removed from within the furcation area of mandibular first molars following the use of curets with a modified blade and slim ultrasonic inserts in an in vitro model simulating a closed root debridement approach to furcation treatment. The furcation areas of 100 artificial mandibular first molars were uniformly coated with black model paint. The molars were fixed into a custom acrylic model, maintained in a firm position with modified occlusal splints, and the roots covered with a heavy rubber dam. The model was set in a mannequin and mounted on a dental chair recreating a clinical situation. Fifty molars (25 right, 25 left) were instrumented with the experimental curets and an equivalent number of molars with the ultrasonic inserts. An experienced dental hygienist completed all the instrumentation, spending 4 minutes on each molar. The molars were sectioned buccolingually from the crown apically to separate the roots, and areas in the internal surface of mesial and distal roots were analyzed to determine the percentage of deposits remaining using a computerized imaging routine system. A 2–factor analysis of variance was conducted to test for differences between both types of instruments. The curets produced furcation root surfaces with significantly less percentage of residual deposits than the ultrasonic inserts (P < 0.01). This study indicates the potential value of small bladed curets in debriding involved furcations during initial therapy and supportive periodontal therapy. The current findings should be corroborated in a clinical study. J Periodontol 1997;68:1098–1101.
Experimental Peri‐Implantitis in Consecutively Placed, Loaded Root‐Form and Plate‐Form Implants in Adult Macaca mulatta Monkeys
Authors: Fritz Michael E. , Braswell Laura D. , Koth David , Jeffcoat Marjorie , Reddy Michael , Cotsonis George
Published: March 2012

This study is part of an on‐going project describing the character of round‐ and plate‐form implants placed in a primate model. In this paper 20 loaded plate‐form and 23 root‐form implants were connected to prostheses and experimental peri‐implantitis was induced by ceasing scaling procedures and placing braided silk ligature around the implants. Twenty‐four prostheses utilizing natural teeth were studied for comparison. Clinical measurements were carried out monthly for 6 months and radiographic measurements at 3 and 6 months post‐ligature placement and cessation of scaling. Both root‐form implants and plate‐form implants showed a significant loss of crestal bone height at 3 and 6 months after ligature placement (P <.001 after 6 months). The difference in bone loss between plate‐ and root‐form implants, however, was not significant. J Periodontol 1997;68:1131–1135.
Multi‐Center Comparative Evaluation of Subgingivally Delivered Sanguinarine and Doxycycline in the Treatment of Periodontitis. I. Study Design, Procedures, and Management
Authors: Polson Alan M. , Garrett Steven , Stoller Norman H. , Bandt Carl L. , Hanes Philip J. , Killoy William J. , Harrold Charles Q. , Southard G. Lee , Duke Susan P.
Published: March 2012

The design and conduct of a 9‐month multi‐center clinical trial to evaluate the safety and efficacy of subgingivally delivered 5% sanguinarium chloride (SC) and 10% doxycycline hyelate (DH) from a biodegradable drug delivery system in the treatment of adult periodontitis is described. The 3‐group randomized study of 180 adults with moderate to severe periodontitis was a modified double‐blind parallel design. One group received DH, one group received SC, and the other group received the vehicle control (VC). Patients selected had two quadrants with a minimum of four periodontal pockets ≥ 5 mm in depth with two sites ≥ 7 mm. All qualifying sites exhibited bleeding on gentle probing. Qualifying sites were treated at baseline and again at 4 months. Clinical response was assessed by measuring attachment level, probing depth, and bleeding on probing at monthly examinations at qualifying sites and the entire dentition. The plaque index was measured monthly to verify oral hygiene status. The parallel design afforded the opportunity to distinguish between treatment effectiveness of SC, DH, and VC independent of possible crossover effects. Also the effectiveness of oral hygiene in untreated sites of the mouth could be evaluated. Finally, treatment effects in moderate (5 to 6 mm) and deep (≥ 7 mm) pockets in both treated and untreated sites could be compared. The design was capable of simulating a periodontal practice maintenance program and assessing the response according to maintenance and treatment history. Study management procedures that emphasized center examiner and therapist training and adherence to protocol and procedures to reduce variability are described. J Periodontol 1997;68:110–118.
Radiographic Measurement of Alveolar Bone Loss in the Living Rat
Authors: Reymond F. , Cimasoni G.
Published: March 2012

We describe a method which allows longitudinal measurements of alveolar bone loss in the living rat. The anesthetized animal is kept in a fixed and reproducible position and radiographs of an upper molar arch are taken with a mammograph. In a preliminary study, 4 rats were repeatedly radiographed. In the main study, 10 rats were radiographed at day 0 and after 63 days of diet known to cause periodontitis. The radiographs were enlarged and the amount of bone lost calculated by comparing the weights of the interdental areas reproduced on standard paper. In the preliminary study, the coefficient of variation (C.V.) of the average weights of paper were fairly low (4 to 9%) in the first 3 rats, and amounted to 17% in the fourth. A statistically significant average loss of bone (16%) was found in the 10 rats in the main study when comparing the weights of papers at days 0 and 63. J Periodontol 1997;68:141–144.
Effects of Hydroxyapatite Particles on Periodontal Ligament Fibroblast‐Like Cell Behavior
Authors: Alliot‐Licht B. , De Lange G.L. , Gregoire M.
Published: March 2012

Although hydroxyapatite (HA), a synthetic calcium phosphate, is used in restoring bone defects associated with periodontal diseases, its specific effect on the periodontal ligament fibroblast population during the regeneration process is unclear. To determine the cellular events occurring in the presence of HA, human periodontal ligament fibroblasts (HPLF) were isolated and maintained in culture. The specificity of the cells was evidenced by their morphology, deposition of extracellular matrix components, and alkaline Phosphatase (ALP) activity (as a marker of osteoblastic differentiation of HPLF). Phase‐contrast investigations revealed morphological alterations of cells in contact with HA particles. Transmission electron microscopy demonstrated the phagocytotic process of HPLF toward HA particles. Moreover, the presence of HA particles was significantly related to an increase in the protein synthesis activity and a decrease in the proliferation and ALP‐specific activity of HPLF. These results provide new information on the phenotypic expression of HPLF, which is comparable to that of osteoblastic cells. A subpopulation of HPLF may be influenced by the presence of HA to undergo transient dedifferentiation prior to redifferentiating into osteoblasts. This process may be important as a means by which HA acts as an osteoconductive material. This experimental study improves our understanding of the cellular processes which occur during healing and regeneration of periodontal defects after implantation of biomaterials. J Periodontol 1997;68:158–165.
Clinical Evaluation of Tetracycline HCl Conditioning in the Treatment of Gingival Recessions. A Comparative Study
Authors: Bouchard Philippe , Nilv́eus Rolf , Etienne Daniel
Published: March 2012

Thirty Class I and Class II recessions in 30 patients were treated with a modified subepithelial connective tissue graft procedure. Fifteen recessions in the test group received a tetracycline hydrochloride (50 mg/ml) root treatment for 5 minutes (TTC‐HCl group); the remaining 15 recessions composed the control group and received a citric acid root treatment for 3 minutes (CA group). Clinical assessments were taken at baseline and at 6 months. The differences between treatments were not statistically significant. In the central area of the recession, the mean percentage of root coverage was 81.7% corresponding to a mean percentage of 79.3% and 84.0% for the TTC‐HCl and the CA group, respectively. In the test group, 6 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 57.8%. In the control group, 8 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 43.6%. The mean surface area of root exposure was reduced from 11.53 mm2 and 13.30 mm2 to 0.34 mm2 and 0.29 mm2 for the TTC‐HCl group and the CA group, respectively. This reduction corresponds to a mean percentage of 97.4% root coverage for both groups. Within the limits of this study, the results indicate that tetracycline hydrochloride and citric acid root conditioning have comparable clinical effects in root coverage surgical therapy. The data also suggest that the measurement of the surface area of the recession is a more accurate criterion in the evaluation of the mean percentage of root coverage than a single central vertical linear measurement. J Periodontol 1997;68:262–269.
Abscess Formation Around a Hydroxyapatite‐Coated Implant Placed Into the Extraction Socket With Autogenous Bone Graft. A Histological Study Using Light Microscopy, Image Processing, and Confocal Laser Scanning Microscopy
Authors: Takeshita Fumitaka , Iyama Shinji , Ayukawa Yasunori , Suetsugu Tsuneo , Oishi Masamichi
Published: March 2012

The purpose of this study was to evaluate the radiologic, histologic, and histometric findings for a retrieved hydroxyapatite (HA)‐coated implant which had been placed into a fresh extraction socket with autogenous bone graft 3 months previously. A periapical radiograph disclosed a vertical bone loss around the implant cervix. Examination of histologic sections disclosed that granulation tissue including bone chips around the cervix, and newly‐formed bone tissue around the grafted bone tissue on the HA coated surface. In the confocal laser scanning microscopic findings toluidine blue‐negative bone tissue showed autofluorescence. Histometric analysis indicated that the average percent bone contact was 29.2% (ranged 26.4% to 34.1%). Suspected reasons for failure were an early exposure of the barrier membrane, its early removal, the implant placement into an infected site, inadequate antibiotic premedication, and/or poor control of infections around teeth prior to implant surgery and around implants before and after placement of barrier membrane. J Periodontol 1997;68:299–305.
Relationship Between Molar Root Fusion and Localized Periodontitis
Authors: Hou Guey‐Lin , Tsai Chi‐Cheng , Huang Jiing‐Sheng
Published: March 2012

We investigated the relationship between molar root fusion and localized periodontitis in this study. A total of 143 individuals (1,109 molars) aged 23 to 68 years were examined for the presence of molar root fusion at diseased and healthy sites. Molar root fusions were diagnosed by periapical radiographs and clinical probing. Periodontal parameters measured included probing depth (PD), clinical attachment loss (CAL), gingival index (Gl), and plaque index (PLI) around fused molars. Results indicated that the prevalence of molar root fusions in males and females was 15.2% (93/612) and 32.2% (160/497), respectively. The distribution of molars with root fusions occurs in the following order: maxillary second molars (51.8%), mandibular second molars (32.3%), maxillary first molars (5.7%), and mandibular first molars (0%). Statistically significant differences were observed between molar root fusions at healthy and diseased sites with respect to PLI, Gl, PD, and CAL. The highest prevalence of molar root fusion was observed in females. J Periodontol 1997;68:313–319.
Option‐4 Algorithm For Automated Disc Probe: Reduction in the Variance of Site‐Specific Relative Attachment Level Measurements
Authors: Breen Harry J. , Rogers Pauline A. , Slaney Roger E. , Lawless Helena C. , Austin Joahanne S. , Gillett Ian R. , Johnson Newell W.
Published: March 2012

Physical periodontal measurement is plagued by many confounders which result in aberrant values. Replicate measurements can reduce the number of aberrant values, the measurement error, and the variance of site‐specific measurements. This study aimed to reduce the variance of site‐specific measurements by using a new clinical algorithm (the Option‐4 algorithm) for an automated disk probe. A single clinician recorded full‐mouth relative attachment levels (RAL) at one visit in 32 patients (mean age 45.5 years) with moderately advanced chronic adult periodontitis. RAL was recorded over two passes at six sites per tooth (4,675 sites). The algorithm accepted the first and second pass RALs (RAL1 and RAL2) if their difference was ≤ 1 mm, otherwise a maximum of two further RALs (RAL3 and RAL4) were recorded until the difference between any two RALs was ≤ 1 mm (SAL1 and SAL2): 4,048 sites (86.6%) required two recordings, 580 sites (12.4%) required three recordings and 47 sites (1%) required four recordings. Correlation coefficients for RAL1 and RAL2 and SAL1 and SAL2 (4,675 sites) were both ≥ 0.91 (P = 0.00). Site‐specific variances were calculated for RAL1 and RAL2 and SAL1 and SAL2. The mean of the RAL1/RAL2 site‐specific variances (A) was 0.45 mm2 (range 0.00 mm2 to 35.28 mm2) whilst the mean of the SAL1/SAL2 variances (B) was 0.09 mm2 (range 0.00 mm2 to 0.5 mm2): the respective medians were 0.08 mm2 and 0.02 mm2. The study demonstrated high intra‐examiner RAL reproducibility. The Option‐4 algorithm produced an 80% reduction in the mean site‐specific variance of RAL1/RAL2 (Y) and a 75% reduction in the median site‐specific variance of RAL1/RAL2 (y = [(A − B)/A] × 100). J Periodontol 1997;68:456–466.
Increased Proliferation, Collagen, and Fibronectin Production by Hereditary Gingival Fibromatosis Fibroblasts
Authors: Tipton David A. , Howell Karen J. , Dabbous Mustafa Kh.
Published: March 2012

Hereditary gingival fibromatosis (HOF) is a fibrotic enlargement of the gingiva. HGF gingiva contains large amounts of interstitial collagen and other extracellular matrix (ECM) molecules. Increased proliferation and elevated production of the ECM molecules type I collagen and fibronectin (FN) could contribute to the clinical increased bulk of HGF gingiva. Fibroblast‐strains from HGF gingiva and normal human gingival fibroblast strains (GN) were used in this in vitro study. Fibroblast proliferation was determined by ELISA which measured the incorporation of 5‐bromo‐2′‐deoxyuridine into DNA. The results showed that HGF fibroblast strains proliferated more rapidly than GN fibroblasts (68% to 488% increase, depending on the strains) (P ≥ 0.01), the only exception being one HGF strain versus one normal strain. All HGF strains produced greater amounts of FN (measured by ELISA) than all of the normal fibroblast strains (23% to 49% increase, depending on the strain) (P ≤ 0.04). Similarly, all HGF strains made significantly greater (P ≤ 0.03) amounts of type I collagen (also measured by ELISA) than all of the normal strains (55% to 235% increase, depending on the strain). The results show that, in vitro, HGF fibroblasts display several phenotypic characteristics of activated fibroblasts: increased proliferative rates as well as increased production of FN and type I collagen, consistent with in vitro studies of fibroblasts derived from other types of fibrotic tissue. These results suggest that the increased proliferation of HGF fibroblasts and their increased production of extracellular matrix molecules such as collagen and FN may contribute to the clinical gingival enlargement characteristic of HGF. J Periodontol 1997;68:524–530.
Guided Tissue Regeneration Therapy of 203 Consecutively Treated Intrabony Defects Using a Bioabsorbable Matrix Barrier. Clinical and Radiographic Findings
Authors: Falk Hanne , Laurell Lars , Ravald Nils , Teiwik Anders , Persson Rutger
Published: March 2012

The aim of this retrospective three‐center study was to evaluate guided tissue regeneration (GTR) therapy in a clinical periodontal setting. The material consisted of 203 consecutively treated intrabony defects ≥ 4 mm in 143 patients using a bioabsorbable matrix barrier. Each center followed the same protocol for presurgical, intrasurgical, and follow up examinations. Initial therapy, surgical, and follow‐up treatments followed the routine of each center. Treatment was evaluated after 1 year by clinical assessments for probing depth (PD) reduction and clinical attachment level (CAL) gain and by bone fill from computer digitized radiographs. Initial intrabony defect depth averaged 6.3 ± 1.0 mm clinically and 5.7 ± 1.8 mm radiographically. Mean PD was reduced from 9.0 ± 1.0 mm to 3.3 ± 1.0 mm. Mean CAL gain amounted to 4.8 ± 1.5 mm corresponding to 79 ± 13% of the initial intrabony defect depth; 78% of the defects exhibited CAL gain ≥ 4 mm. Bone fill averaged 3.2 ± 1.8 mm. Together with a crestal resorption of 1.1 ± 1.4 mm this resulted in a defect resolution of 4.3 ± 1.9 mm or 72%. Forty‐seven percent (47%) of the variability in CAL gain could be explained by defect depth, defect width, early barrier exposure, and presence of plaque in the treated area. CAL gain and bone fill were positively correlated to the intrabony defect depth; i.e., the deeper the defect the more the CAL gain and bone fill. Sites with barrier exposure during the first 2 weeks of healing showed significantly less CAL gain than sites at which exposure occurred at a later stage or not at all. Presence of plaque in the treated area had a significant negative impact on both CAL gain and bone fill. It was concluded that GTR‐treatment of intrabony defects ≥ 4 mm in a periodontal specialist practice will result in clinical attachment level gain and bone fill comparable to what has been demonstrated in case studies and controlled clinical trials. The predictability to obtain CAL gain ≥ 4 mm in defects ≥ 4 mm was 78%. J Periodontol 1997;68:571–581.
A Clinical Evaluation of Guided Tissue Regeneration With a Bioabsorbable Matrix Membrane Combined With an Allograft Bone Graft. A Series of Case Reports
Authors: Harris Randall J.
Published: March 2012

The purpose of this study was to evaluate the clinical effectiveness of a surgical technique in treating periodontal defects. The technique combined tetracycline treatment of a root planed root, grafting of the osseous defect with a demineralized freezedried bone allograft combined with tetracycline and the placement of a bioabsorbable matrix membrane, made of polylactic acid softened with citric acid ester. Thirty defects were treated in 27 patients. Statistically significant changes, as a result of the surgical procedure, were observed in marginal recession (mean: 0.5 mm), probing depth reductions (mean: 5.7 mm), and attachment level gain (mean: 5.2 mm). No statistically significant difference existed between the results in the furcation and non‐furcation groups. The defects with probing depths ≥ 10 mm had a greater mean probing depth reduction (7.4 mm) and mean attachment level improvement (7.2 mm) than the defects with < 10 mm probing depths (probing depth reduction 4.5 mm and attachment level gain 3.9 mm). The proposed surgical procedure seemed to be an effective method to treat periodontal defects. J Periodontol 1997;68:598–607.
Relationship Between Serum Antibody Levels and Subgingival Colonization of Porphyromonas gingivalis in Patients With Various Types of Periodontitis
Authors: Kojima Takehisa , Yano Kazuko , Ishikawa Isao
Published: March 2012

Porphyromonas Gingivalis is considered to be an important pathogen in periodontitis. The present study investigates the relationship between serum anti‐P. gingivalis IgG antibody levels and the subgingival distribution of P. gingivalis in patients with periodontitis. We examined subgingival plaque samples from 15 patients with adult periodontitis (AP), 8 patients with early‐onset periodontitis (EOP), and 6 clinically healthy individuals. The samples were collected from periodontal pockets or gingival crevices of all remaining teeth in each subject. The total number of samples was 3,024, ranging from 76 to 120 per subject. Probing depth and bleeding at each sample site were recorded. P. gingivalis was detected using a non‐radioactive whole genomic DNA probe. Serum samples were taken from the subjects, and the serum anti‐P. gingivalis IgG antibody titer was determined by enzyme‐linked immunosorbent assay (ELISA). P. gingivalis was recovered from all AP and EOP patients, and from 3 of the 6 healthy subjects. Two significant positive correlations were observed among the subjects. The serum anti‐P. gingivalis IgG antibody titer correlated with detection frequency of P. gingivalis, and the antibody titer correlated with the amount of P. gingivalis detected. Higher levels of P. gingivalis were detected in the EOP group than in the AP group. However, no significant difference was found in the serum IgG titer levels between EOP and AP patients. These findings suggest a direct relationship between the serum anti‐P. gingivalis IgG levels and subgingival P. gingivalis colonization; however, the functional capabilities of IgG antibodies may vary among the various types of periodontitis patients. J Periodontol 1997;68:618–625.
The Relationship Between Gingivitis and the Serum Antibodies to the Microbiota Associated With Periodontal Disease in Children With Down's Syndrome
Authors: Morinushi Takanobu , Lopatin Dennis E. , Van Poperin Neal
Published: March 2012

Gingival inflammation in down's syndrome children (DS) develops earlier and is more rapid and extensive than in non‐DS children. Abnormalities in host response to the oral flora have been proposed as etiological factors of this gingival inflammation. However, the relationship between gingivitis and the host response to oral microorganisms in DS by age has not been determined. The objective of this study was to clarify this relationship. Sera were obtained from 75 DS subjects (aged 2 to 18 years) and their gingival health assessed using a modified PMA Index (M‐PMA). Antibody titers to Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Treponema denticola (Td), Fusobacterium nucleatum (Fn), Selenomonas sputigena (Sel), Actinobacillus actinomycetemcomitans (Aa), and Streptococcus mitis (Mi) were determined using the micro‐ELISA. DS subjects under 4 years old were found to have significantly more gingival inflammation than did normal children the same age. A significant positive correlation (r = 0.548, P < 0.0001) existed in the relationship between M‐PMA score and plaque score for subjects in the Gl age group (deciduous dentition). At G1, the average antibody titers to Aa, Mi, and Fn exceeded those of the normal adult reference serum pool. In addition, IgG antibody titers to Pg, Aa, Fn, Sel, and Mi correlated significantly with the M‐PMA scores in the Gl age group. There was a correlation between age (2 to 18 years) and these antibody titers. IgG antibody titers to Pg, Aa, Sel, and Mi increased significantly with increasing M‐PMA score. Furthermore, the IgG antibody titers to Pg were higher (P < 0.05) in the most extensive disease group compared to the DS no‐disease group. The IgG antibody titers to Pg at G3 (early puberty) were significantly higher when compared to G1 (preschool children). The IgM antibody titers to Aa at G3 were higher (P < 0.05) when compared to Gl. This study suggests that colonization by Aa and Fn are closely associated with the onset of gingival inflammation in DS patients under 5 years old. Colonization by Pg, Aa, Sel, and Mi in DS appears to be associated with gingivitis at puberty. J Periodontol 1997;68:626–631.
A Mucosal Irritancy Test Device for Intraoral Use in Dogs
Authors: Wirthlin M. Robert , Armitage Gary C. , Rao Suchitra , Fritzinger Bruce , Phillips Sandra , Heller Jorge
Published: March 2012

The objective of this investigation was to conduct, in dogs, a 6‐hour acute mucosal irritation study of a new bioerodible treatment. The main problem was to retain the test drug in situ without extraneous irritation from the retention device. A buccal cup was machined from acrylic with a chamber capacity of 0.025 ml and a flange that could be ligated to a tooth. Ten female retired breeder beagles, 7 to 8 years old, with naturally occurring moderate periodontitis were examined and the upper canine teeth scaled to remove plaque and calculus. One week later the buccal cups were placed at the gingival margin of the upper canine teeth and fixed in place with wire ligature passing through holes in the flange and around the tooth, engaging shallow nicks made in the enamel near the gingival margin so the wire would not slide up and down. The buccal cup was further stabilized with glass ionomer cement placed on the crown and over the outer surface of the cup. Buccal cups were loaded with test, placebo, or no ointment by technicians in a scheme to which examiners were blind. Hourly examinations were made, and after 6 hours the cups were removed and gingival mucosa scored for irritation by a previously described method. All dogs tolerated the test and retained the cups for 6 hours. There was no mucosal irritation from the empty cups. We conclude that this new device can be used successfully for testing new agents for short‐term mucosal irritancy. J Periodontol 1997;68:746–749.
Protease Profiles of Cells Isolated From Regenerative Membranes Are Associated With Clinical Outcomes
Authors: Grosso Lisa T. , Iha Darin K. , Niu Jianjie , Wakabayashi Robin C. , Johnson Paul W.
Published: March 2012

Guided tissue regeneration (GTR) is a clinical procedure used to restore the attachment apparatus of periodontally diseased teeth. Guided bone regeneration (GBR) is a similar procedure used to augment bone of edentulous ridges. Both therapies enhance the ability of regenerative cells to repopulate wounds by using expanded polytetrafluoroethylene (ePTFE) membranes to exclude gingival fibroblasts and keratinocytes from the healing site. Cells were isolated from 12 membranes used in each procedure and screened for the ability to form mineralized nodules in vitro, a property of cells with osteogenic potential. Using zymography and reverse zymography, lowpassage isolates of cells which formed nodules were examined for the expression of gelatinolytic and caseinolytic proteases as well as for proteinase inhibitors. These molecular data were then compared with clinical outcomes for each procedure. Cells isolated from regenerative membranes exhibited variable expression of 72 kDa gelatinase, fibroblast collagenase, stromelysin, tissue inhibitor of metalloproteinases (TIMP‐1), and other unidentified proteases. The greatest proportion of clinical failures was associated with GTR therapy. Cells from GTR membranes which did not exhibit gains in clinical attachment often exhibited aberrant proteinase profiles. When compared with cells from GBR procedures, most cells from GTR procedures also secreted lower amounts of TIMP‐1. The study shows that cells isolated from regenerative procedures produce degradative enzymes in vitro which may be related to the success or failure of the regenerative process in vivo. Generally, cells from unsuccessful GTR procedures produced low molecular weight gelatinases not associated with cells from successful cases. J Periodontol 1997;68:809–818.