bluuebunny/crossref_metadata_2025 huggingface dataset:
Structure/Function Aspects of Actinobacillus actinomycetemcomitans Leukotoxin
Authors: Lally Edward T. , Kieba Irene R. , Golub Ellis E. , Lear James D. , Tanaka Jacqueline C.
Published: March 2012

Actinobacillus actinomycetemcomitans has been implicated as a causative organism in early‐onset periodontitis. The mechanisms by which A. actinomycetemcomitans is pathogenic are not known, but the organism produces several potential virulence factors, one of which is a leukotoxin. As a group, bacterial protein toxins are made up of structural domains which control various aspects of toxic activity, such as target cell recognition, membrane insertion, and killing. The purpose of this article is to review the structure of RTX, with special emphasis to its relation to toxin function. In addition, we will propose a model based upon other bacterial proteins whereby the water‐soluble A. actinomycetemcomitans leukotoxin is able to achieve insertion into a biological membrane. J Periodontol 1996;67:298–308.
Lymphocyte Function in Early‐Onset Periodontitis
Authors: Engel David
Published: March 2012

This is a limited review of recent research on the role of lymphocytes in earlyonset periodontitis (EOP). EOP lesions are histologically characterized by a dense infiltrate of lymphocytes. The role of lymphocytes in these lesions is unclear, but recent evidence suggests that there may be alterations in the regulatory events that govern immune responsiveness in EOP. These alterations might contribute to increased susceptibility to disease in certain individuals. Although there are no numerical abnormalities in the proportions of T cells, T‐cell subsets, or B cells in the peripheral blood of EOP subjects, there may be alterations in the T helper‐T suppressor ratio within the actual lesions, and these may affect local B‐cell proliferation and function. Antibody produced against the antigens of pathogenic bacteria in EOP has a prominent IgG2 component but is now believed to be primarily protective to the host. Peripheral blood mononuclear cells from EOP patients have been reported to exhibit a reduced autologous mixed lymphocyte reaction, and a higher‐than‐normal response to B‐cell mitogens. Whether or not these phenomena are important in progression or resolution of EOP is unknown. Locally acting cytokines such as IL‐4 may be elevated, and this may influence the nature of the response. Use of molecular techniques to test possible relationships between susceptibility to EOP and the lymphocyte response, such as evaluation of MHC Class II and TCR gene usage, promises to provide further clues as to the role of lymphoid cells in, and genetic nature of, these forms of periodontitis. J Periodontol 1996;67:332–336.
Alveolar Bone Loss in Rats Infected With a Strain of Prevotella intermedia and Fusobacterium nucleatum Isolated From a Child With Prepubertal Periodontitis
Authors: Yoshida‐Minami Ichie , Suzuki Atsuko , Kawabata Keiko , Okamoto Akiko , Nishihara Yumi , Minami Takahiro , Nagashima Shigeru , Morisaki Ichijiro , Ooshima Takashi
Published: March 2012

Prevotella intermedia and Fusobacterium nucleatum are associated with various forms of periodontal disease. The purpose of the present study was to infect the clinical isolates of these periodontopathic bacteria and to induce a significant loss of alveolar bone in specific pathogen‐free (SPF) rats in the absence of ligatures. P. intermedia YKD8 and F. nucleatum YKZ5 were isolated from a prepubertal periodontitis patient, while P. gingivalis MWB13 was from a patient with juvenile periodontitis. At first, SPF Sprague‐Dawley rats (70 days of age, male) were infected with A. viscosus NylR and subsequently superinfected with P. gingivalis MWB13, P. intermedia YKD8, or F. nucleatum YKZ5, respectively. The control group was infected with A. viscosus Ny1R alone. All rats were killed and periodontal bone levels were assessed morphometrically 135 days after the first infection with A. viscosus. P. intermedia YKD8 was recovered frequently from rats, with serum antibody levels remaining highly elevated throughout the experiment. Significant loss of alveolar bone was found in rats infected with P. intermedia YKD8, the virulence of which was equivalent to that of P. gingivalis MWB13. F. nucleatum YKZ5 also induced alveolar bone loss, but not significantly when compared with rats infected with A. viscosus Ny1R alone. J Periodontol 1997;68:12–17.
Oral Carriage of Helicobacter pylori: A Review
Authors: Madinier Isabelle M. , Fosse Thierry M. , Monteil Roger A.
Published: March 2012

Helicobacter pylori is a microaerophilic, motile bacterium, especially adapted to life in the human stomach. The presence of H. pylori in the stomach is strongly associated with chronic gastritis and ulcer disease and is a risk factor for gastric cancers. The microorganism may be transmitted orally and has been detected in dental plaque, saliva, and feces, but the hypothesis that oral microflora may be a permanent reservoir of H. pylori is still controversial. A review of the literature suggests that the recovery of H. pylori in the mouth is probably intermittent, associated with gastroesophageal reflux but not with specific oral disease. Nonetheless, the PCR identification of oral H. pylori may become helpful, particularly in cases of gastritis or ulcer relapse after antimicrobial therapy. Eradication of oral H. pylori by local medication or periodontal procedures would rely on the precise identification of its ecological niche. Within family groups, prophylactic methods should be practiced to avoid oral carriage of H. pylori. The risk of iatrogenic transmission during dental care, however, is already circumscribed by standard professional hygiene procedures. J Periodontol 1997;68:2–6.
Minocycline‐Induced Intraoral Pharmacogenic Pigmentation: Case Reports and Review of the Literature
Authors: Westbury Lawrence W. , Najera Arthur
Published: March 2012

Minocycline, a semi‐synthetic Tetracycline antibiotic, is well documented as being associated with pharmacogenic pigmentation of various tissues in humans and other mammals. The most obvious of these are skin pigmentation, but intraorally include “green” roots of erupted teeth, “black” roots of extracted teeth, a dark stain of the crowns of fully developed teeth, and “black” alveolar bone. This article presents five cases of “black” alveolar bone with photographic documentation of its progress. It also reviews the available English language literature on this phenomenon. The incidence of minocycline staining of alveolar bone is probably 2% of that population taking the drug for 2 months or longer. Presently, minocycline is most widely used in the young adult population for the treatment of acne. With the recent interest in minocycline as a palliative treatment for rheumatoid arthritis, an entirely different population could be experiencing this effect. If minocycline use becomes widespread as a treatment for rheumatoid arthritis, it is likely that more practitioners will be asked to diagnose this sometimes striking, though apparently benign, condition. Recognition of this condition will save the practitioner and the patient from unnecessary concern and surgery. J Periodontol 1997;68:84–91.
Distribution of Metallothionein in Cigarette Smokers and Non‐Smokers in Advanced Periodontitis Patients
Authors: Katsuragi Hiroaki , Hasegawa Akira , Saito Kazuko
Published: March 2012

This study evaluated the effect of smoking on periodontal tissue in periodontal patients. Gingival biopsies were taken from the flap during periodontal surgery of 33 male patients with advanced periodontal disease (22 cigarette smokers; 11 non‐smokers). Frozen sections were made immediately and used for hematoxylin‐eosin and Giemsa staining, and for detection of metallothionein (MT), a free radical scavenger. The expression and distribution of MT in these sections was studied using monoclonal antibody and immunohistochemical staining. The smokers had a large number of infiltrate cells in the gingival epithelium compared with non‐smokers. Moreover, samples from the smokers showed high levels of MT in the prickle cell layer of the epithelium. In the non‐smokers, basal and prickle cell layers of the gingival epithelium also showed detectable MT. Smokers, however, had a higher metallothionein‐positive cell ratio in the prickle cell layer as compared to non‐smokers. This increased level of MT in smokers may reflect an attempt to defend against free radicals in the gingiva of smokers. These results suggest that inflammation is much greater in periodontal tissues of cigarette smoking periodontal patients than in non‐smoking periodontal patients, and that the defense against free radicals is heightened in smokers' gingiva. J Periodontol 1997;68:1005–1009.
Histological Comparison of Early Wound Healing Following Dense Hydroxyapatite Granule Grafting and Barrier Placement in Surgically‐Created Bone Defects Neighboring Implants
Authors: Takeshita Fumitaka , Ayukawa Yasunori , Iyama Shinji , Suetsugu Tsuneo , Oishi Masamichi
Published: March 2012

The purpose of this study was to examine early wound healing following grafting of dense hydroxyapatite granules (HA granules) and barrier placement in surgicallycreated bone defects surrounding implants. Eight healthy adult dogs with an average weight of 15 kg were used in this study. Thirty‐two bone defects measuring 4 mm × 4 mm were removed with a surgical bur to form continuous bucco‐lingual bone defects and 32 implants (16 titanium [Ti]) and 16 hydroxyapatite‐coated [HA]) were then placed into the defects. Four implant groups were created: 1) grafting HA; 2) covering with an expanded polytetrafluoroethylene (ePTFE) membrane; 3) grafting HA and covering with ePTFE membrane; and 4) control (no treatment). Animals were sacrificed 28 days after surgery. Histological sections revealed large amounts of newlyformed bone in all bone defects surrounding the implants treated with ePTFE membranes alone. Fibrous encapsulation of HA granules was observed in the defects of the HA granules grafting group. In the group with grafting of HA granules and covering with ePTFE membranes, small amounts of bone tissue were observed among HA granules, but most HA granules were surrounded with fibrous tissue. Bone defects were completely filled with connective tissue in the control group. There were no differences in the histological findings between Ti and HA‐coated implants in all cases. Histomorphometric data disclosed that the presence of HA granules in the bone defects significantly arrested bone formation. Our study suggests that the grafting of dense HA into bone defects surrounding implants will result in fibrous healing during the early healing stage. J Periodontol 1997;68:924–932.
Guided Tissue Regeneration Using a Bioabsorbable Membrane in the Treatment of Human Buccal Recession. A Re‐Entry Study
Authors: Waterman Clive A.
Published: March 2012

A surgical technique involving a bioabsorbable membrane was used to treat localized buccal recession defects of between 2 and 5 mm on 17 sites in 13 patients. A conventional flap for coronal repositioning was raised consisting of a trapezoid flap with de‐epithelialization of papillae, and the root surface planed back to reduce its convexity. The polylactate membrane with internal spacer bars was placed over the root surface with its coronal edge as near to the cemento‐enamel junction (CEJ) as possible. This was held in place by a bioabsorbable retaining suture around the root, and the flap was coronally repositioned to cover the membrane. The patients were prescribed tetracycline for 2 weeks postsurgically, the sutures removed after 4 weeks, and cleaning procedures in the area reinstated after 6 weeks. Measurements were made using a custom made stent, and subjected to a Wilcoxon signed ranked analysis. These were clinical recession, clinical attachment level, probing depth, width of attached gingiva and the level of the buccal alveolar crest. The healing was monitored for a minimum of 1 year, and a surgical re‐entry procedure was performed on 11 sites. The new buccal alveolar crest position was measured. This procedure resulted in a clinical and statistically significant reduction in clinical recession of 2.4 ± 0.2 mm, a gain in attachment level of 2.7 ± 0.2 mm, a gain in root coverage of 76 ± 6% (P < 0.002), and a regeneration of buccal bone in all cases, with an average of 2.0 ± 0.1 mm (P < 0.0023). This study shows that the use of a bioabsorbable membrane will predictably and significantly increase root coverage and regenerate buccal bone when used to treat localized buccal recession defects. J Periodontol 1997;68:982–989.
Gingival Microcirculation Response to Tooth Brushing Measured by Laser Doppler Flowmetry
Authors: Perry Dorothy A. , McDowell James , Goodis Harold E.
Published: March 2012

This study quantified changes in blood flow following tooth brushing, using laser Doppler flowmetry (LDF). Twenty subjects had polysiloxane Stents fabricated with openings to permit placement of the LDF probe on the mesial papillae of 6 teeth. Probing depth, plaque index, and gingival index were recorded and subjects instructed in brushing. LDF initially recorded a 30.second baseline blood flow. The stent was removed and subjects brushed the site for either 3 or 10 seconds. The stent was repositioned and recordings again taken, followed by a control reading. The process was repeated 4 weeks later. Correlations between baseline and control readings were 0.585 (P < 0.001) at the first visit, and 0.654 (P < 0.001) at the return visit. The mean control blood flow was 156.4 perfusion units. The 3 and 10 second brushing increased the mean value 22.6 units and 21.2 units respectively (both P < 0.001). Tooth brushing for both 3 and 10 seconds significantly increased gingival blood flow in the papillary gingiva of healthy individuals. J Periodontol 1997;68:990–995.
An Investigation of Preferential Fibroblast Wound Repopulation Using a Novel In Vitro Wound Model
Authors: al‐Khateeb Taiseer , Stephens Phil , Shepherd Jonathan P. , Thomas David W.
Published: March 2012

To overcome the difficulties of studying wounding and wound repopulation in monolayer systems, a 3‐dimensional model of wound repopulation has been developed which allows the in vitro investigation of fibroblast migration in response to experimental wounding. This model was utilized to determine whether fibroblasts derived from sites which demonstrate preferential healing (child and oral mucosal fibroblasts) possessed an increased ability to repopulate experimental wounds when compared to adult dermal fibroblasts. Fibroblasts were established from specimens derived from healthy donors undergoing minor elective surgery. Standard wounds were created in fibroblast populated collagen lattices (FPCLs) which were then overlaid upon an extracellular wound matrix. Fibroblast repopulation of the wounds was studied over 12 days using light‐ and scanning electron microscopy and quantified using computerized image analysis. Wound repopulation by fibroblasts derived from child donors (n = 3) was significantly (P < 0.001) more rapid than their adult tissue‐matched counterparts (n = 3). Wound repopulation by oral mucosal fibroblasts (n = 3) was significantly greater than that exhibited by age‐matched dermal fibroblasts (n = 3; P < 0.05). These differences were not reflected in differences in DNA synthesis (P > 0.5) or cell number (P > 0.5) within similar attached FPCL systems. These findings further support the concept of a gradual transition from the fetal to adult phenotype in wound healing. The potential applications of the model are discussed. J Periodontol 1997;68:1063–1069.
Role of Psychiatric Disorders in Self‐inflicted Periodontal Injury: A Case Report
Authors: Sandhu H.S. , Sharma V. , Sidhu G.S.
Published: March 2012

Self‐inflicted or factitious injuries (FI) are not uncommon in psychiatric patients. In general, this kind of behavior is linked to secondary gain. However, the role of underlying psychiatric illness should not be overlooked. Usually, the diagnosis of factitious injury can be confirmed by a careful medical‐dental history, clinical appearance of the lesion, laboratory investigations, and response to established treatment protocol. A case is presented in which repetitive injurious behavior resulted in rapid periodontal attachment loss. The lesion responded well to conservative periodontal treatment. The role of underlying psychiatric morbidity leading to repetitive self‐injurious behavior is discussed. J Periodontol 1997;68:1136–1139.
Periodontal Management of Gingival Overgrowth in the Heart Transplant Patient: A Case Report
Authors: Khocht Ahmed , Schneider Lawrence C.
Published: March 2012

Heart transplant patients take several medications that could affect their periodontal health. Gingival overgrowth associated with cyclosporin (immunosuppressant agent) and nifedipine (calcium channel blocker) is well documented. Candidai infections often develop because of immune suppression. This report describes the clinical and histopathological changes in the gingival tissues of a heart transplant patient and their management. The gingival tissues exhibited pronounced enlargement. The gingivae were lobulated, and the surface of the lobulations was pebbly and granular. Biopsies showed lobules of fibrous connective tissue covered by stratified squamous epithelium. The outer surfaces were dotted with numerous smaller papillations. Candidai hyphae were present in the superficial layers of the epithelium. The extensive papillary lesions appear to be related to candidiasis and constitute a condition which is best designated as papillary stomatitis. Hyperplastic gingival tissues were excised, and the patient was placed on periodic maintenance. One‐year postoperative followup showed minor gingival growth. J Periodontol 1997;68:1140–1146.
Comparison of Manual and Automated Probing in an Untreated Periodontitis Population
Authors: Oringer Richard J. , Fiorellini Joseph P. , Koch Gary G. , Sharp Tonya J. , Nevins Marc L. , Davis Gordon H. , Howell T. Howard
Published: March 2012

Diagnosis of periodontal disease progression involves recording two probing attachment level measurements over an adequate time interval. A diagnostic instrument which exhibits less measurement variability allows for increased sensitivity and earlier disease detection. Traditionally, a manual probe with an occlusal stent or the cemento‐enamel junction (CEJ) as a reference landmark has been the method of choice. Automated probes that use an occlusal disk as the reference landmark have been developed as an alternative means of measure. The aim of this study was to compare the variability of these two probing methods. Four hundred eleven (411) interproximal sites in 46 untreated periodontitis patients were monitored by a single examiner over a 6‐month period. Each site was measured on a monthly basis, first with an automated probe (AP) followed by a manual probe (MP) in combination with a custom‐fabricated acrylic stent. Measurement variability of the two probing methods was also compared over a 7‐day interval. The AP measurements were significantly more variable than the MP measurements (P<0.001) when considering the variability between two passes at the same visit. Over the 6‐month period, the MP measurements demonstrated significantly more variability than the AP measurements (P<0.001). It was also noted that MP measurements exhibited more variability at sites with frequent bleeding during the 6 months of the study (P=0.006). The results of this study demonstrate that AP may have less variability of attachment level measurements over a 6‐month period and may be less influenced by local inflammatory changes. However, future comparison studies should include multiple examiners to reduce examiner bias and should alternate the probing method to reduce bias created by local tissue changes from multiple probings. J Periodontol 1997;68:1156–1162.
Oral Food Consumption and Subgingival Microorganisms: Subgingival Microbiota of Gastrostomy Tube‐Fed Children and Healthy Controls
Authors: Chen Casey , Ashimoto Atsushi , Sangsurasak Sumalee , Flynn M. Jane , Slots Jørgen
Published: March 2012

This study examined the effect of oral food consumption on the prevalence and levels of subgingival bacteria and yeasts in 20 gastrostomy tube‐fed children and 24 healthy controls. Microbial identification was carried out using anaerobic culture and 16S rRNA‐based PCR identification methods. Streptococcal and Actinomyces species were recovered from 100% and 76% of all subjects and averaged 66% and 11% of total cultivable organisms, respectively. In decreasing order of prevalence, Fusobacterium, enteric rods, Prevotella intermedia/Prevotella nigrescens, Capnocytophaga, Propionibacterium, yeasts, Actinobacillus actinomycetemcomitans, coagulase‐negative Staphylococcus, Campylobacter rectus, Bacteroides forsythus, and Porphyromonas gingivalis were detected in 48% to 2% of the study subjects. The cultivable levels of these species varied widely among subjects. PCR detection showed C. rectus and Eikenella corrodens both to occur in 93% of the study subjects and to be the most prevalent putative periodontal pathogens examined. In decreasing order of prevalence, PCR identified Treponema denticola, A. actinomycetemcomitans, P. nigrescens, P. intermedia, B. forsythus, and P. gingivalis in 38% to 21% of the subjects studied. Tube‐fed children and healthy controls exhibited similar subgingival microbial compositions. It appears from this study that oral food consumption is not a major determinant for the establishment of subgingival microbiota in children. J Periodontol 1997;68:1163–1168.
A Study of the Regional Distribution of Bone Formed Around Hydroxyapatite Implants in the Tibiae of Streptozotocin‐Induced Diabetic Rats Using Multiple Fluorescent Labeling and Confocal Laser Scanning Microscopy
Authors: Iyama Shinji , Takeshita Fumitaka , Ayukawa Yasunori , Kido Mizuho A. , Suetsugu Tsuneo , Tanaka Teruo
Published: March 2012

The present study was designed to compare the amount and regional distribution of bone formation around hydroxyapatite (HA) implants in normal (control) rats with that of animals with diabetes mellitus (DM), induced by streptozotocin 2 weeks prior to implant placement. Calcein (CAL), alizarin complexone (AL), and tetracycline (TC) were injected on the 7th, 14th, and 21st days after implantation, respectively, and the rats were sacrificed on the 28th day after implantation. Seventy‐μm undecalcified sections of the HA‐bone interface in both groups were then prepared for confocal laser scanning microscopy (CLSM) observation. In both groups, bone formation developed from the HA surface to the endosteum, periosteum, or bone marrow. In the control group, around the HA close to the endosteum and periosteum, the new bone showed an extensive lamination pattern of three color layers (CAL, AL, and TC), but in the DM group the labeling density of TC on the 21st day was low. In contrast, on the lateral part of the HA surface (away from the endosteum and periosteum), there was considerably less bone formation in the control group, and in the DM group it was almost completely suppressed. These findings indicate that bone formation around the HA was initiated from the HA surface in the control group, while in the DM group, bone formation along the lateral part of the HA away from the endosteum and periosteum was almost completely suppressed. Furthermore, it is also suggested that in the new bone along the HA close to the endosteum and periosteum, only calcification on the 21st day was depressed. J Periodontol 1997;68:1169–1175.
Correlation Between Measurements Using a New Halitosis Monitor and Organoleptic Assessment
Authors: Shimura M. , Watanabe S. , Iwakura M. , Oshikiri Y. , Kusumoto M. , Ikawa K. , Sakamoto S.
Published: March 2012

Halitosis is known as unpleasant oral odor and is a health concern among the general public. Previously, we reported on a new portable monitor with a zinc‐oxide, thin‐film, semiconductor sensor which demonstrated simplicity of handling, high reproducibility and correspondence for organoleptic assessment. The results suggested its usefulness for the diagnosis of halitosis. Using the monitor, oral air samples of 94 subjects were measured in a field survey, and the values were compared with the organoleptic rates of corresponding samples assessed by two judges. A highly significant correlation (r=0.824, P<0.01) was demonstrated between the measures obtained by the two methods. The results suggest that the monitor is useful for not only a clinical study but also a field study of halitosis. J Periodontol 1997;68:1182–1185.
Contemporary Interpretation of Probing Depth Assessments: Diagnostic and Therapeutic Implications. A Literature Review
Authors: Greenstein Gary
Published: March 2012

This paper addresses the diagnostic and therapeutic implications of increased probing depths. In general, in untreated and treated patients, when deep and shallow probing depths are compared, the data indicate that deep sites are associated with increased bleeding upon probing, elevated subgingival temperatures, higher levels of pathogens, more probing errors, a greater amount of infiltrated connective tissue, reduced ability to remove subgingival deposits with root planing, and diminished effectiveness of oral hygiene to alter the subgingival microbiota. Clinical trials demonstrate that probing depth is not a good predictor of future disease progression. However, deep sites are at greater risk of disease progression than shallow sites in untreated and treated patients. Furthermore, the deeper the probing depth, the greater the risk of future disease progression. Overall, the preponderance of evidence indicates that it is advantageous, but not always necessary, for patients to have shallow probing depths. With regards to surgical reduction of probing depths beyond that attained with non‐surgical therapy, clinicians need to consider the advantages (e.g., ease of maintenance, reduced risk of disease progression) and disadvantages (e.g., root sensitivity, cosmetic defects) of treatment procedures. Since numerous variables require consideration (e.g., response to root planing, goals of therapy, acceptable level of risk for future disease progression), treatment decisions will vary depending on the patient and the desired clinical outcome at specific sites. J Periodontol 1997;68:1194–1205.
Scanning Electron Microscopic Evaluation of the Effects of an Air‐Abrasive System on Dental Implants: A Comparative In Vitro Study Between Machined and Plasma‐Sprayed Titanium Surfaces
Authors: Chairay Jean‐Pierre , Boulekbache Habib , Jean Alain , Soyer Alain , Bouchard Philippe
Published: March 2012

An in vitro comparative study was conducted in order to evaluate the effects of an air‐abrasive system on dental implant surfaces. Eight new titanium dental implants, four standard machined implants (machined group), and four standard plasma‐sprayed implants (plasma‐sprayed group) were selected for investigation. Both neck and body surfaces of the implants were analyzed. Each pair of implants in each group was treated as follows: the spray of the air‐abrasive unit was applied to each area for 5 seconds on the first implant and 15 seconds on the second implant. A total of 24 areas were observed: 16 test implants and 8 controls. Scanning electron photomicrographs were analyzed by 3 examiners using a category rating scale (k = 0.594). The images were also computerized for texture analysis. The results indicate that a single air‐powder abrasive treatment of the dental implants selected for this study modified their exposed surfaces. After treatment, the threaded neck surface of a machined group implant was least affected, whereas the body was the most altered. In the plasma‐sprayed group, comparisons between implant surfaces showed little change. In the machined group, more change was observed in both neck and body areas. In all specimens, a 5‐second exposure to the air‐powder abrasive did not induce deep changes in the surfaces. A 15‐second exposure modified all the specimen surfaces. Further studies are needed to evaluate the effect of these changes on the biological osseointegration process. J Periodontol 1997;68:1215–1222.
Host Defensive, Immunological, and Microbiological Observations of an Early‐Onset Periodontitis Patient With Virus‐Associated Hemophagocytic Syndrome
Authors: Kono Takayuki , Takigawa Masayuki , Nishimura Fusanori , Takashiba Shogo , Nakagawa Masatsugu , Maeda Hiroshi , Arai Hideo , Nagai Atsushi , Kurihara Hidemi , Murayama Yoji
Published: March 2012

Virus‐associated hemophagocytic syndrome (VAHS) is a disorder characterized by benign generalized histiocytic proliferation and marked hemophagocytosis associated with systemic viral infection. An immunodeficiency which includes an extremely decreased leukocyte and platelet count together with abnormalities in the CD4/CD8 ratio are the most common features of VAHS. Here we report an early‐onset periodontitis (EOP) patient with VAHS from the standpoint of host‐parasite interaction to understand the effect of this systemic disorder which might possibly influence susceptibility to periodontal disease. The patient is a 16‐year‐old Japanese male clinically diagnosed as having generalized EOP with slight gingival inflammation and moderate bone loss. This patient manifested VAHS at 3 years of age, and then had an unusual 4 recurrences (at 5, 7, ll, and 14 years old). Laboratory tests conducted include: 1) complete blood analyses; 2) peripheral neutrophil functions (chemotaxis, phagocytosis, superoxide production, and adherence); 3) peripheral lymphocyte subpopulations and functions, T‐cell proliferative activity and productivity of cytokines (interleukin‐2 [IL‐2], interferon gamma [DFN‐γ], and tumor necrosis factor alpha [TNF‐α]); 4) serum cytokine levels (IL‐1β, IL‐2, soluble IL‐2 receptor [sIL‐2R], IL‐4, IL‐6, IFN‐γ, and TNF‐α; 5) serum immunoglobulin G (IgG) antibody titers against periodontopathic bacteria; 6) serological human leukocyte antigen (HLA) typing; and 7) determination of bacterial flora of the periodontal pockets. The results indicated that the patient's neutrophil Chemotaxis and random migration were below the normal range. In lymphocyte examinations, T‐cell proliferative activity, IL‐2, and IFN‐γ productivity were elevated. Serum IFN‐γ level was also significantiy higher than normal range. No specific periodontopathic bacteria were predominant in the periodontal pockets, however, the serum IgG titer against Porphyromonas gingivalis was elevated throughout the examination period. It is suggested that VAHS might be a possible risk factor for periodontal disease, and hence may serve as a model in understanding the role of host defense mechanisms in the establishment of inflammatory periodontal disease. J Periodontal 1997;68:1223–1230.
Gingival Overgrowth and Dental Alveolar Alterations: Possible Mechanisms of Cyclosporin‐Induced Tooth Migration. An Experimental Study in the Rat
Authors: Fu Earl , Nieh Shin , Wikesjö Ulf M.E. , Fu‐Gong Lin , Shen E‐Chin
Published: March 2012

The inter‐incisal distance and dimension of the interdental papilla between the mandibular incisors were examined in cyclosporin A (CSA) fed rats over 6 weeks. Rats in the test group received CSA daily in mineral oil by gastric feeding (30 mg/kg body weight); the control group received mineral oil only. The inter‐incisal distance and gingival dimensions, including bucco‐lingual width and vertical height, were assessed biweekly from alginate impressed stone models. Animals were sacrificed at the end of the study and tissue sections were obtained from the anterior region of the mandible for histopathological evaluation. Both the inter‐incisal distance and the dimension of the interdental papilla were significantly greater in CSA‐exposed animals compared to control. The significant alteration appeared earlier in the papillary dimensions than that in the interdental distance. Particular histopathological alterations of the soft and hard tissues of the periodontium were observed in CSA‐exposed animals. Within hmitations of the study, we suggest that the CSA‐induced gingival overgrowth may offer an active force contributing to observed tooth movement, however, remarkable alveolar remodeling should be considered as an undetermined factor for the movement. J Periodontol 1997;68:1231–1236.
Periodontal Regeneration by Application of Recombinant Human Bone Morphogenetic Protein‐2 to Horizontal Circumferential Defects Created by Experimental Periodontitis in Beagle Dogs
Authors: Kinoshita Atsuhiro , Oda Shigeru , Takahashi Koichiro , Yokota Shoji , Ishikawa Isao
Published: March 2012

The purpose of this study was to examine the regeneration of periodontal tissue after the application of recombinant human bone morphogenetic protein‐2 (rhBMP‐2) to horizontal circumferential defects created by experimental periodontitis. Twelve mandibular second premolars in 6 adult beagle dogs were subjected to experimental periodontal breakdown by placing silk ligatures around the teeth until the bone loss exceeded half of the root length. Flap surgery was then performed and the exposed cementum removed. The distance between the bone crest and cemento‐enamel junction (CEJ) was about 5 mm. RhBMP‐2 (40 μg/100 μ1) with a sponge‐type carrier material made of gelatin and polylactic acid polyglycolic acid copolymer was placed in the furcation area (5 mm × 5 mm × 5 mm) and around the roots (10 mm × 5 mm × 2.5 mm × 2 pieces). In the control group, the same carrier material without rhBMP‐2 was placed in the same manner. The flaps were replaced and sutured to cover these materials completely. Twelve weeks after surgery, the animals were sacrificed and serial sections were prepared in a bucco‐lingual plane. Considerable new bone formation was observed in the rhBMP‐2‐treated sites. New cementum with Sharpey's fibers was observed on the instrumented root surface. On histometric analysis, the amount of new bone, new cementum, and connective tissue attachment was significantly greater in the rhBMP‐2‐treated group (paired t test; P < 0.01). These results indicate that suitable application of rhBMP‐2 can produce considerable periodontal tissue regeneration, even in cases of horizontal circumferential defects. J Periodontol 1997;68:103–109.
Multi‐Center Comparative Evaluation of Subgingivally Delivered Sanguinarine and Doxycycline in the Treatment of Periodontitis. II. Clinical Results
Authors: Polson Alan M. , Garrett Steven , Stoller Norman H. , Bandt Carl L. , Hanes Philip J. , Killoy William J. , Southard G. Lee , Duke Susan P. , Bogle Gary C. , Drisko Connie H. , Friesen Lynn R.
Published: March 2012

The clinical safety and effectiveness of a subgingivally delivered biodegradable drug delivery system containing either 10% doxycycline hyclate (DH), 5% sanguinarium chloride (SC) or no agent (VC) was evaluated in a 9‐month multi‐center trial. The study was a randomized parallel design with 180 patients who demonstrated moderate to severe periodontitis. All patients had at least two quadrants with a minimum of four qualifying pockets ≥ 5 mm that bled on probing. Two of the qualifying pockets were required to be ≥ 7 mm. At baseline and at 4 months all qualified sites were treated with the test article administered via syringe. Probing depth reduction (PDR), attachment level gain (ALG), bleeding on probing reduction (BOP), and plaque index were determined monthly. Analysis of efficacy data from the 173 efficacy‐evaluable patients indicated that all treatments gave significant positive clinical changes from baseline at all subsequent timepoints. DH was superior to SC and VC in PDR at all timepoints (P ≤ 0.01 to 0.001) with a maximum reduction of 2.0 mm at 5 months. For ALG, DH was superior to VC at months 2, 3, 4, 5, 6, 8, and 9 (P ≤ 0.04 to 0.002) and superior to SC at months 5, 6, 7, 8, and 9 (P ≤ 0.01 to 0.001) with a maximum ALG of 1.2 mm at 6 months. For BOP reduction, DH was superior to VC at all time points (P ≤ 0.05) and to SC at months 3, 5, 6, 8, and 9 (P ≤ 0.03). For DH, the maximum ALG in deep (≥ 7 mm) pockets was 1.7 mm and PDR 2.9 mm compared to 0.8 mm and 1.6 mm, respectively for moderate (5 to 6 mm) pockets. Test articles were applied without anesthesia and no serious adverse events occurred in the trial. The results of this study indicate that 10% doxycycline hyclate delivered in a biodegradable delivery system is an effective means of reducing the clinical signs of adult periodontitis and exhibits a benign safety profile. J Periodontol 1997;68:119–126.
Inflammatory Mediator Response as a Potential Risk Marker for Periodontal Diseases in Insulin‐Dependent Diabetes Mellitus Patients
Authors: Salvi Giovanni E. , Yalda Behnaz , Collins John G. , Jones Bettye H. , Smith Frances W. , Arnold Roland R. , Offenbacher Steven
Published: March 2012

The gingival crevicular fluid (GCF) and monocytic secretion of prostaglandin E2 (PGE2) and interleukin 1β (IL‐1β) were measured in a group of 39 insulin‐dependent diabetes mellitus (IDDM) patients and 64 systemically healthy individuals. Diabetics were divided into Group A (gingivitis or mild periodontal disease) and Group B (moderate or severe periodontal disease). Diabetics had significantly higher GCF levels of both PGE2 and IL‐1β as compared to non‐diabetic controls who were matched with regard to periodontal disease severity (P < 0.00001 and P = 0.0005, respectively). Within the diabetic population, the GCF levels of these inflammatory mediators were almost 2‐fold higher in Group B as compared to Group A (P = 0.01, P = 0.006, respectively for GCF‐PGE2 and IL‐1β). Furthermore, diabetics as a group had a significantly higher monocytic PGE2 and IL‐1β production in response to various concentrations of both Escherichia coli and Porphyromonas gingivalis lipopolysaccharide (LPS) as compared to non‐diabetic patients with adult periodontitis (P = 0.0001). LPS dose‐response curves demonstrated that monocytes from Group B diabetics produced approximately 3 times more PGE2 than Group A monocytes; however, there was no significant difference in monocytic IL‐1β secretion within the IDDM patients. The levels of GCF or monocytic mediators did not correlate with age, race, or glycosylated hemoglobin (HbA1C) levels. Our data suggest that the high GCF and monocytic secretion of PGE2 and IL‐1β in IDDM patients may be a consequence of a systemic response trait and that the presence of Gram‐negative infections such as periodontal diseases may interact synergistically to yield high local levels of these mediators and a more severe periodontal condition. J Periodontol 1997;68:127–135.
The Relationship Between Clinical Periodontal Status and Insulin‐Dependent Diabetes Mellitus. Results After 5 Years
Authors: Firatli Erhan
Published: March 2012

The clinical periodontal status of 44 insulin‐dependent diabetic children and adolescents and 20 healthy control subjects was compared for a period of approximately 5 years. Fasting blood glucose, fmctosamine, and glycosylated hemoglobin (HbA1) values were determined at baseline and 5 years later. The differences in the clinical and laboratory parameters were compared during the study period. The differences between the two groups were also evaluated. The only statistically significant difference observed in the diabetic group was clinical attachment loss (CAL). The CAL was statistically significantly higher in the diabetic group compared to the controls, and a statistically significant positive correlation was observed between the duration of diabetes and CAL. Fmctosamine was also correlated with the gingival index in the diabetic group while there was no correlation in the controls. It may be concluded that diabetes modifies the clinical status of the periodontal tissues and increases clinical attachment loss. J Periodontol 1997;68:136–140.
The Thickness of Masticatory Mucosa in the Human Hard Palate and Tuberosity as Potential Donor Sites for Ridge Augmentation Procedures
Authors: Studer Stephan P. , Allen Edward P. , Rees Terry C. , Kouba Alena
Published: March 2012

The aim of the present investigation was to clinically determine the thickness of masticatory mucosa in the hard palate and tuberosity as potential donor sites for ridge augmentation procedures. In 31 periodontally healthy, fully dentate subjects the masticatory mucosa thickness was assessed by bone sounding with a periodontal probe. Eighteen standard measurement points were defined in the hard palate, located on 3 lines which ran at different distances parallel to the gingival margin. Six positions were designated on each of these 3 lines between the level of the canine and the second molar. In the tuberosity, 6 standard measurement points were defined, located on 2 lines running parallel to the gingival margin at 2 different distances from the distal aspect of the second molar. Three positions were designated on each line. The hard palate and tuberosity were anesthetized by a spray followed by carticain injection with an epinephrine vasoconstrictor of 1:100,000. Data were analyzed to determine differences in gender, between different positions, and between lines, using an analysis of variance and Wilcoxon test. The mucosa of the tuberosity was significantly thicker than in the hard palate region. Gender did not influence the thickness of masticatory mucosa, either in the hard palate or the tuberosity with the exception of the most distant line in the palate. The mucosa was thickest at the mid‐distal position of the tuberosity. In the hard palate, mucosa thickness increased with greater distances from the marginal gingiva. The mucosa over the palatal root of the maxillary first molar was significantly thinner than at all other positions in the hard palate. This represents an anatomical barrier in graft harvesting. It was concluded that two different regions may be defined for soft tissue graft harvesting from an anatomic point of view: 1) In the canine‐premolar region rather wide and shallow grafts may be harvested. This region extends distally to the first palatal molar root with a significantly thinner mucosa. 2) The tuberosity revealed a significantly more soft tissue thickness in comparison to the hard palate. This region allows the harvesting of deeper grafts, but graft size is limited by the width of keratinized tissue. J Periodontol 1997;68:145–151.
A Study of the Reliability of a No Disease Progression Conclusion
Authors: Hujoel P.P.
Published: March 2012

Concluding that the clinical attachment level at a periodontal site is stable, while in reality it is progressing at a clinically relevant rate, is an example of a falsenegative conclusion. No guidelines are currently available to evaluate the likelihood for false‐negative conclusions in periodontal clinical trials that monitor disease progression by means of clinical attachment levels. The goal of this study was to estimate the amount of linear disease progression in clinical attachment levels that cannot reliably be detected, when it is truly present. This rate is called the critical linear rate; rates equal to or below this critical linear rate cannot reliably be detected. An equation for determining the critical linear rates for various clinical situations is presented and may provide a rule‐of‐thumb guideline for the interpretation of negative conclusions. If the critical linear rate for a study is larger than what is considered a clinically relevant disease progression rate, negative conclusions should be interpreted with caution; clinically relevant disease progression might be present, but the diagnostic tools used were too insensitive to detect it. False‐negative conclusions may be important in diagnostic trials where low sensitivity can translate into lack of clinical utility. J Periodontol 1997;68:152–157.
Damping Characteristics of Teeth With Periodontal Breakdown: Correlation of Mobility Meter Values With Bone and Attachment Loss
Authors: Demirel Korkud , Gür Hasim , Meriç Hasan , Sevük Çetin
Published: March 2012

The reaction of the periodontium to a defined percussive force applied in an orofacial direction can be evaluated by a mobility meter. The elastic and viscous characteristics of the periodontium are evaluated by the device from the contact time between tapping head and the tooth, and reported as a numeric value called the PTV. In this study, the relation between PTVs and bone loss (BL), clinical attachment level (CAL), probing depth, bleeding on probing, and plaque and gingival indices were evaluated in 35 patients with moderate to advanced periodontal disease. The effects of gender, smoking, and initial periodontal therapy on PTVs were also evaluated. Repeated measures analysis of variance was used to determine whether the relationship between PTVs with CAL and BL was dependent on tooth type. Stepwise multiple linear regression was used to test which of the clinical parameters and bone loss would produce the highest predictive value with PTVs. The effects of gender and smoking on PTVs were examined by analysis of covariance. The changes in clinical parameters and PTVs before and after treatment were evaluated by repeated analysis of variance. PTVs were found to give the highest predictive value with bone loss. However, the correlation was observed to be dependent on the location of the tooth in the jaw and the tooth type. Interproximal and midpoint clinical attachment level measurements showed that PTVs correlated more strongly with the overall support, rather than the support on the direction of the percussive movement. No pronounced differences of PTVs were noted between gender. PTVs of smokers were observed to be higher than non‐smokers. There was no significant change of PTVs after the initial phase of periodontal therapy. This cross‐sectional study shows that the mobility meter evaluation was primarily related to the amount of bone loss while being significantly affected by the location of the tooth in the jaw. Factors such as severity of gingival and sulcular inflammation, oral hygiene, and gender do not seem to have an effect on PTVs. J Periodontol 1997;68:166–171.
Bacterial Adherence to Guided Tissue Regeneration Barrier Membranes Exposed to the Oral Environment
Authors: Chen Yen‐Ting , Wang Hom‐Lay , Lopatin Dennis E. , O'Neal Robert , MacNeil R. Lamont
Published: March 2012

Microbial colonization of barrier materials used in guided tissue regeneration (GTR) is known to adversely affect treatment outcomes. The purpose of this study was to compare the rate at which 11 commonly‐occurring oral bacteria species colonize three different barrier materials (collagen, expanded polytetrafluoroethylene, and polylactic acid). The study group consisted of 10 systemically healthy individuals with no history of periodontal disease and absence of antimicrobial therapy within the previous 3 months. In each patient, 4 teeth per quadrant (P1, P2, M1, M2) were selected and 3 teeth were randomly assigned as test teeth while the remaining tooth acted as a control site (i.e., natural colonization of the tooth surface). These teeth were then randomly assigned to receive one of the three barrier types (i.e., each patient received 4 barriers of each type, 1 per quadrant). A 2 × 5 mm piece of barrier material was positioned over the oral surface of the buccal marginal gingiva and secured with an external sling suture. With oral hygiene procedures suspended, one barrier of each type was collected at 1, 3, 7, and 14 days. Slot immunoblot assay demonstrated that all species types (A. actinomycetemcomitans, A. viscosus, B. melaninogenicus, F. nucleatum, P. gingivalis, P. intermedia, S. mutans, S. sanguis, Selenomonas sputigena, T. denticola, and T. vincentii) were present. Semi‐quantitative scoring (scale 0 to 3) of slot blot results and analysis by chi‐square ratio and Pearson correlation test indicated that while total bacteria adherence increased over time (P < 0.05), the 3 barrier types and the control sites did not differ in numbers or species of colonizing bacteria detected per time point. These results suggest that under these experimental conditions the barrier materials tested do not differ in bacteria adherence or antimicrobial properties. J Periodontol 1997;68:172–179.