bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Chlorhexidine Treatment of Root Surfaces on the Attachment of Human Gingival Fibroblasts In Vitro
Authors: Alleyn Charles D. , O'Neal Robert B. , Strong Scott L. , Scheidt Michael J. , Van Dyke Thomas E. , McPherson James C.
Published: March 2012

Chlorhexidine mouthrinse is a widely used adjunct in periodontal therapy due to its bactericidal effects. The effect of this agent on chronic gingivitis and wound healing following surgical therapy in animals and humans has been favorable. The re‐establishment of lost connective tissue attachment to the root surface following periodontal therapy is a desirable goal in which the ability of periodontal ligament fibroblasts to reattach to root surfaces of periodontally involved teeth is a critical event. Understanding the effect of Chlorhexidine on fibroblast attachment will provide the rationale for its use during the healing phase of periodontal surgery. For this study, impacted third molars were sectioned into 4 pieces. Groups of 10 root pieces were exposed to 0.12% Chlorhexidine or saline for 3 minutes followed by a distilled water rinse. The root pieces were incubated with human gingival fibroblasts (HGF) using standard tissue culture techniques for 1, 2, 4, 6, and 8 hours. HGF were prelabeled with 3H‐thymidine to a standard specific activity. The surface area of each root piece was determined and the attached cells quantified by using scintillation spectroscopy. The number of cells per unit area was then calculated and the data expressed as cells/mm2. The repeated measures design was statistically analyzed by repeated measures analysis of variance. There was a significant difference between the number of attached cells in the Chlorhexidine and the control groups (P < 0.001). Exposure of root surfaces to Chlorhexidine significantly inhibits subsequent fibroblast attachment which may interfere with regeneration of the periodontium. Hence, the data suggest that efforts should be made to minimize Chlorhexidine contact with the root surface with physical barriers. J Periodontol 1991; 62:434–438.
Effect of Zinc Upon Cell Attachment and Proliferation on Periodontally‐Diseased Root Surfaces
Authors: Stookey Kenneth R. , Li Yiming , Hancock E. Brady , Stookey George K.
Published: March 2012

The purpose of this study was to determine the effect of zinc ions on fibroblast attachment to periodontally‐diseased root surfaces in vitro. Extracted periodontally‐diseased teeth were treated with 0.5% ZnCl2 by iontophoresis at 0.5 mA for 2 to 6 minutes. Control groups were untreated diseased and untreated healthy teeth. Sections of the root underlying the pocket were cut from the diseased teeth. The specimens were incubated for 18 hours with L929 mouse fibroblasts, then transferred and incubated in cell‐free medium for 48 hours. Cell attachment was evaluated by cell counts and scanning electron microscopy (SEM). Root surfaces were sampled with an acid‐etch technique and zinc was measured with an atomic absorption spectrophotometer. Two samples from each group were examined for cell attachment with SEM. Data were analyzed using the appropriate statistical methods. The results showed that diseased, untreated root surfaces had significantly fewer cells attached; however, zinc iontophoresis did not significantly improve cell attachment to the diseased root surfaces. Zinc analysis showed that diseased, untreated root surfaces had a higher zinc content than healthy ones. SEM examination showed striking differences in cell attachment to healthy versus diseased root surfaces. The data indicated that zinc iontophoresis did not significantly enhance cell attachment to root surfaces of diseased teeth. J Periodontol 1991; 62:445–451.
Odontogenic Epithelial Hamartoma of the Gingiva: A Case Report
Authors: Kitano Motoo , Landini Gabriel , Urago Atsushi , Okubo Akiro , Mukai Hiroshi , Yamashita Sukehide
Published: March 2012

A rare case of odontogenic epithelial hamartoma of the gingiva in a 63‐yearold Japanese female is reported. This tumor‐like lesion probably originated from the reduced tooth‐forming tissues such as rests of dental lamina lying dormant in the gingiva after odontogenesis. The differential diagnosis of this lesion from many other odontogenic and glandular tumors is important; however, through careful clinico‐pathological examinations, it would not be a very difficult task. J Periodontol 1991; 62:452–457.
Halitosis Measurement by an Industrial Sulphide Monitor
Authors: Rosenberg Mel , Septon Idit , Eli Ilana , Bar‐Ness Ronit , Gelernter Ilana , Brenner Shmuel , Gabbay Jacob
Published: March 2012

Previous studies have established that hydrogen sulphide and mercaptans are the primary components of halitosis (bad breath). In the present investigation, we report a simple, rapid technique for measurement of halitosis‐related sulphides. The technique is based on a portable instrument generally used for environmental safety applications. Seventy‐five volunteers were measured using this technique, and the results (in peak ppb hydrogen sulphide equivalents) compared with organoleptic assessment by 7 judges. A highly significant overall correlation (r = 0.603; P<0.001) was obtained between these 2 methods. Moreover, in most cases, the organoleptic ratings of the individual judges correlated more highly with sulphide monitor values than with one another. The simplicity of the technique suggests its use in clinical studies as well as in diagnosis and treatment of patients with this complaint. J Periodontol 1991; 62:487–489.
Lipid Composition and Biosynthesis in the Gingiva of the Domestic Cat
Authors: Rabinowitz Joseph L. , Sheridan Olivia , Craig Ronald G. , Feldman Roy , Grossman Edward R , Harvey Colin E. , Haskins Mark E.
Published: March 2012

Periodontal disease in the domestic cat may assume debilitating and serious consequences; however, little is known of the biochemical composition or metabolism of feline gingiva in health or disease. In this report the chemical composition and metabolism of gingival lipids from inflamed and non‐inflamed sites is presented and compared to other species with naturally occurring periodontitis. The neutral and phospholipid composition of feline gingiva was found to be distinct from that of porcine and human. As a measure of de novo lipid synthesis, the total incorporation of 14C‐acetate into fractionated lipid components was determined and revealed an approximate 2 to 3 fold decrease in inflamed versus non‐inflamed gingiva. The decrease in 14C‐acetate incorporation appeared to result from a 2‐fold increase in free acetate pools in inflamed compared to noninflamed gingival samples, since total lipase and phospholipase activity were comparable in inflamed and non‐inflamed gingiva and total lipid composition was not changed between inflamed and non‐inflamed sites. These data are similar to those reported for periodontally involved human gingival tissue and suggest a common effect of periodontal inflammation on lipid metabolism in both species. J Periodontol 1991; 62:495–498.
Prevention of Infective Endocarditis: A Review of the Medical and Dental Literature
Authors: Barco Clark T.
Published: March 2012

This paper is a review of what is presently known about the cause and prevention of infective endocarditis. Systemic antibiotics alone are not always enough for an effective prevention of infective endocarditis. Non‐streptococcus bacteria frequently found in the periodontal pocket are now reported as causing infective endocarditis; these bacteria are not uniformly susceptible to the antibiotics recommended for prophylaxis. Animal studies indicate that periodontal disease does increase the incidence of infective endocarditis and that the number of microbes entering the blood stream may not be as important in the production of infective endocarditis as other qualities, such as the microbe's ability to adhere. Antibiotics may affect the ability of a microorganism to adhere to tissues of the heart, but this association is yet unclear and may vary with the antibiotic and species of bacteria. Reduction of inflammation of the periodontal tissues is of the utmost importance in the prevention of infective endocarditis; however, mouthrinses have a very limited effect in a periodontal pocket of more than 3 mm in depth and irrigation of a periodontal pocket may create a dangerous bacteremia. Nevertheless, in addition to systemic antibiotics, local antimicrobial agents followed by routine dental treatment and maintenance show promise as an effective means for the prevention of infective endocarditis. Future research in the prevention of infective endocarditis should include placement of antimicrobials in the periodontal pocket and systemic agents that reduce platelet adhesion. The suggestions presented in this review are only recommendations for further research and are not to be construed as a substitute for the current guidelines. J Periodontol 1991;62:510– 523.
Smoker's Melanosis. A Case Report
Authors: Brown Frederic H. , Houston Glen D.
Published: March 2012

Smoker's Melanosis is a benign pigmentation of the oral mucosa, predominantly observed on the attached anterior mandibular gingiva and interdental papillae. These macular lesions are independent of genetic factors, therapeutic medication usage, and various systemic disorders. As a group they are often seen after the third decade of life. Due to the onset in adulthood and the progressive darkening, malignant melanoma must be ruled out. A review of the literature and a case report of this interesting and unique entity is presented. J Periodontol 1991;62:524–527.
Videodensitometrical Study of the Alveolar Bone Crest in Periodontal Disease
Authors: Landini Gabriel
Published: March 2012

The relative mineral content per unit volume of bone in the alveolar bone crest was determined in 81 bone crests from 25 human autopsy cases by means of contact microradiography and videodensitometry of 100 μm thick sections. Each bone crest was divided in 4 areas: crestal, mesial, distal, and trabecular; and the relative mineral content was determined for each area. The data were analyzed statistically and it was found that the crestal area had a significantly lower mineral content than the other 3 areas. Histologically, the crestal area had a reduced number of Sharpey's fibers and it was speculated that these features lower the probability of restoring the natural crestal shape and the fiber reattachment, increasing the risk of bone loss. No correlation was found between relative mineral content and age or extent of inflammatory infiltration of the periodontal tissues. J Periodontol 1991; 62:528–534.
Microbiologic Characterization of Ligature‐Induced Peri‐Implantitis in the Microswine Model
Authors: Hickey Judson S. , O'Neal Robert B. , Scheidt Michael J. , Strong Scott L. , Turgeon David , Van Dyke Thomas E.
Published: March 2012

The purpose of this study was to evaluate the microbiologic changes associated with induction of peri‐implantitis in the microswine. A split‐mouth design was utilized. Three implants were placed in the edentulous mandibular bicuspid region of 2 microswine yielding 12 implants for evaluation. The experimental implant abutments were ligated with 4‐0 silk suture material to induce peri‐implantitis for a period of 45 days. The control implant abutments were not ligated. The control implants were scaled and cleaned at each time interval using plastic scalers. The attachment level (AL), probing depth (PD), gingival index (GI), and plaque index (PI) were measured at day 0 (baseline) and days 14 and 45. Microbiologic samples were taken from the “sulcus” with paper points at each interval and were dispersed in prereduced media; plated on selective and nonselective media; and grown under aerobic, anaerobic, and capnophilic atmospheres. A greater AL, increased PD, and higher GI and PI scores were noted among the experimental implants. The controls remained essentially unchanged. Radiographs revealed that experimental implants showed an increased amount of bone loss when compared to control. Bone loss caused the implant threads to be exposed in the experimental implants. Microbiologic studies revealed that there was a shift from Gram‐positive facultative organisms to Gram‐negative obligate anaerobes, including black pigmented Bacteroides, in experimental implants. The microbiota of the control implants remained primarily Gram‐positive facultative organisms. The microswine appears to be a suitable animal model for evaluation of osseointegrated implants. Importantly, under the experimental conditions reported, osseointegrated implants were susceptible to “periodontal” breakdown or peri‐implantitis. J Periodontol 1991; 62:548–553.
Sounding Depth Measurements: A Method for Evaluating Various Surgical Techniques
Authors: Ben‐Yehouda Amos , Machtei Eli E.
Published: March 2012

Fourteen patients undergoing periodontal treatment for moderate to severe adult‐type periodontitis were included in the study. Seven patients (a total of 210 sites) were treated with modified Widman flap surgery while the other 7 patients (the same number of sites) were treated with apically‐positioned flap surgery. The 2 modalities were compared using sounding depth measurements before and immediately after surgery. The mean sounding depth decreased from 4.89 mm to 3.42 mm in the modified Widman flap group, compared to a drop from 4.77 mm to 2.46 mm in the apicallypositioned flap group. Neither of these procedures resulted in the total eradication of all periodontal pockets. The final outcome of modified Widman flap surgery may, at times, result in zero sounding depth (placement of the flap at the crest of the bone); on the other hand, very often the flap was placed far supra‐crestally in an intended apicallypositioned flap procedure. This lack of consistency between intended and actual flap placement would suggest that studies which try to compare different treatment modalities using a flap approach should include sounding depth measurements immediately postsurgery. This is needed to assure that the intended procedure has actually been carried out. J Periodontol 1991;62:565–569.
Temperature Differences at Periodontal Sites in Health and Disease
Authors: Fedi Peter F. , Killoy William J.
Published: March 2012

The purpose of this study was to determine if a thermocouple probe was capable of detecting differences in temperatures between healthy and diseased periodontal sites. Twenty‐two patients, 11 with radiographic evidence of periodontitis and 11 without, were probed twice with the temperature probe, and twice with a conventional probe by two examiners. Two definitions of health and disease were used. Definition one was that any site probing 5 mm or a site that bled upon probing was considered diseased. Sites 4 mm and with no bleeding on probing were considered healthy. Mean temperature differences were calculated from a baseline sublingual temperature. Each arch and tooth demonstrated different temperatures with temperatures decreasing from posterior to anterior. Differences from baseline between healthy and diseased sites were consistently higher for diseased sites. For example, maxillary second molars were 0.72° C higher than baseline while the maxillary central incisors were 1.40° C higher than baseline. Mean temperature differences between healthy and diseased sites were significant (P < 0.005) for all sites. Definition two was developed since all sites 5 mm or greater and all sites which bled may not be diseased, the data were recalculated with disease including all sites ≥ 5 mm with bleeding on probing and health including all sites ≤ 3 mm without bleeding. With this definition the mean temperature difference between healthy and diseased sites was even greater. Maxillary second molars were 0.96° C higher, while maxillary central incisors were 1.76° C higher. Differences were significant (P < 0.0005) at all sites. In conclusion, the temperature probe was capable of detecting temperature differences between healthy and diseased periodontal sites and might be an effective instrument in monitoring periodontal health. J Periodontol 1992; 63:24–27.
In Vitro Platelet Serotonin Secretion and Inhibition on Variously Treated Root Surfaces
Authors: Steinberg Arnold D. , Lipowski Jeannette , LeBreton Guy
Published: March 2012

Platelet degranulation can result in the release of a variety of factors which are chemotactic, mitogenic, and angiogenic, making platelets extremely important in the regulation of the repair process. This study examines how various types of root surfaces affect platelet deposition and the release of serotonin from dense granules. In addition, experiments were performed to evaluate the effects of the cyclo‐oxygenase inhibitor, indomethacin, on platelet deposition and dense granule release. Roots from freshly extracted teeth from sites with periodontal disease (PD) and from healthy sites were sectioned and had the following surface conditions: 1) periodontal ligament present; 2) PD; 3) PD, root planed; 4) PD, root planed and demineralized; and 5) condition 4 treated with collagenase. In addition, rabbit calcaneal tendon collagen was used. All samples were incubated with platelets labeled with both 111Indium and 14C serotonin, with and without the addition of indomethacin. It was observed that the greatest number of platelets deposited on the tendon collagen. Furthermore, serotonin release occurred on all samples except PD and indomethacin partially inhibited platelet deposition on all samples except tendon collagen. Finally, indomethacin inhibited serotonin release on all surfaces. These results suggest that attachment of platelets to the root surface is facilitated by metabolism through the cyclo‐oxygenase pathway and that limited platelet deposition can occur in the absence of dense body release. J Periodontol 1992; 63:33–38.
Assessment of the Relative Cytotoxicity of Porphyromonas gingivalis Cells, Products, and Components on Human Epithelial Cell Lines
Authors: Shah H.N. , Gharbia S.E. , O'Toole C.M.
Published: March 2012

Established human cell lines derived from a transitional cell carcinoma (J82), a squamous carcinoma (SCaBER), and a normal urothelium (HCV‐29) were used to assess the relative cytotoxicity and tissue specificity of putative virulence determinants of P. gingivalis W83. Intact cells of W83 had no effect on any of the cell lines, whereas disrupted cells caused extensive cytotoxicity particularly to monolayers of HCV‐29 and J82. The purified cysteine proteinase, gingivain, caused marked disruption of the basement membrane of the SCaBER monolayers but had no cytotoxic effects. Use of the thiol‐inhibitor, 2,2′‐dipyridyl disulphide revealed that the effects observed with the vesicles and the culture supernatant were due to the presence of the cysteine proteinase. The attachment of vesicles to the SCaBER cells was evident in electron micrographs. Shortchain volatile fatty acids added in concentrations equivalent to those present in the culture supernatant had no effect on any of the cell lines tested. Culture supernatants obtained from high speed centrifugation (150,000 × g) showed no cytotoxic effects. This was in marked contrast to the supernatant obtained by lower sedimentation (18,000 × g), which damaged all monolayers tested. These results suggest that these cell lines are potentially useful for assessing putative virulence determinants of P. gingivalis and other periodontal pathogens. J Periodontol 1992;63:44–51.
Microbiological and Clinical Results of Metronidazole Plus Amoxicillin Therapy in Actinobacillus actinomycetemcomitans‐Associated Periodontitis
Authors: van Winkelhoff Arie J. , Tijhof Carolien J. , de Graaff J.
Published: March 2012

We report on the microbiological and clinical effects of mechanical debridement in combination with metronidazole plus amoxicillin therapy in 118 patients with Actinobacillus actinomycetemcomitans‐associated periodontitis. Patients were categorized into 3 groups: 28 had localized periodontitis; 50 had generalized periodontitis, and 40 had refractory periodontitis. After initial treatment and metronidazole plus amoxicillin therapy 114 of 118 (96.6%) patients had no detectable A. actinomycetemcomitans. Significant reduction in pocket probing depth and gain of clinical attachment were achieved in almost all patients. Four patients were still positive for A. actinomycetemcomitans after therapy. Metronidazole resistance (MIC > 25 μg/ml) was observed in 2 of 4 strains from these patients. Patients still positive for A. actinomycetemcomitans or Porphyromonas gingivalis showed a significant higher bleeding tendency after therapy. It was concluded that mechanical periodontal treatment in combination with the metronidazole plus amoxicillin therapy is effective for subgingival suppression of A. actinomycetemcomitans in patients with severe periodontitis. J Periodontol 1992;63:52–57.
Comparative Study of Subgingival Microbiological Sampling Techniques
Authors: Renvert S. , Wikström M. , Helmersson M. , Dahlén G. , Claffey N.
Published: March 2012

The presence of specific bacteria in subgingival plaque has been used as an indicator of active periodontal disease. The technique of subgingival sampling may conjecturally influence the identification and enumeration of microorganisms reported. In this study, paper point sampling and sealer sampling are compared. Subgingival samples using both methods were taken from three surfaces in each of 12 patients at the following time points: at each of two appointments one week apart before treatment and at each of two appointments 12 and 13 weeks following treatment. Microbiological analyses were undertaken to determine the total number of colony forming units, the proportions of suspected periodontal pathogens, and the number of spirochetes using phase contrast microscopy. Significantly higher numbers of colony forming units and spirochetes were found for paper point sampling both before and after treatment. J Periodontol 1992; 63: 797–801.
Longitudinal Monitoring for Disease Progression of Localized Juvenile Periodontitis
Authors: Kim K.J. , Kim D.K. , Chung C.P. , Son S.
Published: March 2012

The present study was performed to investigate the factors associated with disease progression in localized juvenile periodontitis (LJP) patients by longitudinal monitoring of microbiological changes. Following a 9‐month period, 9 LIP patients were divided into 2 groups based upon attachment loss, progressing and non‐progressing. Both groups received scaling, root planing, and modified Widman flaps. Clinical and microbiological data were obtained at baseline, following the observation period, and at 6 and 12 months post‐treatment. At 6 and 12 months post‐treatment significantly more cocci were persistent in the non‐progressing group than in the progressing group. Actinobacillus actinomycetemcomitans was also more frequently isolated in the progressing group than in the non‐progressing group initially and following the 9‐month observation period. Also after treatment, A. actinomycetemcomitans recolonized earlier in the progressing group than in the non‐progressing group. These studies suggest that A. actinomycetemcomitans may play a role in disease progression in LIP; however, they do not eliminate the possibility that other organisms may also play a role, since A. actinomycetemcomitans was not detected in all of the patients in whom disease progressed. J Periodontol 1992; 63:806–811.
Serum Levels of Tetracycline During Treatment With Tetracycline‐Containing Fibers
Authors: Rapley John W. , Cobb Charles M. , Killoy William J. , Williams David R.
Published: March 2012

Four adult patients with at least 8 teeth that had attachment loss of 5 to 10 mm which bled on probing were included in this study. Polymeric tetracycline (TCN) containing fibers were placed and left in the pockets for a period of 10 days. Plasma samples were collected at baseline, 1 hour, 3 hours, 3 days, and 10 days after fiber placement. The mean length of fiber used averaged 187 cm with a range of 160 to 222 cm. The maximum TCN dose per patient averaged 105 mg with a range of 91 to 126 mg producing no detectable serum level greater than 0.1 μg/ml. This level was found in 3 of the 4 subjects at 3 hours after fiber placement and in 1 subject at 3 days after fiber placement. Transient and insignificant levels of TCN became available systemically shortly after the placement of multiple fibers. The dose of TCN in each patient was well tolerated and was not associated with any serious adverse effects. J Periodontol 1992; 63:817–820.
Tissue Concentration and Localization of Tetracycline Following Site‐Specific Tetracycline Fiber Therapy
Authors: Ciando Sebastian G. , Cobb Charles M. , Leung Michael
Published: March 2012

The primary objective of this study was to evaluate the concentration and location of tetracycline hydrochloride in tissue adjacent to periodontal pockets treated with a tetracycline impregnated fiber. A secondary objective was to determine if the presurgical placement of fibers had any adverse effects on healing following periodontal surgery. The study population consisted of 10 patients with at least 2 pockets in both maxillary quadrants of ≥ 5 mm in depth and exhibiting bleeding on probing. After an initial scaling and root planing, placebo or tetracycline fibers were randomly assigned by quadrant to 2 non‐adjacent pockets. Fibers were removed at the time of surgery; i.e., day 8, and periodontal surgery was performed utilizing a flap incision that allowed biopsy of 1 interdental papilla from each of the 2 test sites in each quadrant. One biopsy was analyzed for tetracycline concentrations by high performance liquid chromatography (HPLC). The second biopsy was examined by both light and ultraviolet fluorescence microscopy to determine the location of residual tetracycline and the intensity of inflammatory cell infiltrates. Results showed that the tissue concentration of the antibiotic in tetracycline treated sites was 64.4 ± 7.01 ng/mg (ng of tetracycline/mg tissue weight) which corresponds to 43 μg of tetracycline and was below levels of accurate measurement in placebo treated sites. Tetracycline tissue concentrations corresponded to the ultraviolet fluorescence microscopy with a Pearson correlation coefficient of r = 0.92. Tetracycline fluorescence was noted in the soft tissue wall ranging from 1 to 20 μm. No significant difference was noted when comparing 3 and 6 months post‐surgery attachment levels, probing depths, bleeding points, or gingival health between placebo and tetracycline fiber treated sites, indicating no adverse effects on healing and probing depth reductions. These results indicate that presurgical use of site‐specific, controlled delivery of tetracycline does not interfere with post‐surgical healing. J Periodontol 1992; 63:849–853.
The Effect of Certain Systemic Medications on Oral Calculus Formation
Authors: Turesky Samuel , Breuer Miklos , Coffman Gerald
Published: March 2012

A quantitative comparison was made of supragingival calculus that formed in individuals using systemic medications for defined systemic medical problems and individuals not using medication. Measurements of supragingival plaque and calculus were made on the lingual surfaces of the 4 mandibular incisors of 68 consecutive patients presenting for dental examinations and oral prophylaxes. Variables noted in addition to medication and plaque status were: age, sex, time interval since previous prophylaxis, and smoking status. Analysis of results indicated a statistically significant reduction of calculus among individuals medicated with β‐blockers, diuretics, anticholinergics, synthroid and allopurinol despite the high quantity of plaque present. J Periodontol 1992; 63:871–875.
Endotoxin Levels in Periodontally Healthy and Diseased Sites: Correlation With Levels of Gram‐Negative Bacteria
Authors: Fine Daniel H. , Mendieta Carlos , Barnett Michael L. , Furgang David , Naini Ali , Vincent Jack W.
Published: March 2012

This study investigated the correlation between endotoxin levels and the percentage of Gram‐negative bacteria in healthy sites and in periodontitis sites. Twelve healthy adults participated. Each subject provided 3 periodontitis sites with 5 to 8 mm probing depths that bled on gentle probing and 3 healthy sites with sulcus depths of 1 to 3 mm that did not bleed. Clinical examinations and sterile paper point sampling of all study sites were conducted on days 0, 7, and 14, and site‐specific endotoxin levels and percentage of Gram‐negative bacteria were determined. There were significant differences in both endotoxin levels and percentage Gram‐negative bacteria between healthy and periodontitis sites across all 3 sampling periods, but no difference across sampling periods in the healthy sites and the periodontitis sites, respectively. Correlation coefficients revealed a high degree of correlation between site‐specific endotoxin levels and percentage of Gram‐negative organisms. Using a sample dilution of 1 × 104, endotoxin levels differentiated healthy from Periodontitis sites with a specificity of approximately 91% and a sensitivity of approximately 90%. J Periodontol 1992; 63:897–901.
Immunohistochemical Analysis of Cells Attached to Teflon Membranes Following Guided Tissue Regeneration
Authors: Pritlove‐Carson Sandra , Palmer Richard M. , Morgan Peter R. , Floyd Peter D.
Published: March 2012

A wide panel of monoclonal antibodies to various keratins together with an antivimentin antibody to label mesenchymal cells were used to label cells attached to expanded polytetrafluorethylene (ePTFE) membranes removed 6 weeks postoperatively from 7 patients. All membranes demonstrated variable amounts of adherent tissue, within which vimentin‐positive cells were detected. In 8 of the 18 samples, no epithelial cells were detected. Seven of the 18 samples demonstrated small groups of epithelial cells on both sides of the membranes, staining predominantly as basal cells. The remaining 3 samples were more densely populated by epithelium which expressed a diverse keratin profile. Thus, the membranes were successful in establishing mesenchymal cell proliferation, as evidenced by vimentin positivity, but did not totally exclude epithelium. J Periodontol 1992; 63:969–973.
Oral Conditions in Individuals With Selective Immunoglobulin A Deficiency and Common Variable Immunodeficiency
Authors: Engström Gunilla Norhagen , Engström Per‐Erik , Hammarström Lennart , Smith C.I. Edvard
Published: March 2012

Saliva and serum samples were collected from 36 individuals with selective immunoglobulin A deficiency (IgAd) and 23 patients with common variable immunodeficiency (CVI). The oral examination included registration of the teeth, Russell's periodontal index (PI), pocket formation, and salivary flow rate in both unstimulated and stimulated saliva. No differences were found in salivary flow rate, number of teeth, or pocket depth when donors with IgAd or CVI were compared to age and sex matched controls. However, mucosal manifestations of lichenoid type were more frequent in both types of Immunoglobulin deficient individuals. An increased PI was also seen in CVI patients. Increased serum IgG and salivary IgM levels were found in the IgAd population. J Periodontol 1992; 63:984–989.
In‐Vivo Comparisons of Clot Formation on Titanium and Hydroxyapatite‐Coated Titanium
Authors: Steinberg Arnold D. , Willey Ruth , Drummond James L.
Published: March 2012

We investigated in vivo clot formation on the surface of hydroxyapatite (HA)coated titanium (Ti) implants and on non‐coated Ti implants. Immediately after tooth extraction implant samples were inserted into the blood clot, in the same extraction site, for 1, 30, 60, or 120 seconds. Samples were processed for scanning electron microscopy (SEM). Qualitative observations of clotting topography were made by direct SEM viewing. Neither of the implant surfaces appeared to differ markedly in the degree of clotting during the 120 seconds of implantation; they revealed very early clot formation and limited clot attachment. These results were compared to the findings obtained in a previous study using identical methods with an intact periodontal ligament (PDL), root planed roots, and roots planed and treated with pH 1 citric acid. The PDL surface had the most rapid clot formation at all time periods. By 120 seconds, all root surfaces had completed clot formation. J Periodontol 1992; 63:990–994.
A Stereomicroscopic and Immunohistochemical Study of Vasculature in Gingiva Bleeding After Probing
Authors: Fu Earl , Nieh Shin
Published: March 2012

This study investigated the stereomicroscopic appearance of gingival sulcular surfaces and the histologic alterations of subepithelial vasculature of gingiva bleeding after probing. Sixty‐four pairs of gingival biopsies from 49 patients were obtained and the results of stereomicroscopically visible vasculature were observed in half of the specimens. The number of biopsies showing that the vasculature of bleeding gingiva was significantly greater than those of non‐bleeding gingiva. The immunohistochemical marker UEA‐1 was used to identify endothelial cells on the vascular walls of 34 gingival biopsies from 15 patients. Following stereomicroscopic examination, tissue preparation with routine and UEA‐1 stainings was performed. Volumetric and numerical analyses of vasculature in 6 divided portions of subepithelial connective tissue were measured. The results showed that significantly greater numbers of UEA‐1 staining vessels were found within the apico‐superficial portion of bleeding gingiva than those of non‐bleeding gingiva. However, there was no specific correlation between the UEA‐1 positive vessels within gingival tissue and stereomicroscopic visibility of vasculature on the surface appearance. It is suggested that increased vascularity in gingiva may be responsible for bleeding on clinical probing. J Periodontol 1992; 63:997–1004.
Differential Diagnosis in Clinical Trials of Therapy for Periodontitis
Authors: Ranney Richard R.
Published: March 2012

For purposes of clinical trials of therapies for periodontitis, it is recommended that population samples be identified as adult periodontitis (systemically modified or not systemically modified), early onset Periodontitis (localized or juvenile, generalized or rapidly progressive, or associated with systemic disease), or necrotizing ulcerative periodontitis, avoiding overlapping criteria. Population samples of adult or early onset periodontitis modified by or associated with systemic conditions should be used in clinical trials only when the intent is to study effect on the specifically modified condition. Objective identification of the modifying systemic condition should be required for all subjects in such trials. Population samples should be homogeneous for the diagnosis, whether systemically modified or not. Refractory periodontitis, prepubertal periodontitis, and periodontitis associated with systemic disease are not recommended as useful descriptors of population samples without discrete identification of underlying systemic abnormality for all included subjects. Definition of population sample by a bacteriological or a host response feature is not recommended unless the trial is specifically aimed at that feature and the sample is homogeneous for it. All trials of efficacy should include physical or radiographic measurement of attachment level or bone height as a critical outcome variable. Results from trial in one form of periodontitis should not be applied directly to other forms. J Periodontol 1992; 63:1052–1057.
Conduct of Multicenter Trials to Test Agents for Treatment of Periodontitis
Authors: Goodson J. Max
Published: March 2012

The conduct of multicenter trials to test agents for treatment of Periodontitis is conceptually similar to that of single center trials, but the requirement that centers ultimately be combined into a single result places much more stringent requirements on uniformity and control. Multicenter trials should be considered only if numbers of subjects or the ability to generalize to other treatment settings becomes a driving theme. General guidelines for the conduct of studies of this sort are suggested and problems that occur are discussed. Despite formidable difficulties that may occur, multicenter studies provide a convincing demonstration of an agent's therapeutic efficacy for the treatment of Periodontitis. J Periodontol 1992; 63:1058–1063.
DNA Probe and Enzyme Analysis in Periodontal Diagnostics
Authors: Loesche Walter J.
Published: March 2012

Recent research in periodontology has indicated that a finite number of bacterial species are associated with periodontal disease. This has generated the hypothesis that periodontal disease is essentially an infection due to one or more of the putative periodontopathogens; i.e., the specific plaque hypothesis (SPH). This microbial specificity paradigm has already changed the way researchers and some clinicians view periodontal disease. The clinician must heed several cautions signs, however, if he is to use the SPH to provide treatment options that could enhance the delivery of care. There are several diagnostic technologies that can be used to detect and semi‐quantitate those bacterial species that have been identified as periodontopathogens. This paper discusses diagnostic tests based upon the detection in plaque of DNA segments or enzyme activity(ies) that are unique for one or more of the suspected periodontopathogens. J Periodontol 1992; 63:1102– 1109.
Periodontal Response to Mechanical Non‐Surgical Therapy: A Review
Authors: Greenstein Gary
Published: March 2012

This literature review is concerned with the ability of personal oral hygiene and mechanical instrumentation to establish and maintain periodontal health. Clinical, microbiologic, and histologic responses to non‐surgical therapy are evaluated to provide guidelines for expected treatment results. Factors that may limit the effectiveness of nonsurgical therapy as a closed procedure are also addressed. These include length of therapy, skill of therapists, patient compliance, responsibility of clinician for maintenance, and disease activity status of the patient. J Periodontol 1992; 63:118–130.
Relative Proportions of Pathogen‐Related Oral Spirochetes (PROS) and Treponema denticola in Supragingival and Subgingival Plaque From Patients With Periodontitis
Authors: Riviere George R. , Elliot Kathryn S. , Adams Donald F. , Simonson Lloyd G. , Forgas Lorraine B. , Nilius Angela M. , Lukehart Sheila A.
Published: March 2012

The purpose of this study was to use monoclonal antibodies to enumerate spirochetes in dental plaque, including the newly recognized pathogen‐related oral spirochete (PROS) and specific serovars of Treponema denticola. Plaque was collected from control subjects with no apparent periodontal disease and from sites of moderate to severe chronic periodontitis in patients with inflammatory periodontal disease. Individual monoclonal antibodies were used to determine whether spirochetes were present and then a doublestaining protocol was employed to count total spirochetes and specific treponemes in individual microscopic fields. Results indicate that spirochetes are more common at diseased sites and in subgingival plaque than at healthy sites or in supragingival plaque. Together PROS and T. denticola comprised the majority of all spirochetes in all samples and PROS and T. denticola serovars “B” and D were most numerous in plaque from patients with periodontitis. PROS were the majority of all spirochetes in supragingival plaque (76.2% ± 23.8%) and subgingival plaque (60.9% ± 19.1%) from periodontitis patients, significantly larger than the percentage of T. denticola serovar “B” (P <.001 for both supragingival and subgingival plaque) and serovar D (P <.01 for supragingival and P <.001 for subgingival plaque). These observations indicate that PROS are the predominant spirochete in plaque from sites of patients with periodontitis, but other analytical approaches are necessary to determine if PROS or T. denticola are pathogenic. J Periodontol 1992; 63:131–136.
Minocycline Slow‐Release Formulation Effect on Subgingival Bacteria
Authors: Okuda K. , Wolff L. , Oliver R. , Osbom J. , Stoltenberg J. , Bereuter J. , Anderson L. , Foster P. , Hardie N. , Aeppli D. , Hara K.
Published: March 2012

The purpose of this study was to determine the microbiological efficacy of an adjunctive minocycline periodontal formulation delivered subgingivally. Subjects were systemically healthy but exhibited severe Periodontitis; i.e., probing depths greater than 6 mm. The two study groups included individuals who received minocycline or a placebo periodontal formulation after root planing. Subgingival plaque samples were obtained at baseline; prior to treatment; and at 1, 3, and 6 months. Plaque was evaluated by darkfield microscopy and further analyzed for total dark‐pigmented Bacteroides species, P. intermedia, P. gingivalis and Streptococcus, Actinomyces, Eikenella, Actinobacillus, Capnocytophaga, and Fusobacterium species using cultivable flora techniques. In addition, plaque was evaluated for yeast on a selective agar medium. When compared to the placebo, the minocycline group had significantly lower proportions of spirochetes at 1 and 3 months and lower proportions of motile rods at 3 months. Furthermore, when compared to the placebo group, the minocycline patients had lower mean proportions of dark‐pigmented Bacteroides spp. and P. intermedia at 1 and 3 months as well as lower proportions of E. corrodens at 1 month. The minocycline group had significant decreases in proportions of spirochetes at 1 and 3 months, motile rods at 1 and 3 months, and increases in cocci at 1, 3, and 6 months when compared to baseline. In the placebo group, root planing was also effective at decreasing spirochetes at 1, 3, and 6 months, but with significant differences seen only at 3 and 6 months. However, the degree of reduction in spirochete proportions was greater in the minocycline group when compared with the placebo group. When used as an adjunct to root planing, the minocycline formulation resulted in a microbial response more favorable for periodontal health than a placebo. J Periodontol 1992; 63:73–79.
Humoral Antibody Responses in Periodontal Disease
Authors: Zafiropoulos George‐Gregory K. , Flores‐de‐Jacoby Lavinia , Hungerer Klaus‐Dieter , Nisengard Russell J.
Published: March 2012

Several forms of periodontal disease are considered to be infectious diseases with associated specific bacteria. This study examined the humoral antibody levels as assayed by ELISA to Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in adult Periodontitis (AP), localized juvenile Periodontitis (LJP), rapidly progressive Periodontitis (RPP), and in periodontally healthy subjects (HS). Sixty‐two of the 64 (96.9%) patients had significantly elevated antibody levels to at least one of the three organisms. Elevated levels of antibodies to P. gingivalis occurred in 82.8% of the RPP, LJP, and AP patients with all 3 disease groups showing greater responses than HS controls. Antibodies to A. actinomycetemcomitans were found in 59.4% of the RPP, LJP, and AP patients and were significantly higher in both LJP and RPP patients. Only 21.9% of the RPP, LJP, and AP patients showed elevated levels to P. intermedia with only significantly higher levels in the RPP and LJP groups. Antibodies to A. actinomycetemcomitans and P. intermedia were rarely found alone (only 5.1% and 2.6% of the patients respectively) but were usually accompanied by P. gingivalis.‐These results suggest that one or more combinations of these 3 bacteria may play a role in the pathogenesis of these forms of periodontal disease. J Periodontol 1992; 63:80–86.
Clinical Effectiveness of Subgingival Irrigation With a Pulsated Jet Irrigator Versus Syringe
Authors: Itic Joël , Serfaty Raphaël
Published: March 2012

Previous studies have shown clinical and microbiological improvement with subgingival irrigation particularly after scaling and root planing. In this study we monitored the effects of saline irrigation on non‐treated periodontal pockets. Ten subjects with severe periodontal disease and symmetrical lesions on multirooted teeth were selected. They had not received periodontal treatment or antibiotics for the previous 6 months. Patients were given simplified oral hygiene instructions. Neither scaling nor root planing was provided during the study. Two teeth were randomly selected per quadrant for subgingival irrigation with saline solution. One side was treated with a syringe and the other side with a pulsated jet irrigator with a modified tip, professionally administered. Clinical parameters (pocket depth, plaque index, gingival index, crevicular fluid, bleeding index, attachment level, and subgingival microflora) were evaluated on days 0, 15, 30, 60, and 90. Both subgingival irrigation products induced changes (reductions) in these indices during the study. Significant differences (P < 0.001) with the oral irrigator were found for the following parameters: microscopy, pocket depth, crevicular fluid, and plaque index. In this study, professionally administered saline irrigation with a pulsated jet irrigator was more effective than syringe treatment with the same solution. Neither treatment resulted in a detectable gain in probing attachment level. Since gain in attachment level is achievable by other techniques, neither of these subgingival irrigation procedures alone can be considered adequate for periodontal therapy. J Periodontol 1992; 63:174–181.
Immunity to Self‐Antigens in Periodontal Disease
Authors: Anusahathien O. , Singh G. , Peters T.J. , Dolby A.E.
Published: March 2012

Auto‐antibody to collagen, previously detected in periodontal disease, may represent either a response to local tissue damage or be the manifestation of a disturbance of the host immune response induced by the periodontal flora and its products. In an effort to distinguish between these two hypotheses, this study was undertaken to determine circulating IgG auto‐antibody levels in 41 periodontal‐disease patients against 12 self‐antigens (salmon DS‐DNA, calf SS‐DNA, human and bovine thyroglobulin, rabbit proteoglycan, horse myoglobin, bovine myosin, actin, fetuin, human transferrin, cytochrome C, and human Type I collagen) and compare them to those in 21 periodontal disease‐free subjects. None of the detected IgG auto‐antibody levels were significantly different between periodontal disease and control sera (Mann‐Whitney U‐test, P >0.05) except for human Type I collagen (P <0.05). Fifty‐six percent of patients and 38% of controls were “broad responders;” i.e., 50% or more of the auto‐antibody levels were higher than the median values of the control group; however, these values were not significantly different using the chi‐square test. It was concluded that the destruction of connective tissue components is the primary driving force in the induction of the enhanced auto‐antibody response found in periodontal disease. This response is apparently secondary to the primary bacterial infection which remains the major etiologic event. J Periodontol 1992;63:194–199.