bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Guided Bone Regeneration Around Commercially Pure Titanium and Hydroxyapatite‐Coated Dental Implants. II. Histologic Analysis
Authors: Stentz William C. , Mealey Brian L. , Gunsolley John C. , Waldrop Thomas C.
Published: March 2012

The purpose of this study was to determine which treatment of a large osseous defect adjacent to an endosseous dental implant would produce the greatest regeneration of bone and degree of osseointegration: barrier membrane therapy plus demineralized freeze‐dried bone allograft (DFDBA), membrane therapy alone, or no treatment. The current study histologically assessed changes in bone within the healed peri‐implant osseous defect. In a split‐mouth design, 6 implants were placed in edentulous mandibular ridges of 10 mongrel dogs after preparation of 6 cylindrical mid‐crestal defects, 5 mm in depth, and 9.525 mm in diameter. An implant site was then prepared in the center of each defect to a depth of 5 mm beyond the apical extent of the defect. One mandibular quadrant received three commercially pure titanium (Ti) screw implants (3.75 × 10 mm), while the contralateral side received three hydroxyapatite (HA) coated root‐form implants (3.3 × 10 mm). Consequently, the coronal 5 mm of each implant was surrounded by a circumferential defect approximately 3 mm wide and 5 mm deep. The three dental implants in each quadrant received either DFDBA (canine source) and an expanded polytetrafluoroethylene membrane (ePTFE), ePTFE membrane alone, or no treatment which served as the control. Clinically, the greatest increase in ridge height and width was seen with DFDBA/ePTFE. Histologically, statistically significant differences in defect osseointegration were seen between treatment groups (P < 0.0001: DFDBA/ePTFE > ePTFE alone > control). HAcoated implants had significantly greater osseointegration within the defect than Ti implants (P < 0.0001). Average trabeculation of newly formed bone in the defect after healing was significantly greater for HA‐coated implants than for titanium (P < 0.0001), while the effect on trabeculation between treatments was not significantly different (P = 0.14). Finally, there were significantly less residual allograft particles in defect areas adjacent to HA‐coated implants than Ti implants (P = 0.0355). The use of HA‐coated implants in large size defects with DFDBA and ePTFE membranes produced significantly more osseointegration histologically than other treatment options and more than Ti implants with the same treatment combinations. The results of this study indicate that, although the implants appeared osseointegrated clinically after 4 months of healing, histologic data suggest that selection of both the implant type and the treatment modality is important in obtairiing optimum osseointegration in large size defects. J Periodontol 1997;68:933–949.
Quantitative Measurement of Volume Changes Induced by Oral Plastic Surgery: Validation of an Optical Method Using Different Geometrically‐Formed Specimens
Authors: Studer Stephan P. , Sourlier David , Wegmann Urs , Schärer Peter , Rees Terry D.
Published: March 2012

The purpose of this research was to study the validity and variability of a projection Moiré system, measuring volume differences of geometrically different formed specimens nrrirnicking localized alveolar ridge defects. Nine pairs of specimens were fabricated, each of which simulated a preoperative ridge defect and a corresponding surgically‐corrected postoperative ridge defect. All specimen pairs had a mathematically defined form which allowed the accurate assessment of their volume differences by a mechanical 3‐D coordinate measuring machine or by a software‐controlled milling machine. Measurements achieved with these methods were used as the references for comparison. Six specimen pairs, Al to A6, possessed a simple rectangular geometrical form which facilitated their fabrication. Three specimen pairs, B1 to B3, were milled and consisted of geometrically more complex 3‐D sculptured surfaces, which came closest to a true imitation of a localized ridge defect. An optical measurement system in the form of the projection Moiré was utilized, applying a 4‐phase shift technique, and results obtained with this device were regarded as test volumes. The absolute variability of the test volume measurements differed between 0.397 mm3 to 15.872 mm3, corresponding to a relative variability of 0.83% to 2.83%. The mean of the relative variability was within 1.68% for the “A” specimens and 2.15% for the “B” specimens. However, the difference was not significant, probably due to the limited number of “B” specimens. The systematic error of the Moiré measurements in relation to the reference methods was surprisingly low, ranging from –0.12 mm3 to 7.67 mm3. The relative systematic error, expressed as a percentage of reference volume, ranged between 0.06% and –2.23%. The mean of the relative error for the more complex “B” specimens was 1.37%, which was less accurate in comparison to the more simply formed “A” specimens with a relative systematic error of 0.35%. Therefore, in this in vitro model it was possible to measure volume differences of geometrically different formed specimens, mimicking localized alveolar ridge defects, with a vahdity within 2.2% and with a variability of less than 2.8%. J Periodontol 1997;68:950–962.
A 10‐Year Study of the Progression of Destructive Periodontal Disease in Adult and Elderly Chinese
Authors: Baelum Vibeke , Luan Wen‐Min , Chen Xia , Fejerskov Ole
Published: March 2012

This study describes the progression of destructive periodontal disease among Chinese aged 20 to 80 with limited access to dental health facilities and minimal traditions for oral hygiene procedures. These individuals were followed for 10 years to determine whether the rates for progression of periodontal disease were markedly different than for populations with more access to oral health care. At baseline, participants had been examined for tooth mobility, plaque, calculus, gingival conditions, attachment levels, and probing depths on 4 sites of each tooth present. These probing depth and attachment level recordings were repeated at follow‐up, although third molars were excluded from examination. A total of 398 persons remained dentate at follow‐up. The analysis demonstrated that virtually all subjects experienced ≥ 2 mm attachment loss over the 10–year period, and frequently in a large proportion of the sites present. Attachment loss ≥ 3 mm was also widespread, but the distribution of persons according to the extent of ≥ 3 mm attachment loss was positively skewed in all age groups. Positive skewness was even more pronounced when attachment loss of ≥ 4 mm was considered. Some types of teeth, such as mandibular incisors and maxillary molars, had higher progression rates than did, for example, maxillary incisors. The mean individual attachment loss rates did not differ significantly between age groups, and were remarkably similar to those reported for populations whose access to and tradition for oral health care is widespread. J Periodontol 1997;68:1033–1042.
Effect of Inflammation on the Proliferation of Human Gingival Epithelial Cells In Vitro
Authors: Carro Odile M. , Evans Suvia A. S. , Leone Cataldo W.
Published: March 2012

The adaptive or pathologic responses of epithelial cells to inflammation are poorly characterized. The purpose of this study was to determine if epithelial cells cultured from clinically healthy and inflamed human gingival tissues express differences in proliferation rate and viability. Briefly, the inflammation status of individual donor sites from 101 patients was visually assessed at the time of periodontal surgery and categorized as either non‐to‐slightly inflamed, moderately inflamed, or severely inflamed. Discarded gingival tissues were then processed to obtain primary cell cultures, for which proliferation rates were determined by calculating the ratio of mean population doublings to the' number of days required for cultures to become confluent. In general, the cells in the minimally inflamed group exhibited characteristics different than cells in the moderately and severely inflamed groups. Specifically, the cells obtained from clinical sites which exhibited no‐to‐slight inflammation had a significantly higher mean proliferation rate than cells in either the moderate inflammation group or the severe inflammation group. Based on trypan blue exclusion, the cells obtained from clinical sites which exhibited no‐to‐slight inflammation also were more viable than cells obtained from sites with moderate inflammation or severe inflammation. Microscopic evaluation showed morphological changes associated with increased inflammation. Cell cycle analysis by fluorescent‐activated cell sorting (FACS) revealed a directly proportional relationship between the degree of inflammation and apoptosis, and a strong inversely proportional trend between the degree of inflammation and the numbers of cells undergoing mitosis. Taken together, these data suggest that epithelial cell proliferation and viability are inversely associated with the degree of gingival inflammation, once a putative “adaptive threshold” is exceeded. Elucidation of the underlying mechanisms will likely lead to improvements in clinical diagnosis and treatment. J Periodontol 1997;68:1070–1075.
Reduction of Oral Malodor by Oxidizing Lozenges
Authors: Greenstein Ronit Bar‐Ness , Goldberg Sarit , Marku‐Cohen Sharon , Sterer Nir , Rosenberg Mel
Published: March 2012

The main purpose of the study was to examine the anti‐malodor properties of oxidizing lozenges, as compared to breath mints and chewing gum. Healthy, young adult volunteers (N = 123; mean age 24.5 years) were measured for oral malodorrelated parameters (whole mouth odor measured by 2 judges; tongue dorsum posterior odor using the spoon test; volatile sulphide levels; salivary levels of cadaverine and putrescine; and 2 versions of an oral rinse test) on the first afternoon of the study. They were then assigned randomly to one of 6 groups (2 brands of breath mints, chewing gum with no active ingredients, regular and full‐strength oxidizing lozenges, and a no‐treatment control), and instructed to employ the treatment before bedtime, the next morning, and in the early afternoon 3 hours prior to measurements, which were carried out 24 hours following baseline measurements. Volunteers also estimated the level of their own whole mouth and tongue odors at baseline and post‐treatment. The data showed that, among treatments, only the full‐strength oxidizing lozenge significantly reduced tongue dorsum malodor, as determined by the spoon test. The full‐strength lozenge also yielded a significant increase in the modified oral rinse test, presumably due, at least in part, to residual oxidizing activity retained in the oral cavity. Self‐estimations of whole mouth and tongue malodor by volunteers were significantly correlated with corresponding‐judge assessments, suggesting some degree of objectivity in assessing one's own oral malodor. J Periodontol 1997;68:1176–1181.
Periodontal Tissue Disposition of Azithromycin
Authors: Malizia Tecla , Tejada Milvana R. , Ghelardi Emilia , Senesi Sonia , Gabriele Mario , Giuca Maria R. , Blandizzi Corrado , Danesi Romano , Campa Mario , Tacca Mario Del
Published: March 2012

The tissue penetration of azithromycin, the prototype of a new class of macrolide antibiotics named azalides, was studied in patients undergoing surgery for third‐molar removal. Drug concentrations in plasma, saliva, and periodontal tissues were evaluated in 28 patients treated with azithromycin 500 mg/day per os for 3 consecutive days. Samples of blood, saliva, gingiva, and alveolar bone were collected during oral surgery, 12 hours, and 2.5, 4.5, and 6.5 days after the last dosing, and the azithromycin concentration was measured microbiologically by using Micrococcus luteus NCTC 8440 as the reference organism. The highest concentrations of azithromycin were observed 12 hours after the last dose in plasma, saliva, gingiva, and bone (0.33 ± 0.04 mg/1, 2.14 ± 0.30 mg/1, 6.47 ± 0.57 mg/kg, and 1.86 ± 0.15 mg/kg, respectively) and then declined gradually. However, consistent levels of the drug in saliva and periodontal tissues could be detected up to 6.5 days, indicating that azithromycin was retained in target tissues and fluids for a long time after the end of treatment. Among the samples examined, the highest concentration of azithromycin was found in the gingiva at each time studied. Moreover, the ratios of salivary or periodontal tissue levels versus plasma concentrations remained nearly unmodified from 12 hours up to 6.5 days. Overall, these results indicate a favorable disposition of azithromycin into saliva and periodontal tissues and suggest that this macrolide antibiotic represents a valuable option in the pharmacologic treatment of odontogenic infections. J Periodontol 1997;68:1206–1209.
Culture and Characterization of Human Junctional Epithelial Cells
Authors: Matsuyama Takashi , Izumi Yuichi , Sueda Takeshi
Published: March 2012

This study was undertaken to establish a culture of junctional epithelial cells derived from gingival tissue attached to the tooth surface and to characterize these cells immunocytochemically and ultrastructurally. Primary cultures of cells were obtained from the junctional tissue explanted on type I collagen‐coated dishes and immersed in Dulbecco's modified Eagle's medium containing 10% fetal bovine serum (FBS). Cells were subcultured with conditioned serum‐free keratinocyte medium (keratinocyte‐SFM+5% FBS) on dishes coated with solubilized extract of the basement membrane. After 24 hours, the medium was changed to keratinocyte‐SFM (0.09 mM Ca2+). The cell‐doubling time was 40.5 hours. As a control, cells from gingival tissue were cultured by the same method. Cells from junctional tissue and gingival tissue were compared immunocytochemically using monoclonal antibodies to keratin, vimentin, and desmoplakins I and II and using Dolichos biflorus agglutinin (DBA). The keratin AE1 and AE3 was expressed by all of culture cells. The vimentin (specific for the intermediate filament of mesenchymal cells) was also expressed by all cells. The expression pattern of keratin 19 was observed not only by cells from junctional tissue but also by cells from gingival tissue. All keratin peptides were expressed in both cells. However, DBA reacted only with cells from the junctional tissue. Anti‐desmoplakin I and II reacted with both cells, however, the staining patterns differed. DBApositive cultured epithelial cells from the junctional tissue showed poor tonofilament bundles and were rich in cytoplasmic organelles. These findings suggest that junctional epithelial cells can be isolated from junctional tissue and cultured under improved conditions. J Periodontol 1997;68:229–239.
Important Differences in Clinical Data From Third, Second, and First Generation Periodontal Probes
Authors: Breen Harry J. , Rogers Pauline A. , Lawless Helena C. , Austin Johanne S. , Johnson Newell W.
Published: March 2012

This study compared relative attachment levels (RAL) and probeable crevice depths (PCD) from 6 periodontal probes (1 third, 4 second, and 1 first generation). A single clinician recorded RAL and PCD in 6 patients with chronic adult periodontitis (mean age 48.2 years) during two visits (interval: 1 week) using a Latin square examination order. Replicate measurements were recorded at the 4 interproximal sites of the Ramfjord index teeth to examine intra‐probe differences. Additional single measurements were recorded at similar sites of units 11, 26, 31 and 46 to investigate interprobe differences. Intra‐probe RAL and PCD reproducibility was ≥ 1 mm at > 94% of the sites. All intra‐probe Pearson correlation coefficients were > 0.85 (P = 0.00). Inter‐probe RAL and PCD agreement was ≤ 1 mm at > 49% of the sites for RAL and > 61% of the sites for PCD. All inter‐probe Pearson correlation coefficients were > 0.42 (P = 0.00) for RAL and > 0.49 (P = 0.00) for PCD. Analyses of variance showed significant differences in RAL and PCD between the first generation probe and the second generation probes (P < 0.005); in RAL between the third generation probe and the first and second generation probes (P = 0.0354); and in PCD between the third generation probe and the first and second generation probes (P = 0.0475). Inter‐probe differences were clinically significant in the recorded percentages of pockets ≥ 4 mm and ≥ 6 mm. Significant inter‐probe differences were found in RAL and PCD which have clinical importance in data interpretation and comparison. J Periodontol 1997;68:335–345.
Myofibroblasts in Phenytoin‐Induced Hyperplastic Connective Tissue in the Rat and in Human Gingival Overgrowth
Authors: Dill Russell E. , Iacopino Anthony M.
Published: March 2012

Phenytoin is a commonly used anticonvulsant drug for the prevention of seizures. A common side effect of phenytoin (PHT) therapy is connective tissue hyperplasia, particularly in the oral cavity manifesting as gingival overgrowth. Our previous studies concerning the molecular mechanisms of drug‐induced gingival overgrowth have demonstrated that PHT alters the normal tissue turnover/wound healing signal by causing changes in macrophage phenotype, resulting in the upregulation of essential polypeptide growth factors such as platelet‐derived growth factor (PDGF). The cellular consequences of this elevation in growth factor have not been investigated. The present light and electron microscopic study of rat hyperplastic connective tissue and human gingival overgrowth induced by PHT treatment revealed the presence of numerous myofibroblasts. Cells identified as myofibroblasts were evident in all PHT‐treated tissue samples and were characterized by an elongated fusiform cell shape, abundant cytoplasmic rough endoplasmic reticulum/polyribosomes, and accumulations of subplasmalemmal microfilaments containing spindle densities. These cells were never observed in control tissues. Myofibroblasts are associated with the later stages of tissue turnover, specifically with the transition from the granulation to the remodeling phases of the wound healing process. The presence of myofibroblasts in hyperplastic connective and gingival tissues induced by PHT treatment suggests that PHT exacerbates the normal tissue turnover/wound healing signals responsible for the appearance of myofibroblasts. J Periodontol 1997;68:375–380.
The Effect of Surface Roughness on Early In Vivo Plaque Colonization on Titanium
Authors: Rimondini Lia , Faré Silvia , Brambilla Eugenio , Felloni Andrea , Consonni Claudio , Brossa Francesco , Carrassi Antonio
Published: March 2012

This study assesses in vivo the surface roughness necessary to reduce plaque colonization on titanium after 24 hours. Three groups of 16 titanium disks were assigned to 3 different polishing groups (A, B, and C). The roughness was evaluated with a laser profilometer and the morphology with a scanning electron microscope (SEM). Eight volunteers were enrolled and two Stents were applied in the mandibular posterior region of each. Each Stent supported 3 disks, one per group. The volunteers suspended oral hygiene for 24 hours, after which the Stents were removed; one was processed for evaluation of the adherent biomass and the other for SEM study. On each specimen a global area of 100 × 125 μm was examined with SEM. The area was composed of five 20 × 25 μm randomly selected fields. For each field the density of bacteria and the morphotypes were recorded. The data quoted for the global area are cumulative of those observed in the 20 × 25 μm fields. Group A had a significantly smoother surface than groups B and C. The adherent microbial biomass determination and SEM evaluation revealed that group A contained less bacteria than the roughest group. The bacterial population was composed of cocci in group A, and of cocci and short and long rods in groups B and C. We conclude that a titanium surface with Ra ≤ 0.088 μm and Rz < 1.027 μm strongly inhibits accumulation and maturation of plaque at the 24‐hour time period and that such smoothness can be achieved in transgingival and healing implant components. J Periodontol 1997;68:556–562.
Histologic Aspects of the Bone and Soft Tissues Surrounding Three Titanium Non‐Submerged Plasma‐Sprayed Implants Retrieved at Autopsy: A Case Report
Authors: Piattelli A. , Scarano A. , Piattelli M. , Bertolai R. , Panzoni E.
Published: March 2012

The authors report the histological features found around three non‐submerged titanium plasma‐sprayed implants retrieved, after a 10‐month loading period, from an autopsy case. At the time of implant insertion, the clinician had noted a wide vestibular dehiscence of the central implant, and it was decided to use a bioabsorbable membrane for guided bone regeneration in this area. After specimen processing, it was possible at low magnification to observe that in the most vestibular slides, the central implant was almost completely surrounded by connective tissue, while in the most lingual slides, the quantity of bone around the implant tended to increase. The other two implants had a bone‐implant contact percentage of about 60%. Only in a few areas was mineralized bone in direct contact with the metal surface, while around the major portion of the implant perimeter a layer of unmineralized, red‐stained, osteoid material was present. No inflammatory infiltrate was present in the epithelium and in the supracrestal connective tissues. The fibers of this tissue had a different orientation: in the most coronal portion of the implants (smooth surface), they tended to run parallel to the implant's surface, while in the most apical region (plasma‐sprayed surface), they tended to be arranged in a perpendicular fashion. These results, in man, were strikingly similar to those previously reported in dogs and monkeys. J Periodontol 1997;68:694–700.
The Survival Rate of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Bacteroides forsythus Following 4 Randomized Treatment Modalities
Authors: Shiloah Jacob , Patters Mark R. , Dean John W. , Bland Paul , Toledo Gilbert
Published: March 2012

The overall goal of this clinical study was to determine the short‐term anti‐infective effects of four randomized treatment modalities on Actinobacillus actinomycetem.comitans (Aa), Porphyromonas gingivalis (Pg), and Bacteroides forsythus (Bf) and determine the effects of bacterial survival on treatment outcomes in patients with adult periodontitis. Twelve adult patients requiring therapy for moderate periodontitis were selected for this study. All patients had at least one tooth in each quadrant that had an inflamed pocket of probing depth ≥5 mm with probing attachment loss that harbored at least one of the following three periodontal pathogens: Aa, Pg, or Bf. The number of target organisms per site was determined pre‐operatively, at 1 week, and 1 month and 3 months postoperatively utilizing DNA probes. One quadrant in each patient was randomly assigned to each one of the following four treatment groups: 1) scaling and root planing (SRP group); 2) pocket reduction through osseous surgery and apically‐positioned flap (OS group); 3) modified Widman flap (MWF group); and 4) modified Widman flap and topical application of saturated citric acid at pH 1 for 3 minutes (CA group). The 4 treatment modalities were performed in one appointment. No postoperative antibiotics were used. Patients were instructed to supplement their daily oral hygiene with chlorohexidine oral rinse during the study. The results of this investigation indicated that: 1) none of the treatment modalities was effective in eliminating the target species; 2) the incidence of infected sites for all groups was 100% preoperatively; 62.5%, 33.3%, and 31.3% at 1 week, and 1 and 3 months postoperatively, respectively; 3) these infected sites lost 1.1 ± 0.4 mm of probing attachment compared to gain of 0.0 ± 0.3 mm for uninfected sites; 4) the infected sites had higher plaque and bleeding on probing 0.9 ± 0.3, 73 ± 12%, respectively, compared to 0.3 ± 0.1 and 30 ± 8% for the uninfected sites; and 5) no statistically significant differences were detected among the infected sites in regard to gingival index (1.0 ± 0.2 vs. 0.8 ± 0.1) or probing depth (3.5 ± 0.4 vs. 3.0 ± 0.1 mm). These results indicate that bacterial survival negatively affects the short‐term clinical outcomes of non‐surgical and surgical periodontal therapy. J Periodontol 1997;68:720–728.
Carbon Dioxide Laser for De‐Epithelialization of Periodontal Flaps
Authors: Centty Ivonne G. , Blank Lawrence W. , Levy Bernard A. , Romberg Elaine , Barnes Douglas M.
Published: March 2012

Regeneration of mineralized and soft connective tissue components of the attachment apparatus is the main goal in the treatment of periodontal diseases. Often, apical migration of epithelium (long junctional epithelium) effectively prevents the formation of bone and connective tissue attachment after periodontal surgery. The purpose of the present study was to compare conventional periodontal surgery combined with carbon dioxide laser and conventional periodontal surgery alone with respect to epithelial elimination and degree of necrosis of mucoperiosteal flaps. After signing a consent form, five patients with at least two comparable bilateral periodontal defects needing pocket elimination surgery participated in this study. The investigators randomly divided each side into test and control sites. Each patient received oral hygiene instruction and initial therapy prior to surgery. At surgery, the test site received a sulcular incision and carbon dioxide laser de‐epithelialization of the outer and inner aspects of the flap. The control group received reverse bevel incision only. The surgeon performed open flap debridement on all teeth. At the time of surgery, the surgeon did a biopsy of each site and submitted specimens for histologic evaluation. A matched pairs t‐test was used to analyze the data. The results show significant differences between the carbon dioxide laser and reverse bevel incision with respect to sulcular (P ≤ 0.025) and gingival (external) (P ≤ 0.01) flap surface epithelial elimination and tissue necrosis (P ≤ 0.005). These results should be replicated with a larger number of subjects. The carbon dioxide laser eliminated sulcular and gingival (external) epithelium without disturbing underlying connective tissue. This finding supports the concept that the carbon dioxide wavelength has little or no effect on tissues beyond the target. However, neither laser nor blade eliminated all the epithelium. Researchers observed chronic inflammation in the control and test sites, with a predominance of plasma cells. Lining the sulcular and gingival (external) lased areas, investigators found coagulation necrosis covered by fibrin and coagulated blood. The laser appears to effectively remove epithelium at the time of surgery; however, future long‐term, well‐controlled quantitative histologic studies are needed to evaluate the effect of repeated carbon dioxide laser de‐epithelialization of the gingival (external) surface of mucoperiosteal flaps at intervals during the healing period. J Periodontol 1997;68:763–769.
Phenotype Expression of Gingival Fibroblasts Cultured on Membranes Used in Guided Tissue Regeneration
Authors: Locci Paola , Calvitti Mario , Belcastro Salvatore , Pugliese Mariano , Guerra Mario , Marinucci Lorella , Staffolani Nicoletta , Becchetti Ennio
Published: March 2012

Human gingival fibroblasts were cultured in vitro using as substrates an extracellular matrix (matrix) and polytetrafluoride (PTFE) membranes, which are used in guided tissue regeneration. To test the degree of biocompatibility of these membranes, the cellular proliferation and the accumulation of extracellular matrix (ECM) macromolecules were considered as parameters. The fibroblasts were cultured in vitro for 24 and 48 hours without serum on plastic, matrix, and PTFE membranes in the presence of 3H‐thyrnidine, 3H‐glucosamine, and 3H‐proline to study the neo‐synthesis of DNA, glycosaminoglycans (GAG), and collagen proteins, respectively. Studies on cell proliferation showed that fibroblasts grown on matrix membrane significantly increased 3H‐thymidine incorporation, while fibroblasts grown on PTFE membrane decreased 3H‐thymidine incorporation, compared to plastic used as a control. Moreover, the PTFE membrane induced a marked decrease of collagen and GAG accumulation both in the cellular and extracellular pool, while the matrix membrane provoked a decrease of the two macromolecules in the cellular pool and an increase in the extracellular one, compared to the control. The data we obtained demonstrate that matrix membranes are the most suitable to stimulate both cellular proliferation and ECM macromolecule accumulation. J Periodontol 1997;68:857–863.
The Structure of Bovine Periodontal Ligament With Special Reference to the Epithelial Cell Rests
Authors: Berkovitz Barry K.B. , Whatling Rosemary , Barrett Andrew W. , Omar Samia S.
Published: March 2012

The aim of this study was to determine the structure of the bovine periodontal ligament, with special reference to epithelial cell rests (ECR) and their cytokeratin content. Periodontal ligament was obtained from bovine molar teeth and studied at both the light microscopic and electron microscopic levels. Cytokeratin content was determined using immunohistochemistry against a number of cytokeratin antibodies and specificity tested against bovine and human oral mucosa. Collagen fibril diameters and the area of a fiber bundle occupied by collagen were determined using a digital planimeter with a digitizing tablet. The majority of periodontal fibroblasts possessed considerable quantities of roughened endoplasmic reticulum, indicating rapid synthesis and secretion of collagen, but no intracellular collagen profiles were present. Endothelial cells showed Weibel‐Palade bodies. Collagen fibril diameters showed a unimodal distribution with a mean collagen fibril diameter of 55.3 nm. The mean percentage area of the extracellular matrix occupied by collagen was 42%. Structurally, ECR were unusual in exhibiting large numbers of microvilli and conspicuous amounts of cytokeratin filaments. Bovine ECR showed a positive reaction to the pancytokeratin MNF116 (which reacts with the cytokeratins 5, 6, 8, 17, and probably 19), to PCK‐26 (which reacts with the type II cytokeratins 1, 5, 6, and 8) and to cytokeratin 13. There was no reaction for cytokeratins 1, 4, 10, 11 and 18. Structurally, bovine periodontal ligament showed features common to other species. However, ECR in terms of both structure and cytokeratin content showed features indicative of important species differences which may have relevance when considering the etiology of radicular cysts. J Periodontol 1997;68:905–913.
Clinical Evaluation of Electronic and Manual Constant Force Probes
Authors: Khocht Ahmed , Chang Kuang‐Min
Published: March 2012

The objective of this study was to compare the measurements of an electronic controlled‐force probe (FP) to that of a manual controlled‐force probe (SP) and a conventional probe (CP). Twelve subjects were recruited. A quadrant with no missing teeth (excluding third molars) was selected. Probing depth was measured at 6 sites per tooth (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual) by two examiners (AK and KC) each using the three probes in the following sequence: FP, SP, and CP. The same measurements were repeated a week later by both examiners. The mean difference of measurements between CP and FP was 0.375 ± 0.858 mm (P < 0.05), with 52.7% of the measurements within 0.5 mm and 80% within 1.0 mm. Correlation between measurements was high (0.7208) and significant (P < 0.001). The mean difference between SP and FP was 0.450 ± 0.863 mm (P < 0.05), with 49.1% of the measurements within 0.5 mm and 76.9% within 1.0 mm. Correlation between measurements was high (0.7354) and significant (P < 0.001). The mean difference between CP and SP was −0.074 ± 0.373 mm (P < 0.05), with 49.1% of the measurements within 0.5 mm and 76.9% within 1.0 mm. Correlation between measurements was high (0.95) and significant (P < 0.001). Intra‐examiner differences varied for each examiner. For both examiners, the correlations for FP (AK = 0.77, KC = 0.46) were lower than that for CP (AK = 0.86, KC = 0.80) and SP (AK = 0.86, KC = 0.83). Inter‐examiner comparisons showed that the correlation for FP (0.50) was lower than that for CP (0.85) and SP (0.86). The percentage of sites within 1 mm differences was less for FP (70%) than for CP (94%) or SP (94%). In conclusion, both CP and SP correlated well with FP. None of the three probes investigated completely eliminated probing errors. The CP and SP yielded more reproducible measurements than FP. Regardless of the type of probe used, probing measurements are subject to both intra‐ and interexaminer errors. J Periodontol 1998;69:19–25.
The Pharmacokinetic Profile of a Biodegradable Controlled‐Release Delivery System Containing Doxycycline Compared to Systemically Delivered Doxycycline in Gingival Crevicular Fluid, Saliva, and Serum
Authors: Stoller Norman H. , Johnson Lonnie R. , Trapnell Sheri , Harrold Charles Q. , Garrett Steve
Published: March 2012

The primary goal of this study was to characterize the release profile of doxycycline hyclate (8.5% w/w) from a biodegradable controlled‐release delivery system (DH) placed in periodontal pockets. Pharmacokinetic data were obtained from gingival crevicular fluid (GCF), saliva, and serum of adult periodontitis patients. These results were compared to those obtained from individuals who received standard oral doses of doxycycline hyclate (200 mg on day 0, then 100 mg/day for 7 days). All participants presented with multiple pockets ≥ 5 mm that bled upon probing. At the baseline visit patients receiving local drug delivery had all pockets ≥ 5 mm that bled upon probing on one side of the mouth filled with DH. Drug retention was enhanced with 1 of 2 periodontal dressings (non‐eugenol [NE] or 2‐octyl cyanoacrylate [2‐octyl]). Doxycycline concentrations were analyzed with the aid of reverse phase high performance liquid chromatography. GCF, saliva, and serum samples were obtained just prior to drug delivery and then at hours 2, 4, 6, 8, 18, 24 and days 2, 3, 5, 7, and 8. GCF and saliva samples were also obtained at days 10, 14, 21, and 28. Thirty two subjects participated in the study; 13 in the NE group, 13 in the 2‐octyl group, and 6 in the group taking oral doxycycline. The release of doxycycline in the GCF peaked at 2 hours (1473 μg/ml in the NE group, and 1986 μg/ml in the 2‐octyl group). The mean concentration at day 7 was 309 μg/ml for the NE group and 148 μg/ml for the 2octyl group. Minimal levels of drug were detected in the GCF of the oral doxycycline group with a peak concentration of 2.53 μg/ml at 12 hours. Salivary concentrations for both local delivery groups peaked at hour 2 (4.05 μg/ml for the NE group and 8.78 μg/ml for the 2‐octyl group); by the end of day 1 levels were ≤ 2 μg/ml. For subjects who took the oral doxycycline, salivary concentrations never exceeded 0.11 μg/ml. Serum concentrations of doxycycline for individuals receiving the local drug delivery never exceeded 0.1 μg/ml. For the oral doxycycline group serum concentrations ranged from 0.91 to 2.26 μg/ml over the 8 days data were collected. The high concentration of drug available at the treated sites coupled with the relatively low levels in the saliva and almost non‐existent levels in the serum indicate that this biodegradable controlled‐release delivery system displays an appropriate pharmacokinetic profile for the delivery of doxycycline into periodontal pockets. J Periodontol 1998;69:1085–1091.
A Classification System for Loss of Papillary Height
Authors: Nordland W. Peter , Tarnow Dennis P.
Published: March 2012

A classification system for loss of papillary height is proposed. It uses readily identifiable anatomical landmarks for reference, and sorts the degree of loss into 3 classes. The 3 broad categories allow for a quick descriptive assessment. In addition to the basic classification, it is suggested that additional and incremental description may be included to further define the defects. J Periodontol 1998;69:1124–1126.
Immediate Placement of an Endosseous Root‐Form Implant in an HIV‐Positive Patient: Report of a Case
Authors: Rajnay Z. William , Hochstetter Robert L.
Published: March 2012

Use of combination antiretroviral therapy regimens, including a protease inhibitor, has greatly improved the survival and systemic health of HIV‐positive patients. Due to the esthetic requirements of the patient in this case report, placement of an endosseous implant into a fresh extraction site, restored with a single crown, was the treatment of choice. The implant and restoration are functioning well 18 months after placement of the fixture. J Periodontol 1998;69:1167–1171.
Early Bacterial Accumulation on Guided Tissue Regeneration Membrane Materials. An In Vivo Study
Authors: Zucchelli G. , Cesari C. , Clauser C. , DeSanctis M.
Published: March 2012

The aim of the study was to compare the in vivo early bacterial plaque colonization of 3 different guided tissue regeneration (GTR) membrane materials using a morphological (scanning electron microscope) method. Rectangular‐shaped strips were cut from 3 periodontal membranes (expanded polytetrafluoroethylene, polyglactin 910, and polylactic acid) and glued to the buccal aspect of removable acrylic devices, which were applied to the molar‐premolar region of the upper quadrants in 8 dental students. Each device held 3 strips: one ePTFE, one polyglactin 910, and one polylactic acid. The surface roughness of each membrane material was measured by means of a laser profilometer. During a 24‐hour period, the students had to refrain from any oral hygiene procedures and did not use chlorhexidine mouthrinses. In each subject, one device was removed after 4 hours and the other after 24 hours. After removal, the devices were placed in a 2.5% gluteraldehyde solution to fix the membranes, which were then processed for SEM analysis. Fifty‐four microscopic fields (at 200X magnification) were randomly selected and analyzed in each strip. Magnification was increased to determine the presence of bacterial morphotypes. The presence or absence of bacteria was assessed in a binomial fashion. In such a system, the field was bacteriapositive when bacteria constituted the deposits covering the surface of the membrane. The microscopic field was considered bacteria‐negative when no bacteria were present. Bacteria‐positive fields showing rods and filaments as prevalent bacterial morphotypes were recorded as rod‐positive fields. A different pattern of plaque accumulation was demonstrated on different membrane materials. The 4‐hour results indicated a statistically significant difference (P = 0.008, ANOVA) in the proportion of bacteria‐positive fields among the 3 membranes; a greater amount of bacteria was demonstrated on the ePTFE membrane compared to the other 2 membranes. At 24 hours, the difference in the proportion of bacteria‐positive fields was statistically significant (P = 0.002, ANOVA); a lesser amount of bacterial plaque was present on the polylactic acid membrane compared to the ePTFE and polyglactin 910 membranes. No difference in the proportion of rod/bacteria‐positive fields was demonstrated among the 3 membranes at either 4 or 24 hours. It was concluded that quantitative differences in early plaque accumulation on various membranes seem to be related to the textural and structural characteristics of the surface, which is not adequately represented by the surface Ra value measured with a profilometric instrument. J Periodontol 1998;69:1193–1202.
The Use of Autogenous Periosteal Grafts as Barriers for the Treatment of Intrabony Defects in Humans
Authors: Kwan Stephen K. , Lekovic Vojislav , Camargo Paulo M. , Klokkevold Perry R. , Kenney E. Barrie , Nedic Melica , Dimitrijevic Bozidar
Published: March 2012

The purpose of this study was to evaluate the clinical effectiveness of a connective tissue graft including periosteum used as a barrier for guided periodontal tissue regeneration in interproximal bony defects. An open flap debridement of a comparable interproximal bony defect in the same patient was used as a control. This study was performed at 2 different clinical centers. Six paired defects were treated at one center, and 16 paired defects at the other. Reentry surgeries were performed at 6 months. Preoperative comparisons of control and experimental sites with respect to clinical parameters and osseous measurements were similar. Post‐surgical experimental sites produced more gain in clinical attachment (1.25 mm on buccal and 1.25 mm on lingual sites at center A and 1.26 mm on buccal and 1.18 mm on lingual sites at center B) and osseous defect fill (1.84 mm on buccal and 2.00 mm on lingual sites at center A and 1.66 mm on buccal and 2.04 mm on lingual sites at center B) when compared to control sites. The results of this trial indicate that clinical resolution of interproximal periodontal defects can be obtained with periosteal grafts used as barriers. J Periodontol 1998;69:1203–1209.
Diagnostic Utility of Specific Microbiological Markers for Periodontal Diseases
Authors: Eggert F.‐Michael , Flowerdew Gordon , McLeod M. Herbert , McIntyre Edward W. , Wasylyk Jason , Koschzeck Lea
Published: March 2012

Specific detection of marker organisms Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans with an immunoassay provided 2 types of useful information directly into private clinical practice: 1) persistence of P. gingivalis in patients undergoing regular treatment allowed rapid identification of pockets requiring further treatment without waiting for measurable progression of lesions and 2) presence of A. actinomycetemcomitans in adults at any stage of diagnosis or treatment identified patients who may prove to have difficult‐to‐manage periodontitis. We made these findings in 253 patients (234 in specialist periodontal practices [F‐ME 55; MHM 179] and 19 in general dental practice [EWM]). The search for useful diagnostic markers overlaps only partly with the search for periodontal pathogens. The P. gingivalis marker and the A. actinomycetemcomitans marker identify 2 different patterns of infection that appear to reflect 2 different underlying problems. Demonstration of pocket‐dependent infection with P. gingivalis in treated patients provides an outcome marker for sites not converting to marker‐negative sites at detection levels of the immunoassay. This information facilitates selection of sites and patients requiring adjustment of treatment regimens. Detection of A. actinomycetemcomitans in adult patients is significantly associated with periodontitis characterized as refractory. Positive identification of A. actinomycetemcomitans with the immunoassay supports clinical decision‐making by drawing attention to adult patients who require closer monitoring and intensive persistent treatment. Successful application of immunoassay detection of microbiological markers is based on continuous patient monitoring to support clinical decisions; it does not replace careful clinical judgment. J Periodontol 1998;69:1373–1381.
Hydroxyapatite Cement Implant for Regeneration of Periodontal Osseous Defects in Humans
Authors: Brown Graig D. , Mealey Brian L. , Nummikoski Pirkka V. , Bifano Sandra L. , Waldrop Thomas C.
Published: March 2012

A newly developed calcium phosphate cement used to promote bone regeneration in craniofacial defects was examined to determine its potential for treatment of periodontal osseous defects. Sixteen patients with moderate to severe periodontal disease and 2 bilaterally similar vertical bony defects received initial therapy including scaling and root planing followed by treatment with either calcium phosphate cement, flap curettage (F/C) or debridement plus demineralized freeze‐dried bone allograft (DFDBA). Standardized radiographs were exposed at baseline and 12 months postsurgery for computer assisted densitometric image analysis (CADIA). The extent of the bony defect was determined during initial and 12 month re‐entry surgery. Within 6 months of implant placement, 11 of 16 patients treated with calcium phosphate cement exfoliated all or most of the implant through the gingival sulcus. At all 16 test sites, a narrow radiolucent gap formed by 1 month postsurgery at the initially tight visual interface between the radiopaque calcium phosphate cement and the walls of the bony defect. Mean probing depth reduction and clinical attachment gain at sites treated with calcium phosphate cement were 1.6 mm and 1.3 mm, respectively at 1 year. Minimal bony defect fill was accompanied by mean eresiai resorption of 1.4 mm. Alveolar crestal resorption at sites with calcium phosphate cement was statistically significant (P = 0.001). These findings contrasted with the more favorable outcomes for controls treated with DFDBA or F/C. DFDBA sites exhibited probing depth reduction of 3.1 mm, clinical attachment gain of 2.9 mm, and defect fill of 2.4 mm. Respective clinical changes at F/C sites were 2.4 mm, 1.4 mm, and 1.1 mm. CADIA revealed clinically significant trends between the three treatment modalities at various areas‐of‐interest. Based on the findings of this study, there is no rationale available to support the use of hydroxyapatite cement implant in its current formulation for the treatment of vertical intrabony periodontal defects. J Periodontol 1998;69:146–157.
The Influence of Smoking and Race on Adult Periodontitis and Serum IgG2 Levels
Authors: Quinn Stephen M. , Zhang Ji‐Bo , Gunsolley John C. , Schenkein Harvey A. , Tew John G.
Published: March 2012

Smoking is a known risk factor for developing periodontal diseases, but the risk appears to be greater for white smokers than black smokers. Furthermore, it has been reported that young white subjects have significantly lower levels of serum IgG2 than their non‐smoking counterparts while‐ young black adult subjects are generally not affected by smoking. These relationships prompted the hypothesis that adult white subjects, including periodontitis subjects, who smoked would have more attachment loss than adult black subjects and that smoking would be associated with lower serum IgG2 levels in adult white subjects but not in adult black subjects. Smoking status was established from serum cotinine levels determined by radioimmunoassay. Serum IgG subclass levels were determined using radial immunodiffusion. White adult periodontitis (AP) and non‐periodontitis (NP) subjects who smoked had greater mean attachment loss per site than their non‐smoking counterparts. Furthermore, smoking white AP subjects and their age‐matched NP controls had substantially less IgG2 in their serum. In marked contrast, we were unable to detect any increase in periodontal destruction or a significant decrease in serum IgG2 levels in smoking black AP subjects or their age‐matched controls. However, IgG1 and IgG4 levels were reduced in smoking black AP subjects. IgG3 was the only subclass in adults that was unaffected by smoking. IgG2 can be a good opsonin and may help control periodontitis‐associated bacteria in adults. Even though a cause‐and‐effect relationship has not been established, the association between a smoking‐related decrease in serum IgG2 and an increase in periodontal destruction in white subjects is striking. J Periodontol 1998;69:171–177.