bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Study of Collagen and Expanded Polytetrafluoroethylene Membranes in the Treatment of Human Class II Furcation Defects
Authors: Black Barbara S. , Gher Marlin E. , Sandifer Johnny B. , Fucini Stephen E. , Richardson A. Charles
Published: March 2012

The purpose of this study was to compare the changes in clinical attachment when either a non‐resorbable ePTFE membrane or an absorbable collagen membrane was used as a barrier during surgical treatment of class II molar furcation defects. Thirteen patients, mean age 43.2 years, with two comparable class II molar defects were treated using a split mouth design. Pre‐surgical standardized probings were made using an automated probe at a constant force of 25 grams. Four to 6 weeks after initial therapy, the furcations were surgically debrided, the membranes placed to occlude separate furcation defects in each patient, and the sites closed. The ePTFE membrane was removed 6 weeks after placement. Six months postsurgery, the clinical measurements were repeated. Student t test was used to compare the results. There were no significant differences in the mean initial measurements between the treatment groups. The mean decrease in vertical probing depth was 1.40±1.68 mm for the collagen treated sites and 1.07±0.81 mm for the ePTFE treated sites. The decrease in horizontal probing depth was 1.49±1.97 mm for the collagen treated sites and 0.79±2.16 mm for the ePTFE treated sites. No significant differences were found between any of the clinical parameters measured. Based on the results of this short‐term clinical study, the absorbable collagen membrane was statistically equivalent to the non‐resorbable ePTFE membrane in the clinical resolution of class II furcation defects. J Periodontol 1994;65:598–604.
A Clinical Study of an Electronic Constant Force Periodontal Probe
Authors: Tupta‐Veselicky Louise , Famili Pouran , Ceravolo Francis J. , Zullo Thomas
Published: March 2012

Automated probing systems have been developed to provide a more precise method of evaluating periodontal pocket depths and attachment levels. The purpose of this study was to assess the clinical performance (reproducibility, time, and comfort) of a new electronic probe (E.P.) compared to the UNC 15 conventional probe (C.P.). Paired measurements 2 hours apart were performed by one examiner on 20 patients with moderate to advanced localized or generalized adult periodontitis. Both the E.P. and C.P. were used on each patient in a random manner. Overall reproducibility (± 1.5 mm) was: E.P. 94% (n = 1181); C.P. 96.5%. (n = 1254); E.P./C.P. used interchangeably 82.4% (n = 830). In assessing the reproducibility of bleeding on probing, using the Wilcoxon matched pairs signed ranks test, only the mid‐facial surface, when using the C.P. exhibited differences between measurements (P < 0.017). Paired t test revealed E.P. took significantly longer per exam (4 minutes, 46 seconds). Comfort levels, evaluated with a visual analog scale, were not significantly different between probes as shown by the Mann Whitney U test. The data suggest that, in general, there was no major significant difference in reproducibility measurements between the E.P. and the C.P. The E.P. took more time. Comfort levels were similar for both probes. J Periodontol 1994;65:616–622.
Use of Furcal Bone Sounding to Improve Accuracy of Furcation Diagnosis
Authors: Mealey Brian L. , Neubauer Michael F. , Butzin Clifford A. , Waldrop Thomas C.
Published: March 2012

Accurate diagnosis of periodontal destruction in the furcation region of multirooted teeth is a critical component of treatment planning, with different therapeutic approaches chosen based upon clinical determination of the severity of involvement. The current study assessed both vertical and horizontal depths of 274 furcations from 67 patients at three separate time points: by probing prior to anesthesia, by bone sounding after administration of anesthesia, and by direct measurement at the time of surgery. All measurements were made to the nearest millimeter. The mean vertical (1.8 mm) and horizontal (2.16 mm) furcation depths determined prior to anesthesia were significantly less than surgical measurements (2.79 mm and 3.65 mm, respectively). Use of sounding significantly improved the mean accuracy of vertical (2.40 mm) and horizontal (3.11 mm) furcation depth measurements relative to surgical determinations (P = 0.000). Surgical vertical depth was exactly the same as pre‐anesthesia probing in 42% of furcations, within ± 1 mm in 72.3% and within ±2 mm in 83.6%. Use of post‐anesthesia sounding improved agreement in vertical measurements to 59.5%, 85.7%, and 93.1%, respectively. Surgical horizontal depth was exactly the same as pre‐anesthesia probing measurements in 47.1% of furcations, within ±1 mm in 68.3% and within ±2 mm in 77.4%. Sounding improved agreement of horizontal measurements to 64.2%, 83.6%, and 88.3%, respectively. Underestimation of surgical furcation depths by pre‐anesthesia probing was much more common than overestimation. Sounding reduced the percent and degree of underestimation in all furcation types. The data demonstrate the ability of postanesthesia bone sounding to significantly improve the diagnostic accuracy of furcation invasions. J Periodontol 1994;65:649–657.
Factors Related to the Incidence and Severity of Cyclosporin‐Induced Gingival Overgrowth in Transplant Patients. A Longitudinal Study
Authors: Somacarrera M.L. , Hernández G. , Acero J. , Moskow B. S.
Published: March 2012

A longitudinal study was conducted during the first 6 months following transplant surgery in 100 heart, liver, or kidney transplant patients to assess the incidence and severity of cyclosporin‐induced gingival overgrowth, as well‐as the most important associated factors. Gingival overgrowth, plaque, and gingivitis indices, in addition to cyclosporin blood concentration, were assessed monthly. Statistical analysis was applied to evaluate the relationship between gingival overgrowth and other study variables and to test the influence of age, sex, time, and transplant type. Forty‐three percent (43%) of the patients developed gingival overgrowth. Gingival overgrowth increased significantly during the study, while plaque and gingivitis, subject to an oral hygiene training and motivation program, decreased significantly. The findings from this study would suggest that the basic factor influencing gingival overgrowth is cyclosporin blood concentration, followed by plaque/gingivitis level. The significant differences observed among transplant types, as well as among age groups, might be attributed to the differences in cyclosporin concentrations. An oral hygiene program prior to the transplant surgery is recommended. J Periodontol 1994;65:671–675.
Subgingival Temperature in Rats With Natural Gingivitis
Authors: Isogai E. , Isogai H. , Hirose K. , Kimura K. , Fujii N. , Shibahara N.
Published: March 2012

Elevated temperature, normally a characteristic of inflammation, is a potential indicator of periodontal disease. The present investigation examined the relationship of subgingival temperature and various indicators of gingivitis in rats with spontaneous gingivitis (SUS rat) and in control rats (RES rat). In 24 SUS rats with gingivitis, the subgingival temperature rose, but not in 6 SUS and 20 RES rats with healthy gingiva. Subjects with high mean subgingival temperatures had significantly higher mean percentages of Prevotella intermedia and Fusobacterium nucleatum than age‐matched RES rats. The results show that dental plaque, including specific bacteria P. intermedia and F. nucleatum, can play some role in causing the elevated temperatures. J Periodontol 1994;65:710–712.
Effects of Antibiotic Treatment on Clinical Conditions with Guided Tissue Regeneration: One‐Year Results
Authors: Demoion Isabelle A. , Persson G. Rutger , Ammons William F. , Johnson Robert H.
Published: March 2012

The one‐year results of a regenerative procedure in patients treated with or without antibiotics are presented. Expanded polytetrafluoroethylene (ePTFE) was placed over mandibular molar Class II furcation invasions and retained for four weeks. The patients in group 1 received no antibiotics; patients in group 2 received amoxicillin/clavulanate potassium during the first 10 post‐operative days. The initial differences in tested microorganisms and post‐surgical inflammation indicated that the use of the antibiotic might enhance the long‐term outcome. After one year, the reduction in mean probing depth of the furcation invasions was 2.0 ± 1.2 mm for group 1 and 1.8 ± 1.1 mm for group 2. An overall gain of 0.8 mm of clinical attachment was found. Twentytwo of the 24 sites were re‐entered. Wide individual variations were found but the changes between pre‐treatment and one‐year data for any of 6 linear measurements of hard tissue landmarks did not differ between groups or between pre‐treatment and re‐entry. A combination of an overall loss of 0.4 mm alveolar bone at the crest and 0.3 mm gain of bone at the bottom of the furcation defects was found. Volumetric analysis indicated an average 32% bone fill for both groups, ranging from a decrease in defect volume by 84% (gain) to an increase of the size of the furcation invasion by 66% (loss). A decrease in defect volume > 30% was found at 7 sites from each group. The antibiotic may have controlled initial inflammation, but 12 months later it had no direct effect on bone regeneration or soft tissue attachment. J Periodontol 1994; 65:713–717.
Immunohistochemical Study of 30 Cases of Cyclosporin A‐Induced Gingival Overgrowth
Authors: O'Valle Francisco , Mesa Francisco L. , Gómez‐Morales Mercedes , Aguilar David , Caracuel María D. , Medina‐Cano María T. , Andújar Miguel , López‐Hidalgo Javier , García del Moral Raimundo
Published: March 2012

Immunohistochemical techniques were used to study the presence of cyclosporin A (CsA) and leukocyte subsets in 30 gingival biopsies of renal transplant subjects with gingival overgrowth (GO). Statistical analysis revealed significant differences in the total number of inflammatory cells determined by monoclonal antibody CD45, the monocyte/macrophage (CD68) subset, the plasmatic cells (EMA), and the total of T‐lymphocytes (CD3) (P < 0.001, Student t test) between the treated subjects and the healthy control group. Differences were found in the helper/inducer T lymphocytes CD4 (P < 0.001 Student t test) and cyrotoxic/suppressor T lymphocyte (CD8) (P <0.01, Student t test) subsets between both groups. The CD4/CD8 ratio was greater in the transplant subjects than in the control group (1.82 ± 0.16 versus 1.35 ± 0.05 respectively) (P <0.05 Student t test). There was no significant difference in the populations CD16+, CD57+, and CD20+. The CD45+ CD4+, and CD68+ cells increased in number along with the degree of GO. The number of epithelial cells/mm2 which displayed a deposit of CsA increased in accordance with the degree of GO (P <0.05, Kruskal‐Wallis's test). Likewise, the intraepithelial deposit of CsA in the GO region was found to be related to the inflammatory infiltrate CD4+, CD8+, and CD68+ (r = 0.7432; r = 0.7346; r = 0.77005, respectively). Our findings suggest that the intraepithelial deposit of CsA and the inflammatory infiltrate play a predominantly pathogenic role and are both related to the degree of GO. J Periodontol 1994; 65:724–730.
Attachment Loss Trends Over 3 Years in Community‐Dwelling Older Adults
Authors: Beck James D. , Koch Gary G. , Offenbacher Steven
Published: March 2012

Most of our knowledge regarding the natural history of periodontitis in adults has come from clinical studies of dental patients. However, it is known that dental patients usually are not representative of what actually happens in the population. For this type of information, epidemiologie studies are required. The purpose of this paper is to present the trends in attachment loss over a 3‐year period in a population of communitydwelling elderly blacks and whites. Specifically, this paper presents attachment loss trends both at the person and site level to address the following issues: 1) whether attachment loss during one period in time makes a person at higher risk for attachment loss at a subsequent period; 2) whether sites with deeper periodontal pockets at baseline are more likely to experience future attachment loss; and 3) whether teeth that experience attachment loss during one time period are more likely to be lost at the next time period. In 1988, the University of North Carolina School of Dentistry initiated the Piedmont 65+ Dental Study, which is a subsample of the parent study, the Piedmont 65+ Study of the Elderly under the direction of investigators from Duke University. The dental study subsample was designed to elicit 800 dentate respondents in the 5‐county area who were examined again at 18 and 36 months. Our findings indicated that, for the two 18‐month periods investigated, attachment loss during the first period was related positively to the incidence of attachment loss at a subsequent period at the person level, but not at the site level. This is consistent with an episodic, random hit model of disease which places overall risk at the patient level with variation at the site level due to site characteristics. Our data also indicated that baseline probing depth was positively associated with the proportion of sites that demonstrated break down over the next 3 years. However, the vast majority of sites that experienced attachment loss had probing depths of 3 mm or less. Finally, teeth with more attachment loss at baseline had a higher probability of being lost during the next 3 years and teeth that experienced attachment loss during the initial 18 months were more likely to be lost during the next 18 months than teeth without additional attachment loss. In summary, this population‐based study of older adults who experienced a substantial incidence of attachment loss over a 3‐year period supports the findings from a number of clinical studies that indicate that attachment loss and pocket depth are related to probability of future breakdown in individual sites. J Periodontol 1994; 65:737–743.
A Preliminary Report on a Method for Studying the Permeability of Expanded Polytetrafluoroethylene Membrane to Bacteria In Vitro: A Scanning Electron Microscopic and Histological Study
Authors: Simion M. , Trisi P. , Maglione M. , Piattelli A.
Published: March 2012

The technique of guided tissue regeneration using expanded polytetrafluoroethylene (ePTFE) membranes has been shown to be effective in implant dentistry (bony defects, extremely thin alveolar ridges, and implants placed in fresh extraction sockets). One of the drawbacks associated with the use of membranes is their premature exposure with consequent bacterial contamination. The aim of this study was to examine the possibility that oral bacteria migrate through the occlusive portion of ePTFE membranes and to determine the time needed for microorganisms to pass from the outer surface to the inner surface of the membranes. A removable acrylic device was adapted to the molarpremolar region of one quadrant of the jaws in each of three volunteers. Five cylindrical teflon chambers were glued to the buccal aspect of each device. The chambers were divided into two rooms separated by the inner portion of a ePTFE membrane. The outer room was open to the oral cavity allowing plaque accumulation; the inner room was isolated from the oral cavity by the ePTFE membrane. One of the 5 chambers was completely closed and used as control. The test period lasted for 4 weeks. Every week, one chamber was removed from each device and processed for scanning electron microscopic and histologic examinations. Our study showed the possibility that oral bacteria may contaminate ePTFE membranes exposed to the oral cavity. One specimen showed partial bacterial penetration after 2 and 3 weeks, but after 4 weeks, all membrane specimens demonstrated bacterial contamination. Complete bacterial penetration through the membrane and contamination of the inner surface was observed in one specimen after 3 weeks and in two specimens after 4 weeks of exposure to the oral cavity. Therefore, the partially occlusive porosity of the membranes seems to be able to delay bacterial penetration through the membrane for approximately 3 to 4 weeks. After this time, prematurely exposed membranes should probably be removed to prevent bacterial infection of the underlying regenerating tissues. J Periodontol 1994;65:755–761.
Response of Regenerative Tissues to Plaque: A Histological Study in Monkeys
Authors: Ling Li‐jane , Lai Yu‐lin , Hwang Huey‐hwa , Chen Henry
Published: March 2012

This study was designed to determine the histologic response of regenerated tissue to plaque, using an adult Taiwan monkey model with chronically‐inflamed, surgically‐created, periodontal defects. Standardized 2‐walled periodontal defects were surgically created at the mesial of the mandibular lateral incisor on one side. Sutures, 3‐0 braided silk, were placed for 8 weeks and tissues positioned so that denuded root surfaces were exposed to plaque, with the subsequent development of the chronically‐inflamed periodontal tissues. At 8 weeks the defects were subjected to guided tissue regeneration procedures using expanded polytetrafluoroethylene membrane and allowed to heal for 6 months. Contralateral clinically healthy sites, without surgical procedures, were used as controls. In both experimental (membrane) and control sites, silk ligatures were placed to allow plaque accumulation for 2 or 10 weeks. Four monkeys were sacrificed at each time point and specimens processed for histologic and histometric study. The results indicated that plaque‐induced inflammation was less at sites treated by guided tissue regenerative procedures when compared to originally clinically‐healthy sites exposed to plaque for the same duration. However, histologically the newly formed osseous tissue was compromised under these conditions. J Periodontol 1994; 65:781–787.
Incidence of Early Periodontitis in a Group of Young Individuals During 8 Years: Associations With Selected Potential Predictors
Authors: Aass A.M. , Rossow I. , Preus H.R. , Gjermo P.
Published: March 2012

The aim of the present study was to assess the incidence of early radiographic bone loss in a birth cohort over 8 years and to assess possible associations between incidence of bone loss and reported dental behavior, ethnic background, and previous orthodontic treatment. In a case control study comprising a proportion of the study population, the detection of black pigmented Bacteroides and Actinobacillus actinomycetemcomitans and their association with early radiographic bone loss was assessed. At the beginning of the study in 1984, there were 2,767 subjects. In 1992 sets of bite‐wing radiographs were obtained from 215 subjects, who also filled out a questionnaire concerning their present and past dental behavior, ethnic background, and orthodontic treatment. Radiographic alveolar bone loss was recorded if the distance from the cemento‐enamel junction to the alveolar crest exceeded 2 mm. Thirteen subjects (6%) showed new sites with bone loss over the 8‐year period. Subgingival plaque was sampled from these 13 subjects and from 13 control subjects. None of the independent variables could be associated with the observed incidence of radiographic bone loss in this cohort, with the possible exception of the presence of A. actinomycetemcomitans which was detected in about 50% of the new sites with bone loss. J Periodontol 1994; 65:814–819.
Overview of Effects of Electrical Stimulation on Osteogenesis and Alveolar Bone
Authors: Kubota Kohzoh , Yoshimura Naoki , Yokota Makoto , Fitzsimmons Robert J. , Wikesjö Ulf M.E.
Published: March 2012

One endpoint of periodontal therapy is to regenerate structure lost to periodontal disease. Periodontal regeneration requires both formation of a new connective tissue attachment to the tooth and formation of alveolar bone. Several procedural advances may support regeneration of the attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical stimulation which naturally occurs in bone, and as‐such bone may be particularly susceptible to electrical therapy. This overview describes the potential of electrical stimulation for bone regeneration and applications in alveolar and periodontal research. J Periodontol 1995;66:2–6.
The Effect of a Single Application of Subgingival Antimicrobial or Mechanical Therapy on the Clinical Parameters of Juvenile Periodontitis
Authors: Ünsal Elif , Walsh Trevor Frank , Akkaya Murat
Published: March 2012

Twenty‐six (26) patients, 18 female and 7 male, aged 16 to 25 years (mean age 19.03 ±2.2 years) previously diagnosed as suffering from localized juvenile periodontitis were randomly assigned to one of the following treatment groups: 9 patients acted as controls; 8 received subgingival chlorexidine gel; and 9 had subgingival tetracycline paste application. All treatment modalities resulted in a pronounced improvement in PI, GI, and GI‐S by 12 weeks (P <0.001). The mean probing depths also decreased, but there were no significant‐differences found between the three groups. However, when the interproximal sites of the 3 groups were examined separately from the buccal and lingual sites, it was found that there was a significant (P <0.05) difference between the probing depths, with the control group showing the greatest reduction of 2.58 mm and the Chlorhexidine group showing the least reduction of 1.37 mm. It was concluded that a single application of topical subgingival tetracycline did not result in any short‐term improvement over that achieved by standard non‐surgical therapy in the clinical parameters of these localized juvenile periodontitis patients. J Periodontol 1995;66:47–51.
Immunoglobulin Isotypes in Gingival Crevicular Fluid: Possible Protective Role of IgA
Authors: Grbic John T. , Singer Robert E. , Jans Hans H. , Celenti Romanita S. , Lamster Ira B.
Published: March 2012

In order to simultaneously assess the local humoral immune and polymorphonuclear leukocyte (PMN) responses in periodontal disease, IgG, IgM, and IgA, as well as the PMN lysosomal enzyme β‐glucuronidase (βG), were examined in gingival crevicular fluid (GCF) from patients with varying degrees of periodontal pathology. Evaluations were made before and after conservative therapy (scaling and root planing). Thirty patients with varying degrees of periodontal pathology, ranging from mild inflammatory gingivitis to moderate periodontitis, were studied. GCF was collected from the mesial surfaces of all teeth. The presence of the 3 Immunoglobulin isotypes was determined by enzyme linked immunosorbent assays (ELISA), while total βG activity in GCF was determined by a fluorometric assay. Clinical parameters were obtained from 6 sites per tooth. Our data indicate that prior to treatment, total βG activity is strongly related to the severity of periodontal disease as measured by mean probing attachment level (AL; r = 0.89; P <.005), mean probing depth (PD; r = 0.89; P <.0005) and percentage of sites exhibiting bleeding on probing (% BOP; r = 0.49; P <.005). Following treatment, no statistically significant relationship of disease severity and βG is found. The concentrations of IgG and IgM in GCF do not follow a specific pattern when related to disease severity. In contrast, prior to treatment the concentration of IgA is negatively correlated to mean AL (r = ‐0.54; P <.005), mean PD (r = ‐0.59; P <.005), and % BOP (r = ‐0.47, P <.005). Following treatment, the negative correlation of IgA concentration to the clinical parameters is not as strong as seen before treatment, but still reaches significance for AL and PD. We also examined individual sites within patients who were categorized as displaying either gingivitis or periodontitis. We compared sites of comparable probing depth (1 to 3 mm or 4 to 6 mm) in the two groups of patients. With these analyses, the inverse relationship of the concentration of IgA in GCF and clinical measures of periodontal disease is still observed, suggesting that this finding was independent of probing depth of the individual site, and is a characteristic of the patient. In summary, the increased concentration of IgA in GCF from patients with minimal periodontal pathology suggests that IgA may play a protective role in the crevicular environment. Furthermore, this investigation supports the concept that a biochemical profile of GCF can be used to investigate the nature of the host response in periodontal disease. J Periodontol 1995; 66:55–61.
Platelet Association With Gingival Tissue Inflammation
Authors: Steinberg Arnold D. , Alves Mario E.A.F. , Lipowski Jeannette , Lebreton Guy C.
Published: March 2012

Platelets (PL) may be involved in the inflammatory process through the release of a variety of factors which could contribute to gingival tissue injury. Thus, conditions which result in the localized discharge of PL constituents could lead to amplification of the inflammatory process at these sites. The purpose of this study was to determine if there was evidence of PL activation in gingival crevicular fluid and whether the degree of gingival inflammation, as measured by the gingival index (GI), was associated with the degree of platelet activation. This was monitored by assaying for betathromboglobulin (β‐TG), a platelet specific protein released from alpha granules of PL when activated. One uL samples of the fluids were obtained from human subjects from gingival sites with various GI scores. Fluid samples were also obtained at probeinduced bleeding gingival crevicular sites. β‐TG levels in the various fluids obtained from the crevice were determined by radioimmunoassay (RIA). The RIA data indicated that detectable β‐TG levels were observed in all samples, the means ranging from 5.5 ng/ml to 45.2 ng/ml. Additionally, a positive association between the GI scores of 0 and 1 and the β‐TG levels where observed. For GI scores of 2 and above the β‐TG concentrations appeared to approach a maximum value. These findings provide evidence for PL activation and suggest a relationship with gingival inflammation. J Periodontol 1995;66:860–863.
Bacterial Colonization of the External and Internal Sulci and of Cellulose Membranes at Time of Retrieval
Authors: Novaes Arthur B. , Gutierrez Ferney Gonzalez , Francischetto Irani F. , Novaes Arthur B.
Published: March 2012

Membrane exposure with bacterial contamination is often considered one of the main reasons for the lack of predictability in achieving complete regeneration of periodontal defects. Ten cellulose membranes, retrieved from 7 patients treated for Class II furcation lesions in lower molars with‐at least 4 mm of exposure at time of retrieval were studied. Contamination of exposed membranes was studied using SEM analysis of four surfaces of the membrane, upper external, lower external, upper internal, and lower internal surfaces. DNA probe analysis of three periodontopathic bacteria, Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinmycetemcomitans, was carried out for specimens collected from the external and internal sulci. The results suggest that bacterial contamination of the membranes could be controlled if proper pre‐ and postoperative care is followed, since significant amounts of any of the three periodontopathogenic bacteria studied were not found. The SEM analysis corroborated the DNA probe analysis since the predominant morphotypes detected were not suggestive of periodontopathogenic bacteria. The importance of membrane contamination and of root concavities in the lack of predictability of the GTR procedure is discussed. J Periodontol 1995;66:864–869.
A Newly‐Developed Electrodeposited Diamond Sealer With High Abrasive Resistance
Authors: Fujimura Tetsuyuki , Kaya Hidehiro , Kimura Shigenobu
Published: March 2012

A diamond scaler on which blade diamond particles were coated by electrodeposition was developed to improve the abrasive resistance of sealer blades. The electrodeposited coating was tested with diamond particles of four different sizes, designated D‐4000 with 2 to 4 μm diameter of the particles; D‐800 with 12 to 25 μm; D‐600 with 20 to 30 μm; and D‐400 with 30 to 40 μm. The abrasive resistance of the scalers was examined quantitatively using a recently‐developed automatic scaling apparatus that simulated the scaling process of hand instrumentation, as well as SEM observation of the blades. A series of abrasion tests suggested that all the diamond sealers except D‐4000 showed better abrasive resistance than the control (D‐0), and that D‐600 showed the highest abrasive resistance and cutting quality. The SEM observation also suggested that D‐600 and D‐400 might have higher abrasive resistance. Furthermore, the profilometric evaluation of the surface roughness of the scaled natural dentin after hand instrumentation indicated that the average surface roughness increased in the order of D‐4000, D‐800, D‐600, and D‐400, although no marked differences were observed among D‐4000, D‐800, D‐600 and D‐0, but not D‐400. These results suggested that the electrodeposited diamond sealer with 20 to 30 μm diamond particles (D‐600) might have marked abrasive resistance as well as cutting quality without remarkable damage to the tooth surface after conventional scaling procedure. J Periodontol 1995;66:878–886.
A Case of Myiasis Gingiva
Authors: Günbay Şule , Biçakçi Nurgün , Canda Tülay , Canda Şerefettin
Published: March 2012

A case of myiasis gingiva was diagnosed in an investigation designed to evaluate the histopathological features of the adjacent tissues of 100 advanced periodontal lesions. The patient was a 36‐year old female and her chief complaint was discomfort and swelling in the area between the upper left central and lateral incisors. The patient's medical history, review of the symptoms, and family history were non‐contributory and her oral hygiene was acceptable. The surgeon was not aware of anything unusual during the operation. Although the Parasitology Department was unable to define the entomologic identification of the infesting parasite from histopathological tissue slides, it was agreed that this case, of myiasis might be produced by larvae of genus Sarcophaga or Enterobius vermicularis. J Periodontol 1995;66:892–895.
Clinical Significance of Bacterial Resistance to Tetracyclines in the Treatment of Periodontal Diseases
Authors: Greenstein Gary
Published: March 2012

Tetracyclines are frequently employed during the treatment of clinical infections in medicine and dentistry, however, emergence of resistant bacterial strains has decreased the utility of these drugs. Accordingly, there is concern that indiscriminant administration of tetracyclines during periodontal therapy will further contribute to the development of additional resistant microorganisms which can complicate infectious disease therapy. This review paper briefly discusses the utility of tetracyclines as an antimicrobial agent in the treatment of periodontal diseases. It then focuses on the clinical significance of bacterial resistance to tetracyclines. Patterns of resistance that may be associated with the following scenarios are addressed: short‐ and long‐term antibiotic therapy, individuals with a history of prior tetracycline therapy, patients with refractory periodontitis, and following controlled local drug delivery. It appears that selection and development of bacterial resistant strains is an inevitable consequence of antibiotic therapy. Nevertheless, prudent administration of tetracyclines may help delay or prevent the emergence of resistant microorganisms. J Periodontol 1995;66:925–932.
An In Vitro Investigation of the Role of High Molecular Weight Human Salivary Sulphated Glycoprotein in Periodontal Wound Healing
Authors: Zentner Andrej , Heaney Thomas G.
Published: March 2012

High molecular weight human salivary sulphated glycoprotein (SGP) inhibits attachment of fibroblasts to cementum in vitro and thus may enhance periodontal wound healing by repair with long junctional epithelium. However, competitive inhibition by serum constituents might prevent adequate binding of SGP for this effect to occur in vivo. The primary aim of this study was to investigate the co‐adsorption in vitro, of SGP, fibronectin (FN), and albumin (ALB) to synthetic hydroxyapatite (HA) from solutions of SGP/FN (62.5/2 μg/mL respectively), or SGP/FN/ALB (62.5/2/4 μg/mL), or from individual solutions of the agents as controls. Desorption of SGP and FN was studied by preabsorbing HA with SGP or FN and subsequently exposing it to the other agent, or to buffer only as control. Adsorbates were assayed after incubation periods of up to 26 hours using specific ELISAs. SGP displaced previously adsorbed FN after 3 hours and significantly inhibited adsorption of FN and ALB compared with controls. Neither FN or ALB had a significant effect on SGP adsorption. These results are consistent with the possibility that salivary adsorption to cementum during surgery might interfere with repopulation of the root by connective tissue cells and thus contribute to wound healing by repair rather than regeneration. Separate studies taken to validate the ELISA used for SGP determination showed that HA‐bound SGP contained all constituents of native SGP as revealed by SDS‐PAGE and that ion exchange chromatography of SGP gave 6 fractions (I through VI), of which only the most ionic (VI) was able to inhibit cell attachment in vitro. J Periodontol 1995;66:944–955.
The Effect of Bisphosphonate on Alveolar Bone Resorption Following Mucoperiosteal Flap Surgery in the Mandible of Rats
Authors: Yaffe Avinoam , Fine Nachum , Alt Ido , Binderman Itzhak
Published: March 2012

Following elevation of a full thickness flap a transient burst of regional remodeling occurs. This phenomenon is termed in orthopedic surgery as regional accelerated phenomenon (RAP), beginning with accelerated resorption activity followed by a slow process of bone regeneration. Recently we have demonstrated that a mucoperiosteal surgical flap of rat mandible is producing a typical RAP process. Bisphosphonates are synthetic compounds that are taken up preferentially by the skeleton and suppress osteoclast‐mediated bone resorption by a mechanism that is not yet fully understood. Amino bisphosphonate has been shown to inhibit active bone resorption without interfering with bone formation. In this study we evaluated the effect of amino bisphosphonate on bone resorption associated with a mucoperiosteal flap used as a resorptive model. We compared the effect of amino bisphosphonate in rats using IV administration with topical application at 3 dose levels. The results show that topical application of all 3 doses (0.15, 0.75, and 1.5 mg/ml) had no inhibiting effect on bone resorption after surgery, while IV administration at 0.5 mg/kg body weight significantly reduced the bone resorption. Interestingly, in the non‐operated side, amino bisphosphonate increased mineral density. J Periodontol 1995;66:999–1003.
Effect of ND:YAG Laser Irradiation and Root Planing on the Root Surface: Structural and Thermal Effects
Authors: Wilder‐Smith Petra , Arrastia Anne‐Marie A. , Schell Michael J. , Liaw Lih‐Hueh , Grill Gary , Berns Michael W.
Published: March 2012

Effects of Nd:YAG laser irradiation on untreated and root planed tooth roots were investigated to determine whether a cleaning effect and/or removal of smear layer could be achieved without concomitant microstructural or thermal damage. Sixty (60) healthy extracted teeth were either untreated, irradiated only, root planed only, or irradiated and root planed. Intra‐pulpal and surface temperatures were monitored during irradiation, then SEM was performed. Smear layer elimination was achieved without inducing hard tissue microstructural damage at 5W, using pulse durations and intervals of 0.1 s, a fluence of 0.77 J/cm2, and a total energy density of approximately 700 J/cm2. However, these results were not consistent in all samples. At these parameters, intra‐pulpal temperature increases of 9 to 22°C and surface temperature increases of 18 to 36°C were recorded. Thus, despite their effectiveness for smear layer removal, these parameters may not be appropriate for clinical use as an adjunct to conventional periodontal therapy. J Periodontol 1995;66:1032–1039.
Clinical Evaluation of an Allogeneic Bone Matrix in the Treatment of Periodontal Osseous Defects
Authors: Francis John R. , Brunsvold Michael A. , Prewett Annamarie B. , Mellonig James T.
Published: March 2012

The objective of this study was to evaluate an allogeneic bone matrix (ABM) as a graft material for the treatment of periodontal osseous defects. ABM is allogeneic demineralized freeze‐dried human bone which has been processed to eliminate contaminating lipids, serum proteins, and cellular components which, when present, have the potential to reduce the osteoinductive capacity of the graft. ABM is provided in a glycerine delivery suspension which enhances graft stability and ease in placement. Paired osseous defects, ranging in depth from 3 to 12 mm, within 11 patients, were randomized to receive ABM or demineralized freeze‐dried bone allograft (DFDBA). Probing depth, clinical attachment level, bone fill, and defect resolution were determined at baseline and at the 6‐month re‐entry procedure. Standardized radiographs and computer‐assisted densitometric image analysis (CADIA) were used to assess bone density changes. Complete bone defect resolution was seen in 7 of 11 defects receiving ABM, and in 5 of 11 defects with the use of DFDBA. Mean defect fill with ABM was 69% (33 to 100%) compared to 77% (66 to 100%) with DFDBA. Soft tissue healing without clinical evidence of tissue reaction to ABM was observed. ABM and DFDBA sites exhibited similar probing depth reduction of 4.0 and 4.6 mm, respectively. In sites with initial probing depth of 7 mm or more, probing depths were reduced a mean of 5.8 mm with ABM and 6.7 mm with DFDBA; both grafts resulted in a mean 4 mm of attachment gain. Results of radiographic analysis suggest similar density changes with each graft. These results demonstrate that both treatments were effective and that ABM may be a useful graft material in the treatment of periodontal osseous defects. J Periodontol 1995;66:1074–1079.
Detection and Incidence of the Tetracycline Resistance Determinant tet(M) in the Microflora Associated with Adult Periodontitis
Authors: Lacroix Jean‐Michel , Walker Clay B.
Published: March 2012

Subgingival plaque samples were collected from 68 patients with adult periodontitis, enumerated on Trypticase‐soy blood agar plates, with and without tetracycline at 4 μg/ml, and incubated anaerobically for 5 days. Each different colony morphotype was enumerated, and a representative colony was subcultured for identification and examined for the tetracycline resistance gene tet(M). Both PCR amplification and DNA hybridization, using a fragment of tet(M) from TN1545, were used to detect tet(M). The PCR primers (5′‐GACACGCCAGGACATATGG‐3′ and 5′‐TGCTTTCCTCTTGTTCGAG‐3′) were chosen to amplify a 397 bp region of tet(M). Tetracycline‐resistant bacteria represented approximately 12% of the total viable count. The percentage of tet(M)‐positive bacteria in the tetracycline resistant microflora varied from ≤ 0.05 to 83% (mean of 10%). ref(M) was detected in 60% of 204 tetracycline‐resistant strains subcultured arid identified. The tet(M) containing strains consisted of streptococci (55%, mainly S. intermedius, S. oralis, S. sanguis, and Streptococcus SM4), Actinomyces D01 (14%), Bifidobacterium D05 (11%), and Veillonella spp. (10%). Tetracycline‐resistant strains in which tet(M) was not detected included the Prevotella and Bacteroides species (41%, mainly Bacteroides D28, P. intermedia, P. nigrescens, and P. oris). These results suggest that tet(M) is widely spread in the adult periodontal microflora, but it appears, with the exception of S. intermedius, to be mainly associated with microorganisms not considered to be periodontopathogens. Assessment of other tetracycline‐resistant genes in oral organisms is needed to fully evaluate the nature of resistance to this antibiotic in the oral flora. J Periodontal 1995;66:102–108.
Periodontal Repair in Dogs: Recombinant Human Bone Morphogenetic Protein‐2 Significantly Enhances Periodontal Regeneration
Authors: Sigurdsson Thorarinn J. , Lee Michael B. , Kubota Kohzoh , Turek Thomas J. , Wozney John M. , Wikesjö Ulf M.E.
Published: March 2012

This study evaluated bone and cementum regeneration following periodontal reconstructive surgery using recombinant human bone morphogenetic protein‐2 (rhBMP2) in six beagle dogs. Surgically created mandibular supraalveolar premolar tooth defects in contralateral jaw quadrants were randomly assigned to receive rhBMP‐2 or control vehicle. Clinical defect height was prepared to 5 mm. rhBMP‐2 was applied with synthetic bioerodable particles and autologous blood using 20 μg rhBMP‐2 per 100 μl implant volume. Flaps were advanced to submerge the teeth and sutured. The dogs were sacrificed 8 weeks postsurgery. Histometric recordings included defect height, height and area of alveolar bone regeneration, height of cementum regeneration, root resorption, and ankylosis. Group means, standard deviations, and P values are shown (Student t test; n = 6). Histometric defect height for rhBMP‐2 and control defects was 3.7±0.3 and 3.9±0.4 mm, respectively (P = 0.446). Height of alveolar bone regeneration amounted to 3.5±0.6 and 0.8±0.6 mm for rhBMP‐2 and control defects, respectively (P = 0.000). Corresponding values for bone area were 8.4±4.5 and 0.4±0.5 mm2, respectively (P = 0.006). Cementum regeneration was observed in all experimental defects (17/17) and in 15 out of 17 controls, averaging 1.6±0.6 and 0.4±0.3 mm for rhBMP‐2 and control defects, respectively (P = 0.005). Small amounts of root resorption were seen in rhBMP2 defects, whereas controls exhibited substantial resorption (0.2±0.1 and 1.1±0.3 mm, respectively; P = 0.001). When present, ankylosis was limited and localized in both rhBMP‐2 and control defects, suggesting it was unrelated to the experimental variable. Our data suggest that wound conditioning with rhBMP‐2 has a significant potential for stimulating periodontal regeneration. J Periodontol 1995; 66:131–138.
Compliance With Supportive Periodontal Treatment in Private Periodontal Practice. A 14‐Year Retrospective Study
Authors: Demetriou N. , Tsami‐Pandi A. , Parashis A.
Published: March 2012

The purpose of this study was to determine the degree of compliance with supportive periodontal treatment (SPT) recommended in private periodontal practice and to determine if any significant differences existed in the characteristics of compliant, non‐compliant, and erratically compliant patients. The study covered a period of 14 years (1977 to 1991) and included 521 patients who were classified by sex, age, socioeconomic class, disease severity, treatment rendered, and the year maintenance began. Compliance was categorized into four groups: complete compliance, erratic compliance, patients who discontinued SPT, and patients who never presented for SPT. Females began SPT more often than males (P = 0.054). Only 27.4% of the patients were in complete compliance at the end of the study. A significantly greater percentage of females (P = 0.032) and patients who had been treated by only scaling and root planing (P = 0.014) were in complete compliance. Drop‐out rates from SPT tended to decrease during the first 6 years from 13.9% in the first 2 years to 9% in the sixth year. Thereafter, the percentage of patients presenting for SPT stabilized at 48.4% after 6 and 43.2% after 11 years. Younger patients (P = 0.04), those who had received only scaling and root planing (P = 0.008), and individuals in socioeconomic class I (P = 0.017) had a significantly lower tendency to drop out. The results confirm that compliance to SPT in private periodontal practice is far from ideal. Suggestions for improving compliance are discussed. J Periodontol 1995; 66:145–149.
The Effects of Scaling Procedures on Epithelial Cell Growth on Titanium Surfaces
Authors: Kuempel Deena R. , Johnson Georgia K. , Zaharias Rebecca S. , Keller John C.
Published: March 2012

This study examined in vitro epithelial cell growth on titanium surfaces which had been instrumented by 3 types of periodontal curets. Commercially pure titanium discs were uniformly scaled using plastic, stainless steel, or gold‐coated curets and then seeded with a microdot (50,000 cells per 10 μl) of rat gingival epithelial cells. After 5 days of growth, epithelial cell surface area (mm2) coverage was measured on photographed specimens using a computer digitizing system. Scanning electron microscopic evaluation showed a denser central core of cellular growth on the stainless steel‐treated surfaces as compared to the other surface treatments. Epithelial surface area coverage on the stainless steel, plastic, and control groups did not vary significantly among groups. However the gold‐coated curet exposed surfaces supported significantly less epithelial growth than the stainless steel and control surfaces. A better understanding of in vitro epithelial cell responses to different titanium surface characteristics will assist in designing implant scaling procedures which allow maintenance of the implant perimucosal seal. J Periodontol 1995; 66:228–234.
Short‐Term Effects of Phase I Therapy on Crevicular Cell Populations
Authors: Boretti G. , Zappa U. , Graf H. , Case D.
Published: March 2012

The purpose of the present study was to use a novel intracrevicular lavage technique to evaluate short‐term effects of phase I therapy on crevicular cell populations. Nineteen patients with untreated advanced adult periodontitis were selected for phase I therapy. One side of the dentition was treated with ultrasonic curets (U), the other side with manual curets (M). Nine months before (−9), immediately prior to (0), and 1 month after treatment (+1) gingival index (GI), plaque index (PI), bleeding index (BI), bleeding on probing (BOP), probing depth (PD), and probing attachment levels (PAL) were measured at all sites in the dentition. Crevicular lavages were obtained from 3 to 4 selected sites per patient at the same time points. Crevicular leukocytes were vital stained with ethydium bromide‐fluorescein‐diacetate (EB‐FDA). The total number of cells and the percentage of vital cells (%) were calculated for each sample. Clinical and lavage parameters obtained from the selected sites were compared between U and M sites, and between pre‐ and post‐treatment values. The results showed that without treatment PAL remained at the same level at both pretreatment time points −9 and −0 (control). At 1 month after treatment there were statistically significant reductions in GI, PI, BOP, and PD (P <0.001 for each comparison), and a statistically significant gain in PAL from 4.9 to 4.1 mm (P = 0.014). The total number of leukocytes per sample was similar at both pretreatment time points, but numerically reduced at 1 month after treatment. The percent of vital leukocytes was above 74% at both pretreatment time points (control). After treatment these values were below 70%. This reduction was statistically significant (P <0.002). These results suggest that periodontal phase I therapy leads to shifts in crevicular cell populations. J Periodontol 1995;66:235–240.