bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Citric Acid Treatment on Pedicle Flap Coverage of Localized Recession
Authors: Oles R. D. , Ibbott C. G. , Laverty W. H. 
Published: March 2012

Citric acid conditioning of denuded roots prior to laterally positioned pedicle flap (LPPF) coverage may increase the likelihood of reattachment, but no controlled studies to determine the efficacy of the procedure in managing naturally occurring defects in humans have been reported. This investigation compared the effects of LPPF root coverage with and without citric acid (pH1) pretreatment in a group of patients with gingival recession and associated denuded roots.Thirty‐six patients participated in the study. Eighteen received LPPFs without citric acid pretreatment and 18 received LPPFs with citric acid pretreatment. Gingival recession and sulcus depth were measured preoperatively and 30, 60 and 90 days after the surgical procedure.LPPFs both with and without citric acid pretreatment reduced significantly the amount of exposed root, but no differences between groups were found. For sulcus depth, the 90day value for the citric acid group was significantly increased over the preoperative level, but no other changes were noted.There appears to be no clinical justification for using citric acid conditioning as an adjunct to LPPF coverage of denuded roots.
Evaluation of the Effect on Root Surfaces of Air Turbine Sealers and Ultrasonic Instrumentation
Authors: Lie T. , Leknes K. N. 
Published: March 2012

Three air turbine scalers were compared to each other and to an ultrasonic instrument (CAVITRON®) on medium and maximum power setting. The amount of remaining calculus, roughness and loss of tooth substance were estimated by means of well‐defined index systems (RCI and RLTSI). The time required to clean the test surfaces—marked on proximal root surfaces of mandibular incisors—was also noted. Standardized scanning electron microscope (SEM) micrographs were independently “blind‐scored” by three examiners, and total mean scores were calculated.The results revealed significant differences (P < 0.001) between the instruments with respect to the amount of remaining calculus. There were also significant differences (P < 0.05) between roughness and loss of tooth substance produced by CAVITRON® at maximum power setting and that produced by the other instruments. No differences were found with regard to the time required to clean the test surface (until visually clean).
Repigmentation of the Gingiva Following Surgical Injury
Authors: Perlmutter Samuel , Tal Haim 
Published: March 2012

Oral melanin pigmentation is not uncommon in some races and ethnic groups. Repigmentation of depigmented oral mucosa has been described after chemical, thermal, surgical, pharmacologic or idiopathic factors. Information on the repigmentation of oral tissues after surgical procedures is extremely limited. This communication reports on gingival repigmentation over a 7 to 8 year period following removal of gingival tissues.Pigmented keratinized gingiva was removed in two Jewish Yemanite adult males, who had moderate or heavily pigmented gingiva. After surgery, the exposed lamina propria was covered by a periodontal pack for 7 to 10 days. The tissues were then observed periodically for signs of repigmentation. Healing was uneventful and the surgically treated areas in both patients remained depigmented over the first 2 years. After 32 months, some pigmentation was found in one of the patients, and with the exception of two limited sites, the area was completely repigmented after 7 years. The surgically treated area in the second patient remained depigmented over an 8‐year follow‐up period.These observations agree with previous reports that described gingival pigmentation as spontaneous and suggest that further controlled experimental studies be undertaken to explore the biologic basis for repigmentation.
The Effect of Different Treatment Modalities on Connective Tissue Attachment
Authors: Lai Hongmin , O'Leary Timothy J. , Kafrawy Abdel H. 
Published: March 2012

This study compared the effect of four treatment modalities on connective tissue attachment. Ligature‐induced periodontitis was established around the mandibular premolare of five young beagle dogs over 8 weeks. Following a 2‐week period without ligatures, a reference dog was sacrificed to estimate the extent and nature of the disease. Three dogs received flap procedures in one mandibular posterior segment, and the six experimental roots were treated with citric acid (pH 1) for 3 minutes; the contralateral mandibular segments received flap procedures and the roots were treated with 4% Chlorhexidine gluconate in the Hibiclens® preparation for 3 minutes. One segment of the control dog received flap procedures, and the roots were treated with sterile normal saline; the contralateral segment received closed root planing. The experimental dogs were sacrificed 1, 2 and 3 months after treatment. The control dog was sacrificed 3 months postoperatively. One week before sacrifice each dog received a Procion dye injection.At sacrifice the study segments of all four treated dogs were clinically healthy, with no observable differences between the different treatment modalities. Histologically, the 1‐ and 3‐month Chlorhexidine, the 3‐month saline and 3‐month root planed specimens had long junctional epithelial adhesions with little connective tissue attachment. The 2‐month Chlorhexidine and all citric acid‐treated sections showed appreciable amounts of new connective tissue attachment. Some 2‐month and 3‐month citric acid and 2‐month Chlorhexidine sections showed cementum over the apical portion of the long junctional epithelium. The frequency of occurrence and the length of cementum overlapping epithelium increased appreciably over time.Chlorhexidine was less predictable than citric acid in enhancing connective tissue attachment. When compared with the size of the periodontally involved area in the reference dog, all new connective tissue attachment could have occurred on uninvolved surfaces denuded by the root planing or flap procedures. The finding of cementum overlying the junctional epithelium indicates that coronal migration of connective tissue attachment is possible.
Relative Influence of Scaling and Root Planing and Occlusal Adjustment on Sulcular Fluid Flow
Authors: Hakkarainen Kristiina 
Published: March 2012

The aim of the investigation was to clarify the effects of the resolving of inflammation on one hand and the removal of occlusal trauma on the other hand on the rate of sulcular fluid flow (SFF) from deep periodontal pockets. Forty‐seven adult patients having at least one tooth with an inflamed >5 mm periodontal pocket and elevated mobility associated with occlusal trauma were selected for the study. After oral hygiene instruction and supragingival scaling, the rate of sulcular fluid flow of the test teeth was recorded on Day 0. After the baseline recording, each patient was randomly assigned to either Group A or Group B. The test teeth of Group A were subjected to subgingival scaling and root planing under local anesthesia, and the test teeth of Group B were subjected to occlusal adjustment. On Day 14 sulcular fluid flow was recorded for both groups, after which Group A received occlusal adjustment and group B received scaling and root planing. On Day 28 the sulcular fluid flow recordings were repeated for both groups.The mean flow rates of both Group A and Group B decreased significantly (P < 0.05) from Day 0 to Day 28. When the occlusal interference was eliminated 2 weeks after scaling and root planing (Group A), no additional decrease in sulcular fluid flow was observed. When the occlusal interference was eliminated before scaling and root planing (Group B), the reduction in sulcular fluid flow remained statistically insignificant through the first 2week observation period. For the incisors and canines, a significant (P < 0.05) reduction in SFF was measured after scaling and root planing of the occlusally adjusted teeth (Group B). It was concluded that occlusal interferences do not affect the quality of sulcular fluid flow.
A Study of Epithelial Odontogenic Residues in the Pig
Authors: Spouge J. D. 
Published: March 2012

Formation of the junctional epithelium was studied by routine light microscopy in the molar teeth of commercially slaughtered pigs. It was found that the process whereby the reduced enamel epithelium (REE) contributed to the junctional epithelium formation corresponded largely with changes in man previously described by Schroeder and Listgarten (Monographs in Developmental Biology, Vol. II, Basel, S. Karger, 1971).The configuration of the marginal rests of Malassez (ROM) and their relationship to the junctional epithelium and REE was similarly studied by means of true serial sections. It was found that the ROM in that portion of the periodontium below the alveolar crest formed a well defined network of epithelial strands, but the network became more poorly defined and diverged away from the surface of the cementum as the cementoenamel junction was approached. The coronal border of this network ultimately became continuous with the REE by means of a relatively few vertical strands of epithelium.The possibility that the presence of epithelial residues in the periodontium may contribute to pocket formation and the potential effects of its configuration and continuity with the junctional epithelium are speculatively considered.
A Periodontitis Severity Index
Authors: Adams R. A. , Nystrom G. P. 
Published: March 2012

A Periodontitis Severity Index (PSI) was developed and then tested in a population of 154 patients attending the University of Mississippi School of Dentistry screening clinic. Patients were grouped by age decade. The premises of the PSI follow: (1) Periodontitis is diagnosed on the concurrence of clinically apparent marginal inflammation and vertical loss of supporting periodontium (the severity of the associated clinical inflammation does not seem to be related to the severity of the tissue loss) and (2) a Schei ruler is used to determine from the radiograph the percentage of bone loss for a tooth surface.For each patient, a 0 to 1 Clinical Inflammation Score (CIS) was determined at the mesial and distal of every tooth. A CIS of 0 reflected no demonstrable clinical inflammation, whereas a CIS of 1 meant that clinical inflammation could be detected. A modified Schei ruler was used to determine the percentage of bone loss at each interproximal site. A Bone Loss Score (BLS) was calculated on a 0 to 10 whole number continuum. A BLS of 0 meant no bone loss, 1 = up to 10%, etc., up to BLS 10 = 90 to 100% loss.The PSI was then calculated for each mesial and distal surface. PSI = BLS × CIS. The PSI could be 0 if either no bone loss could be determined or the gingiva was healthy. In the presence of marginal inflammation, the PSI value was directly proportional to the percentage of bone loss. Mean PSI values were calculated for each age group. The PSI tended to increase with age.The PSI offers several advantages. Healthy sites can be distinguished from diseased sites, ratio data can be produced, arbitrarily weighted clinical observations can be largely avoided, and direct measurements of periodontitis severity can be made.
Periodontal Adaptation Following Extensive Extrusion and Rotation of a Horizontally Impacted Maxillary Central Incisor
Authors: Khouri Suhail Awwad 
Published: March 2012

This report reviews the literature concerning the periodontal considerations involved in nonextraction management of impacted teeth. Further, it describes the clinical and radiographic features of periodontal tissue response to an 18‐mm extrusion and 160 degree simultaneous rotation of a horizontally impacted maxillary central incisor in a 22‐year‐old female patient.Following surgical exposure of the unerupted incisor, an elastic thread traction was used to orthodontically move the tooth to the line of occlusion. Posttreatment evaluation of the periodontal and gingival response to a tooth movement of this complexity and magnitude was very favorable from the esthetic and functional aspects.
Antibodies to Actinobacillus actinomycetemcomitans in a Korean Population
Authors: Chung Chong‐Puoung , Lee Young‐Kwan , Choi Sang‐Mook , Nisengard Russell J. 
Published: March 2012

Previous studies demonstrated that serum antibodies to Actinobacillus actinomycetemcomitans strain Y4 are significantly elevated in sera from localized juvenile periodontitis (LJP) and postlocalized juvenile periodontitis (P‐LJP) patients compared to normal controls in United States populations. This study examined the age of subjects in relation to the antibody levels to A. actinomycetemcomitans in a Korean population. Seven groups were investigated including sera from newborns, infants, children, periodontally normal puberty and adult groups and LJP and P‐LJP groups. Antibody levels were determined by an enzyme‐linked immunosorbent assay (ELISA) to A. actinomycetemcomitans strain SNUDC 10–1 (serotype C) isolated from a Korean LJP patient.In the healthy non‐LJP and non‐P‐LJP subjects, IgG levels decreased from the newborn group to the 5‐month‐old group and then gradually increased through the adult group. The IgM levels in these groups continuously increased from birth until a plateau was reached in the 2‐ to 6‐year group. Serum IgA levels to strain SNUDC 10–1 were too low to be measured by this assay.
Occurrence of Actinobacillus actinomycetemcomitans and Spirochetes in Relation to Age in Localized Juvenile Periodontitis
Authors: Asikainen Sirkka 
Published: March 2012

Occurrence of Actinobacillus actinomycetemcomitans (A.a.) and spirochetes was examined in relation to the age of patients suffering from localized juvenile periodontitis (LJP). Twenty LJP patients were divided into three age groups: 14–16, 17–19, and 20–25 years of age. Two sites with radiographic alveolar bone loss and two sites without bone loss were examined in each patient. Probing depth, gingival bleeding after probing, and orthopantomographic alveolar bone loss were recorded. Subgingival bacterial samples were taken from the same four sites for cultivation of A.a., and for dark‐field microscopic assessment of spirochetes. A.a. was isolated in the youngest group more frequently than in the two older ones. Spirochetes were detected in the youngest group as well, but were not related to the age of the patients. A.a. occurred as frequently with as without spirochetes, both in pockets exhibiting and not exhibiting bone loss. There was no difference in the spirochete proportions between the A.a.‐positive and ‐negative sites.The occurrence of A.a. was not related to the absence, presence, or proportions of the spirochetes, but, unlike the situation with spirochetes, was related to the age of the LJP patients. Thus the occurrence of A.a. is possibly associated with the activity of the disease.
Comparative Effectiveness of Ultrasonic and Hand Scaling for the Removal of Subgingival Plaque and Calculus
Authors: Breininger David R. , O'Leary Timothy J. , Blumenshine Ruth V. H. 
Published: March 2012

The purpose of the study was two‐fold: to determine the nature of stainable deposits on periodontally diseased root surfaces subsequent to in vivo scaling and root planing procedures, and to quantify the distribution of residual plaque on instrumented root surfaces. Thirty molar and 30 nonmolar teeth which were condemned for periodontal or prosthetic reasons and had proximal probing depths of 4 to 7 mm were treated. Half of these were instrumented with I.U. curettes and the other half with an ultrasonic scaling device. Instrumentation was continued until the root surface felt hard and smooth to an explorer tip. The location of the gingival margin was recorded by notching the treated proximal surface with a No. 1/2 round bur. Twenty control teeth, 10 molar and 10 nonmolar, were extracted without instrumentation. Control and experimental teeth were irrigated with saline and stored in a 2.5% glutaraldehyde fixative solution until the time of assessment.All teeth were stained with a 0.5% solution of toluidine blue, and the amount of residual stained material and calculus was assessed under the stereomicroscope using an eyepiece fitted with a 10 × 10 optical grid. Stained deposits were marked by placing small V‐shaped notches in the adjacent root surface as an aid to identification after the specimens were processed for scanning electron microscopic (SEM) examination. The nature of stained deposits on selected teeth was then characterized using the SEM. Treated root surfaces were also surveyed in detail to assess the quantity and extent of residual plaque deposits.The findings showed that although a large percentage of the treated proximal root surface may possess stainable deposits, these surfaces were often unexpectedly free of microbial organisms. In this study, the majority of stained deposits were composed of adherent fibrin and instrumentation debris. When bacterial plaque was present, it was usually found in small „mini‐colonies” smaller than 0.5 mm across. Such findings cast doubt on the validity of using histologic and disclosing stains as an indicator for the presence of bacterial plaque immediately after instrumentation. Although only partially effective in removing subgingival calculus, both methods of instrumentation in this study appeared to be remarkably effective in bacterial debridement of subgingival root surfaces.
A Biochemical Approach to Periodontal Regeneration
Authors: Terranova Victor P. , Hic Susanne , Franzetti Louis , Lyall Raymond M. , Wikesjö Ulf M. E. 
Published: March 2012

Recent investigations on regeneration of the periodontium have attempted to define factors involved in the formation of a new connective tissue attachment. One essential biological event involved in tissue regeneration is directed cell migration (Chemotaxis). Extracellular matrix proteins have been shown to influence Chemotaxis, cell proliferation and differentiation. Recently, the extracellular matrix proteins, fibronectin (FN) and laminin (LM), and the Polypeptide, endothelial cell growth factor (ECGF), have been shown to stimulate a variety of biological processes.Current assay systems which attempt to define cell migration are the Boyden chamber assay and a random cell migration assay. Neither assay system adequately defines in vivo cell migration.Here we present a new in vitro assay system that tests the capacity of several biological response modifiers applied on dentin to stimulate a chemotactic and proliferative response from various cell types. The assay system consists of two types of assays. Assay I measures the chemotactic activity of test substances bound to dentin. In this assay cells must actively move through a filter (Nuclepore®) towards a factor bound to dentin. Assay II examines the ability of dentin‐bound biological response modifiers to stimulate directed movement and proliferation of cells on dentin surfaces. We report that periodontal ligament (PDL) cells migrate towards FN and ECGF; that PDL cell migration is enhanced when dentin is preconditioned with tetracycline HCl; that PDL cells have an increased proliferative response when dentin is conditioned with both FN and ECGF; that gingival epithelial cells have increased migratory and proliferative responses when LM is used to condition dentin; and that there is a reciprocal utilization of biological response modifiers by gingival epithelial cells and PDL cells.
Tissue Localization of Actinobacillus actinomycetemcomitans in Human Periodontitis
Authors: Christersson Lars A. , Albini Boris , Zambon Joseph J. , Wikesjö Ulf M.E. , Genco Robert J. 
Published: March 2012

Invasion of periodontal tissues by different bacterial morphotypes has been reported in human periodontitis; however, limited information is available as to prevalence, localization and the bacterial species involved. The present study determined prevalence and gingival localization of Actinobacillus (Haemophilus) actinomycetemcomitans in periodontal lesions of juvenile periodontitis patients.Thirty‐five gingival biopsies were obtained from 12 juvenile periodontitis patients at the time of periodontal therapy. One additional control biopsy was obtained from each of two adult periodontally healthy subjects, one adult periodontitis patient and one periodontally healthy monkey (Macaca fosibolius). The biopsies were carefully processed to avoid mechanical introduction of bacteria into the tissues and were examined using light and electron microscopy. Rabbit antisera specific for the three A. actinomycetemcomitans serotypes were used for immunofluorescence microscopic localization of A. actinomycetemcomitans antigens in the gingival sections.Immunofluorescence microscopy showed A. actinomycetemcomitans specific antigens in the gingival tissues of 11 of the 12 juvenile patients examined. None of the control specimens showed evidence of A. actinomycetemcomitans antigens in the gingival connective tissue. One specimen from a periodontally healthy subject and the monkey biopsy, however, showed A. actinomycetemcomitans antigens in bacterial plaque on the surface of the crevicular epithelium.Transmission electron microscopic examination showed microcolonies of small gramnegative rods in the connective tissue, as well as single bacterial cells between collagen fibers and in areas of cell debris. In addition to these extracellular bacterial cells, evidence of bacterial cells was also found within gingival connective tissue phagocytic cells.The data from the present study suggest that the gingival tissue in juvenile periodontitis lesions harbors A. actinomycetemcomitans.
A Comparison of Mandibular Lingual Surgical Flaps with and without a Vertical Releasing Incision
Authors: Lynch Thomas J. , Ficara Anthony J. , Ekvall William M. , Raulin Leslie A. , Rossmann Jeffrey A. , Scheidt Michael J. 
Published: March 2012

The purpose of this study was to evaluate the short‐term postoperative pain for surgical flaps with mandibular lingual vertical releasing incisions (ML‐VRI) compared with envelope flaps and to observe the postoperative clinical healing of ML‐VRI. Using a split mouth design, 12 adult periodontal patients received bilateral posterior mandibular surgery with an envelope flap on one side and a flap with an ML‐VRI on the contralateral side. Surgical procedures were performed at separate appointments, varied in order, and performed an equal number of times on the right and left sides. Postoperative pain was scored by the patients, and scores for each technique were compared using an analysis of variance and covariance with repeated measures. Photographs were used to assess postoperative clinical healing of ML‐VRI with various degrees of initial closure. Results indicated no significant statistical difference (P > 0.05) between pain levels for the two surgical techniques. There was complete clinical healing despite variations in the degree of closure of ML‐VRI.The findings of this study support the use of ML‐VRI. They are indicated in areas with flat contours or with slight ledges and inferior concavities. ML‐VRI are contraindicated in areas with prominent ledges and inferior concavities and in areas with exostoses. Suturing the vertical incision is unnecessary and may be detrimental to the tissues. A “step down” incision that preserves attachment levels in nondiseased sites is discussed.