bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regulatory T cell populations in sepsis and trauma
Authors: Venet Fabienne , Chung Chun-Shiang , Monneret Guillaume , Huang Xin , Horner Brian , Garber Megan , Ayala Alfred 
Published: October 2007

AbstractSepsis syndrome remains the leading cause of mortality in intensive care units. It is now believed that along with the body’s hyperinflammatory response designated to eliminate the underlying pathogen, mechanisms are initiated to control this initial response, which can become deleterious and result in immune dysfunctions and death. A similar state of immune suppression has been described after numerous forms of severe trauma/injury. Although the evidence for immune dysfunctions after sepsis has grown, much remains to be understood about mechanisms underpinning its development and how it acts to increase the morbid state of the critically ill patient. In this context, although the majority of clinical and basic science conducted so far has focused on the roles of myeloid cell populations, the contribution of T lymphocytes and in particular, of regulatory T cells has been somewhat ignored. The studies presented here support the concept that regulatory T lymphocytes (CD4+CD25+ regulatory, γδ, and NK T cells) play a role in the control of immune responses and are affected by injury and sepsis. This may be related to their capacity to interact with components of the innate and adaptive immune responses and to their ability to be activated nonspecifically by bacterial products and/or cytokines and to regulate through direct cell–cell and/or soluble mediators. It is our hope that a better understanding of the mechanism through which those rare lymphocyte subsets exert such a profound effect on the immune response may help in improving our ability not only to diagnose but also to treat the critically ill individual.
Toll‐Like Receptor 2 and 4 Gene Polymorphisms in Generalized Aggressive Periodontitis
Authors: Emingil Gülnur , Berdeli Afig , Baylas Haluk , Saygan Buket Han , Gürkan Ali , Köse Timur , Atilla Gül 
Published: October 2007

Background: Toll‐like receptors (TLRs) recognize exogenous ligands such as lipopolysaccharide and bacterial lipoprotein during the immune responses to pathogens. The aim of the present study was to investigate whether TLR2 and TLR4 gene polymorphisms are related to susceptibility to generalized aggressive periodontitis (GAgP).Methods: A total of 245 subjects were included in the present study. Genomic DNA was obtained from the peripheral blood of 90 patients with GAgP and 155 periodontally healthy subjects. Probing depth, clinical attachment loss, plaque accumulation, and bleeding on probing were recorded. The TLR2 gene Arg753Gln and Arg677Trp polymorphisms and TLR4 gene Asp299Gly and Thr399Ile polymorphisms were genotyped by the polymerase chain reaction–restriction fragment length polymorphism method. The data were analyzed by χ2 and Mann‐Whitney U tests and logistic regression analysis.Results: There was no significant difference in the distribution of TLR2 and TLR4 genotypes and allele frequencies between GAgP patients and healthy subjects (P >0.05). The TLR2 753Gln allele was found in 3.9% of the GAgP patients compared to 6.1% in the healthy group. The GAgP patients and healthy subjects did not show homozygosity for the TLR2 mutant alleles. The TLR2 677Trp mutant allele was not found in any of the subjects; 2.2% of the GAgP patients and 2.9% of the periodontally healthy subjects were identified as having the TLR4 299Gly polymorphic allele. With regard to the TLR4 399Ile polymorphic allele, 1.1% of the GAgP patients and 2.3% of the periodontally healthy subjects had this allele.Conclusions: The present study failed to find any significant association between the TLR polymorphisms and GAgP, potentially because of the small sample size. To the best of our knowledge, this was the first study to examine the prevalence of these polymorphisms in a Turkish population with aggressive periodontitis.
Periodontal Disease at the Biofilm–Gingival Interface
Authors: Offenbacher S. , Barros S.P. , Singer R.E. , Moss K. , Williams R.C. , Beck J.D. 
Published: October 2007

Background: A molecular epidemiologic study provided the opportunity to characterize the biology of the biofilm–gingival interface (BGI) in 6,768 community‐dwelling subjects.Methods: Disease classifications and multivariable models were developed using clinical, microbial, inflammatory, and host‐response data. The purpose was to identify new clinical categories that represented distinct biologic phenotypes based upon DNA checkerboard analyses of eight plaque bacteria, serum immunoglobulin G (IgG) titers to 17 bacteria, and the gingival crevicular fluid (GCF) levels of 16 inflammatory mediators. Five BGI clinical conditions were defined using probing depths (PDs) and bleeding on probing (BOP) scores. Subjects with all PDs ≤3 mm were grouped as BGI‐healthy (14.3% of sample) or BGI‐gingivitis (BGI‐G, 15.1%). Subjects with one or more PDs ≥4 mm [deep lesion (DL)] were divided into low BOP (18.0%), moderate BOP (BGI‐DL/MB, 39.7%), and severe BOP (BGI‐DL/SB, 12.9%).Results: Subjects with BGI‐G had increased levels of Campylobacter rectus–specific serum IgG levels (P = 0.01), and those with BGI‐DL/SB had increased IgG levels to Porphyromonas gingivalis (P < 0.0003) and C. rectus (P < 0.01). BGI‐DL/SB subjects had an excessive GCF interleukin (IL)‐1β and prostaglandin E2 response and an enhanced chronic inflammatory response with significant increases in GCF IL‐6 and monocyte chemotactic peptide‐1. Within BGI‐DL/SB subjects, more severe pocketing and BOP were associated with higher levels of GCF IL‐1β, not higher microbial counts or plaque scores.Conclusions: New BGI classifications create categories with distinct biologic phenotypes. The increased titers of C. rectus IgG among 68.5% of the BGI‐G subjects and elevated P. gingivalis titers among BGI‐DL/MB and BGI‐DL/SB subjects (63.8% and 75.7%, respectively) are strongly supportive of the microbial specificity of pathogenesis for BGI categories.
Successful Management of Aggressive Periodontitis By Regenerative Therapy: A 3‐Year Follow‐Up Case Report
Authors: Miliauskaite Asta , Selimovic Denis , Hannig Matthias 
Published: October 2007

Background: This case report presents a new treatment for localized aggressive periodontitis using surgery (papilla preservation technique [PPT]) combined with enamel matrix proteins and bioactive glass.Methods: Eight intrabony defects in a 19‐year‐old woman with localized aggressive periodontitis were treated by PPT and the application of enamel matrix proteins or enamel matrix proteins in combination with bioactive glass. Probing depth, gingival recession, and clinical attachment level (CAL) were evaluated at baseline, 6 and 12 months, and 2 and 3 years after treatment. The primary outcome variable was CAL.Results: After 3 years, the sites treated with enamel matrix proteins demonstrated a mean CAL change from 8.3 ± 3.2 mm to 4.0 ± 3.6 mm (P <0.39), and the sites treated with enamel matrix proteins combined with bioactive glass showed a mean CAL change from 8.6 ± 2.4 mm to 3.7 ± 0.8 mm (P <0.001).Conclusion: In the present case of aggressive periodontitis, application of enamel matrix proteins with or without the addition of bioactive glass resulted in the successful treatment of intrabony defects.
Does Periodontal Disease Reflect Atherosclerosis in Continuous Ambulatory Peritoneal Dialysis Patients?
Authors: Cengiz M. Inanç , Bal Seda , Gökçay Sibel , Cengiz Kuddusi 
Published: October 2007

Background: Chronic infection and inflammation, including periodontitis, are linked to an increased risk for atherosclerosis. To investigate the possible adverse effects of periodontitis in continuous ambulatory peritoneal dialysis (CAPD) patients, we compared periodontal severity with inflammation and malnutrition, which are associated with poor atherosclerotic outcome in CAPD patients.Methods: A total of 110 CAPD patients were included in this study to evaluate their clinical periodontal status by using the plaque index, gingival index, and periodontal disease index. Values for nutritional and inflammatory markers and atherosclerotic risk factors were included for analysis with the periodontal index. Analysis of variance, post hoc Tukey's honestly significant difference, univariate and multivariate linear regression analysis, Pearson correlation analysis, and χ2 analysis were used in the evaluation of the data.Results: Poor oral health status was exhibited by 85.5% of our CAPD patients with periodontal disease. We found that age and longer dialysis duration were associated with the severity of periodontitis. Parameters of malnutrition and inflammation and atherosclerotic risk factors also were associated with poor periodontal status. We carried out multiple regression analysis and found that age, albumin level, and duration of dialysis were associated independently with the severity of periodontitis in CAPD patients. A higher percentage of patients in the severe periodontitis group had malnutrition (χ2 = 59.4; P < 0.001), inflammation (χ2 = 60; P < 0.001), and atherosclerosis (χ2 = 65.6; P < 0.001).Conclusions: Periodontal health is poor in CAPD patients and correlates with markers of malnutrition, inflammation, and atherosclerosis. The diagnosis and treatment of periodontal diseases require better awareness.
Fibrin Adhesive Derived From Snake Venom in Periodontal Surgery
Authors: Barbosa Mônica D.S. , Gregh Sebastião Luis A. , Passanezi Euloir 
Published: October 2007

Background: A new fibrin adhesive made of buffalo plasma‐derived fibrinogen and a thrombin‐like enzyme obtained from snake venom was evaluated in this case series with regard to its applicability in periodontal surgery. Free gingival grafts that were sutured (control group) were compared to others immobilized through the use of the adhesive (experimental group).Methods: The grafts were carried out in contralateral mandibular bicuspids of 15 patients so that each subject received one treatment of each type. The analysis included measurements of probing and vertical dimension of the grafts and photographic follow‐up for 90 days. The patients answered a questionnaire concerning postoperative signs and symptoms.Results: The decrease in the vertical dimension of the grafts was significant during the first 30 days and more dramatic for the control group. Probing depth and attachment level presented statistically significant decreases for both groups. The grafts of the experimental group presented better appearance during the first 14 postoperative days. Pain was observed more often in the control group.Conclusions: Within the limits of the present study, it is suggested that the alternative fibrin adhesive tested may represent an alternative to sutures in periodontal surgery. Nevertheless, randomized clinical trials should be performed to evaluate the clinical advantages and disadvantages of the material.
Chronic Administration of Lipopolysaccharide and Proteases Induces Periodontal Inflammation and Hepatic Steatosis in Rats
Authors: Tomofuji Takaaki , Ekuni Daisuke , Yamanaka Reiko , Kusano Hiroki , Azuma Tetsuji , Sanbe Toshihiro , Tamaki Naofumi , Yamamoto Tatsuo , Watanabe Tatsuo , Miyauchi Mutsumi , Takata Takashi 
Published: October 2007

Background:Epidemiologic studies suggest a relationship between periodontitis and liver diseases. A rat periodontitis model was used to investigate whether a causal relationship exists between periodontitis and liver diseases.Methods:Fourteen male Wistar rats (8 weeks old) were divided into two groups: a periodontitis group in whichEscherichia colilipopolysaccharide (LPS) andStreptomyces griseusproteases were applied into the gingival sulcus for 8 weeks, and a control group using pyrogen‐free water instead. After blood samples were collected, periodontal tissues and liver specimens were analyzed.Results:Chronic administration of LPS and proteases to the gingival sulcus induced periodontitis and liver injury, including steatosis with inflammation and sinusoidal fibrosis. Apoptosis, enhanced concentration of 8‐hydroxydeoxyguanosine, and activated production of tumor necrosis factor‐alpha in liver were observed in the periodontitis group, with increased gingival inflammation, serum LPS, and reactive oxygen species.Conclusion:Periodontal inflammation in a rat model induced fatty liver disease through increased serum LPS.
Anorganic Bone Matrix Retrieved 14 Years After a Sinus Augmentation Procedure: A Histologic and Histomorphometric Evaluation
Authors: Iezzi Giovanna , Degidi Marco , Scarano Antonio , Petrone Giovanna , Piattelli Adriano 
Published: October 2007

Background: Anorganic bone matrix (ABM) is reported to have osteoconductive properties. No inflammatory or adverse responses have been reported when this material is used in sinus augmentation procedures. ABM is said to be a bioabsorbable biomaterial, but histologic data seem to suggest that the resorption process is slow. Long‐term histologic data in humans are lacking. The aim of this case report was to evaluate the bone response to ABM used in maxillary sinus augmentation and retrieved 14 years after surgery.Methods: Titanium dental implants were inserted in two sinuses augmented with ABM. The implants were osseointegrated and functioned well for 14 years. After this period of loading, the connecting screw of one of the implants inserted in the left maxilla broke, and it was necessary to remove the implant. A bone core of the augmented area was harvested separately during the implant removal.Results: A very high quantity of mature, compact bone and a small percentage of residual grafted biomaterial were found. About 5% to 7% of the bone was undergoing remodeling. In most cases, residual ABM particles were surrounded by marrow spaces. In other areas, lamellar bone was found in tight contact with the particle surfaces. Histomorphometry showed that the mean amount of mature, compact bone was 71.0% ± 2.28%, the mean amount of ABM was 22.1% ± 3.18%, and the mean amount of marrow spaces was 11.2% ± 5.42%.Conclusions: ABM seemed to resorb very slowly; after 14 years, only a small quantity of residual grafted particles was present. ABM is an effective graft material for sinus augmentation procedures. Vital, mature bone was formed and maintained over a long period with no chronic inflammatory cell infiltrate, foreign body response, or other adverse effects.
Effect of Adjunctive Systemic Azithromycin With Periodontal Surgery in the Treatment of Chronic Periodontitis in Smokers: A Pilot Study
Authors: Dastoor Sarosh F. , Travan Suncica , Neiva Rodrigo F. , Rayburn Lindsay A. , Giannobile William V. , Wang Hom‐Lay 
Published: October 2007

Background: Along with conventional surgical therapy, systemic antibiotics may provide more effective treatment in smokers by targeting tissue‐invasive bacteria. The aim of this randomized, placebo‐controlled, double‐masked clinical trial was to evaluate the adjunctive effects of systemic azithromycin (AZM) in combination with periodontal pocket reduction surgery in the treatment of chronic periodontitis in smokers.Methods: Thirty patients with a greater than one pack/day smoking habit and generalized moderate to severe chronic periodontitis were randomized to the test (surgery plus 3 days of AZM, 500 mg) or control group (surgery plus 3 days of placebo). Full‐mouth probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival index (GI), plaque index, and wound healing indices (WHI) were assessed at baseline and at 2 weeks and 1, 3, and 6 months following surgical intervention. Plaque and gingival crevicular fluid were collected for trypsin‐like enzyme activity (benzoyl‐dl‐arginine naphthylamine) and bone biomarker (cross‐linked telopeptide of type I collagen [ICTP]) analyses, respectively, at baseline, 2 weeks, and 1, 3, and 6 months.Results: Surgical treatment of moderate (PD = 4 to 6 mm) and deep (PD >6 mm) pockets significantly improved clinical parameters of treated and untreated teeth (CAL gain, PD reduction, and reduction of BOP). The additional use of AZM did not enhance this improvement nor did it promote reduction of ICTP levels. Compared to the control group, the test group had significantly better WHI scores at 1 month, significantly less GI at 2 weeks, and sustained reductions of red‐complex bacteria with trypsin‐like enzyme activity at 3 months. For non‐surgery teeth, only the test group showed significant gains in overall CAL compared to baseline.Conclusions: The findings of this pilot study demonstrated that in heavy smokers, adjunctive systemic AZM in combination with pocket reduction surgery did not significantly enhance PD reduction or CAL gain. However, the clinical value of adjunctive AZM may be appreciated by more rapid wound healing, less short‐term gingival inflammation, and sustained reductions of periopathogenic bacteria. More expanded studies are recommended to better determine the clinical effects of adjunctive AZM in patients who smoke.
Culture of Human Gingival Fibroblasts on a Biodegradable Scaffold and Evaluation of Its Effect on Attached Gingiva: A Randomized, Controlled Pilot Study
Authors: Mohammadi Mohammad , Shokrgozar Mohammad Ali , Mofid Rasool 
Published: October 2007

Background: An adequate width of attached gingiva is necessary to maintain healthy periodontium, especially in orthodontics or restorative treatments in periodontics. The purpose of this study was to evaluate the width of attached gingiva after clinical application of a cultured gingival graft compared to a periosteal fenestration technique.Methods: This study was conducted on nine patients (18 sites) with insufficient attached gingiva adjacent to at least two teeth in contralateral quadrants of the same jaw. A small portion (∼3 × 2 × 1 mm) of attached gingiva (epithelial + connective tissue) was removed with a surgical blade. After culture of gingival fibroblasts, 2 × 105 cells in 250 μl nutritional medium were added to 250 μl collagen gel. One tooth in each patient was randomized to receive a periosteal fenestration technique for gingival augmentation (control) or a tissue‐engineered mucosal graft (test). Clinical parameters measured at baseline and 3 months included width of keratinized tissue, probing depth, and width of attached gingiva.Results: An increased amount of keratinized tissue was seen at all treated sites after 3 months. The mean increased amount of attached gingiva was 2.8 mm at test sites and 2 mm at control sites; this difference was significant (P < 0.05).Conclusion: Based on the results of this investigation, the tissue‐engineered mucosal graft is safe and capable of generating keratinized tissue.
A Determination of the Range of Oral Conditions Submitted for Microscopic and Direct Immunofluorescence Analysis
Authors: Rinaggio Joseph , Crossland David M. , Zeid Mohamed Y. 
Published: October 2007

Background: Direct immunofluorescence (DIF) testing is a useful adjunct for the diagnosis of immune‐mediated oral vesiculobullous diseases, helping to identify separate, histologically similar, but prognostically different, conditions. It is unknown how often biopsy of these lesions yields positive DIF results.Methods: A total of 270 consecutive archival cases submitted to a reference laboratory in Buffalo, New York, over a 2‐year span were examined. These specimens were submitted to establish or rule out a diagnosis of a DIF‐positive oral vesiculobullous disease. Demographic, clinical, and diagnostic information, based on conventional microscopic and DIF analysis, was tabulated. To assess the contribution of DIF to successful diagnosis, three pathologists examined the hematoxylin and eosin–stained slides of the known DIF‐positive specimens without knowledge of the DIF results.Results: Approximately 48% of the specimens demonstrated positive DIF findings and consisted of pemphigus vulgaris, mucous membrane pemphigoid, lichen planus, linear immunoglobulin A disease, and chronic ulcerative stomatitis. The remaining specimens had negative DIF findings and consisted of numerous non‐specific inflammatory conditions. Of particular interest were several cases of epithelial dysplasia and squamous cell carcinoma. Of the DIF‐positive cases, only pemphigus vulgaris could be diagnosed reliably by conventional microscopy alone.Conclusions: Approximately half of biopsies of oral conditions that clinically resembled typically DIF‐positive vesiculobullous diseases did not yield positive findings on DIF testing. Instead, a wide range of oral diseases can mimic these lesions clinically. With the exception of pemphigus vulgaris, DIF is essential for establishing a definitive diagnosis for known DIF‐positive diseases.
A p38 Mitogen‐Activated Protein Kinase Inhibitor Arrests Active Alveolar Bone Loss in a Rat Periodontitis Model
Authors: Rogers Jill E. , Li Fei , Coatney Derek D. , Otremba Jodie , Kriegl Jaclynn M. , Protter Andrew A. , Higgins Linda S. , Medicherla Satyanarayana , Kirkwood Keith L. 
Published: October 2007

Background: Gram‐negative bacterial species, such as Actinobacillus actinomycetemcomitans, contain lipopolysaccharide (LPS) that initiates the innate immune system, resulting in inflammatory alveolar bone loss. LPS activates Toll‐like receptors on membrane surfaces, stimulating many intracellular signaling cascades, including the p38 mitogen‐activated protein kinase (MAPK). Activation of p38 signaling mediates inflammatory cytokine expression, contributing toward osteoclastogenesis and bone loss. The aim of this study was to determine whether the novel, orally active p38 MAPK inhibitor SD282 could arrest progression of LPS‐induced alveolar bone destruction in rats.Methods: Three groups of female Sprague‐Dawley rats received LPS injections to the palatal molar gingiva three times per week for 4 weeks to establish periodontitis. From weeks 5 through 8, two groups received the drug SD282 (N = 14) or 1% polyethylene glycol drug vehicle (N = 14) via oral gavage in addition to LPS injections. The third group continued to receive only LPS injections (N = 8). Microcomputed tomography was used to measure volumetric alveolar bone loss, expressed as bone volume fraction (BVF). Expression of interleukin (IL)‐1 and ‐6 and tumor necrosis factor‐alpha (TNF‐α) was assessed by immunohistochemistry, and osteoclasts were enumerated by tartrate‐resistant acid phosphatase staining.Results: By 4 weeks, severe alveolar bone resorption was seen in LPS‐injected animals. Administration of SD282 significantly blocked additional volumetric bone loss in the LPS‐only versus LPS + SD282 groups (0.37 ± 0.01 BVF versus 0.43 ± 0.01 BVF; P <0.01). Significant reductions in IL‐1β (P <0.01), TNF‐α (P <0.05), and osteoclast formation (P <0.01) occurred in the presence of SD282.Conclusions: An orally active p38 MAPK inhibitor reduced LPS‐induced inflammatory cytokine expression, osteoclastogenesis, and alveolar bone loss in rats. Within the limits of the current study, SD282 arrested periodontal disease progression, thus highlighting the therapeutic potential of this novel class of inhibitors.