bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implant Survival in Patients With Type 2 Diabetes: Placement to 36 Months
Authors: Morris Harold F. , Ochi Shigeru , Winkler Sheldon 
Published: February 2005

Background: Because the life expectancy of individuals continues to increase, dentists providing dental implant treatment can expect to see an increasing number of patients with diabetes mellitus. Today, there are little data available concerning the clinical outcomes involving the use of implant treatment for patients with diabetes mellitus. There are three types of diabetes mellitus: Type 1 (insulin dependent), Type 2 (non‐insulin dependent), and gestational. Because of possible complications from patients with diabetes mellitus, they are excluded from participation in most clinical studies of endosseous dental implant survival.Methods: This study attempted to determine if Type 2 diabetes represents a significant risk factor to the long‐term clinical performance of dental implants, using the comprehensive DICRG database. Diabetes was a possible exclusion criterion; however, the final decision on Type 2 patients was left to the dental implant team at the research center. A total of 2,887 implants (663 patients) were surgically placed, restored, and followed for a period of 36 months. Of these, 2,632 (91%) implants were placed in nondiabetic patients and 255 (8.8%) in Type 2 patients. Failures (survival) were compared using descriptive data. Possible clustering was also studied.Results: A model assuming independence showed that implants in Type 2 patients have significantly more failures (P = 0.020). However, if correlations among implants within the patient are considered, the significance level becomes marginal (P = 0.046). The experience of the surgeon did not produce a clinically significant improvement in implant survival. The use of chlorhexidine rinses following implant placement resulted in a slight improvement (2.5%) in survival in non‐Type 2 patients and a greater improvement in Type 2 patients (9.1%); the use of preoperative antibiotics improved survival by 4.5% in non‐Type 2 patients and 10.5% in Type 2 patients. The use of HA‐coated implants improved survival by 13.2% in Type 2 diabetics.Conclusion: Type 2 diabetic patients tend to have more failures than non‐diabetic patients; however, the influence was marginally significant. These findings need to be confirmed by other scientific clinical studies with a larger Type 2 diabetic sample size.Ann Periodontol 2000;5:157‐165.
Role for Periodontal Bacteria in Cardiovascular Diseases
Authors: Kuramitsu Howard K. , Qi Mingshan , Kang In‐chol , Chen Wen 
Published: February 2005

Background: Several epidemiological studies as well as a recent animal model approach have suggested a role for periodontal diseases in the development of cardiovascular disease (CVD). This relationship could be mediated by inflammatory responses induced by periodontal pathogens as well as direct interaction of these organisms with cardiac tissue.Methods: In order to explore these possibilities, the effects of the periodontal pathogen Porphyromonas gingivalis on cellular events proposed to play a role in CVD were investigated.Results: P. gingivalis, as well as its outer membrane vesicles (OMV), was able to induce foam cell formation (an important characteristic of CVD) in the murine macrophage cell line J774 A.1. This property appears to be mediated by the lipopolysaccharide (LPS) fraction of the cells. Several other oral bacteria were also able to induce foam cell formation. Furthermore, since the rupture of the fibrous cap of plaque appears to be an important factor in acute coronary syndrome, it was demonstrated that P. gingivalis 381 degraded fibrous caps isolated from autopsy samples. In addition, it was observed that strain 381 strongly induced matrix metalloproteinase (MMP)‐9 protease activity, implicated in plaque rupture, from the J774 A.1 macrophages. Finally, strain 381 was able to enhance monocyte chemoattractant protein‐1 (MCP‐1) and NADH oxidase expression from endothelial cells.Conclusions: Therefore, P. gingivalis exhibits several properties which could play a role in CVD as mediators of LDL oxidation, foam cell formation, and rupture of atherosclerotic plaque. Ann Periodontol 2001;6:41‐47.
Associations Between Periodontal Disease and Risk for Atherosclerosis, Cardiovascular Disease, and Stroke. A Systematic Review
Authors: Scannapieco Frank A. , Bush Renee B. , Paju Susanna 
Published: February 2005

Background: Recent studies implicate exposure to systemic conditions involving chronic inflammation, including chronic periodontitis, in the etiology of atherosclerosisRationale: A systematic review of the literature was conducted to assess the association between chronic inflammatory periodontal disease and atherosclerosis.Focused Question:Does periodontal disease influence the initiation/ progression of atherosclerosis and, therefore, cardiovascular disease (CVD), stroke, and peripheral vascular disease (PVD)?Search Protocol: MEDLINE, pre‐MEDLINE, MEDLINE Daily Update, and the Cochrane Controlled Trials Register were searched to identify human studies that related variables associated with atherosclerosis to periodontal disease. Searches were made for papers published from 1966 through March 2002.Inclusion criteria: Published randomized controlled clinical trials (RCTs), longitudinal, cohort, and case‐control studies were included. Study participants included those with atherosclerosis, myocardial infarction (MI), stroke, or PVD. Oral conditions included periodontal disease.Exclusion criteria: Only studies on humans were included. Data Collection and Analysis: Because the studies used different oral assessment measures, it was not possible to perform a metaanalysis of the data reported. Weighted mean differences, relative risks, or odds ratios were compared for cohort studies.

Main Results

Of the initial 1,526 studies identified, 31 (including 8 case‐control and 18 cross‐sectional reports) were included in the analysis. Taken together, most of the literature supports a modest association between periodontal disease and atherosclerosis. However, data reported in several studies do not show this association.

The absence of a standard definition and measures for periodontal disease complicates interpretation of results, as do potential confounding risk factors common to both conditions.

Reviewers' Conclusions

Periodontal disease may be modestly associated with atherosclerosis, MI, and CVD.

Additional large‐scale longitudinal epidemiologic and intervention studies are necessary to validate this association and to determine causality.

Ann Periodontol 2003;8:38‐53.
Effective Laser Ablation of Bone Based on the Absorption Characteristics of Water and Proteins
Authors: Spencer Paulette , Payne John M. , Cobb Charles M. , Reinisch Lou , Peavy George M. , Drummer Dino D. , Suchman David L. , Swafford James R. 
Published: February 2005

Background: Collateral thermal damage and residual char formation have severely limited the use of conventional lasers in the surgical preparation of bony tissue. Thermal damage from lasers can be minimized by selecting a wavelength that is strongly absorbed and by reducing the laser pulse duration. In contrast to the fixed wavelengths and microsecond pulse intervals of conventional lasers, the Vanderbilt free electron laser (FEL) can be set at wavelengths ranging from 2.1 to 9.8 μm, and the pulse duration can be reduced to a series of 1 to 2 picosecond (ps) micropulses delivered in succession over intervals of 4 microsecond macropulses. The purpose of this study was to compare the morphologic and chemical changes induced in the near‐surface region of bone following exposure to the FEL at 3.0, 6.1, and 6.45 μm wavelengths. The selected wavelengths coincide with the vibrational modes of proteins and water within bone.Methods: Under general anesthesia, laser incisions were made in the tibias of 14 skeletally mature rabbits. Laser parameters included 22.5 ± 2.5 mJ/pulse delivered in individual 4 microsecond macropulses at a repetition rate of 30 Hz, focused to 200 μm and 500 μm spot sizes. Laser incisions were made using a computer‐assisted surgical program, and control incisions were created with a bone saw. Rabbits were euthanized after the final incision, tibias recovered, and non‐decalcified specimens processed for light microscopy. Separate samples were prepared for FTIR (Fourier transform infrared) photoacoustic spectroscopic analysis.Results: The light microscopy sections of the ablation defects created at the differing wavelengths showed similar features, i.e., 2 zones of collateral damage, a zone generally <10mm of extensive thermal damage, and a wider zone of empty lacunae. In comparing treated and untreated surfaces, the spectral differences were limited to a relative decrease in intensity of the amide II and III absorption peaks in all laser‐treated surfaces.Conclusions: Spectroscopic and histologic results indicated minimal thermal damage to bone ablated at 3.0, 6.1, and 6.45 μm wavelengths using the FEL (Fourier transform infrared) at the specified parameters. The FTIR photoacoustic spectroscopic results suggest that the char layer is limited to an area less than approximately 6 µm from the surface. J Periodontol 1999; 70: 68‐74.
Clinical Evaluation of the Treatment of Class II Furcation Involvements With Bioabsorbable Barriers Alone or Associated With Demineralized Freeze‐Dried Bone Allografts
Authors: De Leonardis D. , Garg A.K. , Pedrazzoli V. , Pecora G.E. 
Published: February 2005

Background: Class II furcation lesions are a challenging scenario for periodontal therapy and a serious threat for tooth prognosis. Guided tissue regeneration represents a viable treatment option, but some aspects remain to be clarified as to the efficacy of bone substitutes used in GTR procedures. The clinical efficacy of demineralized freeze‐dried bone allografts (DFDBA) for regenerative procedures is presently under scrutiny.Methods: This study evaluated the adjunctive clinical effects of DFDBA associated with a bioabsorbable (polylactic acid) barrier membrane in the regenerative treatment of human Class II furcation lesions as compared to the same type of barrier alone. Twelve patients with bilateral Class II furcation defects on lower first molars participated in the study. In each patient, one tooth was randomly assigned to treatment consisting of open surgical debridement followed by the placement of DFDBA (GTR+DFDBA, or test group) and a bioabsorbable barrier, while the contralateral side received the same flap surgery followed by use of the bioabsorbable membrane alone (GTR, or control group). The clinical efficacy of the 2 treatment modalities was evaluated at 6 and 12 months postoperatively. Measurements included vertical probing depth (VPD), horizontal probing depth (HPD), clinical attachment level (CAL), amount of gingival recession (GR), and change in class of clinically detectable furcation involvement (FC).Results: Both treatments yielded significant improvements for all clinical parameters between baseline and 6 and 12 months (P<0.05). The comparison between test and control groups revealed significantly greater reduction in HPD (P=0.01) and higher values of GR (P=0.008) for the test group. The mean gain in HPD for test sites was 2.3 mm, while it amounted to 1.7 mm for controls. A significantly greater proportion of test sites could be classified postoperatively as Class I defects compared to controls (91% versus 50%, respectively).Conclusions: The results of this study indicate that significant improvements from baseline occurred in VPD, HPD, CAL, and clinically detectable furcation involvement after the treatment of Class II furcation lesions with a bioabsorbable membrane with or without the adjunctive use of DFDBA. In addition, the placement of DFDBA in the furcation defect under the bioabsorbable membrane resulted in a greater mean reduction of horizontal probing depth when compared to the regenerative therapy alone. J Periodontol 1999; 70: 8‐12.
Spontaneous Repositioning of Pathologically Migrated Teeth
Authors: Gaumet Pierre E. , Brunsvold Michael I. , McMahan C. Alex 
Published: February 2005

Background: There is limited clinical evidence that pathologically migrated teeth may reposition themselves after conventional periodontal treatment. The current research was carried out to determine the frequency of spontaneous repositioning of pathologically migrated teeth after routine periodontal therapy, and to study the relation between the severity of migration and the degree of repositioning following treatment.Methods: Sixteen patients with moderate to severe periodontal disease and presenting 33 diastema sites secondary to pathologic migration participated in this study. After conventional periodontal treatment had been performed, reactive repositioning was assessed by measuring the space between pathologically migrated teeth and adjacent teeth on study models obtained at baseline, re‐evaluation at 6 weeks after scaling and root planing, and 4 months after surgery.Results: After scaling and root planing only, 48.5% of all sites exhibited some degree of repositioning with 36.4% of all sites closing completely. After surgery (6 months after baseline observations), 69.7% of all sites exhibited some degree of repositioning with 51.5% of all sites closing completely. When only small to moderate diastemata were considered (<1 mm), 77.8% of sites closed completely.Conclusions: The findings of this study support the hypothesis that spontaneous repositioning after conventional periodontal treatment is likely, particularly when only light to moderate degrees of pathologic migration are considered. We hypothesize that this spontaneous movement is due to wound contraction during healing. J Periodontol 1999;70:1177‐1184.
Qualitative Analysis of Peripheral Peri‐Implant Bone and Influence of Alendronate Sodium on Early Bone Regeneration
Authors: Meraw Stephen J. , Reeve Charles M. 
Published: February 2005

Background: Alendronate sodium increases alveolar bone density with systemic use. It inhibits osteoclast activity and is thought to result in a net increase in osteoblastic activity. However, little is known about local in vivo use. The purpose of this study was to evaluate the effect of local delivery of alendronate on bone regeneration within peri‐implant defects. Peri‐implant bone was examined histomorphometrically to evaluate the amount of supporting bone peripheral to the bone‐implant interface.Methods: Six adult hound dogs were evenly divided into 2 groups, with one group receiving alendronate‐coated dental implants and the other group serving as controls. Dental implants were placed immediately after extraction of right and left second, third, and fourth mandibular premolars. Forty‐eight dental implants were placed (2 types in each dog: 24 hydroxyapatite [HA]‐coated and 24 titanium machine‐polished [TMP]), for a total of 4 variables. A bioabsorbable collagen membrane was secured over the implants and defects, and the flaps closed primarily. The dogs were sacrificed on day 28. Specimens were sectioned, mounted, and stained with Stevenel's blue and van Gieson's picric fuchsin. The amount of bone adjacent and 1 mm peripheral to the implant surface was recorded with a computerized microscopic digitizer.Results: Locally applied alendronate resulted in significantly increased amounts of bone (P <0.0002, ANOVA) in the peripheral area with both HA and TMP implants. However, the most influential factor in the amount of peripheral bone was the type of implant surface (P <0.0001).Conclusions: Local application of alendronate is useful in increasing the amount of peripheral peri‐implant bone. Also, the amount of supporting bone was not related to the bone‐to‐implant contact but to the surface characteristics of the implant. The findings of the present study indicate that the evaluation of dental implant‐supporting bone should include peripheral bone as well as bone‐to‐implant interface. J Periodontol 1999;70:1228‐1233.
Culture of Gingival Fibroblasts on Bioabsorbable Regenerative Materials In Vitro
Authors: Simain‐Sato F. , Lahmouzi J. , Kalykakis G.K. , Heinen E. , Defresne M.P. , De Pauw M.C. , Grisar T. , Legros J. J. , Legrand R. 
Published: February 2005

Background: The use of membranes in guided tissue regeneration (GTR) can limit the apical migration of gingival cells and favor the establishment of new attachment by periodontal ligament fibroblasts. However, gingival recession during healing following GTR has been described as a frequent complication. The purpose of this study was to determine if gingival fibroblasts are affected by the composition of the bioabsorbable membranes used in mucogingival surgery.Methods: Two type of bioabsorbable regenerative materials were used as cell carriers. Wistar rat gingival fibroblasts (RGF) were obtained from attached gingiva, cut into small fragments, and placed in culture dishes. When confluent, cells were detached using trypsin and identified as “first transferred cells” (P1). At the third passage (P3), cell count, trypan blue exclusion test, acid phosphatase activity, DNA synthesis, phase contrast microscopy, and scanning electron microscopy were performed. The cells were then placed in wells containing the membranes and incubated for 72 hours.Results: When examined under microscopy, the control wells (without membranes) showed one cell type with the elongated appearance characteristic of fibroblasts. The wells with membranes showed an altered cell morphology with a high proportion of cell fragments regardless of the type of membrane used.Conclusions: These results suggest that cell carrier membranes could affect RGF morphology and thus alter gingival tissue healing following GTR. J Periodontol 1999;70:1234‐1239.
The Effect of Smoking and Periodontal Treatment on Salivary Composition in Patients With Established Periodontitis
Authors: Zuabi Otman , Machtei Eli E. , Ben‐Aryeh Hanna , Ardekian Leon , Peled Micha , Laufer Dov 
Published: February 2005

Background: The purpose of this study was to evaluate the effect of smoking on the periodontal status and the salivary composition in subjects with established periodontitis before and after periodontal therapy.Methods: Our study group included 26 healthy subjects, 12 smokers and 14 non‐smokers with established periodontitis. Clinical measurements and non‐stimulated whole saliva were obtained and analyzed at baseline and after scaling and root planing. Smokers presented at baseline with significantly greater probing depth (4.16 ± 0.26) compared to non‐smokers (3.52 ± 0.32) which was statistically significant (P = 0.0268); likewise, baseline clinical attachment level was greater in smokers (4.49 ± 0.31 compared to non‐smokers 3.87 ± 0.13; P = 0.0620). Mean plaque index was also greater in smokers compared to non‐smokers (0.86 and 0.65, respectively; P = 0.0834). Baseline pretreatment sodium values were significantly greater in non‐smokers (14.36 mEq/l compared to 9.31 mEq/l in smokers; P = 0.0662); likewise non‐smokers exhibited 50% greater salivary calcium levels (6.04 mg/100 ml compared to 4.32 mg/100 ml in smokers; P = 0.0133).Results: Post‐treatment probing depth and clinical attachment level were not different between smokers and non‐smokers; this in spite of significant difference in plaque index in smokers (0.35 compared to 0.13 in non‐smokers; P = 0.0135). Post‐treatment, smokers had reduced calcium concentration (3.58 mg/100 ml compared to 5.11 mg/100 ml in non‐smokers; P = 0.0438). Treatment affected albumin level in smokers only, consequently non‐smokers had significantly greater salivary albumin concentration (1.1 mg/100 ml compared to 0.38 mg/100 ml in smokers; P = 0.0274).Conclusions: Subjects with established periodontitis exhibited elevated concentrations of salivary electrolytes and proteins. Within this study group, smokers exhibited greater disease level but reduced sodium, calcium, and magnesium concentrations. Smokers responded favorably to treatment. The clinical improvement eliminated the differences in salivary composition. J Periodontol 1999;70:1240‐1246.
Comparison of Nd:YAG Laser Versus Scaling and Root Planing in Periodontal Therapy
Authors: Liu Cheing‐Meei , Hou Lein‐Tuan , Wong Man‐Ying , Lan Wan–Hong 
Published: February 2005

Background: The Nd:YAG laser has recently been used in the treatment of periodontal disease. However, although a clinical reduction of probing depth and gingival inflammation to this new approach has been reported, it has not been fully evaluated. Interleukin‐1 beta (IL‐1β), a potent stimulator of bone resorption, has been identified in gingival crevicular fluid (GCF), which is closely associated with periodontal destruction. The aim of this study was to compare the effects of Nd:YAG laser treatment versus scaling/root planing (SRP) treatment on crevicular IL‐1β levels in 52 sampled sites obtained from 8 periodontitis patientsMethods: One or 2 periodontitis‐affected sites with a 4 to 6 mm probing depth and horizontal bone loss from 3 adjacent single‐root teeth in each of 4 separate quadrants were selected from patients for clinical documentation and IL‐1β assay. Sampling site(s) from each diseased quadrant was randomly assigned to one of the following groups: 1) subgingival laser treatment (20 pps, 150 mJ) only; 2) SRP only; 3) laser treatment first, followed by SRP 6 weeks later; or 4) SRP first, followed by laser therapy 6 weeks later. The GCF was collected and the amount of IL‐1β was assayed by enzyme‐linked immunosorbent assay (ELISA). Clinical parameters and GCF were measured at baseline and biweekly after therapy for 12 weeks.Results: An obvious clinical improvement (marked decrease in the number of diseased sites with gingival index ≥2) and reduction of crevicular IL‐1β were found in all groups. The level of IL‐1β was significantly lower in the SRP group (P = 0.035) than in the laser therapy group for the duration of the 12 weeks. The laser combined SRP therapy group showed a further reduction of IL‐1β (6 to 12 weeks after treatment) than either laser therapy alone or SRP combined laser therapy.Conclusions: Our data suggest that laser therapy appeared to be less effective than traditional SRP treatment. Of the 4 treatment modalities, inclusion of SRP was found to have a superior IL‐1β response, when compared to other therapies without it. In addition, no additional benefit was found when laser treatment was used secondary to traditional SRP therapy. J Periodontol 1999;70:1276‐1282.