bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Periodontal Disease in a Patient With Ehlers‐Danlos Syndrome. A Case Report and Literature Review
Authors: Perez Luis A. , Al‐Shammari Khalaf F. , Giannobile William V. , Wang Hom‐Lay 
Published: February 2005

Background: Ehlers‐Danlos syndrome (EDS) designates a heterogeneous group of connective tissue disorders characterized by skin elasticity, tissue fragility, and chronic joint pain. Dental findings have been reported with some types of EDS. This case report describes the periodontal findings in a patient with a previously undiagnosed EDS type VIII.Methods: Diagnostic aids utilized included microbial testing, histological examination, gingival crevicular fluid (GCF) analysis for the levels of C‐telopeptide pyridinoline cross‐links (ICTP), and genetic counseling. Periodontal treatment consisted of mechanical debridement and adjunctive antibiotic therapy.Results: Genetic counseling and clinical presentation confirmed the diagnosis of EDS type VIII. Periodontal treatment led to marked clinical improvements and GCF levels of the bone resorptive marker ICTP were significantly reduced. The patient and her siblings are currently pursuing appropriate medical care and genetic counseling.Conclusion: Periodontal involvement may lead to the diagnosis of an underlying systemic condition. Identification of suspected etiological factors of periodontal disease may prove critical for the general wellbeing of some patients.J Periodontol 2002;73:564‐570.
Tooth Auto‐Transplantation With Double Periodontal Ligament Stimulation to Replace Periodontally Compromised Teeth
Authors: Gault Philippe C. , Warocquier‐Clerout Rita 
Published: February 2005

Background: The healing process of autotransplantation puts 2 different tissues in competition: the ligament on the root surface and the bone tissue the alveolus. This study shows the effects of a protocol with 2 surgical stages, which promote ligament repair, inhibit adhesion between bone and dental root, and reduce the occurrence of the ankylosis‐root resorption phenomenon.Methods: Forty‐three patients, 33 to 73 years old, received 47 transplantations of mature teeth (including retained teeth) during a 5‐year period. During the first surgical step, the transplanted tooth is extracted, measured, immediately replaced in its origin site, and maintained with an original suture technique. The alveolus to which the tooth will be transplanted is adapted after extraction of the periodontally compromised tooth. The second surgery occurs at day 14, when regeneration of periodontal ligament (PDL) is at a maximum (first stimulation). The tooth is transplanted in its new alveolus and retained using the same suture technique to avoid a rigid splint and to create mechanical stimulation of the PDL (second stimulation).Results: The results were 95.75% positive with normal PDL, with a 4.25% failure rate (transplant loss) and no ankylosis. Mean probing reduction was 8.37 ± 3.0 mm. Mean radiographic bone gain was 7.73 ± 4.32 mm.Conclusions: This study suggests that auto‐transplantation with double PDL stimulation can be a viable treatment in clinical practice, especially to replace teeth with large periodontal lesions, deep furcation defects, and/or root fractures. This study shows the high potential of stimulated PDL to regenerate alveolar bone and periodontal structures in severe destruction sites. J Periodontol 2002;73:575‐583.
The Modulation of Androgen Metabolism by Estradiol, Minocycline, and Indomethacin in a Cell Culture Model
Authors: Tilakaratne A. , Soory M. 
Published: February 2005

Background: This investigation attempts to clarify the proanabolic effects of minocycline and indomethacin by studying their effects on androgen metabolism and mediation by estradiol. A cell culture model was used with androgen substrates because of the proanabolic effects of androgen metabolites.Methods: Monolayer cultures of human gingival fibroblasts (HGF) derived from 6 patients were incubated in duplicate with 14C‐ testosterone or 14C‐4‐androstenedione as substrates and optimal concentrations of estradiol (E1,3 μg/ml) and minocycline (M25 μg/ml) or indomethacin (I, 1 μg/ml) alone and in combination (E1,3+I1 or E1,3+M25 μg/ml); similar experiments were carried out with human oral periosteal fibroblasts (HPF), M, I, E, and the combinations. At the end of a 24‐hour incubation period in Eagle's MEM, the medium was solvent extracted with ethyl acetate and the metabolites were separated by TLC in a benzene:acetone solvent system (4:1 v/v). The separated metabolites were quantified using a radioisotope scanner.Results: Both androgens were metabolized to 5α‐dihydrotestosterone (DHT) and 4‐androstenedione (4‐A) or testosterone (T) at baseline and in response to the agents tested, by HGF and HPF. With HGF, there were significant increases in the yields of DHT and 4‐A or T in response to M, E, and M+E, resulting in 50% to 2.4‐fold increases in these metabolites over control incubations (n = 6; P <0.01). The responses to I and combinations of I+E were similar. HPF also demonstrated significant increases of 29% to 4‐fold in the yields of androgen metabolites in response to M, E, and M+E (n = 6; P <0.01). I and E similarly increased the yields of androgen metabolites, alone and in combination.Conclusions: Adjunctive periodontal treatment with minocycline or indomethacin can contribute to hormone‐modulated anabolic responses in males and females in gingival and periosteal fibroblasts derived from a chronically inflamed source. J Periodontol 2002;73:585‐590.
Genetic Dependence of the Specific T‐Cell Cytokine Response to Porphyromonas gingivalis in Mice
Authors: Gemmell Erica , Carter Christine L. , Bird Philip S. , Seymour Gregory J. 
Published: February 2005

Background: Susceptibility to periodontal infections may, in part, be genetically determined. Porphyromonas gingivalis is a major periodontopathogen, and the immune response to this organism requires T‐cell help. The aim of the present study was to examine the specific T‐cell cytokine responses to P. gingivalis outer membrane antigens in a mouse model and their relationship with H‐2 haplotype.Methods: BALB/c and DBA/2J (H‐2d), CBACaH (H‐2k), and C57BL6 (H‐2b) mice were immunized with P. gingivalis outer membrane antigens weekly for 3 weeks. One week after the final injection, the spleens were removed, and 6 T‐cell lines specific for P. gingivalis were established for each mouse strain. The percentage of CD4 and CD8 cells in the P. gingivalis‐specific T‐cell lines staining positive for intracytoplasmic interleukin (IL)‐4, interferon (IFN)‐γ, and IL‐10 was determined by 2‐color flow cytometry.Results: The cytokine profiles of T‐cell lines from BALB/c and DBA/2J mice showed no significant differences. Significantly fewer IL‐4+, IFN‐γ+, and IL‐10+ CD4 cells than IL‐4+, IFN‐γ+, and IL‐10+ CD8 cells, respectively, were demonstrated for both strains. P. gingivalis‐specific Tcell lines generated from CBACaH mice were similar to those generated from BALB/c and DBA/2J mice; however, the mean percentage of IL‐4+ CD4 cells in CBACaH mice was lower than the percentage of IFN‐γ+ CD4 cells. Also, the mean percentage of IFN‐γ+ CD4 cells in CBACaH mice was significantly increased compared to DBA/2J mice. Unlike the other 3 strains, T‐cell lines established from C57BL6 mice contained similar percentages of cytokine‐positive cells, although the percentage of IL‐4+ CD4 cells was reduced in comparison to the percentage of CD8 cells. However, comparisons with the other 3 strains demonstrated a higher percentage of IL‐4+ CD4 cells than in lines established from the spleens of DBA/2J mice, IFN‐γ+ CD4 cells than in lines established from BALB/c and CBACaH mice, and IL‐10+ CD4 cells than in lines established from all 3 other strains. No significant differences in the percentage of positive CD8 cells were demonstrated between lines in the 4 strains of mice.Conclusion: The specific T‐cell response to P. gingivalis in mice may, in the case of the CD4 response, depend on MHC genes. These findings are consistent with the concept that patient susceptibility is important to the outcome of periodontal infection and may, in part, be genetically determined. J Periodontol 2002;73:591‐596.
Periodontal Assessment of Patients Undergoing Angioplasty for Treatment of Coronary Artery Disease
Authors: Bazile Anca , Bissada Nabil F. , Nair Ravi , Siegel Burton P. 
Published: February 2005

Background: The purpose of this cross‐sectional study was to assess the periodontal condition of patients with coronary artery disease (CAD) in order to verify the association between CAD and certain periodontal parameters.Methods: Eighty patients (48 males and 32 females) were recruited from the Cleveland University Hospitals, Division of Cardiology (aged 23 to 83, median age 54 years). Upon cardiac catherization, 50 were diagnosed with severe CAD (experimental group) and 30 with no angiographic evidence of CAD (control group). Patients with CAD were divided into 3 subgroups according to the clinical diagnosis of acute infarction (AI) (n = 20), stable angina (SA) (n = 20), and unstable angina (UA) (n = 10). The following dental, medical, and social histories were recorded: number of dental visits/year, frequency of brushing/day and flossing/week, tobacco use, presence/absence of hypertension, diabetes, total cholesterol level, and the highest level of education completed. The following periodontal parameters were also assessed for each subject: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and number of missing teeth. Logistic regression analysis was used to determine whether there was a significant correlation between these periodontal parameters and CAD.Results: The significant confounding factors for the present study were found to be age and gender. The periodontal condition of the 80 subjects was clinically diagnosed as gingivitis and/or mild periodontitis. Analysis of the data after adjusting for age and gender demonstrated a statistically significant association between BOP and GI and CAD in patients with AI; and facial/lingual CAL in patients with UA. No significant associations were found between PD, interproximal CAL, number of missing teeth, or dental/medical histories and CAD.Conclusion: Based on the results of this study, gingival inflammation may be considered a more significant risk factor for CAD than previously reported. J Periodontol 2002;73:631‐636.
Scanning Electron Microscopy and Fourier Transformed Infrared Spectroscopy Analysis of Bone Removal Using Er:YAG and CO2 Lasers
Authors: Sasaki Katia M. , Aoki Akira , Ichinose Shizuko , Yoshino Toshiaki , Yamada Sachiko , Ishikawa Isao 
Published: February 2005

Background: A thorough analysis of laser‐ablated bone tissue is required before applying the technique to osseous surgery. In this study, we examine the morphological features and chemical composition of the bone surface after Er:YAG and CO2 lasers ablation.Methods: Six Wistar rats were used. An Er:YAG laser was used for ablation at an output energy of 100 mJ/pulse and a pulse rate of 10 Hz (1 W). Continuous CO2 laser irradiation was performed at an output energy of 1 W. Sites drilled using a conventional micromotor were used as controls. Analysis using scanning electron microscopy (SEM) and Fourier transformed infrared (FTIR) spectroscopy was performed.Results: Er:YAG laser ablation produced a groove with similar dimensions to that produced by bur drilling, whereas the CO2 laser produced only a charred line with minimal tissue removal. SEM observations revealed that the groove produced by the Er:YAG laser had well‐defined edges and a smear layerfree surface with a characteristically rough appearance and with entrapped fibrin‐like tissue. The melting and carbonization produced by the CO2 laser were not observed on sites irradiated by the Er:YAG laser. FTIR spectroscopy revealed that the chemical composition of the bone surface after Er:YAG laser ablation was much the same as that following bur drilling. The production of toxic substances that occurred after CO2 laser irradiation was not observed following Er:YAG laser irradiation or bur drilling.Conclusion: These results suggest that the use of Er:YAG laser ablation may become an alternative method for oral and periodontal osseous surgery. J Periodontol 2002;73:643‐652.
Oral Pemphigoid Masquerading as Necrotizing Ulcerative Gingivitis in a Child
Authors: Musa Nour J. , Kumar Vijay , Humphreys Lewis , Aguirre Alfredo , Neiders Mirdza E. 
Published: February 2005

Background: Cicatricial pemphigoid (benign mucous membrane pemphigoid) is an autoimmune vesiculobullous disease that affects mucosal tissues of adults and rarely presents in children. Only 9 cases in the English literature have reported cicatricial pemphigoid in children, primarily as oral mucosal lesions. This paper presents a case of childhood cicatricial pemphigoid that clinically manifested as necrotizing ulcerative gingivitis (NUG).Methods: A 9‐year‐old girl presented with gingival bleeding and discomfort for 2 weeks. NUG was suspected and the patient was treated with antibiotics and an oral hygiene regimen. When the condition did not improve after repeated treatment trials, routine hematoxylin and eosin (H&E) and direct immunofluorescence examinations were performed.Results: Microscopic examination of H&E stained sections showed a non‐specific ulceration with chronic inflammation. Direct immunofluorescence studies of peri‐lesional tissue showed linear deposition of C3 at the basement membrane zone that was consistent with a diagnosis of cicatricial pemphigoid.Conclusion: Cicatricial pemphigoid is an autoimmune ulcerative condition that is rarely seen in children. Immunofluorescence studies are essential to differentiate this condition from other ulcerative oral lesions. J Periodontol 2002;73:657‐663.
Aggressive Periodontitis: 5‐Year Follow‐Up of Treatment
Authors: Buchmann Rainer , Nunn Martha E. , Van Dyke Thomas E. , Lange Dieter E. 
Published: February 2005

Background: The hypothesis that in subjects with aggressive periodontitis, a long‐term stability of periodontal health can be achieved following comprehensive mechanical/surgical and systemic antimicrobial therapy was tested in this prospective study.Methods: Thirteen patients (36.9 ± 7.4 years) with aggressive periodontitis were monitored before and up to 5 years following periodontal therapy. Clinical attachment levels (CAL) were assessed pretherapy, and at 3 months following completion of active periodontal therapy supplemented by amoxicillin plus metronidazole. All subjects were subsequently enrolled in a maintenance program and provided with supportive periodontal therapy with 3 to 4 appointments annually. Reexaminations were performed after 6 months and 1, 2, 3, 4, and 5 years. The data were analyzed using the method of generalized estimating equations (GEE) for CAL changes from baseline to the 3‐month visit, and from completion of periodontal therapy to each annual visit up to the 5‐year followup reappointment.Results: During the 5‐year study, all subjects strongly benefited from periodontal treatment. Between baseline and the 3‐month reexamination, the CAL levels revealed a significant decrease of 2.23 mm (95% confidence interval [CI]: 1.77 to 2.69 mm; P ≤0.001). At the 5‐year maintenance visit, the CAL changes ranged from ‐0.04 to +0.29 mm with no further statistically significant periodontal breakdown (P >0.05). Five years after surgery, 3.2% of the treated sites demonstrated a further CAL gain ≥3 mm. A stabilization (CAL ‐2 to +2 mm) occurred in 94.6% of the cases. The number of periodontal sites experiencing a breakdown varied from 5.3% at 6 months to 2.2% at 5 years.Conclusions: In aggressive periodontitis, comprehensive mechanical/surgical and antimicrobial therapy is an appropriate treatment regimen for long‐term stabilization of periodontal health. In this study, periodontal disease progression was successfully arrested in 95% of the initially compromised lesions, while 2% to 5% experienced discrete or recurrent episodes of loss of periodontal support. J Periodontol 2002;73: 675‐683.
The Single‐Tooth Implant: A Viable Alternative for Single‐Tooth Replacement
Authors: Mayer Todd M. , Hawley Charles E. , Gunsolley John C. , Feldman Sylvan 
Published: February 2005

Background: The use of dental implants for single‐tooth replacement cases introduces a challenge to the performance of these restorations. Clinical data suggest that single‐tooth implant restorations do not benefit from lateral support from the surrounding dentition as do bridged implants, and that these restorations are subjected to greater masticatory forces. Therefore, single‐tooth implants are exposed to an increased risk of failure. This prospective clinical trial was designed to evaluate the cumulative success rate of dual acid‐etched single‐tooth replacement implants in two clinical centers.Methods: The study protocol included 59 patients between 19 and 73 years. Implants were evaluated for mobility, infection, and crestal bone loss from 30.9 to 60 months.Results: Seventy‐one (71) implants were placed in 59 patients, 20 male and 39 female. Forty‐seven (47) were placed in the maxilla and 24 in the mandible. The percentages of anterior and posterior implants were 45.1 % and 54.9%, respectively. A total of 13 (18.4%) implants were placed in soft, poor quality (Type IV) bone. Beginning 1 month post‐implant placement, cases were followed for 30.9 to 60 months with a mean followup of 45.9 months. One implant failed (peri‐implant infection) yielding an overall success rate of 98.6%.Conclusions: This success rate for single‐tooth replacement dual acid‐etched implants compares favorably with bridged implants and with success rates of other single‐tooth implant studies. Dual acid‐etched implants performed well even under conditions of poor quality bone, where concomitant bone augmentation was performed, and when used for immediate replacement of extracted teeth. J Periodontal 2002;73:687‐693.
Effect of Polylactide/Glycolide (PLGA) Membranes Loaded With Metronidazole on Periodontal Regeneration Following Guided Tissue Regeneration in Dogs
Authors: Kurtiş Bülent , Ünsal Berrin , Çetiner Deniz , Gültekin Elif , Özcan Gönen , Çelebi Nevin , Ocak Ömer 
Published: February 2005

Background: Bioabsorbable membranes have been successfully used for guided tissue regeneration (GTR) and local delivery systems because they are biocompatible and do not require second surgery for removal. Several studies have demonstrated that metronidazole, when applied topically, produced immediate effects on microbiological and clinical parameters, most notably a reduction in probing depth and loss of attachment. The purpose of this study was to evaluate the regenerative potential of a metronidazole‐loaded biodegradable (polylactide/glycolide) (PLGA) GTR membrane in dogs.Methods: Six male adult dogs with 36 created osseous defects were enrolled. Bilateral dehiscence type defects in 5 mm diameter were created at buccal aspect of the alveoler bone in maxillary premolar teeth. After full thickness flap elevation, exposed root surfaces were thoroughly planed. In the experimental sites, PLGA membranes with or without metronidazole were fitted and placed over the defects. On the control defects only root planing was performed. Gingival flaps were replaced slightly coronal to the cemento‐enamel junction. Animals were sacrified at 60 days. The histometric analysis was evaluated with the following parameters: defect height (DH), apical extension of junctional epithelium (AEJE), new cementum height (NCH), new bone height (NBH), and new gingival connective tissue height (NCTH).Results: Postoperative clinical healing was similar in the 3 groups. There were no statistically significant differences between the 2 experimental groups in any parameters. Statistically significant differences were observed for AEJE, NCH, NBH, and NCTH in experimental groups when compared with the controls. Statistically significantly greater NCH, NBH, and NCTH were seen in the experimental groups than the controls and control defects showed longer AEJE than the experimental defects.Conclusions: These results suggest that PLGA membranes with and without metronidazole may have a beneficial effect on periodontal regeneration. J Periodontol 2002;73:694‐700.
Level of Neopterin, a Marker of Immune Cell Activation in Gingival Crevicular Fluid, Saliva, and urine in Patients With Aggressive Periodontitis
Authors: Ozmeriç Nurdan , Baydar Terken , Bodur Ayşen , Engin Ayse Basak , Uraz Ahu , Eren Kaya , Sahin Gonul 
Published: February 2005

Background: Neopterin, a marker of cellular immune activation, is produced by human macrophages after induction by interferon gamma that is secreted by T lymphocytes. Neopterin concentrations in diverse body fluids have been reported to increase in parallel with bacteria in the clinical course of infections. Therefore, determination of neopterin in body fluids was thought to be useful for predicting the prognosis and diagnosis of aggressive forms of periodontal disease, in which the cell‐mediated immune response plays an important role in immunopathogenesis. The aim of the present study was to observe the role of neopterin in the pathogenesis of aggressive periodontitis (AgP).Methods: Thirteen individuals who were systemically and periodontally healthy and 16 systemically healthy individuals diagnosed with AgP were recruited for this study. Mixed saliva and urine samples were collected from each subject. Gingival crevicular fluid (GCF) samples were obtained from 6 teeth with ≥5 mm probing depth (PD). After evaluation of GCF amount from paper strips, enzyme‐linked immunosorbent assay (ELISA) was employed to determine the amount of neopterin in urine, saliva, and GCF.Results: The amount of neopterin in urine and saliva measured 235.77 ± 405.31 µmol neopterin/mol creatinine and 9.85 ± 7.66 nmol/l, respectively, for the AgP group and 225.45 ± 100.72 µmol neopterin/mol creatinine and 5.25 ± 5.76 nmol/l, respectively, for controls. The present data demonstrate that, while salivary neopterin levels were found to be significantly different between periodontitis and control subjects, there were non‐significant differences in urine neopterin levels. The amount and concentration of neopterin in GCF measured was 18 ± 12.75 nmol/l and 3.67 ± 2.40 nmol/ml for the AgP group and 2.51 ± 1.72 nmol/l and 3.88 ± 4.50 nmol/ml for the control group. When total amounts of neopterin are taken into consideration, a significant difference between AgP and controls is shown; however, no significant difference in net concentration of neopterin was found between both groups.Conclusions: This study is the first report to evaluate the involvement of neopterin in AgP and this might be considered of value in understanding periodontal disease mechanisms. J Periodontal 2002;73:720‐725.