bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Smoking on 3‐Year Clinical Success of Osseointegrated Dental Implants
Authors: Lambert Paul M. , Morris Harold F. , Ochi Shigeru 
Published: February 2005

Background: Health risks associated with smoking have been exhaustively documented and include increased incidence of periodontal disease, greater risk of osteitis following oral surgery, and compromised wound healing due to hypoxia. Information related directly to dental implants, although limited, points to higher rates of implant failures among smokers than non‐smokers. This paper reports on long‐term clinical outcomes of osseointegrated dental implants placed in smokers and non‐smokers in a longitudinal clinical study of endosseous dental implants.Methods: In 1990, the Dental Implant Clinical Research Group (DICRG) of the Department of Veterans Affairs (DVA) launched an 8‐year, randomized, prospective clinical study of more than 2,900 endosseous dental implants in more than 800 patients at 32 study centers. Confounding variables, including smoking patterns, were recorded. For this report, new follow‐up data were analyzed for two groups: 1) current smokers and 2) those who never smoked combined with those who quit. Most of the variables recorded for each implant were screened on a univariate basis as possible predictors associated with implant survival/failure. Those with P values less than 0.15 and those likely to be a factor of clinical importance were placed in a logistic regression equation and analyzed for a simultaneous effect on survival. A step‐wise procedure was used to eliminate those variables that showed the least significance, until only those variables with a Wald chi‐square of significance in the presence of others remained. The effects of clustering within patients and of unbalanced distribution within hospitals were standardized to facilitate analysis of influence of demographic variables. The GEE analysis was performed with the patient as the primary cluster.Results:Current data do not support earlier findings that smoking contributes to early implant failure (placement to uncovering). A trend of greater failures in smokers appeared between the time after uncovering and before insertion of the prosthesis. Hydroxyapatite (HA)‐coated implants had significantly lower failure rates. For the entire 3‐year period, overall failures were significantly higher for smokers than non‐smokers.Conclusions: Results suggest that increased implant failures in smokers are not the result of poor healing or osseointegration, but of exposure of peri‐implant tissues to tobacco smoke. Data also suggest that detrimental effects may be reduced by: 1) cessation of smoking; 2) the use of preoperative antibiotics; and 3) the use of HA‐coated implants.Ann Periodontol 2000;5:79‐89.
Population Studies of Microbial Ecology in Periodontal Health and Disease
Authors: Papapanou Panos N. 
Published: February 2005

It has been established that the bacterial diversity in any given environment is severely underestimated when assessed by means of culture‐based techniques. Yet, almost all currently available knowledge related to the periodontal microbiota in health and disease has been generated either by culture‐based surveys or by methods that require prior species identification by culture. A handful of recent studies using culture‐independent molecular methods providing 16S rRNA sequences for both cultivable and not yet cultivated species of human periodontal bacteria demonstrated a high bacterial diversity in the oral cavity. It has been estimated that approximately 500 species may colonize the human oral cavity, half of which have been cultivated to date.A review of the available epidemiological data on the prevalence of certain periodontal microbiota on a population level reveals considerable variation in estimates with respect to 1) sampling strategy, 2) mode of bacterial identification, and 3) race/ethnicity of the studied population. Nevertheless, specific bacterial profiles appear to confer high odds ratios for pathological periodontal conditions and/or progressive periodontal disease. However, the currently recognized periodontal pathogens are commonly recovered from periodontally healthy children, and their carrier rate in adults is substantial. Virulent clones, such as a highly leukotoxic strain of Actinobacillus actinomycetemcomitans, have been found to be closely associated with aggressive forms of periodontitis.In conclusion, while the majority of the periodontal microbiota are commensals, a subset of likely opportunistic pathogens fulfills the epidemiologic requirements needed in order to be ascribed as risk/causative factors. Given the large proportion of the periodontal microbial habitat that is currently insufficiently explored, and assuming that the hitherto uncultivated segment of the bacterial community will include similar levels of pathogenic species, the list of periodontal pathogens should be expected to expand. Ann Periodontol 2002;7:54‐61.
The Use of the Evidence‐Based Approach in a Periodontal Therapy Contemporary Science Workshop
Authors: Newman Michael G. , Caton Jack G. , Gunsolley John C. 
Published: February 2005

Background: When appropriately evaluated and carefully managed, the integration of emerging technology into practice can improve health and enhance the quality of life. Since the last American Academy of Periodontology Workshop in 1996, great technological advances in the areas of data access, retrieval, and management have been made. The World Wide Web has “exploded” with great possibilities for gathering data from many sources. Evaluation methods such as meta‐analysis and modeling have likewise improved, permitting a more objective and useful assessment of the retrieved information. The purpose of this paper is to demonstrate how the evidence‐based (EB) approach was used to plan and implement a consensus conference on periodontal therapy, the Workshop on Contemporary Science in Clinical Periodontics.Rationale:The methodologies and philosophies associated with the EB approach provided the ideal framework for assessing the applicability of the newest clinical research to patient therapy.Methods: Evidence‐based systematic reviews on 15 topics associated with contemporary clinical periodontal practice were conducted prior to the Workshop. High standards of scientific rigor and scholarly ideals were stressed throughout the process. At the highly structured conference the reviews served as the basis for development of consensus reports that include implications for practice and research.

Material Covered:

The rationale, design, and implementation of a conference on contemporary clinical periodontics using an evidence‐based approach.

Data management, clinical versus statistical significance, and the challenges of technology transfer and dissemination.

The benefits and limitations of using the EB approach in a consensus conference.

Conclusions:

The consensus statements resulting from the conference should serve to augment clinical decision‐making, research priorities, education, and reimbursement.

The evidence‐based approach removed much of the subjectivity traditionally associated with classical reviews of the literature and allowed participants to focus on substantive issues.

Ann Periodontol 2003;8:1‐11.
Surgical Therapies for the Treatment of Gingival Recession. A Systematic Review
Authors: Oates Thomas W. , Robinson Melanie , Gunsolley John C. 
Published: February 2005

Background: A variety of soft tissue augmentation procedures directed at root coverage have been documented in the literature utilizing autogenous or allogenic soft tissue grafting or guided tissue regeneration (GTR).Rationale: The purpose of this systematic review was to assess the literature regarding the efficacies of various surgical gingival augmentation procedures relative to clinical and patient‐oriented outcomes.Focused Question: What is the effect of surgical therapy for root coverage in patients with gingival recession compared with other treatment modalities or baseline values?Search Protocol: PubMed and the Cochrane Oral Health Group Trials Register were searched to identify human studies in English investigating the therapeutic use of a soft tissue surgical procedure to treat gingival recession. Searches were performed for articles published by April 2002.Selection Criteria: Initial screening of identified abstracts accepted all studies evaluating surgical intervention of gingival recession. Independent review by 2 reviewers evaluated full‐text reports regarding study characteristics. Only those studies determined to be randomized clinical trials (RCTs) were included in the final analysis.Data Analysis and Collection: Outcome measures included changes in root coverage, clinical attachment levels (CAL), probing depth (PD), and width of keratinized tissue (KT). The only data suitable for metaanalysis were comparisons of the efficacy of connective tissue grafts with GTR.

Main Results

Thirty‐two articles (total study population: 687) met the criteria for RCTs: 11 (population: 286) related to various autogenous soft tissue augmentation procedures; 18 (population: 360) to GTR; and 3 (population: 41) to allogenic soft tissue augmentation

Meta‐analysis identified greater gains in both root coverage and keratinized tissue width for connective tissue graft procedures compared to GTR.

No other data were compatible with meta‐analysis.

Reviewers' Conclusions

Soft tissue augmentation procedures are effective means of obtaining root coverage.

Connective grafting techniques appear to have an advantage over GTR.

There is a need for further efficacy studies and for investigation of these procedures relative to patientoriented outcomes such as esthetics, root sensitivity, and postoperative morbidities.

Ann Periodontol 2003;8:303‐320.
Localized Ridge Augmentation/Preservation. A Systematic Review
Authors: Fiorellini Joseph P. , Nevins Marc L. 
Published: February 2005

Background: Osseointegrated implants have been documented as efficacious, however, their placement may be contraindicated in some patients due to insufficient bone volume. Techniques such as guided bone regeneration (GBR), immediate implantation, and distraction osteogenesis (DO) have been utilized as ridge enhancement therapies.Rationale: This systematic review evaluates dental implant survival rates in patients treated with ridge augmentation or preservation techniques.Focused Question: In patients requiring dental implant placement, what is the effect of localized ridge preservation versus implant placement without augmentation on implant survival and adverse effects?Search Protocol: MEDLINE and Cochrane Oral Health Group Specialized Trial Register were searched. Hand searches were performed on Clinical Oral Implants Research, International Journal of Oral and Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, Journal of Clinical Periodontology, Journal of Periodontology, and Journal of Periodontal Research. All searches were performed for articles published through April 2002.Selection Criteria:Publications reporting survival rate of dental implants following ridge therapy were included in the analysis. Reports describing techniques were excluded.Data Collection and Analysis:Due to the absence of controlled studies, a meta‐analysis was not performed. Descriptive statistics are used to report the data.

Main Results

A total of 18 studies were included: 13 reporting on guided bone regeneration (GBR, 1,741 patients) and 5 on distraction osteogenesis (DO, 92 patients).

There is a high level of predictable implant survival in sites treated by GBR or DO.

These survival rates are similar to those of implants placed in native bone.

Reviewers' Interpretations: Survival rates were similar for both GBR and DO implants. These survival rates were similar to implants placed in native bone.Ann Periodontol 2003;8:321‐327.
Gingival Recession, Gingival Bleeding, and Dental Calculus in Adults 30 Years of Age and Older in the United States, 1988‐1994
Authors: Albandar J.M. , Kingman A. 
Published: February 2005

Background: The aim of this study was to assess the prevalence and extent of gingival recession, gingival bleeding, and dental calculus in United States adults, using data collected in the third National Health and Nutrition Examination Survey (NHANES III).Methods: The study group consisted of 9,689 persons 30 to 90 years of age obtained by a stratified, multi‐stage probability sampling method in 1988 to 1994. The weighted sample is representative of U.S. adults 30 years or older and represents approximately 105.8 million civilian, non‐institutionalized Americans. Gingival recession, gingival bleeding, and dental calculus were assessed at the mesio‐buccal and mid‐buccal surfaces in 2 randomly selected quadrants, one maxillary and one mandibular. Data analysis accounted for the complex sampling design used.Results: We estimate that 23.8 million persons have one or more tooth surfaces with ≥3 mm gingival recession; 53.2 million have gingival bleeding; 97.1 million have calculus; and 58.3 million have subgingival calculus; and the corresponding percentages are 22.5%, 50.3%, 91.8%, and 55.1% of persons, respectively. The prevalence, extent, and severity of gingival recession increased with age, as did the prevalence of subgingival calculus and the extent of teeth with calculus and gingival bleeding. Males had significantly more gingival recession, gingival bleeding, subgingival calculus, and more teeth with total calculus than females. Of the 3 race/ethnic groups studied, non‐Hispanic blacks had the highest prevalence and extent of gingival recession and dental calculus, whereas Mexican Americans had the highest prevalence and extent of gingival bleeding. Mexican Americans had similar prevalence and extent of gingival recession compared with non‐Hispanic whites. Gingival recession was much more prevalent and also more severe at the buccal than the mesial surfaces of teeth. Gingival bleeding also was more prevalent at the buccal than mesial surfaces, whereas calculus was most often present at the mesial than buccal surfaces.Conclusions: Dental calculus, gingival bleeding, and gingival recession are common in the U.S. adult population. In addition to their unfavorable effect on esthetics and self‐esteem, these conditions also are associated with destructive periodontal diseases and root caries. Appropriate measures to prevent or control these conditions are desirable, and this may also be effective in improving the oral health of the U.S. adult population. J Periodontol 1999; 70: 30‐43.
Prevalence of Gingival Overgrowth Induced by Calcium Channel Blockers: A Community‐Based Study
Authors: Ellis Janice S. , Seymour Robin A. , Steele James G. , Robertson Pauline , Butler Tim J. , Thomason J. Mark 
Published: February 2005

Background: The prevalence of gingival overgrowth induced by chronic medication with calcium channel blockers is uncertain. Although there have been several studies examining this question, the results are conflicting, with previous estimates ranging from 20% to 83%. There have been only 2 studies examining the prevalence of overgrowth induced by diltiazem and amlodipine, with estimates of 74% and 3.3%, respectively.Methods: The current study aimed to address the problems associated with these studies by examining a sample of patients taking one of 3 calcium channel blockers, who were drawn from a community‐based population in northeastern England. Nine hundred eleven (911) subjects were recruited from general medical practices in the area. Of these, 442 were taking nifedipine, 181 amlodipine, and 186 diltiazem. In addition, 102 control subjects were examined. Drug and demographic data for each subject were recorded. The periodontal condition of all subjects was assessed including plaque index, papillary bleeding index, and a photograph of the anterior gingivae for subsequent analysis of overgrowth severity.Results: More than six percent (6.3%) of subjects taking nifedipine were seen to have significant overgrowth. This overgrowth was statistically greater than the amount of overgrowth seen in either of the other 2 drug groups or the control population. The prevalence of gingival overgrowth induced by amlodipine or diltiazem was not statistically significant when compared to the control group. The severity of overgrowth within the nifedipine group was found to be related to the amount of gingival inflammation and also to the gender of the subject, with males being 3 times as likely to develop overgrowth than females.Conclusions: The prevalence of clinically significant overgrowth related to chronic medication with calcium channel blockers is low, i.e., 6.3% for nifedipine. Males are 3 times as likely as females to develop clinically significant overgrowth. The presence of gingival inflammation is an important cofactor for the expression of this effect. J Periodontol 1999; 70: 63‐67.
Laser Irradiation of Bone: II. Healing Response Following Treatment by CO2 and Nd:YAG Lasers
Authors: Friesen Lynn R. , Cobb Charles M. , Rapley John W. , Forgas‐Brockman Lorraine , Spencer Paulette 
Published: February 2005

Background: Currently, the most commonly used lasers for dental procedures are the Nd:YAG and CO2. Studies comparing healing of osteotomy defects prepared with rotary burs to those created by laser irradiation have reported conflicting results. The purpose of this study was to evaluate and compare the histologic healing of bone in rat tibial osteotomy defects created either by a dental bur, CO2 laser with and without removal of the char layer, and Nd:YAG laser with char layer removed and with and without use of an air/water surface cooling spray.Methods: Tibial osteotomy defects were created in 4 groups of 6 rats each using the following: 1) #6 round bur with simultaneous saline irrigation; 2) CO2 laser with char layer intact; 3) CO2 laser with char layer removed; 4) Nd:YAG laser with air/water surface cooling, and char layer intact; 5) Nd:YAG laser with air/water surface cooling, and char layer removed; and 6) Nd:YAG laser without air/water surface cooling, and char layer removed. Both laser types were used at energy densities typically utilized for oral soft tissue surgery.Results: Progressive healing from day 0 through day 21 post‐treatment was observed in all treatment groups. However, compared to controls treated by rotary dental bur, those specimens treated by laser, regardless of laser type, energy density, or other parameters, exhibited a delay in healing that appeared to be related to the presence of residual char in the osseous defect. Specimens treated with the Nd:YAG laser using an air/water surface coolant exhibited a decreased thickness and continuity of the char layer and yielded the only specimens with new bone formation at the surface of the laser ablation defect. In addition, the normal pattern of bone remodeling in the rat tibia appeared to have been altered by laser irradiation.Conclusions: In this animal model, laser‐induced osteotomy defects, when compared to those prepared by rotary bur, exhibited a delayed healing response that appeared to be related to the presence of residual char in the osseous defect. J Periodontol 1999; 70: 75‐83.
Implications of Minocycline, Platelet‐Derived Growth Factor, and Transforming Growth Factor‐Beta on Inflammatory Repair Potential in the Periodontium
Authors: Soory M. , Virdi H. 
Published: February 2005

Background: Semisynthetic tetracyclines used in the adjunctive treatment of inflammatory periodontal disease enhance collagen expression in induced periodontal lesions of rats. Polypeptide growth factors regulate key cellular events in tissue repair. The physiologically active androgen 5α‐dihydrotestosterone (DHT) stimulates bone and connective tissue turnover. It was relevant to study the effects of transforming growth factor beta (TGF‐β)/platelet‐derived growth factor (PDGF) and minocycline alone and in combination on the formation of biologically effective androgens which can influence repair.Methods: Confluent monolayer cultures of human gingival fibroblasts of the fifth through the ninth passage were incubated in Eagle's minimum essential medium, with 14C‐testosterone/14C‐4‐androstenedione in the presence or absence of optimal concentrations of TGF‐β/PDGF/minocycline (M), alone and in combination. At the end of a 24‐hour incubation period, the medium was analyzed for steroid metabolites and quantified using a radioisotope scanner.Results: The androgen substrates 14C‐testosterone (14C‐T) and 14C‐4‐androstenedione (14C‐4‐A) were metabolized to DHT and 4‐androstenedione/testosterone respectively. There were significant increases in the formation of DHT from 14C‐T in response to M, TGF‐β, and PDGF, alone and in combination (13 to 48%), compared with controls (n = 4; P <0.01). The yields of 4‐androstenedione were also greater in response to these agents (31%; 3‐fold). When 14C‐4‐A was used as substrate, there were 21 to 80% increases in the formation of DHT in response to these agents alone and in combination (n = 4; P <0.01).Conclusions: The biologically effective androgen metabolites formed in response to minocycline, TGF‐β, and PDGF can contribute to reparatory events in the inflamed periodontium. Judicious, adjunctive usage of the chemically‐modified tetracyclines in the treatment of periodontal diseases can obviate the risk of microbial resistance, with potential applications of their anti‐inflammatory and proanabolic effects in regenerative technology. J Periodontol 1999;70:1136‐1143.
Relationship Between a Self‐Reported Health Questionnaire and Laboratory Tests at Initial Office Visits
Authors: Thompson Kelley S. , Yonke Mary L. , Rapley John W. , Cobb Charles M. , Johnson Valerie 
Published: February 2005

Background: Dental patients routinely complete a medical questionnaire and have an oral interview during their initial visit, but may have undiagnosed systemic problems which can affect their dental treatment.Methods: Thirty‐nine consecutive patients referred for a periodontal evaluation completed a medical questionnaire and an oral interview. They were referred to a hospital laboratory for an urinalysis, complete blood count, and a standard blood chemistry panel.Results: The self‐reported medical history responses were compared with the laboratory data and several abnormalities were noted. Abnormal levels were found with cholesterol, (26/39 patients, 67%); triglycerides, (13/39, 33%); glucose, (6/39, 15%); eosinophils, (18/39, 46%); and monocytes, (10/39, 26%). Smokers (17/39, 44%) had a higher number of abnormal levels or percentages of cholesterol, triglycerides, basophils, lymphocytes, eosinophils, and monocytes. Gender differences were seen in elevated triglyceride levels, abnormal aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and self‐reported cardiovascular disease.Conclusions: This study demonstrated that many patients are unaware of their current medical status and a significant number had undiagnosed abnormalities. J Periodontol 1999;70:1153‐1157.