bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ridge Preservation with Freeze‐Dried Bone Allograft and a Collagen Membrane Compared to Extraction Alone for Implant Site Development: A Clinical and Histologic Study in Humans
Authors: Iasella John M. , Greenwell Henry , Miller Richard L. , Hill Margaret , Drisko Connie , Bohra Aziz A. , Scheetz James P. 
Published: February 2005

Background: Tooth extraction typically leads to loss of ridge width and height. The primary aim of this 6‐month randomized, controlled, blinded, clinical study was to determine whether ridge preservation would prevent post‐extraction resorptive changes as assessed by clinical and histologic parameters.Methods: Twenty‐four patients, 10 males and 14 females, aged 28 to 76 (mean 51.5 ± 13.6), requiring a non‐molar extraction and delayed implant placement were randomly selected to receive either extraction alone (EXT) or ridge preservation (RP) using tetracycline hydrated freeze‐dried bone allograft (FDBA) and a collagen membrane. A replaced flap, which did not completely cover the sockets, was used. Following extraction, horizontal and vertical ridge dimensions were determined using a modified digital caliper and an acrylic stent, respectively. Prior to implant placement, a 2.7 × 6.0 mm trephine core was obtained and preserved in formalin for histologic analysis.Results: The width of the RP group decreased from 9.2 ± 1.2 mm to 8.0 ± 1.4 mm (P <0.05), while the width of the EXT group decreased from 9.1 ± 1.0 mm to 6.4 ± 2.2 mm (P <0.05), a difference of 1.6 mm. Both the EXT and RP groups lost ridge width, although an improved result was obtained in the RP group. Most of the resorption occurred from the buccal; maxillary sites lost more width than mandibular sites. The vertical change for the RP group was a gain of 1.3 ± 2.0 mm versus a loss of 0.9 ± 1.6 mm for the EXT group (P <0.05), a height difference of 2.2 mm. Histologic analysis revealed more bone in the RP group: about 65 ± 10% versus 54 ± 12% in the EXT group. The RP group included both vital bone (28%) and nonvital (37%) FDBA fragments.Conclusions: Ridge preservation using FDBA and a collagen membrane improved ridge height and width dimensions when compared to extraction alone. These dimensions may be more suitable for implant placement, especially in areas where loss of ridge height would compromise the esthetic result. The quantity of bone observed on histologic analysis was slightly greater in preservation sites, although these sites included both vital and non‐vital bone. The most predictable maintenance of ridge width, height, and position was achieved when a ridge preservation procedure was employed. J Periodontol 2003;74:990‐999.
Orthodontic Movement into Infrabony Defects in Patients with Advanced Periodontal Disease: A Clinical and Radiological Study
Authors: Corrente Giuseppe , Abundo Roberto , Re Stefania , Cardaropoli Daniele , Cardaropoli Giuseppe 
Published: February 2005

Background: In cases of advanced periodontal disease with a pathologic flaring of frontal teeth, a combined periodonticorthodontic therapy may be a reliable approach in order to solve both functional and esthetic problems. The aim of the present study was to evaluate the periodontal tissue alterations following periodontal surgery and orthodontic intrusion in migrated upper central incisors with intrabony defects.Methods: Ten patients with advanced periodontal disease and an extruded maxillary central incisor infrabony defect at its mesial aspect and probing depth (PD)≥6 mm were included in the present study. At baseline, PD and clinical attachment level (CAL) were measured. The vertical and horizontal dimensions of the defects were assessed on standardized radiographs. Seven to 10 days after surgery the active orthodontic treatment started using the segmented arch technique, in order to intrude and move the teeth into the defects. Maintenance therapy was performed every 2 to 3 months until the orthodontic treatment was completed.Results: At the end of treatment, mean PD reduction was 4.35 mm, with a residual mean PD of 2.80 mm. Mean CAL gain was 5.50 mm. The mean radiological vertical and horizontal bone fills were, respectively, 1.35 mm and 1.40 mm. All differences were of statistical significance (P <0.001).Conclusion: The present study showed that the combined orthodontic and periodontic therapy performed resulted in the realignment of extruded teeth with infrabony defects, obtaining a significant probing depth reduction, clinical attachment gain, and radiological bone fill. J Periodontol 2003;74:1104‐1109.
Evaluation of Human Recession Defects Treated with Coronally Advanced Flaps and Either Enamel Matrix Derivative or Connective Tissue. Part 1: Comparison of Clinical Parameters
Authors: McGuire Michael K. , Nunn Martha 
Published: February 2005

Background: Recession defects around teeth have been treated with a variety of surgical techniques. Most of the literature suggests that the subepithelial connective tissue graft has the highest percentage of mean root coverage with the least variability. Previous studies have demonstrated that enamel matrix derivative (EMD) has the ability to improve clinical parameters. The purpose of this study was to compare the clinical efficacy of enamel matrix derivative placed under a coronally advanced flap to subepithelial connective tissue placed under a coronally advanced flap in patients with recession type defects.Methods: Twenty patients with incisors or premolars presenting with a facial recession of ≥4 mm in contralateral quadrants of the same jaw were treated; 17 patients completed the study. One tooth in each patient was randomized to receive either a coronally advanced flap with a subepithelial connective tissue graft (control) or a coronally advanced flap with EMD (test). Clinical parameters measured at baseline and at 6, 9, and 12 months included amount of recession; width at the coronal extent of the gingival defect; width of keratinized tissue; probing depth; clinical attachment level; inflammation score; plaque score; plaque index; alveolar bone level; tissue texture and color; and patient perception of pain, bleeding, swelling, and sensitivity.Results: Results for both the test and control groups were similar for all measured clinical parameters with the exception of early healing, self‐reported discomfort, and the amount of keratinized tissue obtained. The coronally advanced flap with EMD was superior to the subepithelial connective tissue graft with regard to early healing and patient‐reported discomfort, whereas the subepithelial connective tissue graft demonstrated greater amount of keratinized tissue during the 12‐month evaluation period. However, both the test and control showed a significant increase in the amount of keratinized tissue at 9 and 12 months compared to baseline. No significant difference in the amount of root coverage was found between the test and control groups (n = 19; P = 0.82). On average, a gain of 4.5 mm (range 4 to 8 mm) tissue covering the previously exposed root surfaces was achieved with both treatment groups. The average percentages of root coverage for control and test groups were 93.8% and 95.1%, respectively. One hundred percent root coverage was obtained 89.5% of the time with the coronally advanced flap with EMD and 79% of the time with the subepithelial connective tissue graft.Conclusion: Based on the results of this investigation, the addition of EMD to the coronally advanced flap resulted in root coverage similar to the subepithelial connective tissue graft but without the morbidity and potential clinical difficulties associated with the donor site surgery. J Periodontol 2003;74:1110‐1125.
Partial‐Mouth Assessment of Periodontal Disease in an Adult Population of the United States
Authors: Owens Jason D. , Dowsett Sherie A. , Eckert George J. , Zero Domenick T. , Kowolik Michael J. 
Published: February 2005

Background: It has been previously demonstrated, using periodontal data from an untreated population, that half‐mouth assessment of six sites/tooth provides an appropriate alternative to whole‐mouth assessment of periodontal disease status. Since periodontal destruction exhibits left‐right symmetry, it was hypothesized that this would be equally applicable to a population with access to routine dental care.Methods: Adult subjects (N = 92) with a range of disease levels participated in the study. Probing depths (PDs) and recession (REC) were measured directly on six sites/tooth, on all teeth excluding third molars), and clinical attachment levels (CALs) were derived. Partial‐mouth assessments, i.e., assessment of limited sites and/or teeth, were compared with whole‐mouth assessment as follows. Intraclass correlation coefficients (ICCs) were calculated for mean PD, CAL, and REC, and for percentage of sites with disease above a specified threshold, to determine the agreement between the whole‐ and partial‐mouth assessment. The sensitivity of partial‐mouth assessment of disease prevalence also was determined.Results: For assessment of six sites per tooth in one upper and one lower quadrant, ICCs were consistently >0.80. Assessment of two sites per tooth or only Ramfjord teeth generally underestimated disease extent and severity, and prevalence, compared to half‐mouth assessment.Conclusions: These results support the use of a half‐mouth examination of six sites/tooth, to conserve time, limit cost, and reduce patient and examiner fatigue, while providing maximal clinical information. Assessment of only two sites per tooth or the Ramfjord teeth was not suitable for evaluation of either disease extent and severity or prevalence. JPeriodontol 2003; 74:1206‐1213.
Periodontal Disease and Preterm Birth: Results of a Pilot Intervention Study
Authors: Jeffcoat Marjorie K. , Hauth John C. , Geurs Nico C. , Reddy Michael S. , Cliver Suzanne P. , Hodgkins Pamela M. , Goldenberg Robert L. 
Published: February 2005

Background: Previous case‐control and prospective studies have shown an association between the presence of periodontitis and the risk of preterm birth (PTB). The goal of this pilot trial was to determine the feasibility of conducting a trial to determine whether treatment of periodontitis reduces the risk of spontaneous preterm birth (SPTB).Methods: Three hundred sixty‐six (366) women with periodontitis between 21 and 25 weeks' gestation were recruited and randomized to one of three treatment groups with stratifi‐ cation on the following two factors: 1) previous SPTB at <35 weeks and 2) body mass index <19.8 or bacterial vaginosis as assessed by gram stain. The treatment groups consisted of: 1) dental prophylaxis plus placebo capsule; 2) scaling and root planing (SRP) plus placebo capsule; and 3) SRP plus metronidazole capsule (250 mg t.i.d. for one week). An additional group of 723 pregnant women meeting the same criteria for periodontitis and enrolled in a prospective study served as an untreated reference group.Results: The rate of PTB at <35 weeks was 4.9% in the prophylaxis group, compared to 3.3% in the SRP plus metronidazole group and 0.8% in the SRP plus placebo group (P = 0.75 and 0.12, respectively). The rate of PTB at <35 weeks was 6.3% in the reference group.Conclusions: This trial indicates that performing SRP in pregnant women with periodontitis may reduce PTB in this population. Adjunctive metronidazole therapy did not improve pregnancy outcome. Larger trials will be needed to achieve statistical significance, especially at less than 35 weeks gestational age. J Periodontol 2003;74:1214‐1218.
Pain Experienced by Patients During Periodontal Maintenance
Authors: Chung Denine T. , Bogle Gary , Bernardini Melanie , Stephens Denise , Riggs Matt L. , Egelberg Jan H. 
Published: February 2005

Background: The aims of this study were to determine: 1) the degree of pain experienced by patients during probing and debridement; 2) whether the treating hygienists could estimate the degree of pain experienced by the patients; and 3) whether the patients' pain responses could be predicted by factors such as the patients' age, gender, number of residual periodontal lesions, and answers to a questionnaire on dental anxiety.Methods: Prior to periodontal maintenance procedures, two groups of 20 adult patients to be treated by two hygienists completed an anxiety questionnaire. Subsequently, measurements of probing depths were performed, followed by pain ratings by each patient using a visual analog scale (VAS). The hygienists also completed a VAS, estimating the pain level they perceived their patient to have experienced. The same protocol was repeated for instrumentation (debridement).Results: Most patients showed low pain responses to both probing and instrumentation. However, using an arbitrary threshold of VAS ≥40 mm, 20% to 33% of the patients had a significant pain experience. The hygienists were quite accurate in their relative estimates of their patients' pain experiences. Regression analyses disclosed that significant portions of the pain responses could be predicted by the patients' answers to one of the dental anxiety questions.Conclusions: Recognition of patients who are likely to experience significant pain during periodontal treatment may be facilitated by the use of one question on dental anxiety. During treatment, the ability to gauge and respond to patients' pain experiences would seem to be an important component of a therapist's clinical skills. J Periodontol 2003;74:1293‐1301.
Platelet‐Derived Growth Factor‐BB Stimulated Cell Migration Mediated Through p38 Signal Transduction Pathway in Periodontal Cells
Authors: Ray Angel K. , Jones Anne C. , Carnes David L. , Cochran David L. , Mellonig James T. , Oates Thomas W. 
Published: February 2005

Background: Intracellular signaling pathways mediate specific responses to growth factors. The manipulation of these pathways ultimately may be used to control the clinical outcomes of periodontal regenerative therapy. The purpose of this study was to examine the role of the p38 signal transduction pathway in the responses of periodontal cells to platelet‐derived growth factor‐ BB (PDGF).Methods: Primary cultures of human periodontal ligament cells (PDLs) and gingival fibroblasts (GFs) were used for all experiments. Cell numbers, 3H‐thymidine incorporation, and Boyden chamber assays were used to characterize the effects of SB 203580 (SB), a specific inhibitor of the p38 signaling pathway, on cell proliferation and migration. An in vitro wound model also was used to assess the effects of SB. For the in vitro wound assay, triplicate wells were incubated for 1, 3, 5, and 7 days using 0.1% fetal bovine serum (FBS), 10% FBS ± 10 μM SB, or 20 ng/ml PDGF ± 10 μM SB. Digital histomorphometric analysis assessed cellular fill within the wound area.Results: SB specifically inhibited PDGF‐induced migration in the Boyden chamber assays without affecting cell proliferation. The wound model data showed similar levels of wound fill for PDLs and GFs in 10% FBS. Relative to 10% FBS, PDLs stimulated with PDGF showed significantly (P <0.01, analysis of variance) greater wound fill (74%) than GFs (12%). SB inhibited the PDGF‐induced wound fill of PDLs and GFs by 64% and 57%, respectively. This inhibition was significant (P <0.01, ANOVA) only for PDLs. The addition of SB to 10% FBS did not significantly affect the wound fill response of either cell type compared to 10% FBS alone.Conclusions: These results demonstrate that periodontal cells possess distinct responses to PDGF that may be altered at the signal transduction level. The manipulation of these responses through the use of inhibitors to specific signaling pathways may enhance our control of periodontal regeneration in the future. J Periodontol 2003;74:1320‐1328.
A Gingival Cul‐de‐Sac Following a Root Coverage Procedure with a Subepithelial Connective Tissue Submerged Graft
Authors: Wei Pein‐Chi , Geivelis Milton 
Published: February 2005

Background: The subepithelial connective tissue graft (SCTG) used as a submerged graft in combination with a partial thickness advanced flap or rotated flap is a predictable technique for achieving coverage of the denuded root surface and/or for increasing the width of attached gingiva in Miller's class I and II marginal tissue recessions. However, even with a successful result, complications may occasionally occur.Methods: A 4‐mm marginal tissue recession with an insufficient zone of attached gingiva on the facial aspect of a mandibular left lateral incisor (#23) was covered with a submerged SCTG and an envelope partial thickness flap. The mucogingival defect was successfully corrected. Nevertheless, the facial gingiva, specifically between teeth #22 (mandibular left canine) and #23, remained bulky and was reshaped 6 months postoperatively. A 5‐mm long gingival cul‐de‐sac with an intermittent thick white discharge was detected 3 months following the gingivoplasty procedure.Results: With a periodontal probe kept in the tract, the lining of the cul‐de‐sac was exposed to the oral cavity by making an incision on the facial gingiva, along the axis of the probe, through to the lumen. The gingival tissue was then removed with a rotary bur until only a thin layer of periosteum remained. The mucosal defect was subsequently repaired by grafting with a non‐submerged SCTG. The gingival contour was significantly improved and no sign of recurrence was noted up to 4 years later.Conclusions: The existence of a cyst cannot be verified without a histological evaluation. However, the development of a gingival cyst should be suspected with persistent tissue bulkiness and/or emergence of a thick white discharge from a site where a submerged SCTG procedure was performed. In addition, the illcircumscribed border around the lesion makes complete elimination of the pathosis relatively hard to achieve by a “superficial” gingivoplasty procedure. J Periodontol 2003;74:1376‐1380.
The Effect of Adjunctive Low‐Dose Doxycycline Therapy on Clinical Parameters and Gingival Crevicular Fluid Matrix Metalloproteinase‐8 Levels in Chronic Periodontitis
Authors: Emingil Gülnur , Atilla Gül , Sorsa Timo , Luoto Hanne , Kirilmaz Levent , Baylas Haluk 
Published: February 2005

Background: Low‐dose doxycycline (LDD) is recognized to have non‐antimicrobial properties that can therapeutically modulate the host response. The aim of the present randomized, double‐blind, placebo‐controlled, parallel‐arm study was to examine the effectiveness of LDD in combination with non‐surgical periodontal therapy, compared to non‐surgical periodontal therapy alone, on gingival crevicular fluid (GCF) matrix metalloproteinase‐8 (MMP‐8) levels and clinical parameters over a 12‐month period in patients with chronic periodontitis.Methods: GCF samples were collected, and clinical parameters including probing depth (PD), clinical attachment level, gingival index (GI), and plaque index were recorded. Thirty chronic periodontitis patients were randomized either to a low‐dose doxycycline (LDD) or placebo group. The LDD group received lowdose doxycycline (20 mg) b.i.d. for 3 months plus scaling and root planing (SRP), while the placebo group was given placebo capsules b.i.d. for 3 months plus SRP. The patients were evaluated every 3 months during the 12‐month study period. At each visit, all clinical measurements and GCF sampling were repeated. GCF MMP‐8 levels were determined by a time‐resolved immunofluorescence assay. Intragroup comparisons were tested by the Friedman test followed by Wilcoxon signed‐rank test to analyze significance of changes over time. The Mann‐Whitney test was used to determine differences between the LDD and placebo groups.Results: Significant improvements were observed in all clinical parameters in both groups over the 12‐month period (P <0.0125). The LDD group showed a significantly greater reduction in mean PD scores at 9 and 12 months and in mean GI scores at all time points than the placebo group (P <0.05). From baseline to 12 months, GCF MMP‐8 levels were significantly reduced in both groups (P <0.0125). The GCF MMP‐8 level in the LDD group was significantly lower than that of the placebo group at 6 months (P <0.05).Conclusions: The present results indicate that low‐dose doxycycline therapy in combination with scaling and root planing can reduce GCF MMP‐8 levels and improve clinical periodontal parameters in patients with chronic periodontitis. These results provide additional information about the usefulness of low‐dose doxycycline therapy as an adjunct to non‐surgical periodontal therapy in the long‐term management of periodontal disease. The effectiveness and course of low‐dose doxycycline therapy can be monitored conveniently by assessing GCF MMP‐8 levels. J Periodontol 2004;75:106‐115.
The Oral Conditions and Pregnancy Study: Periodontal Status of a Cohort of Pregnant Women
Authors: Lieff Susan , Boggess Kim A. , Murtha Amy P. , Jared Heather , Madianos Phoebus N. , Moss Kevin , Beck James , Offenbacher Steven 
Published: February 2005

Background: Our objective was to describe the oral health of pregnant women, to determine oral health changes during pregnancy, and to determine factors associated with maternal periodontal health or disease.Materials and Methods: Between December 1997 and July 2001, 1,224 pregnant women at <26 weeks’ gestation were enrolled in the study and oral health examinations were performed at enrollment and within 48 hours of delivery. Demographic, medical, and health behavior data were determined by chart abstraction and questionnaire. Comparisons between oral health at enrollment and delivery were made by student t test or Fisher's exact test. Ordinal logistic regression analysis was used to identify risk factors for maternal periodontal disease.Results: Among 903 women, there was a significant increase in those with health/periodontal disease absence between enrollment and delivery (P <0.001). However, we also observed a significant increase in women with four or more sites with attachment loss ≥2 mm or ≥3 mm (P <0.05, 0.001). Race, smoking, and insurance status were significantly associated with maternal periodontal disease. Black women were more likely than white women to have periodontal disease at enrollment (adj. odds ratio 2.9, 95% confidence interval 2.2 to 3.9) and delivery (adj. odds ratio 3.1, 95% confidence interval 2.2 to 4.2), and experience incident disease (adj. odds ratio 2.3, 95% confidence interval 1.6 to 3.4).Conclusions: Oral health examinations were well accepted by pregnant women. An increase in attachment loss may represent active periodontal infection accelerated by pregnancy. Further study on racial disparity in oral health among pregnant women is needed. Continued efforts to evaluate and establish appropriate definitions of oral disease in pregnancy are warranted. J Periodontol 2004;75:116‐126.