bluuebunny/crossref_metadata_2025_split huggingface dataset:
Altered Healing Following Mucogingival Surgery in a Patient with Crohn's Disease: A Literature Review and Case Report
Authors: Andersen Kari‐M. , Selvig Knut A. , Leknes Knut N. 
Published: February 2005

Background: Crohn's disease is a chronic inflammatory bowel disease characterized by uncertainty in etiology and pathogenesis occasionally with manifestations in oral mucous membranes. This report reviews the literature on Crohn's disease and presents a patient with Crohn's disease on continuous antiinflammatory and immunosuppressive medication who showed adverse healing response following surgical treatment of gingival recession type defects.Methods: A 28‐year‐old male in generally good health apart from his bowel disease requested treatment of multiple maxillary gingival recessions due to esthetic concerns and root sensitivity. Following oral hygiene instruction, 3 coronally advanced flap procedures were performed in the maxillary anterior region to cover the defects. In 2 of the surgical areas, the exposed root surfaces were treated by etylenediaminetetraacetic acid (EDTA) in combination with enamel matrix derivative (EMD) before coronally positioning the buccal flap. Postoperatively, chlorhexidine gluconate was used for oral hygiene control.Results: The first surgical procedure, performed as a coronally advanced flap, showed delayed and altered healing. Two weeks postoperatively, the flapped tissue remained intensely red and swollen. In the following 2 surgical sites where EDTA and EMD were applied the healing was uneventful. Differences in immediate tissue response, however, did not influence the 3‐month treatment outcome with respect to root coverageConclusions: Patients with Crohn's disease on recommended systemic medications may show a delayed and altered wound healing indicating that periodontal surgery must be closely monitored. Treatment planning should take into account the potential wound healing promoting effects of enamel matrix derivative as well as adverse healing effects of chlorhexidine gluconate administration. J Periodontol 2003;74:537‐546.
Severe Alveolar Bone Loss and Gingival Hyperplasia as Initial Manifestation of Burkitt Cell Type Acute Lymphoblastic Leukemia
Authors: Haytac M.C. , Antmen B. , Dogan M.C. , Sasmaz I. 
Published: February 2005

Background: The purpose of this case report is to present severe alveolar bone destruction and gingival enlargement as initial manifestation of Burkitt cell type acute lymphoblastic leukemia (ALL‐L3) in a 14‐year‐old boyMethods: The patient was referred to the periodontology department with a 4‐week history of gingival enlargement and loosening of teeth. The clinical examination revealed gingival enlargement and expansion of alveolar mucosa particularly in molar regions of both jaws. Almost all teeth had deep periodontal pockets and severe mobility. While the radiographs showed severe alveolar bone loss which extended to apical thirds of many teeth, the microbiologic analysis revealed that the patient did not harbor major periodontopathogenic bacteria species. The results of blood tests and bone marrow aspiration were compatible with ALL‐L3.Results: Remission‐induction treatment with BFM‐90 ALL chemotherapy protocol was started; however, the patient died 4 weeks after the diagnosis due to neutropenic sepsis.Conclusions: Although no biopsy was performed, it is possible that the severe periodontal destruction and gingival enlargement in this case may have been due to the infiltration of leukemic cells in gingiva, periodontal ligament, and alveolar bone. The similarities of these findings with numb chin syndrome (NCS) and Burkitt's lymphoma (BL) are discussed in this report. J Periodontol 2003;74:547‐551.
An Unusual Oral Chronic Graft‐Versus‐Host Disease‐Like Syndrome Following a Liver Transplant
Authors: Bunetel Laurence , Le Gall François , Delaval Yvonne , Sixou Jean‐Louis , Dabadie Alain , Bonnaure‐Mallet Martine 
Published: February 2005

Background: Giving the immunosuppressive drug tacrolimus (FK506) to liver transplant patients has helped to considerably reduce oral side effects such as gingival hyperplasia. Patients taking cyclosporin who suffer from gingival hyperplasia are often switched to tacrolimus.Methods: We present here a pediatric liver transplantation case study. The patient has been followed for 5.5 years. She developed oral lesions that resulted in the immunosuppressive therapy being changed from tacrolimus to cyclosporin. In clinical terms, the atypical pathology consisted of hyperpigmented patches on the gingival margin, the internal surfaces of the cheeks, and the intraoral surfaces of the lips. When located on the lips, the hyperpigmented patches were associated with pruriginous and edematous lesions.Results: Optical and electronic microscopic examinations of a gingival tissue sample revealed the presence of melanin incontinence and lichenoid lesions with degenerated keratinocytes and a mild infiltrate of lymphocytes. This points to a chronic graft‐versushost disease (cGvHD)‐like syndrome linked to tacrolimus. This diagnosis was given further credence by improvement in the lesions following the switch to cyclosporin.Conclusion: To our knowledge, this is the first reported case of tacrolimus‐associated chronic GvHDlike syndrome occurring in the oral mucosa. J Periodontol 2003;74:552‐556.
Dimensions of Peri‐Implant Mucosa: An Evaluation of Maxillary Anterior Single Implants in Humans
Authors: Kan Joseph Y.K. , Rungcharassaeng Kitichai , Umezu Kiyotaka , Kois John C. 
Published: February 2005

Background: Attempts have been made to evaluate the biologic dimension of osseointegrated implants; however, most are histologic studies in animals, and the effect of soft tissue support from adjacent teeth on the interproximal dimension of the peri‐implant mucosa for anterior single implants has not been addressed. This study clinically evaluated the dimensions of the periimplant mucosa around 2‐stage maxillary anterior single implants in humans after 1 year of function. The influence of the peri‐implant biotype was also examinedMethods: Forty‐five patients (20 males and 25 females) with a mean age of 47.3 years were included in this study. A total of 45 maxillary anterior single implant crowns with a mean functional time of 32.5 months (range, 12 to 78) were evaluated. The dimensions of peri‐implant mucosa were measured by bone sounding using a periodontal probe at the mesial (MI), mid‐facial (F), and distal (DI) aspects of the implant restoration and the proximal aspects (MT, DT) of adjacent natural teeth. In addition, the peri‐implant biotype was evaluated and categorized as thick or thin. Statistical analysis was performed using an independent t test (P <0.05).Results: The means and standard deviations of the dimensions of peri‐implant mucosa at MT, MI, F, DI, and DT were 4.20 ± 0.77 mm, 6.17 ± 1.27 mm, 3.63 ± 0.91 mm, 5.93 ± 1.21 mm, and 4.20 ± 0.64 mm, respectively. The dimensions of peri‐implant mucosa in the thick biotype were significantly greater than the thin biotype at MT, MI, and DT (P<0.05).Conclusions: The mean facial dimension of periimplant mucosa of 2‐stage implants is slightly greater than the average dimension of the dentogingival complex. The level of the interproximal papilla of the implant is independent of the proximal bone level next to the implant, but is related to the interproximal bone level next to the adjacent teeth. Greater periimplant mucosal dimensions were noted in the presence of a thick peri‐implant biotype as compared to a thin biotype.J Periodontol 2003;74:557‐562.
Periodontal Terminology Revisited
Authors: Weinberg Mea A. , Eskow Robert N. 
Published: February 2005

The body of knowledge that was the basis of the science and therapy of periodontics can be found in the literature of the 1950s and 60s. This information conveniently was presented in various textbooks. The evolution of research utilizing histochemistry and electron microscopy, along with disciplined clinical studies, has resulted in an exponential increase in information. A by‐product of this worldwide effort is confusion resulting from the misuse and interchangeable application of terms disregarding the definitions originally accepted. Even with workshops1‐3 designed in part to arrive at consensus to preclude confusion, the literature is replete with misleading use of nomenclature.The lack of attention to the appropriate use of terms is, at best, confusing to the student, researcher, and clinician. In the worst case, it may result in poor performance on examinations and improper evaluation of techniques and materials.Many periodontal terms are used inappropriately or are not completely understood, probably because these words have not been adequately described in the literature. Some of the more commonly used and confused terms will be discussed using literature to support the definitions.J Periodontol 2003;74:563‐565.
Spatial Extent of Gingival Cell Activation Due to Mechanical Stimulation by Toothbrushing
Authors: Sakamoto Tomonori , Horiuchi Masazumi , Tomofuji Takaaki , Ekuni Daisuke , Yamamoto Tatsuo , Watanabe Tatsuo 
Published: February 2005

Background: Mechanical stimulation by toothbrushing enhances gingival fibroblast proliferation and collagen synthesis, and reduces inflammatory cell infiltration. The aim of this study was to investigate the spatial extent of proliferation of fibroblasts and endothelial cells in dog gingiva in response to mechanical stimulation by toothbrushing.Methods: All maxillary fourth premolars and mandibular first molars of 6 mongrel dogs were used. Dental plaque was removed with a curet. One of each pair of bilateral teeth (in the same jaw) was assigned to the brushing group, and the corresponding tooth (opposite side) was assigned to the control group. The Bass method was used to brush the limited mesial half of the tooth at 1.96 N for 20 seconds with a fitted plastic stent. Immediately before fixation of tissue, the surface of brushed gingiva was notched to indicate the borderline between the brushed and nonbrushed areas. Histometrical analyses of the sections were performed using assays for proliferating cell nuclear antigen (PCNA) and von Willebrand factor.Results: The numbers of fibroblasts and PCNA‐positive fibroblasts in the subepithelial connective tissue adjacent to oral sulcular epithelium significantly increased in brushed gingiva, not only in the brushed area but also in the non‐brushed area 0 to 0.5 mm from the notch. Increased numbers of vascular endothelial cells were observed only in the brushed area.Conclusion: The effect of mechanical stimulation by toothbrushing on gingival cell proliferation was not observed more than 0.5 mm from the brushed area. These results indicate that effective activation of gingival cell proliferation requires mechanical stimulation of gingiva in all areas. J Periodontol 2003;74:585‐589.
Inhibitory Effects of Incadronate on the Progression of Rat Experimental Periodontitis by Porphyromonas gingivalis Infection
Authors: Tani‐Ishii Nobuyuki , Minamida Genshi , Saitoh Daisuke , Chieda Keiko , Omuro Hiromasa , Sugaya Akira , Hamada Nobushiro , Takahashi Yusuke , Kiyohara Shiro , Kashima Isamu , Teranaka Toshio , Umemoto Toshio 
Published: February 2005

Background: Incadronate (YM175, disodium cycloheptylaminomethylenediphosphonate monohydrate), a bisphosphonate, has been suggested to prevent the bone resorption associated with periodontitis by inhibiting osteoclast activity. The purpose of this study was to investigate the effect of incadronate in preventing periodontal destruction in rats with Porphyromonas gingivalis‐induced periodontitis.Methods: Periodontitis was induced in 35 Wister rats by inoculating P. gingivalis into the oral cavity and feeding the rats a soft diet for 4 weeks. Incadronate or placebo was administered to the oral cavity of the rats 2 days per week for 2, 4, or 8 weeks.Results:P. gingivalis infection resulted in destruction of the periodontal ligament, reduced bone density, and caused inflammatory cell migration. Radiographic, morphometric, and histological results showed that incadronate had the ability to increase the bone mineral density (quantum level score; cortex 518.9 [placebo 612.8]; sponge 579.8 [placebo 672.0]) and to prevent periodontal ligament destruction (width 0.16 mm [placebo 0.20 mm]; area 0.36 mm2 [placebo 0.54 mm2]) after 8 weeks' administration. Furthermore, the polymorphonuclear leukocyte (PMN) infiltration in gingival tissue was significantly decreased.Conclusion: These results showed that incadronate inhibits bone resorption and PMN migration in P. gingivalis‐induced periodontitis. J Periodontol 2003;74:603‐609.
Obesity and Periodontal Disease in Young, Middle‐Aged, and Older Adults
Authors: Al‐Zahrani Mohammad S. , Bissada Nabil F. , Borawski Elaine A. 
Published: February 2005

Background: The growing prevalence of increased body weight and obesity in the United States has raised significant public health concerns. Obesity has been implicated as a risk factor for several chronic health conditions, as well as being associated with increased mortality. Recently, an association between obesity and periodontal disease was found in a Japanese population. The purpose of the present study is to examine the relation between body weight and periodontal disease in a representative United States sample.Methods: Participants in the third National Health and Nutrition Examination Survey (NHANES III) who were ≥18 years and had undergone a periodontal examination were selected for the analysis (n = 13,665). Body mass index (BMI) and waist circumference (WC) were used as measures of overall and abdominal fat content, respectively. Univariable and multivariable logistic regression models were used to estimate the association between increased body weight and periodontal disease. BMI and WC were assessed independently in a multivariable logistic model containing the following variables: gender, race, education, poverty index, smoking, diabetes, and time elapsed since last dental visit. Significant interactions with age were found and analyses were then stratified by age: younger (18 to 34 years old), middle‐aged (35 to 59 years old), and older (60 to 90 years old) adults.Results: A significant association between the measures of body fat and periodontal disease was found among the younger adults, but not middle or older adults. The adjusted odds ratios (OR) for having periodontal disease were 0.21 (0.080 to 0.565), 1.00 (0.705 to 1.407), and 1.76 (1.187 to 2.612) for subjects with BMI <18.5 kg/m2, 25−29.9 kg/m2, and ≥30 kg/m2, respectively. Young subjects with high WC had an adjusted OR of 2.27 (1.480 to 3.487) for having periodontal disease.Conclusions: In a younger population, overall and abdominal obesity are associated with increased prevalence of periodontal disease, while underweight (BMI <18.5) is associated with decreased prevalence. Obesity could be a potential risk factor for periodontal disease especially among younger individuals. Promotion of healthy nutrition and adequate physical activity may be additional factors to prevent or halt the rate of progression of periodontal disease. J Periodontol 2003;74:610‐615.
Mouthrinses with Alcohol: Cytotoxic Effects on Human Gingival Fibroblasts In Vitro
Authors: Poggi Paola , Baena Ruggero Rodriguez Y. , Rizzo Silvana , Rota Massimo T. 
Published: February 2005

Background: Mouthrinses are widely utilized in daily oral and dental hygiene to control plaque. However, most commercially available mouthrinses contain alcohol as an excipient. Most studies have focused on the clinical side effects related to the alcoholic fraction of mouthrinses, overlooking alcohol metabolism in the mouth. Due to this oral enzymatic process, the wellrecognized toxic compound acetaldehyde is emitted in the mouth. Since gingival fibroblasts play a key role in oral connective tissue health maintenance, we investigated the effects of different doses of acetaldehyde on human gingival fibroblasts (HGFs) in order to better define the effects of alcohol‐containing mouthrinses on oral tissue.Methods: Cultured HGFs were exposed to different concentrations of acetaldehyde (10−4 M to 10−2 M). The cell adhesion rate was measured after a 3‐hour incubation period, and cell viability over a 5‐day period. In order to assess the reversibility of the damage produced by acetaldehyde, treatment was interrupted at critical doses (10−3 M and 3 × 10−3 M), and cell viability was evaluated on the third and fifth day of incubation. The HGF cytoskeleton was studied by immunocytochemical technique, and internal cell structures were observed with transmission electron microscopy to evaluate the morphological changes due to acetaldehyde.Results: The results showed that acetaldehyde produced a dose‐ and time‐dependent inhibition on cell adhesion and viability, together with disruption of cytoskeletal structures and cytoplasmic organelles. Nevertheless, these quantitative and qualitative damages were reversible when the treatment was interrupted.Conclusions: Although more knowledge is necessary, our results suggest that these deleterious effects may also occur in vivo. Pending further investigations, clinicians should be alerted to the potentially adverse effect of alcohol‐containing mouthrinses and, to promote oral health, patients should be warned about improper use of these products. J Periodontol 2003;74:623‐629.
Optimum Force and Duration of Toothbrushing to Enhance Gingival Fibroblast Proliferation and Procollagen Type I Synthesis in Dogs
Authors: Tomofuji Takaaki , Ekuni Daisuke , Yamamoto Tatsuo , Horiuchi Masazumi , Sakamoto Tomonori , Watanabe Tatsuo 
Published: February 2005

Background: Toothbrushing enhances gingival fibroblast proliferation, which promotes wound healing. Optimum force and duration of toothbrushing for stimulation of fibroblast proliferation are key factors in maximizing effects of toothbrushing on periodontal wound healing. We therefore evaluated the effects of different durations and forces of toothbrushing on proliferative activity and procollagen synthesis of gingival fibroblasts.Methods: Twelve dogs were used. In each dog, buccal gingivae of 12 teeth were examined for 3 weeks. Nine of these 12 teeth were each assigned to 1 of 9 different combinations of brushing force (0.98, 1.96, or 2.45 N) and duration (10, 20, or 40 seconds). The remaining 3 teeth received plaque removal without brushing, via a scaler.Results: Force and duration of toothbrushing affected both proliferating cell nuclear antigen (PCNA)‐positive and procollagen Type I C‐peptide (PIP)‐positive fibroblast ratios (P <0.05). The highest ratio of PCNA‐positive fibroblasts was produced by brushing at 1.96 N for 20 seconds. The highest ratio of PIP‐positive fibroblasts was produced by brushing at 1.96 N for 10 seconds.Conclusions: Toothbrushing at certain forces and durations enhanced the proliferative activity and procollagen synthesis of gingival fibroblasts. The toothbrushing duration that increased procollagen synthesis (10 seconds) was shorter than that which increased fibroblast proliferative activity (20 seconds). J Periodontol 2003;74:630‐634.
Evidence‐Based Mucogingival Therapy. Part 2: Ordinary and Individual Patient Data Meta‐Analyses of Surgical Treatment of Recession Using Complete Root Coverage as the Outcome Variable
Authors: Clauser Carlo , Nieri Michele , Franceschi Debora , Pagliaro Umberto , Pini‐Prato Giovanpaolo 
Published: February 2005

Background: The literature (1970‐2000) on the outcome of surgical root coverage has been revised and summarized in a companion paper. The overall conclusion was that the various procedures are effective, but it was not possible to determine which procedure was best indicated in different clinical conditions. In this study, meta‐analysis techniques were used to seek evidence for guiding clinical decisions when planning root coverage surgery. The aim of this study was to illustrate the differences between meta‐analyses applied to summarized and individual patient data (IPD) and to present suggestions for reducing the costs of IPD meta‐analysis.Methods: Only clinical trials and case series that included data on the number of teeth treated, baseline recession depth (BRD) and the proportions of postoperative complete root coverage (CRC) were considered. The first group of meta‐analyses (the outcome of each procedure based on summarized data) covered 65 studies dealing with coronally advanced flap (CAF), epithelial free gingival graft (EFGG), connective tissue graft (CTG), and guided tissue regeneration (GTR) procedures. The second group of metaanalyses was done to determine the outcome of each procedure on the basis of 26 studies that reported IPD for at least baseline recession depth (BRD) and final CRC for each site. The third group of meta‐analysis compared the outcomes of CTG and GTR in 5 randomized studies, 4 of which reported only summarized data.Results: The first analysis showed that CRC was achieved more often in non‐randomized than in randomized studies. The heterogeneity tests revealed great variability of results in both the randomized and non‐randomized studies, which makes it difficult to draw any definite conclusions. In the second analysis all the tested techniques revealed similar trends: greater baseline recession depths were always associated with a decreased CRC. The third analysis showed that CRC was achieved more frequently in the sites treated with CTG as opposed to GTR. The small sample size and the lack of IPD rendered the analyses inconclusive despite the randomized design.Conclusions: Few studies reported individual patient data; they are a valuable contribution to clinical decision making, but IPD published in the literature are still insufficient to provide a reliable guide for clinical decision making. Therefore, decisive steps should be taken to facilitate the publication of IPD, in electronic format, whenever a clinical study is published in a leading journal. J Periodontol 2003;74:741‐756.
Effect of Recombinant Human Bone Morphogenetic Protein‐4 with Carriers in Rat Calvarial Defects
Authors: Ahn Seong‐Hee , Kim Chang‐Sung , Suk Hun‐Joo , Lee Yong‐Jun , Choi Seong‐Ho , Chai Jung‐Kiu , Kim Chong‐Kwan , Han Soo‐Boo , Cho Kyoo‐Sung 
Published: February 2005

Background: Bone morphogenetic proteins (BMPs) are being evaluated as candidates for periodontal and bone regenerative therapy. However, the research on recombinant human bone morphogenetic protein‐4 (rhBMP‐4) has been insufficient to evaluate its capacity to enhance bone formation and its carrier system. The purpose of this study was to evaluate the bone regenerative effect of rhBMP‐4 delivered with an absorbable collagen sponge (ACS) or β‐tricalcium phosphate (β‐TCP). We also compared the potential of β‐TCP to that of ACS as a carrier system for rhBMP‐4.Methods: Eight‐mm calvarial critical‐sized defects were created in 100 male Sprague‐Dawley rats. The animals were divided into 5 groups of 20 animals each. The defects were treated with rhBMP‐4/ACS (rhBMP‐4 at 0.05 mg/ml), rhBMP‐4/β‐TCP (rhBMP‐4 at 0.05 mg/ml), ACS alone, β‐TCP alone, or left untreated for surgical control. The rats were sacrificed at 2 or 8 weeks postsurgery, and the results were evaluated radiodensitometrically, histologically, and histomorphometrically.Results: The results of radiodensitometric analysis were as follows: the rhBMP‐4/ACS and the rhBMP‐4/β‐TCP groups were more radiopaque than other groups at both 2 and 8 weeks (P <0.01). The histologic observations were as follows: in the rhBMP‐4/ACS and the rhBMP‐4/β‐TCP groups, new bone was evident at the defect sites at 2 weeks and 8 weeks. The results of histomorphometric analysis were as follows: the rhBMP‐4/ACS and the rhBMP‐4/β‐TCP groups had more bone (%) than other groups at both 2 and 8 weeks (P <0.01).Conclusions: Surgical implantation of rhBMP‐4/ACS may be used to support bone regeneration in the rat calvarial criticalsized defect, and rhBMP‐4/β‐TCP may be able to regenerate bone in the rat calvarial critical‐sized defect without complication. In addition, both ACS and β‐TCP may be considered as available carriers for rhBMP‐4. J Periodontol 2003;74:787‐797.