bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Clinical Study of a Bioabsorbable Membrane and Subepithelial Connective Tissue Graft in the Treatment of Human Gingival Recession
Authors: Borghetti Alain , Glise Jean‐Marc , Monnet‐Corti Virginie , Dejou Jacques 
Published: February 2005

Background: Connective tissue grafts and guided tissue regeneration (GTR) are the most current procedures in the treatment of gingival recession, but very few clinical comparative studies have been conducted.Methods: The purpose of this study was to compare 2 types of treatment of gingival recession in the same patients. Fourteen pairs of Miller Class I defects were selected in 14 patients. In each pair, one recession was randomly assigned for treatment by GTR using a bioabsorbable membrane, and the other treated by subepithelial connective tissue graft (CTG). Height of recession (HR), clinical attachment level (CAL), probing sulcus depth (PSD), height of keratinized tissue (HKT), and distance from the cemento‐enamel junction to the mucogingival junction (CEJ‐MGJ) were recorded before surgery and 6 months postoperatively.Results: The initial width and height of recession were, respectively, 3.73 mm (SD 0.56) and 3.85 mm (SD 1.15) for the CTG group, and 4.04 mm (SD 0.92) and 4.28 mm (SD 1.20) for the GTR group. The differences were not significant. CAL changes were not different. Both in the CTG group and in the GTR group, mean HR reduction was 2.89 mm (SD 1.18), representing a mean root coverage of 76% and 70.2%, respectively. The difference was not significant. HKT mean gain was significantly greater (P = 0.0001) with CTG (2.03 mm, SD 0.92) than with GTR (0.42 mm, SD 0.91). The GTR technique displaced the mucogingival junction significantly (P = 0.007) more coronally (2.35 mm, SD 1.44) than the CTG technique (0.78 mm, SD 1.23).Conclusions: Within the limits of this study, no difference could be found between subepithelial connective tissue graft and GTR with a bioabsorbable membrane with regard to root coverage, but the GTR technique did not increase the height of keratinized tissue and displaced the mucogingival junction more coronally at 6 months. J Periodontol 1999; 70: 123‐130.
Recombinant Human Bone Morphogenetic Protein‐2 Stimulation of Bone Formation Around Endosseous Dental Implants
Authors: Cochran David L. , Schenk Robert , Buser Daniel , Wozney John M. , Jones Archie A. 
Published: February 2005

Background: Successful endosseous implant placement requires that the implant be stable in alveolar bone. In certain cases, the implant can be stabilized in native bone but some part of the implant is not covered by bone tissue. This often occurs during placement of implants into extraction sites or in areas where bone resorption has occurred and the ridge width is not sufficient to completely surround the implant. In those cases, the clinician usually employs a procedure to encourage bone formation. These procedures typically include a bone graft and/or membrane therapy. Recent advances have led to the isolation, cloning, and production of recombinant human proteins that stimulate bone formation. One of these bone morphogenetic proteins (rhBMP‐2) has been extensively studied in animal models and is currently being tested in human clinical trials.Methods: In this study, rhBMP‐2 was tested using a collagen sponge carrier to stimulate bone formation in defects in the canine mandible around endosseous dental implants. Six animals had a total of 48 implants placed. rhBMP‐2 with the collagen carrier was implanted around 24 of these, the remainder having only the collagen carrier placed. Half the sites were covered with a nonresorbable expanded polytetrafluoroethylene membrane. Histologic analysis was performed after 4 and 12 weeks. The area of new bone formed, percentage of bone‐to‐implant contact in the defect area, and percentage fill of the defect was calculated.Results: The addition of rhBMP‐2 resulted in significantly greater amounts of new bone area and percentage of bone‐to‐implant contact and with more percentage fill after 4 and 12 weeks of healing. The area of new bone formed was reduced after 4 weeks when a membrane was present but after 12 weeks, there was no significant difference between membrane and non‐membrane treated sites. In some specimens, new bone was found coronal to the membranes, with rhBMP‐2 – treated sites having greater amounts than non‐rhBMP‐2 – treated sites.Conclusions: These data demonstrate that a bone differentiation factor significantly stimulates bone formation in peri‐implant bone defects in the canine mandible. In addition, bone‐to‐implant contact was significantly enhanced along the rough implant surface. Membrane‐treated sites had less new bone formation after 4 weeks of healing but were similar to non‐membrane sites after 12 weeks. These results demonstrate that rhBMP‐2 can be used to stimulate bone growth both around and onto the surface of endosseous dental implants placed in sites with extended peri‐implant osseous defects. J Periodontol 1999; 70: 139–150.
Use of Alendronate in Peri‐Implant Defect Regeneration
Authors: Meraw Stephen J. , Reeve Charles M. , Wollan Peter C. 
Published: February 2005

Background: Previous studies have demonstrated an increase in bone mass and density with use of systemic alendronate sodium. This agent acts as an inhibitor of osteoclast activity, and is thought to result in more net osteoblastic activity. The objective of this study was to determine the effects of locally applied alendronate sodium on guided bone regeneration around dental implants.Methods: Six adult mongrel dogs were divided into 2 groups: one group received alendronate‐coated dental implants, and the other group served as control. Two types of dental implants were used in each dog: hydroxyapatite (HA)‐coated and titanium machine‐polished (TMP), for a total of 4 groups. Dental implants were placed immediately after extraction of the right and left second, third, and fourth mandibular premolars; a resorbable collagen membrane was secured over the implants and defects; and the flaps were closed primarily. Fluorescent labels were administered intravenously on days 0, 6, 12, and 22 to measure bone formation rate. Dogs were sacrificed on day 28. The specimens were sectioned and mounted, and bone formation rate was recorded with a computerized microscopic digitizer. Specimens were stained with Stevenel's blue and van Gieson's picric fuchsin. Bone‐to‐implant contact was recorded with a computerized microscopic digitizer.Results: The results indicated a significant effect of locally applied alendronate (P < 0.0001) with both types of implants (HA and TMP), as well as the HA coating (P < 0.02) on increased bone formation rate. Additionally, alendronate had a significant effect on bone‐to‐implant contact, with an increase in the TMP model (P < 0.0001) and a decrease in the HA model (P < 0.0001). HA coating also had a significant effect on increasing bone‐to‐implant contact (P < 0.04).Conclusions: The results indicate that alendronate increases early bone formation rate around dental implants. Additionally, the local application as described resulted in greater bone‐to‐implant contact with TMP implants. J Periodontol 1999; 70: 151‐158.
Option‐4 Algorithm for Third Generation Disc Probe: Agreement of Selected Site‐Specific Relative Attachment Level Measurements and Detection of Longitudinal Site‐Specific Attachment Level Change
Authors: Breen Harry J. , Rogers Pauline A. , Slaney Roger E. , Gillett Ian R. , Johnson Newell W. 
Published: February 2005

Background: Longitudinal site‐specific attachment level change (SSAC), identified from serial relative attachment level measurements (RAL), is the principal indicator of progression/regression of periodontal diseases. Many variables confound RAL reproducibility and affect measurement error. The Option‐4 algorithm was designed to reduce measurement error and improve accuracy and sensitivity of SSAC detection. The study aimed to evaluate the performance of the Option‐4 algorithm.Methods: A precalibrated clinician recorded full mouth RAL with a third generation disc probe on 4 occasions over 6 months in 16 subjects (mean age 48.1 years) with moderately advanced chronic adult periodontitis (2,312 sites). Option‐4 allowed up to 4 RAL recordings per site per visit until 2 values had differences ≤ 1.0 mm and their mean was ≤1.0 mm from the previous visit mean: the clinician made the selection if these criteria were unfulfilled.Results: Within‐visit agreement ≤1.0 mm was ≥ 99.6%: all withinvisit correlation coefficients = 0.98 (P < 0.001). At each visit, mean difference in Option‐4 values was < 0.05 mm, mean absolute difference (ignoring direction) was ≤ 0.34 mm. Mean site‐specific variances ranged from 0.092 mm2 to 0.097 mm2 across all visits. Subject thresholds for site‐specific attachment level change (from estimated 95% confidence limits of visit 1 data) ranged from 0.52 mm to 0.67 mm. Linear SSAC (by linear regression) and betweenvisit patterns of SSAC were investigated. SSAC was detected in 100% subjects and at 51.0% measured sites. Linear SSAC (R2 ≥ 0.90: P ≤ 0.05) occurred at 105 sites (4.5%): 32 sites (1.4%) deteriorated, 73 sites (3.1%) improved. Between‐visit SSAC occurred at 1,074 sites (46.5%): 391 sites (16.9%) deteriorated, 295 sites (12.8%) improved, and 388 sites (16.8%) showed exacerbation/remission patterns.Conclusions: The Option‐4 algorithm produced high RAL agreement. Site‐specific attachment level change was detected in both directions in 100% subjects and at 51.0% measured sites. J Periodontol 1999; 70:159‐170.
Periodontitis and Anti‐Neutrophil Cytoplasmic Antibodies in Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Comparative Study
Authors: Novo Ernesto , Garcia‐MacGregor Ernesto , Viera Ninoska , Chaparro Neira , Crozzoli Yolanda 
Published: February 2005

Background: This investigation was designed to determine and compare the distribution pattern of anti‐neutrophil cytoplasmic antibodies (ANCA) in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) in the presence or absence of periodontal disease.Methods: Sera of 30 patients with SLE and 30 with RA were tested for ANCA utilizing an indirect enzyme immunosorbent assay (ELISA) directed to a neutrophil granular extract and 6 neutrophil granule proteins. A control group of 20 healthy individuals showing neither evidence of periodontal disease nor systemic compromise was also included in this study.Results: For RA, the number of ANCA‐positive sera was very low but was evenly distributed among patients with and without periodontitis. Conversely, a high number of ANCA‐positive sera in SLE was found mostly in individuals presenting periodontal compromise. A statistically significant association between ANCA and periodontitis in SLE patients was found (P <0.005, chi square test).Conclusions: A marked difference in the number and distribution of ANCA with respect to periodontitis between RA and SLE was found. Hyperresponsiveness of B cells and polyclonal B activation to periodontopathic bacteria in SLE might be accountable for the high numbers of ANCA and the close association observed between those autoantibodies and periodontitis in SLE. J Periodontol 1999;70:185‐188.
Periodontitis in the House Musk Shrew (Suncus murinus): A Potential Animal Model for Human Periodontal Disease
Authors: Takata Takashi , Matsuura Masahiro , Murashima Miwako , Miyauchi Mutsumi , Nikai Hiromasa 
Published: February 2005

Background: Our understanding of periodontal diseases has been facilitated greatly by the use of animal models. However, no animal model has been identified that truly reflects the disease seen in humans. Suncus murinus, a rat‐sized laboratory house musk shrew, has received attention as a valuable animal model due to ease of handling. In the studies described here, periodontal conditions in Suncus murinus were evaluated to determine the usefulness of the shrew as an experimental model for understanding various aspects of periodontal diseases.Methods: Periodontal tissues of 34 Suncus murinus (18 to 430 days old) were examined macroscopically, morphometrically, histologically, and ultrastructurally.Results: Dentition pattern is I3/1, C1/1, P2/1, M3/3. Spontaneous gingival swelling with accumulation of plaque was observed in more than twothirds of animals older than 200 days. Morphometric analysis of alveolar bone demonstrated a pattern of bone loss that correlated closely with animal age. Histologically, periodontal lesions varying from gingivitis to periodontitis, similar to those observed in humans, were noted. Marked infiltration of lymphocytes and plasma cells in the connective tissue was noted, usually not seen in periodontal lesions of rodents. Although osteoclastic alveolar bone resorption was noted, active bone resorption was not a frequent feature in specimens obtained from chronic inflammatory lesions. Ultrastructurally, degradation of collagen fibers in the inflamed area and ingestion of collagen fibrils by fibroblasts in the deeper connective tissue were often seen.Conclusions: These results indicate the potential utility of Suncus murinus as a model to study periodontal disease; e.g., chronic nature of the inflammatory periodontal lesions, similar to those in humans, as well as other advantages including size and ease of handling and housing of these animals. J Periodontol 1999;70:195‐200.
Spontaneous Early Exposure of Submerged Implants: I. Classification and Clinical Observations
Authors: Tal Haim 
Published: February 2005

Background: It is believed that during the osseointegration phase of submerged dental implants, complete mucosal coverage and isolation of the implant from the oral cavity avoids trauma and infection and establishes favorable conditions for osseointegration. Spontaneous early exposure is one of the complications that could adversely affect osseointegration of implants. Methods: This study clinically classifies spontaneous early exposure and describes and analyzes this complication in a group of 148 patients treated with 372 submerged implants: 216 (58%) in the mandible and 156 (42%) in the maxilla. Edentulous sites were exposed by mid‐crestal incisions and full thickness gingival flaps. Incisions were closed in an attempt to achieve complete closure and healing by primary intention. Measurements were taken to avoid mechanical trauma to the mucosa over the implants. Patients were followed up weekly and examined to identify early exposures. Perforations were classified according to the degree of exposure from 0 (no perforations) to 4 (complete exposure). Results: Of the implants 51 (13.7%) presented spontaneous early exposure,28 (13%) in the mandible and 23 (14.7%) in the maxilla. Class 2 perforation was the most frequent, followed by Class 3, Class 1 and Class 4. Inflammation at the mucosal orifices of the perforations was minimal, but no objective index (bleeding, probing) was taken in order to avoid morphological changes of the lesions that were biopsied for histological examination. Conclusions: Early perforation and partial exposure of the implant's covering device are a focus for plaque accumulation which, if left untreated, may result in inflammation, damage to the peri‐implant mucosa, and possible periimplant loss. J Periodontol 1999;70:213‐219.
Topical and Systemic Antimicrobial Therapy in Guided Tissue Regeneration
Authors: Zucchelli G. , Sforza N.M. , Clauser C. , Cesari C. , De Sanctis M. 
Published: February 2005

Background:Bacterial contamination of membrane material negatively affects healing after guided tissue regeneration (GTR) procedures; conversely, flap connective tissue integration on barrier material improves the clinical outcomes. The objective of this study was to evaluate the effect of topical application of antibiotics on: 1) clinical outcomes of GTR surgical procedures using titanium reinforced expanded polytetrafluoroethylene (ePTFE) periodontal membrane; 2) bacterial colonization of membrane material; and 3) flap connective tissue‐membrane integration.Methods: Fifty‐six deep interproximal bony defects were treated with GTR surgical procedures using titanium reinforced ePTFE periodontal membranes. Patients were randomly assigned to 1 of the 2 antimicrobial treatment groups: the test group received weekly topical application of 25% metronidazole gel and the control group received systemic antibiotics (amoxicillin plus clavulanic acid 1g/day for 14 days). Clinical outcomes were assessed at 1 year; the amount of bacterial contamination and connective tissue integration on membrane material was evaluated at time of membrane removal by means of a morphological (SEM) method.Results: No statistically significant difference was found between test and control groups in terms of clinical attachment (CAL) gain (baseline CAL — 12 months CAL; P = 0.2) and probing depth (PD) reduction (baseline PD — 12 months PD; P = 0.6). A greater increase in gingival recession (REC) (12 months REC — baseline REC) was found in the test group compared to the control group (P= 0.003). The SEM analysis revealed no statistically significant (t test) difference between test and control groups in the number of fields positive to integrated connective tissue (P = 0.82), while the number of fields positive to bacteria was statistically higher (P < 0.001) in the control group.Conclusions: Local antibiotic administration is more effective than systemic use in preventing membrane contamination, but it does not improve clinical outcomes due to an interference of the vehicle (gel) with gingival tissues which may reduce the potential benefits derived from better control of the bacterial load. J Periodontol 1999; 70:239‐247.
A Radiographic Evaluation of Bone Healing Around Submerged and Non‐Submerged Dental Implants in Beagle Dogs
Authors: Fiorellini Joseph P. , Buser Daniel , Paquette David W. , Williams Ray C. , Haghighi Douglas , Weber Hans Peter 
Published: February 2005

Background: The rehabilitation of the oral cavity with dental implants has become a predictable treatment modality. However, there have been only a few direct comparisons evaluating the submerged and nonsubmerged placement techniques. The purpose of this study was to characterize radiographic peri‐implant bone changes following the insertion of submerged and nonsubmerged implants in the beagle dog.Methods: At the end of the extraction healing phase, 19 submerged and 19 nonsubmerged implants were randomly placed in a split‐mouth study design and observed over an 18‐week period. For submerged implants, a second stage surgery and transmucosal abutment attachment was performed at week 12. Standardized dental radiographs taken at baseline, week 12, and week 18 were used to measure peri‐implant bone changes. The radiographs were analyzed with a simple computer assisted method.Results: A total of 43 standardized radiographs were exposed to evaluate the 38 implants. During the study period, all submerged and nonsubmerged implants demonstrated peri‐implant bone loss. At baseline, both submerged and nonsubmerged implants had similar bone levels (P ≥ 0.05). When the mean peri‐implant bone levels for submerged and nonsubmerged implants were compared from baseline to week 12, nonsubmerged implants had a significantly greater amount and rate of bone resorption than submerged implants (P ≤ 0.05). Following week 12, the initially submerged implant had a significantly higher rate and amount of peri‐implant bone loss than the nonsubmerged implants (P ≤ 0.05). However, by the end of the study period, week 18, both submerged and nonsubmerged implants had comparable bone levels (P ≥ 0.05).Conclusions: The study indicates that, although the temporal patterns of peri‐implant bone resorption differed, there were no differences between submerged and nonsubmerged implants in the overall amount and rate of peri‐implant bone loss. J Periodontol 1999;70:248‐254.
Interleukin (IL)‐1 and Porphyromonas gingivalis Lipopolysaccharide Stimulation of IL‐6 Production by Fibroblasts Derived From Healthy or Periodontally Diseased Human Gingival Tissue
Authors: Kent Leigh W. , Rahemtulla Firoz , Michalek Suzanne M. 
Published: February 2005

Background: Human gingival fibroblasts (HGF) play a key role in tissue repair and destruction. These cells express low levels of interleukin (IL)‐6 constitutively and increased levels after stimulation with lipopolysaccharide (LPS) or the cytokines IL‐1 and tumor necrosis factor‐α (TNF‐α ). However, little information is available on IL‐6 production by fibroblasts derived from diseased tissue. The present study compared constitutive and induced IL‐6 production by human gingival fibroblasts (HGF) derived from healthy and diseased periodontal tissue. We also evaluated whether IL‐1 acted in a synergistic manner with LPS in inducing IL‐6 production by HGF and whether LPS acted via CD14.Methods: HGF derived from healthy and diseased tissue and foreskin fibroblasts were grown to confluency, photographed, and counted, and their constitutive IL‐6 production was quantitated by ELISA. Healthy and diseased HGF were also pretreated with IL‐1α , followed by incubation with Porphyromonas gingivalis or Escherichia coli LPS. Culture supernatants were assessed for IL‐6 protein by ELISA and cell lysates for mRNA by reverse transcription‐polymerase chain reaction (RT‐PCR). In order to determine if LPS stimulation was mediated through the LPS receptor, CD14, surface receptors on HGF were assessed by flow cytometry and the total RNA CD14 mRNA was assessed.Results: Higher quantities of IL‐6 were produced by the diseased HGF before and after stimulation than by the healthy HGF. Pretreatment with IL‐1α followed by LPS stimulation of the healthy and diseased HGF cell lines resulted in an additive effect on IL‐6 production. Pretreatment with IL‐1α followed by a second incubation with the same stimulant produced higher amounts of IL‐6 than cultures incubated with LPS alone or following IL‐1α pretreatment. Similar amounts of IL‐6 mRNA were present in unstimulated HGF from either diseased or healthy tissue and in those incubated with IL‐1α only. After incubation with IL‐1α and LPS, diseased HGF produced slightly more mRNA than healthy HGF. CD14 was not expressed by healthy or diseased HGF even after stimulation with either P. gingivalis or E. coli LPS. CD14 message was also undetectable.Conclusions: Taken together, these results indicate heterogeneity among gingival fibroblasts and an additive effect of IL‐1 and P. gingivalis LPS on IL‐6 production by HGF. Furthermore, the LPS effect on HGF was not mediated by CD14.J Periodontol 1999;70:274‐282.