bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Simplified Papilla Preservation Flap in the Regenerative Treatment of Deep Intrabony Defects: Clinical Outcomes and Postoperative Morbidity
Authors: Cortellini Pierpaolo , Tonetti Maurizio S. , Lang Niklaus P. , Suvan Jean E. , Zucchelli Giovanni , Vangsted Tine , Silvestri Maurizio , Rossi Roberto , McClain Pamela , Fonzar Alberto , Dubravec Dominik , Adriaens Patrik 
Published: February 2005

Background: The aims of the present multi‐center, randomized, controlled clinical trial were: 1) to compare the efficacy of the simplified papilla preservation flap with and without a barrier membrane in deep intrabony defects; 2) to evaluate the postoperative morbidity and surgical complications; and 3) to preliminarily test the impact of baseline tooth mobility on clinical outcomes.Methods: This parallel group, randomized, multi‐center, controlled clinical trial involved 112 patients in 8 periodontal practices in 4 countries. A deep intrabony defect in each patient was accessed with the simplified papilla preservation flap. In the test defects, a bioabsorbable membrane was positioned. Patients' experiences with the surgical procedure and postoperative period were evaluated with a questionnaire. Clinical outcomes included clinical attachment level (CAL) and probing depth (PD) changes.Results: Complete observations were available for 55 test and 54 control defects. CAL gains at 1 year were 3.5 ± 2.1 mm in the guided tissue regeneration (GTR) group and 2.6 ± 1.8 mm in the control group (P = 0.0117). CAL gains ≥4 mm were observed in 50.9% of GTR sites and 33.3% of control sites. A signifi‐cant center effect of 2.1 mm was observed (P = 0.01). Initial PD (P = 0.01) and baseline tooth mobility (P = 0.036) were significant covariates. During the procedure, 30.4% of test and 28.6% of controls reported feeling moderate pain, and subjects estimated the hardship of the procedure at 24 ± 25 visual analog scale (VAS) units in the test group, and at 22 ± 23 VAS in controls. In terms of the investigated outcomes, differences between test and control groups were not statistically significant. Among the postoperative complications, edema was most prevalent at week 1, and more frequently associated with the test treatment (P = 0.01). In the test group, 53.6% of membranes were exposed at week 3.Conclusions: The present study further supports the added benefits of guided tissue regeneration with respect to access flap alone in the treatment of deep intrabony defects, as well as the general efficacy of GTR in different clinical settings. Furthermore, our study indicates a possible influence of baseline tooth mobility on clinical outcomes. J Periodontol 2001;72:1702‐1712.
Some Effects of Non‐Surgical Therapy on Gingival Inflammatory Cell Subsets in Patients With Early‐Onset Periodontitis Associated With Actinobacillus actinomycetemcomitans
Authors: Kleinfelder Jörg W. , Sculean Anton , Lange Dieter E. 
Published: February 2005

Background: Limited information is available as to whether local cellular immunity in early‐onset periodontitis (EOP) subjects harboring Actinobacillus actinomycetemcomitans (Aa) differs from that in patients without Aa. In addition, the effect of scaling and root planing on various lymphocyte subsets is described rather sparsely.Methods: In 10 subjects with early‐onset periodontitis harboring Aa (EOP‐Aa) and in 10 subjects without Aa (EOP‐nonAa), clinical measurements were recorded and gingival biopsies were performed before and after scaling and root planing. The specimens were cut into serial sections; using the alkaline phosphatase‐antialkaline phosphatase technique, monoclonal antibodies to CD20 (B cells), CD30 (plasma cells), and CD45RO (T‐memory cells) were applied as well as polyclonal antibodies to alpha, gamma, and mu chains (Ig A, G, and M). Cells were counted from an area of 0.25 mm2 in areas showing the largest infiltration.Results: Before therapy, mean counts of all cell phenotypes were found to be markedly enhanced in the EOP‐Aa group compared to EOP‐nonAa subjects. Following scaling and root planing, the numbers of all phenotypes decreased in both groups. However, comparing the data before and after therapy in the EOP‐Aa group, the P value was <0.05 only for CD30‐positive cells. In the EOP‐nonAa group, the differences before and after therapy reached statistical significance (P <0.05) for all cell counts, except for IgMpositive cells. Furthermore, reduction of probing depth and gain of clinical attachment reached the 0.05 level of statistical significance only in EOP‐nonAa subjects.Conclusions: In EOP subjects harboring Aa, inflammatory cell subsets were detected in 2‐ to 3‐fold higher numbers compared to patients without Aa. Scaling and root planing resulted in a decrease of all cell phenotypes studied in individuals without Aa, whereas in subjects with Aa, the only significant decrease that was seen occurred in plasma cells. J Periodontol 2001;72:1713‐1719.
Distribution of the Receptor for Advanced Glycation End Products Gene Polymorphisms in Patients With Chronic Periodontitis: A Preliminary Study
Authors: Hollá Lydie Izakovičová , Kaňková Kateřina , Fassmann Antonín , Bučková Dana , Halabala Tomáš , Znojil Vladimír , Vaněk Jiří 
Published: February 2005

Background: Periodontal diseases are viewed today as multifactorial problems initiated and sustained by bacteria but significantly modified by the body's response to bacterial plaque. A recent study suggested that receptor for advanced glycation end products (RAGE) could be involved in the pathophysiology of periodontitis. The aim of this study was to investigate a possible association of 3 common polymorphisms in the RAGE gene with chronic periodontitis.Methods: We studied 101 Caucasian patients with chronic periodontitis together with 162 orally healthy subjects. Three polymorphisms, one in intron 7 (1704G/T), second in intron 8 (2184A/G), and the third in exon 3 (G82S) of the RAGE gene, were investigated by polymerase chain reaction methods (PCR) with subsequent enzymatic restriction with BfaI, BsmFI, or AluI, respectively.Results: A statistically significant difference in allele frequencies between patients and the reference group was found for intron variant 1704G/T (P = 0.02, Pcorr >0.05). There was no significant difference in genotype or allele frequency distributions between groups for intron variant 2184A/G or for the exon variant exchanging amino acid Gly for Ser at position 82 (G82S).Conclusions: We can speculate that susceptibility to the development of chronic periodontitis could be influenced by the 1704G/T polymorphism of the RAGE gene, independently of diabetes. J Periodontol 2001;72:1742‐1746.
Myospherulosis Complicating Cortical Block Grafting: A Case Report
Authors: Fisher Steven C. , Horning Gregory M. , Hellstein John W. 
Published: February 2005

Background: Myospherulosis of the oral cavity is an inflammatory, granulomatous lesion historically associated with the use of petrolatum‐based antibiotic ointment placed in third molar extraction sites to prevent postoperative infection.Methods: A case of bilateral myospherulosis is presented, in which large lesions complicated the procurement of a cortical block graft used to prepare a mandibular molar edentulous space for implant placement. By obtaining the block graft from a more lateral location on the mandible, an adequate graft was procured and was successfully grafted into an atrophic edentulous ridge.Results: The cortical block graft was successfully incorporated by the recipient site, which received a wide‐body, threaded dental implant 6 months later. Healing was uncomplicated, and a functional implantsupported restoration was successfully achieved.Conclusions: Myospherulosis, though rare today, may present a significant obstacle to the procurement of cortical block grafts. In this case, thorough debridement of the material resulted in subsequent healing of the myospherulosis defect, but prevented procurement of the cortical graft from the planned site. The dimension and volume of the neighboring cortical bone were adequate, and the augmented edentulous space was subsequently restored with a functional endosseous implant. The success seen in these 2 sites would seem to confirm the assumption that size and location of myospherulosis defects are critical factors in obtaining a successful clinical result in implant patients. J Periodontol 2001;72:1755‐1759.
Clinical Comparison of Bioactive Glass Bone Replacement Graft Material and Expanded Polytetrafluoroethylene Barrier Membrane in Treating Human Mandibular Molar Class II Furcations
Authors: Yukna Raymond A. , Evans Gerald H. , Aichelmann‐Reidy Mary Beth , Mayer Elizabeth T. 
Published: February 2005

Background: Class II furcations present difficult treatment problems and historically several treatment approaches to obtain furcation fill have been used.Methods: The response of mandibular Class II facial furcations to treatment with either bioactive glass (PG) bone replacement graft material or expanded polytetrafluoroethylene (ePTFE) barrier membrane was evaluated in 27 pairs of mandibular molars in 27 patients with moderate to advanced periodontitis. Following initial preparation, full thickness flaps were raised in the area being treated, the bone and furcation defects debrided of granulomatous tissue, and the involved root surfaces mechanically prepared and chemically conditioned. By random allocation, PG or ePTFE was placed into or fitted over the furcations, packed or secured in place, and the host flap replaced or coronally positioned with sutures. Postsurgical deplaquing was performed every 10 days leading up to ePTFE removal at about 6 weeks. Continuing periodontal maintenance therapy was provided until surgical reentry at 6 months for documentation and any further necessary treatment.Results: Direct clinical measurements demonstrated essentially similar clinical results with both treatments for bone and soft tissue changes. There were no statistically or clinically significant differences (e.g., mean horizontal furcation fill 1.4 mm PG, 1.3 mm ePTFE; mean percent horizontal furcation fill 31.6% PG, 31.1% ePTFE, both P >0.85). Seventeen of the PG treated and 18 of the ePTFE furcations became Class I clinically and 1 furcation completely closed clinically with each treatment. Intrapatient comparisons showed similar horizontal furcation responses with both treatments.Conclusion: The findings of this study suggest essentially equal clinical results with PG bone replacement graft material and e‐PTFE barriers in mandibular molar Class II furcations. PG use was associated with simpler application and required no additional material removal procedures. J Periodontol 2001;72:125‐133.
Systemic Neutrophil Response Resulting From Dental Plaque Accumulation
Authors: Kowolik Michael J. , Dowsett Sherie A. , Rodriguez Jessica , De La Rosa R Manuel , Eckert George J. 
Published: February 2005

Background: There is considerable current interest in putative relationships between oral and systemic diseases. Since the host response to oral bacteria may be the critical link in this association, our hypothesis was that dental plaque accumulation in healthy subjects would elicit a systemic inflammatory response.Methods: Twenty‐three healthy subjects, aged 18 to 25, participated in a 4‐phase study. An initial hygiene phase was followed by a 21‐day experimental phase (the so‐called experimental gingivitis model) in which subjects refrained from all oral hygiene practices, thus permitting the accumulation of bacterial plaque. At days 0, 7, and 21 total and differential peripheral white blood cell (wbc) counts, together with full mouth plaque and gingivitis scores, were recorded. Following a 28‐day recovery phase, in which normal oral hygiene practices were resumed, subjects entered the final 21‐day control phase which mirrored the experimental phase but with subjects maintaining normal oral hygiene practices.Results: The experimental model performed as anticipated with a correlation between plaque and gingivitis scores of 0.95, also reflecting subject compliance. Total wbc and neutrophil counts increased during the experimental phase. Furthermore, comparison of neutrophil counts between the experimental and control phases demonstrated a significantly higher cell count for the experimental phase on both days 7 and 21 (P = 0.0301 and 0.009, respectively). For total wbc, this was significant on day 21 (P = 0.0262).Conclusion: The results of this study support the hypothesis that the accumulation of dental plaque can result in a measurable systemic inflammatory response, providing further in vivo data to support a mechanistic relationship between oral and systemic pathology. J Periodontol 2001;72:146‐151.
Mitotic Activity of Keratinocytes in Nifedipine‐ and Immunosuppressive Medication‐Induced Gingival Overgrowth
Authors: Nurmenniemi Petri K. , Pernu Hilkka E. , Knuuttila Matti L. E. 
Published: February 2005

Background: The purpose of the study was to compare mitotic activity in the basal cell layer of normal human gingiva and in nifedipine‐ and immunosuppressive medication‐induced gingival overgrowth.Methods: Gingival samples were collected from 19 generally healthy individuals, 12 nifedipine‐medicated cardiac patients, and 22 immunosuppression‐medicated (azathioprine, prednisolone, and cyclosporin A) organ transplant recipients. The transplant recipients were divided into those not taking nifedipine and those taking nifedipine. Cryostat sections were stained with monoclonal antibody for Ki‐67, using an avidin‐biotinenzyme complex method. The mitotic activities of epithelial cells were determined as percentages of Ki‐67 labeled cells in relation to total numbers of epithelial cells in the basal layer of oral, oral sulcular, and sulcular epithelium.Results: Mitotic activities were significantly higher in all 3 medication groups in the oral epithelium (P ≤0.003), and in the immunosuppression group in the sulcular epithelium (P = 0.032) than in the controls. In the oral sulcular epithelium, mitotic activity was fairly similar in all medication groups. In the nifedipine group a significant negative correlation was found between duration of nifedipine medication and the percentage of Ki‐67 labeled cells in the oral epithelium (P = 0.025).Conclusions: The results suggest that the increased epithelial thickness observed in nifedipine‐ and cyclosporin A‐induced gingival overgrowth is associated with increased mitotic activity, especially in the oral epithelium. J Periodontol 2001;72:167‐173.
The Effect of Postsurgical Antibiotics on the Healing of Intrabony Defects Following Treatment With Enamel Matrix Proteins
Authors: Sculean Anton , Blaes Anja , Arweiler Nicole , Reich Elmar , Donos Nikolaos , Brecx Michel 
Published: February 2005

Background: Regenerative treatment with enamel matrix proteins has been shown to promote healing in intrabony defects. However, up to now various postoperative antibiotic regimens have been used in combination with enamel matrix proteins and therefore it cannot be excluded that the results may also be attributable to the effect of the antibiotic treatment. The aim of this randomized, controlled, blinded, clinical investigation was to determine the effect of postsurgical administration of antibiotics on the healing of intrabony periodontal defects treated with enamel matrix proteins.Methods: Thirty‐four patients each of whom exhibited one deep intrabony defect were randomly treated with either enamel matrix proteins plus antibiotics (test: EMD + AB) or with enamel matrix proteins alone (control: EMD). The antibiotic regimen consisted of a combination of 3 × 375 mg amoxicillin and 3 × 250 mg metronidazole daily for 7 days. The following parameters were recorded at baseline and at 1 year by the same calibrated and blinded investigator: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL). Power analysis to determine superiority of antibiotic treatment showed that the available sample size would yield 85% power to detect a 1 mm difference.Results: No statistically significant differences in any of the investigated parameters between the 2 groups were observed at baseline. No serious adverse events such as allergic reactions or abscesses after any of the treatments were observed during the entire study period. The results have shown that in the EMD + AB group the PD decreased from 9.1 ± 1.5 mm to 4.5 ± 1.1 mm (P <0.0001) and the CAL changed from 11.0 ± 1.6 mm to 7.5 ± 1.4 mm (P <0.0001). In the EMD group the PD decreased from 9.0 ± 1.7 mm to 4.3 ± 1.7 mm (P <0.0001) and the CAL changed from 10.6 ± 1.6 mm to 7.3 ± 1.5 mm (P <0.0001). There were no significant differences in any of the investigated parameters between the 2 groups.Conclusions: It can be concluded that the systemic administration of amoxicillin and metronidazole adjacent to the use of EMD for the surgical treatment of intrabony periodontal defects does not produce statistically superior PD reduction and CAL gain when compared to treatment with EMD alone. Hence, the present results do not support the routine administration of amoxicillin and metronidazole following regenerative treatment with EMD. J Periodontol 2001;72:190‐195.
Bioabsorbable Materials for Guided Bone Regeneration Prior to Implant Placement and 7‐Year Follow‐Up: Report of 14 Cases
Authors: Brunel Gérard , Brocard Daniel , Duffort Jean François , Jacquet Edmond , Justumus Pierre , Simonet Thierry , Benqué Edmond 
Published: February 2005

Background: The purpose of the present study was to evaluate the efficacy of a guided bone regeneration (GBR) procedure prior to implant placement and the long‐term outcome of the inserted implants.Methods: Prior to dental implant placement, GBR procedure was performed on 14 patients (mean age 48 years) using a synthetic hydroxyapatite (HA) spacer under a collagen membrane. After a mean healing period of 8 months, bone biopsies were obtained during the placement of 14 implants. The specimens were processed for histology without demineralization in order to assess bone quality and quantity of the regenerated bone.Results: Both the bone density and the resorption degree of HA particles were relatively varied between samples. The different phenotypes of osteoclasts and multinucleated giant cells and the individual host response could partially explain the unpredictable results in terms of bone remodeling and biomaterial resorption. However, the presence of HA particles in the regenerated bone had no influence on the osseointegration of implants presenting a success rate of 86% after a 7‐year observation period.Conclusions: These results confirm the possibility of regenerating bone by means of bioabsorbable materials, assuring at the same time the long‐term success for implants inserted in regenerated sites. J Periodontol 2001;72:257‐264.
Management of Soft Tissue Ridge Deformities With Acellular Dermal Matrix. Clinical Approach and Outcome After 6 Months of Treatment
Authors: Batista Eraldo L. , Batista Felipe C. , Novaes Arthur B. 
Published: February 2005

Background: Soft tissue ridge defects often hamper ideally shaped artificial crowns and are basically treated using autogenous soft tissue grafts or alloplastic materials. These approaches present disadvantages such as the necessity of creating additional surgical fields to harvest the graft and the requirement of primary closure, which may reduce ridge height. This investigation evaluated the use of acellular dermal matrix (ADM) in the treatment of soft tissue ridge defects.Methods: Eight patients, non‐smokers with noncontributory medical history, provided 18 sites corresponding to missing teeth in the anterior maxillary arch. The ideal horizontal gain (desired gain) was waxed up in study casts, which served as templates for construction of modified acrylic stents with orthodontic wires. These stents served as references for ideal horizontal gain and also as fixed reference points for further evaluation. The distance from the orthodontic wire to the buccal plate of the defect also represented its baseline horizontal component. Vertical variations were evaluated with another stent and, in this case, no desired gain was considered. After raising partial‐thickness flaps, the ADM material was rehydrated and folded to fill the defect and reproduce the desired gain. Flaps were sutured with no tension, and part of the material was intentionally left exposed to avoid pressure on the incision line and prevent height loss. Patients used local and systemic antimicrobials, and the sutures were removed at 7 days.Results: Evaluations were carried out at 30 days, and 3 and 6 months, and all sites healed uneventfully. Neither infection nor significant pain was reported by the patients, and the material was covered by tissue at about 21 days. Mean horizontal gain of 1.72 ± 0.59 mm (58.5%) at 6 months and mean shrinkage of 1.22 ± 0.46 mm (41.4%) were observed. There was a mean improvement in vertical gain of only 0.61 ± 0.77 mm, although 66.7% of the treated sites showed a 1 to 2 mm gain. Clinically, the total gain in the subjects was very effective and matched the receptor tissues nicely.Conclusions: ADM may be a suitable material for the treatment of soft tissue ridge deformities due to its biocompatibility, color matching, and horizontal gain. Additional controlled, comparative trials are necessary to establish its advantages and potential compared to autogenous soft tissue techniques. J Periodontol 2001;72:265‐273.
A 2‐Step Non‐Surgical Procedure and Systemic Antibiotics in the Treatment of Rapidly Progressive Periodontitis
Authors: Sigusch B. , Beier M. , Klinger G. , Pfister W. , Glockmann E. 
Published: February 2005

Background: In the last few years knowledge about periodontal infections has increased enormously, nevertheless practitioners are still seeking guidelines for suitable treatment concepts.Methods: The aim of this study was to examine the effect of doxycycline, metronidazole, and clindamycin used adjunctively in a 2‐step nonsurgical procedure in patients with rapidly progressive periodontitis (RPP). The first step included scaling, root planing, and polishing (SRP) in each quadrant using 4 to 5 visits. The second step included full‐mouth enhanced root planing (RP) and wound dressing in 1 or 2 visits after SRP and the beginning of antibiotic therapy. Forty‐eight patients (mean age 32.4 years) with generalized RPP, with an average of 16 sites with probing depths (PD) deeper than 8 mm, and high counts of Porphyromonas gingivalis were randomly assigned to 4 different groups: group 1 (doxycycline) n = 12, group 2 (metronidazole) n = 15, group 3 (clindamycin) n = 11, and group 4 (control group; no antibiotic treatment) n = 10. Clinical evaluations, including plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), clinical attachment level (CAL), and bacteriological and crevicular cell sampling, were done at baseline (BL), 3 weeks after SRP, and 6 and 24 months after RP.Results: After the first step (SRP), we observed an improvement of PI and SBI in all 4 groups, but did not see any statistically significant PD reduction 3 weeks after SRP compared to baseline. However, 6 and 24 months after the second step (RP) we observed a significantly greater reduction of PD in groups 2 and 3 and a significantly greater CAL gain in comparison to groups 1 and 4. After 24 months, the attachment level gain in group 1 and group 4 was less than 1.5 mm, and less than 1.0 mm in PD site categories 6 to 9 mm and >9 mm. PI showed no significant difference between the groups throughout the period after SRP until 24 months, compared to 3 weeks after SRP. SBI decreased most in the metronidazole and clindamycin groups. P. gingivalis and Actinobacillus actinomycetemcomitans were almost completely eradicated in these 2 groups 24 months after RP. In addition, the phagocytotic capacity of crevicular polymorphonuclear neutrophils was increased in groups 2 and 3 after the second step.Conclusions: The present results show that metronidazole and clindamycin are effective antibiotics when used adjunctively in a 2‐step nonsurgical procedure of scaling and root planing in RPP patients. J Periodontol 2001;72:275‐283.