bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Radiological Improvement of Periodontal Disease in Patients With Type 2 Diabetes Mellitus Treated With Alendronate: A Randomized, Placebo‐Controlled Trial
Authors: Rocha Miriam , Nava Laura Eugenia , de la Torre Carlos Vázquez , Sánchez‐Marín Francisco , Garay‐Sevilla Ma. Eugenia , Malacara Juan Manuel 
Published: February 2005

Background: Alendronate (ALN) is an aminobisphosphonate commonly used for osteoporosis in postmenopausal women. We studied the effect of ALN on bone loss prevention in type 2 diabetes mellitus patients with periodontal disease.Methods: In a controlled double‐blind, randomized study we evaluated prospectively diabetic patients paired by gender and years since diagnosis for 6 months. The study included 40 patients (20 men and 20 women), 50 to 60 years old, with more than 5 years since diagnosis of diabetes and established periodontitis. They were randomly allocated to alendronate (10 mg/daily) or placebo treatment for 6 months. The endpoints of treatment were: the distance between the alveolar bone border and the cemento‐enamel‐junction (CEJ) evaluated by means of digital radiographic imaging, a biochemical marker of bone resorption (urine N‐telopeptide) (Ntx), and periodontal parameters. Metabolic control was assessed at baseline and after 6 months.Results: Baseline and 6‐month glycated hemoglobin levels were similar in both groups. Alendronate induced a significant decrease in NTx at 6 months (P = 0.006). Periodontal parameters improved in both groups. However, they were significantly better for the ALN treated group. Alveolar bone border‐CEJ distance increased in the placebo, but decreased in the ALN group (P = 0.0003).Conclusions: In type‐2 diabetic patients, alendronate induced more improvement in alveolar bone crest height than control therapy. No differences in urinary N‐telopeptide or glycated hemoglobin were observed in this short‐term randomized controlled pilot trial. J Periodontol 2001;72:204‐209.
Bacteremia Due to Periodontal Probing: A Clinical and Microbiological Investigation
Authors: Daly Christopher G. , Mitchell David H. , Highfield John E. , Grossberg David E. , Stewart Douglas 
Published: February 2005

Background: Infective endocarditis can occur in susceptible individuals due to bacteremia of oral origin. The aim of this study was to investigate the occurrence of bacteremia caused by full mouth periodontal probing.Methods: Forty patients, 20 with adult periodontitis (10 males, 10 females; mean age 43.0 years) and 20 with chronic gingivitis (11 males, 9 females; mean age 35.5 years) were investigated. Prior to and immediately following periodontal probing, 20 mL of venous blood were obtained from each patient and inoculated into aerobic and anaerobic blood culture bottles and incubated. Negative bottles were monitored continuously for 3 weeks before being discarded. Bottles which signalled positive were subcultured and isolates identified to genus level. Periodontal probing consisted of measuring pockets at 6 points around each tooth and recording the presence or absence of bleeding. A plaque index (PI) was assessed on the 6 Ramfjord teeth.Results: Probing caused bacteremia of oral origin in 8 (40%) of the periodontitis patients and 2 (10%) of the gingivitis patients. Streptococcus spp. were the most common isolates in both groups. Compared with the gingivitis group the odds ratio (OR) for bacteremia in the periodontitis group was 5.993 (95% CI 1.081 to 33.215). Bleeding on probing (OR 1.025, 95% CI 1.004 to 1.047) and mean probing depth per tooth (OR 1.444, 95% CI 1.055 to 1.977) were significantly associated with bacteremia. No significant correlations were found between bacteremia and age, number of teeth probed, smoking status, PI, or total probing depth.Conclusions: Patients with untreated adult periodontitis are at greater risk of bacteremia due to periodontal probing than patients with chronic gingivitis. For individuals at risk of infective endocarditis, radiographic assessment prior to periodontal probing would be advisable to identify those with periodontitis so that appropriate antibiotic prophylaxis can be provided. J Periodontol 2001;72:210‐214.
Guided Bone Regeneration for Dehiscence and Fenestration Defects on Implants Using an Absorbable Polymer Barrier
Authors: Rosen Paul S. , Reynolds Mark A. 
Published: February 2005

Background: Guided bone regeneration (GBR) using a non‐absorbable barrier has provided clinicians the ability to place implants in sites compromised by insufficient bone, including immediate extraction sites. Recent evidence suggests that successful GBR outcomes may be possible using bioabsorbable polymer barriers.Methods: This report presents a case series of 9 patients with 8 fenestration and 3 dehiscence defects on implants consecutively treated with GBR. A bioabsorbable polymer barrier of poly(DL‐lactide) was used in conjunction with a composite graft of freeze‐dried bone allograft (FDBA)/demineralized freeze‐dried bone allograft (DFDBA) mixed in a ratio of 1:1. Secondstage surgeries were performed at 4 to 8.5 months (5.7 months average) post‐placement. Biopsy material from 2 sites was obtained while exposing the implant for healing abutment connection.Results: Ten of the 11 defects (90.9%) achieved complete coverage of the osseous defects. Histologic evaluations revealed the formation of viable bone, frequently in close amalgamation with residual graft particles.Conclusion: These case reports suggest that a poly(DL‐lactide) polymer can be used as a physical barrier with a composite bone replacement graft to achieve successful GBR results of dehiscence/fenestration defects when placing implants. J Periodontol 2001;72:250‐256.
The Effects of Platelet‐Derived Growth Factor‐BB on Periodontal Cells in an In Vitro Wound Model
Authors: Mumford John H. , Carnes David L. , Cochran David L. , Oates Thomas W. 
Published: February 2005

Background: Platelet‐derived growth factor (PDGF‐BB) has been shown to enhance periodontal regeneration. Principles of guided tissue regeneration dictate that one of the goals of therapy is to modulate the wound healing processes to favor repopulation of the wound with cells derived from the periodontal ligament rather than from the gingival tissues. Using an in vitro wound model, gingival fibroblasts (GF) have been shown to fill a wound space significantly faster than periodontal ligament cells (PDL). There are no data reported directly comparing the response of these 2 cell types to PDGF‐BB within such a wound model. Therefore, the aims of this research were: 1) to characterize both the proliferative and wound fill (WF) effects of PDGF‐BB within an in vitro model and 2) to compare specific growth factor effects between GF and PDL.Methods: Primary cultures of both human PDL and GF were derived from explanted tissues and passaged to 12‐well tissue culture plates. Triplicate cultures of both cell types were grown to confluence and in vitro wounds were mechanically created, removing a 3 mm wide band of the cell layer across the diameter of the wells. The wells were then incubated for 2, 6, and 9 days in media containing 0.1% fetal bovine serum (FBS) and 1 of 5 concentrations of PDGF‐BB. At each time point, cells were pulsed with 5‐bromo, 2‐deoxyuridine (BrdU) fixed, and nuclei were stained to measure BrdU incorporation (as a measure for proliferation). Cells were counter‐stained with cytoplasmic stain to measure cell number. Quantitative analyses within the wound boundaries, marginally (area of interest [AOI] 1) and centrally (AOI 2), were accomplished using computer‐assisted histomorphometry.Results: PDL exhibited a significantly greater proliferative response to PDGF‐BB in both AOI when compared to GF (P <0.0001). The PDL exhibited increased levels of proliferation at concentrations of PDGF‐BB greater than or equal to 10 ng/ml. By contrast, GF displayed no increase in proliferation in response to stimulation with PDGF‐BB at any of the concentrations tested when compared to negative controls. The wound fill (WF) responses to PDGF‐BB were similar between PDL and GF, with both cell types responding in an all or none fashion when measured at day 2, and in a concentration‐dependent manner at later time points. The only significant difference in WF between PDL and GF occurred in AOI 2 in negative control medium (0 ng/ml of PDGF‐BB), with GFs having greater (P <0.01) levels of WF over the 9 days.Conclusion: The findings from this study demonstrate differing effects of PDGF‐BB on the proliferation of PDL and GF in this in vitro model. These results suggest that there may be cell‐specific differences critical to periodontal wound healing that may be exploited in the development of new therapies. J Periodontol 2001;72:331‐340.
Relationship of Periodontopathic Bacteria With Early‐Onset Periodontitis in Down's Syndrome
Authors: Amano Atsuo , Kishima Tetsuhiko , Akiyama Shigehisa , Nakagawa Ichiro , Hamada Shigeyuki , Morisaki Ichijiro 
Published: February 2005

Background: Down's syndrome (DS) patients often develop severe early‐onset marginal periodontitis in early adulthood; however, there is little information available on the microbiology of DS periodontitis.Methods: Subgingival plaque specimens were taken from 67 DS young adults and 41 age‐matched systemically healthy individuals with mental disabilities (MD). The prevalence of 10 possible periodontopathic bacterial species, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Treponema denticola, Prevotella intermedia, Prevotella nigrescens, Capnocytophaga ochracea, Capnocytophaga sputigena, Campylobacter rectus, and Eikonella corrodens, were investigated in their subgingival plaque samples using a polymerase chain reaction method. The detection of P. gingivalis fimA genotypes was also performed in P. gingivalis‐positive samples.Results: Although DS subjects generally develop an earlier and more extensive periodontal breakdown than those with MD, no significant differences were observed in the bacterial profiles. The profiles of subjects with periodontitis were significant in DS, but not in MD. The prevalence of P. gingivalis, B. forsythus, and P. intermedia were significant in the DS periodontitis group, compared to DS gingivitis group. Moreover, the occurrence of P. gingivalis with the type II fimA gene was significantly related to periodontitis in both DS and MD, with odds ratios of 6.32 and 12.03, respectively.Conclusions: These results suggest that early‐onset periodontitis in DS is mainly due to the more susceptible host for the causative microbial agents including P. gingivalis with type II fimA. J Periodontol 2001;72:368‐373.
Identification and Consequences of Distinct Löe‐Silness Gingival Index Examiner Styles for the Clinical Assessment of Gingivitis
Authors: McClanahan Stephen F. , Bartizek Robert D. , Biesbrock Aaron R. 
Published: February 2005

Background: In clinical studies, gingivitis is most frequently assessed by the Löe‐Silness gingival index (GI). The objective of this work was to develop an understanding of how clinicians experienced with GI differ with respect to how they apply GI and to assess the impact of different examination styles on statistical outcomes and magnitude of treatment differences.Methods: A method was developed to mathematically relate the average GI score and degree of bleeding observed for a subject. Graphical analyses were used to profile examiner styles with respect to using the GI index. A prospective single‐center, examiner‐blind study comparing the effects of a staggered prophylaxis on gingivitis was then conducted, where a difference in gingivitis was created between two balanced groups by providing subjects a prophylaxis at two staggered time points. Subjects were assigned to one of two cohorts; within each cohort, group 1 subjects received a dental prophylaxis following the baseline examination and group 2 subjects received a dental prophylaxis 8 weeks later. Five to 7 days after the group 2 prophylaxis, all subjects were examined for GI. Twelve experienced clinicians participated.Results: Retrospective analyses indicated the presence of distinct examiner styles which are based on the frequency that a given GI score (0, 1, 2, or 3) is measured by a clinician. In the prospective study, all 12 examiners observed statistically significant differences between the prophylaxis treatment groups at the final visit for both mean number of bleeding sites and mean GI; the magnitude ranged from 21.5% to 84.6% for mean number of bleeding sites and 9.4% to 39.2% for mean GI. There were 4 distinct styles employed by these experienced clinicians.Conclusions: Varying examiner styles impact the structure of resulting data. Importantly, the implementation of arbitrary thresholds (e.g., 20%) regarding percent treatment differences between groups as a guideline for judging the clinical significance is scientifically unsupported. A more scientific criterion in the field of gingivitis clinical testing would be the independent demonstration of statistical superiority compared to a negative control and/or a demonstration of similar or superior efficacy to clinically proven positive controls. In addition, interexaminer calibration is a mechanism that can be utilized to minimize the impact of different examiner styles in clinical settings involving more than one examiner. J Periodontol 2001;72:383‐392.
Cyclooxygenase‐2 Is Upregulated in Inflamed Gingival Tissues
Authors: Morton Rakhi Sinha , Dongari‐Bagtzoglou Anna I. 
Published: February 2005

Background: Increased release of prostaglandins (PG) within periodontal tissues is considered to play a pathogenetic role during periodontal disease progression. The rate‐limiting step in the formation of PG from arachidonic acid is catalyzed by cyclooxygenase (COX). Currently there are 2 known isoforms of the enzyme. COX‐1 is constitutively expressed in various tissues whereas COX‐2 is an inducible enzyme believed to be responsible for PG synthesis at sites of inflammation. The purpose of this study was to compare COX‐2 expression in inflamed and healthy human gingiva and further explore some of the pathogenetic mechanisms which may lead to elevated COX‐2 expression in vivo.Methods: Thirty‐two gingival biopsies were obtained during routine oral surgical procedures and were processed histologically using hematoxylin and eosin to determine the degree of inflammation. Of these biopsies, 7 with low and 7 with high histological levels of inflammation were further processed immunohistochemically in order to assess the levels of COX‐2 expression in situ. To explore some potential mechanisms of COX‐2 upregulation, gingival connective tissue primary cell cultures were established and challenged with periodontal bacteria or proinflammatory cytokines in vitro. The levels of COX‐2 expression were analyzed by Western blot of cell lysates. COX‐2 activity was assessed by quantifying prostaglandin E2 (PGE2) levels in culture supernatants by competitive EIA.Results: We have shown by immunohistochemistry that COX‐2 expression was significantly higher (P <0.01) in tissues with higher levels of inflammatory infiltrates. Expression of COX‐2 was detected in gingival epithelium, endothelial cells as well as cells with fibroblast morphology. In vitro studies indicated that gingival fibroblasts (GF) did not express COX‐2 constitutively. However, when these cells were challenged with interleukin (IL)‐1β or bacterial cells (A. actinomycetemcomitans JP2 or B. forsythus ATCC 43037), COX‐2 expression as well as COX‐2 activity were upregulated. COX‐2 expression was upregulated as early as 2 hours post IL‐1β challenge and was accompanied by a sustained PGE2 release in the culture supernatants. Cyclosporin A (CsA) did not inhibit COX‐2 expression induced by bacterial challenge. In contrast, NS‐398, a selective inhibitor of COX‐2 activity, almost completely abolished PGE2 synthesis by these cells in response to bacterial or cytokine challenge.Conclusions: We conclude that COX‐2 expression is significantly upregulated in inflamed periodontal tissues. Both inflammatory cytokines such as IL‐1β and bacterial constituents may be responsible for the enhanced COX‐2 expression and PGE2 synthesis in vivo. J Periodontol 2001;72:461‐469.
Predictable Multiple Site Root Coverage Using an Acellular Dermal Matrix Allograft
Authors: Henderson Robin D. , Greenwell Henry , Drisko Connie , Regennitter Fred J. , Lamb James W. , Mehlbauer Michael J. , Goldsmith Linda J. , Rebitski George 
Published: February 2005

Background: The primary aim of this randomized, controlled, blinded clinical investigation was to determine if orientation of an acellular dermal matrix (ADM) allograft, basement membrane side against the tooth or connective tissue side against the tooth, affected the percent root coverage. Additional aims were to: 1) compare results of this study with results obtained from other root coverage studies; 2) determine if multiple additional sites could be successfully covered with the same surgery; 3) determine the effect of the procedure on keratinized tissue; and 4) evaluate the amount of creeping attachment obtained.Methods: Ten patients with 2 Miller Class I or II buccal recession defects ≥3 mm were treated with a coronally positioned flap plus ADM and followed for 12 months. Test sites received ADM with the basement membrane side against the root (AB), while the control sites received the connective tissue side against the root (AC). Multiple additional recession sites were treated with the same flap procedure.Results: Mean baseline recession for the AB sites was 4.2 mm and for the AC sites, 3.7 mm. Mean root coverage of 95% was obtained for both AB and AC sites. Sixty‐eight additional Class I or II AB and AC sites obtained about 93% root coverage. The mean increase in keratinized tissue for both treatments was 0.80 mm. No additional root coverage was gained due to creeping attachment between 2 and 12 months.Conclusions: Treatment with ADM was an effective and predictable procedure for root coverage. The orientation of the material did not affect the treatment outcome for any of the parameters tested. J Periodontol 2001;72:571‐582.
Combination Use of Bovine Porous Bone Mineral, Enamel Matrix Proteins, and a Bioabsorbable Membrane in Intrabony Periodontal Defects in Humans
Authors: Lekovic Vojislav , Camargo Paulo M. , Weinlaender Michael , Kenney E. Barrie , Vasilic Nikola 
Published: February 2005

Background: The purpose of this study was to evaluate the effectiveness of a combination of enamel matrix proteins (EMP), bovine porous bone mineral (BPBM), and a bioabsorbable membrane for guided tissue regeneration (GTR) as regenerative therapy for intrabony defects in humans and compare it to an open flap debridement (OFD) technique.Methods: Using a split‐mouth design, 18 pairs of intrabony defects were treated and surgically reentered 6 months after the initial surgery. Experimental sites were treated with EMP, grafted with BPBM, and received a collagen/polylactic acid membrane for GTR. Control sites were treated with OFD. The primary outcomes evaluated in the study included probing depth resolution, clinical attachment gain, and bony defect fill.Results: Preoperative probing depths, attachment levels, and intraoperative bone measurements were similar for the experimental and control groups. Postsurgical measurements taken at 6 months revealed a significantly greater reduction in probing depth in the experimental group (4.95 ± 1.52 mm on buccal sites and 4.74 ± 1.47 mm on lingual sites) when compared to the control group (2.83 ± 0.83 mm on buccal sites and 2.90 ± 0.91 mm on lingual sites). The experimental sites also presented with significantly more attachment gain (3.89 ± 1.16 mm on buccal sites and 3.78 ± 1.14 mm on lingual sites) than the control sites (1.52 ± 0.83 mm on buccal sites and 1.48 ± 0.78 mm on lingual sites). Surgical reentry of the treated defects revealed a significantly greater amount of defect fill in favor of the experimental group (4.76 ± 1.36 mm on buccal sites and 4.81 ± 1.37 mm on lingual sites) as compared to the control group (1.78 ± 0.92 mm on buccal sites and 1.67 ± 0.90 mm on lingual sites).Conclusions: The results of this study indicate that a combination technique including BPBM, EMP, and GTR results in better clinical resolution of intrabony defects than treatment with OFD. Differences observed were both statistically and clinically significant. The exact role of each of the 3 technique components in achieving the clinical improvement observed in this study remains to be determined. J Periodontol 2001;72:583‐589.
Expression of Cytokines and Inducible Nitric Oxide Synthase in Inflamed Gingival Tissue
Authors: Hirose Michiko , Ishihara Kazuyuki , Saito Atsushi , Nakagawa Taneaki , Yamada Satoru , Okuda Katsuji 
Published: February 2005

Background: Periodontopathic bacteria induce inflammation of periodontal tissues. The cytokines and nitric oxide released in periodontal lesions have been reported to play a protective role in bacterial infection and to relate to the process of inflammation. To clarify the relationship between colonization of periodontopathic bacteria and cytokines, we evaluated profiles of inflammatory cytokines, chemokine, anti‐inflammatory cytokines, and inducible nitric oxide synthase (iNOS) and colonization by Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans, which are major pathogens of periodontitis.Methods: mRNA expression of cytokines and iNOS in inflamed and healthy gingival tissue was determined using reverse transcription‐polymerase chain reaction (RT‐PCR), and the relationship between their profiles and the detection of specific bacteria was analyzed.Results: The relative expression of interleukin (IL)‐6 and iNOS mRNAs in periodontal lesions was significantly higher than those in healthy individuals. IL‐6 mRNA expression was also significantly higher at bleeding on probing (BOP)‐positive sites than at BOP‐negative sites. The expressions of IL‐1α and IL‐8 increased, but IL‐10 expression decreased at sites where A. actinomycetemcomitans was detected. We found no correlation between the expression of cytokine and iNOS mRNA and infection by P. gingivalis.Conclusions: The expression of IL‐6 may reflect inflammation in gingival tissue, and iNOS may be involved in the inflammatory process in periodontitis. The presence of A. actinomycetemcomitans or P. gingivalis might relate to the different cytokine profiles of IL‐1α, IL‐8, and IL‐10. J Periodontol 2001;72:590‐597