bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Menstrual Cycle on Periodontal Health
Authors: Machtei Eli E. , Mahler Dan , Sanduri Hana , Peled Micha 
Published: February 2005

Background: Fluctuation in estrogen/progesterone levels has been shown to affect the periodontium. The effects of pregnancy, prepuberty, and oral contraceptives on gingival health has been studied extensively, with gingival scores reported to be higher, in most instances, than in controls. Fluctuation in steroid sex hormone is also noticeable through women's menstrual cycle. Many women report an increase in gingival inflammation and discomfort associated with their menstrual cycle, most commonly around the menses period. However, this well‐known phenomenon has never been studied. The purpose of this longitudinal, prospective study was to compare the periodontal status of premenopausal women at different times during their menstrual cycle.Methods: Eighteen premenopausal women, enrolled in our maintenance program, were recruited. Clinical examination was performed before the recall visit at three different time points in their menstrual cycle: ovulation (OV), premenstruation (PM), and menstruation (M). Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were examined around the Ramfjord index teeth. Analysis of variance, with Scheffe modification, was used to determine differences between the menstrual time points.Results: Several women in this study reported appreciable oral symptoms just before or during menses. Mean PI (0.85 ± 0.06) was almost identical at all time points. Despite this, GI was significantly higher (P = 0.0245) in OV (0.54 ± 0.07) and in PM (0.5 ± 0.08) than in M (0.38 ± 0.07). Mean patient's PD (2.22 ± 0.08 mm) and CAL (2.92 ± 0.15 mm) was not significantly different between examinations.Conclusions: We observed changes in gingival scores during the menstrual cycles of periodontally healthy women. These changes need to be addressed when analyzing data from epidemiological and treatment studies in premenopausal women. J Periodontol 2004;75:408‐412.
The Short‐Term Effects of Treatment of Chronic Periodontitis on Circulating Levels of Endotoxin, C‐Reactive Protein, Tumor Necrosis Factor‐α, and Interleukin‐6
Authors: Ide Mark , Jagdev Daljit , Coward Paula Y. , Crook Martin , Barclay G. Robin , Wilson Ron F. 
Published: February 2005

Background: The acute‐phase response involves molecules including tumor necrosis factor‐alpha (TNF‐α), interleukin‐6 (IL‐6), and C‐reactive protein (CRP). This study aimed to determine whether subgingival scaling resulted in rapid changes in plasma concentrations of these molecules.Methods: Twenty‐three non‐smoking adults with chronic periodontitis received subgingival scaling for 60 minutes. Venous blood samples were taken at 0, 15, 30, 60, and 120 minutes. TNF‐ α and IL‐6 were assayed from all samples and CRP from the baseline and final samples. Lipopolysaccharide (LPS) was assayed at 0, 15, and 30 minutes using limulus lysate assay (LAL) and EndoCAb Ig assays.Results: LPS assays were suggestive of a transient low‐grade bacteremia, but changes in LPS approaching significance (P = 0.061) were seen with LAL only. There was a significant increase in circulating TNF‐α (P = 0.0387) and IL‐6 (P <0.0001), and the degree of change in TNF‐α was correlated with the severity of periodontal breakdown (P = 0.001). There was also a significant correlation between levels of IL‐6 and TNF‐α (P <0.001).Conclusions: Chronic periodontitis patients undergoing an episode of subgingival scaling show a significant elevation in circulating TNF‐α and IL‐6. This may account for anecdotal reports of pyrexia following treatment and may be significant in terms of the relationship between periodontal disease, bacteremia, and cardiovascular disease. J Periodontol 2004;75:420‐428.
Locally Delivered Doxycycline as an Adjunctive Therapy to Scaling and Root Planing in the Treatment of Smokers: A Clinical Study
Authors: Machion Luciana , Andia Denise Carleto , Benatti Bruno Braga , Carvalho Marcelo Diniz , Nogueira‐Filho Getúlio R. , Casati Márcio Zafallon , Nociti Francisco H. , Sallum Enilson Antonio 
Published: February 2005

Background: The aim of this clinical study was to evaluate the association of locally delivered doxycycline (10%) with scaling and root planing in the periodontal treatment of smokers.Methods: Forty‐three patients with chronic periodontitis and a minimum of four pockets (≥5 mm) on anterior teeth that bled on probing were selected. Patients were randomly assigned to scaling and root planing (SRP) or scaling and root planing followed by local application of doxycycline (SRP‐D). Plaque, bleeding on probing, gingival recession, relative attachment level RAL), and probing depth (PD) were recorded at baseline, 45 days, and 3 and 6 months. Differences between baseline and each period were considered for analysis.Results: At 6 months, no difference was found between groups regarding plaque, bleeding reduction, gingival recession or PD (P >0.05). However, RAL gain was greater for SRP‐D (1.63 ± 0.93 mm) than for SRP (1.04 ± 0.71 mm) (P = 0.025). In addition, deep pockets (≥7 mm) showed a significant reduction (3.78 ± 1.41 versus 2.60 ± 1.28 mm, P = 0.039) and RAL gain (2.54 ± 1.27 mm versus 1.29 ± 0.95 mm, P = 0.01) when doxycycline was applied. The proportion of sites showing RAL gain of 1 to 2 mm was 36.8% versus 21.7% for SRP‐D and SRP, respectively (P = 0.01).Conclusion: The use of locally delivered doxycycline may constitute an important adjunct for the treatment of severe periodontal disease in smokers. J Periodontol 2004;75:464‐469.
The Influence of Enamel Matrix Derivative Associated With Insulin‐Like Growth Factor‐I on Periodontal Ligament Fibroblasts
Authors: Palioto Daniela B. , Coletta Ricardo D. , Graner Edgard , Joly Julio Cesar , de Lima Antonio Fernando Martorelli 
Published: February 2005

Background: Enamel matrix derivative (EMD) has recently been shown to promote periodontal regeneration in vivo. Insulin‐like growth factor‐I (IGF‐I) is a potent modulator of periodontal regeneration stimulating cell proliferation, differentiation, synthesis of type I collagen, and non‐collagenous proteins. However, the biochemical effects of these factors on periodontal ligament (PDL) fibroblasts are not completely understood. The objective of the present study was to evaluate the effect of EMD, IGF‐I, and the combination of these two factors on the proliferation, adhesion, migration, and expression of type I collagen in PDL fibroblasts.Methods: The proliferation rate was measured by automated cell counting and immunohistochemical expression of proliferating cell nuclear antigen (PCNA). The cell adhesion was analyzed by a colorimetric assay and cell migration was measured in Boyden chambers. Type I collagen expression and production was determined by semi‐quantitative reverse transcriptase‐polymerase chain reaction (RT‐PCR) and enzyme‐linked immunosorbent assay (ELISA), respectively.Results: The results indicated that the proliferation of PDL fibroblasts was significantly stimulated by EMD and EMD plus IGF‐I in a dose‐ and time‐dependent manner. EMD, IGF‐I, and the combination of both factors had no effects on cellular migration and adhesion or expression and production of type I collagen.Conclusion: Our results showed that EMD, IGF‐I, and the combination of both factors stimulated PDL fibroblast proliferation, whereas these factors did not affect adhesion, migration, or expression of type I collagen of these cells. J Periodontol 2004;75:498‐504.
The Prevalence of Surgical Complications of the Sinus Graft Procedure and Their Impact on Implant Survival
Authors: Schwartz‐Arad Devorah , Herzberg Ran , Dolev Eran 
Published: February 2005

Background: Grafting of the maxillary sinus floor has been performed successfully over the last decade. The ultimate goal of this procedure is to allow surviving implants to support a functional prosthesis. Surgical complications of the procedure are rarely reported and their impact on implant survival has been investigated even to a lesser extent. The purpose of this study was to evaluate the prevalence of surgical complications of the sinus graft procedure and their impact on implant survival.Methods: The study consisted of 70 patients who underwent 81 sinus graft procedures using the lateral wall approach from 1995 to 2000. A total of 212 screw‐shaped implants were placed in the grafted sinuses and were restored by fixed prosthesis. Mean follow‐up period for the implants was 43.6 months. Intra‐ and postoperative complications were thoroughly documented regarding clinical signs, times of occurrence, and treatment regimens.Results: Perforation of the Schneiderian membrane was the major intraoperative complication, observed in 36 of the 81 sinuses 44%). Of the 70 patients, seven (10%) suffered from postoperative complications, specifically related to the sinus graft procedure, which included an uncommon cyst formation and an infection. Membrane perforations were strongly associated with the appearance of postoperative complications (specific and nonspecific to the procedure) (P <0.001). However, no association was found between membrane perforations or postoperative complications and implant survival.Conclusions: Intraoperative complications may lead to postoperative complications. Surgical complications did not signifi‐ cantly influence implant survival. J Periodontol 2004;75:511‐516.
Specific Pro‐Apoptotic Fibronectin Fragments Modulate Proteinase Expression in Periodontal Ligament Cells
Authors: Jee Sang‐Wook , Wang Shaohui , Kapila Yvonne L. 
Published: February 2005

Background: During inflammation and periodontal disease, the extracellular matrix protein fibronectin (FN) is degraded into fragments whose activities differ from those of the intact molecule. In periodontal ligament cells in vitro, some fragments elevate the expression of matrix metalloproteinases and serine proteinases, while others induce apoptosis through a mechanism regulated by caspase proteases and specific signaling pathways. In this study, we investigated whether the pro‐apoptotic V+H– fibronectin fragment modulates proteinase expression as part of the apoptotic mechanism in periodontal ligament cells. The importance of this study is that a structurally similar fibronectin fragment found in vivo (40‐kDa) is associated with periodontal disease status. However, the recombinant V+H– FN protein which is structurally and functionally similar to the in vivo 40‐kDa fragment was chosen as the focus of these studies over the in vivo fragment because of the ability to readily produce and purify large quantities of recombinant fragments for detailed studies. Thus, findings from this study relate to our understanding of how the extracellular matrix of the periodontal ligament in an inflamed environment may contribute to periodontal disease and its progression.Methods: We used substrate zymography, reverse zymography, proteinase inhibitors, and partial sequencing to investigate whether the pro‐apoptotic V+H– fibronectin fragment modulates proteinase expression as part of this apoptotic mechanism.Results: Incubation with the V+H– fragment reduced the expression of all gelatinolytic proteinases and inhibitors commonly expressed by periodontal ligament cells. In the presence of caspase inhibitors, inhibitors known to suppress apoptosis, however, the reduced proteinase profile was rescued, showing that caspase inhibitors were able to reverse the reduced proteinase profile and indicating that caspase‐mediated pathways are pertinent to fibronectin‐fragment‐mediated matrix metalloproteinase expression. In addition, the V+H– fragment also triggered the expression of a unique high molecular weight gelatinolytic proteinase of approximately 200 kDa. This proteinase was a serine proteinase, whose identity is not known.Conclusion: These findings suggest that matrix‐degrading proteinases may be involved in apoptosis as part of a unique mechanism of periodontal tissue breakdown, in which novel proteinases may help execute the dissolution of the extracellular matrix. J Periodontol 2004;75:523‐530.
Guided Bone Regeneration May Be Negatively Influenced by Nicotine Administration: A Histologic Study in Dogs
Authors: Saldanha Juliana B. , Pimentel Suzana P. , Casati Marcio Z. , Sallum Enilson A. , Barbieri Deise , Moreno Heitor , Nociti Francisco H. 
Published: February 2005

Background: A series of animal and in vitro data confirms that nicotine impairs bone healing, diminishes osteoblast function, and causes autogenous bone graft morbidity. Therefore, this study aimed to investigate the impact of nicotine on the healing of bone defects treated by the guided bone regeneration (GBR) principle.Methods: Sixteen mongrel dogs were used. One defect was surgically created bilaterally and randomly assigned as an expanded polytetrafluoroethylene (ePTFE) membrane site or a non‐membrane control site. The animals were randomly assigned to one of the following groups: group 1, placebo (n = 8) and group 2, subcutaneous administration of nicotine (2 mg/kg) twice daily (n = 8). After 4 months, the animals were sacrificed and the specimens routinely processed for semi‐serial decalcified sections. The evaluated parameters were bone height, bone width, bone density, and bone area of newly formed bone.Results: Intergroup analysis (Kruskal‐Wallis) showed that membrane‐protected defects in the placebo group demonstrated an increased bone area when compared to membrane‐protected defects in the nicotine group and non‐membrane sites, regardless of nicotine administration (P <0.05). In addition, nicotine administration significantly affected bone density in membrane‐ and non–membrane‐protected sites (P <0.05).Conclusions: Within the limits of the present study, nicotine might affect, but not prevent, bone healing in defects treated by guided bone regeneration. The mechanisms of this effect should be investigated further. J Periodontol 2004;75:565‐571.
Initial Implant Position Determines the Magnitude of Crestal Bone Remodeling
Authors: Hartman Gary A. , Cochran David L. 
Published: February 2005

Background: The ability to predict the amount of bone remodeling around implants is important for a stable and predictable esthetic result. The purpose of this study was to investigate the amount of radiographic bone remodeling that occurs over time using a one‐piece implant system.Methods: Twenty‐seven patients receiving implants in the maxilla and 15 receiving implants in the mandible were included in the study. All implants were placed with a non‐submerged surgical technique with varying locations of the rough‐smooth border with respect to the alveolar crest. Clinical exams and radiographs were taken on the day of implant placement, at 6 months, and annually up to 5 years. Linear measurements from digitized radiographs were made from the implant shoulder to the first boneto‐ implant contact at all time points.Results: A significant amount of bone remodeling compared to baseline occurred for all implants at the 6‐month follow‐up visit (1.10 mm), with the remaining time points showing virtually no change (0.1 mm). A relationship was found between the amount of bone remodeling and the location of the rough‐smooth border with respect to the alveolar crest. Those implants with the rough‐smooth border surgically placed below the crest had, on average, a greater amount of remodeling at 6 months (average 1.72 mm) than implants with the rough‐smooth border placed at or near the crest (average 0.68 mm). In both situations, this remodeling: 1) occurred early (within 6 months), 2) reached a similar level, and 3) remained virtually unchanged up through 60 months (0.05 mm).Conclusions: A physiologic dimension appears to exist between the bone and the implant‐crown interface around onepiece implants that is established early and maintained over time. These results are significant because they demonstrate in patients that the magnitude of initial bone remodeling around these onepiece dental implants is dependent on the positioning of the rough‐smooth border of the implant in an apico‐coronal dimension. Furthermore, the dimension, from the crown‐implant interface to the first bone‐to‐implant contact, is consistent with the formation of a biologic width similar to that found around the natural dentition. J Periodontol 2004;75:572‐577.
Smoking May Affect Root Coverage Outcome: A Prospective Clinical Study in Humans
Authors: Martins Angela Guimarães , Andia Denise Carleto , Sallum Antonio Wilson , Sallum Enilson A. , Casati Márcio Z. , Nociti Francisco H. 
Published: February 2005

Background: Cigarette smoking has been shown to negatively influence healing following periodontal therapeutic procedures. Therefore, the aim of this study was to evaluate the impact of smoking on clinical outcome of root coverage following subepithelial connective tissue graft (CTG) surgery.Methods: Eighteen defects were treated in 15 patients (seven smokers and eight non‐smokers) who presented canine and premolar Miller Class I and II recessions. CTG was performed and clinical measurements were obtained at baseline, and 30, 60, 90, and 120 days after surgery. Clinical measurements included plaque and gingival indexes, gingival recession, probing depth, clinical attachment level, gingival thickness, and keratinized tissue width.Results: Intragroup analysis showed that CTG was able to promote root coverage, increase gingival thickness, and improve clinical attachment level in both groups (P <0.05). On the other hand, intergroup analysis demonstrated that smokers presented with a lower percentage of root coverage (58.84% ± 13.68% versus 74.73% ± 14.72%), less clinical attachment level gain (2.54 ± 0.79 mm versus 2.00 ± 1.04 mm), and deeper probing depths (1.56 ± 0.53 mm versus 2.35 ± 0.67 mm) than non‐smokers (P <0.05). Moreover, 4 months after CTG, smokers presented more keratinized tissue compared to non‐smokers (3.30 < 0.86 mm versus 4.50 ± 1.16 mm) (P <0.05).Conclusion: Within the limits of the present study, it can be concluded that cigarette consumption may present a negative impact on root coverage outcome by CTG and, therefore, may represent one more challenge for periodontal plastic therapy. J Periodontol 2004;75:586‐591.
A Radiographic Evaluation of Cervical Bone Loss Associated With Immediate and Delayed Implants Placed for Fixed Restorations in Edentulous Jaws
Authors: Schwartz‐Arad Devorah , Yaniv Yael , Levin Liran , Kaffe Israel 
Published: February 2005

Background: Placement of dental implants is considered a successful and predictable procedure. An important biological benefit is the preservation of bone height following implantation. The purpose of this study was to examine the cervical bone loss (CBL) and its correlation with implant characteristics and anatomic factors, 1 to 8 years post‐implantation of immediate and delayed implants.Methods: A total of 381 implants (144 immediate and 237 delayed) were placed in 44 edentulous patients (53 jaws) for fixed ceramometal restoration from 1989 to 1996. The mean mesial and distal cervical bone resorption of each implant was measured using panoramic radiographs, by an objective examiner using a computerized scanner before second stage surgery and 1 to 8 years (mean 3.5 years) follow‐up. The length of the implant served as an internal standard. The examiner had no prior information on the examined implants.Results: Total CBL was 0.78 ±1.22 mm. There was a significant difference (P = 0.049) between CBL of immediate implants compared to delayed ones. Implants >13 mm showed a significantly (P <0.001) lower CBL than shorter implants. Hydroxyapatite‐coated implants had a higher CBL (P <0.001) compared to commercially pure titanium implants (P <0.001). The CBL of maxillary implants was higher than mandibular implants (P <0.001). Step‐wise multiple regression probability tests demonstrated that implant location followed by coating, length, and timing of placement were the most important parameters for implant success (R2 = 0.102).Conclusion: Cervical bone loss around dental implants is influenced by location, coating, length, and implant timing. J Periodontol 2004;75:652‐657.
Estrogen Suppression Induces Papillary Gingival Overgrowth in Pregnant Baboons
Authors: Reynolds Mark A. , Aberdeen Graham W. , Pepe Gerald J. , Sauk John J. , Albrecht Eugene D. 
Published: February 2005

Background: Alterations in sex steroids during pregnancy are associated with the development and exacerbation of reactive lesions involving the gingiva. Currently, few experimental animal models similar to humans are available to examine regulatory pathways involving sex steroids and the periodontium.Methods: In the present study, we used the baboon as a novel experimental model for the study of the regulatory actions of estrogen on the periodontium during pregnancy. Pregnant baboons (N = 5) were administered the potent, highly specific aromatase inhibitor CGS 20267 (2 mg/day subcutaneously) daily on days 60 through 165 of gestation (term = 184). Untreated females (N = 10) and females (5) concomitantly administered aromatase inhibitor and estradiol benzoate (2.0 mg/day each subcutaneously) served as controls. Gingival biopsies were taken between days 145 and 165 of gestation.Results: Administration of CGS 20267 in all females suppressed maternal serum concentrations of estradiol by 95% and induced the development of an exuberant papillomatous enlargement of the gingiva by gestational day 110, with the most prominent development involving the labial aspects of the anterior sextants. None of the untreated pregnant controls or females concomitantly administered aromatase inhibitor and estradiol benzoate developed gingival overgrowth. Thus, estradiol alone prevented the onset of gingival overgrowth induced by estrogen suppression. In all baboons, discontinuation of the aromatase inhibitor at time of cesarean section resulted in spontaneous regression and resolution of the papillomatous hyperplasia within 4 to 6 weeks. Clinically, the gingival papillary overgrowth was erythematous and edematous, with a propensity toward spontaneous subgingival hemorrhage. Histologically, the biopsy specimens demonstrated hyperplasia of the epithelium typified by mild hyperkeratosis, acanthosis, and elongation and isolated anastamoses of rete ridges. Subjacent to the intact epithelium was a loose connective tissue stroma with isolated areas of inflammatory cell infiltrate. Special stains verified the presence of isolated bacterial biofilms; however, no evidence of fungal filaments was present. Histological features suggestive of viral infection were notably absent in the epithelium. No evidence of viral particles or capsids was identified using transmission electron microscopy. Reverse transcription polymerase chain reaction analysis, using a panel of degenerate primers, was negative for papilloma family viruses.Conclusions: These results are consistent with a significant role for estrogen during primate pregnancy in the regulation of cellular proliferation and differentiation within the gingiva. The baboon represents an important experimental model for studying the regulatory actions of estrogen on the periodontium during pregnancy. J Periodontol 2004;75:693‐701.