Gingivitis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

GINGIVITIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES J AMES N. ...

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GINGIVITIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Gingivitis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83957-3 1. Gingivitis-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on gingivitis. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON GINGIVITIS ................................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Gingivitis ...................................................................................... 8 The National Library of Medicine: PubMed ................................................................................ 24 CHAPTER 2. NUTRITION AND GINGIVITIS....................................................................................... 57 Overview...................................................................................................................................... 57 Finding Nutrition Studies on Gingivitis..................................................................................... 57 Federal Resources on Nutrition ................................................................................................... 61 Additional Web Resources ........................................................................................................... 61 CHAPTER 3. ALTERNATIVE MEDICINE AND GINGIVITIS ................................................................ 63 Overview...................................................................................................................................... 63 National Center for Complementary and Alternative Medicine.................................................. 63 Additional Web Resources ........................................................................................................... 67 General References ....................................................................................................................... 70 CHAPTER 4. DISSERTATIONS ON GINGIVITIS .................................................................................. 71 Overview...................................................................................................................................... 71 Dissertations on Gingivitis.......................................................................................................... 71 Keeping Current .......................................................................................................................... 71 CHAPTER 5. PATENTS ON GINGIVITIS ............................................................................................. 73 Overview...................................................................................................................................... 73 Patents on Gingivitis ................................................................................................................... 73 Patent Applications on Gingivitis ............................................................................................... 87 Keeping Current ........................................................................................................................ 104 CHAPTER 6. BOOKS ON GINGIVITIS ............................................................................................... 105 Overview.................................................................................................................................... 105 Book Summaries: Federal Agencies............................................................................................ 105 Book Summaries: Online Booksellers......................................................................................... 106 The National Library of Medicine Book Index ........................................................................... 106 Chapters on Gingivitis............................................................................................................... 107 CHAPTER 7. MULTIMEDIA ON GINGIVITIS .................................................................................... 109 Overview.................................................................................................................................... 109 Video Recordings ....................................................................................................................... 109 Bibliography: Multimedia on Gingivitis.................................................................................... 110 CHAPTER 8. PERIODICALS AND NEWS ON GINGIVITIS ................................................................. 111 Overview.................................................................................................................................... 111 News Services and Press Releases.............................................................................................. 111 Newsletter Articles .................................................................................................................... 112 Academic Periodicals covering Gingivitis ................................................................................. 115 CHAPTER 9. RESEARCHING MEDICATIONS ................................................................................... 117 Overview.................................................................................................................................... 117 U.S. Pharmacopeia..................................................................................................................... 117 Commercial Databases ............................................................................................................... 119 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 123 Overview.................................................................................................................................... 123 NIH Guidelines.......................................................................................................................... 123 NIH Databases........................................................................................................................... 125 Other Commercial Databases..................................................................................................... 129 APPENDIX B. PATIENT RESOURCES ............................................................................................... 131 Overview.................................................................................................................................... 131

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Patient Guideline Sources.......................................................................................................... 131 Finding Associations.................................................................................................................. 133 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 135 Overview.................................................................................................................................... 135 Preparation................................................................................................................................. 135 Finding a Local Medical Library................................................................................................ 135 Medical Libraries in the U.S. and Canada ................................................................................. 135 ONLINE GLOSSARIES................................................................................................................ 141 Online Dictionary Directories ................................................................................................... 143 GINGIVITIS DICTIONARY ....................................................................................................... 145 INDEX .............................................................................................................................................. 201

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with gingivitis is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about gingivitis, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to gingivitis, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on gingivitis. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to gingivitis, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on gingivitis. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON GINGIVITIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on gingivitis.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and gingivitis, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “gingivitis” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Influence of Toothbrush Wear on the Variables of Plaque and Gingivitis in Clinical Trials Source: Journal of Dental Hygiene. 75(2): 150-155. Spring 2001. Contact: Available from American Dental Hygienists' Association. 444 North Michigan Avenue, Chicago, IL 60611. (312) 440-8900. Website: www.adha.org. Summary: Although toothbrush wear has been shown not to be critical in ensuring optimal plaque removal, the degree of toothbrush wear occurring in a clinical trial may influence the results of the trial. This article reports on a study undertaken to determine the effects of toothbrush wear on the clinical variables of dental plaque and gingivitis (inflamed gums). There were 107 subjects who participated in the six month clinical trial in which plaque and gingivitis scores were assessed in relation to toothbrush wear at 2,

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4, 12, and 24 weekly intervals. At each appointment, the toothbrushes being used were assessed for wear and replaced if necessary. The researchers found that 58 percent of the group were 'rapid' and 42 percent were 'slow' wearers. Of the group, 18.6 percent required replacement toothbrushes within two weeks from baseline with 50.9 percent of replacement toothbrushes being issued within four weeks of the start of the trial. Two subjects required as many as 10 replacement toothbrushes over the six month trial period. 'Slow' wearers had significantly lower plaque scores than 'rapid' wearers at weeks 4 and 12, whereas the 'rapid' wearers had significantly lower gingivitis scores than 'slow' wearers at weeks 2 and 4. The author concludes that significant toothbrush wear patterns of people participating in clinical trials should be taken into account when designing clinical trials assessing plaque and gingivitis scores. It may be necessary to exclude 'rapid' toothbrush wearers from clinical trials that assess plaque and its removal. In addition, as the rate of toothbrush wear varied considerably among subjects, the simple classification of subjects into 'rapid' and 'slow' wearers may require further subgrouping. 4 tables. 11 references. •

Painful Gingivitis May Be an Early Sign of Infection with the Human Immunodeficiency Virus Source: Clinical Infectious Diseases. 16(3): 233-236. February 1993. Summary: Anecdotal reports have suggested that painful gingivitis may be associated with infection due to the human immunodeficiency virus (HIV). This article reports on a study of 20 patients who came to the emergency room and complained about gum pain. They were then evaluated for HIV infection. Seven of the 20 patients (35 percent) were seropositive for HIV. Three of the seven HIV-seropositive patients were unaware of their HIV infection until tested in this study. Regardless of HIV serological status, all patients demonstrated a severely depressed mitogenic response when compared with control subjects. The authors conclude that identification of clinical presentations that reflect an early stage of HIV infection such as painful gingivitis, could aid in the timing of therapy and prevention of the spread of HIV infection. 1 table. 19 references. (AA-M).

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Gingivitis in Young Adults with Actinobacillus Actinomycetemcomitans Source: Clinical Oral Investigations. 5(2): 83-88. June 2001. Contact: Available from Springer-Verlag, New York Inc. Journal Fulfillment Services Department, P.O. Box 2485, Secaucus, NJ 07096-2485. Fax (202) 348-4505. Summary: High intraoral load of the bacterium Actinobacillus actinomycetemcomitans in subjects with no or minimal periodontal disease may induce subtle changes in clinical periodontal conditions. This article reports on a study undertaken to compare, at a site level, the clinical conditions in two groups of young adults with plaque-induced gingivitis. In one group, more than 20 percent of subgingival (under the gums) sites harbored cultivable A. actinomycetemcomitans (n = 9), whereas in the other group, the organism was present I n20 percent of fewer subgingival plaque samples (n = 8). Whereas no overt differences in clinical conditions could be ascertained, on average, the association between the presence of subgingival plaque and bleeding upon probing was considerably stronger in subjects with only a few subgingival sites harboring A. actinomycetemcomitans, as compared to subjects with a widespread intraoral distribution of the organism. Since the proportion of sites not bleeding upon probing in the presence of supragingival plaque was slightly elevated in these subjects, the present findings may suggest a suppressed inflammatory reaction on supragingival plaque in

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the presence of a pronounced intraoral load of A. actinomycetemcomitans. 2 figures. 2 tables. 41 references. •

Gingivitis in the Genesis of Heart Attack and Other Arteriosclerotic Diseases Source: Dentistry Today. 20(11): 94-95. November 2001. Contact: Available from Dentistry Today Inc. 26 Park Street, Montclair, NJ 07042. (973) 783-3935. Summary: New evidence of microbial aggravation and its mechanisms in coronary artery disease (CAD) and other atherosclerotic (hardening of the arteries) disorders was presented during the 50th annual session of the American College of Cardiology, held in Orlando, Florida in 2001. This article reviews the role of gingivitis in the genesis of heart attack and other arteriosclerotic diseases, reporting on data from the conference and other major recent conferences and publications. The author notes that few patients recognize how much infection and inflammation are present in their mouths. Their risks should be identified for them by a dentist. The author also reports that prior to this new information, attention was mainly directed to the progression of the arterial damage; now, increasing attention is directed to mechanisms for regression, or improvement in the vascular status. Dentists, physicians, and patients can all benefit from adequate evaluation of periodontal disease, and adequate professional communication among themselves.

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Gingivitis: A Prelude to Periodontitis? Source: Journal of Clinical Dentistry. 6(Special Issue): 41-45. 1995. Summary: This article explores the role of gingivitis in the progression of periodontitis. Topics covered include therapeutic intervention in gingival disease, the progression from gingival health to gingival disease, age-related gingival microbiology, predictive patterns of destructive periodontal disease, the host response to pathogenic bacteria, predicting disease progression, the management of gingival health, and the benefits of stannous fluoride. The author concludes that the reduction of gingivitis in the general population results in more than merely cosmetic improvement following the reduction of gingival bleeding and some forms of halitosis. There is overwhelming evidence that gingivitis is linked to periodontitis and that the elimination of gingivitis will result in the reduction of attachment loss in the majority of the population. 59 references.

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Validation of School Nurses to Identify Severe Gingivitis in Adolescents Source: American Journal of Public Health. 92(6): 946-947. June 2002. Contact: Available from American Public Health Association (APHA). Subscriptions, Department 5037, Washington, DC 20061-5037. (202) 777-2462. Fax (202) 777-2534. Website: www.apha.org. Summary: This article reports on a project that created a mechanism to identify adolescents with marked gingival (gum) disease with a visual screening instrument that can be administered by a school nurse or health care worker. School-based interventions are effective in oral health promotion, so the intervention strategy focused on identification of the health problem; referral for diagnosis, treatment, and follow up; education and counseling about risk behaviors and impediments to access to care; and evaluation of the intervention methods. The examinations were conducted in a mobile dental van at a middle school located in a predominantly Hispanic and dentally underserved community in the greater San Antonio area. The study addressed three

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issues: agreement of the nurse and dentist in the outcome of the visual examination; effectiveness of the screening tool in detecting marked gingival disease; and effectiveness of the screening process determined by referral for treatment. The study showed that this screening tool provides the school nurse with defined criteria to identify students with severe gingival inflammation. 2 tables. •

Postscaling Bacteremia in HIV-Associated Gingivitis and Periodontitis Source: Oral Surgery, Oral Medicine, Oral Pathology. 73(5): 550-554. May 1992. Summary: This article reports on a study that assessed the incidence of postscaling bacteremias in patients seropositive for HIV who have unequivocal evidence of periodontal infection. In addition, the authors tried to ascertain whether the posttreatment febrile episode reported by HIV-positive patients is a predictable sequela to the temporary presence of microorganisms in the peripheral circulation. Aseptive venipuncture was used to obtain samples of blood from 22 HIV-positive patients with gingivitis (HIV-G) and 19 HIV-positive patients with periodontitis (HIV-P), 15 and 30 minutes after the initiation of routine dental scaling and root planing. Six of the samples from HIV-G subjects were positive for colony-forming units 15 minutes after scaling but not at 30 minutes. Similar evidence of bacteremia was found in seven of the HIV-P patients 15 minutes after scaling, with no microbial growth detectable in samples obtained at 30 minutes. In two HIV-G and three HIV-P patients with demonstrable bacteremias a postoperative fever developed. For both HIV-G and HIV-P groups, no significant difference was found between the absolute CD4 T-cell counts of nonbacteremic versus bacteremic patients. The authors conclude that special provisions for antibiotic prophylaxis in this patient group may be unnecessary. 3 tables. 12 references. (AA-M).

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Comparison of the Efficacy of a Novel Electric Toothbrush and a Manual Toothbrush in the Treatment of Gingivitis Source: American Journal of Dentistry. 11(Special Issue): S23-S28. September 1998. Contact: Available from American Journal of Dentistry. Subscription Department, 9859 IH-10 West, Suite 107/489, San Antonio, TX 78230-2236. Summary: This article reports on a study undertaken to compare the efficiency of a new electric toothbrush featuring a novel three dimensional brush head action, with a manual toothbrush, in resolving gingivitis which had been allowed to develop in a group of subjects prior to the treatment phase of the study. This randomized split mouth study includes a total of 35 healthy non dental students who refrained from any oral hygiene on the lower jaw for a period of 21 days in order to develop gingivitis (inflamed gums). They then brushed one quadrant of the lower jaw with the Braun Oral B 3D Plaque Remover and the other with a manual toothbrush for a period of 4 weeks. Plaque and gingivitis were evaluated at the start of the study, after the 21 days of no oral hygiene, and after 1, 2, 3, and 4 weeks of brushing twice a day. At the end of the study, the 3D was found to be significantly more effective at reducing bleeding on probing for all sites combined and all individual sites. Plaque removal was also significantly more effective with the 3D. Subjects in the study reported that they preferred the 3D to the manual toothbrush and said that it would encourage them to brush for longer. The authors conclude that the new Braun Oral B 3D Plaque Remover offers advantages over a manual toothbrush in terms of plaque control and improvement of gingival condition. 3 figure. 2 tables. 18 references.

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Impact of the Sonicare Toothbrush on Plaque and Gingivitis Source: Compendium of Continuing Education in Dentistry. 23(7): 7-10. July 2002. Contact: Available from Dental Learning Systems. 241 Forsgate Drive, Jamesburg, NJ 08831. (800) 926-7636. Website: www.dentallearning.com. Summary: This article reviews both in vivo and in vitro studies that illustrate the effectiveness of the sonicare toothbrush in improving oral health. The sonicare toothbrush has been shown to be 40 percent more effective in removing plaque than a manual toothbrush, 82 percent better in removing plaque from interproximal areas, and to reverse gingivitis (inflamed gums). In vitro studies have examined the ability of the sonicare toothbrush to remove plaque bacteria beyond the reach of the bristles. The sonicare toothbrush has also been shown to produce significantly less dentin wear in vitro than another leading power toothbrush. 6 figures. 12 references.

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Review of Efficacy Studies of an Antiplaque-Antigingivitis Essential-Oil-Containing Dentifrice Source: Journal of Practical Hygiene. 10(2): 29-33. March-April 2001. Contact: Available from Montage Media Corporation. 1000 Wyckoff Avenue, Mahwah, NJ 07430-3164. (201) 891-3200. Summary: This article reviews the efficacy studies that investigated an antiplaque antigingivitis dentifrice (a mouthrinse) that contained essential oils. The effectiveness of a new essential oil containing (EOC) dentifrice in the control of plaque and gingivitis (gum infection) was initially evaluated in multiple short term human studies and later confirmed in a definitive six month clinical trial conducted according to guidelines established by the American Dental Association (ADA). The addition of zinc salts provided desired anticalculus benefits as demonstrated in two long term human clinical studies, while the bactericidal, anticaries, and stain reduction properties were verified utilizing accepted scientific testing methods. The authors conclude that the research demonstrates that a dentifrice containing a fixed combination of essential oils is effective against dental plaque and gingivitis and is consistent with the body of published long term clinical trials on essential oil mouthrinses (Listerine). The authors briefly discuss the use of these dentifrices in a program of oral hygiene. Increasing confidence in the value of dentifrices containing chemotherapeutic agents has resulted in their expanded use by people affected by gingivitis and acceptance by the professional dental community. 1 figure. 3 tables. 22 references.

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Role of Pharmacotherapeutics in the Reduction of Plaque and Gingivitis Source: Journal of Practical Hygiene. 9(6): 46-50. November-December 2000. Contact: Available from Montage Media Corporation. 1000 Wyckoff Avenue, Mahwah, NJ 07430-3164. (201) 891-3200. Summary: This article reviews the role of pharmacotherapeutics in the reduction of dental plaque and gingivitis (gum infection). The author notes that while mechanical aids (e.g., toothbrushes, floss, and interdental devices) are widely used to achieve proper oral hygiene, they occasionally fail to meet this goal and to reduce the bacteria below the patient's threshold for disease. In these patients, drug therapy may be indicated. The author discusses selection, research, and delivery considerations; and specific drugs including phenolic related essential oils, triclosan, bisbiguanides (including chlorhexidine), quaternary ammonium compounds, herbal extracts, and

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oxygenating agents. The author concludes that the ineffectiveness of mechanical plaque control is based largely on the fact that people do not brush or floss effectively or regularly. Several antimicrobial products have demonstrated safety and range of efficacy. Recommendations should be based on level of infection, research, expected outcomes, and patient input. Mouthrinses should be used as adjuncts and not replacements for traditional plaque control. 2 tables. 60 references. •

Treatment of Plaque-Induced Gingivitis, Chronic Periodontitis, and Other Clinical Conditions Source: Journal of Periodontology. 72(12): 1790-1800. December 2001. Contact: Available from American Academy of Periodontology. Suite 800, 737 North Michigan Avenue, Chicago, IL 60611-2690. (312) 573-3220. Fax (312) 573-3225. Summary: This article was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology and is intended for the information of the dental profession. The article represents the position of the American Academy of Periodontology regarding the current state of knowledge about treatment of plaqueinduced gingivitis (inflamed gums), chronic periodontitis, and some other clinical conditions. Therapy for individuals with chronic gingivitis is initially directed at reduction of oral bacteria and associated calcified and noncalcified deposits. Necrotizing ulcerative gingivitis (NUG) usually responds rapidly to the reduction of oral bacteria by a combination of personal plaque control and professional debridement (scaling). Appropriate therapy for patients with periodontitis varies considerably with the extent and pattern of attachment loss, local anatomical variations, type of periodontal disease, and therapeutic objectives. The introduction notes that there are some situations where the described therapies will not resolve disease or arrest disease progression. Furthermore, the treatments discussed should not be deemed inclusive of all possible therapies, or exclusive of methods of care reasonably directed at obtaining good results. 162 references.

Federally Funded Research on Gingivitis The U.S. Government supports a variety of research studies relating to gingivitis. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to gingivitis. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore gingivitis. The following is typical of the type of information found when searching the CRISP database for gingivitis: 2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Project Title: BACTERIAL SPECIES ON OR IN GINGIVAL EPITHELIAL CELLS Principal Investigator & Institution: Socransky, Sigmund S.; Professor & Head; Forsyth Institute Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 01-APR-1995; Project End 31-MAR-2005 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BIOFILM FORMATION AND METABOLISM ON DENTAL SURFACES Principal Investigator & Institution: Ferretti, Joseph J.; Senior Vice President & Provost; Microbiology and Immunology; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): The present Center of Biomedical Research Excellence (COBRE) proposal is designed to grow oral health related research, and increase the competitiveness of investigators associated with the University of Oklahoma College of Dentistry and affiliated institutions with common interests in dental research. At the center of this proposal are the junior investigators who will take a multidisciplinary approach to study microbial biofilm formation and metabolism on natural and artificial dental surfaces. The establishment and evolution of microbial biofilms on smooth surfaces in the oral cavity leads to dental caries, gingivitis, and periodontitis, accounting for the majority of all dental disease. To approach this problem from a number of vantage points, project investigators in the present proposal were drawn from complementary fields, including microbiology and genetics, pathology and cell biology, periodontics, and dental materials. An administrative core will oversee and work with the junior investigators, providing mentoring from senior investigators, enhanced core facilities, and an external advisory committee of internationally recognized scientists in the thematic topic of microbial biofilms on dental surfaces. In addition, a training program for students at all levels will be initiated as well as an outreach program to identify faculty and students at other institutions in the state interested in dental biofilm research. The university administration has committed to expand this effort with the addition of two permanent faculty positions from institutional resources. This COBRE proposal provides the necessary resources, infrastructure, and mentoring required for Oklahoma dental researchers to be successful in competing for future NIH funding as independent investigators. The ultimate benefit of this program will be the translation of research knowledge to treatment and prevention of oral diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BONE MINERAL DENSITY AS A PREDICTOR OF PERIODONTITIS Principal Investigator & Institution: Wactawski-Wende, Jean; Assistant Professor; Social and Preventive Medicine; State University of New York at Buffalo Suite 211 Ub Commons Amherst, Ny 14228 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2006 Summary: (provided by applicant): The overall purpose of this study is to determine the role of oral and systemic bone mineral density (BMD) in the development of new and progressive periodontal disease in postmenopausal women. We hypothesize that low BMD will be associated with both new and progressive periodontitis over time by

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increasing susceptibility to destructive periodontitis. We propose a longitudinal assessment of BMD and its role in establishment of periodontal disease in postmenopausal women with systematic studies using sensitive and accurate measures of skeletal and oral BMD, and periodontal disease. As part of the BMD assessment, we will further validate the methodology for oral BMD. In concert with these, assessment of a variety of potential co-risk factors for both low BMD and periodontitis will allow us to determine their contribution to this association. The systemic covariates include age, body mass index, smoking, alcohol, hormone use, socioeconomic and psychosocial factors, medications, medical and reproductive history, and diet. Local covariates include plaque, gingivitis, probing depth, previous dental care, and dental care habits. Study subjects will be recruited from an established cohort of postmenopausal women with baseline assessments of BMD and periodontitis as part of an ongoing crosssectional study. We propose a 3-vear follow-up examination in 1000 postmenopausal women already enrolled in the NIH Women's Health Initiative study. To date, studies have not characterized the specific role of BMD either skeletal or mandibular on periodontal disease incidence and progression in a large cohort of postmenopausal women. Our preliminary cross-sectional studies have determined that skeletal BMD is associated with alveolar crestal height, tooth loss and clinical attachment loss. The proposed longitudinal study will have sufficient sample size and statistical power to assess the temporal relationship between BMD and periodontitis and the effects of a large set of co-risk factors and potential confounding factors affecting osteopenia, periodontal disease or both. This study provides a unique opportunity to define this relationship in a cost effective manner in a cohort of postmenopausal women under study as part of the Women's Health Initiative and has great practical significance. Low BMD is likely of considerable importance in the onset and progression of periodontitis. Hence once the relationship is established, modalities effective in the prevention and treatment of osteoporosis may prove useful for prevention and treatment of periodontitis and subsequent tooth loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLINICAL/MICROBIAL EVALUATION OF TOPICAL P-113 GELS IN HUMANS WITH GINGIVITIS Principal Investigator & Institution: Paquette, David; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CULTIVABLE & UNCULTIVABLE PERIODONTAL SPIROCHETES Principal Investigator & Institution: Dewhirst, Floyd E.; Senior Member of Staff; Forsyth Institute Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 01-AUG-1992; Project End 30-JUN-2004 Summary: The long-term goal of the proposed research is to determine the role of spirochetes in the etiology of oral infectious diseases and to develop means to prevent or control spirochete infections. There is substantial evidence implicating spirochetes, particularly T denticola, as etiologic agents in periodontal diseases. In acute necrotizing ulcerative gingivitis (ANUG) and some forms of periodontal disease, spirochetes may comprise over 50 percent of the bacterial flora. Previously in this grant, we have helped to expand the number of known cultivated treponemes from 4 to 10 species, and

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identified an additional 47 currently uncultivable Treponema species. We have developed 16S rRNA based DNA probes that allow identification of cultivable and uncultivable treponemes in clinical samples. Aim 1 of this proposal will determine which spirochetes are associated with a variety of oral infectious diseases, and how treponemes other than T. denticola relate to Socransky's previously described periodontal bacterial complexes. Determining associated pathogens is a requisite first step in any study of infectious disease. Aim 2 will obtain a molecular understanding of msp, a major surface antigen of T. denticola. We will determine the diversity of msp genotypes in individuals and how msp genotypes shift over time in bacterial populations. Preventive measures, such as vaccines, require an understanding of the diversity of epitopes of the major antigens and how expression of antigen diversity varies over time. Aim 3 of this proposal will obtain information on the genome size and degree of host association as reflected by genome size reduction for each of the known cultivable oral treponemes. The final Aim will examine the genomic repertoire of T. maltophilum, a second oral treponeme implicated in oral infections. This genome survey will provide insight into the metabolic and pathogenic capabilities of the organism and will identify targets for vaccines or drug treatment. This research will improve our understanding of a major segment of the oral bacteria and will provide information necessary for the eventual control and prevention of oral infectious diseases such as periodontitis, pericoronitis, ANUG, noma, and Ludwig's angina. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DENDRITIC CELLS IN PERIODONTAL HEALTH AND DISEASE Principal Investigator & Institution: Oringer, Richard J.; Periodontics; State University New York Stony Brook Stony Brook, Ny 11794 Timing: Fiscal Year 2003; Project Start 05-AUG-2003; Project End 30-APR-2008 Summary: (provided by applicant): This proposal for a mentored patient-oriented research career development award will provide the candidate the knowledge and skills required to design, conduct, and analyze clinical research projects. The educational, clinical, and research resources at Stony Brook University's School of Dental Medicine, School of Medicine (SOM), School of Health Technology and Management (SHTM), and General Clinical Research Center (GCRC) will provide the candidate a robust environment for career development. A systematic plan has been developed that incorporates didactic courses provided by the GCRC, SHTM, and SOM with supervised research that includes clinical studies and complimentary laboratory analysis. The acquisition of both basic and applied research skills is essential for the candidate to transition into an independent investigator who can interface with basic scientists to design studies that evaluate novel hypotheses and ultimately translate this information into new diagnostic and therapeutic modalities. The research plan includes human studies to address a novel hypothesis regarding the role of dendritic cells (DC) in the pathogenesis of gingivitis and chronic periodontitis (CP). The hypothesis is that species in the plaque biofilm such as Porphyromonas gingivalis may promote the development of organized lymphoid aggregates in the lamina propria around the dentition, described as oral lymphoid follicles (OLF). Preliminary data indicate that Langerhans Cells (LC), mature dendritic cells, and T cells are the principal cellular components of the OLF. Furthermore, the transition from periodontal health to gingivitis to CP involves different stages in the development of OLF, as initiated by the plaque biofilm, propagated by cytokine/chemokine milieu, and induced by LCs. The specific aims of this proposal will use 2 longitudinal studies to establish the changes that occur in DCs and their trafficking molecules during 1) experimental gingivitis (EG) and 2) CP. In Aim

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1, periodontally healthy subjects will be restored to gingival health following the EG protocol, and in Aim 2, CP subjects will receive conventional treatment and then be enrolled in a maintenance program. The information generated in this training program will further elucidate the role of the host response in periodontal diseases and potentially lead to the development of therapies aimed at prevention and treatment of these conditions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DIAGNOSTIC OPITCAL IMAGING OF PERIODONTAL TISSUES Principal Investigator & Institution: Otis, Linda L.; Associate Professor and Director; Oral Medicine; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 30-SEP-1994; Project End 31-JUL-2003 Summary: (Adapted from Applicant's Abstract): Optical Coherence Tomography (OCT) is a non-invasive optical technique for cross-sectional imaging of biologic tissues which permits identification of both internal structure and surface contour of hard and soft tissues without ionizing radiation. Based on previously sponsored efforts, the authors have designed and constructed an OCT instrument for imaging teeth and periodontal tissues. Initial human studies demonstrate the feasibility of this method. The goal of this proposal is to construct a small, compact clinical instrument that will allow access to all tooth-bearing regions within the oral cavity. The capacity of OCT to characterize morphology, localize structures and quantify sub-gingival calculus will be determined in a small patient study. The authors hope to identify OCT signals associated with periodontitis and/or gingivitis. In order to make the device clinically relevant., the authors propose to optimize the instrument and evaluate its performance in comparison to standard techniques. The specific aims of the proposal are to (1) construct an improved, miniaturized intraoral OCT imaging hand piece; (2) miniaturize OCT imaging system components; (3) image and characterize healthy and diseased periodontal tissue and optimize OCT imaging parameters; (4) compare OCT imaging to standard assessment methods; and (5) investigate the potential of OCT to quantify gingival inflammation. Images produced to date suggest that OCT may delineate pathological changes in gingival fiber groups based on changes in optical properties. Finally operating OCT systems at multiple wavelengths may be used for quantification of blood and fluid content in tissue. This project is carried out in conjunction with Lawrence Livermore National Laboratory. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EFFICACY OF TAILORED ORAL HEALTH EDUCATION Principal Investigator & Institution: Pallonen, Unto E.; Associate Research Scientist; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-JUL-2008 Summary: (Provided by the applicant): The long-term objective of this project is to develop an effective tailored behavior change expert system (ES) education program to promote and maintain good oral health and prevent oral diseases among low-income children and their caregivers. To achieve this, the proposed multimedia-based, self-help intervention is designed to be easy to use and easy to diffuse for large-scale use through personal computers. Due to the current lack of tailored self-help behavior change dental interventions, substantial time and resources are needed to develop the content and to test the instruments and feasibility of the proposed interventions. This project has five

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specific aims: 1) To design and produced two interventions to promote oral health and prevent oral disease among caregivers and their children: (i) an interactive, tailored, theory-driven, behavior change ES education program, and (ii) an untailored health information HI comparison program. 2) To assess the feasibility and usability of these unique interventions with a small-scale feasibility study prior to their final implementation. 3) To revise the interventions based on the findings of the feasibility study and implement the efficacy trial. 4) To evaluate the efficacy of the interventions with two clinical outcomes: gingivitis among caregivers and untreated tooth decay among caregivers and their children. 5) To examine the extent to which the clinical outcomes are mediated by the affective, evaluative, and situational individual factors influenced by the tailored intervention, or by broader psychosocial factors addressed in other center projects. The efficacy of the tailored ES intervention, whether it results in better oral health than the untailored HI intervention, will be tested by the randomized controlled trial. In year 4 of the course of the longitudinal center research, the participating caregivers, low income African Americans recruited from the poorest 39 census tracks in the city of Detroit, will be randomly assigned to one of the two education programs at the beginning of the multimedia intervention session. The oral follow-up examination at year four will be the baseline measurement of this trial, and changes in the outcomes will be assessed in the follow-up examination in year 6. Both the participants and examiners will be blinded from the intervention regimens. Production and evaluation of a state of the science, interactive, tailored multimedia selfhelp ES program for oral health will provide an opportunity to obtain currently nonexistent information about the ability to influence behaviors that determine oral health status among low SES African Americans caregivers and their children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INITITATION OF BIOFILM FORMATION IN STREPTOCOCCUS GORDONII Principal Investigator & Institution: Gilmore, Keeta S.; Associate Research Professor; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008 Summary: Biofilms are central to oral ecology in health and disease. Historically, bacteria have been viewed as single-celled entities, but it is now clear that bacteria exist in stable communities that form specific and highly optimized architectures. The central hypothesis of this proposal is that the structures of these biofilms, as well as their persistence, requires a delicately orchestrated developmental program and communications network, characteristics traditionally reserved for the behavior of multicellular organisms. Just as tissue development requires the orchestrated and sequential nurturing of select cells and culling of others, the central hypothesis of this proposal predicts an analogous process that results in the outgrowth of bacterial cells in some areas of a colonized surface, and the culling of cells in others. The net affect of orchestrated cell growth and cell elimination is the production of a specifically designed biofilm architecture that optimizes nutrient access, waste elimination, protection from environmental hazards, and collectively, the ability to persist. An innovative aspect of this hypothesis is that the model predicts the existence of a "programmed cell death" pathway, as well as a specific, phase-varied antidote or neutralization pathway, both of which being critical for controlled development of the optimized biofilm architecture. The overarching goal of this research is to develop a rational basis for the design of new therapeutics to treat biota shift diseases of the oral cavity, such as gingivitis and

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periodontitis, while nurturing the formation or restoration of healthy oral flora. Streptococcus gordonii, an organism that is one of the first to colonize the tooth surface, and hence occurs at the base of the dental plaque consortium, will be the model organism of study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LYSIS OF CARIOGENIC BACTERIA BY PHAGE-ENCODED ENZYMES Principal Investigator & Institution: Delisle, Allan L.; Oral & Craniofacial Biol Scis; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2001; Project Start 15-SEP-2000; Project End 31-AUG-2003 Summary: The long-range, health-related goal of this proposal is to develop speciesspecific, cell wall-hydrolyzing enzymes encoded in the genomes of phages specific for Streptococcus mutans and Actinomyces naeslundii as new therapeutic treatments for dental caries. S. mutans is the primary etiological agent of human enamel caries, whereas A. naeslundii (A. viscosus), an early colonizer of dental plaque, has long been believed to be involved in gingivitis and root surface (cementum) caries. The major objective of the research proposed herein is to isolate, purify and characterize the enzymes which enable phages specific for these species to lyse their host cells. The lysis genes of two previously studied phages which are specific for S. mutans and A. naeslundii will be isolated, cloned and sequenced. To accomplish this, the complete genomes of these two phages will be sequenced, which will allow direct PCR subcloning of their holin and endolysin genes and characterization of their respective products. The DNA sequences of these holin/lysin gene pairs will provide information on their regulatory mechanisms and further our knowledge of the evolutionary relatedness of these viral proteins. Comparative analyses of their deduced primary amino acid sequences may also reveal conserved protein domains that are important in determining their structural and functional properties. Additional cloning experiments will be employed to isolate holin genes, and nearby endolysin genes, from these two phages and three additional oral phages, in order to develop a generally applicable method for directly isolating oral phage lysis genes. Phage DNA libraries will be constructed in a phage vector having a defective holin gene, which will allow recombinants expressing oral phage holins to be selected by complementation (plaque formation) of the defect in the phage vector. Inserts will then be sequenced to identify the phage holin genes and primers complementary to the ends of these genes will then be used to sequence, directly from the phage genomes, the adjacent, downstream endolysin genes. Selected endolysin genes will be subcloned, by PCR, from phage genomic DNAs, or from recombinant phage vectors, into expression vectors and introduced into E. coli in order to isolate and purify their gene products. The enzymatic activities of these proteins will then be extensively characterized, including determining the specific bonds which they cleave in the cell walls of their respective hosts. Purified preparations of these lytic enzymes might ultimately be used to kill, in a species-specific manner, S. mutans and A. naeslundii in dental plaque. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MECHANISMS OF ORAL SIV TRANSMISSION Principal Investigator & Institution: Ruprecht, Ruth M.; Professor of Medicine; DanaFarber Cancer Institute 44 Binney St Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 25-SEP-1999; Project End 31-AUG-2004

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Summary: Oral HIV-1 transmission is well documented in children who become infected postnatally through breast milk. In contrast, epidemiological surveys have yielded conflicting data regarding oral HIV-1 transmission among adults, even though case reports have described infection in adults whose only risk was oral/genital contact. In earlier work, we exposed rhesus macaques of various ages to cell-free SIV. In neonates, viremia and AIDS developed after non-traumatic oral exposure to several strains, including chimeric SHIV containing HIV-1 env. In adult macaques, well controlled, non-traumatic experimental oral exposure to uncloned as well as molecularly cloned SIV resulted in systemic infection. Many questions regarding oral lentiviral infection remain unanswered, e.g., the tropism of the virus strains that can traverse the upper gastro-intestinal mucosal surfaces, the site(s) of viral entry, and the potential role of inflammation in the oral cavity in facilitating virus transmission. The Specific Aims of this proposal are to: 1. Test the hypothesis that macrophage (M)-tropic strains are transmitted preferentially after oral inoculation. 2. Test whether neonates are more susceptible to systemic infection after oral SIV inoculation than adults. 3. Test the hypothesis that the presence of inflammation in the oral cavity facilitates virus transmission. 4. Test whether the eruption of teeth (and its accompanying gingival inflammation) increases the susceptibility of infant macaques to orally administered SIV. 5. Determine site(s) of virus entry and initial target cells after oral inoculation. We will perform serial sacrifice experiments to identify the site(s) of SIV passage across the mucosa and the initial target cells. This work is significant because it will shed light on key aspects of the mechanisms involved in oral virus transmission in adult and neonatal primates, including identification of important cofactors in oral virus transmission. The data generated will help in formulating strategies to decrease the risks of oral HIV-1 transmission, including late virus transmission during breast feeding. transport and the roles of TC10 in cellular growth. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MICROBIAL MEDIATORS OF TISSUE CELL BEHAVIOR Principal Investigator & Institution: Dmytryk, John J.; Professor; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008 Summary: The overall goal of this proposed subproject is to further our understanding of how oral bacteria and their products directly influence the behavior of tissue cells within the periodontium, specifically gingival epithelial cells and connective tissue fibroblasts. The central hypothesis to be tested in this Subproject is that biofilm bacteria exert direct effects on tissue cell behavior within the periodontium. Our specific aims are: 1) to analyze the effects of mediators produced by Actinobacillus actinomycemcomitans (Aa) (released from planktonic or biofilm associated organisms) and microbial-induced mediators (epithelial defensins and supernatants from bacteria stimulated cell cultures) on the migration and proliferation of gingival epithelial cells and fibroblasts; and 2) to determine the effects of Aa-produced mediators and microbialinduced host tissue cell mediators on the synthesis of extracellular matrix proteins, cytokines and other cell signaling molecules by gingival epithelial cells and fibroblasts. Motility of gingival epithelial cells and fibroblasts will be analyzed using time-lapse videomicroscopy and computer-assisted image analysis. Cell migration and proliferation will be studied using an in-vitro wound model, in which a confluent monolayer of epithelial cells and fibroblasts is wounded and repopulation of the created wound space is measured over time. Synthetic activities of cells will be analyzed for production of collagen and non-collagen proteins, prostaglandins, cytokines, defensins,

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and defensin-like molecules. Although defensins have not been been detected in fibroblasts, this has not been adequately studied in situations where bacteria are in direct contact with connective tissues for extended periods of time. This is relevant to several clinical situations in periodontics, for example, exposed surgical materials, and in certain periodontal diseases characterized by bacterial invasion into gingival connective tissue, such as aggressive periodontitis and necrotizing ulcerative gingivitis. Collectively, this group of studies will further our understanding of the the effects of bacterial biofilms on epithelial and connective tissue cell behavior and metabolism in periodontal diseases and will pave the way for further studies focusing on how these pathogenic mechanisms may become targets for therapeutic intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MICROBIOLOGY/IMMUNOLOGY OF PERIODONTAL DISEASE IN T1DM Principal Investigator & Institution: Moore, Paul A.; Professor; Dental Public Health; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2003 Summary: (provided by applicant): We propose to evaluate the periodontal disease, microbiology and immunology of a large adult Type 1 diabetic cohort and previously identified health control population. In 1992-1994, the University of Pittsburgh's Oral Health Science Institute (OHS) completed periodontal assessments of 406 subjects being followed by the ongoing University of Pittsburgh Epidemiology of Diabetes Complications Study (EDC). We propose to continue our collaboration by reexamining subjects in this cohort, who will now be 30 to 55 years old. This exploratory proposal will determine the prevalence, incidence and 10-year progression of periodontal disease of Type 1 diabetic and nondiabetic control subjects, and characterize the periodontal microflora and immune response within these populations. The overall goals of this proposal are to assess the impact of periodontal risk factors (diabetes, smoking, age of onset, elevated glucose, etc.) on disease progression microbiotas and immune responses. Additionally we plan to explore the interrelationships between periodontal infections and the incidence of coronary artery disease complications in this high-risk population. Because we have 10-year baseline periodontal disease data, we will be able to determine not only the prevalence, but also the incidence and site-specific progression of periodontal disease within this adult Type 1 diabetic cohort and an age-matched nondiabetic control group. In collaboration with the microbiology laboratory at Forsyth Dental Institute, we will be able to identify and quantify the gingival and periodontal microflora found within healthy and diseased sites of these populations. The impact of diabetic glycemic control (GhbA1, GhbA1-months, elevated fasting blood glucose) as well as salivary and GCF glucose concentrations will also be evaluated. The integration of this 10-year follow-up periodontal, microbiologic and immunologic assessment by the University of Pittsburgh's Oral Health Science Institute (OHSI) into this ongoing medical epidemiologic study (EDC) has several scientific and methodological benefits. The availability of a large Type 1 population having 10 years of baseline periodontal and medical data is a valuable asset. This inter-institutional collaboration has demonstrated reliable examination methodologies as well as the ability to share data management and statistical resources. An integrated multidisciplinary effort provides significant data collection capabilities essential for understanding the complex multifactorial etiology of periodontal disease in Type 1 diabetes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DIVERSITY

MOLECULAR

ANALYSIS

OF

SUBGINGIVAL

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Principal Investigator & Institution: Relman, David A.; Assistant Professor; Medicine; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2004 Summary: (Adapted from the Investigator's Abstract): Bacteria are the primary cause of plaque-associated gingivitis and chronic adult periodontitis. It is unclear, however, whether the microorganisms responsible for gingivitis also contribute to the development of adult periodontitis or whether a unique assemblage of microorganisms is responsible for periodontitis. Studies indicate that plaque-associated gingivitis progresses to chronic adult periodontitis in only a subset of individuals. Previous work on this topic has been hampered by the limitations of cultivation-based methods, taxonomic inconsistencies, insufficient microbial characterization and inter-patient heterogeneity. The proposed work relies upon sensitive molecular methods to identify predictive associations between specific bacterial and archaeal species and the onset of adult periodontitis. The short-term objectives are to determine the subgingival microbial markers of gingival health, plaque-associated gingivitis and chronic adult periodontitis. The long-term objectives are to understand oral microbial ecology, to determine its relationship with local and systemic disease, and by so doing, to identify healthy individuals with increased risk of disease who would benefit from early intervention. The Specific Aims of this proposal are: Aim 1. Identify the bacterial and archaeal species within subgingival plaque from healthy sites in periodontitis patients. Phylogenetic analysis of 16S ribosomal DNA sequences and high density DNA microarrays will be used to identify the microbial species composition of subgingival plaque. Aim 2. Identify the bacteria and archaea from plaque-associated gingivitis and chronic adult periodontitis sites using the approach in Aim 1. Aim 3. Quantify differences in bacterial and archaeal contribution to the total microbial population within subgingival plaque associated with healthy gingiva, plaque-associated gingivitis and chronic adult periodontitis. Slot-blot and in situ hybridization methods will be applied with groupand species-specific 16S rDNA probes. Targeted organisms will include those implicated in the development of disease from the work in the above aims. Among the expected long-term benefits of this work will be the identification of organisms that can serve as predictors of intra-oral health and disease, and the development of broadly useful DNA microarray for microbial surveys and diagnostic studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEWLY IDENTIFIED ANTIGENS FOR GAMMA/DELTA T CELLS Principal Investigator & Institution: Bukowski, Jack F.; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 01-AUG-1998; Project End 31-JUL-2002 Summary: (Adapted from Investigator's abstract): It is becoming evident that gamma/delta (gd) T cells play an important role in defense against bacterial and viral infections as well as in autoimmunity. gd T cells are expanded in humans with infectious diseases such as tuberculosis, salmonellosis, brucellosis, ehlichiosis, tularemia, malaria, leishmaniasis, mononucleosis, and in HIV (early stages). They are expanded in the synovium of patients with sarcoidosis. In contrast to alpha/beta (ab) T cells, which recognize peptide antigens in the context of MHC molecules, the predominant subset of gd T cells in human peripheral blood, termed Vg2Vd2 T cells, having no homologue in rodents, recognize unprocessed nonpeptide phosphate antigens in the absence of

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professional APC or known antigen presenting molecules. Abundant data describing in detail the interactions of the ab TCR with MHC-bound peptide have deepened our understanding of their role in infectious disease and in autoimmunity. In contrast, there is little information regarding the nature of interaction between the gd TCRs and their ligands. In fact, the identities of most microbial and autoimmune antigens reactive with gd T cells is unknown. Preliminary evidence in the investigator's laboratory shows that the TCR g junctional region is of crucial importance for the recognition of phosphate antigens by Vg2Vd2 T cells, arguing against a superantigen-like recognition of such antigens. The laboratory recently has found that alkylamines, which are major products of certain bacteria that cause gingivitis and many other diseases and are also found in plant foods and human body fluids, cause proliferation of Vg2Vd2 T cells in a TCRspecific manner. Alkylamine antigens are the first phosphate-free antigens described for Vg2Vd2 T cells and thus represent a distinct chemical class of ligand for Vg2Vd2 T cells. The investigator proposes to 1) Define the structural characteristics necessary for bioactivity of alkylamine antigens by testing a panel of naturally occurring alkylamine antigens for reactivity to gd T cells; 2) Identify specific domains and residues in the gd TCR important for recognition of alkylamine and phosphate antigens; 3) Determine the requirements of alkylamine antigens for antigen presentation and processing; 4) Define the phenotypes and alkylamine antigen reactivities of gingival gd T cells from patients with chronic gingivitis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NON-TOXIC ANTIMICROBIAL RINSE FOR GINGIVITIS Principal Investigator & Institution: Bhatt, Bakul M.; Biomedical Development Corporation 500 Sandau, Ste 200 San Antonio, Tx 78216 Timing: Fiscal Year 2003; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: (provided by applicant): The overall goal of this proposal is to develop Iocide(r), a unique non-toxic, non-staining mouthrinse to treat gingivitis. Antimicrobial mouthrinses are valuable supplements to normal oral hygiene procedures and have demonstrated their ability to control plaque formation and prevent the onset of early periodontal disease. However, currently available antimicrobial rinses are either indicated only for short term use or demonstrate ineffective microbicidal activity. Chlorhexidine is the most effective antimicrobial mouthrinse available, but due to its side effects can only be used in acute settings. Other available animicrobial mouthrinses can be used over longer periods of time but are less effective than chlorhexidine in reducing oral bacteria. The Specific Aims of this grant are to 1) Optimize the Iocide(r) oral rinse formulation for use in the oral cavity, 2) Evaluate the safety profile in animals, and 3) Demonstrate its safety and efficacy in human clinical trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NOVEL ANTIOXIDANTS FOR PERIODONTAL DISEASE Principal Investigator & Institution: Szabo, Csaba; Vice President for Research; Inotek Pharmaceuticals Corporation 100 Cummings Ctr, Ste 419E Beverly, Ma 01915 Timing: Fiscal Year 2003; Project Start 15-SEP-2000; Project End 30-JUN-2005 Summary: (provided by the applicant) The current application represents the first revision of a Phase 2 continuation of the Phase I NIH SBIR Grant 1 R43 DE13625 entitled "A novel agent for the therapy of gingivitis". The applicants are leaders in the research and preclinical development of novel, nitric oxide based innovative technologies for the development of periodontal disease. In the Phase I application, we have presented

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evidence that selenoethylguanidine (SEG) is a promising nitric oxide synthase (NOS) inhibitor with selectivity for the inducible nitric oxide synthase isoform (iNOS), and with an increased free radical scavenger activity, and proposed to perform pre-clinical studies in the rat to demonstrate its efficacy in gingivitis. The studies performed in the Phase I studies confirmed iNOS expression and peroxynitrite generation in periodontitis, and demonstrated the potent anti-inflammatory effects of SEG in a rat model of ligature-induced periodontitis. Further, we have demonstrated marked efficacy in the same experimental model with FP15, a novel peroxynitritie decomposition catalyst, and with PJ34, an inhibitor of the multifunctional nuclear enzyme poly(ADP-ribose) polymerase. These additional strategies specifically target NO-related downstream inflammatory pathways of periodontal inflammatory disease. In the current application, we propose to perform pre-clinical studies with SEG, FP15 and PJ34 in order to develop a lead candidate as treatments for gingivitis/periodontitis. The specific aims of the present proposal are to synthesize large quantities of the three test compounds, and perform studies in beagle dog models of gingivitis and periodontitis in order to obtain definitive proof of principle that the agents can reduce the tissue injury and inflammation. Based on the efficacy and safety data, a lead agent will be selected for further development for the experimental therapy of gingivitis and periodontitis. Additional aims of the current submission are to complete the pre-clinical pharmaceutical testing (GMP synthesis, advanced formulation, stability, and local irritation tests), to reach the stage of investigational drug application to the FDA. Throughout the work, Inotek Corporation collaborates with scientists at the University of North Carolina, a leading group in the experimental therapy of periodontal inflammation, as well as with leading contract research organizations to conduct GMP synthesis, formulation work and GLP animal safety testing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ORAL ANTIMICROBIAL PEPTIDES IN HEALTH AND DISEASE Principal Investigator & Institution: Dale-Crunk, Beverly A.; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2004 Summary: Children have excellent defenses against oral infections. They lose deciduous teeth and erupt permanent teeth without infections and rarely get periodontal disease even in the presence of plaque. This project will investigate the role without infections and rarely get periodontal disease even in the presence of plaque. This project will investigate the role of beta- defensins, a newly recognized family of small, cationic peptides with anti- microbial activity, in oral health and disease susceptibility. Oral epithelia are constantly exposed to microbial challenges that lead to bacterially induced gingivitis, periodontal diseases and other infections. Recent findings show that mucosal epithelial cells, including gingival epithelial are the source of beta-defensins. These peptides are predicted to function as a first line of host defense against microbial pathogens and are now recognized as part of the innate or non-adaptive hot defense system. Two beta-defensin peptides, hBD-1 and hBD-2, are expressed and differentially regulated in gingival epithelial cells. This proposal is based on the hypotheses that (1) beta- defensin peptides produced by oral epithelial cells play an important role in determining the outcome of the host pathogen interaction at the oral mucosal barrier, (2) these peptides may be important in the normal protective function of the oral mucosa during development, and (3) variation in individual expression of these peptides may be a contributing factor to susceptibility to specific oral disorders in children and adults. These peptides have future potential for prevention and treatment of oral microbial

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disorders, including periodontal disease, caries, recurrent candidal infections, and oral mucositis. The goals of this study encompass basic investigations and applied studies. We seek to understand the regulation of beta-defensin mRNA expression emphasizing epithelial differentiation and cell signaling pathways for expression upon stimulation by examples of commensal and pathogenic organisms, and by a two-component biofilm; to explore the relationship of beta-defensin expression and that of inflammatory cytokines; to determine beta-defensin expression in non- invasively collected oral samples from children, and to explore variation in defensin expression as a function of age and to test the hypothesis that defensin expression has correlated with oral health status in test populations in collaboration with other Comprehensive Center investigators. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ORAL MICROBIAL ASSOCIATIONS IN HIV+SUBJECTS Principal Investigator & Institution: Paster, Bruce J.; Senior Member of Staff; Forsyth Institute Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant): The broad objectives of this proposal are to examine the hypothesis that the more common periodontal infections in HIV+ subjects are caused by specific bacterial or fungal species, which are not necessarily the typical putative periodontal pathogens usually found in comparable periodontal infections in HIV negative subjects. Our preliminary data indicated that HIV+ subjects with necrotizing ulcerative periodontitis (NUP), a more severe periodontal disease unique to these individuals, indeed lacked many of the classical periodontal pathogens, but instead possessed "unusual" taxa, such as Bulleidia extructa and Dialister pneumosintes, and novel "uncultivable" phylotypes of the genera Dialister, Peptostreptococcus, Selenomonas, and members of the "uncultivable" phylum TM7. Our objectives are addressed in two Specific Aims. Aim 1 will identify the predominant cultivable and notyet-cultivated bacteria and fungi that are associated with periodontal infections in HIV+ subjects, such as gingivitis, low/moderate and severe adult periodontitis, and Linear Gingival Erythema (LGE), another periodontal infection unique to HIV+ subjects. These studies will be performed by analyzing bacterial 16S rRNA and fungal 18S rRNA gene sequences of inserts in clones from plaque libraries. The libraries will be generated by PCR amplification of rRNA genes present in subgingival plaque followed by ligation of the amplicons into appropriate vectors and by transformation of E. coli. The sequence of each clone will be used to determine species identity, or if unknown, its phylogenetic position. It is anticipated that 25 to 50 additional new taxa will be identified. Aim 2 will test the hypothesis that specific bacterial and fungal species are associated with periodontal infections with the deterioration of immune status in HIV+ patients. In each periodontal disease category, 25 subjects with high viral loads and low CD4 levels and 25 subjects with low viral load and high CD4 levels will be analyzed. Comparisons of subgingival microbial and fungal populations will be made between these HIV+ groups vs. control groups of HIV negative subjects. Up to 200 predominant bacterial species will be assayed for each sample using Checkerboard hybridization, which allows for the simultaneous analysis of multiple samples with multiple probes. Up to 30 fungal species will be assayed for each sample in a second, separate checkerboard hybridization. It is likely that specific bacterial complexes (e.g., specific combinations of bacteria/fungi) are associated with these periodontal diseases and may change with the severity of HIV infection. The proposed studies may provide insight for the identity of putative pathogens in comparable periodontal infections in HIV negative individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ORAL TRANSMISSION OF A FLUORESCENT SIV Principal Investigator & Institution: Sodora, Donald L.; Assistant Professor; Internal Medicine; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2001; Project Start 01-FEB-1999; Project End 31-JAN-2004 Summary: Oral transmission of HIV is one of the factors fueling the current AIDS pandemic. Here we utilize the simian immunodeficiency virus (SIV)/macaque AIDS animal model to investigate the early events following oral transmission. We hypothesize that the very early events in mucosal transmission are crucial to determining whether or not an infection occurs. By investigating these earliest events, a clear picture will emerge as to how infection via the oral route occurs and why a successful HIV/SIV infection is only observed after some oral inoculations. A fluorescently labeled SIV (SIVmac239gfp) will be used to enable us to identify the cell infected very early after the virus inoculation (Aim 2). Low doses of virus will be used to assess the role of an inflamed gingivitis mucosa in SIV transmission (Aim 2). The role of gingivitis will be assessed in juvenile macaques and the role of inflamed gums associated with the cutting of teeth will be assessed in infants. Transient infections represent an important disease outcome in which the virus is detected several weeks post-inoculation but can not be detected at later time points. We will investigate both virologic and immunologic aspects of transient infections (Aim 3). This study will include an assessment of the number of SIV responsive T-cells in macaques utilizing a new assay developed by Dr. Louis Picket at the University of Texas Southwestern Medical Center. PBMC's will be obtained from SIV vaccinated, SIV infected and uninfected macaques and assessed for the ability to produce cytokines in the presence of SIV antigens through a flow cytometric analysis. In total these studies are designed to assess the entry of virus via the oral mucosa, follow the virus as it disseminates throughout the macaque and to assess the factors which influence a successful or abortive oral transmission. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ORAL TREPONEMES IN PERIODONTAL DISEASES Principal Investigator & Institution: Ebersole, Jeffrey L.; Director; Oral Health Practice; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2001; Project Start 30-SEP-1994; Project End 30-APR-2003 Summary: (adapted from the Investigator's abstract): There is a growing awareness that oral treponemes play a role in the progression from health to periodontitis. Despite the interest in the relationship of this genus to periodontitis, only a few Treponema spp. have been isolated and grown. Substantial literature has implicated Treponema denticola as an oral pathogen: however, few investigations have examined other species. These investigators have discovered that the predominant cultivable oral spirochete in subgingival These investigators propose to investigate T. pectinovorum virulence components and its potential contribution to the tissue and cellular destruction observed vitro and in vivo models which have been developed during the initial phases of the grant. The hypothesis to be tested is that T. pectinovorum is a major this organism presents unique outer membrane proteins and an LPS-like molecule distinctive from other oral treponemes, the hypothesis to be tested is that the 42 kDa major outer membrane protein (MompA) and the LPS like molecule (LPSL) have characteristics of virulence components in in vitro and in vivo models of disease. Successful testing of these hypotheses would imply that T. pectinovorum utilizes these components in subgingival plaque ecology to contribute to the soft tissue destructive and bone

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resorptive manifestations of functions of the 42 kDa major outer membrane protein (MompA) of T. pectinovorum including i) cloning and sequencing the MompA gene, ii) developing Abs to localize the molecule and determine its distribution among T. pectinovorum isolates, and iii) determining functional characteristics of MompA including its role as an adhesin for epithelial cells and fibroblasts, its activity as a ligand in eliciting host cell cytokine responses, and determination of its antigens capacity in a murine model. A highly innovative aspect of these studies will investigate variations in binding and effects on host cell functions following interaction of T. pectinovorum with fibroblasts derived from normal and HIV-infected individuals; 2) To isolate and characterize the LPSL molecule from T. pectinovorum including: i) biochemical characterization of the LPSL, ii) determining the endotoxic activity in vitro and in vivo, and iii) examining its biological functions in vitro and in vivo; and 3) To evaluate the presence and level of T. pectinovorum in human plaque samples using molecular and immunologic probes, including i) species-specific probes for T. pectinovorum and other oral treponemes, ii)MompA probes: iii) intragenic probes for T. pectinovorum; iv) Antibody to the MompA, and v) Ab to the LPSL. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PERIODONTITIS AND SYSTEMIC DISEASE: CONFOUNDING? Principal Investigator & Institution: Hujoel, Philippe P.; Professor; Dental Public Health Sciences; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 30-JUN-2004 Summary: Periodontitis has been associated with systemic diseases such as cardiovascular disease and low birth weight. Establishing the causality of these associations is difficult; the compared groups, individuals with and without periodontitis, may differ on factors other than periodontitis. If these other factors are causally related to systemic disease risk, confounding may be present. The primary goal of this R03 proposal is to provide a methodological study of confounding by means of different approaches. This methodological work will be performed in three large databases: the First National Health & Nutrition Examination Survey (NHANES I) (n=31,973), the NHANES I Epidemiological Follow-up Study (NHEFS) (n=11,348), and the Third National Health & Nutrition Examination Survey (NHANES III) (n=30,818). Exhaustive information regarding most potentially confounding variables is present in these datasets (greater than 1000 variables per individual). Preliminary analyses of the NHANES I and NHEFS suggest that confounding is a significant methodological challenge. Periodontitis was associated with unexpected differences that may in and of itself cause other systemic diseases. Individuals with periodontitis, after adjustment for age and gender, were more likely to have an unhealthy diet (less fruit, less vitamin C, less riboflavin, and less linoleic acid), were more likely to have suffered a nervous breakdown, less likely to exercise, more likely to be overweight, and more likely to have high blood pressure. In addition, after adjustment for known risk factors, periodontitis was associated with a two-fold increase in lung cancer mortality, an unexpected finding that suggests that confounding may have a strong influence. The aims of this study are: 1) to provide a systematic evaluation of potentially confounding variables in NHANES I and NHANES III; 2) to provide a systematic evaluation of the association between periodontitis and the most common causes of mortality in NHEFS, 3) to assess the benefits of using alternate referent or unexposed groups in cohort studies in NHEFS; and 4) to perform a series of sensitivity analyses to assess the extent to which confounding variables may cause spurious associations. The investigators believe the completion of these projects may play a pivotal role in determining whether the

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previously observed associations between periodontitis and systemic diseases are spurious or causal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RAGE AND MECHANISMS OF VASCULAR AND MONOCYTE DYSFUNCTION Principal Investigator & Institution: Schmidt, Ann M.; Professor; Physiology/Cellualr Biophysics; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2003; Project Start 01-FEB-1999; Project End 31-JAN-2004 Summary: Sustained endothelial and mononuclear phagocyte dysfunction is critical to the pathogenesis of chronic vascular disorders. Non-enzymatic glycoxidation of proteins and lipids forming Advanced Glycation Endproducts (AGEs) in the vasculature and tissues is accelerated in atherosclerosis, diabetes and renal failure. Interaction of AGES with Receptor for AGE (RAGE) on endothelium and monocytes perturbs cellular properties critical to vascular and tissue homeostatic processes, and causes chronic cellular activation. The central hypothesis of the Program Project is that AGE-RAGEmediated modulation of endothelial and monocyte functions compromises physiologic effector mechanisms and eventuates in aggressive atherosclerosis, delayed wound repair, and impaired resolution of local inflammation. Employing glucose intolerance as the stimulus for enhanced AGE formation, our pilot studies have shown that antagonism of AGE-RAGE interaction suppresses accelerated atherosclerosis, ameliorates wound healing and diminishes inflammatory consequences of soft tissue infection. Project 1 will exploit our recently developed murine model of accelerated atherosclerosis associated with glucose intolerance to probe the role of RAGE in rapid formation of vascular lesions. Project 2 will extend our concept to a secondary intention wound model in insulin- resistant mice in which AGE-RAGE-mediated cellular dysfunction underlies compromised tissues reparative mechanisms. Project 3 will focus on local inflammation/infection in AGE-rich soft tissues using a model of gingivitis triggered by bacterial infection. The overlapping host response mechanisms triggered by atherogenesis, wound repair and local inflammation, the intimate involvement of endothelium and monocytes, as well as the central role of AGE binding to RAGE, provide the basis for close interactions among the three Projects. By collaborative studies between each of the Projects, the contribution of RAGE will be determined using transgenic mice and mutated RAGE molecules. At the end of this Program Project, we expect to have generated new and important information related to vascular and monocyte dysfunction underlying accelerated atherosclerosis, impaired wound healing and the compromised host response to local inflammation common to disorders characterize by tissue deposition of AGEs. These data should provide insight into a novel target for the development of future therapeutic agents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SALIVARY PROTEINS IN DENTAL INTEGUMENTS Principal Investigator & Institution: Oppenheim, Frank G.; Professor and Chair; Periodontology; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2001; Project Start 01-JAN-1983; Project End 31-MAY-2005 Summary: The acquired enamel pellicle is a protein film readily formed on tooth mineral surfaces in the oral environment. It has been established that its formation is driven by the adsorption of proteins and peptides derived from oral fluid. Most of these

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proteins originate from either parotid or submandibular/ sublingual secretions which undergo modifications in the oral cavity before or after adsorption to the hydroxyapatite crystallites of tooth enamel. The composition and the structure of this acquired enamel pellicle are still largely unknown but play functionally a vital role with important physiological/clinical implications. A major thrust of this application is to use state-ofthe-art proteomics to identify and characterize the major components of the in-vivo formed pellicle. Since the pellicle has an inner aspect facing the tooth surface and an outer aspect connected to the bacterial biofilm known as Dental plaque the functions of pellicle are multifaceted and complex. Another major goal is to investigate the protective functions of the pellicle vis-a-vis the maintenance of the mineral phase of enamel and the interplay between molecular entities of the pellicle and those bacteria which constitute the early colonizers of the biofilm forming on the tooth surface. The nature of the pellicle with respect to the early attachment of bacteria including those which are known periodontal pathogens will be studied in vitro and in vivo. The Specific Aims of the project are to: 1) Characterize components from pellicles formed in vivo by a variety of isolation techniques including 2D-electrophoresis followed by proteomic analyses comprising MALDI-TOF MS. LC-ESI MS and LC-MS/MS; 2) Explore the protective functions of the enamel pellicle by determining the affinity of its components to hydroxyapatite, the inhibitory potential of pellicle proteins/peptides of calcium phosphate precipitation from supersaturated solutions, and the capacity to retard demineralization; 3) Determine in vitro binding parameters of individual early pellicle colonizers, assess the role of transglutaminase in pellicle-bacterial interactions and employ biomimetic approaches to modify functional aspects of pellicle components; 4) Investigate with the checkerboard DNA-DNA hybridization assay the in vivo binding of early pellicle colonizers in healthy individuals and gingivitis patients, assess the relative role of exocrine and serum derived proteins/peptides on pellicle colonization in vivo and explore effects of different local environments in the oral cavity on these processes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with gingivitis, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “gingivitis” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for gingivitis (hyperlinks lead to article summaries):

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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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6-month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo. (I). Effect on plaque formation and gingivitis. Author(s): Hase JC, Attstrom R, Edwardsson S, Kelty E, Kisch J. Source: Journal of Clinical Periodontology. 1998 September; 25(9): 746-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9763330&dopt=Abstract

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A 6-month home-usage trial of 0.1% and 0.2% delmopinol mouthwashes (I). Effects on plaque, gingivitis, supragingival calculus and tooth staining. Author(s): Claydon N, Hunter L, Moran J, Wade W, Kelty E, Movert R, Addy M. Source: Journal of Clinical Periodontology. 1996 March; 23(3 Pt 1): 220-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8707981&dopt=Abstract

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A case of prepubertal periodontitis and prevalence of gingivitis in a population attending a university clinic in Rosario, Argentina. Author(s): Funosas E, Martinez A, Maestri L, Siragusa M. Source: Acta Odontol Latinoam. 1999; 12(2): 89-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12905909&dopt=Abstract

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A case report. Treating localized refractory idiopathic gingivitis with Superoxol. Author(s): Meraw SJ, Reeve CM. Source: The Journal of the American Dental Association. 1998 April; 129(4): 470-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9573698&dopt=Abstract

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A clinical methods study of the effects of triclosan dentifrices on gingivitis over six months. Author(s): Winston JL, Bartizek RD, McClanahan SF, Mau MS, Beiswanger BB. Source: J Clin Dent. 2002; 13(6): 240-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12518498&dopt=Abstract

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A comparison of stabilized stannous fluoride dentifrice and triclosan/copolymer dentifrice for efficacy in the reduction of gingivitis and gingival bleeding: six-month clinical results. Author(s): McClanahan SF, Beiswanger BB, Bartizek RD, Lanzalaco AC, Bacca L, White DJ. Source: J Clin Dent. 1997; 8(2 Spec No): 39-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9238872&dopt=Abstract

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A comparison of the efficacy of 2 powered toothbrushes in affecting plaque accumulation, gingivitis, and gingival bleeding. Author(s): Barnes CM, Russell CM, Weatherford TW 3rd. Source: J Periodontol. 1999 August; 70(8): 840-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10476890&dopt=Abstract

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A comparison of the efficacy of a novel electric toothbrush and a manual toothbrush in the treatment of gingivitis. Author(s): van der Weijden FA, Timmerman MF, Piscaer M, IJzerman Y, Warren PR, van der Velden U. Source: Am J Dent. 1998 September; 11(Spec No): S23-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10530096&dopt=Abstract

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A double blind clinical study on the effectiveness of a chlorhexidine containing lozenge (Septofort) in the treatment of chronic gingivitis. Author(s): Gera I, Benedek E, Mezei J. Source: Fogorv Sz. 1997 April; 90 Spec No: 38-47. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9170727&dopt=Abstract

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A method to compare four mouthrinses: time to gingivitis level as the primary outcome variable. Author(s): Yates R, Shearer BH, Huntington E, Addy M. Source: Journal of Clinical Periodontology. 2002 June; 29(6): 519-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296779&dopt=Abstract

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A modification to the experimental gingivitis protocol to compare the antiplaque properties of two toothpastes. Author(s): Yates RJ, Shearer BH, Morgan R, Addy M. Source: Journal of Clinical Periodontology. 2003 February; 30(2): 119-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622853&dopt=Abstract

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A novel closed-tube quantitative--PCR method for enumerating Porphyromonas gingivitis, Prevotella intermedia and Actinobacillus actinomycetemcomitans. Author(s): Doung-udomdacha S, Rawlinson A, Douglas CW. Source: Journal of Periodontal Research. 2000 October; 35(5): 247-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11005152&dopt=Abstract

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A review of plaque, gingivitis, calculus and caries clinical efficacy studies with a fluoride dentifrice containing triclosan and PVM/MA copolymer. Author(s): Volpe AR, Petrone ME, De Vizio W, Davies RM, Proskin HM. Source: J Clin Dent. 1996; 7 Suppl: S1-S14. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9238866&dopt=Abstract

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A short-term brushing model for assessing antiplaque/antigingivitis dentifrice effectiveness: a pilot study. Author(s): Kohut B, Coelho J, Sharma NC, Galustians J, Proskin HM. Source: J Clin Dent. 1999; 10(4): 119-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10825859&dopt=Abstract

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A split-mouth comparison of a three-dimensional-action electric toothbrush and a high-frequency electric toothbrush for reducing plaque and gingivitis. Author(s): Putt MS, Milleman JL, Davidson KR, Kleber CJ, Cugini M. Source: J Int Acad Periodontol. 2001 October; 3(4): 95-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666948&dopt=Abstract

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A study of antitrypsin and macroglobulin levels in serum and saliva of patients with gingivitis. Author(s): Rao RN, Balamuralikrishnan K, Vasantkumar A, Karanth KS, Bhat MK, Aroor AR. Source: Indian J Dent Res. 1995 April-June; 6(2): 41-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9495108&dopt=Abstract

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Activities of lysozyme and salivary peroxidase in unstimulated whole saliva in relation to plaque and gingivitis scores in healthy young males. Author(s): Rosin M, Hanschke M, Splieth C, Kramer A. Source: Clinical Oral Investigations. 1999 September; 3(3): 133-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10803124&dopt=Abstract

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Acute necrotising ulcerative gingivitis epidemic. Author(s): Cohen TL. Source: Sadj. 2002 December; 57(11): 494. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12674872&dopt=Abstract

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Acute necrotizing ulcerative gingivitis: risk factors involving host defense mechanisms. Author(s): Murayama Y, Kurihara H, Nagai A, Dompkowski D, Van Dyke TE. Source: Periodontology 2000. 1994 October; 6: 116-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9673175&dopt=Abstract

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Acute necrotizing ulcerative gingivitis-periodontitis: a literature review. Author(s): Wade DN, Kerns DG. Source: Military Medicine. 1998 May; 163(5): 337-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9597852&dopt=Abstract

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Advances in home therapy for gingivitis--revolution or evolution? Author(s): Hill M, Moore RL. Source: Pract Periodontics Aesthet Dent. 1997 November-December; 9(9 Suppl): 2-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9573828&dopt=Abstract

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An evaluation of a commercial chewing gum in combination with normal toothbrushing for reducing dental plaque and gingivitis. Author(s): Sharma NC, Galustians JH, Qaqish JG. Source: Compend Contin Educ Dent. 2001 July; 22(7A): 13-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11913304&dopt=Abstract

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An evaluation of sodium bicarbonate chewing gum in reducing dental plaque and gingivitis in conjunction with regular toothbrushing. Author(s): Kleber CJ, Putt MS, Milleman JL, Davidson KR, Proskin HM. Source: Compend Contin Educ Dent. 2001 July; 22(7A): 4-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11913310&dopt=Abstract

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An investigation of the efficacy and safety of a new electric interdental plaque remover for the reduction of interproximal plaque and gingivitis. Author(s): Cronin M, Dembling W. Source: J Clin Dent. 1996; 7(3 Spec No): 74-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9238869&dopt=Abstract

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Analysis of desquamative gingivitis using direct immunofluorescence in conjunction with histology. Author(s): Yih WY, Maier T, Kratochvil FJ, Zieper MB. Source: J Periodontol. 1998 June; 69(6): 678-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9660337&dopt=Abstract

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Antiplaque and antigingivitis effectiveness of a hexetidine mouthwash. Author(s): Sharma NC, Galustians HJ, Qaqish J, Charles CH, Vincent JW, McGuire JA. Source: Journal of Clinical Periodontology. 2003 July; 30(7): 590-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834495&dopt=Abstract

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Association of oral spirochetes from periodontally healthy sites with development of gingivitis. Author(s): Riviere GR, DeRouen TA. Source: J Periodontol. 1998 April; 69(4): 496-501. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9609381&dopt=Abstract

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Benign mucous membrane pemphigoid presenting as desquamative gingivitis in a 14-year-old child. Author(s): Roche C, Field EA. Source: International Journal of Paediatric Dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children. 1997 March; 7(1): 31-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9524469&dopt=Abstract

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Campylobacter species in health, gingivitis, and periodontitis. Author(s): Macuch PJ, Tanner AC. Source: Journal of Dental Research. 2000 February; 79(2): 785-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10728981&dopt=Abstract

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Case report: plasma cell gingivitis A. Author(s): Gargiulo AV, Ladone JA, Ladone PA, Toto PD. Source: Cds Rev. 1995 April; 88(3): 22-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9528423&dopt=Abstract

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Case reports. 4. Desquamative gingivitis. Author(s): Konzelman JL Jr, Herman WW, Whitaker SB. Source: Compend Contin Educ Dent. 1997; 18(2 Spec No): 60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090079&dopt=Abstract

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CD30+ lymphocytes in chronic gingivitis from HIV-positive patients: a pilot study. Author(s): Gomez RS, de Souza PE, da Costa JE, Araujo NS. Source: J Periodontol. 1997 September; 68(9): 881-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9379333&dopt=Abstract

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Chemiluminescent assay of alkaline phosphatase in human gingival crevicular fluid: investigations with an experimental gingivitis model and studies on the source of the enzyme within crevicular fluid. Author(s): Chapple IL, Socransky SS, Dibart S, Glenwright HD, Matthews JB. Source: Journal of Clinical Periodontology. 1996 June; 23(6): 587-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8811480&dopt=Abstract

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Chlorhexidine varnishes prevent gingivitis in adolescents. Author(s): Bretz WA, Valente MI, Djahjah C, do Valle EV, Weyant RJ, Nor JE. Source: Asdc J Dent Child. 2000 November-December; 67(6): 399-402, 374. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11204062&dopt=Abstract

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Chronic gingival erythema and tenderness. Foreign body gingivitis. Author(s): Damm DD, Fantasia JE. Source: Gen Dent. 2001 November-December; 49(6): 574, 658. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12024744&dopt=Abstract

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Clinical and microbial evaluation of a histatin-containing mouthrinse in humans with experimental gingivitis. Author(s): Mickels N, McManus C, Massaro J, Friden P, Braman V, D'Agostino R, Oppenheim F, Warbington M, Dibart S, Van Dyke T. Source: Journal of Clinical Periodontology. 2001 May; 28(5): 404-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11350502&dopt=Abstract

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Clinical and microbial evaluation of a histatin-containing mouthrinse in humans with experimental gingivitis: a phase-2 multi-center study. Author(s): Van Dyke T, Paquette D, Grossi S, Braman V, Massaro J, D'Agostino R, Dibart S, Friden P. Source: Journal of Clinical Periodontology. 2002 February; 29(2): 168-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11895545&dopt=Abstract

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Clinical and microbiological findings in elderly subjects with gingivitis or periodontitis. Author(s): Schlegel-Bregenzer B, Persson RE, Lukehart S, Braham P, Oswald T, Persson GR. Source: Journal of Clinical Periodontology. 1998 November; 25(11 Pt 1): 897-907. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9846799&dopt=Abstract

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Clinical controlled study on plaque and gingivitis reduction under long-term use of low-dose chlorhexidine solutions in a population exhibiting good oral hygiene. Author(s): Hoffmann T, Bruhn G, Richter S, Netuschil L, Brecx M. Source: Clinical Oral Investigations. 2001 June; 5(2): 89-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11480815&dopt=Abstract

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Clinical effect of a Mexican sanguinaria extract (Polygonum aviculare L.) on gingivitis. Author(s): Gonzalez Begne M, Yslas N, Reyes E, Quiroz V, Santana J, Jimenez G. Source: Journal of Ethnopharmacology. 2001 January; 74(1): 45-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11137347&dopt=Abstract

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Clinical effect of a new liquid dentifrice containing triclosan/copolymer on existing plaque and gingivitis. Author(s): Triratana T, Rustogi KN, Volpe AR, DeVizio W, Petrone M, Giniger M. Source: The Journal of the American Dental Association. 2002 February; 133(2): 219-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11868841&dopt=Abstract

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Clinical efficacy of an optimized stannous fluoride dentifrice, Part 2: A 6-month plaque/gingivitis clinical study, northeast USA. Author(s): Mankodi S, Petrone DM, Battista G, Petrone ME, Chaknis P, DeVizio W, Volpe AR, Proskin HM. Source: Compend Contin Educ Dent. 1997 Winter; 18 Spec No: 10-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12206029&dopt=Abstract

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Clinical efficacy of an optimized stannous fluoride dentifrice, Part 3: A 6-month plaque/gingivitis clinical study, southeast USA. Author(s): Williams C, McBride S, Bolden TE, Mostler K, Petrone DM, Petrone ME, Chaknis P, DeVizio W, Volpe AR, Proskin HM. Source: Compend Contin Educ Dent. 1997 Winter; 18 Spec No: 16-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12206030&dopt=Abstract

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Clinical evaluation of an ionic toothbrush in the removal of established plaque and reduction of gingivitis. Author(s): Van Swol RL, Van Scotter DE, Pucher JJ, Dentino AR. Source: Quintessence Int. 1996 June; 27(6): 389-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8941832&dopt=Abstract

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Clinical studies for evaluation of chemotherapeutic agents for control of plaque and gingivitis. Author(s): Khocht A. Source: J N J Dent Assoc. 1994 Spring; 65(2): 15-8, 20-1. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9520711&dopt=Abstract

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Clinical, microbiological and immunological profile of healthy, gingivitis and putative active periodontal subjects. Author(s): Tanner A, Kent R, Maiden MF, Taubman MA. Source: Journal of Periodontal Research. 1996 April; 31(3): 195-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8814590&dopt=Abstract

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Comparative effectiveness of an essential oil mouthrinse and dental floss in controlling interproximal gingivitis and plaque. Author(s): Sharma NC, Charles CH, Qaqish JG, Galustians HJ, Zhao Q, Kumar LD. Source: Am J Dent. 2002 December; 15(6): 351-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691269&dopt=Abstract

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Comparative efficacy of an antiseptic mouthrinse and an antiplaque/antigingivitis dentifrice. A six-month clinical trial. Author(s): Charles CH, Sharma NC, Galustians HJ, Qaqish J, McGuire JA, Vincent JW. Source: The Journal of the American Dental Association. 2001 May; 132(5): 670-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11367972&dopt=Abstract

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Comparative efficacy of Colgate Actibrush battery-powered toothbrush and Colgate Plus (manual) toothbrush on established plaque and gingivitis: a 30-day clinical study in New Jersey. Author(s): Sowinski JA, Battista GW, Petrone DM, Petrone ME, Rustogi KN, Chaknis P, DeVizio W, Volpe AR; American Dental Association. Source: Compend Contin Educ Dent Suppl. 2000; (31): S4-8; Quiz S34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11908374&dopt=Abstract

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Comparative efficacy of the Colgate Actibrush battery-powered toothbrush vs Oral-B CrossAction toothbrush on established plaque and gingivitis: a 6-week clinical study. Author(s): Nathoo S, Rustogi KN, Petrone ME, DeVizio W, Zhang YP, Volpe AR, Proskin HM. Source: Compend Contin Educ Dent Suppl. 2000; (31): S19-24; Quiz S35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11908371&dopt=Abstract

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Comparative efficacy on supragingival plaque and gingivitis of a manual toothbrush (Colgate Plus) and a battery-powered toothbrush (Colgate Actibrush) over a 30-day period. Author(s): Sharma N, Galustians HJ, Qaqish JG, Rustogi KN, Petrone ME, Volpe AR. Source: Compend Contin Educ Dent Suppl. 2000; (31): S9-13; Quiz S34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11908375&dopt=Abstract

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Comparative study of plaque and gingivitis prevention by AmF/SnF2 and NaF. A clinical and microbiological 9-month study. Author(s): Mengel R, Wissing E, Schmitz-Habben A, Flores-de-Jacoby L. Source: Journal of Clinical Periodontology. 1996 April; 23(4): 372-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8739170&dopt=Abstract

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Comparing measures of reliability for indices of gingivitis and plaque. Author(s): Spolsky VW, Gornbein JA. Source: J Periodontol. 1996 September; 67(9): 853-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8884641&dopt=Abstract

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Comparison of 5 protocols based on their abilities to use data extracted from digitized clinical radiographs to discriminate between patients with gingivitis and periodontitis. Author(s): Shrout MK, Hildebolt CF, Potter BJ, Comer RW. Source: J Periodontol. 2000 November; 71(11): 1750-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11128924&dopt=Abstract

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Comparison of a sonic and a manual toothbrush for efficacy in supragingival plaque removal and reduction of gingivitis. Author(s): Tritten CB, Armitage GC. Source: Journal of Clinical Periodontology. 1996 July; 23(7): 641-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8841896&dopt=Abstract

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Comparison of gingivitis and plaque efficacy of a battery-powered toothbrush and an ADA-provided manual toothbrush. Author(s): Soparkar PM, Rustogi KN, Petrone ME, Volpe AR; American Dental Association. Source: Compend Contin Educ Dent Suppl. 2000; (31): S14-8; Quiz S34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11908370&dopt=Abstract

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Comparison of the bleeding on marginal probing index and the Eastman interdental bleeding index as indicators of gingivitis. Author(s): Barendregt DS, Timmerman MF, van der Velden U, van der Weijden GA. Source: Journal of Clinical Periodontology. 2002 March; 29(3): 195-200. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11940136&dopt=Abstract

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Comparison of two dentifrices with respect to efficacy for the control of plaque and gingivitis, and with respect to extrinsic tooth staining: a six-month clinical study on adults. Author(s): Mankodi S, Lopez M, Smith I, Petrone DM, Petrone ME, Chaknis P, Proskin HM. Source: J Clin Dent. 2002; 13(6): 228-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12518496&dopt=Abstract

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Concentration of interleukin-1beta and neutrophil elastase activity in gingival crevicular fluid during experimental gingivitis. Author(s): Gonzales JR, Herrmann JM, Boedeker RH, Francz PI, Biesalski H, Meyle J. Source: Journal of Clinical Periodontology. 2001 June; 28(6): 544-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11350521&dopt=Abstract

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Crevicular fluid levels of interleukin-1alpha and interleukin-1beta during experimental gingivitis in young and old adults. Author(s): Tsalikis L, Parapanisiou E, Bata-Kyrkou A, Polymenides Z, Konstantinidis A. Source: J Int Acad Periodontol. 2002 January; 4(1): 5-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670080&dopt=Abstract

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Demography and seasonal variation of acute necrotising gingivitis in Nairobi, Kenya. Author(s): Kaimenyi JT. Source: Int Dent J. 1999 December; 49(6): 347-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10907433&dopt=Abstract

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Gingivitis

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Dental caries and gingivitis in schoolchildren from the municipality of Porto Alegre, Brazil in 1975 and 1996. Author(s): Maltz M, Schoenardie AB, Carvalho JC. Source: Clinical Oral Investigations. 2001 September; 5(3): 199-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11642566&dopt=Abstract

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Desquamative gingivitis and balanitis--linear IgA disease or cicatricial pemphigoid? Author(s): Kirtschig G, Mengel R, Mittag H, Flores-De-Jacoby L, Happle R. Source: Clinical and Experimental Dermatology. 1998 July; 23(4): 173-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9894362&dopt=Abstract

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Desquamative gingivitis, sole manifestation of tosylamide/formaldehyde resin allergy. Author(s): Staines KS, Felix DH, Forsyth A. Source: Contact Dermatitis. 1998 August; 39(2): 90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9746196&dopt=Abstract

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Desquamative gingivitis. Author(s): Carson-Mann LD. Source: Probe. 1996 January-February; 30(1): 36-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9611444&dopt=Abstract

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Desquamative gingivitis: a clinical, histopathologic, and immunologic study. Author(s): Markopoulos AK, Antoniades D, Papanayotou P, Trigonidis G. Source: Quintessence Int. 1996 November; 27(11): 763-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9161269&dopt=Abstract

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Detection of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 2(PAI-2) in gingival crevicular fluid from healthy, gingivitis and periodontitis patients. Author(s): Yin X, Bunn CL, Bartold PM. Source: Journal of Clinical Periodontology. 2000 March; 27(3): 149-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10743860&dopt=Abstract

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Development of gingivitis around aged restorations of resin-modified glass ionomer cement, polyacid-modified resin composite (compomer) and resin composite. Author(s): van Dijken JW, Sjostrom S. Source: Clinical Oral Investigations. 1998 December; 2(4): 180-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10388391&dopt=Abstract

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Differences in the inflammatory response in young and old human subjects during the course of experimental gingivitis. Author(s): Fransson C, Mooney J, Kinane DF, Berglundh T. Source: Journal of Clinical Periodontology. 1999 July; 26(7): 453-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10412850&dopt=Abstract

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Effect of 3 dentifrices containing triclosan and various additives. An experimental gingivitis study. Author(s): Nogueira-Filho GR, Toledo S, Cury JA. Source: Journal of Clinical Periodontology. 2000 July; 27(7): 494-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10914890&dopt=Abstract

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Effect of a toothpaste containing triclosan on dental plaque, gingivitis, and bleeding on probing--an investigation in periodontitis patients over 28 weeks. Author(s): Bruhn G, Netuschil L, Richter S, Brecx M, Hoffmann T. Source: Clinical Oral Investigations. 2002 June; 6(2): 124-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12166713&dopt=Abstract

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Effect of amine fluoride-stannous fluoride containing toothpaste (Meridol) on plaque and gingivitis in adults: a six-month clinical study. Author(s): Shapira L, Shapira M, Tandlich M, Gedalia I. Source: J Int Acad Periodontol. 1999 October; 1(4): 117-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666956&dopt=Abstract

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Effect of delmopinol hydrochloride mouthrinse on plaque formation and gingivitis in “rapid” and “slow” plaque formers. Author(s): Zee K, Rundegren J, Attstrom R. Source: Journal of Clinical Periodontology. 1997 July; 24(7): 486-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9226389&dopt=Abstract

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Effect of localized experimental gingivitis on early supragingival plaque accumulation. Author(s): Daly CG, Highfield JE. Source: Journal of Clinical Periodontology. 1996 March; 23(3 Pt 1): 160-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8707973&dopt=Abstract

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Effect of social class on the prevalence and severity of necrotising ulcerative gingivitis in Nigerian children. Author(s): Taiwo JO. Source: Afr J Med Med Sci. 1996 December; 25(4): 357-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9532307&dopt=Abstract

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Effect of triclosan dentifrices on mouth volatile sulphur compounds and dental plaque trypsin-like activity during experimental gingivitis development. Author(s): Nogueira-Filho GR, Duarte PM, Toledo S, Tabchoury CP, Cury JA. Source: Journal of Clinical Periodontology. 2002 December; 29(12): 1059-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492904&dopt=Abstract

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Effectiveness of an electrically active brush in the removal of overnight plaque and treatment of gingivitis. Author(s): van der Weijden GA, Timmerman MF, Piscaer M, Snoek I, van der Velden U, Galgut PN. Source: Journal of Clinical Periodontology. 2002 August; 29(8): 699-704. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12390566&dopt=Abstract

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Effectiveness of the Sonicare sonic toothbrush on reduction of plaque, gingivitis, probing pocket depth and subgingival bacteria in adolescent orthodontic patients. Author(s): Ho HP, Niederman R. Source: J Clin Dent. 1997; 8(1 Spec No): 15-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9487840&dopt=Abstract

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Effects of a chewable sodium bicarbonate oral composition on plaque and gingivitis. Author(s): McCombs GB, Green ML, Root J. Source: The Journal of Contemporary Dental Practice [electronic Resource]. 2001 February 15; 2(1): 31-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12167942&dopt=Abstract

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Effects of nonopsonized Escherichia coli on myeloperoxidase activity in medium used for incubation of leukocytes from patients with gingivitis and periodontitis. Author(s): Zekonis J, Zekonis G, Sakalauskiene J. Source: J Nihon Univ Sch Dent. 1997 March; 39(1): 12-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9198330&dopt=Abstract

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Effects of SCN-/H2O2 combinations in dentifrices on plaque and gingivitis. Author(s): Rosin M, Kocher T, Kramer A. Source: Journal of Clinical Periodontology. 2001 March; 28(3): 270-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11284542&dopt=Abstract

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Effects of triclosan/copolymer dentifrice on dental plaque and gingivitis in a 3-month randomized controlled clinical trial: influence of baseline gingivitis on observed efficacy. Author(s): McClanahan SF, Bartizek RD. Source: J Clin Dent. 2002; 13(4): 167-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12116727&dopt=Abstract

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Effects on gingivitis of two different 0.4% SnF2 gels. Author(s): Boyd RL, Leggott PJ, Robertson PB. Source: Journal of Dental Research. 1988 February; 67(2): 503-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11039067&dopt=Abstract

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Efficacy of a 0.5% chlorhexidine gel on the control of gingivitis in Brazilian mentally handicapped patients. Author(s): Pannuti CM, Saraiva MC, Ferraro A, Falsi D, Cai S, Lotufo RF. Source: Journal of Clinical Periodontology. 2003 June; 30(6): 573-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795797&dopt=Abstract

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Efficacy of a 2-phase oil: water mouthrinse in controlling oral malodor, gingivitis, and plaque. Author(s): Kozlovsky A, Goldberg S, Natour I, Rogatky-Gat A, Gelernter I, Rosenberg M. Source: J Periodontol. 1996 June; 67(6): 577-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8794967&dopt=Abstract

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Efficacy of a dentifrice containing zinc citrate for the control of plaque and gingivitis: a 6-month clinical study in adults. Author(s): Williams C, McBride S, Mostler K, Petrone DM, Simone AJ, Crawford R, Patel S, Petrone ME, Chaknis P, DeVizio W, Volpe AR, Proskin HM. Source: Compend Contin Educ Dent. 1998; 19(2 Suppl): 4-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10371876&dopt=Abstract

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Efficacy of a mouthrinse containing 0.05% cetylpyridinium chloride for the control of plaque and gingivitis: a 6-month clinical study in adults. Author(s): Allen DR, Davies R, Bradshaw B, Ellwood R, Simone AJ, Robinson R, Mukerjee C, Petrone ME, Chaknis P, Volpe AR, Proskin HM. Source: Compend Contin Educ Dent. 1998; 19(2 Suppl): 20-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10371878&dopt=Abstract

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Efficacy of a sonic toothbrush in reducing plaque and gingivitis in adolescent patients. Author(s): White LW. Source: J Clin Orthod. 1996 February; 30(2): 85-90. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9063177&dopt=Abstract

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Efficacy of a triclosan/NaF dentifrice in the control of plaque and gingivitis and concurrent oral microflora monitoring. Author(s): Fine DH, Furgang D, Bonta Y, DeVizio W, Volpe AR, Reynolds H, Zambon JJ, Dunford RG. Source: Am J Dent. 1998 December; 11(6): 259-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10477976&dopt=Abstract

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Efficacy of two antiplaque and antigingivitis treatments in a group of young mentally retarded patients. Author(s): Montiel-Company JM, Almerich-Silla JM. Source: Medicina Oral : Organo Oficial De La Sociedad Espanola De Medicina Oral Y De La Academia Iberoamericana De Patologia Y Medicina Bucal. 2002 March-April; 7(2): 136-43. English, Spanish. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11887021&dopt=Abstract

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Electron microscopic study of chronic desquamative gingivitis. Author(s): Nikai H, Rose GG, Cattoni M. Source: J Periodontal Res Suppl. 1971; 6: 1-30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10847728&dopt=Abstract

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Emotional stress effects on immunity, gingivitis and periodontitis. Author(s): Breivik T, Thrane PS, Murison R, Gjermo P. Source: European Journal of Oral Sciences. 1996 August; 104(4 ( Pt 1)): 327-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8930578&dopt=Abstract

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Essential oils in an antiplaque and antigingivitis dentifrice: a 6-month study. Author(s): Coelho J, Kohut BE, Mankodi S, Parikh R, Wu MM. Source: Am J Dent. 2000 September; 13(Spec No): 5C-10C. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763912&dopt=Abstract

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Evaluation of 2 methods to assess gingival bleeding in smokers and non-smokers in natural and experimental gingivitis. Author(s): Lie MA, Timmerman MF, van der Velden U, van der Weijden GA. Source: Journal of Clinical Periodontology. 1998 September; 25(9): 695-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9763323&dopt=Abstract

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Evaluation of an alum containing mouthrinse on plaque and gingivitis inhibition over 2 weeks of supervised use. Author(s): Bihani SN, Damle SG. Source: J Indian Soc Pedod Prev Dent. 1997 March; 15(1): 34-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9522768&dopt=Abstract

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Evaluation of an alum-containing mouthrinse in children for plaque and gingivitis inhibition during 4 weeks of supervised use. Author(s): Putt MS, Kleber CJ, Smith CE. Source: Pediatr Dent. 1996 March-April; 18(2): 139-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8710717&dopt=Abstract

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Evaluation of the safety and efficacy of over-the-counter oral hygiene products for the reduction and control of plaque and gingivitis. Author(s): Wu CD, Savitt ED. Source: Periodontology 2000. 2002; 28: 91-105. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12013351&dopt=Abstract

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Evidence-based control of plaque and gingivitis. Author(s): Santos A. Source: Journal of Clinical Periodontology. 2003; 30 Suppl 5: 13-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787197&dopt=Abstract

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Experimental gingivitis in periodontitis-susceptible subjects. Author(s): Johnson TC, Reinhardt RA, Payne JB, Dyer JK, Patil KD. Source: Journal of Clinical Periodontology. 1997 September; 24(9 Pt 1): 618-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9378832&dopt=Abstract

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Experimental gingivitis in women using oral contraceptives. Author(s): Preshaw PM, Knutsen MA, Mariotti A. Source: Journal of Dental Research. 2001 November; 80(11): 2011-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11759012&dopt=Abstract

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Experimental gingivitis studies: effects of triclosan and triclosan-containing dentifrices on dental plaque and gingivitis in three-week randomized controlled clinical trials. Author(s): Lang NP, Sander L, Barlow A, Brennan K, White DJ, Bacca L, Bartizek RD, McClanahan SF. Source: J Clin Dent. 2002; 13(4): 158-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12116726&dopt=Abstract

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Expression of estrogen receptors in desquamative gingivitis. Author(s): Yih WY, Richardson L, Kratochvil FJ, Avera SP, Zieper MB. Source: J Periodontol. 2000 March; 71(3): 482-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10776938&dopt=Abstract

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Flow cytometry as a new method to quantify the cellular content of human saliva and its relation to gingivitis. Author(s): Aps JK, Van den Maagdenberg K, Delanghe JR, Martens LC. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 2002 July; 321(1-2): 35-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12031590&dopt=Abstract

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Flow-cytometric analysis of T-lymphocyte subsets in sinistral and dextral patients with gingivitis. Author(s): Orbak R, Canakci V, Erciyas K, Kaya H. Source: The International Journal of Neuroscience. 2003 January; 113(1): 1-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690998&dopt=Abstract

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Foreign body gingivitis associated with a new crown: EDX analysis and review of the literature. Author(s): Gordon S. Source: Oper Dent. 2000 July-August; 25(4): 344-8. Review. Erratum In: Oper Dent 2000 September-October; 25(5): 455. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11203841&dopt=Abstract

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Foreign body gingivitis: clinical and microscopic features of 61 cases. Author(s): Gordon SC, Daley TD. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 1997 May; 83(5): 562-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9159816&dopt=Abstract

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Foreign body gingivitis: identification of the foreign material by energy-dispersive xray microanalysis. Author(s): Gordon SC, Daley TD. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 1997 May; 83(5): 571-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9159817&dopt=Abstract

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Gingival crevicular neutrophils: membrane molecules do not distinguish between periodontitis and gingivitis. Author(s): Asman B, Gustafsson A, Bergstrom K. Source: Journal of Clinical Periodontology. 1997 December; 24(12): 927-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9442431&dopt=Abstract

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Gingival crevicular pH in experimental gingivitis and occlusal trauma in man. Author(s): Kobayashi K, Kobayashi K, Soeda W, Watanabe T. Source: J Periodontol. 1998 September; 69(9): 1036-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9776032&dopt=Abstract

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Gingivitis and toothbrushes: potential roles in viridans streptococcal bacteraemia. Author(s): Kennedy HF, Morrison D, Tomlinson D, Gibson BE, Bagg J, Gemmell CG. Source: The Journal of Infection. 2003 January; 46(1): 67-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504614&dopt=Abstract

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Gingivitis artefacta--a case report of a patient undergoing orthodontic treatment. Author(s): Spencer RJ, Haria S, Evans RD. Source: British Journal of Orthodontics. 1999 June; 26(2): 93-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10420242&dopt=Abstract

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Gingivitis in children with malnutrition. Author(s): Abrams RG, Romberg E. Source: J Clin Pediatr Dent. 1999 Spring; 23(3): 189-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10686865&dopt=Abstract

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Gingivitis in the genesis of heart attack and other arteriosclerotic diseases. Author(s): Wehrmacher WH. Source: Dent Today. 2001 November; 20(11): 94-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11715659&dopt=Abstract

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Gingivitis in young adults with Actinobacillus actinomycetemcomitans. Author(s): Muller HP, Heinecke A, Zoller L, Fuhrmann A, Eger T. Source: Clinical Oral Investigations. 2001 June; 5(2): 83-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11480814&dopt=Abstract

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Gingivitis, facial weakness and focal seizures. Author(s): Lee PY, Hillier CE, Viagappan GM. Source: Postgraduate Medical Journal. 1997 June; 73(860): 327-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9246327&dopt=Abstract

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Gingivitis: to treat or not to treat? Author(s): Sprague P, Lazarus J. Source: Dent Today. 1995 January; 14(1): 106-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9567104&dopt=Abstract

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Growth and development considerations in the diagnosis of gingivitis and periodontitis in children. Author(s): Bimstein E, Matsson L. Source: Pediatr Dent. 1999 May-June; 21(3): 186-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10355010&dopt=Abstract

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Human gingival crevicular fluid keratin at healthy, chronic gingivitis and chronic adult periodontitis sites. Author(s): McLaughlin WS, Kirkham J, Kowolik MJ, Robinson C. Source: Journal of Clinical Periodontology. 1996 April; 23(4): 331-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8739164&dopt=Abstract

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Human Herpesviridae in acute necrotizing ulcerative gingivitis in children in Nigeria. Author(s): Contreras A, Falkler WA Jr, Enwonwu CO, Idigbe EO, Savage KO, Afolabi MB, Onwujekwe D, Rams TE, Slots J. Source: Oral Microbiology and Immunology. 1997 October; 12(5): 259-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9467378&dopt=Abstract

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Identification and consequences of distinct Loe-Silness gingival index examiner styles for the clinical assessment of gingivitis. Author(s): McClanahan SF, Bartizek RD, Biesbrock AR. Source: J Periodontol. 2001 March; 72(3): 383-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11327067&dopt=Abstract

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Identification of lymphocyte subsets in pregnancy gingivitis. Author(s): Aboul-Dahab OM, el-Sherbiny MM, Abdel-Rahman R, Shoeb M. Source: Egypt Dent J. 1994 January; 40(1): 653-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9588151&dopt=Abstract

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Immunohistologic and morphometric analysis of cytotoxic T lymphocytes in gingivitis. Author(s): Seguier S, Godeau G, Leborgne M, Pivert G, Brousse N. Source: J Periodontol. 1999 November; 70(11): 1383-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10588503&dopt=Abstract

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Immunopathological diagnosis of cicatricial pemphigoid with desquamative gingivitis. A case report. Author(s): Kurihara M, Nishimura F, Hashimoto T, Komai A, Ueda H, Kokeguchi S, Takashiba S, Murayama Y. Source: J Periodontol. 2001 February; 72(2): 243-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11288799&dopt=Abstract

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Impact of the sonicare toothbrush on plaque and gingivitis. Author(s): Kugel G, Boghosian AA. Source: Compend Contin Educ Dent. 2002 July; 23(7 Suppl 1): 7-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789978&dopt=Abstract

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Increase of crevicular interleukin 1beta under academic stress at experimental gingivitis sites and at sites of perfect oral hygiene. Author(s): Deinzer R, Forster P, Fuck L, Herforth A, Stiller-Winkler R, Idel H. Source: Journal of Clinical Periodontology. 1999 January; 26(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9923503&dopt=Abstract

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Interleukin-1 gene polymorphisms and experimental gingivitis. Author(s): Jepsen S, Eberhard J, Fricke D, Hedderich J, Siebert R, Acil Y. Source: Journal of Clinical Periodontology. 2003 February; 30(2): 102-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622850&dopt=Abstract

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Is the chemical prevention of gingivitis necessary to prevent severe periodontitis? Author(s): Sheiham A. Source: Periodontology 2000. 1997 October; 15: 15-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9643228&dopt=Abstract

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Levels of cytokines and collagen type I and type III as a function of age in human gingivitis. Author(s): Yakovlev E, Kalichman I, Pisanti S, Shoshan S, Barak V. Source: J Periodontol. 1996 August; 67(8): 788-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8866318&dopt=Abstract

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Levels of TGFbeta1 in gingival crevicular fluid during a 21-day experimental model of gingivitis. Author(s): Wright HJ, Chapple IL, Matthews JB. Source: Oral Diseases. 2003 March; 9(2): 88-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12657035&dopt=Abstract

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Local application of n-3 or n-6 polyunsaturated fatty acids in the treatment of human experimental gingivitis. Author(s): Eberhard J, Heilmann F, Acil Y, Albers HK, Jepsen S. Source: Journal of Clinical Periodontology. 2002 April; 29(4): 364-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11966935&dopt=Abstract

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Longitudinal changes in TCRB variable gene expression and markers of gingival inflammation in experimental gingivitis. Author(s): Preshaw PM, Geatch DR, Lauffart B, Jeffcoat MK, Taylor JJ, Heasman PA. Source: Journal of Clinical Periodontology. 1998 October; 25(10): 774-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9797048&dopt=Abstract

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Low-dose oral interferon-alpha: effective prophylaxis for gingivitis and aphthous ulcers in AIDS patients. Author(s): Jordan WC. Source: Journal of the National Medical Association. 1997 October; 89(10): 647. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9347677&dopt=Abstract

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Maintenance of periodontal attachment levels in prosthetically treated patients with gingivitis or moderate chronic periodontitis 5-17 years post therapy. Author(s): Moser P, Hammerle CH, Lang NP, Schlegel-Bregenzer B, Persson R. Source: Journal of Clinical Periodontology. 2002 June; 29(6): 531-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296781&dopt=Abstract

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Microbiota of health, gingivitis, and initial periodontitis. Author(s): Tanner A, Maiden MF, Macuch PJ, Murray LL, Kent RL Jr. Source: Journal of Clinical Periodontology. 1998 February; 25(2): 85-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9495607&dopt=Abstract

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Microorganism presence in desquamative gingivitis. Author(s): Felton RE, Glass RT. Source: J Okla Dent Assoc. 1998 Summer; 89(1): 40-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10596631&dopt=Abstract

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Microvasculature in gingivitis and chronic periodontitis: disruption of vascular networks with protracted inflammation. Author(s): Zoellner H, Chapple CC, Hunter N. Source: Microscopy Research and Technique. 2002 January 1; 56(1): 15-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11810703&dopt=Abstract

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Necrotizing ulcerative gingivitis, periodontitis, and stomatitis: clinical staging and predisposing factors. Author(s): Horning GM, Cohen ME. Source: J Periodontol. 1995 November; 66(11): 990-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8558402&dopt=Abstract

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Necrotizing ulcerative gingivitis. Author(s): Rowland RW. Source: Ann Periodontol. 1999 December; 4(1): 65-73; Discussion 78. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10863376&dopt=Abstract

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Occurrence of Prevotella intermedia and Prevotella nigrescens in relation to gingivitis and gingival health. Author(s): Lie MA, van der Weijden GA, Timmerman MF, Loos BG, van Steenbergen TJ, van der Velden U. Source: Journal of Clinical Periodontology. 2001 February; 28(2): 189-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11168745&dopt=Abstract

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Oligoclonal accumulations of T-cell clones in gingivitis and periodontitis lesions. Author(s): Itoh H, Ohsawa Y, Yoshie H, Yamazaki K. Source: Oral Microbiology and Immunology. 2002 October; 17(5): 324-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12354216&dopt=Abstract

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Oral and maxillofacial pathology case of the month. Chronic desquamative gingivitis. Author(s): Wright JM. Source: Tex Dent J. 1999 December; 116(12): 36, 78-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10860080&dopt=Abstract

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Oral and maxillofacial pathology case of the month. Granulomatous (foreign-body) gingivitis. Author(s): Newland JR. Source: Tex Dent J. 2002 May; 119(5): 449, 465. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12046407&dopt=Abstract

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Oral cleanliness, gingivitis, dental caries and oral health behaviours in Jordanian children. Author(s): Sayegh A, Dini EL, Holt RD, Bedi R. Source: J Int Acad Periodontol. 2002 January; 4(1): 12-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670081&dopt=Abstract

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Oral hygiene and gingivitis in a Swedish adult population 1973, 1983 and 1993. Author(s): Hugoson A, Norderyd O, Slotte C, Thorstensson H. Source: Journal of Clinical Periodontology. 1998 October; 25(10): 807-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9797053&dopt=Abstract

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Oral hygiene, gingivitis, and periodontitis in persons with Down syndrome. Author(s): Lopez-Perez R, Borges-Yanez SA, Jimenez-Garcia G, Maupome G. Source: Spec Care Dentist. 2002 November-December; 22(6): 214-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790229&dopt=Abstract

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Oral microbiota in smokers and non-smokers in natural and experimentally-induced gingivitis. Author(s): Lie MA, van der Weijden GA, Timmerman MF, Loos BG, van Steenbergen TJ, van der Velden U. Source: Journal of Clinical Periodontology. 1998 August; 25(8): 677-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9722273&dopt=Abstract

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Oral microbiota in subjects with a weak or strong response in experimental gingivitis. Author(s): Lie MA, Danser MM, van der Weijden GA, Timmerman MF, de Graaff J, van der Velden U. Source: Journal of Clinical Periodontology. 1995 August; 22(8): 642-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8583022&dopt=Abstract

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Oral pemphigoid masquerading as necrotizing ulcerative gingivitis in a child. Author(s): Musa NJ, Kumar V, Humphreys L, Aguirre A, Neiders ME. Source: J Periodontol. 2002 June; 73(6): 657-63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12083540&dopt=Abstract

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Parotid salivary S-IgA antibodies during experimental gingivitis in smokers and nonsmokers. Author(s): Lie MA, Myint MM, Schenck K, Timmerman MF, van der Velden U, van der Weijden GA, Loos BG. Source: Journal of Periodontal Research. 2002 April; 37(2): 86-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12009188&dopt=Abstract

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Peptostreptococcus micros smooth and rough genotypes in periodontitis and gingivitis. Author(s): Kremer BH, Loos BG, van der Velden U, van Winkelhoff AJ, Craandijk J, Bulthuis HM, Hutter J, Varoufaki AS, van Steenbergen TJ. Source: J Periodontol. 2000 February; 71(2): 209-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10711611&dopt=Abstract

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Periodontal status and detection frequency of bacteria at sites of periodontal health and gingivitis. Author(s): Riviere GR, Smith KS, Tzagaroulaki E, Kay SL, Zhu X, DeRouen TA, Adams DF. Source: J Periodontol. 1996 February; 67(2): 109-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8667130&dopt=Abstract

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Permeability of the gingival tissues to IgM during an experimental gingivitis study in man. Author(s): Griffiths GS, Wilton JM, Curtis MA. Source: Archives of Oral Biology. 1997 February; 42(2): 129-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9134125&dopt=Abstract

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Physicochemical characterization and preliminary in vivo efficacy of bioadhesive, semisolid formulations containing flurbiprofen for the treatment of gingivitis. Author(s): Jones DS, Irwin CR, Woolfson AD, Djokic J, Adams V. Source: Journal of Pharmaceutical Sciences. 1999 June; 88(6): 592-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10350494&dopt=Abstract

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Pilot study on n-3 polyunsaturated fatty acids in the treatment of human experimental gingivitis. Author(s): Campan P, Planchand PO, Duran D. Source: Journal of Clinical Periodontology. 1997 December; 24(12): 907-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9442428&dopt=Abstract

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Plaque and gingivitis in spinal paralysed individuals. Author(s): Lancashire P, Janzen J, Zach GA, Addy M. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 1996 August; 34(8): 498-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8856860&dopt=Abstract

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Plaque formation and gingivitis after supervised mouthrinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 6 months. Author(s): Lang NP, Hase JC, Grassi M, Hammerle CH, Weigel C, Kelty E, Frutig F. Source: Oral Diseases. 1998 June; 4(2): 105-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9680899&dopt=Abstract

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Plasma cell gingivitis. Author(s): Roman CC, Yuste CM, Gonzalez MA, Gonzalez AP, Lopez G. Source: Cutis; Cutaneous Medicine for the Practitioner. 2002 January; 69(1): 41-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11829177&dopt=Abstract

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Plasma cell gingivitis: treatment with 2% fusidic acid. Author(s): Mahler V, Hornstein OP, Kiesewetter F. Source: Journal of the American Academy of Dermatology. 1996 January; 34(1): 145-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8543685&dopt=Abstract

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Polymerase chain reaction detection of 8 putative periodontal pathogens in subgingival plaque of gingivitis and advanced periodontitis lesions. Author(s): Ashimoto A, Chen C, Bakker I, Slots J. Source: Oral Microbiology and Immunology. 1996 August; 11(4): 266-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9002880&dopt=Abstract

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Pregnancy gingivitis. Author(s): Zachariasen RD. Source: J Gt Houst Dent Soc. 1997 October; 69(3): 10-2. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9594803&dopt=Abstract

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Prevalence of gingivitis in 6-year-olds in Reykjavik, Iceland. Author(s): Arnlaugsson S, Magnusson TE. Source: Acta Odontologica Scandinavica. 1996 August; 54(4): 247-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8876736&dopt=Abstract

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Quantitative assessment of apoptotic and proliferative gingival keratinocytes in oral and sulcular epithelium in patients with gingivitis and periodontitis. Author(s): Jarnbring F, Somogyi E, Dalton J, Gustafsson A, Klinge B. Source: Journal of Clinical Periodontology. 2002 December; 29(12): 1065-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492905&dopt=Abstract

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Re: Local predisposing events leading to gingivitis and periodontitis. Author(s): Ratcliff P. Source: J Periodontol. 1995 August; 66(8): 749-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7473020&dopt=Abstract

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Reactive antibodies in sera from pubertal and adult gingivitis patients against various Porphyromonas gingivalis antigens. Author(s): Nakagawa T, Nakagawa S, Ishihara K, Yamada S, Machida Y, Okuda K. Source: Journal of Periodontal Research. 1995 November; 30(6): 396-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8544103&dopt=Abstract

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Recent advances in clinical research on toothpastes and mouthwashes: clinical efficacy of commercial products for gingivitis, tartar control and antimicrobial activity. Author(s): White DJ. Source: J Clin Dent. 1997; 8(2 Spec No): 37-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9238871&dopt=Abstract

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Relationship of surface epithelium concentrations of IL-1 alpha and IL-1 beta to clinical inflammation during experimental gingivitis. Author(s): Biesbrock A, Yeh CH. Source: Monogr Oral Sci. 2000; 17: 20-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10949833&dopt=Abstract

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Research backs up role of home irrigators in controlling gingivitis and bleeding. Author(s): O'Hehir TE. Source: Rdh. 1997 February; 17(2): 22-3, 34. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9442725&dopt=Abstract

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Safety and clinical effects of topical histatin gels in humans with experimental gingivitis. Author(s): Paquette DW, Simpson DM, Friden P, Braman V, Williams RC. Source: Journal of Clinical Periodontology. 2002 December; 29(12): 1051-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492903&dopt=Abstract

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Salivary anti-hsp65 antibodies as a diagnostic marker for gingivitis and a possible link to atherosclerosis. Author(s): Schett G, Metzler B, Kleindienst R, Moschen I, Hattmannsdorfer R, Wolf H, Ottenhoff T, Xu Q, Wick G. Source: International Archives of Allergy and Immunology. 1997 November; 114(3): 24650. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9363905&dopt=Abstract

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Salivary cystatin activity and cystatin C in natural and experimental gingivitis in smokers and non-smokers. Author(s): Lie MA, Loos BG, Henskens YM, Timmerman MF, Veerman EC, van der Velden U, van der Weijden GA. Source: Journal of Clinical Periodontology. 2001 October; 28(10): 979-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11686817&dopt=Abstract

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Seasonal variation of acute necrotising ulcerative gingivitis in South Africans. Author(s): Arendorf TM, Bredekamp B, Cloete CA, Joshipura K. Source: Oral Diseases. 2001 May; 7(3): 150-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11495190&dopt=Abstract

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Serum antibody titers to Bacteroides forsythus in elderly subjects with gingivitis or periodontitis. Author(s): Persson GR, Schlegel-Bregenzer B, Chung WO, Houston L, Oswald T, Roberts MC. Source: Journal of Clinical Periodontology. 2000 November; 27(11): 839-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11073327&dopt=Abstract

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Serum IgG reactivity to subgingival bacteria in initial periodontitis, gingivitis and healthy subjects. Author(s): Tanner AC, Kent RL Jr, Maiden MF, Macuch PJ, Taubman MA. Source: Journal of Clinical Periodontology. 2000 July; 27(7): 473-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10914887&dopt=Abstract

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Some effects of mouthrinses containing salifluor on de novo plaque formation and developing gingivitis. Author(s): Furuichi Y, Ramberg P, Lindhe J, Nabi N, Gaffar A. Source: Journal of Clinical Periodontology. 1996 August; 23(8): 795-802. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8877668&dopt=Abstract

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Stain, plaque and gingivitis reduction by combining chlorhexidine and peroxyborate. Author(s): Grundemann LJ, Timmerman MF, Ijzerman Y, van der Weijden GA, van der Weijden GA. Source: Journal of Clinical Periodontology. 2000 January; 27(1): 9-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10674956&dopt=Abstract

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Statistical analysis of data derived from clinical variables of plaque and gingivitis. Author(s): Galgut PN, O'Mullane D. Source: Journal of Clinical Periodontology. 1998 July; 25(7): 549-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9696254&dopt=Abstract

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Subgingival irrigation effects of chlorhexidine or sanguinarine on gingivitis in orthodontic patients. Author(s): Babay N, Al Jasser N. Source: J Clin Pediatr Dent. 1996 Spring; 20(3): 225-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8634210&dopt=Abstract

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The achievement and maintenance of inter-examiner consistency in the assessment of plaque and gingivitis during a multicentre study based in general dental practices. Author(s): Eaton KA, Rimini FM, Zak E, Brookman DJ, Newman HN. Source: Journal of Clinical Periodontology. 1997 March; 24(3): 183-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9083903&dopt=Abstract

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The benefits of toothpaste--real or imagined? The effectiveness of toothpaste in the control of plaque, gingivitis, periodontitis, calculus and oral malodour. Author(s): Sheen S, Pontefract H, Moran J. Source: Dent Update. 2001 April; 28(3): 144-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11819975&dopt=Abstract

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The clinical effect of a newly designed electric toothbrush on supragingival plaque, gingivitis and gingival bleeding. Author(s): Stabholz A, Babayof I, Mann J. Source: J Clin Dent. 1996; 7(1): 17-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9238880&dopt=Abstract

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The clinical efficacy of Colgate Total Plus Whitening Toothpaste containing a special grade of silica and Colgate Total Fresh Stripe Toothpaste in the control of plaque and gingivitis: a six-month clinical study. Author(s): Allen DR, Battista GW, Petrone DM, Petrone ME, Chaknis P, DeVizio W, Volpe AR. Source: J Clin Dent. 2002; 13(2): 59-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11695207&dopt=Abstract

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The clinical spectrum of desquamative gingivitis. Author(s): Scully C, Porter SR. Source: Semin Cutan Med Surg. 1997 December; 16(4): 308-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9421223&dopt=Abstract

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The comparative efficacy of stabilized stannous fluoride dentifrice, peroxide/baking soda dentifrice and essential oil mouthrinse for the prevention of gingivitis. Author(s): Beiswanger BB, McClanahan SF, Bartizek RD, Lanzalaco AC, Bacca LA, White DJ. Source: J Clin Dent. 1997; 8(2 Spec No): 46-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9238873&dopt=Abstract

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The effect of a single mechanical treatment on the subgingival microflora in patients with HIV-associated gingivitis. Author(s): Hofer D, Hammerle CH, Grassi M, Mombelli A. Source: Journal of Clinical Periodontology. 1996 March; 23(3 Pt 1): 180-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8707976&dopt=Abstract

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The effect of age on the development of gingivitis. Clinical, microbiological and histological findings. Author(s): Fransson C, Berglundh T, Lindhe J. Source: Journal of Clinical Periodontology. 1996 April; 23(4): 379-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8739171&dopt=Abstract

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The effect of herbal extracts in an experimental mouthrinse on established plaque and gingivitis. Author(s): Van der Weijden GA, Timmer CJ, Timmerman MF, Reijerse E, Mantel MS, van der Velden U. Source: Journal of Clinical Periodontology. 1998 May; 25(5): 399-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9650877&dopt=Abstract

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The effect of local application of chlorhexidine on plaque and gingivitis. Author(s): Lee YC, Charles SL, Holborow DW. Source: N Z Dent J. 1996 March; 92(407): 13-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8649661&dopt=Abstract

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The effect of mouthrinses containing zinc and triclosan on plaque accumulation, development of gingivitis and formation of calculus in a 28-week clinical test. Author(s): Schaeken MJ, Van der Hoeven JS, Saxton CA, Cummins D. Source: Journal of Clinical Periodontology. 1996 May; 23(5): 465-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8783053&dopt=Abstract

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The effectiveness of an ionic toothbrush in the removal of dental plaque and reduction on gingivitis in orthodontic patients. Author(s): Pucher JJ, Lamendola-Sitenga K, Ferguson D, Van Swoll R. Source: J West Soc Periodontol Periodontal Abstr. 1999; 47(4): 101-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11830911&dopt=Abstract

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The effects of a potassium citrate, cetylpyridinium chloride, sodium fluoride mouthrinse on dentine hypersensitivity, plaque and gingivitis. A placebo-controlled study. Author(s): Yates R, West N, Addy M, Marlow I. Source: Journal of Clinical Periodontology. 1998 October; 25(10): 813-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9797054&dopt=Abstract

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The efficacy of a dentifrice with caries, plaque, gingivitis, tooth whitening and oral malodor benefits. Author(s): Volpe AR, Petrone ME, Prencipe M, DeVizio W. Source: J Clin Dent. 2002; 13(2): 55-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11695206&dopt=Abstract

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The efficacy of a herbal-based toothpaste on the control of plaque and gingivitis. Author(s): Mullally BH, James JA, Coulter WA, Linden GJ. Source: Journal of Clinical Periodontology. 1995 September; 22(9): 686-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7593698&dopt=Abstract

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The efficacy of an anti-gingivitis chewing gum. Author(s): Smith AJ, Moran J, Dangler LV, Leight RS, Addy M. Source: Journal of Clinical Periodontology. 1996 January; 23(1): 19-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8636452&dopt=Abstract

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The efficacy of an essential oil antiseptic mouthrinse vs. dental floss in controlling interproximal gingivitis: a comparative study. Author(s): Bauroth K, Charles CH, Mankodi SM, Simmons K, Zhao Q, Kumar LD. Source: The Journal of the American Dental Association. 2003 March; 134(3): 359-65. Erratum In: J Am Dent Assoc. 2003 May; 134(5): 558. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699051&dopt=Abstract

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The efficacy of Decapinol mouthwash 2 mg/mL in preventing gingivitis. Author(s): Yeung S, Groenlund C, Chapple C, Kemm A, Spencer R, Grossberg D, Newell P, Fitzpatrick J, Kelty E, Movert R. Source: Aust Dent J. 1995 August; 40(4): 220-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7575274&dopt=Abstract

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The experimental gingivitis studies: the microbiological perspective. Author(s): Theilade E. Source: Journal of Dental Research. 1996 July; 75(7): 1434-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8876594&dopt=Abstract

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The influence of gingival dimensions on bleeding upon probing in young adults with plaque-induced gingivitis. Author(s): Muller HP, Heinecke A. Source: Clinical Oral Investigations. 2002 June; 6(2): 69-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12166716&dopt=Abstract

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The influence of titanium abutment surface roughness on plaque accumulation and gingivitis: short-term observations. Author(s): Quirynen M, Bollen CM, Papaioannou W, Van Eldere J, van Steenberghe D. Source: Int J Oral Maxillofac Implants. 1996 March-April; 11(2): 169-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8666447&dopt=Abstract

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The influence of toothbrush wear on the variables of plaque and gingivitis in clinical trials. Author(s): Galgut PN. Source: Journal of Dental Hygiene : Jdh / American Dental Hygienists' Association. 2001 Spring; 75(2): 150-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11475760&dopt=Abstract

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The optimization of the BANA test as a screening instrument for gingivitis among subjects seeking dental treatment. Author(s): Loesche WJ, Kazor CE, Taylor GW. Source: Journal of Clinical Periodontology. 1997 October; 24(10): 718-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9350555&dopt=Abstract

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The reduction of gingivitis using battery-powered toothbrushes over a one-month period. Author(s): Williams K, Walters PA, Bartizek RD, Biesbrock AR. Source: J Clin Dent. 2002; 13(5): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12518491&dopt=Abstract

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The relationship between elastase and lactoferrin in healthy, gingivitis and periodontitis sites. Author(s): Murray MC, Mooney J, Kinane DF. Source: Oral Diseases. 1995 September; 1(3): 106-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8705815&dopt=Abstract

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The relationship between gingivitis and colonization by Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in children. Author(s): Morinushi T, Lopatin DE, Van Poperin N, Ueda Y. Source: J Periodontol. 2000 March; 71(3): 403-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10776927&dopt=Abstract

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The relationship between gingivitis and the serum antibodies to the microbiota associated with periodontal disease in children with Down's syndrome. Author(s): Morinushi T, Lopatin DE, Van Poperin N. Source: J Periodontol. 1997 July; 68(7): 626-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9249633&dopt=Abstract

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The relationship between irregularity of the incisor teeth, plaque, and gingivitis: a study in a group of schoolchildren aged 11-14 years. Author(s): Ashley FP, Usiskin LA, Wilson RF, Wagaiyu E. Source: European Journal of Orthodontics. 1998 February; 20(1): 65-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9558766&dopt=Abstract

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The relationship between oral malodor, gingivitis, and periodontitis. A review. Author(s): Ratcliff PA, Johnson PW. Source: J Periodontol. 1999 May; 70(5): 485-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10368052&dopt=Abstract

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The relationship of dental calculus to caries, gingivitis, and selected salivary factors in 11- to 13-year-old children in Chiang Mai, Thailand. Author(s): Pattanaporn K, Navia JM. Source: J Periodontol. 1998 September; 69(9): 955-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9776022&dopt=Abstract

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The relevance of pH to gingivitis and periodontitis. Author(s): Galgut PN. Source: J Int Acad Periodontol. 2001 July; 3(3): 61-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666943&dopt=Abstract

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The role of therapeutic antimicrobial mouthrinses in clinical practice: control of supragingival plaque and gingivitis. Author(s): Barnett ML. Source: The Journal of the American Dental Association. 2003 June; 134(6): 699-704. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839405&dopt=Abstract

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Therapeutic effects of supervised chlorhexidine mouthrinses on untreated gingivitis. Author(s): Corbet EF, Tam JO, Zee KY, Wong MC, Lo EC, Mombelli AW, Lang NP. Source: Oral Diseases. 1997 March; 3(1): 9-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9456641&dopt=Abstract

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Tongue coating and salivary bacterial counts in healthy/gingivitis subjects and periodontitis patients. Author(s): Mantilla Gomez S, Danser MM, Sipos PM, Rowshani B, van der Velden U, van der Weijden GA. Source: Journal of Clinical Periodontology. 2001 October; 28(10): 970-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11686816&dopt=Abstract

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Treatment of gingivitis and periodontitis. Research, Science and Therapy Committee of the American Academy of Periodontology. Author(s): Pihlstrom BL, Ammons WF. Source: J Periodontol. 1997 December; 68(12): 1246-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9444602&dopt=Abstract

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Treatment of gingivitis with hyaluronan. Author(s): Jentsch H, Pomowski R, Kundt G, Gocke R. Source: Journal of Clinical Periodontology. 2003 February; 30(2): 159-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622859&dopt=Abstract

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Treatment of plaque-induced gingivitis, chronic periodontitis, and other clinical conditions. Author(s): Research, Science and Therapy Committee of the American Academy of Periodontology. Source: J Periodontol. 2001 December; 72(12): 1790-800. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11811516&dopt=Abstract

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Treponema parvum sp. nov., a small, glucoronic or galacturonic acid-dependent oral spirochaete from lesions of human periodontitis and acute necrotizing ulcerative gingivitis. Author(s): Wyss C, Dewhirst FE, Gmur R, Thurnheer T, Xue Y, Schupbach P, Guggenheim B, Paster BJ. Source: International Journal of Systematic and Evolutionary Microbiology. 2001 May; 51(Pt 3): 955-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11411720&dopt=Abstract

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Triclosan/pyrophosphate dentifrice: dental plaque and gingivitis effects in a 6-month randomized controlled clinical study. Author(s): Grossman E, Hou L, Bollmer BW, Court LK, McClary JM, Bennett S, Winston JL, McClanahan SF. Source: J Clin Dent. 2002; 13(4): 149-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12116725&dopt=Abstract

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Urinary catecholamine levels and gingivitis in children. Author(s): Vanderas AP, Kavvadia K, Papagiannoulis L. Source: J Periodontol. 1998 May; 69(5): 554-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9623898&dopt=Abstract

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Validation of school nurses to identify severe gingivitis in adolescents. Author(s): Cappelli D, Brown JP. Source: American Journal of Public Health. 2002 June; 92(6): 946-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12036787&dopt=Abstract

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CHAPTER 2. NUTRITION AND GINGIVITIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and gingivitis.

Finding Nutrition Studies on Gingivitis The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “gingivitis” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “gingivitis” (or a synonym): •

A short-term brushing model for assessing antiplaque/antigingivitis dentifrice effectiveness: a pilot study. Author(s): Warner-Lambert Co., Morris Plains, NJ, USA. Source: Kohut, B Coelho, J Sharma, N C Galustians, J Proskin, H M J-Clin-Dent. 1999; 10(4): 119-23 0895-8831

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Caries inhibition efficacy of an antiplaque/antigingivitis dentifrice. Author(s): The Warner-Lambert Consumer Healthcare Division of the Warner-Lambert Consumer Group of Pfizer, Morris Plains, NJ, USA. [email protected] Source: Yu, D Pearson, S K Bowen, W H Luo, D Kohut, B E Harper, D S Am-J-Dent. 2000 September; 13(Spec No): 14C-17C 0894-8275

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Clinical controlled study on plaque and gingivitis reduction under long-term use of low-dose chlorhexidine solutions in a population exhibiting good oral hygiene. Author(s): Department of Periodontology, Dental School TU Dresden, Germany. [email protected] Source: Hoffmann, T Bruhn, G Richter, S Netuschil, L Brecx, M Clin-Oral-Investig. 2001 June; 5(2): 89-95 1432-6981

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Comparative clinical trial with natural herbal mouthwash versus chlorhexidine in gingivitis. Source: Serfaty, R Itic, J J-Clin-Dent. 1988 Summer; 1 Suppl AA34-7 0895-8831

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Double-blind evaluation of the clinical efficacy of an herbal dentifrice against gingivitis and periodontitis. Source: Emling, R C J-Clin-Dent. 1988 Summer; 1 Suppl AA27-9 0895-8831

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Effect of a toothpaste containing triclosan on dental plaque, gingivitis, and bleeding on probing--an investigation in periodontitis patients over 28 weeks. Author(s): Department of Conservative Dentistry, Carl Gustav Carus Medical Faculty, University of Technology, Dresden, Germany. [email protected] Source: Bruhn, G Netuschil, L Richter, S Brecx, M Hoffmann, T Clin-Oral-Investig. 2002 June; 6(2): 124-7 1432-6981

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Effect of a triclosan/copolymer/fluoride dentifrice on plaque formation and gingivitis: a 7-month clinical study. Author(s): University of Texas Health Science Center at San Antonio. Source: Garcia Godoy, F Garcia Godoy, F DeVizio, W Volpe, A R Ferlauto, R J Miller, J M Am-J-Dent. 1990 September; 3 Spec NoS15-26 0894-8275

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Effect of insulin on naturally occurring gingivitis rats with diabetes. Author(s): Department of Pharmacology, Osaka Dental University, Japan. Source: Hayashi, A Shinohara, M Ohura, K J-Osaka-Dent-Univolume 1999 April; 33(1): 1-7 0475-2058

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Effect of the NSAID piroxicam, topically administered, on the development of gingivitis in beagle dogs. Author(s): Harvard School of Dental Medicine, Boston, MA. Source: Howell, T H Fiorellini, J Weber, H P Williams, R C J-Periodontal-Res. 1991 May; 26(3 Pt 1): 180-3 0022-3484

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Effects of triclosan/copolymer dentifrice on dental plaque and gingivitis in a 3-month randomized controlled clinical trial: influence of baseline gingivitis on observed efficacy. Author(s): Health Care Research Center, Procter & Gamble Company, Mason, OH, USA. [email protected] Source: McClanahan, Stephen F Bartizek, Robert D J-Clin-Dent. 2002; 13(4): 167-78 08958831

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Effects of zirconium silicate chewing gum on plaque and gingivitis. Author(s): University of Texas Health Science Center at Houston 77225. Source: Anderson, G B McLean, T N Caffesse, R G Smith, B A Quintessence-Int. 1990 June; 21(6): 479-89 0033-6572

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Efficacy of a dentifrice containing zinc citrate for the control of plaque and gingivitis: a 6-month clinical study in adults. Author(s): McWill Research Laboratories, Inc. Atlanta, Georgia, USA. Source: Williams, C McBride, S Mostler, K Petrone, D M Simone, A J Crawford, R Patel, S Petrone, M E Chaknis, P DeVizio, W Volpe, A R Proskin, H M Compend-Contin-EducDent. 1998; 19(2 Suppl): 4-15

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Efficacy of a mouthrinse containing 0.05% cetylpyridinium chloride for the control of plaque and gingivitis: a 6-month clinical study in adults. Author(s): Department of Periodontics, Howard University College of Dentistry, Washington, DC, USA. Source: Allen, D R Davies, R Bradshaw, B Ellwood, R Simone, A J Robinson, R Mukerjee, C Petrone, M E Chaknis, P Volpe, A R Proskin, H M Compend-Contin-EducDent. 1998; 19(2 Suppl): 20-6

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Efficacy of a triclosan/NaF dentifrice in the control of plaque and gingivitis and concurrent oral microflora monitoring. Author(s): Dental Research Center, University of Dentistry and Medicine of New Jersey, Newark 07103, USA. Source: Fine, D H Furgang, D Bonta, Y DeVizio, W Volpe, A R Reynolds, H Zambon, J J Dunford, R G Am-J-Dent. 1998 December; 11(6): 259-70 0894-8275

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Essential oils in an antiplaque and antigingivitis dentifrice: a 6-month study. Author(s): The Warner-Lambert Consumer Healthcare Division of the Warner-Lambert Consumer Group of Pfizer, Morris Plains, NJ 07950, USA. [email protected] Source: Coelho, J Kohut, B E Mankodi, S Parikh, R Wu, M M Am-J-Dent. 2000 September; 13(Spec No): 5C-10C 0894-8275

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Experimental gingivitis studies: effects of triclosan and triclosan-containing dentifrices on dental plaque and gingivitis in three-week randomized controlled clinical trials. Author(s): School of Dental Medicine, University of Berne, Switzerland. Source: Lang, Niklaus P Sander, Lone Barlow, Ashley Brennan, Kieran White, Donald J Bacca, Lori Bartizek, Robert D McClanahan, Stephen F J-Clin-Dent. 2002; 13(4): 158-66 0895-8831

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Longitudinal evaluation of the effect of sanguinarine on plaque and gingivitis. Source: Palcanis, K G Sarbin, A G Koertge, T E Brooks, C N Gunsolley, J C Gen-Dent. 1990 Jan-February; 38(1): 17-9 0363-6771

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Long-standing plaque and gingivitis at implants and teeth in the dog. Author(s): Faculty of Odontology, University of Goteborg, Sweden.

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Source: Ericsson, I Berglundh, T Marinello, C Liljenberg, B Lindhe, J Clin-Oral-ImplantsRes. 1992 September; 3(3): 99-103 0905-7161 •

Long-term effects of Listerine antiseptic on dental plaque and gingivitis. Source: Ross, N M Charles, C H Dills, S S J-Clin-Dent. 1989 Spring; 1(4): 92-5 0895-8831

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Meswak versus chlorhexidine and a commercial toothpaste in plaque formation and gingivitis. Source: Gazi, M I Lambourne, A Chagla, A H Odontostomatol-Tropage 1987 March; 10(1): 29-38 0251-172X

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Microbiological studies of the prevention and control of plaque and gingivitis by a zinc and triclosan-containing dentifrice. Author(s): PHLS Centre for Applied Microbiology and Research, Salisbury, England. Source: Marsh, P D Newsl-Int-Acad-Periodontol. 1991 June; 1(1): 4-5 0963-5742

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Mouthrinses as adjuncts for plaque and gingivitis management. A status report for the American Journal of Dentistry. Source: Fine, D H Am-J-Dent. 1988 December; 1(6): 259-63 0894-8275

•

The benefits of toothpaste--real or imagined? The effectiveness of toothpaste in the control of plaque, gingivitis, periodontitis, calculus and oral malodour. Author(s): University of Bristol Dental School, Bristol. Source: Sheen, S Pontefract, H Moran, J Dent-Update. 2001 April; 28(3): 144-7 0305-5000

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The effect of local application of chlorhexidine on plaque and gingivitis. Author(s): Department of Periodontology, School of Dentistry, University of Otago, Dunedin. Source: Lee, Y C Charles, S L Holborow, D W N-Z-Dent-J. 1996 March; 92(407): 13-5 0028-8047

•

The relationship between chewing sticks (Miswak) and periodontal health. 2. Relationship to plaque, gingivitis, pocket depth, and attachment loss. Author(s): King Saud University, College of Dentistry, Riyadh 11545, Saudi Arabia. Source: Eid, M A al Shammery, A R Selim, H A Quintessence-Int. 1990 December; 21(12): 1019-22 0033-6572

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Triclosan/copolymer/fluoride dentifrices: a new technology for the prevention of plaque, calculus, gingivitis and caries. Author(s): Department of Periodontology, University of Gothenburg, Sweden. Source: Lindhe, J Am-J-Dent. 1990 September; 3 Spec No53-4 0894-8275

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Triclosan/pyrophosphate dentifrice: dental plaque and gingivitis effects in a 6-month randomized controlled clinical study. Author(s): New Institutional Services Company, Northfield, NJ, USA. Source: Grossman, E Hou, Linda Bollmer, Bernard W Court, Linda K McClary, John M Bennett, Scott Winston, J Leslie McClanahan, Stephen F J-Clin-Dent. 2002; 13(4): 149-57 0895-8831

Nutrition

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Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMD®Health: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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The following is a specific Web list relating to gingivitis; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Folic Acid Source: Healthnotes, Inc.; www.healthnotes.com Vitamin C Source: Healthnotes, Inc.; www.healthnotes.com

•

Minerals Calcium Source: Healthnotes, Inc.; www.healthnotes.com Hmg-coa Reductase Inhibitors (statins) Source: Integrative Medicine Communications; www.drkoop.com Zinc Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND GINGIVITIS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to gingivitis. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to gingivitis and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “gingivitis” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to gingivitis: •

Clinical and histological evaluation of gingival massage in the treatment of chronic gingivitis. Author(s): Simaan C, Skach M. Source: J Periodontol. 1966 September-October; 37(5): 383-90. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4161925&dopt=Abstract

•

Clinical effect of a Mexican sanguinaria extract (Polygonum aviculare L.) on gingivitis. Author(s): Gonzalez Begne M, Yslas N, Reyes E, Quiroz V, Santana J, Jimenez G. Source: Journal of Ethnopharmacology. 2001 January; 74(1): 45-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11137347&dopt=Abstract

•

Comparative clinical trial with natural herbal mouthwash versus chlorhexidine in gingivitis. Author(s): Serfaty R, Itic J.

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Source: J Clin Dent. 1988 Summer; 1 Suppl A: A34-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3076781&dopt=Abstract •

Comparative clinical trials of a European herbal sodium bicarbonate dentifrice and a widely-used dentifrice containing MFP, in brace-induced gingivitis. Author(s): Bellet L, Bellet A. Source: J Clin Dent. 1988 Summer; 1 Suppl A: A25-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2855713&dopt=Abstract

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Comparison of an herbal toothpaste with a fluoride toothpaste on plaque and gingivitis. Author(s): Moran J, Addy M, Newcombe R. Source: Clin Prev Dent. 1991 May-June; 13(3): 12-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1860291&dopt=Abstract

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Desquamative gingivitis, sole manifestation of tosylamide/formaldehyde resin allergy. Author(s): Staines KS, Felix DH, Forsyth A. Source: Contact Dermatitis. 1998 August; 39(2): 90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9746196&dopt=Abstract

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Double-blind evaluation of the clinical efficacy of an herbal dentifrice against gingivitis and periodontitis. Author(s): Emling RC. Source: J Clin Dent. 1988 Summer; 1 Suppl A: A27-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2855714&dopt=Abstract

•

Effects of extended systemic and topical folate supplementation on gingivitis of pregnancy. Author(s): Thomson ME, Pack AR. Source: Journal of Clinical Periodontology. 1982 May; 9(3): 275-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7047579&dopt=Abstract

•

Effects of topical and systemic folic acid supplementation on gingivitis in pregnancy. Author(s): Pack AR, Thomson ME. Source: Journal of Clinical Periodontology. 1980 October; 7(5): 402-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7007454&dopt=Abstract

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Experimental gingivitis in ODU plaque-susceptible rats. V. The presence of bradykinin in the gingival tissue and the bradykinin inactivating factor in rat dental plaque. Author(s): Iga K, Kobayashi H, Mori M.

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Source: J Periodontol. 1980 June; 51(6): 348-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6930475&dopt=Abstract •

Holistic care concepts, bruxism and necrotizing ulcerative gingivitis. Author(s): Pear JH. Source: Dent Hyg (Chic). 1982 September; 56(9): 24-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6958589&dopt=Abstract

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Immunization with Porphyromonas gingivalis cysteine protease: effects on experimental gingivitis and ligature-induced periodontitis in Macaca fascicularis. Author(s): Moritz AJ, Cappelli D, Lantz MS, Holt SC, Ebersole JL. Source: J Periodontol. 1998 June; 69(6): 686-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9660338&dopt=Abstract

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Increase of free collagenase and neutral protease activities in the gingival crevice during experimental gingivitis in man. Author(s): Kowashi Y, Jaccard F, Cimasoni G. Source: Archives of Oral Biology. 1979; 24(9): 645-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=231957&dopt=Abstract

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Levels of TGFbeta1 in gingival crevicular fluid during a 21-day experimental model of gingivitis. Author(s): Wright HJ, Chapple IL, Matthews JB. Source: Oral Diseases. 2003 March; 9(2): 88-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12657035&dopt=Abstract

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Local application of n-3 or n-6 polyunsaturated fatty acids in the treatment of human experimental gingivitis. Author(s): Eberhard J, Heilmann F, Acil Y, Albers HK, Jepsen S. Source: Journal of Clinical Periodontology. 2002 April; 29(4): 364-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11966935&dopt=Abstract

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Meswak versus chlorhexidine and a commercial toothpaste in plaque formation and gingivitis. Author(s): Gazi MI, Lambourne A, Chagla AH. Source: Odontostomatol Trop. 1987 March; 10(1): 29-38. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3474596&dopt=Abstract

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Notes on treating a case of acute lymphocytic leukemia resembling necrotizing ulcerative gingivitis: a case history. Author(s): Aker F, Magera J, Vernino A.

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Source: Quintessence Int. 1978 March; 9(3): 51-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=287120&dopt=Abstract •

Pilot study on n-3 polyunsaturated fatty acids in the treatment of human experimental gingivitis. Author(s): Campan P, Planchand PO, Duran D. Source: Journal of Clinical Periodontology. 1997 December; 24(12): 907-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9442428&dopt=Abstract

•

Plasma cell gingivitis of unusual origin. A case report. Author(s): Serio FG, Siegel MA, Slade BE. Source: J Periodontol. 1991 June; 62(6): 390-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1870070&dopt=Abstract

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Plasma cell gingivitis related to the use of herbal toothpaste. Author(s): Macleod RI, Ellis JE. Source: British Dental Journal. 1989 May 20; 166(10): 375-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2736170&dopt=Abstract

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Postscaling bacteremia in HIV-associated gingivitis and periodontitis. Author(s): Lucartorto FM, Franker CK, Maza J. Source: Oral Surg Oral Med Oral Pathol. 1992 May; 73(5): 550-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1518641&dopt=Abstract

•

The benefits of toothpaste--real or imagined? The effectiveness of toothpaste in the control of plaque, gingivitis, periodontitis, calculus and oral malodour. Author(s): Sheen S, Pontefract H, Moran J. Source: Dent Update. 2001 April; 28(3): 144-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11819975&dopt=Abstract

•

The effect of herbal extracts in an experimental mouthrinse on established plaque and gingivitis. Author(s): Van der Weijden GA, Timmer CJ, Timmerman MF, Reijerse E, Mantel MS, van der Velden U. Source: Journal of Clinical Periodontology. 1998 May; 25(5): 399-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9650877&dopt=Abstract

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The effects of megadoses of ascorbic acid on PMN chemotaxis and experimental gingivitis. Author(s): Vogel RI, Lamster IB, Wechsler SA, Macedo B, Hartley LJ, Macedo JA.

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Source: J Periodontol. 1986 August; 57(8): 472-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3462380&dopt=Abstract •

The efficacy of a herbal-based toothpaste on the control of plaque and gingivitis. Author(s): Mullally BH, James JA, Coulter WA, Linden GJ. Source: Journal of Clinical Periodontology. 1995 September; 22(9): 686-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7593698&dopt=Abstract

•

The relationship between chewing sticks (Miswak) and periodontal health. 2. Relationship to plaque, gingivitis, pocket depth, and attachment loss. Author(s): Eid MA, al-Shammery AR, Selim HA. Source: Quintessence Int. 1990 December; 21(12): 1019-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2082419&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMD®Health: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

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The following is a specific Web list relating to gingivitis; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Gingivitis Source: Healthnotes, Inc.; www.healthnotes.com Periodontal Disease Alternative names: Gum Disease Source: Prima Communications, Inc.www.personalhealthzone.com

•

Herbs and Supplements Achillea Alternative names: Yarrow; Achillea millefolium L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Alpha2-adrenergic Agonists Source: Integrative Medicine Communications; www.drkoop.com Beta-blockers Source: Integrative Medicine Communications; www.drkoop.com Bloodroot Alternative names: Sanguinaria canadensis Source: Healthnotes, Inc.; www.healthnotes.com Bloodroot Source: Prima Communications, Inc.www.personalhealthzone.com Caraway Alternative names: Carum carvi Source: Healthnotes, Inc.; www.healthnotes.com Carnosine Source: Healthnotes, Inc.; www.healthnotes.com Chamaemelum Nobile Source: Integrative Medicine Communications; www.drkoop.com Chamomile Alternative names: Matricaria recutita Source: Healthnotes, Inc.; www.healthnotes.com Chlorhexidine Source: Healthnotes, Inc.; www.healthnotes.com Coenzyme Q10 Source: Healthnotes, Inc.; www.healthnotes.com

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Cranberry Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10019,00.html Echinacea Alternative names: Echinacea purpurea, Echinacea angustifolia, Echinacea pallida Source: Healthnotes, Inc.; www.healthnotes.com Echinacea Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Fibric Acid Derivatives Source: Integrative Medicine Communications; www.drkoop.com Flavonoids Source: Healthnotes, Inc.; www.healthnotes.com Glycyrrhiza1 Alternative names: Licorice; Glycyrrhiza glabra L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Juniperus Alternative names: Juniper; Juniperus sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Melaleuca Alternative names: Tea Tree Oil; Melaleuca alternifolia Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Myrrh Alternative names: Commiphora molmol Source: Healthnotes, Inc.; www.healthnotes.com Myrrh Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Peppermint Alternative names: Mentha piperita Source: Healthnotes, Inc.; www.healthnotes.com Phenothiazine Derivatives Source: Integrative Medicine Communications; www.drkoop.com Potentilla Alternative names: Cinquefoil, Silverweed; Potentilla sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org

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Roman Chamomile Alternative names: Chamaemelum nobile Source: Integrative Medicine Communications; www.drkoop.com Rosmarinus Alternative names: Rosemary; Rosmarinus officinalis L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Sage Alternative names: Salvia officinalis Source: Healthnotes, Inc.; www.healthnotes.com Sanguinaria Alternative names: Bloodroot; Sanguinaria canadensis L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Sassafras Alternative names: Sassafras albidum (Nuttall) Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Sulfonylureas Source: Integrative Medicine Communications; www.drkoop.com Thiazide Diuretics Source: Integrative Medicine Communications; www.drkoop.com Thioxanthene Derivatives Source: Integrative Medicine Communications; www.drkoop.com Thyme Alternative names: Thymus vulgaris Source: Healthnotes, Inc.; www.healthnotes.com Tricyclic Antidepressants (tcas) Source: Integrative Medicine Communications; www.drkoop.com Vasodilators Source: Integrative Medicine Communications; www.drkoop.com Wild Indigo Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON GINGIVITIS Overview In this chapter, we will give you a bibliography on recent dissertations relating to gingivitis. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “gingivitis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on gingivitis, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Gingivitis ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to gingivitis. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Assessment of Gingivitis with Photocolorimetry: the Cie L*, A*, and B* Color Parameters of Human Gingiva by Haerian, Andre; PhD from University of Michigan, 2003, 164 pages http://wwwlib.umi.com/dissertations/fullcit/3079452

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. PATENTS ON GINGIVITIS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “gingivitis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on gingivitis, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Gingivitis By performing a patent search focusing on gingivitis, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We

5Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on gingivitis: •

Alcohol free mouthwash Inventor(s): Chaudhari; Atma (Scarborough, CA), Pan; Pauline (Morris Plains, NJ), Scheurer; Heinrich (Scarborough, CA), Volpe; Frank (Kinnelon, NJ) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,817,295 Date filed: January 28, 1997 Abstract: A pleasant-tasting, substantially alcohol-free oral mouthwash composition is effective in eliminating the bacteria and other oral microflora responsible for the production of plaque, periodontitis, gingivitis, gum disease and bad breath. The composition consists of a unique blend of the essential oils thymol or eucalyptol, methyl salicylate, menthol and tripartite blend of peppermint flavor oils that are dissolved in solution using a non-ionic surfactant blend. Excerpt(s): The invention relates generally to oral mouthwashes for the prevention and elimination of bad breath as well as the reduction of oral microflora responsible for the development of plaque. Dental plaque can lead to tooth decay, gingivitis and other related gum disease. In particular, the present invention relates to an alcohol free mouthwash that is effective in preventing those problems and is pleasant tasting as well. Oral rinse and mouthwash compositions have been used by people for many years for the prevention of bad breath and for the elimination of bacteria and other oral microorganisms that are responsible not only for bad breath but also tooth decay, plaque and gum disease such as gingivitis and periodontitis. To this end mouthwashes in the past have been designed to clean the oral cavity, provide fresh breath and kill the harmful bacteria. Conventional mouthwashes have always contained fairly high levels of ethyl alcohol with percentages ranging from approximately 10% up to about 30% by volume. Alcohol is used both as a disinfectant and as a solvent in which other additives such as astringents, fluorides, color additives, flavor oils, bactericidal actives and the like can be dissolved and then dispersed into solution. High levels of alcohol are generally used to provide a disinfection function since lower concentrations are sufficient to dissolve and disperse the various components into solution. Alcohol also provides a preservative role for the mouthwash during storage and use as well as enhancement of flavor oil organoleptic cues. Web site: http://www.delphion.com/details?pn=US05817295__

•

Anti-inflammatory composition comprising tetracycline Inventor(s): Gardner; Wallace J. (1791 Mass Ave., Cambridge, MA 02140) Assignee(s): none reported Patent Number: 6,610,274 Date filed: December 18, 2001 Abstract: Therapeutic composition having anti-infective activity. The therapeutic composition is a formulation comprising an antibiotic, preferably a tetracycline, most preferably doxycycline, which has not been chemically modified to eliminate antimicrobial efficacy. The antibiotic is preferably in a liquid vehicle, most preferably

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one that contains at least 20% alcohol by volume. The therapeutic composition is preferably in local delivery form and is self-administered orally or via the nasal cavity. Administration of the therapeutic composition of the present invention treats diseases that originate from the oral cavity or that do not originate in the oral cavity, but are affected by contaminants, such as viruses or bacteria, in the oral cavity entering the bloodstream including but not limited to periodontal disease, sinusitis, gingivitis, the common cold, sore throat, influenza, allergies (particularly to tree pollen), resistant pneumonia, diseases of the gastrointestinal tract, inflammatory diseases such as rheumatoid arthritis, cancer, ulcers, heart disease, etc. Excerpt(s): The accumulation bacteria in the oral cavity, such as on the teeth or tongue has been identified as a contributor or cause of various inflammatory conditions, including gingivitis, periodontitis and other gum diseases. Treatment of the oral cavity with antibiotics to reduce or eliminate the effects of bacteria is known. For example, broad spectrum antibiotics such as tetracyclines and metronidazole have been used in the treatment of periodontal disease to reduce oral cavity microflora. Typically such use has been systemic, which can result in various undesirable side effects, including the threat or danger or building allergies or immunity to the antibiotic, overgrowth of opportunistic yeast and fungi and intestinal disturbances. Many other common inflammatory diseases, such as sinusitis, diseases of the gastrointestinal tract (including those that manifest themselves in stomach and bowel problems), the common cold, influenza, allergies, halitosis, pneumonia, etc., also may be caused by viruses and/or bacteria. Often the source of the bacteria and viruses is the oral cavity, especially the ear, nose and throat passages, and the sinuses. Once the bacteria and/or viruses are resident in the oral cavities or sinuses (e.g., the maxillary, frontal and ethmoid), they can continually cause infection through circulation in the blood stream. Continual reduction or elimination of these bacteria and viruses would reduce chronic infection in the body. The problems of the prior art have been overcome by the present invention, which provides a therapeutic composition having anti-infective activity. In a preferred embodiment, the therapeutic composition is a formulation comprising an antibiotic, preferably a tetracycline, most preferably doxycycline, which has not been chemically modified to eliminate antimicrobial efficacy. The antibiotic is preferably in a liquid vehicle, most preferably one that contains at least 20% alcohol by volume. The therapeutic composition is preferably in local delivery form and is preferably selfadministered orally or via-the nasal cavity. The therapeutic composition most preferably is a self-delivered formulation in local delivery form that consists essentially of a tetracycline, most preferably doxycline, which has not been chemically modified to eliminate antimicrobial efficacy, and a liquid vehicle, more preferably one which contains at least 20% alcohol by volume, and most preferably one which consists essentially of sterile water or Listerine or the like, which tetracyline is preferably present in the formulation in the amount of between 50 to 100 mgs per ounce of liquid vehicle. Web site: http://www.delphion.com/details?pn=US06610274__ •

Antimicrobial chewing gum Inventor(s): Barry; John E. (Derry, NH), Trogolo; Jeffrey A. (Boston, MA) Assignee(s): AgION Technologies L.L.C. (Wakefield, MA) Patent Number: 6,365,130 Date filed: November 23, 1998

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Abstract: The present invention provides a novel chewing gum product generally for the lysis and killing of oral microbes. In a preferred embodiment, the chewing gum product comprises an antimicrobial metal ion component and an inorganic ceramic carrier, and provides a concentration of such substances from about 0.05 to 50 weight percent of the chewing gum. In particular, these compositions may comprise zeolites ion-exchanged with antimicrobial metals, in addition to other oral care compounds. The present invention also relates to methods of using such compositions for treating and inhibiting dental caries, dental plaque and gingivitis, oral malodor and periodontal conditions. The compositions of the present invention may be incorporated into chewing gum according to conventional methods used in the art. Excerpt(s): The present invention relates to chewing gum products containing an antimicrobial agent for killing microbes, particularly oral bacteria, for reducing or preventing dental plaque and caries and gingivitis, and to methods for treating the same, and the like. There is a need in the dental arts for an improved means of promoting dental health and hygiene, including a means for reducing plaque and dental caries, gingivitis, and especially for killing microbes which cause these dental problems, as a result of improper and inadequate tooth brushing. Plaque may be removed to some extent by effective brushing of the teeth. However, some areas of the teeth, which are less accessible and cannot be easily reached by a toothbrush, are particularly susceptible to plaque formation and consequently to calculus. Left unhindered, the plaque increases in size and more tenaciously adheres to the teeth. Although brushing with a toothbrush and dentifrice is a widely recognized technique for maintaining dental health, the average person brushes only once a day for approximately one minute. Therefore, a great need exists for finding additional methods for improving daily oral hygiene. Dental caries, which cause the progressive decay of teeth, are manifested by localized demineralization, caused by acids produced from bacteria that ferment carbohydrate foods. The process may begin when bacteria in the mouth adhere to a tooth surface, thereby forming a dental plaque. The plaque is a product of microbial growth, primarily derived from food residues in the mouth. Mucoproteins and minerals present in saliva and dead cells in the mouth also contribute to plaque formation. There is substantial evidence that dental plaque is the predominant etiological factor responsible for both dental caries and periodontal disease, due to the generation of acids within the plaque structure. Thus, dental compositions having antimicrobial properties are beneficial for killing oral bacteria that contribute to the formation of dental plaque. Web site: http://www.delphion.com/details?pn=US06365130__ •

Chewable softgel oral hygiene product Inventor(s): Montes; Rebecca (Los Angeles, CA), Steele; Donald R. (Los Angeles, CA) Assignee(s): Soft Gel Technologies, Inc. (Los Angeles, CA) Patent Number: 5,948,388 Date filed: June 12, 1998 Abstract: A chewable softgel formulation to deliver water soluble vitamins and supplements to improve dissolution time and availability. The formulation contains components design for the elimination and prevention of dental caries, bad breath, gingivitis and also inner ear infections. Excerpt(s): A chewable softgel formulation to deliver water soluble vitamins and supplements to improve dissolution time and availability. The formulation contains

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components specifically designed for oral hygiene, including breath freshening, dental caries prevention, gingivitis prevention, and also inner ear infection prevention. The formulation includes a powerful active ingredient which exhibits impressive antimutagenic activity. Applephenon, an apple extract an essential component of the encapsulated softgel formulation also functions as a breath neutralizing agent. It is also beneficial in the prevention of dental caries by preventing bacterial cells from adhering to tooth surfaces. Various chewable formulations have been utilized in the past to inhibit plaque, neutralize bad breath and limit sugar quantity. None of the formulations are chewable softgel formulations which encapsulate a powerful ingredient applephenon, to combat various dental maladies. Web site: http://www.delphion.com/details?pn=US05948388__ •

Composition for enhancing oral hygiene Inventor(s): Ahn; Ho Jeong (Youseong-ku, KR), Bak; Hong Soon (Youseong-ku, KR), Chang; Sug Youn (Youseong-ku, KR), Choi; Eu Jene (Songpa-ku, KR), Choi; Jong Heon (Dong-ku, KR), Ha; Jae Mong (Youseong-ku, KR), Kim; Moon Moo (Youseong-ku, KR), Lee; Seung Joon (Seo-ku, KR), Lim; Hyeong Jun (Youseong-ku, KR) Assignee(s): LG Chemical Ltd. (Seoul, KR) Patent Number: 5,817,297 Date filed: January 29, 1997 Abstract: The present invention relates to a composition for enhancing oral hygiene which can effectively prevent and treat periodontal diseases and dental caries, characterized in that it contains as an effective component one or more component selected from ursodesoxycholic acid and chenodesoxycholic acid having a good inhibiting effect on collagenase, which is known as the inducer of gingivitis. Excerpt(s): The present invention relates to a composition for enhancing oral hygiene which is effective for the prevention and treatment of periodontal diseases and for the prevention of dental caries. More specifically, the present invention relates to a composition for enhancing oral hygiene which can effectively prevent and treat periodontal diseases and dental caries, characterized in that it contains one or more component selected from ursodesoxycholic acid and chenodesoxycholic acid having a good inhibiting effect on collagenase activity, as an effective component. Various oral diseases occurring in the oral tissues are caused by plaque formed by the action of numerous microorganisms present in oral cavity. Their importance in clinical and pathological view has been widely studied and also identified by many reseachers including Alexander (Alexander A. G., J. Periodent, 42, 21-28, 1971), Ash(Ash, M. M., J. Periodontol, 35, 424, 1964), etc. Saliva is a unique mixture comprising electrolytes and other constituents, which play an important role in maintenance of oral health and digestion. The saliva contains various enzymes of which some enzymes including metalloproteinase show an enhanced enzymatic activity in patients suffering from periodontal diseases. Therefore, saliva enzymes are the important subject of study in view of prevention and treatment of periodontal diseases. Generally, it has been known that salivary gland, serum, leukocytes, epithelial cells, oral microorganisms, etc. are involved in production of such saliva enzymes. Web site: http://www.delphion.com/details?pn=US05817297__

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Device and method to treat oral disease in felines Inventor(s): Moran; Kelly (495 Main St., Wilbraham, MA 01095), Morello; Carol (495 Main St., Wilbraham, MA 10195), Morello; Jane (89 Springfield St., Wilbraham, MA 01095), Muller; Kimberly A. (16 Puritan Valley, Brookfield, CT 06804), Siminovsky; Bill (1301 Trumansburg Rd., Ithaca, NY 14850) Assignee(s): none reported Patent Number: 5,941,701 Date filed: July 14, 1998 Abstract: A laser system and method are described that will effectively interrupt the progression of periodontal disease in felines, particularly in situations where the disease has progressed to advanced stages of periodontitis and feline lymphocytic-plasmacytic gingivitis stomatitis. A laser system is employed to achieve precision in surgical procedures where the working field is limited due to the anatomical structure of a feline's mouth. The laser system is also capable of effectively sealing tubules and of eradicating bacteria in the periodontium to significantly reduce the risk of infection. Additionally, the laser therapy can be preceded by pretreatment methods to effectively interrupt the progression of periodontal diseases. Excerpt(s): The present invention relates to a device and method to treat periodontal disease in felines, particularly in situations where the disease has progressed to advanced stages of periodontitis and feline lymphocytic-plasmacytic gingivitis (commonly referred to as feline lymphocytic-plasmacytic stomatitis). Oral diseases are especially prevalent in cats. Periodontal disease can range from a localized inflammation of the gingiva (gingivitis) to inflamation and destruction of the gingiva, alveolar bone, the periodontal ligament, and tooth structure (periodontitis). Etiology of the disease can involve plaque, calculus, and systemic inflammatory response. Generally, the protocol for treating periodontal disease focuses on cleaning the oral cavity, repairing the tissue, and stopping the progression of the disease. However, the available treatment methods, which include scalping, polishing, curettage, dental extractions, root planing, gingivectomies and in extreme cases, gingival flaps or grafts, are inadequate when treating advanced periodontitis and feline lymphocytic-plasmacytic gingivitis/stomatitis. Web site: http://www.delphion.com/details?pn=US05941701__

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Dual phase stannous oral compositions Inventor(s): Dixon, Jr.; Cloyd (Covington, KY), Glandorf; William M. (Mason, OH), Jacobs; David S. (Hamilton, OH), Walden; Gary L. (West Chester, OH), Wireko; Fred C. (West Chester, OH) Assignee(s): The Procter & Gamble Company (Cincinnati, OH) Patent Number: 6,521,216 Date filed: November 10, 2000 Abstract: The present invention relates to dual phase oral compositions providing effective antimicobial activity for reducing plaque and gingivitis. One of the phases of the dual phase composition will contain stannous. The stannous phase comprises a stannous ion source, a fluoride ion source, and a gluconate salt. The stannous phase is essentially free of either an abrasive polishing material or chloride ions. The stannous

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phase containing phase inhibits the formation of a stannous chloro gluconate complex. The present invention also provides a method for effective delivery of stannouscontaining compositions. Excerpt(s): The present invention relates to improved dual phase oral compositions containing stannous salts, such as stannous fluoride. These improved compositions provide a spectrum of intraoral benefits derived from stannous fluoride and/or other stannous salt, including antimicrobial effects, control of breath malodor, control of dental plaque growth and metabolism, reduced gingivitis, decreased progression to periodontal disease, reductions in dentinal hypersensitivity and reduced coronal and root dental caries. The improved stannous containing compositions provide high efficacy by having the stannous stabilized in a separate phase from the rest of the composition. The stannous is stabilized without increasing the negative aesthetics associated with stannous and ingredients commonly used to stabilize stannous. This improvement results in a more aesthetically pleasing, particularly less astringent, oral composition compared to other oral composition with the same efficacy. Stannous fluoride is commonly known for its efficacy when formulated into oral products. Stannous fluoride was the first fluoride source incorporated into toothpastes for therapeutic efficacy in the control of dental caries. Stannous fluoride gels, rinses, and dentifrices have since been shown to provide clinical efficacy for the reduction of dental caries, dentinal hypersensitivity, dental plaque and gingivitis. In addition to these clinical effects, formulations containing stannous fluoride may also help to provide improved breath benefits through chemical and antibacterial actions. Stannous fluoride formulations typically include stabilization systems designed to maintain bioavailable (i.e., soluble and active) levels of stannous during shelf storage, accounting for loss of stannous to oxidation, hydrolysis or precipitation. Therefore, stannous fluoride formulations may contain other additional stannous containing ingredients, which may provide important stabilization benefits for efficacy. High concentrations of stannous in dental formulations helps to ensure stability of stannous fluoride and therefore clinical efficacy of formulations containing the latter. Unfortunately, although stannous fluoride compositions are known to be highly effective, successful commercial utilization is complicated by complexity in the development of formulations providing adequate stannous fluoride stability and in the side effects of stannous. Formulations providing increased or improved efficacy typically promote increased side effects. This limits clinical and commercial applications. A negative side effect routinely encountered during use of effective stannous fluoride formulations is unacceptable formulation astringency. Astringents are locally applied protein precipitants that have low cell permeability, thus restricting actions to cell surfaces and interstitial spaces. Strong astringents can induce contraction and wrinkling of the tissues and mucous secretions can be precipitated or reduced. Within oral products, these chemical actions produce an unpleasant `drying` sensation in the oral cavity, such as on the tongue, gingival tissues or buccal epithelia. Stannous formulations containing sufficient stannous for bioavailability are routinely described as astringent by patients and consumers and this property is undesirable. The astringency is most noticeable after use of the product. Astringency is caused by stannous and by ingredients commonly used to help stabilize stannous, such as citrate and gluconate. Another commonly found side effect from the regular use of stannous fluoride is cosmetic yellow-brown tooth staining. This stain is derived from pellicle, plaque and dietary component reactions with available stannous deposited on tooth surfaces during treatment with effective stannous fluoride formulations. Web site: http://www.delphion.com/details?pn=US06521216__

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Fast dissolving orally comsumable films Inventor(s): Kumar; Lori D. (Skillman, NJ), Leone; Robert S. (Fanwood, NJ), Leung; SauHung Spence (Parsippany, NJ) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 6,596,298 Date filed: September 14, 1999 Abstract: Physiologically acceptable films, including edible films, are disclosed. The films include a water soluble film-forming polymer such as pullulan. Edible films are disclosed that include pullulan and antimicrobially effective amounts of the essential oils thymol, methyl salicylate, eucalyptol and menthol. The edible films are effective at killing the plaque-producing germs that cause dental plaque, gingivitis and bad breath. The film can also contain pharmaceutically active agents. Methods for producing the films are also disclosed. Excerpt(s): This invention relates to fast dissolving orally consumable films. The films are used to deliver breath deodorizing agents, antimicrobial agents and salivary stimulants to the oral cavity. The films can also be used to deliver pharmaceutically active agents. In a more perfect world, people would thoroughly cleanse their mouths after each meal as part of their routine oral hygienic practices. Unfortunately, several factors conspire to prevent widespread compliance with this basic requirement of a good oral cleaning regimen. Oral cleansing can be difficult or inconvenient at times, depending on the nature of the cleansing and the situation in which the cleansing must occur. Brushing, flossing, cleaning your tongue and gargling using a variety of devices and compositions well-suited for the privacy of one's home are common oral care practices. However, the devices and compositions used in oral cleansing practices are less convenient to use away from home, where bathroom facilities might be scarce, unavailable or unsanitary. Web site: http://www.delphion.com/details?pn=US06596298__

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Immunogenic compositions comprising porphyromonas gingivalis proteins and/or peptides and methods Inventor(s): Genco; Caroline Attardo (Atlanta, GA), Potempa; Jan (Athens, GA), Travis; James (Athens, GA) Assignee(s): Morehouse School of Medicine (Atlanta, GA), The University of Georgia Research Foundation, Inc. (Athens, GA) Patent Number: 6,129,917 Date filed: March 21, 1997 Abstract: Provided herein are methods and immunogenic compositions useful for protecting mammals from infection and pathology of P. gingivalis. Specifically, arginine-specific proteases of Porphyromonas gingivalis and peptides derived therefrom offer protection against infection. Immunogenic compositions comprising a 50 kDa arginine-specific protease, the high molecular weight complex or peptides from one of the foregoing proteins are capable of protecting against P. gingivalis infection and/or gingivitis and/or periodontitis caused thereby in mammals, including humans. Excerpt(s): The field of this invention is immunogenic compositions comprising bacterial proteases and/or peptides derived therefrom, more particularly those of

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Porphyromonas gingivalis, most particularly the arginine-specific proteases and immunogenic compositions containing Arg-gingipains and/or peptides derived therefrom, and the lysine-specific proteases termed Lys-gingipains herein and immunogenic compositions containing Lys-gingipain(s) and/or peptides derived therefrom. Those immunogenic compositions are useful in the protection of a mammal, including a human, from infection and pathology caused by P. gingivalis. Porphyromonas gingivalis (formerly Bacteroides gingivalis) is an obligately anaerobic bacterium which is implicated in periodontal disease. P. gingivalis produces several distinct proteolytic enzymes; its proteinases are recognized as important virulence factors, together with other factors such as lipopolysaccharide and a polysaccharide capsule, fimbriae, lectin-like adhesins, hyaluronidase, keratinase, superoxide dismutase and hemagglutinating and hemolyzing activities. A number of physiologically significant proteins, including collagen, fibronectin, immunoglobulins, complement factors C3, C4, C5, and B, lysozyme, iron-binding proteins, plasma proteinase inhibitors, fibrin and fibrinogen, and factors of the plasma coagulation cascade system, are hydrolyzed by P. gingivalis proteases. Broad proteolytic activity plays a role in the evasion of host defense mechanisms and the destruction of gingival connective tissue in progressive periodontitis [Saglie et al. (1988) J. Periodontal. 59:259-265]. Progressive periodontitis is characterized by acute tissue degradation promoted by collagen digestion and a vigorous inflammatory response characterized by excessive neutrophil infiltration [White and Maynard (1981) J. Periodontal Res. 16:259-265]. Gingival crevicular fluid accumulates in periodontitis as periodontal tissue erosion progresses at the foci of the infection, and numerous plasma proteins are exposed to proteinases expressed by the bacteria at the injury site. Neutrophils are recruited to the gingiva, in part, by the humoral chemotactic factor C5a. The complement components C3 and C5 are activated by complex plasma proteases with "trypsin-like" specificities called convertases [Muller-Eberhard (1988) Ann. Rev. Biochem. 57:321-347]. The human plasma convertases cleave the.alpha.-chains of C3 and C5 at a specific site generating biologically active factors known as anaphylatoxins (i.e. C3a and C5a). The anaphylatoxins are potent proinflammatory factors exhibiting chemotactic and/or spasmogenic activities as well as promoting increased vascular permeability. The larger products from C3 and C5 cleavage (i.e. C3b and C5b) participate in functions including complement cascade activation, opsonization, and lytic complex formation. Web site: http://www.delphion.com/details?pn=US06129917__ •

Laminin 5 for periodontal treatment Inventor(s): Halberstadt; Craig (San Diego, CA) Assignee(s): Desmos, Incorporated (San Diego, CA) Patent Number: 6,034,068 Date filed: April 14, 1998 Abstract: A trans-epithelial appliance or shaped article coated with laminin 5. Laminin 5 stimulates cell attachment and may be comprise an insoluble or soluble cell matrix. The appliance will be useful for reducing inflammation and/or infection at the site of entry of the appliance. The appliance may also be used to stimulate gum junctional epithelium adhesion in the treatment of, for example, gingivitis and periodontitis. Excerpt(s): The present invention relates to the attachment of cells to shaped articles. More specifically, the invention relates to the attachment of epithelial cells to laminin 5coated biologically compatible implants and trans-epithelial appliances. When organs of

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the body are formed, they develop in neatly organized arrays. Often, cell types are separated by connective tissue called basement membranes. In skin, for instance, the superficial layer of epidermal cells adheres to the underlying basement membrane. This skin basement membrane acts as a barrier between the epidermal cells on the outside, and the dermal cells underneath. A similar arrangement of cells occurs in the lining of the gut and in the oral cavity. Basement membranes have been implicated in the growth, attachment, migration, repair and differentiation of their overlying cell populations. Three layers have been defined in basement membranes: a) the lamina lucida, an electronmicroscopically clear region in close approximation to the overlying cells; b) the lamina densa, an electron dense region of 20-300 nm in width; and c) the sublamina densa which contains anchoring fibrils, microfibrillar bundles and collagen fibers. Web site: http://www.delphion.com/details?pn=US06034068__ •

Lysine decarboxylase inhibitors for the prevention and treatment of periodontal disease Inventor(s): Levine; Martin (505 Kensington Rd., Norman, OK 73072) Assignee(s): none reported Patent Number: 6,103,220 Date filed: January 22, 1999 Abstract: An agent,.alpha.-difluoromethyl lysine (DFML) or.alpha.-monofluoromethyl lysine (MFML), inhibits lysine decarboxylases produced by bacteria associated with periodontal tissues. Inhibition of such lysine decarboxylases can prophylactically and therapeutically treat periodontal diseases such as gingivitis and periodontitis. The agent may be incorporated into toothpastes, mouthwashes, irrigation solutions, tablets, periodontal treatment packs, or an adhesive paste or film coatings for applying to the teeth. Excerpt(s): Adult periodontal disease is a widespread medical problem that is difficult to treat, especially in the middle-aged and elderly. It develops when bacteria indigenous to the oral cavity colonize gingival sulci, forming bacterial plaques in the absence of oral hygiene. Inflammation (gingivitis) develops and eventually spreads, causing tooth attachment loss (periodontitis). The diversity of the oral flora, the chronic nature of the disease, and the absence of a generally accepted animal or in vitro model, have made the molecular pathogenesis of this disease by bacteria difficult to study [1]. Therapies for this disease have also been hampered by ignorance of the bacterial induction process [2]. Current therapy requires that the dentist improve oral hygiene by debridement (scaling and root-planing) and repair tissue architecture using periodontal surgery as necessary [3]. The patient must undertake regular toothbrushing and flossing [4,5]. This therapy is expensive, time-consuming and unpredictable in its outcome [6]. Gingivitis is detected when the gingival sulcus, a shallow crevice between the teeth and gingiva, bleeds on gentle probing [7]. Bacterial plaques extend into this sulcus by an orderly process of colonization and coaggregation in the absence of oral hygiene [8-10]. The initial plaque is mostly composed of actinomyces and viridans streptococci, but it is soon overgrown by Gram-negative bacteria and spirochetes [8,11]. One of the earliest bacterial complexes that overgrow the initial flora in gingival sulci consists of E. corrodens and Capnocytophaga spp. These Gram-negative bacteria are found equally in sulci that are both healthy and inflamed, whereas different bacterial complexes are found exclusively at inflamed sulci and in association with uncontrolled periodontitis [12]. Many of these disease-associated bacteria are thought to induce inflammation by making short-chain

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fatty acids that inhibit cell growth in culture [13,14]. A key observation is that the colonization by indigenous bacteria is required before the disease-associated flora appears in a sulcus. The number of inflamed sulci increases until, by 21 days of no oral hygiene, gingivitis is apparent throughout the mouth [11]. Eventually, the tooth attachment recedes beneath the cemental-enamel junction, forming periodontal pockets or causing gingival recession [15]. Saline extracts of bacterial plaques contain toxic proteins and short chain fatty acids that inhibit mammalian cell growth in culture [2022]. The short chain fatty acid content indicates the presence of disease-associated bacteria in the samples. The toxic proteins were identified with plaque toxinneutralizing monoclonal antibodies [23] and found to cross-react with a toxic 80 kilodalton protein (p80) from E. corrodens [24]. This protein is homologous to lysine decarboxylases from enteric bacteria [25], enzymes that metabolize extracellular lysine into cadaverine and carbon dioxide [26]. The inventor has found that this enzyme inhibits mammalian cell growth by depleting the culture medium of lysine, an amino acid which is not synthesized de novo by mammalian cells. Web site: http://www.delphion.com/details?pn=US06103220__ •

Method for the treatment of topical inflammatory diseases Inventor(s): Arginteanu; Ronit Y. (401 E. 86th St., Ninth Floor, New York, NY 10028), Youssefyeh; Parvin (1175 York Ave, Apt 14D, New York, NY 10021) Assignee(s): none reported Patent Number: 5,968,519 Date filed: May 15, 1998 Abstract: Method for the treatment of inflammation and pain associated with inflammatory dermatoses, gingivitis and acute injury with a composition of finely divided powder of safflower seed or its extract contained in a pharmaceutically acceptable carrier. Excerpt(s): The present invention relates to treatment of mammals by reducing inflammation that triggers the onset of rheumatic diseases, eczema, urticaria, psoriasis, erythema multiforme and lichen planus; inflammation of the gums, and chronic locaized bodily pain derived from acute injury. The present invention is also directed to the treatment of delaying menopause. Rheumatoid arthritis (hereinafter sometimes referred to as RA) is a common type of arthritis that causes inflammation in the lining of the joints and sometimes other internal organs. RA tends to persist for many years, typically affects many different joints throughout the body, and ultimately can cause damage to cartilage, bones, tendons and ligaments. RA is a chronic, inflammatory, connective-tissue disorder affecting more than five million individuals in the U.S., and accounting for considerable disability in terms of missed work, lost wages, and reduced productivity. The disease can occur at any age, but it most commonly begins in the third to fifth decades of life. 7. Changes on hand radiographs typical of rheumatoid arthritis that must include erosions or unequivocal bony decalcification. Web site: http://www.delphion.com/details?pn=US05968519__

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Method of using IL-11 for treating antibiotic induced diarrhea Inventor(s): Keith; James (Andover, MA), Schendel; Paul (Wayland, MA) Assignee(s): Genetics Institute, Inc. (Cambridge, MA) Patent Number: 5,948,402 Date filed: July 15, 1997 Abstract: Provided by the present invention are methods of treating a variety of disorders including AIDS, arthritis (rheumatoid arthritis, osteoarthritis, spondyloarthropathies), antibiotic induced diarrheal diseases (Clostridium difficile), multiple sclerosis, osteoporosis, gingivitis, peptic ulcer disease, esophagitis, diabetes, retinitis, uveitis, reperfusion injury after myocardial infarction (MI) or cerebral vascular accident (CVA), aphthous ulcers (oral), atherosclerosis (plaque rupture), prevention of tumor metastases, asthma, preeclampsia, and allergic disorders such as rhinitis, conjunctivitis, and urticaria. Excerpt(s): The present invention relates generally to methods of treating disorders such as AIDS, arthritis (rheumatoid arthritis, osteoarthritis, spondyloarthropathies), antibiotic induced diarrheal diseases (Clostridium difficile), multiple sclerosis, osteoporosis, gingivitis, peptic ulcer disease, esophagitis, diabetes, retinitis, uveitis, reperfusion injury after myocardial infarction (MI), cerebral vascular accident (CVA), aphthous ulcers (oral), atherosclerosis (plaque rupture), prevention of tumor metastases, asthma, preeclampsia, and allergic disorders such as rhinitis, conjunctivitis, and urticaria. Inflammatory responses include a broad range of host reaction to a variety of insults, such as injury, infection, or rejection. It is the over production of mediators that is believed to be associated with a broad range of disorders, including AIDS, arthritis (rheumatoid arthritis, osteoarthritis, spondyloarthropathies), antibiotic induced diarrheal diseases (Clostridium difficile), multiple sclerosis, osteoporosis, gingivitis, peptic ulcer disease. esophagitis, diabetes, retinitis, uveitis, reperfusion injury after myocardial infarction (MI). cerebral vascular accident (CVA), aphthous ulcers (oral), atherosclerosis (plaque rupture), tumor metastases, asthma, preeclampsia, and allergic disorders such as rhinitis, conjunctivitis, and urticaria. These disorders and their symptoms are briefly summarized below. According to the methods of the present invention, IL-11 is administered to modulate the hosts' over reaction to insult thereby treating the following disorders. Web site: http://www.delphion.com/details?pn=US05948402__

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Pharmaceutical dental formulation for topical application of metronidazole benzoate and chlorhexidine gluconate Inventor(s): Doshi; Madhukant Mansukhlal (Maharashtra, IN), Mody; Pranabh Dinesh (Maharashtra, IN), Mody; Shri Shirish Bhagwanlal (Maharashtra, IN) Assignee(s): Lekar Pharma Limited (Mumbai, IN) Patent Number: 6,017,516 Date filed: October 31, 1997 Abstract: A pharmaceutical dental formulation of therapeutically effective amounts of metronidazole benzoate and chlorhexidine gluconate is described. The formulation also includes a gelled hydrophilic and water-dipersible polymer having free carboxylic groups, an aqueous base, a penetration enhancer and a chelating agent. The formulation

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is for topical application in the form of an aqueous gel in the treatment of periodontal diseases including gingivitis, stomatitis, Apthous ulcers and post-extraction infection. Excerpt(s): The present invention relates to the pharmaceutical dental formulation for topical application in the form of aqueous gel suitable for the treatment of periodontal diseases which mainly include gingivitis, stomatitis, apthous ulcers, post extraction infections. The periodontal disease as used herein is a broad term used to describe those diseases which attack the gingiva and the underlying alveolar bone supporting the teeth. Two common periodontal diseases are gingivitis (inflammation of the gingiva) and periodontitis manifested by progressive resorption of alveolar bone, increasing mobility of the teeth and loss of the teeth at advanced stage). Periodontal disease is characterised by one or more of the following inflammation of the gingiva, formation of periodontal pockets bleeding and/or pus discharge from the periodontal pockets, resorption of alveolar bone, loose teeth and loss of teeth. This disease is generally considered to be caused by/associated with bacteria which are generally present in dental plaque which forms on the surface of the teeth and in periodontal pocket. Inflammation of the soft tissues (gingivae) around teeth is referred to as gingivitis and may be caused by microbial infection. In the case of progressive infection, direct microbial actions as well as the production of tissue-destructive enzymes such as collagenase, with or without stimulation of host tissue-destructive enzyme activity by the infectious agents can lead to destruction of supporting tissues around the teeth, a condition referred to as periodontitis (Klausen et al, 1991). The subgingival microbiota associated with these peridental conditions may be comprised of multiple species and may change during the course and progression of the dental infections. Gram (-ve) anaerobic bacteria in particular, are known to play an essential role. Streptococcus mutans: Aerobic. Synthesizes dextran. Colony density on tooth surface plaque rises to >50% in presence of high dietary sucrose. Able to produce acid from most sugars. The most important organism in the aetiology of dental caries. Web site: http://www.delphion.com/details?pn=US06017516__ •

Testkit and method Inventor(s): Blomlof; Leif (Lindingo, SE), Lindskog; Sven (Stockholm, SE), Zetterstrom; Olle (Jarfalla, SE) Assignee(s): Peridoc AB (Stockholm, SE) Patent Number: 6,340,455 Date filed: June 23, 1999 Abstract: Skin prick test for the determination of the predisposition of an individual to develop marginal periodontitis, said kit comprising: (a) a first reagent containing a known quantity of a surface structure common to anaerobic Gram negative pathogens which is capable of triggering the inflammatory response associated with periodontitis and gingivitis; (b) second reagent containing an agonist to said individual; (c) a negative control; and (d) instructions for the use of said kit; and a method for such determination of predisposition. Excerpt(s): The present invention relates to a skin prick test kit for the determination of the predisposition of an individual to develop marginal periodontitis. The invention also involves a method for the determination of such predisposition. The most frequent disease that affects the attachment apparatus of the teeth or the periodontium is gingivitis. It is caused by our indigenous bacterial flora and is, for some individuals a

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first step towards marginal periodontitis. A shift towards more anaerobic bacteria in the bacterial plaque is thought to be the reason why gingivitis turns into marginal periodontitis. Despite the fact that almost all individuals suffer from gingivitis, there is no clear relation between the degree of gingivitis and development of marginal periodontitis. Epidemiological studies have, however, shown that between 5 and 10% of the adult population develop severe marginal periodontitis, while a moderate form affects 50 to 80%. Progression of periodontitis is influenced by a multitude of modifying factors (Genco, RJ, Loe H. The role of systemic conditions and disorders in periodontal disease. Periodontol 2000 1994; 2: 98-116). These can be divided into systemic factors which affect the entire dentition and local factors which affect a single tooth or tooth surface. Web site: http://www.delphion.com/details?pn=US06340455__ •

Treatment of inflammation with 2,4,6-trihydroxy-alpha-rhomethoxyphenylacetophenone, or its pharmaceutically acceptable derivatives Inventor(s): Malaviya; Ravi (St. Paul, MN), Uckun; Fatih M. (White Bear Lake, MN) Assignee(s): Parker Hughes Institute (Roseville, MN) Patent Number: 6,248,790 Date filed: June 29, 2000 Abstract: 2,4,6-trihydroxy-.alpha.-p-methoxyphenylacetophenone (also identified herein as "D-58"), or its pharmaceutically acceptable derivatives such as salt and ester forms, is administered for inhibiting inflammatory reactions. The treatment can be remedial or prophylactic. Examples of the conditions that can be treated include acute inflammatory reactions and allergic inflammatory reactions, and specific examples include allergy, asthma, arthritis, psoriasis, skin sunburn, inflammatory pelvic disease, inflammatory bowel disease, urethritis, uvitis, senusitis, pneumonitis, encephalitis, meningitis, myocarditis, nephritis, osteomyelitis, myositis, hepatitis, gastritis, enteritis, dermatitis, gingivitis, appendicitis, pancreatitis, cholocystitis and cholangitis. The 2,4,6-trihydroxy.alpha.-p-methoxyphenylacetophenone can be administered by various routes as needed. Excerpt(s): The present invention is directed to the treatment of acute and chronic inflammatory responses, for example resulting from the presence of an allergen, injury, infection, etc. Allergic and acute inflammatory responses to injury, infection, or other tissue damage can set into motion a complex series of events. A variety of host cells that guard the host environment interface, including macrophages, mast cells, and epithelial/epidermal cells serve as the initiators of the inflammatory responses. These cells release various mediators during an inflammatory response, which include histamine, prostaglandins (PGs), leukotrienes (LTs) and proinflammatory cytokines (refs 1-4). These mediators have been implicated in the pathogenesis of a number of acute and chronic inflammatory conditions such as allergy, asthma, arthritis, psoriasis, and skin sunburn (refs 3-5). The release of inflammatory agents is mediated by a cascade of intracellular signaling events which include activation of phosphoinositide turnover (ref 6), increase in cAMP levels (ref 7), activation of protein kinase C, and an increase in intracellular calcium levels and tyrosine phosphorylation of several cytosolic proteins (refs 7 and 8). Considerable efforts have been made for identification of chemical compounds that can interrupt these signaling events as potential anti-inflammatory agents (refs 9-12). However, the need for agents providing improved inhibition continues. In accordance with the present invention, 2,4,6-trihydroxy-.alpha.-p-

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methoxyphenylacetophenone (also identified herein as "D-58"), or its pharmaceutically acceptable derivatives such as salt and ester forms, is administered for inhibiting inflammatory reactions to a subject in need thereof. The treatment can be remedial or prophylactic. Examples of the conditions that can be treated include acute as well as chronic inflammatory reactions and allergic inflammatory reactions, and specific examples include allergy, asthma, arthritis, psoriasis, skin sunburn, inflammatory pelvic disease, inflammatory bowel disease, urethritis, uvitis, sinusitis, pneumonitis, encephalitis, meningitis, myocarditis, nephritis, osteomyelitis, myositis, hepatitis, gastritis, enteritis, dermatitis, gingivitis, appendicitis, pancreatitis, cholocystitis and cholangititis. The 2,4,6-trihydroxy-.alpha.-p-methoxyphenylacetophenone can be administered by one of a variety of routes as needed. Web site: http://www.delphion.com/details?pn=US06248790__

Patent Applications on Gingivitis As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to gingivitis: •

1,3,4-Oxadiazolin-2-one derivatives and drugs containing these derivatives as the active ingredient Inventor(s): Ohmoto, Kazuyuki; (Mishima-gun, JP), Okuma, Motohiro; (Mishima-gun, JP), Sekioka, Tomohiko; (Mishima-gun, JP) Correspondence: Sughrue Mion, Pllc; 2100 Pennsylvania Avenue, N.W.; Washington; DC; 20037; US Patent Application Number: 20030087831 Date filed: May 31, 2002 Abstract: 1The compounds of formula (I) have an elastase inhibitory activity, therefor, they are useful for the treatment and/or prevention of a disease induced by an abnormal enhancement of degradation of elastin, collagen fiber and/or proteoglycans by elastase, for example, pulmonary emphysema, rheumatoid arthritis, arteriosclerosis, adult respiratory distress syndrome, myocardial infarction, ulcerative colitis and gingivitis. Excerpt(s): (3) a pharmaceutical composition comprising them as active ingredient. Recently, researches and developments concerning elastase inhibitors are becoming active. was disclosed. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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This has been a common practice outside the United States prior to December 2000.

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Benzoic acid derivatives, processes for producing the same and drugs containing the same as the active ingredient Inventor(s): Kobayashi, Kaoru; (Osaka, JP), Maruyama, Takayuki; (Osaka, JP), Tani, Kousuke; (Osaka, JP) Correspondence: Sughrue Mion, Pllc; 2100 Pennsylvania Avenue, N.W.; Washington; DC; 20037; US Patent Application Number: 20030114435 Date filed: August 16, 2002 Abstract: An agent comprising the benzoic acid of formula (I) 1, wherein A, B, R.sup.6, R.sup.7 are carbocyclic ring, heterocyclic ring, etc.; R.sup.1 is hydroxy etc.; R.sup.2, R.sup.3, R.sup.4 are alkyl etc.; R.sup.5, D, E are alkylene, etc.; G is oxygen etc., as active ingredient.The compound of formula (I) is considered to be useful for the treatment and/or prophylaxis of bone diseases, cancer, systemic granuloma, immunological diseases, allergy, atopy, asthma, gumboil, gingivitis, periodontitis, neurocyte death, Alzheimer's diseases, lungs injury, pulmopathy, acute hepatitis, nephritis, myocardial ischemia, Kawasaki disease, ambustion, ulcerative colitis, Crohn's disease, multiple organ failure, sleeping disorder, platelet aggregation, etc. Excerpt(s): The present invention relates to benzoic acid derivatives. , wherein all symbols have the same meanings as hereafter described, a process for the preparation thereof and a pharmaceutical agent comprising the same as active ingredient. Prostaglandin E.sub.2 (abbreviated as PGE.sub.2) has been known as a metabolite in the arachidonic acid cascade. It has been known that PGE.sub.2 possesses cyto-protective activity, uterine contractile activity, a pain-inducing effect, a promoting effect on digestive peristalsis, an awaking effect, a suppressive effect on gastric acid secretion, hypotensive activity, and diuretic activity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Compositions to control oral microbial oxidation-reduction (Eh) levels Inventor(s): Codipilly, Milroy; (Coram, NY), Kleinberg, Israel; (Smithtown, NY) Correspondence: Darby & Darby P.C.; Post Office Box 5257; New York; NY; 10150-5257; US Patent Application Number: 20020182267 Date filed: June 24, 2002 Abstract: The present invention relates to an oral composition containing a zinc compound containing free available zinc ion and at least one stabilized or stable E.sub.h raising compound distributed in an oral vehicle. The present invention further relates to a method of inhibiting the formation of sulfur containing anions and preventing a reduction in the E.sub.h of the oral cavity. A method of reducing oral malodor and gingivitis and periodontitis is also provided by this invention. Excerpt(s): This application is a continuation of application Ser. No. 09/506,662, filed Feb. 17, 2000, which is a divisional of application Ser. No. 09/077,249, filed Jun. 10, 1998 which is a 371 national phase of PCT/US97/19598, filed Oct. 23, 1997, which is a continuation-in-part of U.S. Ser. No.08/736,356, filed Oct. 23, 1996 all incorporated herewith by reference. The present invention provides oral compositions comprising a zinc compound containing free available zinc and at least one stabilized or stable

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E.sub.h raising compound distributed in an oral vehicle. The present invention is further directed to a method of inhibiting the formation of anionic sulfur species in the oral cavity and preventing a lowering of the E.sub.h of the oral cavity. A method of simultaneously reducing oral malodor, gingivitis and periodontitis by preventing or reducing oral putrefaction is also provided by this invention. The hard and soft tissues of the mouth are covered with microbial populations that contain bacteria with different metabolic capabilities. The Gram-positive bacteria within these microbial populations readily catabolize carbohydrates to produce acids which attack the hard tissues of the oral cavity, resulting in the formation of dental caries lesions (cavities). In contrast, the Gram-negative bacteria, especially the anaerobes readily metabolize various amino acids contained in salivary (and to lesser extent other) peptides and proteins in the oral cavity to form end-products which favor the formation of oral malodor and periodontitis. This process of peptide, protein and amino acid degradation by the mouth bacteria is referred to as oral bacterial putrefaction. The mixture of malodorous compounds produced by the Gram-negative anaerobic bacteria during putrefactive degradation of proteins, peptides and amino acids include hydrogen sulfide, methyl mercaptan, and dimethyl sulfide (formed from the sulfur containing amino acids cysteine, cystine and methionine); indole and skatole (formed during the metabolism of tryptophan); cadaverine and putrescine (produced from lysine and ornithine); and butyrate and valerate (produced from the metabolism of other amino acids). The production of these malodorous compounds in the oral cavity results in a condition commonly referred to as oral malodor. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Cyclodextrins in dental products Inventor(s): Nelson, Dennis G.A.; (New York, NY), Sheehan, Craig J.; (New York, NY) Correspondence: Paul H. Ginsburg; Pfizer Inc; 235 East 42nd Street; New York; NY; 10017; US Patent Application Number: 20010006958 Date filed: January 29, 2001 Abstract: Oral rinse and dentifrice compositions, comprising a phenolic selected from the group consisting of menthol, eucalyptol, methyl salicylate, thymol, triclosan, and mixtures thereof; and a cyclodextrin selected from the group consisting of hydroxypropyl.beta.-cyclodextrin, hydroxyethyl.beta.-cyclodextrin, hydroxypropyl.gamma.-cyclodextrin, hydroxyethyl.gamma.-cyclodextrin,.alpha.cyclodextrin, methyl.beta.-cyclodextrin, and mixtures thereof. These compositions are useful in retarding the development of plaque, treating gingivitis, and in treating the presence of micro-organisms in the oral cavity. Excerpt(s): This non-provisional application is based upon and claims priority from Provisional Application No. 60/016,135 filed Apr. 24, 1996. The present invention relates to dental products comprising cyclodextrins. Dental plaque is present to some degree, in the form of a film, on virtually all dental surfaces. It is a by-product of microbial growth, and comprises a dense microbial layer consisting of a mass of micro-organisms embedded in a polysaccharide matrix. The micro-organisms present in plaque are mainly coccoidal organisms, particularly in early plaque. As plaque ages and matures, gram negative anaerobes and filamentous organisms appear and become more common after a few days. Plaque itself adheres to dental surfaces and may not be removed completely even with a rigorous brushing regimen and can build up, for example, in

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recessed areas of tooth surfaces, such as approximal regions and fissures. Moreover, plaque rapidly reforms on the tooth surface after it is removed. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Fast dissolving orally consumable films Inventor(s): Kulkarni, Neema; (Randolph, NJ), Kumar, Lori D.; (Skillman, NJ), Leone, Robert S.; (Fanwood, NJ), Leung, Sau-Hung S.; (Parsippany, NJ), Sorg, Albert F.; (Columbia, NJ) Correspondence: Fitzpatrick Cella Harper & Scinto; 30 Rockefeller Plaza; New York; NY; 10112; US Patent Application Number: 20010022964 Date filed: April 18, 2001 Abstract: Physiologically acceptable films, including edible films, are disclosed. The films include a water soluble film-forming polymer such as pullulan. Edible films are disclosed that include pullulan and antimicrobially effective amounts of the essential oils thymol, methyl salicylate, eucalyptol and menthol. The edible films are effective at killing the plaque-producing germs that cause dental plaque, gingivitis and bad breath. The film can also contain pharmaceutically active agents. Methods for producing the films are also disclosed. Excerpt(s): This invention relates to fast dissolving orally consumable films. The films are used to deliver breath deodorizing agents, antimicrobial agents and salivary stimulants to the oral cavity. The films can also be used to deliver pharmaceutically active agents. In a more perfect world, people would thoroughly cleanse their mouths after each meal as part of their routine oral hygienic practices. Unfortunately, several factors conspire to prevent widespread compliance with this basic requirement of a good oral cleaning regimen. Oral cleansing can be difficult or inconvenient at times, depending on the nature of the cleansing and the situation in which the cleansing must occur. Brushing, flossing, cleaning your tongue and gargling using a variety of devices and compositions well-suited for the privacy of one's home are common oral care practices. However, the devices and compositions used in oral cleansing practices are less convenient to use away from home, where bathroom facilities might be scarce, unavailable or unsanitary. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Lactone formulations and method of use Inventor(s): Terrero, David; (Ensanche Quisquella, DO) Correspondence: Patrea L. Pabst; Holland & Knight Llp; Suite 2000, One Atlantic Center; 1201 West Peachtree Street, N.E.; Atlanta; GA; 30309-3400; US Patent Application Number: 20030069393 Date filed: June 12, 2002 Abstract: Compounds of Formulae Ia and Ic having a lactone structure and an methylene group at the alpha-position of the lactone structure and methods for using and making the compounds have been disclosed. The lactone compounds can be reacted with an neucleaphilic agent to open the lactone ring to a compound of Formula Ib. The

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lactone of Formula Ia and its functional derivatives have been isolated from Securidaca virgata. These compounds are referred to as LMSV-6 or Securolide.TM. The purified compounds have demonstrated activity in assays for anti-bacterial and anti-fungal activities, and for treating proliferation disorders such as cancer. Based on the in vitro assays, the lactones are useful for treating proliferation disorders including, for example, breast cancer, colon cancer, rectal cancer, stomach cancer, pancreatic cancer, lung cancer, liver cancer, ovarian cancer, esophageal cancer, and leukemia. They are also effective for treatment of bacterial and fungal infections, including treatment of peptic ulcer disease, gingivitis and periodontitis. The lactone and its derivatives has the following chemical structure: 1wherein R.sub.1-R.sub.9 and Y.sub.1-Y.sub.3 taken independently are preferably a hydrogen atom, a halogen atom, a hydroxyl group, or any other organic groups or groupings which optionally include a heteroatom such as oxygen, sulfur, or nitrogen groupings in linear, branched, or cyclic structural formats; Z and X are independently and preferably a heteroatom such as oxygen, sulfur, or nitrogen groupings in linear, branched, or cyclic structural formats; and Z' may a hydrogen atom, a halogen atom, a hydroxyl group, or any other organic groups or groupings which optionally include a heteroatom such as oxygen, sulfur, or nitrogen groupings in linear, branched, or cyclic structural formats. Excerpt(s): This application claims priority to U.S. Provisional Patent Application No. 60/297,875 filed Jun. 13, 2001. The present inventions are generally in the fields of pharmaceutically active lactones, their pharmaceutical formulations, and method of use thereof, and methods for the synthetic preparation of chemically functionalized lactones useful therefor as anticancer and antiinfective agents. Despite the development of many different compounds which are useful in the treatment of infection, cancer, and other disorders, there remains a need for the development of new compounds which may be effective at lower dosages, more selective, having fewer side effects or capable of treating diseases or disorders where resistance to the known compounds has developed. Chemotherapeutic agents are used for the treatment of infections, cancer, abnormal proliferation disorders (endometriosis, restenosis, psoriasis), and other disorders. Most chemotherapeutic agents have side effects due to lack of specificity. For example, cancer is one of the leading causes of death. One of the primary modes of treating cancer, chemotherapy, is used specifically to limit cell growth and replication. Most chemotherapy agents also affect neoplastic and rapid proliferating cells of normal tissues (e.g., bone marrow, hair follicles, etc.), which results in several negative side effects including hair loss, nausea, vomiting, and suppression of bone marrow function. Moreover, effectiveness of these agents frequently diminishes over time due to the development of resistance. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for reducing the viability of detrimental oral microorganisms in an individual, and for prevention and/or treatment of diseases caused by such microorganisms; and whitening and/or cleaning of an individual's teeth Inventor(s): Salonen, Jukka; (Turku, FI), Soderling, Eva; (Rusko, FI), Stoor, Patricia; (Turku, FI), Yli-Urpo, Antti; (Littoinen, FI) Correspondence: James C. Lydon; Suite 100; 100 Daingerfield Road; Alexandria; VA; 22314; US Patent Application Number: 20020114768 Date filed: December 7, 2001

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Abstract: The invention relates to a method for reducing the viability of detrimental oral microorganisms in an individual, said method comprising subjecting the individual's oral cavity to a bioactive glass, the average particle size of which is less than 100.mu.m.Furthermore, this invention concerns a method for the prevention of dental caries and/or gingivitis in an individual, said caries being caused by a cariogenic bacteria; or for prevention or treatment of periapical infections.Further the invention relates to a method for the whitening and/or mechanical cleaning of an individual's teeth. Excerpt(s): This invention relates to a method for reducing the viability of detrimental oral microorganisms in an individual, and for prevention of dental caries and gingivitis, and for prevention or treatment of periapical infections, and whithening and/or mechanical cleaning of an individual's teeth. The publications and other materials used herein to illuminate the background of the invention, and in particular, cases to provide additional details respecting the practice, are incorporated by reference. Bioactive glasses have been tested as substitutes for reconstruction of defects of the facial bones (1), rehabilitation of the dentoalveolar complex (2), regeneration of periodontal pockets (3), and recently also for treatment of hypersensitive teeth (4). The surface reactive bioactive glass contains SiO.sub.2, Na.sub.2O, CaO and P.sub.2O.sub.5. The chemical bond with bone in vivo is reported to result from the leaching of Na.sup.+-ions and the congruent dissolution of calcium, phosphate and silica from the glass in an aqueous environment, giving rise to an Si-rich layer on the material. The Si-rich layer acts as a templet for a calcium phosphate precipitation, which then binds to the bone (5). Bioactive glass has been successfully used for reconstructions of closed bone defects, which are not exposed to the external environment after the clinical procedure (1). However, there are a number of conditions for which bioactive glasses are used as therapeutic materials but that, at the same time, are imminently prone to microbial infections. These include clinical conditions such as infected frontal sinuses (6), periodontal pockets (3) and hypersensitive teeth as a complication of periodontal treatment or tooth wear that has resulted in the exposure of dentin and dentinal tubules (4). Obviously, the demonstration of any antibacterial activity of the biactive glass would add to the therapeutic value of the material in the clinical conditions described. Earlier studies have shown that P. gingivalis is agglutinated in the presence of granules (315-500.mu.m) of the bioactive glass S53P4 in an aqueous environment due to Ca.sup.+2-ions released from the granules (19, 7). The minimum Ca.sup.2+concentration needed to induce agglutination of P. gingivalis was found to be 0.04 g/l (7). In these studies, however, no reduction of the viability of the bacteria was noticed. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Novel lactic acid bacteria Inventor(s): Oh, Jong Suk; (Kwangju-City, KR) Correspondence: Frommer Lawrence & Haug; 745 Fifth Avenue- 10th FL.; New York; NY; 10151; US Patent Application Number: 20030077814 Date filed: April 15, 2002 Abstract: Enterococcus spp. 1357, Lactobacillus spp. V20 and Lactococcus spp. 1370, and H.sub.2O.sub.2-producing Streptococci have a potent and lasting inhibitory activity on the production of water-insoluble glucan (mutan) and dental plaque in human mouth,

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or the growth of anaerobic bacteria causing gingivitis, periodontitis, and accompanied halitosis. Excerpt(s): The present invention relates to some novel lactic acid bacteria which inhibit the production of dental plaque in human mouths. More specifically, the production of water-insoluble glucan (mutan), a major component of dental plaque, which is produced by bacteria normally inhibiting in human mouths, can be inhibited by the novel bacteria. Oral anaerobic bacteria causing gingivitis, periodontitis, and accompanied halitosis (malodor) can be inhibited by the novel bacteria, too. These lactic acid bacteria belong to Enterococcus spp., Lactobacillus spp., Lactococcus spp., and Stretococcus spp. which inhibit the production of water-insoluble glucan or antagonize against the bacteria playing a role in forming water-insoluble glucan, or inhibit the growth of anaerobic bacteria causing gingivitis and periodontitis. Lactic acid bacteria generally ferment carbohydrates to lactic acid. Lactic acid bacteria live in the oral cavities and the alimentary tracts of men and animals and are utilized for the manufacture of fermentative foods, such as yogurt, cheese, etc. In addition, they are used for the production of biologically active materials, such as medicines. Representatives of these lactic acid-producing bacteria are Streptococcus thermophilus, Enterococcus faecalis, Enterococcus durans, Lactococcus lactis, Lactobacillus acidophilus, Lactobacillus bulgaricus, Lactobacillus casei, and Lactobacillus plantarum. As inhabitants in the entrails of men and animals, these Gram-positive lactic acid bacteria are known to play an important role in maintaining the entrails healthy by the production of lactic acid and antibacterial materials which inhibit the growth of pathogenic bacteria. The most important component of dental plaque is glucan. Glucan is either water-soluble glucan, dextran having 1,6-.alpha. linkage as a predominant linkage, or water-insoluble glucan (mutan) having 1,3-.alpha. linkage as a predominant linkage. The solubility in water is inversely proportional to the number of 1,3-.alpha. linkage. Therefore, water-insoluble glucan (mutan) serves as a main matrix of dental plaque. Dextranase (.alpha.-1,6 glucan hydrolase) which digests dextran, was tested as to its ability to prevent dental plaque. But the effectiveness value of dextranse to prevent dental plaque was questionable (Essential Dental Microbiology: Appleton & Lange, Norwalk, San Mateo, p.337, 1991), because dextranase can not digest mutan, the main matrix of dental plaque. Mutanase (endo-.alpha.-1,3-glucanase) which decomposes mutan was found to have some effect on the digestion of dental plaque. The decomposition effect of the mutanase on dental plaque, however, was trivial and it took too much time to express its effectivity. Therefore, these enzymes were found to have an insignificant effect on dental plaque formation in human oral cavity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Operatory water disinfection system Inventor(s): Burris, William A.; (Pittsford, NY), Prinsen, Phillip M.; (Ontario, NY) Correspondence: Steven R. Scott; Eugene S. Stephens & Associates; 56 Windsor Street; Rochester; NY; 14605; US Patent Application Number: 20020134736 Date filed: February 13, 2002 Abstract: This ozone appliance for the professional dental office and other medical applications introduces dissolved ozone into dental and surgical operatory water lines. This dissolved ozone can not only disinfect water and water lines; it can also reduce gum bleeding, gingivitis, bad breath, teeth stains and oral bacteria. Additionally, it can

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aid in wound disinfection in surgery and attack microbial contamination of water from dental and surgical operatory water lines and attached hand pieces and dispensing devices by automatically killing waterborne germs and destroying biofilms where germs can hide and grow. It can, therefore, be used to disinfect water lines in dental operations and for other medical applications such as providing liquid containing ozone for cleaning and disinfecting skin prior to surgery (and tissue exposed during surgery). Further, a unit connected to operatory water lines can give an audible or other alarm if the water becomes unsafe. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/269,403, filed on Feb. 16, 2001, which provisional application is incorporated by reference herein. Ozone disinfection of operatory water lines, in particular dental operatory unit water lines. There has been serious concern that microbial contamination of dental office water systems puts dental patients at risk of diseases. The problem of water contamination, especially when due to cross contamination from other patients, is greatest for patients with weak immune systems. Additionally, dental water can become contaminated from the water supply. More commonly, contamination results from growth of microbial biofilms on the inner surface of water lines. Such biofilms can include germs introduced from patients. Germs can slough off from biofilms as water passes through water lines. Thus, it is not uncommon for water coming out of dental hand pieces to have more than one million bacteria per milliliter while the water entering the dental lines has less than 100 bacteria per milliliter. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Oral care compositions comprising chlorite and methods Inventor(s): Wimalasena, Rohan Lalith; (Liberty Township, OH), Witt, Jonathan James; (Cincinnati, OH), Wong, Andrew Lee; (West Chester, OH) Correspondence: Emelyn L. Hiland; The Procter & Gamble Company; Health Care Research Center (box 1050); P.O. Box 8006; Mason; OH; 45040-8006; US Patent Application Number: 20010006624 Date filed: January 30, 2001 Abstract: The present invention relates to oral care compositions, including therapeutic rinses, especially mouth rinses, as well as toothpastes, gels, tooth powders, chewing gums, mouth sprays, and lozenges (including breath mints), comprising at least a minimally effective amount of chlorite ion, wherein preferably the pH of the final composition is greater than 7 and level of chlorine dioxide or chlorous acid is less than about 50 ppm, preferably is essentially free of chlorine dioxide or chlorous acid. This invention fuirther relates to a method for treating or preventing gingivitis, plaque, periodontal disease, and/or breath malodor, and/or for the whitening of teeth, in humans or other animals, by applying a safe and effective amount of the chlorite ion composition to the oral cavity. Excerpt(s): The present invention relates to oral care compositions, including therapeutic rinses, especially mouth rinses, as well as toothpastes, tooth gels, tooth powders, chewing gums, mouth sprays, and lozenges (including breath mints), comprising an effective amount of chlorite ion. This invention further relates to a method for treating or preventing conditions of the oral cavity, such as gingivitis, plaque, periodontal disease, and/or breath malodor, as well as to a method for whitening teeth, in humans or other animals. Oral malodor, plaque, gingivitis, periodontal disease, and

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discoloration of the teeth, are all undesirable conditions that affect many people. First malodor of the oral cavity is also known as halitosis or bad breath. It is broadly estimated in the US. that 20-90 million individuals have oral malodor. It is generally believed that the cause of this condition is due to the presence of anaerobic bacteria, especially gram-negative anaerobic bacteria, in the mouth. These bacteria will generate volatile sulfur compounds (VSC) which are known to cause breath malodor. It is recognized in the art that some breath malodor is caused by three chemical compounds. Specifically, these compounds are hydrogen sulfide (H--S--H), methyl mercaptan (CH.sub.3--S--H) and dimethyl sulfide (CH.sub.2--S--CH.sub.3). These compounds result from the degradation of epithelial cells and bacteria in the oral cavity. Specifically, the polypeptide chains of the epithelial cell walls, are composed of a series of amino acids including cysteine and methionine which contain sulfur side chains. The death of microorganisms or epithelial cells results in degradation of the polypeptide chains into their amino acid components, especially cysteine and methionine. Cysteine and methionine are precursors to the formation of VSC. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Oral composition containing NSAIDs and essential oils Inventor(s): Pan, Pauline; (Morris Plains, NJ), Rubin, Michael; (Boonton, NJ), Volpe, Frank; (Kinnelon, NJ) Correspondence: Evan J. Federman; Legal Division; Warner-lambert Company; 201 Tabor Road; Morris Plains; NJ; 07950; US Patent Application Number: 20010049363 Date filed: January 16, 2001 Abstract: Oral compositions for treating and/or preventing gingivitis are provided. The compositions include at least one NSAID, thymol, methyl salicylate, menthol and eucalyptol. The NSAID, thymol, methyl salicylate, menthol and eucalyptol are present in the composition in synergistically effective amounts. The compositions can be provided in the form of, e.g., mouthwashes or toothpastes, and are not only effective against gingivitis, but can also prevent or treat halitosis and other detrimental conditions of the oral cavity. Excerpt(s): This invention relates to oral compositions for treating and/or preventing diseases of the mouth, and more particularly to oral compositions for treating and/or preventing gingivitis. Gingivitis is a disease characterized by inflammation of the gingiva or gums. It is generally accepted that this inflammation is typically caused by an overabundance of bacterial plaque about the base of the teeth. Thus, a good deal of research has focused on preventing or treating gingivitis by minimizing the amount of bacterial plaque on the teeth and countering the inflammatory response of the gingiva. The amount of bacterial plaque on the teeth can be controlled by good hygiene, including mechanical removal by frequent brushing, flossing and the like. As an adjunct to the traditional mechanical methods for limiting the amount of bacterial plaque on the teeth, chemical methods have been developed that typically function by killing the bacteria responsible for forming plaque on the teeth. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Ozone irrigator Inventor(s): Burris, W. Alan; (Pittsford, NY), Prinsen, Phillip M.; (Ontario, NY) Correspondence: Steven R. Scott; Eugene S. Stephens & Associates; 56 Windsor Street; Rochester; NY; 14605; US Patent Application Number: 20020094309 Date filed: January 9, 2002 Abstract: This portable appliance can be used to clean teeth by liquid (water or solution) containing dissolved ozone, which is a potent oxidizer and germ killer. Preferably, its cleaning action is enhanced by pulsations of the liquid stream. The dissolved ozone can reduce or eliminate gingivitis, gum bleeding, bad breath, teeth stains, and harmful oral bacteria. This appliance can also be used for nasal irrigation for sinusitis treatment and for ear irrigation, eye care, and general cleaning. Additionally, since its output pump is independent of the ozone dissolving system, the ozone dissolving system can be configured as an add on device for an oral irrigator such as a Water Pik.TM. manufactured by WaterPik Technologies, Inc. In this configuration, the ozonated liquid is delivered by either gravity or pumped flow, to the original reservoir connection with the irrigator serving as the delivery portion of this invention. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/261,415, filed on Jan. 12, 2001, which provisional application is incorporated by reference herein. Our invention pertains generally to ozone generators used for the creation of ozonated fluids. It can be used for a variety of purposes, including oral irrigation devices primarily for home use. By this invention, we have improved upon the portable oral irrigation device. WaterPik.TM. is a well-known trade name belonging to WaterPik Technologies, Inc. The WaterPik.TM. is an example of the type of consumer appliance we are improving. By dissolving ozone in the liquid and removing the undissolved gas from the dispensed liquid, we are able to deliver a potent oxidizing liquid to the oral cavity. The benefits of oxidation are known and will be detailed in the summary of the invention. We believe the addition of dissolved ozone to an oral irrigant to be a significant and beneficial improvement to oral irrigators without dissolved ozone. We also believe dissolved ozone to be much more effective at oxidizing oral bacteria than undissolved ozone gas transported to a point of desired disinfection. It also should be noted that an ozone-containing gas potent enough to cause disinfection is known to be offensive to the sense of smell. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Polypyrrolinone based inhibitors of matrix metalloproteases Inventor(s): Hirschmann, Ralph F.; (Blue Bell, PA), Nittoli, Thomas; (West Caldwell, NJ), Smith, Amos B. III; (Merion, PA), Sprengeler, Paul; (El Granada, CA) Correspondence: Mathews, Collins, Shepherd & Gould, P.A.; 100 Thanet Circle, Suite 306; Princeton; NJ; 08540-3674; US Patent Application Number: 20020123635 Date filed: October 9, 2001 Abstract: A compound of the formula 1wherein R1, R2, R3, R4, R5, R6 are as defined herein, useful for the inhibition of inhibition of matrix metalloproteases (MMPs)and for treating conditions mediated by elevated levels of MMPs such as osteoarthritis,

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rheumatoid arthritis, septic arthritis, periodontal disease, gingivitis, solid tumor growth and tumor invasion by secondary metastasis, corneal ulceration, dermal ulceration, epidermolysis bullosa, neural degeneration, multiple sclerosis and surgical wound healing. Excerpt(s): This application claims the benefit of the following provisional application: U.S. Ser. No. 60/238,735 filed Oct. 6, 2000. Most tissues exist in a highly regulated dynamic equilibrium wherein new tissue is formed and existing tissue is degraded and eliminated. The degradation of the extracellular matrix (ECM), including connective tissue and basement membranes, is effected by the metalloproteinases which are released from connective tissue and invading inflammatory cells. There are at least for distinct groups of the more than 20 matrix metalloproteinases (MMP) which have been identified (Birkedal-Hansen, H. J. Oral Pathol. 1988 17:445; Birkedal-Hansen, H. Curr. Opin. Cell Biol. 1995 7:728; Emonard, H.; Grimaud, J. A. Cell. Mol. Biol. 1990 36:131; Murphy, G.; Docherty, A. J. P. Am. J. Respir. Cell Mol. Biol. 1992 7:120; Baramova, E.; Foidart, J. Cell Biol. Int. 1995 19:239; Borkakoti, N. Prog. Biophys. Mol. Biol. 1998 70:73; Johnson, L. L., Dyer, R., Hupe, D. J. Curr. Opin. Chem. Biol. 1998 2:466; Shapiro, S. D.; Senior, R. M. Am. J. Respir. Cell Mol. Biol. 1999 20:1100): the collagenases (interstitial collagenase, MMP-1; PMN collagenase, MMP-8, collagenase-3, MMP-13), the gelatinases (gelatinase A, MMP-2, 72 kDa-gelatinase, Type IV collagenase; gelatinase B, MMP-9, 92 kDa-gelatinase, Type IV collagenase) the stromelysins (Proteoglycanase, MMP-3, stromelysin-1, transin; stromelysin-2, MMP-10; stromelysin 3, MMP-11) and the membrane type matrix metalloproteinases (MT-1, MMP-14; MT-2, MMP-15; MT-3, MMP-16 and MT-4, MMP-17). Excessive unregulated activity of these enzymes can result in undesirable tissue destruction and their activity is regulated at the transcription level, by controlled activation of the latent proenzyme and, after translation, by intracellular specific inhibitory factors such as TIMP ("Tissue Inhibitors of MetalloProteinase") or by more general proteinase inhibitors such as.alpha.2macroglobulins. Inhibitors of MMPs also have been found to inhibit the release of the pleiotropic proinflammatory cytokine, tumor necrosis factor alpha which has be associated with the pathogenesis of numerous inflammatory, autoimmune, and neoplastic diseases. The protease, TNF.alpha.-Converting Enzyme (TACE), catalyzes the release of TNF.alpha. from a membrane bound precursor protein. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Protease inhibitors Inventor(s): Halbert, Stacie Marie; (Harleysville, PA), Michaud, Evelyne; (Norristown, PA), Thompson, Scott Kevin; (Phoenixville, PA), Veber, Daniel Frank; (Ambler, PA) Correspondence: Glaxosmithkline; Corporate Intellectual Property - Uw2220; P.O. Box 1539; King OF Prussia; PA; 19406-0939; US Patent Application Number: 20020049316 Date filed: December 17, 2001 Abstract: The present invention provides compounds of formula (I) which inhibit proteases, including cathepsin K, pharmaceutical compositions of such compounds, and methods for treating diseases of excessive bone loss or cartilage or matrix degradation, including osteoporosis; gingival disease including gingivitis and periodontitis; arthritis, more specifically, osteoarthritis and rheumatoid arthritis; Paget's disease; hypercalcemia or malignancy; and metabolic bone disease therewith.

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Excerpt(s): This invention relates in general to heterocycleketohydrazide protease inhibitors, particularly such inhibitors of cysteine and serine proteases, more particularly compounds which inhibit cysteine proteases, even more particularly compounds which inhibit cysteine proteases of the papain superfamily, yet more particularly compounds which inhibit cysteine proteases of the cathepsin family, most particularly compounds which inhibit cathepsin K. Such compounds are particularly useful for treating diseases in which cysteine proteases are implicated, especially diseases of excessive bone or cartilage loss, e.g., osteoporosis, periodontitis, and arthritis. Bone is composed of a protein matrix in which spindle- or plate-shaped crystals of hydroxyapatite are incorporated. Type I Collagen represents the major structural protein of bone comprising approximately 90% of the structural protein. The remaining 10% of matrix is composed of a number of non-collagenous proteins, including osteocalcin, proteoglycans, osteopontin, osteonectin, thrombospondin, fibronectin, and bone sialoprotein. Skeletal bone undergoes remodeling at discrete foci throughout life. These foci, or remodeling units, undergo a cycle consisting of a bone resorption phase followed by a phase of bone replacement. Bone resorption is carried out by osteoclasts, which are multinuclear cells of hematopoietic lineage. The osteoclasts adhere to the bone surface and form a tight sealing zone, followed by extensive membrane ruffling on their apical (i.e., resorbing) surface. This creates an enclosed extracellular compartment on the bone surface that is acidified by proton pumps in the ruffled membrane, and into which the osteoclast secretes proteolytic enzymes. The low pH of the compartment dissolves hydroxyapatite crystals at the bone surface, while the proteolytic enzymes digest the protein matrix. In this way, a resorption lacuna, or pit, is formed. At the end of this phase of the cycle, osteoblasts lay down a new protein matrix that is subsequently mineralized. In several disease states, such as osteoporosis and Paget's disease, the normal balance between bone resorption and formation is disrupted, and there is a net loss of bone at each cycle. Ultimately, this leads to weakening of the bone and may result in increased fracture risk with minimal trauma. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Protease inhibitors Inventor(s): Marquis, Robert Wells JR.; (Wayne, PA), Veber, Daniel Frank; (Ambler, PA) Correspondence: Glaxosmithkline; Corporate Intellectual Property - Uw2220; P.O. Box 1539; King OF Prussia; PA; 19406-0939; US Patent Application Number: 20020165222 Date filed: July 2, 2002 Abstract: The present invention provides 7-14 membered ring ether protease inhibitors and pharmaceutically acceptable salts, hydrates and solvates thereof which inhibit proteases, including cathepsin K, pharmaceutical compositions of such compounds, novel intermediates of such compounds, and methods for treating diseases of excessive bone loss or cartilage or matrix degradation, including osteoporosis; gingival disease including gingivitis and periodontitis; arthritis, more specifically, osteoarthritis and rheumatoid arthritis; Paget's disease; hypercalcemia of malignancy; and metabolic bone disease, comprising inhibiting said bone loss or excessive cartilage or matrix degradation by administering to a patient in need thereof a compound of the present invention. Excerpt(s): This invention relates in general to 7-14 membered ring ether protease inhibitors, particularly such inhibitors of cysteine and serine proteases, more

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particularly compounds which inhibit cysteine proteases, even more particularly compounds which inhibit cysteine proteases of the papain superfamily, yet more particularly compounds which inhibit cysteine proteases of the cathepsin family, most particularly compounds which inhibit cathepsin K. Such compounds are particularly useful for treating diseases in which cysteine proteases are implicated, especially diseases of excessive bone or cartilage loss, e.g., osteoporosis, periodontitis, and arthritis. Cathepsins are a family of enzymes which are part of the papain superfamily of cysteine proteases. Cathepsins B, H, L, N and S have been described in the literature. Recently, cathepsin K polypeptide and the cDNA encoding such polypeptide were disclosed in U.S. Pat. No. 5,501,969 (called cathepsin O therein). Cathepsin K has been recently expressed, purified, and characterized. Bossard, M. J., et al., (1996) J. Biol. Chem. 271, 12517-12524; Drake , F. H., et al., (1996) J. Biol. Chem. 271, 12511-12516; Bromme, D., et al., (1996) J. Biol. Chem. 271, 2126-2132. Cathepsin K has been variously denoted as cathepsin O or cathepsin O2 in the literature. The designation cathepsin K is considered to be the more appropriate one. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Pullulan free edible film compositions and methods of making the same Inventor(s): Barkalow, David G.; (Deerfield, IL), Chapdelaine, Albert H.; (Naperville, IL), Dzija, Michael R.; (LaGrange Park, IL) Correspondence: Robert M. Barrett; Bell, Boyd & Lloyd; P.O. Box 1135; Chicago; IL; 60690-1135; US Patent Application Number: 20020131990 Date filed: November 8, 2001 Abstract: Improved and inexpensive pullulan free edible film formulations and methods for making the same are provided. The edible pullulan free film compositions comprise effective amounts of at least one film forming agent; at least one bulk filler agent; at least one plasticizing agent; and optionally at least one thickening agent. Medicaments and other additive agents can also be incorporated into the edible films. The present invention further provides methods of delivering a medicament, treating halitosis, treating xerostomia, and treating plaque or gingivitis using the pullulan free edible film compositions. Excerpt(s): The present invention generally relates to edible films. More specifically, the present invention relates to pullulan free edible film compositions and methods of making the same. Oral cleansing and breath freshening may be difficult or inconvenient at times, depending on the nature of the breath freshening desired and the situation in which the breath freshening must occur. Brushing, flossing, cleaning your tongue and gargling using a variety of devices and compositions are common oral care practices well-suited for the privacy of one's home. However, such devices and compositions are less convenient to use away from the home where bathroom facilities might be scarce, unavailable or unsanitary. However, less obtrusive oral products have been developed. These include breath-freshening gums, lozenges, mouth sprays, and edible films. Many thin edible films are made of pullulan, which may be used to deliver medicaments or other agents such as flavors and sweeteners to the oral cavity. However, pullulan is an expensive ingredient to use in the manufacture of such edible films because it has limited availability within the film formulation industry. Other edible materials such as modified starches and cellulosics have been employed as a replacement for pullulan within edible film compositions. Unfortunately, such materials typically lack one or

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more of pullulan's desirable film properties. Those properties include for example: rapid dissolution, flexibility, non-hygroscopity, clean mouth feel, clean flavor and ease of manufacture. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Systems for delivering a cosmetic and/or therapeutic active to oral surfaces using an integral carrier Inventor(s): Case, Ann Maria; (Cincinnati, OH), Ernst, Lisa Catron; (Cincinnati, OH), Glandorf, William Michael; (Mason, OH), Ha, Thinh Nguyen; (Cincinnati, OH), Mayer, Christopher Robert; (Cincinnati, OH), Rajaiah, Jayanth; (Loveland, OH) Correspondence: The Procter & Gamble Company; Intellectual Property Division; Winton Hill Technical Center - Box 161; 6110 Center Hill Avenue; Cincinnati; OH; 45224; US Patent Application Number: 20020176827 Date filed: February 28, 2002 Abstract: Systems for delivering cosmetic and therapeutic actives to the oral cavity employ a strip comprising a first layer of material, a second layer comprising polybutene with a molecular weight of about 300 to about 3000, and a cosmetic or therapeutic active included within the second layer. Therapeutic and cosmetic actives in compositions comprising polybutene inhibit or prevent gingivitis, caries, staining, fungi, bacteria and plaque build-up in the oral cavity by means of the delivery system. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/276,977, filed March 19, 2001. The present invention relates to systems for delivering cosmetic and therapeutic benefits to the oral cavity by applying low molecular weight polybutene to the teeth by means of an integral carrier, in one embodiment, a strip of material. Dental products by which various cosmetic and/or therapeutic actives are delivered to teeth and oral cavity have been previously known. Examples of such products include: brushing aids such as dentifrice products for delivery of anti-caries actives like fluoride; effervescent denture cleansing tablets, which require the artificial teeth to soak for a period of time, to remove plaque and debris; and mouthwashes containing breath fresheners or antibacterial actives. However, such conventional dental care products typically do not maintain actives in the oral cavity long enough to optimally enhance or prolong their therapeutic, prophylactic and/or cosmetic benefits. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Taste masking of phenolics using citrus flavors Inventor(s): Delli Santi, Patricia A.; (Union, NJ), Nelson, Dennis G.A.; (Mountain Lakes, NJ) Correspondence: Paul H. Ginsburg; Pfizer INC.; 235 East 42nd Street; New York; NY; 11768; US Patent Application Number: 20010009660 Date filed: January 30, 2001 Abstract: An oral rinse, dentifrice, or oral gel composition comprising:a) about 0.01 weight % to about 5 weight % of a citrus flavor, citrus flavor ingredient, or mixtures

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thereof;b) about 0.01 weight % to about 5 weight % of a phenolic, said phenolic selected from the group consisting of menthol, eucalyptol, methyl salicylate, thymol, triclosan, and mixtures thereof; andc) an orally acceptable carrier.The claimed composition is useful in retarding the development of plaque, treating gingivitis, and reducing the viable population of micro-organisms in the oral cavity of a mammal.This nonprovisional application is based upon and claims priority from Provisional Application No. 60/042,874 filed Mar. 31, 1997 Excerpt(s): The present invention relates to oral care products comprising citrus-masked phenolics Oral compositions including mouthwashes and dentifrices containing phenolic compounds have been formulated using one or more of the following: menthol, methyl salicylate, eucalyptol and thymol are well known (U.S. Pat. No. 4,945,087; PCT Int. Appl. Nos. WO 94 16,674; WO 94 07,477; WO 94 18,939). These compositions are characterized by their relatively high alcohol levels (20-27 volume %) which causes them to have negative aesthetics, including excessive "bite" and "burn". These compositions often have an unpleasant medicinal taste which can be unattractive to consumers. In particular, thymol is the ingredient which contributes most to the unpleasant, medicinal and harsh taste of these compositions although the combination of several phenolics imparts greater negative taste attributes to these compositions than any one phenolic by itself. Triclosan (2, 4, 4'-trichloro-2'-hydroxydiphenyl ether) is a phenolic, nonionic antimicrobial agent used in various soap and toiletry products. In the oral care area, triclosan has been used as a plaque-inhibitory agent in various toothpastes and mouthrinses. Triclosan can have an unpleasant, medicinal taste and at sufficient concentration can cause numbing of the tongue and other mucosal and gingival tissues. Citrus-flavored mouthwashes or dentifrices have been formulated, as well as methods for preparing clear citrus-flavored mouthwashes including for example, U.S. Pat. Nos. 3,876,759 and 4,420,471. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Therapeutic mouthwash containing alkali metal hypohalite Inventor(s): Camper, Jurdon Wayne; (Rolla, ND), Delorme, Marilyn A.; (Bellcourt, ND), Festvog, John E.; (Rolla, ND) Correspondence: Dorsey & Whitney Llp; 801 Grand, Suite 3900; Des Moines; IA; 50309; US Patent Application Number: 20020114851 Date filed: February 16, 2001 Abstract: A mouthwash or oral rinse containing a mixture of an aqueous solution and an alkali metal hypohalite (e.g., sodium hypochlorite). Optionally, the aqueous solution contains a flavor masking or neutralizing agent such as fruit juice. The user rinses the oral cavity or gargles with the mouthwash to treat gingivitis or kill odor or plaque causing bacteria, or to eliminate viruses, fungi and/ or other microorganisms in the oral cavity. Excerpt(s): The instant invention relates to a mouthwash. More specifically, the invention relates to a mouthwash or oral rinse that contains an alkali metal hypohalite (AMH), e.g., sodium hypochlorite. The AMH kills bacteria, fungi, and viruses in the mouth and throat. The most common AMH is sodium hypochlorite (NaOCl). Sodium hypochlorite is the active agent in household bleach. Due to its bactericidal properties, it is also a common ingredient in swimming pool disinfectants and water purification

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treatments. See Hawley's Condensed Chemical Dictionary 13th ed., by Richard R. Lewis, John Wiley & Sons, New York, N.Y., page 1019 (1997). A number of compositions containing sodium hypochlorite have been patented. Representative patents include U.S. Pat. Nos.: 4,737,307; 4,927,641; 5,273,678; 5,472,714; and 5,427,801. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Topical formulations for delivery of interleukin-11 Inventor(s): Bedrosian, Camille L.; (Belmont Hills, MA), Keith, James C. JR.; (Andover, MA), Schendel, Paul F.; (Wayland, MA), Schwerschlag, Ullrich S.; (Beverly Farms, MA), Warne, Nicholas W.; (Andover, MA) Correspondence: Mintz, Levin, Cohn, Ferris,; Glovsky And Popeo, P.C.; One Financial Center; Boston; MA; 02111; US Patent Application Number: 20030147849 Date filed: February 7, 2003 Abstract: Provided by the present invention are topical formulations of Interleukin-11 and methods for treating a variety of disorders, including inflammatory bowel diseases (e.g., Crohn's disease, ulcerative colitis, indeterminate colitis, and infectious colitis), mucositis (e.g., oral mucositis, gastrointestinal mucositis, nasal mucositis, and proctitis), necrotizing enterocolitis, inflammatory skin disorders (e.g., psoriasis, atopic dermatitis, and contact hypersensitivity), aphthous ulcers, pharyngitis, esophagitis, peptic ulcers, gingivitis, periodontitis, and ocular diseases (e.g., conjunctivitis, retinitis, and uveitis). Excerpt(s): This is a continuation-in-part of U.S. patent application Ser. No. 09/179,026 filed Oct. 26, 1998, which is a continuation-in-part of U.S. patent application Ser. No. 08/892,407, filed Jul. 15, 1997, now U.S. Pat. No. 5,948,402, which is a divisional of U.S. patent application Ser. No. 08/495,724, filed Jun. 27, 1995, now U.S. Pat. No. 5,679,339, issued Oct. 21, 1997. The present invention relates generally to novel compositions and methods for topical delivery of interleukin-11 (IL-11). In preferred embodiments, patients are treated employing topical delivery of recombinant human IL-11 for inflammatory bowel diseases (e.g., Crohn's disease, ulcerative colitis, indeterminate colitis, and infectious colitis), mucositis (e.g., oral mucositis, gastrointestinal mucositis, nasal mucositis, and proctitis), necrotizing enterocolitis, inflammatory skin disorders (e.g., psoriasis, atopic dermatitis, and contact hypersensitivity), aphthous ulcers, pharyngitis, esophagitis, peptic ulcers, gingivitis, periodontitis, and ocular diseases (e.g., conjunctivitis, retinitis, and uveitis). Inflammatory responses include a broad range of host reaction to a variety of insults, such as injury, infection, or rejection. It is the overproduction of mediators that is believed to be associated with a broad range of disorders, including AIDS, arthritis (rheumatoid arthritis, osteoarthritis, spondyloarthropathies), antibiotic-induced diarrheal diseases, multiple sclerosis, osteoporosis, gingivitis, peptic ulcer disease, esophagitis, diabetes, retinitis, uveitis, reperfusion injury after myocardial infarction, cerebral vascular accident, aphthous ulcers (oral), atherosclerosis, tumor metastases, asthma, preeclampsia, pancreatitis, psoriasis, infertility and allergic disorders such as rhinitis, conjunctivitis, and urticaria. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Treatment of inflammation with 2,4,6-trihydroxy-alpha-para-methoxyphenylacetophenone, or its pharmaceutically acceptable derivatives Inventor(s): Malaviya, Ravi; (St. Paul, MN), Uckun, Fatih M.; (White Bear Lake, MN) Correspondence: Merchant & Gould PC; P.O. Box 2903; Minneapolis; MN; 55402-0903; US Patent Application Number: 20020010217 Date filed: June 19, 2001 Abstract: 2,4,6-trihydroxy-.alpha.-p-methoxyphenylacetophenone (also identified herein as "D-58"), or its pharmaceutically acceptable derivatives such as salt and ester forms, is administered for inhibiting inflammatory reactions. The treatment can be remedial or prophylactic. Examples of the conditions that can be treated include acute inflammatory reactions and allergic inflammatory reactions, and specific examples include allergy, asthma, arthritis, psoriasis, skin sunburn, inflammatory pelvic disease, inflammatory bowel disease, urethritis, uvitis, senusitis, pneumonitis, encephalitis, meningitis, myocarditis, nephritis, osteomyelitis, myositis, hepatitis, gastritis, enteritis, dermatitis, gingivitis, appendicitis, pancreatitis, cholocystitis and cholangitis. The 2,4,6-trihydroxy.alpha.-p-methoxyphenylacetophenone can be administered by various routes as needed. Excerpt(s): The present invention is directed to the treatment of acute and chronic inflammatory responses, for example resulting from the presence of an allergen, injury, infection, etc. Allergic and acute inflammatory responses to injury, infection, or other tissue damage can set into motion a complex series of events. A variety of host cells that guard the host environment interface, including macrophages, mast cells, and epithelial epidermal cells serve as the initiators of the inflammatory responses. These cells release various mediators during an inflammatory response, which include histamine, prostaglandins (PGs), leukotrienes (LTs) and proinflammatory cytokines (refs 1-4). These mediators have been implicated in the pathogenesis of a number of acute and chronic inflammatory conditions such as allergy, asthma, arthritis, psoriasis, and skin sunburn (refs 3-5). The release of inflammatory agents is mediated by a cascade of intracellular signaling events which include activation of phosphoinositide turnover (ref 6), increase in cAMP levels (ref 7), activation of protein kinase C, and an increase in intracellular calcium levels and tyrosine phosphorylation of several cytosolic proteins (refs 7 and 8). Considerable efforts have been made for identification of chemical compounds that can interrupt these signaling events as potential anti-inflammatory agents (refs 9-12). However, the need for agents providing improved inhibition continues. In accordance with the present invention, 2,4,6-trihydroxy-.alpha.-- pmethoxyphenylacetophenone (also identified herein as "D-58"), or its pharmaceutically acceptable derivatives such as salt and ester forms, is administered for inhibiting inflammatory reactions to a subject in need thereof. The treatment can be remedial or prophylactic. Examples of the conditions that can be treated include acute as well as chronic inflammatory reactions and allergic inflammatory reactions, and specific examples include allergy, asthma, arthritis, psoriasis, skin sunburn, inflammatory pelvic disease, inflammatory bowel disease, urethritis, uvitis, sinusitis, pneumonitis, encephalitis, meningitis, myocarditis, nephritis, osteomyelitis, myositis, hepatitis, gastritis, enteritis, dermatitis, gingivitis, appendicitis, pancreatitis, cholocystitis and cholangititis. The 2,4,6-trihydroxy-.alpha.-p-methoxyphenylacetophenone can be administered by one of a variety of routes as needed. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Keeping Current In order to stay informed about patents and patent applications dealing with gingivitis, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “gingivitis” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on gingivitis. You can also use this procedure to view pending patent applications concerning gingivitis. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON GINGIVITIS Overview This chapter provides bibliographic book references relating to gingivitis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on gingivitis include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “gingivitis” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on gingivitis: •

Microbiology of HIV-Associated Gingivitis and Periodontitis Source: Perspectives on Oral Manifestations of AIDS: Diagnosis and Management of HIV-Associated Infections. San Diego, CA, January 18-20, 1988. Contact: PSG Publishing Company, 545 Great Rd, Littleton, MA, 01460, (508) 486-8971. Summary: These proceedings of the Conference Perspectives on Oral Manifestations of AIDS: Diagnosis and Management of HIV-Associated Infections held in San Diego, CA, on January 18-20, 1988. They describes the investigation of microbiota associated with intraoral lesions associated with infection by the Human immunodeficiency virus (HIV) that causes Acquired immunodeficiency syndrome (AIDS). Subgingival plaque samples from HIV-seropositive males and from HIV-seronegative controls were examined by indirect immunofluorescence and microbiological culturing. Samples were classified as HIV-associated gingivitis, HIV-associated periodontitis, or disease-free in an HIVpositive person. Microbiological analysis revealed that HIV-gingivitis and HIV-

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periodontitis sites contained more Candida albicans compared with control sites. Also, Bacteroides gingivalis, B intermedius, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Eikenella Corrodens, and Wolinella were more prevalent in HIV-periodontitis sites and HIV-gingivitis sites than in HIV-positive healthy sites and control sites. Distribution of microbiota in HIV-periodontitis and HIV-gingivitis sites appeared similar to those found in classic periodontitis sites. The microbiota from HIVpositive healthy and HIV-negative control sites was characteristic of healthy periodontium. It is suggested that HIV-gingivitis may be a precursor to HIVperiodontitis.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “gingivitis” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “gingivitis” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “gingivitis” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Gingivitis by William George Cross; ISBN: 0723604525; http://www.amazon.com/exec/obidos/ASIN/0723604525/icongroupinterna

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The Official Patient's Sourcebook on Gingivitis by Icon Health Publications, et al (2002); ISBN: 0597831424; http://www.amazon.com/exec/obidos/ASIN/0597831424/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “gingivitis” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:7 •

Chlorhexidine in the prevention and treatment of gingivitis Author: Löe, Harald.; Year: 1970; Copenhagen: Munksgaard, [1986]; ISBN: 8716063678

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Development of experimental gingivitis at different ages in young individuals: clinical, light microscopy and transmission electron microscopy studies Author:

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In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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Matsson, Lars.; Year: 1983; Malmö: Departments of Pedodontics and Periodontology, School of Denistry, University of Lund, 1979 •

Electron microscopic study of chronic desquamative gingivitis [by] Hiromasa Nikai, George G. Rose, and Martin Cattoni. Author: Nikai, Hiromasa,; Year: 1958; Copenhagen, Munksgaard, 1971

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Gingivitis. Author: Cross, W. G. (William George); Year: 1970; Bristol, Wright, 1965

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Initial gingivitis in dogs Author: Kahnberg, Karl-Erik.; Year: 1984; Göteborg, Sweden: Dept. of Periodontology, University of Göteborg, 1976

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Interstitial gingivitis and pyorrhoea alveolaris. Author: Talbot, Eugene Solomon,; Year: 1977; Toledo, Ransom; Randolph, 1913

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Longitudinal study of the use of chlorhexidine in the prevention of dental plaque, caries and gingivitis. Author: Löe, Harald; Year: 1974

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Some effects of antimicrobial therapy on plaque and gingivitis in dogs Author: Heijl, Lars.; Year: 1986; Göteborg: [s.n.], 1981; ISBN: 9172224150

•

Vincent's infection; necrotizing ulcerative gingivitis. Author: Ivancie, Gerald P.,; Year: 1971; Chicago, Year Book Publishers, 1958

Chapters on Gingivitis In order to find chapters that specifically relate to gingivitis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and gingivitis using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “gingivitis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on gingivitis: •

Gingivitis and Periodontal Disease Source: in McDonald, R.E. and Avery, D.A., eds. Dentistry for the Child and Adolescent. 7th ed. St. Louis, MO: Mosby, Inc. 2000. p. 440-484. Contact: Available from Harcourt Health Sciences. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 325-4177. Fax (800) 874-6418. Website: www.harcourthealth.com. PRICE: $72.00 plus shipping and handling. ISBN: 0815190174. Summary: Gingivitis, a type of periodontal disease, is an inflammation involving only the gingival (gum) tissues next to the tooth. This chapter on gingivitis and periodontal disease is from a textbook on dentistry for the child and adolescent that is designed to help undergraduate dental students and postdoctoral pediatric dentistry students provide comprehensive oral health care for infants, children, teenagers, and individuals with various disabilities. The authors cover simple gingivitis, including eruption gingivitis, gingivitis associated with poor oral hygiene, and allergy and gingival inflammation; acute gingival disease, including that due to herpes simplex virus infection, recurrent aphthous ulcer (canker sore), acute necrotizing ulcerative gingivitis (ANUG), acute candidiasis (thrush, a fungal infection), and acute bacterial infections; chronic nonspecific gingivitis; chlorhexidine as a therapeutic plaque control agent; conditioned gingival enlargement, including puberty gingivitis, fibromatosis, and phenytoin (Dilantin) induced gingival overgrowth; scorbutic gingivitis (associated with

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vitamin C deficiency); periodontal diseases in children, including periodontitis, premature bone loss in primary dentition, Papillon Lefevre syndrome (precocious periodontosis), gingival recession, the differential diagnosis of self mutilation, abnormal frenum attachment, and frenectomy; the clinical assessment of oral cleanliness and periodontal disease; extrinsic stains and deposits on teeth; and dental calculus (seen with low frequency in children). 44 figures. 93 references. •

Gingivitis Source: in Soderman, W.A., Jr. Instructions for Geriatric Patients. Orlando, FL: W.B. Saunders Company. 1995. p. 95-96. Contact: Available from W.B. Saunders Company. Book Orders Fulfillment Department, 6277 Sea Harbor Drive, Orlando, FL 32821-9854. (800) 545-2522; Fax (800) 874-6418 or (407) 352-3445; http://www.wbsaunders.com. PRICE: $38.95 plus shipping and handling. ISBN: 0721643353. Summary: This chapter on gingivitis is from a book of strategies to help caregivers provide better care to geriatric patients. The book provides simple, direct aids to improve communication between physicians, other health care providers, caregivers, and patients. Gingivitis, like dental caries, is a result of mouth bacteria infecting normal tissues. The author focuses on the importance of regular oral hygiene to prevent problems like gingivitis, particularly in this patient population. The chapter covers important points in treatment, including control and reversal of gingivitis and the associated periodontal disease and diseases that may cause or exacerbate gingivitis (e.g., diabetes), regular toothbrushing and flossing, and contacting a health care provider.

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CHAPTER 7. MULTIMEDIA ON GINGIVITIS Overview In this chapter, we show you how to keep current on multimedia sources of information on gingivitis. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on gingivitis is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “gingivitis” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “gingivitis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on gingivitis: •

Dental Care Source: Evanston, IL: Altschul Group Corporation. 1994. (videocassette). Contact: Available from Altschul Group Corporation. 1560 Sherman Avenue, Suite 100, Evanston, IL 60201-9971. (800) 323-9084 or (828) 328-6700; Fax (847) 328-6706; E-mail: [email protected]; http://www.agcmedia.com. PRICE: $179.00 plus shipping and handling. Order Number 7884. Summary: This videotape program presents an overview of dental health. The composition of the tooth and its role in the body are detailed. Viewers are shown the dental development from birth to old age. The proper care of teeth and preventive devices for sports activities are demonstrated. Orthodontics is explained, and techniques for treating dental abnormalities are shown. Periodontal disease, plaque, tartar, and gingivitis are defined and described. The video program stresses preventive measures, including proper brushing style, use of dental floss, and proper nutrition. The program is one in a series of self-health videos in which, by emphasizing lifestyle and

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environmental factors that increase the risk of illness, the prevention of disease is motivated. The programs also illustrate the impact of health problems on individuals and society. Each program in the series provides viewers with a better understanding of bodily functions and helps them to detect signs or symptoms of illness. (AA-M).

Bibliography: Multimedia on Gingivitis The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in gingivitis (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on gingivitis: •

Histopathology of non-specific gingivitis [slide] Source: College of Dentistry, University of Florida; Year: 1973; Format: Slide; [Gainesville, Fla.]: The College: [for loan by J. Hillis Miller Health Center, Learning Resource Center, 1973?]

•

Signs and symptoms of gingivitis [slide] Source: David J. Mishkin, in cooperation with the Office of Education, College of Dental Medicine, Medical University of South Carolina; Year: 1978; Format: Slide; Atlanta: National Medical Audiovisual Center; [Washington: for sale by National Audiovisual Center], 1978

•

Systemic conditions affecting non-specific gingivitis [slide] Source: College of Dentistry, University of Florida; produced by Ron Baughman; Year: 1973; Format: Slide; [Gainesville, Fla.]: The College, [1973]

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CHAPTER 8. PERIODICALS AND NEWS ON GINGIVITIS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover gingivitis.

News Services and Press Releases One of the simplest ways of tracking press releases on gingivitis is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “gingivitis” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to gingivitis. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “gingivitis” (or synonyms). The following was recently listed in this archive for gingivitis: •

Gingivitis vaccine shows early promise Source: Reuters Medical News Date: February 27, 2003

•

Salmeterol tied to gingivitis in asthmatic children Source: Reuters Industry Breifing Date: December 12, 2001

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “gingivitis” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “gingivitis” (or synonyms). If you know the name of a company that is relevant to gingivitis, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “gingivitis” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly

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to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “gingivitis” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on gingivitis: •

Healthy Mouth, Healthy Life Source: Harvard Women's Health Watch. 10(7): 4-5. March 2003. Contact: Available from Harvard Women's Health Watch. P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. Website: www.health.harvard.edu/newsletters/subinfo.html. Summary: Research conducted in recent decades has uncovered potential links between chronic gum infection and conditions as serious as diabetes, stroke, heart disease, and pregnancy complications. Also, oral diseases may contribute to malnutrition and create a variety of psychosocial difficulties, including low self-esteem and discrimination in work or social settings. This article, from a health newsletter, describes the new understanding of the relationship between oral health and general health. Topics include the pathology of dental decay, including plaque and the development of cavities (dental caries); periodontal disease, including gingivitis and periodontitis; and the fundamentals of toothbrushing and flossing, including the use of electric toothbrushes, different types of toothpaste, and mouthrinses. 2 figures.

•

Oral Health and Heart Disease Source: Harvard Health Letter. 11(7): 1-3. March 2001. Contact: Available from Harvard Health Publications. P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. Website: www.health.harvard.edu. Summary: This article explores the recent evidence that by averting gum disease, patients might actually be reducing their chances for developing heart disease. The author notes that, at the very least, it seems clear that people with worse dental health have a higher risk of heart attack. Recent findings link periodontal disease to cardiovascular disease. Periodontal disease is any disease, including gingivitis or periodontitis, that affects the gums and associated membranes. However, not all of these studies adequately controlled for other risk factors (for example, socioeconomic status, age, or unhealthy behaviors). Poor dental health may consequently have been an indication of poor personal hygiene or suboptimal health habits. The author cautions that the observed increase in heart disease risk among those with poor dental health may have reflected a general lack of health care, rather than a lack of dental care in particular. The article also reports on present Harvard studies that are evaluating the role of inflammation and diet as potential mediators. For example, periodontal disease and resulting tooth loss may lead to poor dietary habits that, in turn, might increase heart disease risk. The article concludes by hypothesizing the role of inflammation (the body's response to infection or injury) in heart disease. 1 figure.

•

Oral and Systemic Linkages: Effects of Nutritional Supplements on Periodontal Status Source: Oral Care Report. 11(4): 6,8. 2001.

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Contact: Available from Oral Care Report. c/o Dr. Chester W. Douglass, Department of Oral Health Policy, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115. Fax (617) 432-0047. E-mail: [email protected]. Website: www.colgateprofessional.com (full-text available online). Summary: This article reminds dental hygienists of the effects of nutritional supplements on periodontal status. It has been shown that a large percentage of patients with gingivitis and periodontal disease are deficient in vitamins that are vital for the maintenance of healthy gingival (gum) tissues. This article briefly reports on a research study undertaken to assess whether nutritional supplements can aid in improving the oral health of patients with these conditions. Results after 60 days of nutritional supplements were suggestive but not conclusive. Comparison of the bleeding index (BI) between the two treatment groups indicated a 21 percent improvement for the nutritional supplements group, and a 14 percent improvement for the placebo group. One table lists various nutritional supplements with their proposed function. 1 table. 3 references. •

Dental Care: How to Help Your Teeth Last a Lifetime Source: Mayo Clinic Health Letter. 15(10): 1-3. October 1997. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 291-1128. Summary: This health newsletter article reviews the basics of good oral hygiene and the role of preventive dental care. Written primarily for an audience of older adults, the article emphasizes that although aging can bring changes that make teeth more vulnerable, with proper care, the teeth can last a lifetime. Topics include dental plaque, gingivitis, periodontitis, dental risk factors associated with aging, and the adverse effects of medications (notably xerostomia, or dry mouth). The article concludes with a brief discussion of the risk factors for cavities and periodontal disease in older adults. These factors include co-existing medical conditions or systemic disease, a poor diet, lack of preventive dental care, lack of fluoridated water, and lack of transportation to dental care. One sidebar provides a brief quiz for readers to determine if they need a dental check-up. 1 figure.

•

Gum Disease: You Can Often Prevent This Cause of Tooth Loss Source: Mayo Clinic Health Letter. 10(12): 4-6. December 1992. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037. Summary: This newsletter article reminds readers of the steps to take in preventing gum disease, including gingivitis and periodontitis. Topics covered include the symptoms of these types of gum disease; how the dentist screens for gum disease; risk factors, including genetics, medications, smoking, pregnancy, and decreased immunity; and treatment options, such as scaling and root planing, antibiotic therapy, and surgery. The article concludes with a brief discussion on research and development of new treatment strategies. One sidebar summarizes daily tooth care recommendations. 6 figures.

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Academic Periodicals covering Gingivitis Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to gingivitis. In addition to these sources, you can search for articles covering gingivitis that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for gingivitis. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with gingivitis. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to gingivitis: Chlorhexidine •

Dental - U.S. Brands: Peridex; PerioGard http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202131.html

Clindamycin •

Systemic - U.S. Brands: Cleocin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202145.html

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Topical - U.S. Brands: Clinda-Derm http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202146.html

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Vaginal - U.S. Brands: Cleocin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202700.html

Corticosteroids •

Dental - U.S. Brands: Kenalog in Orabase; Orabase-HCA; Oracort; Oralone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202010.html

•

Inhalation - U.S. Brands: AeroBid; AeroBid-M; Azmacort; Beclovent; Decadron Respihaler; Pulmicort Respules; Pulmicort Turbuhaler; Vanceril; Vanceril 84 mcg Double Strength http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202011.html

•

Nasal - U.S. Brands: Beconase; Beconase AQ; Dexacort Turbinaire; Flonase; Nasacort; Nasacort AQ; Nasalide; Nasarel; Nasonex; Rhinocort; Vancenase; Vancenase AQ 84 mcg; Vancenase pockethaler http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202012.html

•

Ophthalmic - U.S. Brands: AK-Dex; AK-Pred; AK-Tate; Baldex; Decadron; Dexair; Dexotic; Econopred; Econopred Plus; Eflone; Flarex; Fluor-Op; FML Forte; FML Liquifilm; FML S.O.P.; HMS Liquifilm; Inflamase Forte; Inflamase Mild; I-Pred; Lite Pred; Maxidex; Ocu-Dex; Ocu-Pred; Ocu-Pr http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202013.html

•

Otic - U.S. Brands: Decadron http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202014.html

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Rectal - U.S. Brands: Anucort-HC; Anu-Med HC; Anuprep HC; Anusol-HC; Anutone-HC; Anuzone-HC; Cort-Dome; Cortenema; Cortifoam; Hemorrhoidal HC; Hemril-HC Uniserts; Proctocort; Proctosol-HC; Rectosol-HC http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203366.html

Nystatin •

Oral - U.S. Brands: Mycostatin; Nilstat; Nystex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202417.html

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Topical - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202418.html

•

Topical - U.S. Brands: Mycostatin; Nilstat; Nystex; Nystop; Pedi-Dri http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202418.html

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Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute8: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

8

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:10 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

9

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 10 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “gingivitis” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “gingivitis” (or synonyms) into the “For these words:” box. The following is a sample result: •

Operational Definitions for Year 2000 Objectives: Priority Area 13, Oral Health Source: Healthy People 2000. Statistical Notes. Number 12: 1-20. May 1997. Contact: Available from National Center for Health Statistics. Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Service, 6525 Belcrest Road, Hyattsville, MD 20782. (301) 436-8500; E-mail: [email protected]; http://www.cdc.gov/nchswww/nchshome.htm. PRICE: Single copy free. DHHS Publication Number 97-1237. Summary: This issue of Statistical Notes provides definitions and data collection specifications for objectives in Priority Area 13: Oral Health, one of 22 priority areas of the Healthy People 2000 project. In this publication, the text and operational definitions of the objectives are presented, important data issues are discussed, and references are cited for expanded discussions of the data systems that provide data for the national objectives. Topics covered in the objectives include dental caries (in children and adolescents), untreated dental caries, no tooth loss (tooth retention), complete tooth loss, gingivitis, periodontal diseases, oral cancer deaths, protective sealants, water fluoridation, topical and systemic fluorides, baby bottle tooth decay, oral health screening (including referral and follow up), oral health care at institutional facilities, regular dental visits, oral health care for infants with cleft lip or palate, protective equipment in sporting and recreation events, and the reduction of smokeless tobacco (spit tobacco) use. One appendix lists the oral health objectives in total. One chart provides a data comparability worktable with objective definitions, data sources, and issues. This table presents the short text of each objective, the measure, the operational definition, the national data source, and a brief description of data issues. 8 figures. 1 table. (AA-M).

•

Priority Area 13: Oral Health Source: in National Center for Health Statistics. Healthy People 2000 Review, 1993. Hyattsville, MD: Public Health Service. 1994. p. 80-86. Contact: Available from National Technical Information Service (NTIS). Springfield, VA 22161. Voice (703) 487-4650; TDD (703) 487-4639; Fax (703) 321-8547. PRICE: $27 plus shipping and handling. DHHS Publication Number (PHS) 94-1232-1.

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Summary: This report is a section of the 1993 report on the Healthy People 2000 project of the U.S. Department of Health and Human Services. Priority Area 13, Oral Health, is the focus of this report. Topics covered include background and data summary; data issues, including definition; and proxy measures. A detailed table summarizes the original, present, and target status for each oral health objective, including level of dental caries, untreated dental caries, no tooth loss, complete tooth loss, gingivitis, periodontal diseases, oral cancer deaths, protective sealants, water fluoridation, topical and systemic fluorides, baby bottle tooth decay, oral health screening, oral health care at institutional facilities, regular dental visits, oral health care for infants with cleft lip and/or palate, and protective equipment in sporting and recreation events. 1 figure. 1 table. 8 references. •

Recent Advances in Oral Health: Report of a WHO Expert Committee Source: Albany, NY: World Health Organization (WHO). 1992. 48 p. Contact: Available from World Health Organization (WHO). Publications Center, 49 Sheridan Avenue, Albany, NY 12210. (518) 436-9686; Fax (518) 436-7433. PRICE: $6.30 each; bulk orders available. Summary: This report is from a World Health Organization (WHO) Committee charged to consider advances in the fields of prevention, diagnosis, treatment, and computerization within the oral health profession; to advise on which measures should be implemented now and which after further development; to examine the polarity that has developed in oral health between tissue-invasive or other high-technology interventions and preventive, control, and self care strategies; and to give guidance on the growing need to integrate many activities with different areas of the health profession and other sectors in the search for broader health strategies and involvement. Specific topics include fluoride, sealants, saliva, artificial saliva, diet, antimicrobials, modifying molecules, immunization, risk assessment, gingivitis, microbiology, risk factors for periodontal diseases, oral hygiene, oral cancer, treatment of gingivitis, tissue regeneration, juvenile periodontitis, necrotizing ulcerative gingivitis, malocclusion, dental implants, orofacial lesions, oral manifestations of HIV infection and AIDS, facial pain, oral surgical techniques, advances in technology, personnel issues, work environment and support, and professional education and training. The document concludes with recommendations in five areas: self care and low intervention oral health care; technology transfer; informatics developments in the advancement of oral health; enhancement of scientific research; and broadening the scope of oral health care. One appendix presents a classification of oral lesions associated with HIV infection. 22 references.

•

Dental Management of the HIV+ Patient Contact: University of California Davis, Western AIDS Education and Training Center, 5110 E Clinton Way Ste 115, Fresno, CA, 93727-2098, (209) 252-2851. Summary: This script to accompany a slide set briefly describes various symptoms and treatments for the oral and dental manifestations of HIV/AIDS. It covers ulcers, Kaposi's sarcoma, herpes, HIV periodontitis, HIV gingivitis, and candidiasis.

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The NLM Gateway11 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “gingivitis” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 8766 63 58 36 0 8923

HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.15 Simply search by “gingivitis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists16 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI 11

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

12

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 16 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

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staff.17 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.18 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

17

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 18 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on gingivitis can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to gingivitis. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to gingivitis. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “gingivitis”:

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•

Other guides Child Dental Health http://www.nlm.nih.gov/medlineplus/childdentalhealth.html Cosmetic Dentistry http://www.nlm.nih.gov/medlineplus/cosmeticdentistry.html Dental Health http://www.nlm.nih.gov/medlineplus/dentalhealth.html Gum Disease http://www.nlm.nih.gov/medlineplus/gumdisease.html Tooth Disorders http://www.nlm.nih.gov/medlineplus/toothdisorders.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on gingivitis. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Trench Mouth (Necrotizing Ulcerative Gingivitis; Vincent's Disease) Source: in Griffith, H.W. Instruction for Patients. 5th ed. Orlando, FL: W.B. Saunders Company. 1994. p. 476. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522 (individuals) or (800) 782-4479 (schools); Fax (800) 874-6418 or (407) 352-3445; http://www.wbsaunders.com. PRICE: $52.00 (English); $49.95 (Spanish); plus shipping and handling. ISBN: 0721649300 (English); 0721669972 (Spanish). Summary: This fact sheet on necrotizing ulcerative gingivitis (trench mouth) is from a compilation of instructions for patients, published in book format. Also known as Vincent's Disease, necrotizing ulcerative gingivitis is an infection of the tissue between the teeth. The fact sheet provides information in three sections: basic information, including a description of the condition, frequent signs and symptoms, causes, risk factors, preventive measures, expected outcome, and possible complications; treatment, including general measures, medication, activity guidelines, and diet; and when to contact one's health care provider. The fact sheet is designed to be photocopied and distributed to patients as a reinforcement of oral instructions and as a teaching tool.

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The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “gingivitis” (or synonyms). The following was recently posted: •

Parameter on plaque-induced gingivitis Source: American Academy of Periodontology - Professional Association; 1996 October (revised 2000 May); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2324&nbr=1550&a mp;string=gingivitis The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to gingivitis. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to gingivitis. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with gingivitis.

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The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about gingivitis. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “gingivitis” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “gingivitis”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “gingivitis” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “gingivitis” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.19

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

19

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)20: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

20

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on gingivitis: •

Basic Guidelines for Gingivitis Gingivitis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001056.htm HIV infection Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000602.htm Misaligned teeth Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001058.htm

•

Signs & Symptoms for Gingivitis Erythema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm

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Gums bleed easily Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003062.htm Halitosis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003058.htm Malaise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm Mouth sores Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003059.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Swollen gums Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003066.htm Ulcers Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003228.htm •

Diagnostics and Tests for Gingivitis ALT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003473.htm Dental X-rays Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003801.htm X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm

•

Background Topics for Gingivitis Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Dental hygiene Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001957.htm Oral hygiene Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001957.htm Scaling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003226.htm

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Systemic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002294.htm Toxins Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002331.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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GINGIVITIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Actinomyces: A genus of gram-positive, rod-shaped bacteria whose organisms are nonmotile. Filaments that may be present in certain species are either straight or wavy and may have swollen or clubbed heads. [NIH] Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adsorption: The condensation of gases, liquids, or dissolved substances on the surfaces of solids. It includes adsorptive phenomena of bacteria and viruses as well as of tissues treated with exogenous drugs and chemicals. [NIH] Adsorptive: It captures volatile compounds by binding them to agents such as activated carbon or adsorptive resins. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aetiology: Study of the causes of disease. [EU] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the

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tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Aggravation: An increasing in seriousness or severity; an act or circumstance that intensifies, or makes worse. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alpha-Defensins: Defensins found in azurophilic granules of neutrophils and in the secretory granules of intestinal paneth cells. [NIH]

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Alpha-helix: One of the secondary element of protein. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alum: A type of immune adjuvant (a substance used to help boost the immune response to a vaccine). Also called aluminum sulfate. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Ammonium Compounds: Inorganic and organic compounds that contain the hypothetical radical NH4. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU]

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Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anionic: Pertaining to or containing an anion. [EU] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anode: Electrode held at a positive potential with respect to a cathode. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble

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substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH]

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Articular: Of or pertaining to a joint. [EU] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astringent: Causing contraction, usually locally after topical application. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atopic: Pertaining to an atopen or to atopy; allergic. [EU] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Bacteraemia: The presence of bacteria in the blood. [EU] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Balanitis: Inflammation of the glans penis. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus

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and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benzoic Acid: A fungistatic compound that is widely used as a food preservative. It is conjugated to glycine in the liver and excreted as hippuric acid. [NIH] Beta-Defensins: Defensins found mainly in epithelial cells. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Bioavailable: The ability of a drug or other substance to be absorbed and used by the body. Orally bioavailable means that a drug or other substance that is taken by mouth can be absorbed and used by the body. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biofilms: Films of bacteria or other microbial organisms, usually embedded in extracellular polymers such as implanted medical devices, which adhere to surfaces submerged in, or subjected to, aquatic environments (From Singleton & Sainsbury, Dictionary of Microbiology and Molecular Biology, 2d ed). Biofilms consist of multilayers of microbial cells glued together to form microbial communities which are highly resistant to both phagocytes and antibiotics. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

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Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Breast Feeding: The nursing of an infant at the mother's breast. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchioles: The tiny branches of air tubes in the lungs. [NIH] Brucellosis: Infection caused by bacteria of the genus Brucella mainly involving the reticuloendothelial system. This condition is characterized by fever, weakness, malaise, and weight loss. [NIH] Bruxism: A disorder characterized by grinding and clenching of the teeth. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Cadaverine: A foul-smelling diamine formed by bacterial decarboxylation of lysine. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calculus I: An abnormal concretion occurring within the animal body and usually composed of mineral salts. [EU] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it

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most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capillary Permeability: Property of blood capillary walls that allows for the selective exchange of substances. Small lipid-soluble molecules such as carbon dioxide and oxygen move freely by diffusion. Water and water-soluble molecules cannot pass through the endothelial walls and are dependent on microscopic pores. These pores show narrow areas (tight junctions) which may limit large molecule movement. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH]

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Causal: Pertaining to a cause; directed against a cause. [EU] Causality: The relating of causes to the effects they produce. Causes are termed necessary when they must always precede an effect and sufficient when they initiate or produce an effect. Any of several factors may be associated with the potential disease causation or outcome, including predisposing factors, enabling factors, precipitating factors, reinforcing factors, and risk factors. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Count: A count of the number of cells of a specific kind, usually measured per unit volume of sample. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cetylpyridinium: Cationic bactericidal surfactant used as a topical antiseptic for skin, wounds, mucous membranes, instruments, etc.; and also as a component in mouthwash and lozenges. [NIH] Check-up: A general physical examination. [NIH] Chemical Actions: A collective grouping for how the application of drugs and chemicals result in the prevention, treatment, cure or diagnosis of disease. Included here are drugs and chemicals that act by altering normal body functions, such as the reproductive control agents and anesthetics. Effects of chemicals on the environment are also included. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chlorhexidine: Disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH]

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Cholangitis: Inflammation of a bile duct. [NIH] Chorioretinitis: Inflammation of the choroid in which the sensory retina becomes edematous and opaque. The inflammatory cells and exudate may burst through the sensory retina to cloud the vitreous body. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chymopapain: A cysteine endopeptidase isolated from papaya latex. Preferential cleavage at glutamic and aspartic acid residues. EC 3.4.22.6. [NIH] Cicatricial: Ectropion due to scar tissue on the margins or the surrounding surfaces of the eyelids. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Cleave: A double-stranded cut in DNA with a restriction endonuclease. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]

Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]

Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These

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groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagenases: Enzymes that catalyze the degradation of collagen by acting on the peptide bonds. EC 3.4.24.-. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Commensal: 1. Living on or within another organism, and deriving benefit without injuring or benefiting the other individual. 2. An organism living on or within another, but not causing injury to the host. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complement Activation: The sequential activation of serum components C1 through C9, initiated by an erythrocyte-antibody complex or by microbial polysaccharides and properdin, and producing an inflammatory response. [NIH] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy,

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spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementation: The production of a wild-type phenotype when two different mutations are combined in a diploid or a heterokaryon and tested in trans-configuration. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [NIH] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

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Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corneal Ulcer: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue; usually caused by bacterial, fungal, or viral infection. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Arteriosclerosis: Thickening and loss of elasticity of the coronary arteries. [NIH] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with longitudinal studies which are followed over a period of time. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Curettage: Removal of tissue with a curette, a spoon-shaped instrument with a sharp edge. [NIH]

Curette: A spoon-shaped instrument with a sharp edge. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclodextrins: A homologous group of cyclic glucans consisting of alpha-1,4 bound glucose units obtained by the action of cyclodextrin glucanotransferase on starch or similar substrates. The enzyme is produced by certain species of Bacillus. Cyclodextrins form

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inclusion complexes with a wide variety of substances. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]

Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Defensins: Family of antimicrobial peptides that have been identified in humans, animals, and plants. They are thought to play a role in host defenses against infections, inflammation, wound repair, and acquired immunity. Based on the disulfide pairing of their characteristic six cysteine residues, they are divided into alpha-defensins and beta-defensins. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [NIH]

Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Calculus: Abnormal concretion or calcified deposit that forms around the teeth or dental prostheses. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dental Hygienists: Persons trained in an accredited school or dental college and licensed by

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the state in which they reside to provide dental prophylaxis under the direction of a licensed dentist. [NIH] Dental implant: A small metal pin placed inside the jawbone to mimic the root of a tooth. Dental implants can be used to help anchor a false tooth or teeth, or a crown or bridge. [NIH] Dental Materials: Materials used in the production of dental bases, restorations, impressions, prostheses, etc. [NIH] Dental Plaque: A film that attaches to teeth, often causing dental caries and gingivitis. It is composed of mucins, secreted from salivary glands, and microorganisms. [NIH] Dental Scaling: Removal of dental plaque and dental calculus from the surface of a tooth, from the surface of a tooth apical to the gingival margin accumulated in periodontal pockets, or from the surface coronal to the gingival margin. [NIH] Dentifrices: Any preparations used for cleansing teeth; they usually contain an abrasive, detergent, binder and flavoring agent and may exist in the form of liquid, paste or powder; may also contain medicaments and caries preventives. [NIH] Dentition: The teeth in the dental arch; ordinarily used to designate the natural teeth in position in their alveoli. [EU] Dentures: An appliance used as an artificial or prosthetic replacement for missing teeth and adjacent tissues. It does not include crowns, dental abutments, nor artificial teeth. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Dietary Sucrose: Sucrose present in the diet. It is added to food and drinks as a sweetener. [NIH]

Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH]

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Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disease Susceptibility: A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the individual more than usually susceptible to certain diseases. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disinfection: Rendering pathogens harmless through the use of heat, antiseptics, antibacterial agents, etc. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuretic: A drug that increases the production of urine. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Doxycycline: A synthetic tetracycline derivative with a range of antimicrobial activity and mode of action similar to that of tetracycline, but more effective against many species. Animal studies suggest that it may cause less tooth staining than other tetracyclines. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dysmenorrhea: Painful menstruation. [NIH] Dystrophic: Pertaining to toxic habitats low in nutrients. [NIH] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient.

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[NIH]

Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]

Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium,

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characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endopeptidases: A subclass of peptide hydrolases. They are classified primarily by their catalytic mechanism. Specificity is used only for identification of individual enzymes. They comprise the serine endopeptidases, EC 3.4.21; cysteine endopeptidases, EC 3.4.22; aspartic endopeptidases, EC 3.4.23, metalloendopeptidases, EC 3.4.24; and a group of enzymes yet to be assigned to any of the above sub-classes, EC 3.4.99. EC 3.4.-. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Endotoxin: Toxin from cell walls of bacteria. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Enteric bacteria: Single-celled microorganisms that lack chlorophyll. Some bacteria are capable of causing human, animal, or plant diseases; others are essential in pollution control because they break down organic matter in the air and in the water. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Enteropeptidase: A specialized proteolytic enzyme secreted by intestinal cells. It converts trypsinogen into its active form trypsin by removing the N-terminal peptide. EC 3.4.21.9. [NIH]

Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH]

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Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermolysis Bullosa: Group of genetically determined disorders characterized by the blistering of skin and mucosae. There are four major forms: acquired, simple, junctional, and dystrophic. Each of the latter three has several varieties. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythema Multiforme: A skin and mucous membrane disease characterized by an eruption of macules, papules, nodules, vesicles, and/or bullae with characteristic "bull's-eye" lesions usually occurring on the dorsal aspect of the hands and forearms. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagitis, Peptic: Inflammation of the esophagus caused by reflux of gastric juice and/or stomach and duodenal contents. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]

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Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Ethmoid: An unpaired cranial bone which helps form the medial walls of the orbits and contains the themoidal air cells which drain into the nose. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]

Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Facial Pain: Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as facial pain syndromes. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH]

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Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibronectin: An adhesive glycoprotein. One form circulates in plasma, acting as an opsonin; another is a cell-surface protein which mediates cellular adhesive interactions. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filler: An inactive substance used to make a product bigger or easier to handle. For example, fillers are often used to make pills or capsules because the amount of active drug is too small to be handled conveniently. [NIH] Flatus: Gas passed through the rectum. [NIH] Flexor: Muscles which flex a joint. [NIH] Fluoridation: The addition of fluorine usually as a fluoride to something, as the adding of a fluoride to drinking water or public water supplies for prevention of tooth decay in children. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Flurbiprofen: An anti-inflammatory analgesic and antipyretic of the phenylalkynoic acid series. It has been shown to reduce bone resorption in periodontal disease by inhibiting carbonic anhydrase. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follicles: Shafts through which hair grows. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Frontal Sinus: One of the paired, but seldom symmetrical, air spaces located between the inner and outer compact layers of the frontal bone. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or

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asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gelatinases: A class of enzymes that catalyzes the degradation of gelatin by acting on the peptide bonds. EC 3.4.24.-. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH]

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Geriatric: Pertaining to the treatment of the aged. [EU] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gingival Recession: The exposure of root surface by an apical shift in the position of the gingiva. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [NIH] Glucans: Polysaccharides composed of repeating glucose units. They can consist of branched or unbranched chains in any linkages. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH]

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Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-Negative Anaerobic Bacteria: A large group of anaerobic bacteria which show up as pink (negative) when treated by the Gram staining method. [NIH] Gram-Negative Bacteria: Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Halitosis: An offensive, foul breath odor resulting from a variety of causes such as poor oral hygiene, dental or oral infections, or the ingestion of certain foods. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH]

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Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Heterotrophic: Pertaining to organisms that are consumers and dependent on other organisms for their source of energy (food). [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histamine Release: The secretion of histamine from mast cell and basophil granules by exocytosis. This can be initiated by a number of factors, all of which involve binding of IgE, cross-linked by antigen, to the mast cell or basophil's Fc receptors. Once released, histamine binds to a number of different target cell receptors and exerts a wide variety of effects. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hyaluronidase: An enzyme that splits hyaluronic acid and thus lowers the viscosity of the acid and facilitates the spreading of fluids through tissues either advantageously or disadvantageously. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic

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acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hygienic: Pertaining to hygiene, or conducive to health. [EU] Hyperaemia: An excess of blood in a part; engorgement. [EU] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Immune adjuvant: A drug that stimulates the immune system to respond to disease. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

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Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incisor: Anything adapted for cutting; any one of the four front teeth in each jaw. [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infectious Mononucleosis: A common, acute infection usually caused by the Epstein-Barr virus (Human herpesvirus 4). There is an increase in mononuclear white blood cells and other atypical lymphocytes, generalized lymphadenopathy, splenomegaly, and occasionally

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hepatomegaly with hepatitis. [NIH] Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-11: Lymphohematopoietic cytokine that has the ability to modulate antigenspecific antibody responses, potentiate megakaryocytes, and regulate bone marrow

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adipogenesis. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Interstitial Collagenase: A member of the metalloproteinase family of enzymes that is principally responsible for cleaving fibrillar collagen. It can degrade interstitial collagens, types I, II and III. EC 3.4.24.7. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Irrigation: The washing of a body cavity or surface by flowing solution which is inserted and then removed. Any drug in the irrigation solution may be absorbed. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kallidin: A decapeptide bradykinin homolog produced by the action of tissue and glandular kallikreins on low-molecular-weight kininogen. It is a smooth-muscle stimulant and hypotensive agent that functions through vasodilatation. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal

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constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laser therapy: The use of an intensely powerful beam of light to kill cancer cells. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Leishmaniasis: A disease caused by any of a number of species of protozoa in the genus Leishmania. There are four major clinical types of this infection: cutaneous (Old and New World), diffuse cutaneous, mucocutaneous, and visceral leishmaniasis. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal tract and the immune system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lichen Planus: An inflammatory, pruritic disease of the skin and mucous membranes,

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which can be either generalized or localized. It is characterized by distinctive purplish, flattopped papules having a predilection for the trunk and flexor surfaces. The lesions may be discrete or coalesce to form plaques. Histologically, there is a "saw-tooth" pattern of epidermal hyperplasia and vacuolar alteration of the basal layer of the epidermis along with an intense upper dermal inflammatory infiltrate composed predominantly of T-cells. Etiology is unknown. [NIH] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lipoxygenase: An enzyme of the oxidoreductase class that catalyzes reactions between linoleate and other fatty acids and oxygen to form hydroperoxy-fatty acid derivatives. Related enzymes in this class include the arachidonate lipoxygenases, arachidonate 5lipoxygenase, arachidonate 12-lipoxygenase, and arachidonate 15-lipoxygenase. EC 1.13.11.12. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]

Localized: Cancer which has not metastasized yet. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Lucida: An instrument, invented by Wollaton, consisting essentially of a prism or a mirror through which an object can be viewed so as to appear on a plane surface seen in direct view and on which the outline of the object may be traced. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries

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cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Subsets: A classification of lymphocytes based on structurally or functionally different populations of cells. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports

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the lower teeth. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megakaryocytes: Very large bone marrow cells which release mature blood platelets. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Melanin: The substance that gives the skin its color. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Menthol: An alcohol produced from mint oils or prepared synthetically. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methyl salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH]

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Microbiological: Pertaining to microbiology : the science that deals with microorganisms, including algae, bacteria, fungi, protozoa and viruses. [EU] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocyte: A type of white blood cell. [NIH] Mononuclear: A cell with one nucleus. [NIH] Mononucleosis: The presence of an abnormally large number of mononuclear leucocytes (monocytes) in the blood. The term is often used alone to refer to infectious mononucleosis. [EU]

Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH]

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Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple Organ Failure: A progressive condition usually characterized by combined failure of several organs such as the lungs, liver, kidney, along with some clotting mechanisms, usually postinjury or postoperative. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Myalgia: Pain in a muscle or muscles. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardial Reperfusion: Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing myocardial reperfusion injury. [NIH] Myocardial Reperfusion Injury: Functional, metabolic, or structural changes in ischemic heart muscle thought to result from reperfusion to the ischemic areas. Changes can be fatal to muscle cells and may include edema with explosive cell swelling and disintegration, sarcolemma disruption, fragmentation of mitochondria, contraction band necrosis, enzyme washout, and calcium overload. Other damage may include hemorrhage and ventricular arrhythmias. One possible mechanism of damage is thought to be oxygen free radicals. Treatment currently includes the introduction of scavengers of oxygen free radicals, and injury is thought to be prevented by warm blood cardioplegic infusion prior to reperfusion. [NIH]

Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle

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known as cardiac muscle. [NIH] Myositis: Inflammation of a voluntary muscle. [EU] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Nasal Septum: The partition separating the two nasal cavities in the midplane, composed of cartilaginous, membranous and bony parts. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Necrotizing Enterocolitis: A condition in which part of the tissue in the intestines is destroyed. Occurs mainly in under-weight newborn babies. A temporary ileostomy may be necessary. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroretinitis: Inflammation of the optic nerve head and adjacent retina. [NIH] Neutralization: An act or process of neutralizing. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophil: A type of white blood cell. [NIH] Neutrophil Infiltration: The diffusion or accumulation of neutrophils in tissues or cells in response to a wide variety of substances released at the sites of inflammatory reactions. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH]

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Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Opacity: Degree of density (area most dense taken for reading). [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [NIH]

Orderly: A male hospital attendant. [NIH] Organoleptic: Of, relating to, or involving the employment of the sense organs; used especially of subjective testing (as of flavor, odor, appearance) of food and drug products. [NIH]

Ornithine: An amino acid produced in the urea cycle by the splitting off of urea from

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arginine. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Osteocalcin: Vitamin K-dependent calcium-binding protein synthesized by osteoblasts and found primarily in bone. Serum osteocalcin measurements provide a noninvasive specific marker of bone metabolism. The protein contains three residues of the amino acid gammacarboxyglutamic acid (GLA), which, in the presence of calcium, promotes binding to hydroxyapatite and subsequent accumulation in bone matrix. [NIH] Osteoclasts: A large multinuclear cell associated with the absorption and removal of bone. An odontoclast, also called cementoclast, is cytomorphologically the same as an osteoclast and is involved in cementum resorption. [NIH] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Osteonectin: Non-collagenous, calcium-binding glycoprotein of developing bone. It links collagen to mineral in the bone matrix. In the synonym SPARC glycoprotein, the acronym stands for secreted protein, acidic and rich in cysteine. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxidative metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, cell respiration, or aerobic metabolism. [NIH] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH]

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Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Papain: A proteolytic enzyme obtained from Carica papaya. It is also the name used for a purified mixture of papain and chymopapain that is used as a topical enzymatic debriding agent. EC 3.4.22.2. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]

Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Particle: A tiny mass of material. [EU] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pediatric Dentistry: The practice of dentistry concerned with the dental problems of children, proper maintenance, and treatment. The dental care may include the services provided by dental specialists. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into

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contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Pericoronitis: Inflammation of the gingiva surrounding the crown of a tooth. [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal Ligament: Fibrous connective tissue surrounding the root of a tooth that separates it from and attaches it to the alveolar bone. [NIH] Periodontal Pocket: An abnormal extension of a gingival sulcus accompanied by the apical migration of the epithelial attachment and bone resorption. [NIH] Periodontics: A dental specialty concerned with the histology, physiology, and pathology of the tissues that support, attach, and surround the teeth, and of the treatment and prevention of disease affecting these tissues. [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Peripheral blood: Blood circulating throughout the body. [NIH] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Peroxidase: A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC 1.11.1.7. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharyngitis: Inflammation of the throat. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs

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of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Piroxicam: 4-Hydroxy-2-methyl-N-2-pyridyl-2H-1,2-benzothiazine-3-carboxamide 1,1dioxide. A non-steroidal anti-inflammatory agent that is well established in the treatment of rheumatoid arthritis and osteoarthritis. Its usefulness has also been demonstrated in the treatment of musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily. The drug has also been shown to be effective if administered rectally. Gastrointestinal complaints are the most frequently reported side effects. [NIH] Plague: An acute infectious disease caused by Yersinia pestis that affects humans, wild rodents, and their ectoparasites. This condition persists due to its firm entrenchment in sylvatic rodent-flea ecosystems throughout the world. Bubonic plague is the most common form. [NIH] Plant Diseases: Diseases of plants. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activator Inhibitor 2: Member of the serpin family of proteins. It inhibits both the tissue-type and urokinase-type plasminogen activators. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the

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vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Pneumonitis: A disease caused by inhaling a wide variety of substances such as dusts and molds. Also called "farmer's disease". [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Pollen: The male fertilizing element of flowering plants analogous to sperm in animals. It is released from the anthers as yellow dust, to be carried by insect or other vectors, including wind, to the ovary (stigma) of other flowers to produce the embryo enclosed by the seed. The pollens of many plants are allergenic. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Porphyromonas: A genus of gram-negative, anaerobic, nonsporeforming, nonmotile rods or coccobacilli. Organisms in this genus had originally been classified as members of the Bacteroides genus but overwhelming biochemical and chemical findings indicated the need to separate them from other Bacteroides species, and hence, this new genus was created. [NIH]

Porphyromonas gingivalis: A species of gram-negative, anaerobic, rod-shaped bacteria originally classified within the Bacteroides genus. This bacterium produces a cell-bound, oxygen-sensitive collagenase and is isolated from the human mouth. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium Citrate: A powder that dissolves in water, which is administered orally, and is used as a diuretic, expectorant, systemic alkalizer, and electrolyte replenisher. [NIH]

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Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [NIH] Precipitation: The act or process of precipitating. [EU] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] Pregnancy Complications: The co-occurrence of pregnancy and a disease. The disease may precede or follow conception and it may or may not have a deleterious effect on the pregnant woman or fetus. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Prickle: Several layers of the epidermis where the individual cells are connected by cell bridges. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Proenzyme: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU]

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Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protease Inhibitors: Compounds which inhibit or antagonize biosynthesis or actions of proteases (endopeptidases). [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Proxy: A person authorized to decide or act for another person, for example, a person having durable power of attorney. [NIH] Pruritic: Pertaining to or characterized by pruritus. [EU]

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Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary Emphysema: Condition of the lungs characterized by increase beyond normal in the size of air spaces distal to the terminal bronchioles, either from dilatation of the alveoli or from destruction of their walls. [NIH] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [NIH] Putrescine: A toxic diamine formed by putrefaction from the decarboxylation of arginine and ornithine. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large

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intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Repopulation: The replacement of functional cells, usually by proliferation, following or during irradiation. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (chorioretinitis) and of the optic nerve

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(neuroretinitis). The disease may be confined to one eye, but since it is generally dependent on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Root Planing: A procedure for smoothing of the roughened root surface or cementum of a tooth after subgingival curettage or scaling, as part of periodontal therapy. [NIH] Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Saliva, Artificial: A solution used for irrigating the mouth in xerostomia and as a substitute for saliva. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Salmonellosis: Infection by salmonellae. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Scleroproteins: Simple proteins characterized by their insolubility and fibrous structure. Within the body, they perform a supportive or protective function. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical

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structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Self Mutilation: The act of injuring one's own body to the extent of cutting off or permanently destroying a limb or other essential part of a body. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequela: Any lesion or affection following or caused by an attack of disease. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

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Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Social Class: A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Sodium Fluoride: A source of inorganic fluoride which is used topically to prevent dental caries. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Soybean Oil: Oil from soybean or soybean plant. [NIH] Spasmogenic: Capable of producing convulsions. [NIH]

Dictionary 195

Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spirochete: Lyme disease. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Streptococcal: Caused by infection due to any species of streptococcus. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH]

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Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Sublingual: Located beneath the tongue. [EU] Submandibular: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sulfur Compounds: Inorganic or organic compounds that contain sulfur as an integral part of the molecule. [NIH] Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Superoxide Dismutase: An oxidoreductase that catalyzes the reaction between superoxide anions and hydrogen to yield molecular oxygen and hydrogen peroxide. The enzyme protects the cell against dangerous levels of superoxide. EC 1.15.1.1. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH]

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Tachypnea: Rapid breathing. [NIH] Tartar: A mass of calcium and magnesium salts deposited around the teeth and upon artificial dentures. [NIH] Technology Transfer: Spread and adoption of inventions and techniques from one geographic area to another, from one discipline to another, or from one sector of the economy to another. For example, improvements in medical equipment may be transferred from industrial countries to developing countries, advances arising from aerospace engineering may be applied to equipment for persons with disabilities, and innovations in science arising from government research are made available to private enterprise. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Plasminogen Activator: A proteolytic enzyme in the serine protease family found in many tissues which converts plasminogen to plasmin. It has fibrin-binding activity and is immunologically different from urinary plasminogen activator. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases. EC 3.4.21.68. [NIH] Tooth Loss: The failure to retain teeth as a result of disease or injury. [NIH] Topical: On the surface of the body. [NIH]

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Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxaemia: 1. The condition resulting from the spread of bacterial products (toxins) by the bloodstream. 2. A condition resulting from metabolic disturbances, e.g. toxaemia of pregnancy. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Triclosan: A diphenyl ether derivative used in cosmetics and toilet soaps as an antiseptic. It has some bacteriostatic and fungistatic action. [NIH] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Tropism: Directed movements and orientations found in plants, such as the turning of the sunflower to face the sun. [NIH] Trypsin: A serine endopeptidase that is formed from trypsinogen in the pancreas. It is converted into its active form by enteropeptidase in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tularemia: A plague-like disease of rodents, transmissible to man. It is caused by Francisella tularensis and is characterized by fever, chills, headache, backache, and weakness. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH]

Dictionary 199

Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urethritis: Inflammation of the urethra. [EU] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Plasminogen Activator: A proteolytic enzyme that converts plasminogen to plasmin where the preferential cleavage is between arginine and valine. It was isolated originally from human urine, but is found in most tissues of most vertebrates. EC 3.4.21.73. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urokinase: A drug that dissolves blood clots or prevents them from forming. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH]

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Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH] Viremia: The presence of viruses in the blood. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

201

INDEX A Abdominal, 145, 184, 199 Abdominal Pain, 145, 199 Acceptor, 145, 183 Acetylcholine, 145, 182 Actinomyces, 14, 82, 145 Acute lymphoblastic leukemia, 145 Acute lymphocytic leukemia, 65, 145 Adaptability, 145, 154 Adjustment, 22, 145 Adrenal Medulla, 145, 153, 164, 182 Adrenergic, 68, 145, 164 Adsorption, 23, 145 Adsorptive, 145 Adverse Effect, 114, 145, 194 Aetiology, 85, 145 Affinity, 24, 145, 146, 194 Agar, 146, 186 Age of Onset, 16, 146 Aggravation, 5, 146 Agonist, 85, 146 Albumin, 146, 186 Algorithms, 146, 151 Alimentary, 93, 146, 184 Alkaline, 29, 146, 147, 152 Alkaline Phosphatase, 29, 146 Allergen, 86, 103, 146 Allylamine, 146, 147 Alpha Particles, 146, 190 Alpha-1, 146, 158 Alpha-Defensins, 146, 159 Alpha-helix, 147, 175 Alternative medicine, 112, 147 Alum, 38, 39, 147 Aluminum, 147 Alveolar Process, 147, 191 Alveoli, 147, 160, 190 Amebiasis, 147, 178 Amine, 35, 147, 170 Amino Acid Sequence, 14, 147, 148 Amino Acids, 89, 95, 147, 185, 187, 189, 192, 193, 196, 197, 198, 199 Ammonia, 147, 199 Ammonium Compounds, 7, 147 Amplification, 20, 147 Anaerobic, 81, 85, 86, 89, 93, 95, 147, 169, 187 Anaesthesia, 147, 172

Anal, 147, 176 Analgesic, 147, 166 Analogous, 13, 147, 187, 198 Anaphylatoxins, 81, 148, 156 Anatomical, 8, 78, 148, 162, 192 Anemia, 148, 166, 177 Anesthetics, 148, 154, 164 Angina, 11, 148 Angiogenesis, 148, 178 Animal model, 21, 148 Anionic, 89, 148 Anions, 88, 146, 148, 174, 196 Anode, 148 Antagonism, 23, 148 Antibacterial, 79, 92, 93, 100, 148, 161, 195 Antibiotic, 6, 74, 75, 84, 102, 114, 148, 184, 195, 197 Antibiotic Prophylaxis, 6, 148 Antibodies, 46, 48, 49, 54, 148, 164, 169, 171, 177, 179, 186 Antibody, 22, 49, 146, 148, 149, 156, 169, 170, 172, 173, 174, 179, 195 Antidote, 13, 148 Antigen, 11, 18, 146, 148, 149, 156, 159, 164, 168, 170, 171, 172, 173 Antigen-Antibody Complex, 149, 156 Antigen-presenting cell, 149, 159 Anti-infective, 74, 75, 149, 154, 171, 194 Anti-inflammatory, 19, 74, 86, 103, 149, 166, 178, 186, 192 Anti-Inflammatory Agents, 86, 103, 149 Antimicrobial, 8, 18, 48, 55, 74, 75, 76, 79, 80, 90, 101, 107, 149, 159, 161 Antioxidant, 149, 150 Antipyretic, 149, 166 Antiseptic, 31, 53, 60, 149, 154, 198 Antiviral, 149, 173 Anus, 147, 149, 191 Appendicitis, 86, 87, 103, 149 Aqueous, 84, 85, 92, 101, 149, 150, 171, 175 Arachidonic Acid, 88, 149, 175, 189 Arginine, 80, 81, 148, 149, 182, 183, 190, 198, 199 Arterial, 5, 146, 149, 171, 189 Arteries, 5, 149, 151, 158, 178, 180, 197 Arteriolar, 149, 152 Arterioles, 149, 151, 153, 180 Arteriolosclerosis, 149

202 Gingivitis

Arteriosclerosis, 87, 149 Articular, 150, 176, 183 Ascorbic Acid, 66, 150, 171 Assay, 21, 24, 29, 150 Astringent, 79, 150 Asymptomatic, 147, 150, 184 Atopic, 102, 150 Autodigestion, 150, 184 Autoimmune disease, 150, 180 Autoimmunity, 17, 150 B Bacteraemia, 41, 150 Bacteremia, 6, 66, 150 Bacteria, 5, 7, 8, 11, 13, 15, 17, 18, 20, 24, 36, 46, 50, 74, 75, 76, 78, 81, 82, 85, 86, 89, 92, 93, 94, 95, 96, 100, 101, 108, 145, 148, 149, 150, 151, 152, 159, 162, 163, 164, 167, 169, 179, 187, 195, 199 Bacterial Infections, 107, 150 Bactericidal, 7, 74, 101, 150, 154 Bacteriophage, 150, 186 Bacteriostatic, 150, 198 Bacterium, 4, 81, 150, 187 Balanitis, 34, 150 Base, 14, 84, 95, 150, 159, 174, 197, 199 Basement Membrane, 82, 97, 150, 165, 175 Basophils, 150, 175 Benzoic Acid, 88, 151 Beta-Defensins, 19, 151, 159 Bilateral, 151, 192 Bile, 151, 155, 170, 176 Biliary, 151, 184 Biliary Tract, 151, 184 Bioavailability, 79, 151 Bioavailable, 79, 151 Biochemical, 22, 151, 175, 183, 187, 193 Biofilms, 9, 13, 16, 94, 151 Biological response modifier, 151, 173 Biosynthesis, 149, 151, 189, 193 Biotechnology, 24, 106, 112, 125, 151 Bladder, 151, 180, 199 Blood Coagulation, 151, 152 Blood Glucose, 16, 151, 173 Blood pressure, 22, 151, 153, 171, 179, 194 Blood vessel, 148, 151, 153, 154, 163, 168, 174, 177, 185, 194, 196, 197, 200 Blot, 17, 151 Body Fluids, 18, 152, 161, 194 Body Mass Index, 10, 152, 183 Bone Marrow, 91, 145, 152, 172, 173, 177, 178, 194, 196 Bone Resorption, 98, 152, 166, 185

Bowel, 75, 147, 152, 160, 163, 173, 174, 199 Bradykinin, 64, 152, 174, 182, 186 Branch, 139, 152, 177, 184, 195, 197 Breakdown, 22, 152, 160, 167 Breast Feeding, 15, 152 Bronchial, 152, 170 Bronchioles, 147, 152, 190 Brucellosis, 17, 152 Bruxism, 65, 152 Buccal, 79, 152, 195 C Cadaverine, 83, 89, 152 Calcification, 149, 152 Calcium, 24, 62, 86, 92, 103, 152, 156, 171, 178, 180, 183, 197 Calculus I, 52, 152 Candidiasis, 107, 127, 152 Candidosis, 153 Capillary, 152, 153 Capillary Permeability, 152, 153 Capsules, 153, 166, 167 Carbohydrate, 76, 153, 168, 187 Carbon Dioxide, 83, 153, 159, 191 Carcinogen, 153, 178 Carcinogenic, 153, 173 Cardiac, 146, 153, 163, 164, 167, 180, 181 Cardiovascular, 22, 113, 153, 175, 193 Cardiovascular disease, 22, 113, 153 Carrier Proteins, 153, 186 Case report, 15, 25, 29, 41, 42, 66, 153, 155 Case series, 153, 155 Catecholamine, 56, 153 Cations, 153, 174 Causal, 23, 154 Causality, 22, 154 Cell Count, 6, 154 Cell Death, 13, 154, 168, 181 Cell Division, 150, 154, 186 Cell proliferation, 149, 154 Central Nervous System, 145, 154, 168, 169, 175, 180, 182, 193 Cerebral, 84, 102, 154, 158, 164, 165, 177 Cerebrovascular, 153, 154 Cerebrum, 154 Cetylpyridinium, 37, 52, 59, 154 Check-up, 114, 154 Chemical Actions, 79, 154 Chemotactic Factors, 154, 156 Chemotaxis, 66, 154 Chemotherapy, 91, 154

Index 203

Chlorhexidine, 7, 18, 25, 26, 29, 30, 37, 47, 50, 52, 55, 58, 60, 63, 65, 68, 84, 106, 107, 118, 154 Chlorine, 94, 154 Chlorophyll, 154, 163, 167 Cholangitis, 86, 103, 155 Chorioretinitis, 155, 191 Choroid, 155, 191, 199 Chromosomal, 147, 155 Chromosome, 155, 176 Chymopapain, 155, 184 Cicatricial, 34, 42, 155 Citrus, 100, 101, 150, 155 Cleave, 14, 81, 155 Clinical Medicine, 155, 188 Clinical study, 26, 31, 32, 33, 35, 37, 51, 56, 58, 59, 60, 155, 157 Clinical trial, 3, 7, 8, 18, 31, 53, 58, 63, 64, 125, 155, 157, 189, 190 Clone, 20, 155 Cloning, 14, 22, 151, 155 Coagulation, 81, 151, 155, 186, 197 Cochlea, 155, 173 Coenzyme, 68, 150, 155 Cofactor, 155, 189 Cohort Studies, 22, 155 Colitis, 102, 156 Collagen, 15, 43, 81, 82, 87, 98, 150, 156, 165, 166, 167, 174, 178, 183, 187, 188 Collagenases, 97, 156 Collapse, 152, 156 Colloidal, 146, 156, 162 Commensal, 20, 156 Complement, 81, 148, 156, 157, 167, 186 Complement Activation, 148, 156 Complementary and alternative medicine, 63, 70, 156 Complementary medicine, 63, 157 Complementation, 14, 157 Computational Biology, 125, 157 Conception, 157, 166, 188, 195 Concretion, 152, 157, 159 Confounding, 10, 22, 157 Congestion, 157, 164 Conjugated, 151, 157 Conjunctiva, 157, 173, 198 Conjunctivitis, 84, 102, 157 Connective Tissue, 15, 81, 82, 97, 150, 152, 156, 157, 166, 167, 177, 185, 192 Connective Tissue Cells, 157 Constitutional, 157, 192 Contamination, 94, 157

Contraindications, ii, 157 Control group, 16, 20, 157 Controlled clinical trial, 36, 39, 59, 157 Controlled study, 30, 52, 58, 157 Conventional therapy, 158 Conventional treatment, 12, 158 Convulsions, 158, 161, 188, 194 Coordination, 158, 180 Cornea, 158, 192, 199 Corneal Ulcer, 97, 158 Coronary, 5, 16, 153, 158, 178, 180 Coronary Arteriosclerosis, 158, 180 Coronary heart disease, 153, 158 Coronary Thrombosis, 158, 178, 180 Cortex, 158, 165, 183 Cortical, 158, 193 Cranial, 158, 165, 168, 169, 182, 184, 198 Cross-Sectional Studies, 10, 158 Cues, 74, 158 Curative, 158, 181, 197 Curettage, 78, 158, 192 Curette, 158 Cutaneous, 47, 152, 158, 175 Cyclic, 91, 158, 169, 182 Cyclodextrins, 89, 158 Cysteine, 65, 89, 95, 98, 155, 159, 163, 183, 196 Cystine, 89, 159 Cytokine, 11, 22, 97, 159, 173 Cytotoxic, 42, 159 D Data Collection, 16, 126, 159 Databases, Bibliographic, 125, 159 De novo, 50, 83, 159 Decarboxylation, 152, 159, 170, 190 Defense Mechanisms, 27, 81, 159 Defensins, 15, 19, 146, 151, 159 Degenerative, 159, 170, 183 Dendrites, 159 Dendritic, 11, 159 Dendritic cell, 11, 159 Density, 9, 17, 85, 152, 159, 176, 182 Dental Calculus, 55, 108, 159, 160 Dental Care, 10, 100, 109, 113, 114, 159, 184 Dental Caries, 9, 14, 45, 76, 77, 79, 85, 89, 92, 108, 113, 126, 127, 159, 160, 166, 194 Dental Hygienists, 3, 53, 114, 159 Dental implant, 127, 160 Dental Materials, 9, 160 Dental Scaling, 6, 160

204 Gingivitis

Dentifrices, 7, 25, 33, 35, 36, 39, 59, 60, 79, 101, 160 Dentition, 11, 86, 108, 160 Dentures, 160, 197 Dermal, 82, 97, 160, 176 Dermatitis, 34, 64, 86, 87, 102, 103, 160, 162 DES, 148, 160 Deuterium, 160, 171 Developing Countries, 160, 197 Diabetes Mellitus, 160, 168 Diagnostic procedure, 73, 112, 160 Diarrhea, 84, 147, 160 Dietary Sucrose, 85, 160 Diffusion, 153, 160, 181 Digestion, 77, 81, 93, 146, 151, 152, 160, 174, 176, 184, 195 Digestive system, 160, 180 Dilatation, 160, 188, 190 Dilation, 152, 161 Dimethyl, 89, 95, 161 Diploid, 157, 161, 186 Direct, iii, 14, 15, 28, 85, 108, 117, 155, 161, 168, 176, 191 Discrimination, 113, 161 Disease Progression, 5, 8, 16, 161, 200 Disease Susceptibility, 19, 161 Disinfectant, 74, 154, 161 Disinfection, 74, 93, 94, 96, 161 Dissociation, 146, 161, 174 Distal, 161, 189, 190 Diuretic, 88, 161, 187 Dorsal, 161, 164, 187 Doxycycline, 74, 75, 161 Drug Interactions, 119, 161 Duct, 155, 161, 165, 192 Duodenum, 151, 161, 195 Dura mater, 161, 178, 183 Dysmenorrhea, 161, 186 Dystrophic, 161, 164 E Eclampsia, 161, 188 Eczema, 83, 162 Edema, 162, 180, 188, 199 Effector, 23, 145, 156, 162 Efficacy, 6, 7, 8, 13, 18, 19, 25, 26, 28, 31, 32, 33, 36, 37, 38, 39, 47, 48, 51, 52, 53, 58, 59, 64, 67, 74, 75, 79, 162 Elasticity, 149, 158, 162 Elastin, 87, 156, 162, 165 Electrocoagulation, 155, 162 Electrolysis, 148, 153, 162 Electrolyte, 162, 187, 194, 199

Electrons, 149, 150, 162, 174, 183, 190 Electrophoresis, 24, 162 Embolus, 162, 172 Embryo, 162, 172, 187 Enamel, 14, 23, 83, 159, 162, 175 Encapsulated, 77, 162 Encephalitis, 86, 87, 103, 162 Encephalitis, Viral, 162 Endemic, 162, 177 Endocarditis, 153, 162 Endometrial, 163 Endometriosis, 91, 163 Endometrium, 163 Endopeptidases, 163, 189 Endothelium, 23, 163, 182, 187 Endothelium, Lymphatic, 163 Endothelium, Vascular, 163 Endothelium-derived, 163, 182 Endotoxic, 22, 163 Endotoxin, 163, 198 Enhancer, 84, 163 Enteric bacteria, 83, 163 Enteritis, 86, 87, 103, 163 Enterocolitis, 163 Enteropeptidase, 163, 198 Environmental Health, 124, 126, 163 Enzymatic, 14, 23, 77, 152, 156, 159, 163, 170, 184 Enzyme Inhibitors, 164, 186 Eosinophils, 164, 175 Epidemic, 27, 164 Epidemiological, 15, 22, 86, 164 Epidermal, 82, 86, 103, 164, 175, 176 Epidermis, 164, 175, 176, 188 Epidermolysis Bullosa, 97, 164 Epinephrine, 145, 164, 182, 199 Epithelial, 15, 19, 22, 77, 81, 86, 95, 103, 151, 158, 164, 170, 175, 185 Epithelial Cells, 15, 19, 22, 77, 81, 95, 151, 164, 170, 175 Epithelium, 48, 49, 81, 150, 163, 164, 167 Epitopes, 11, 164 Erythema, 20, 29, 83, 141, 164, 196, 199 Erythema Multiforme, 83, 164 Erythrocytes, 148, 152, 164 Esophageal, 91, 164 Esophagitis, 84, 102, 164 Esophagitis, Peptic, 102, 164 Esophagus, 160, 164, 185, 191, 195 Estrogen, 39, 164 Estrogen receptor, 39, 164 Ether, 98, 101, 165, 198

Index 205

Ethmoid, 75, 165, 184 Eukaryotic Cells, 165, 172 Evoke, 165, 195 Exhaustion, 148, 165, 177 Exocrine, 24, 165, 184 Exogenous, 145, 162, 165 Expectorant, 165, 187 Extensor, 165, 190 Extracellular, 15, 83, 97, 98, 151, 157, 165, 166, 178, 183, 194 Extracellular Matrix, 15, 97, 157, 165, 166, 178, 183 Extracellular Matrix Proteins, 15, 165, 178 Extracellular Space, 165 Extraction, 85, 165 F Facial, 41, 92, 127, 165, 184 Facial Nerve, 165, 184 Facial Pain, 127, 165 Family Planning, 125, 165 Fat, 149, 152, 158, 162, 166, 176, 180, 183, 187, 192, 194, 196 Fatty acids, 83, 146, 166, 176, 189, 194 Febrile, 6, 166, 177 Fetus, 166, 188 Fibrin, 81, 151, 166, 186, 197 Fibrinogen, 81, 166, 186, 197 Fibroblasts, 15, 22, 157, 166 Fibronectin, 81, 98, 166 Fibrosis, 146, 166, 192 Filler, 99, 166 Flatus, 166, 167 Flexor, 165, 166, 176 Fluoridation, 126, 127, 166 Fluorine, 166 Flurbiprofen, 47, 166 Folate, 64, 166 Fold, 22, 166 Folic Acid, 62, 64, 166 Follicles, 11, 166 Forearm, 151, 166 Frontal Sinus, 92, 166 Fungi, 20, 75, 100, 101, 166, 167, 169, 179, 200 Fungistatic, 151, 167, 198 Fungus, 152, 167 G Gas, 96, 147, 153, 154, 160, 166, 167, 171, 182, 200 Gastric, 88, 150, 164, 167, 170, 184, 185 Gastric Acid, 88, 167 Gastric Juices, 167, 184

Gastric Mucosa, 167, 185 Gastrin, 167, 170 Gastritis, 86, 87, 103, 167 Gastrointestinal, 75, 102, 152, 164, 167, 175, 177, 186, 193, 196 Gastrointestinal tract, 75, 167, 175, 193 Gelatin, 167, 168, 197 Gelatinases, 97, 167 Gels, 37, 49, 79, 94, 167 Gene, 14, 20, 22, 43, 106, 151, 167 Gene Expression, 43, 167 Genetic Engineering, 151, 155, 167 Genetics, 9, 84, 114, 167 Genital, 15, 167 Genotype, 167, 185 Geriatric, 108, 168 Giant Cells, 168, 192 Giardiasis, 168, 178 Gingival Recession, 83, 108, 168 Gland, 77, 145, 168, 177, 184, 193, 195, 196, 197 Glomerular, 168, 191 Glomerulus, 168, 181 Glossopharyngeal Nerve, 165, 168 Glucans, 158, 168 Glucose, 16, 23, 150, 151, 158, 160, 168, 173 Glucose Intolerance, 23, 160, 168 Glucose tolerance, 168 Glucose Tolerance Test, 168 Glutamic Acid, 166, 168, 188 Glycine, 151, 168, 193 Glycoprotein, 166, 168, 175, 183, 198 Glycosaminoglycans, 165, 169 Governing Board, 169, 188 Grade, 51, 169 Graft, 169, 170, 180 Gram-negative, 82, 89, 95, 163, 169, 187 Gram-Negative Anaerobic Bacteria, 95, 169 Gram-Negative Bacteria, 163, 169 Gram-positive, 89, 93, 145, 169, 195 Granuloma, 88, 169 Grasses, 166, 169 Guanylate Cyclase, 169, 182 H Hair follicles, 91, 169, 200 Half-Life, 169, 186 Halitosis, 5, 75, 93, 95, 99, 142, 169 Haptens, 146, 169 Headache, 169, 173, 198 Health Status, 13, 20, 169 Heart attack, 5, 41, 113, 153, 169

206 Gingivitis

Hemorrhage, 162, 169, 170, 180, 196 Hepatitis, 86, 87, 88, 103, 170, 173 Hepatocytes, 170 Hereditary, 170, 185 Heredity, 167, 170 Herpes, 107, 127, 170 Herpes Zoster, 170 Heterogeneity, 17, 146, 170 Heterotrophic, 166, 170 Histamine, 86, 103, 148, 170 Histamine Release, 148, 170 Histidine, 170 Histology, 28, 170, 185 Homologous, 83, 158, 170 Hormone, 10, 160, 164, 167, 170, 173, 178, 192, 197 Host, 5, 11, 12, 14, 15, 19, 22, 23, 27, 81, 84, 85, 86, 102, 103, 150, 153, 156, 159, 170, 172, 175, 200 Humoral, 81, 170 Humour, 170 Hyaluronidase, 81, 170 Hybrid, 155, 170 Hybridization, 20, 24, 170 Hydrogen, 89, 91, 95, 145, 147, 150, 153, 160, 165, 171, 179, 181, 182, 183, 189, 196 Hydrogen Peroxide, 171, 196 Hydrolysis, 79, 171, 187, 189, 198 Hydrophilic, 84, 171 Hydroxylysine, 156, 171 Hydroxyproline, 156, 171 Hygienic, 80, 90, 171 Hyperaemia, 157, 171 Hypercalcemia, 97, 98, 171 Hyperplasia, 171, 176 Hypersensitivity, 52, 79, 102, 146, 171, 175, 192 Hypertension, 149, 153, 169, 171, 188, 199 Hypotensive, 88, 171, 174 I Id, 61, 67, 133, 138, 140, 171 Idiopathic, 25, 171, 192 Ileostomy, 171, 181 Immune adjuvant, 147, 171 Immune response, 16, 147, 148, 149, 150, 169, 171, 172, 196, 200 Immune Sera, 171, 172 Immune system, 94, 149, 150, 171, 172, 175, 177, 180, 185, 199, 200 Immunity, 38, 75, 114, 159, 171, 172, 198 Immunization, 65, 127, 172 Immunodeficiency, 4, 21, 105, 172

Immunodeficiency syndrome, 105, 172 Immunofluorescence, 28, 105, 172 Immunogenic, 80, 172 Immunoglobulin, 148, 172, 179 Immunologic, 16, 21, 22, 34, 154, 172 Immunology, 9, 16, 42, 45, 48, 49, 146, 172 In situ, 16, 17, 78, 172 In Situ Hybridization, 17, 172 In vitro, 7, 21, 24, 82, 91, 172 In vivo, 7, 21, 24, 47, 92, 172, 197 Incision, 172, 174 Incisor, 54, 172 Incubation, 36, 172 Indicative, 106, 172, 184, 200 Induction, 82, 172 Infarction, 84, 172, 191 Infectious Mononucleosis, 172, 179 Infertility, 102, 173 Inflammatory bowel disease, 86, 87, 102, 103, 173 Influenza, 75, 173 Ingestion, 168, 169, 173, 187 Initiation, 6, 173 Inlay, 173, 191 Inner ear, 76, 77, 173 Inorganic, 76, 147, 173, 180, 194, 196 Insight, 11, 20, 23, 173 Insulator, 173, 180 Insulin, 23, 58, 168, 173 Insulin-dependent diabetes mellitus, 173 Interferon, 44, 173, 177 Interferon-alpha, 44, 173 Interleukin-1, 33, 43, 102, 173 Interleukin-11, 102, 173 Interleukin-2, 173, 174 Interstitial, 79, 97, 107, 165, 174, 181, 191 Interstitial Collagenase, 97, 174 Intestinal, 15, 75, 146, 163, 168, 174 Intestine, 152, 163, 174, 175, 185, 195 Intracellular, 86, 97, 103, 172, 174, 178, 182, 187 Intracellular Membranes, 174, 178 Intrinsic, 146, 150, 174 Invasive, 12, 127, 171, 174 Ionization, 174 Ionizing, 12, 146, 174 Ions, 78, 92, 150, 161, 162, 171, 174 Irradiation, 174, 191 Irrigation, 50, 82, 96, 174 Ischemia, 174, 180, 191 J Joint, 150, 166, 174, 183

Index 207

K Kallidin, 152, 174 Kb, 124, 174 Keratin, 42, 174, 175 Keratinocytes, 48, 175 Keratolytic, 159, 175 Kinetic, 174, 175 L Labile, 156, 175 Labyrinth, 155, 173, 175, 193, 200 Laminin, 81, 150, 165, 175 Large Intestine, 160, 174, 175, 191, 194 Laser therapy, 78, 175 Latent, 97, 175, 188 Lectin, 81, 175, 178 Leishmaniasis, 17, 175 Lens, 175, 191 Lesion, 169, 175, 193, 199 Lethal, 150, 175 Leukemia, 91, 175 Leukocytes, 36, 77, 150, 152, 154, 164, 173, 175, 185, 198 Leukotrienes, 86, 103, 149, 175 Library Services, 138, 175 Lichen Planus, 83, 175 Life cycle, 167, 176 Ligaments, 83, 158, 176 Ligands, 18, 176 Ligation, 20, 176 Linkage, 93, 176 Lip, 126, 127, 176 Lipid, 149, 153, 173, 176, 180 Lipopolysaccharide, 81, 169, 176 Lipoprotein, 169, 176 Lipoxygenase, 175, 176 Liver, 91, 145, 146, 149, 151, 160, 166, 168, 170, 176, 180, 192, 199 Liver cancer, 91, 176 Localized, 25, 35, 76, 78, 159, 162, 172, 175, 176, 183, 186, 199 Longitudinal Studies, 11, 158, 176 Longitudinal study, 10, 107, 176 Lucida, 82, 175, 176 Lymph, 163, 170, 172, 176, 177, 192, 196 Lymph node, 177, 192 Lymphatic, 163, 172, 176, 177, 194, 195, 197 Lymphatic system, 176, 177, 194, 195, 197 Lymphoblasts, 145, 177 Lymphocyte, 40, 42, 149, 177 Lymphocyte Subsets, 40, 42, 177 Lymphocytic, 78, 177

Lymphoid, 11, 148, 177 Lysine, 81, 82, 83, 89, 152, 171, 177, 198 Lytic, 14, 81, 177 M Macrophage, 15, 173, 177 Malaise, 142, 152, 177 Malaria, 17, 177 Malaria, Falciparum, 177 Malaria, Vivax, 177 Malignancy, 97, 98, 177 Malignant, 149, 176, 177, 181, 192 Malnutrition, 41, 113, 146, 177 Mandible, 147, 177, 191 Manifest, 75, 178 Matrix metalloproteinase, 97, 178 Maxillary, 75, 178, 184 Medial, 149, 165, 178 Medicament, 99, 178 MEDLINE, 125, 178 Megakaryocytes, 173, 178 Megaloblastic, 166, 178 Melanin, 178, 185, 199 Membrane Proteins, 21, 178, 189 Meninges, 154, 161, 178 Meningitis, 86, 87, 103, 178 Menopause, 83, 178, 187 Menstruation, 161, 178 Menthol, 74, 80, 89, 90, 95, 101, 178 Metabolite, 88, 161, 178 Metastasis, 97, 178 Methionine, 89, 95, 161, 178, 196 Methyl salicylate, 74, 80, 89, 90, 95, 101, 178 Metronidazole, 75, 84, 178 MI, 29, 65, 84, 94, 143, 178 Microbiological, 30, 31, 32, 51, 53, 60, 105, 179 Microbiology, 5, 9, 16, 42, 45, 48, 56, 60, 93, 105, 127, 151, 179 Microorganism, 44, 155, 179, 184, 200 Micro-organism, 89, 101, 159, 179 Microscopy, 44, 106, 150, 179 Migration, 15, 82, 179, 185 Milliliter, 94, 179 Mobility, 85, 179 Modification, 26, 167, 179 Molecular, 11, 17, 22, 24, 80, 82, 100, 125, 129, 147, 151, 157, 166, 174, 179, 186, 196, 198 Molecule, 21, 149, 150, 153, 155, 156, 161, 162, 163, 171, 175, 179, 182, 183, 190, 196, 200

208 Gingivitis

Monitor, 179, 182 Monoclonal, 83, 174, 179 Monoclonal antibodies, 83, 179 Monocyte, 23, 179 Mononuclear, 23, 169, 172, 179, 198 Mononucleosis, 17, 179 Morphology, 12, 179 Motion Sickness, 179, 181 Mucins, 160, 179, 192 Mucociliary, 180, 194 Mucocutaneous, 175, 180 Mucosa, 15, 19, 21, 163, 167, 180, 181, 195 Mucositis, 20, 102, 180 Mucus, 165, 179, 180, 199 Multiple Organ Failure, 88, 180 Multiple sclerosis, 84, 97, 102, 180 Myalgia, 173, 180 Myelin, 180 Myocardial infarction, 84, 87, 102, 158, 178, 180 Myocardial Ischemia, 88, 180 Myocardial Reperfusion, 180, 191 Myocardial Reperfusion Injury, 180, 191 Myocarditis, 86, 87, 103, 180 Myocardium, 178, 180 Myositis, 86, 87, 103, 181 N Nasal Cavity, 75, 181, 184 Nasal Mucosa, 173, 181 Nasal Septum, 181 Nausea, 91, 181, 199 Necrosis, 158, 172, 178, 180, 181, 191, 192 Necrotizing Enterocolitis, 102, 181 Need, 3, 76, 86, 91, 98, 103, 105, 107, 109, 112, 114, 126, 127, 134, 178, 181, 187 Neonatal, 15, 181 Neoplasia, 181 Neoplasm, 181, 192 Neoplastic, 91, 97, 165, 181 Nephritis, 86, 87, 88, 103, 181 Nerve, 145, 159, 165, 168, 180, 181, 182, 193, 195, 198 Networks, 44, 181 Neural, 97, 170, 181 Neuroretinitis, 181, 192 Neutralization, 13, 181 Neutrons, 146, 174, 181, 190 Neutrophil, 33, 81, 181 Neutrophil Infiltration, 81, 181 Niacin, 181, 198 Nitric Oxide, 18, 182 Nitrogen, 91, 147, 165, 182, 198

Norepinephrine, 145, 182 Nuclear, 19, 162, 165, 181, 182 Nucleic acid, 171, 172, 182, 190 Nucleic Acid Hybridization, 171, 182 Nucleus, 150, 158, 160, 164, 165, 179, 181, 182, 189, 195 O Ocular, 102, 182 Opacity, 159, 182 Optic Nerve, 181, 182, 183, 191, 192 Oral Health, 5, 7, 9, 12, 16, 17, 19, 21, 45, 77, 107, 113, 114, 126, 127, 182 Oral Hygiene, 6, 7, 18, 30, 39, 43, 58, 76, 77, 82, 107, 108, 114, 127, 169, 182 Oral Manifestations, 105, 127, 182 Orderly, 82, 182 Organoleptic, 74, 182 Ornithine, 89, 182, 190 Orofacial, 127, 165, 183 Osteoarthritis, 84, 96, 97, 98, 102, 183, 186 Osteoblasts, 98, 183 Osteocalcin, 98, 183 Osteoclasts, 98, 183 Osteomyelitis, 86, 87, 103, 183 Osteonectin, 98, 183 Osteoporosis, 10, 84, 97, 98, 99, 102, 183 Ovary, 183, 187 Overweight, 22, 61, 183 Oxidation, 79, 88, 96, 145, 149, 159, 183 Oxidation-Reduction, 88, 183 Oxidative metabolism, 175, 183 P Pachymeningitis, 178, 183 Palate, 126, 127, 168, 183, 195 Palliative, 184, 197 Pancreas, 145, 160, 173, 184, 198 Pancreatic, 91, 184 Pancreatic cancer, 91, 184 Pancreatitis, 86, 87, 102, 103, 184 Papain, 98, 99, 184 Paranasal Sinuses, 184, 194 Parotid, 24, 46, 168, 184, 192 Particle, 92, 184 Pathogen, 19, 21, 172, 184 Pathogenesis, 11, 23, 82, 86, 97, 103, 184 Pathologic, 153, 158, 171, 184, 190, 191 Patient Education, 132, 136, 138, 143, 184 Pediatric Dentistry, 107, 184 Pelvic, 86, 87, 103, 163, 184 Penicillin, 148, 184 Penis, 150, 184 Pepsin, 184, 185

Index 209

Pepsin A, 184, 185 Peptic, 84, 91, 102, 184 Peptic Ulcer, 84, 91, 102, 184 Peptide, 17, 89, 156, 163, 167, 175, 184, 185, 187, 189 Pericoronitis, 11, 185 Periodontal Ligament, 78, 185 Periodontal Pocket, 83, 85, 92, 160, 185 Periodontics, 9, 11, 16, 27, 59, 185 Peripheral blood, 17, 173, 185 Peristalsis, 88, 185 Peroxidase, 27, 185 Peroxide, 51, 185 Phagocyte, 23, 185 Pharmacologic, 169, 185, 198 Pharyngitis, 102, 185 Pharynx, 173, 181, 185 Phenotype, 157, 185 Phenylalanine, 184, 185, 199 Phosphorus, 152, 185 Phosphorylation, 86, 103, 185 Photocoagulation, 155, 185 Physical Examination, 154, 185 Physiologic, 23, 146, 151, 169, 178, 186, 190, 191 Physiology, 23, 185, 186 Pilot study, 26, 29, 47, 58, 66, 186 Piroxicam, 58, 186 Plague, 186, 198 Plant Diseases, 163, 186 Plants, 153, 155, 159, 168, 175, 179, 182, 186, 187, 198 Plasma, 29, 47, 66, 81, 146, 148, 163, 166, 167, 168, 186, 200 Plasma cells, 148, 186 Plasma protein, 81, 146, 163, 186 Plasmin, 186, 197, 199 Plasminogen, 34, 186, 197, 199 Plasminogen Activator Inhibitor 2, 34, 186 Plasminogen Activators, 186 Platelet Aggregation, 88, 148, 182, 187, 197 Platelets, 178, 182, 187, 193, 197 Pleated, 175, 187 Pneumonitis, 86, 87, 103, 187 Poisoning, 181, 187 Pollen, 75, 187 Polymerase, 19, 48, 187 Polymers, 151, 187, 189 Polypeptide, 95, 99, 147, 156, 166, 171, 184, 186, 187, 188, 189, 200 Polysaccharide, 81, 89, 149, 187, 189

Polyunsaturated fat, 43, 47, 65, 66, 187, 197 Porphyromonas, 11, 26, 48, 54, 65, 80, 81, 187 Porphyromonas gingivalis, 11, 48, 54, 65, 80, 81, 187 Posterior, 147, 155, 161, 168, 183, 184, 187, 192 Postmenopausal, 9, 183, 187 Postoperative, 6, 180, 186, 187 Potassium, 52, 187, 194 Potassium Citrate, 52, 187 Potentiate, 173, 188 Practice Guidelines, 128, 133, 188 Precipitating Factors, 154, 188 Precipitation, 24, 79, 92, 188 Preclinical, 18, 188 Precursor, 97, 106, 149, 162, 163, 182, 185, 186, 188, 198, 199 Predisposition, 85, 188 Preeclampsia, 84, 102, 188 Pregnancy Complications, 113, 188 Prevalence, 16, 25, 35, 48, 188 Prickle, 175, 188 Probe, 23, 34, 188 Proenzyme, 97, 188 Progression, 5, 10, 16, 21, 78, 79, 85, 86, 148, 188 Progressive, 9, 76, 81, 85, 149, 158, 169, 180, 181, 183, 188, 191 Projection, 159, 182, 188 Proline, 156, 171, 188 Prone, 92, 188 Prophylaxis, 44, 88, 160, 188 Proportional, 93, 188 Prospective study, 176, 189 Prostaglandins, 15, 86, 103, 149, 189 Protease, 65, 80, 97, 98, 189, 197 Protease Inhibitors, 98, 189 Protein C, 146, 147, 150, 174, 176, 183, 189, 199 Protein Conformation, 147, 174, 189 Protein S, 106, 151, 183, 189, 192, 197 Proteinuria, 188, 189 Proteoglycans, 87, 98, 150, 165, 189 Proteolytic, 81, 98, 146, 156, 163, 166, 184, 186, 189, 197, 199 Protocol, 12, 26, 78, 189 Proton Pump, 98, 189 Protons, 146, 171, 174, 189, 190 Protozoa, 175, 179, 189 Proximal, 161, 181, 189

210 Gingivitis

Proxy, 127, 189 Pruritic, 162, 175, 189 Psoriasis, 83, 86, 91, 102, 103, 190 Psychic, 190, 193 Puberty, 107, 190 Public Policy, 125, 190 Pulmonary, 87, 151, 154, 175, 190, 196 Pulmonary Artery, 151, 190 Pulmonary Edema, 154, 190 Pulmonary Emphysema, 87, 190 Purines, 190, 193 Putrefaction, 89, 190 Putrescine, 89, 190 Pyogenic, 183, 190 Q Quaternary, 7, 189, 190 R Race, 179, 190 Radiation, 12, 174, 178, 190, 196, 200 Radioactive, 169, 171, 174, 179, 182, 190 Randomized, 6, 13, 36, 39, 56, 59, 60, 162, 190 Reagent, 85, 154, 190 Receptor, 23, 149, 190, 193 Recombinant, 14, 102, 190, 200 Rectal, 91, 118, 190 Rectum, 149, 160, 166, 167, 173, 175, 190, 191 Refer, 1, 152, 156, 167, 170, 179, 181, 191 Reflux, 164, 191 Refraction, 191, 195 Refractory, 25, 162, 191 Regeneration, 92, 127, 191 Regimen, 80, 89, 90, 162, 191 Reliability, 32, 191 Renal failure, 23, 191, 199 Reperfusion, 84, 102, 180, 191 Reperfusion Injury, 84, 102, 191 Repopulation, 15, 191 Resolving, 6, 191 Resorption, 85, 98, 183, 191 Respiration, 153, 179, 183, 191 Respiratory distress syndrome, 87, 191 Restoration, 14, 180, 191, 200 Retina, 155, 175, 181, 182, 191, 192, 199 Retinitis, 84, 102, 191 Rheumatic Diseases, 83, 192 Rheumatism, 192 Rheumatoid, 75, 83, 84, 87, 97, 98, 102, 186, 192 Rheumatoid arthritis, 75, 83, 84, 87, 97, 98, 102, 186, 192

Rhinitis, 84, 102, 192 Riboflavin, 22, 192 Ribose, 19, 192 Ribosome, 192, 198 Risk factor, 10, 16, 22, 27, 113, 114, 127, 132, 154, 189, 192 Rod, 145, 150, 187, 192 Root Planing, 6, 78, 114, 192 S Salicylate, 95, 192 Saliva, 27, 40, 76, 77, 127, 192 Saliva, Artificial, 127, 192 Salivary, 16, 27, 46, 49, 55, 77, 80, 89, 90, 160, 165, 184, 192, 196, 200 Salivary glands, 160, 165, 192 Salmonellosis, 17, 192 Sarcoidosis, 17, 192 Sarcoma, 127, 192 Sclera, 155, 157, 192, 199 Scleroproteins, 174, 192 Sclerosis, 84, 149, 180, 192 Screening, 5, 54, 126, 127, 155, 193 Sebaceous, 193, 200 Secondary tumor, 178, 193 Secretion, 88, 170, 173, 179, 180, 193 Seizures, 41, 193 Self Care, 127, 193 Self Mutilation, 108, 193 Semicircular canal, 173, 193 Senile, 183, 193 Septic, 97, 193 Sequela, 6, 193 Sequencing, 22, 193 Serine, 98, 163, 193, 197, 198 Serotonin, 193, 198 Serous, 163, 193 Serum, 24, 27, 49, 50, 54, 77, 146, 148, 156, 171, 183, 193, 198 Sex Characteristics, 190, 193 Shock, 193, 198 Side effect, 18, 75, 79, 91, 117, 145, 186, 194, 198 Signs and Symptoms, 132, 194, 199 Sinusitis, 75, 87, 96, 103, 194 Skeletal, 10, 98, 194 Skeleton, 174, 194 Skull, 194, 197 Small intestine, 161, 163, 168, 170, 174, 194, 198 Smooth muscle, 146, 148, 157, 170, 194, 196 Soaps, 194, 198

Index 211

Social Class, 35, 194 Sodium, 28, 36, 52, 64, 101, 194 Sodium Bicarbonate, 28, 36, 64, 194 Sodium Fluoride, 52, 194 Soft tissue, 12, 21, 23, 85, 89, 152, 194 Solid tumor, 97, 148, 194 Solvent, 74, 194 Somatic, 168, 170, 194 Soybean Oil, 187, 194 Spasmogenic, 81, 148, 194 Specialist, 134, 161, 195 Specificity, 91, 146, 163, 195 Spectrum, 51, 75, 79, 195 Sperm, 155, 187, 195 Spinous, 164, 175, 195 Spirochete, 10, 21, 195 Spleen, 177, 192, 195 Stabilization, 79, 195 Staging, 44, 195 Sterile, 75, 195 Sterility, 173, 195 Stimulant, 170, 174, 195 Stimulus, 23, 195, 197 Stomach, 75, 91, 145, 150, 160, 164, 167, 168, 170, 181, 184, 185, 191, 194, 195 Stomatitis, 44, 78, 85, 195 Strand, 187, 195 Streptococcal, 41, 195 Streptococci, 82, 92, 195 Streptococcus, 14, 85, 93, 195 Stress, 38, 43, 153, 181, 188, 192, 196, 199 Stroke, 113, 124, 153, 196 Stromal, 163, 196 Subacute, 172, 194, 196 Subclinical, 172, 193, 196 Sublingual, 24, 196 Submandibular, 24, 196 Subspecies, 195, 196 Substance P, 178, 193, 196 Sulfur, 88, 89, 91, 95, 165, 178, 196 Sulfur Compounds, 95, 196 Sunburn, 86, 103, 196 Superoxide, 81, 196 Superoxide Dismutase, 81, 196 Supplementation, 64, 196 Suppression, 91, 196 Suppressive, 88, 196 Surfactant, 74, 154, 196 Symptomatic, 184, 196 Systemic disease, 17, 22, 114, 196 T Tachycardia, 150, 196

Tachypnea, 150, 197 Tartar, 48, 109, 197 Technology Transfer, 127, 197 Temporal, 10, 197 Tetracycline, 74, 75, 161, 197 Therapeutics, 13, 119, 197 Threonine, 193, 197 Threshold, 7, 171, 197 Thrombin, 166, 187, 189, 197 Thrombolytic, 186, 197 Thrombosis, 189, 196, 197 Thromboxanes, 149, 197 Thrombus, 158, 172, 180, 187, 197 Thymus, 70, 172, 177, 197 Thyroid, 197, 199 Tissue Plasminogen Activator, 34, 197 Tooth Loss, 10, 113, 114, 126, 127, 197 Topical, 49, 64, 83, 84, 85, 102, 118, 126, 127, 150, 154, 171, 184, 194, 197 Torsion, 172, 198 Toxaemia, 188, 198 Toxic, iv, 18, 83, 161, 169, 171, 190, 198 Toxicity, 161, 198 Toxicology, 126, 198 Toxins, 143, 149, 162, 172, 179, 198 Transfection, 151, 198 Transfer Factor, 172, 198 Translation, 9, 97, 198 Transplantation, 172, 198 Trauma, 40, 98, 164, 169, 181, 184, 198 Trichomoniasis, 178, 198 Triclosan, 7, 25, 26, 30, 35, 36, 38, 39, 52, 56, 58, 59, 60, 89, 101, 198 Trigeminal, 165, 198 Tropism, 15, 198 Trypsin, 36, 81, 163, 188, 198, 200 Tryptophan, 89, 156, 193, 198 Tuberculosis, 17, 198 Tularemia, 17, 198 Tumor Necrosis Factor, 97, 198 Tyrosine, 86, 103, 199 U Ulcer, 84, 107, 184, 199 Ulceration, 97, 199 Ulcerative colitis, 87, 88, 102, 173, 199 Unconscious, 148, 159, 171, 199 Uraemia, 184, 199 Urea, 182, 199 Uremia, 191, 199 Urethra, 184, 199 Urethritis, 86, 87, 103, 199 Urinary, 56, 197, 199

212 Gingivitis

Urinary Plasminogen Activator, 197, 199 Urine, 151, 161, 189, 192, 199 Urokinase, 186, 199 Urticaria, 83, 84, 102, 199 Uvea, 199 Uveitis, 84, 102, 199 V Vaccine, 111, 147, 189, 199 Vagina, 153, 160, 178, 199 Vaginitis, 153, 199 Vascular, 5, 23, 44, 81, 84, 102, 146, 155, 163, 172, 182, 187, 197, 199, 200 Vasculitis, 184, 200 Vasodilator, 152, 170, 180, 200 VE, 85, 200 Vector, 14, 200 Vein, 182, 184, 200 Venous, 189, 200 Vestibule, 155, 173, 193, 200 Veterinary Medicine, 125, 200 Viral, 14, 15, 17, 20, 158, 162, 168, 173, 200 Viral Load, 20, 200

Viremia, 15, 200 Virulence, 21, 81, 198, 200 Virus, 4, 15, 21, 105, 107, 150, 163, 167, 168, 172, 173, 186, 200 Visceral, 168, 175, 200 Viscosity, 170, 200 Vitro, 7, 15, 21, 24, 200 Vivo, 21, 24, 200 Vulgaris, 70, 200 W White blood cell, 145, 148, 172, 175, 177, 179, 180, 181, 186, 200 Wound Healing, 23, 97, 178, 200 X Xenograft, 148, 200 Xerostomia, 99, 114, 192, 200 X-ray, 40, 142, 174, 182, 200 Y Yeasts, 153, 166, 167, 185, 200 Z Zymogen, 188, 189, 200

Index 213

214 Gingivitis

Index 215

216 Gingivitis

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