摘要:

This experiment was designed to studythe ability of mucoperiosteal flap connective tissue to form new attachment on partially demineralized roots as well as nondemineralized roots in a wound‐model where periodontal ligament (PDL) cells are absent, and ingrowth of bone granulation tissue is controlled.After reflecting mucoperiosteal flaps, bone was removed circumferentially around the distal root of mandibular second premolars and the mesial root of mandibular third premolare in five beagle dogs. The roots were completely denuded from the cementoenamel junction to the apex and curetted to remove PDL and cementum. Following root canal filling, the denuded roots on one side were conditioned with citric acid while the contralateral roots served as controls. To prevent bone‐derived granulation tissue from contacting denuded roots, sheets of Nuclepore® membrane were placed over the exposed bone margins and secured in place with steel ligatures. The flaps werecoronally positionedand sutured. Histologic examination was made after three months of healing accompanied by regular plaque control. Both the experimental (acid conditioned) and control roots showed epithelium extending into the apical third of denuded roots and root resorption confined to the root apices. Some experimental specimens showed connective tissue adhesion in the apical third of roots without any new cementum or oriented fibers. Inflammatory cell infiltrate was seen extending to the apical third of denuded roots in both groups.In this model, the flap connective tissue cells failed to form new cementum and inserting fibers. Whether this was the result of inflammation and epithelial downgrowth or the inability of flap connective tissues to form new attachment could not be concluded from the study.

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.71

出版商:Wiley    

年代:1987

数据来源: WILEY

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.77

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

The purpose of this studywas to clinically evaluate the need for elimination of the pocket epithelium during mucoperiosteal flap surgery aimed at reattachment or readaptation. A split mouth design was used in 13 patients with two bicuspids and two molars included in each quadrant. Two surgical techniques were compared. One of the quadrants received a modified Widman flap with removal of the pocket epithelium, while the contralateral side received a crevicular flap without removing the pocket epithelium.One month after the hygienic phase was completed, the following measurements were taken: Gingival Index, Plaque Index, gingival crevicular fluid flow, mobility, furcation involvement, level of attachment, pocket depth and gingival recession. In addition to these measurements, which were taken immediately prior to the surgery (baseline), 1‐ and 3‐month postsurgical measurements were also taken. Gingival recession was recorded immediately after the flaps were replaced and sutured. All data were analyzed statistically using pairedttest and sign test.The biometrie results showed that without the removal of the pocket epithelium, good clinical results relative to gain in clinical attachment levels and reduction in probing depth were achieved. Greater gingival recession occurred on the crevicular flap side postsurgically when compared to the modified Widman flap. The other clinical parameters remained the same at the three time intervals. This was true within each technique and when both techniques were compared.

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.78

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

There have been no previous reportsin the literature comparing the effects of hand scaling with ultrasonic debridement in furcations, or which have used dark‐field microscopy for this comparison. The purpose of this study was to compare the efficacy of these two modes of debridement in various classes of furcations, using gingival crevicular fluid flow and dark‐field microscopy as parameters. A total of 33 furcated molars were evaluated. Results indicated that both hand scaling and ultrasonic debridement were equally effective in Class I furcations in changing the gingival fluid flow and bacterial proportions to those of a healthy state. In contrast, ultrasonic debridement was significantly more effective than hand scaling in Class II and Class III furcations in altering these parameters.

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.86

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

Amucogingival grafting procedurehas been developed to cover denuded root surfaces. This procedure, the subpedicle connective tissue graft, is a bilaminar graft that is composed of a free connective tissue graft and an overlying pedicle graft. By overlaying grafted free connective tissue with a pedicle, the otherwise compromised section of free graft which covers a denuded root surface is supplied by plasmatic circulation from capillaries in the vascular portion of the pedicle allowing it to survive.In this report 29 teeth were treated and monitored for as long as 42 months. In the group with advanced recession of 7 to 10 mm, there was an average of 88% coverage. The subpedicle graft created a healthy, functional, and esthetic result that appeared resistant to further breakdown. The subpedicle graft is indicated when a single surgical procedure is desired that will predictably cover denuded root surfaces when there is inadequate keratinized gingiva available for a pedicle graft and where the prognosis is poor for root coverage with a free gingival graft.

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.95

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

Five intrabony lesions in a40‐year‐old healthy, white female patient suffering with severe periodontitis were removeden bloc, 13 to 18 months after flap debridement and graft placement. At the time of debridement, the position of the gingival margin and the most apically located calculus were notched in the root to serve as reference points. All lesions received tricalcium phosphate ceramic implants, and the lesions healed uneventfully. The sites were professionally cleaned frequently during the experimental period. At the time of block removal, clinical measurements demonstrated gingival recession (average = 2.6 mm) and a gain in clinical closure (average = 2.3 mm).Histologic evaluation of step serial sections of these blocks showed limited presence of graft particles. The particles were surrounded by dense connective tissue. They did not induce inflammation, nor did they appear to enhance osteogenesis or cementogenesis. Closure of lesions was essentially done by a long junctional epithelium adhesion and limited evidence of new connective tissue—root attachment. In the 18‐month specimen, active root resorption was seen immediately apical to the junctional epithelium at a site demonstrating significant inflammation in some sections. Fibrils apparently arising from the resorbing dentinal wall were seen in these sections. Serial sections of this site showed cellular cementum and functional fiber attachment at the resorption sites. These variations in resorption/repair/ regeneration within the same surgical site were seen 18 months postsurgery and thus may reflect local tissue responses to inflammatory fluctuations rather than surgical sequellae.

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.103

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

To study the biologic response, three commercial calcium phosphate implant materials (Calcitite®, Periograf®, Synthograft®) were implanted in cuspid root “windows” in four beagle dogs. No implant material was placed in the fourth cuspid window which served as a control. Following mucoperiosteal flap elevation, windows were chiseled in bone to the root surface which allowed implant particles to contact bone, fibrous connective tissue, cementum and dentin without exposure to the oral environment. Animals were sacrificed after 1,3,5 and 6 months.Histologically, all implant materials were well tolerated. At 1 month, implant particles were surrounded by fibrous tissue. Fibrous tissues filled the control defect. At 3 months, implant sites exhibited partial bony repair with connective tissue surrounding implant particles. A ring of osteoid surrounded Synthograft particles. Control defect repair was complete. At 5 and 6 months, implant sites exhibited advanced, though incomplete, bony repair. New bone encompassed the Synthograft particles. It was concluded: 1) Control sites healed most rapidly. 2) Calcitite and Periograft were well tolerated space occupiers. 3) Synthograft was a nidus for bone deposition.

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.110

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

Repeated measurements of attachment levelappear to be important assessments in periodontal clinical trials, yet the lack of reliability for this assessment creates measurement error which in turn demands increased sample sizes or reduces the power of the test. A plastic occlusal stent has been developed as a fixed reference point to assess changes in probing depths over time and thus reflect differences in attachment levels. The advantages of this system over traditional methods have not been measured. The purpose of this study was to determine intra‐ and interexaminer reliability for probing depths from the stent and the CEJ.Paired measurements of attachment level using the stent produced correlation coefficients for inter‐ and intraexaminer readings of 0.84 and 0.76, respectively. For subgingival cementoenamel (CEJ) measurements, lower coefficients of 0.71 and 0.59 were found for inter‐ and intraexaminer paired readings, respectively. Thus, measurements using the stent appear to be more reliable than subgingival CEJ readings.

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.115

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

Through the use of the electronmicroscope, yeasts were found invading gingival connective tissue in juvenile periodontitis (JP). Samples (3‐mm punch biopsies, including epithelium and underlying connective tissue) were taken apically to periodontal pockets before and after patient treatment with spiramycin. Some samples underwentin vitrotreatment with spiramycin. Oval and round yeast cells were found before and after in vivo and afterin vitrospiramycin treatment. Larger numbers of yeast cells were seen after spiramycin treatment indicating that their growth might be favored after patient treatment with this antibiotic. This observation has an obvious clinical implication. Budding processes, indicating active yeast multiplication, were observed. Some yeast cells also showed the presence of glycocalyx. Further studies on the role of yeast in the pathogenesis of JP are necessary.

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.119

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

Adenomatoid hyperplasia of the mucoussalivary glands is an uncommon benign tumor of the oral cavity. Two cases of palatal involvement are presented. Since clinical differentiation between benign and malignant growth of the palate cannot be established, microscopic examination is necessary. The palate is the most common location of this lesion, and as such it is useful for the periodontist to be aware of this tumor.

ISSN:1049-8885    

DOI:10.1902/jop.1987.58.2.125

出版商:Wiley    

年代:1987

数据来源: WILEY