Connective tissue response to direct fulguration. What are the clinical and histological effects?
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Biomedical subjects
Publications and source records attributed to K L Kalkwarf.
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The healing of electrosurgical incisions in the gingivae of adult men was investigated at 6-hour intervals. Clinical observation indicated that incisions healed progressively until 72 hours, when they were barely discernible. Clinical evidence of inflammation associated with the wounds was negligible. At a light microscopic level, initial reaction to electrosurgical incisions included disruption of the surface epithelium and denaturation of the connective tissue lateral to the incision. The zone of denatured connective tissue remained for the entire 72-hour period of this study. Young fibroblasts and vascular proliferation were evident in the connective tissue at 30 hours. Epithelium exhibited complete bridging of the wound surface in some specimens as early as 30 hours after incision. All specimens had an intact epithelial surface at 48 hours. Mild-to-moderate accumulations of inflammatory cells, consisting primarily of lymphocytes, surrounded the wound edges. Acute inflammation with polymorphonuclear leukocytic infiltration was not observed, except for moderate accumulation at 6 to 12 hours. Subepithelial hematoma formation within the connective tissue was evident in four of the size specimens at 72 hours.
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Variables affecting tissue response to electrosurgical wounding have been identified and discussed. An electronic measuring device was designed and built to record actual power generated at the active electrode during surgical use of an electrosurgery instrument. In addition, this electronic device measures the amount of time the active electrode is in contact with tissue. Coupled with an electrosurgery unit producing a documented waveform and an electrosurgery electrode having a controlled-depth gauge, variables affecting tissue response to electrosurgery wounding may be measured.
One hundred sixty-eight female patients between the ages of 18 and 35 were evaluated with an Oral Debris Index and a Gingival Inflammatory Index. The patients were then divided into groups and subgroups according to their intake of oral contraceptives. Statistical analysis revealed that the group currently taking oral contraceptives had a higher mean Gingival Inflammatory Index than the group not presently taking oral contraceptives. The group taking oral contraceptives also revealed a lower mean Oral Debris Index than the control group. Further analysis revealed that while some brands of oral contraceptives produced more dramatic index changes than others, no relationship appeared to exist due to the differences of progesterone or estrogen content in the various brands. Increased accumulative exposure to oral contraceptives apparently had no effect upon Oral Debris Indices or Gingival Inflammatory Indices. Further studies with older population groups should be conducted in an attempt to answer questions concerning the effect of long term oral contraceptive intake on periodontal diseases other than gingivitis.
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A panographic radiograph of a 31-year-old man revealed the presence of an impacted supernumerary paramolar. Periapical radiographs of the same area failed to confirm the existence of this supernumerary tooth. A review of the inherent distortion factors present in panographic radiography leading to the misdiagnosis is discussed.
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A double-blind method was used to compare anesthesia duration following intraligamental administration of 1.5% etidocaine with 1:200,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine. Durations of anesthesia in pulpal and soft tissues were monitored following periodontal ligament injections adjacent to the maxillary canines of 20 individuals. Complete pulpal anesthesia was attained in 35% of the teeth injected with etidocaine and in 55% of those receiving lidocaine. Soft tissue anesthesia was consistently achieved. Both pulpal and soft tissue anesthesia were of longer duration following the use of lidocaine solution. These findings suggest that anesthetic duration following periodontal ligament injections is more related to the concentration of vasoconstrictor than to the anesthetic solution employed.