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Biomedical subjects

T Karring

Publications and source records attributed to T Karring.

At least 91 records · Page 5Linked to original sources

New attachment formation on teeth with a reduced but healthy periodontal ligament.

The present investigation was undertaken to examine whether a new connective tissue attachment will form on previously periodontitis-involved roots when reduced but healthy periodontal ligament tissue persists following periodontal treatment and the epithelium is prevented from migrating into the wound. In each of 4 monkeys, periodontal tissue breakdown was induced around one maxillary and one mandibular second premolar or first molar by placing orthodontic elastics around the teeth. The elastics were kept in situ until about 50% of the supporting tissues had been lost. 3 months following removal of the elastics, the crowns of the teeth were resected. The pocket epithelium and subjacent granulation tissue were excised and the cementum of the periodontitis-involved part of the roots was removed using a diamond bur. The roots were covered with a mucosal flap. The animals were sacrificed after 3 months of healing. The jaws were removed and histological sections of the experimental roots including their surrounding periodontal tissues were produced. The microscopic analysis disclosed that in all roots, new cementum with inserting collagen fibers had formed in the apical portion of the previously exposed root surfaces. It was always in continuity with the original cementum layer apical to the instrumental part of the root and was thickest in its apical portion, becoming gradually thinner in the coronal direction. In the roots, which for the entire length of the study remained covered by the oral mucosa, the extension in the coronal direction of this newly formed fibrous attachment amounted to an average of 1.0 mm with a range from 0.1 mm to 2.6 mm. These findings were interpreted to mean that new attachment is formed by coronal migration of cells originating from the periodontal ligament.

Animals↗

Healing after root reimplantation in the monkey.

The aim of the present investigation was to evaluate the regenerative potential of the periodontal tissues following tooth reimplantation using a model which excluded the dentogingival epithelium from the process of healing. Maxillary and mandibular incisors, premolars and molars of 5 monkeys were used. Following root filling of all experimental teeth, the teeth were divided into 3 experimental groups. In 1 group, the teeth were extracted following the elevation of full thickness flaps. The crowns were separated from the roots at the level of the buccal cemento-enamel junction and the roots immediately reimplanted into their sockets. The flaps were replaced and sutured to accomplish complete coverage of the roots. In a 2nd group, the teeth were subjected to the same experimental procedure, but in addition, the buccal alveolar bone was removed to about half its original height prior to root reimplantation. The teeth of the 3rd group were subjected to identical experimental procedures as for group II with the addition that the buccal root surfaces were planed to the level of the surgically created bone crest. The animals were sacrificed after 6 months of healing. The jaws were removed and histological specimens prepared for microscopic examination. The results showed that a complete fibrous re-attachment formed onto roots on which the original periodontal ligament tissue was preserved. This occurred irrespective of whether the roots were reimplanted into sockets with normal (group I) or reduced (group II) bone height. When the original periodontal ligament tissue was removed by root planing before reimplantation (group III), healing resulted in a significant amount of new connective tissue attachment. However, coronal to the newly formed fibrous attachment, the root surface frequently showed signs of resorption and particularly so in those roots which remained covered by the soft tissue during the entire course of healing. In the majority of the roots which perforated the covering soft tissue during the early phase of healing, the dentogingival epithelium had migrated apically into contact with the coronally generated fibrous attachment. In these cases, root resorption was never discernible. New bone formation occurred to a variable extent in the roots of groups II-III. No relationship was found, however, between the amount of connective tissue reattachment or new attachment and newly formed alveolar bone, which in turn indicates that bone tissue regrowth and periodontal ligament regeneration are unrelated phenomena.

Alveolar Process↗

New attachment-reattachment following reconstructive periodontal surgery.

The present study was designed to evaluate if the conditions for reformation of a connective tissue attachment are less favorable on root surfaces which have lost their fibrous attachment because of periodontal disease than on root surfaces surgically deprived of their attachment apparatus. In each of 4 Green monkeys, 2 maxillary and 2 mandibular teeth were selected for experimentation. Periodontal breakdown was produced and allowed to progress to the mid-root level around one of the experimental teeth in both the maxilla and mandible by placing elastic ligatures around the neck of these teeth. 3 months after removal of the ligatures, the crown of the teeth was resected and the epithelium and the subjacent granulation tissue were removed. Using a diamond bur, circumferential defects similar to those obtained by the ligature induced destruction were then produced around the remaining 2 experimental teeth following resection of the crown. The root cementum on both groups of teeth was removed to the level of the reduced bone height. Finally, all roots were submerged to complete coverage by a mucosal flap. After 3 months of healing, the animals were sacrificed and the jaws removed and placed in fixative. After decalcification, histological sections of the experimental roots and their surrounding periodontal tissues were produced. No histological differences in the result of healing were discernible between the specimens of previously periodontitis-affected roots and roots with surgically created defects. New cementum with inserting collagen fibers had formed in the apical part of the instrumented surface in both groups of teeth.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Healing following reimplantation of teeth subjected to root planing and citric acid treatment.

The aim of the present study was to examine the effect of citric acid treatment on periodontal healing around teeth which were extracted, root planed and then reimplanted. Maxillary incisors and mandibular incisors, premolars and molars of 5 monkeys were used. The teeth were divided into 3 experimental groups. In 1 group, the teeth were extracted and immediately reimplanted into their own sockets. In a 2nd group, the teeth were extracted, root planed to a level corresponding to 50-75% of the root length and then reimplanted. In the 3rd group, periodontal breakdown extending to 50-75% of the root length was first induced by placing orthodontic elastic ligatures around the teeth. They were then extracted and root planed and transplanted into the sockets of the contralateral, periodontally healthy teeth which had just been extracted. Half the number of the teeth of groups 2 and 3 were treated with citric acid before reimplantation or transplantation. The animals were sacrificed after 6 months of healing. The jaws were removed and histological specimens prepared for microscopic examination. With the exception of a limited coronal regrowth of new cementum in the apical part of the planed portion of a few roots, connective tissue attachment failed to reform on most root surfaces deprived of their periodontal ligament tissue. Healing was most frequently characterized by root resorption and ankylosis. These were the most predominant features of healing both on root surfaces which had been deprived of the ligament tissue by mechanical means or during a course of experimentally-induced periodontal disease, and occurred in citric acid as well as non-citric acid treated roots. The findings imply that the result of healing following tooth reimplantation or transplantation is determined by the type of cells that repopulate the wound area adjacent to the denuded root surface.

Animals↗

New attachment formation as the result of controlled tissue regeneration.

The present study was designed to examine whether new attachment forms on root surfaces previously exposed to plaque by preventing the oral epithelium and the gingival connective tissue from participating in the process of healing following treatment. 4 roots in each of 3 monkeys were used as test units while the roots of contralateral teeth served as controls. A surgical procedure was first used to expose the coronal half of the buccal root surfaces. Plaque was allowed to accumulate on the exposed surfaces for a period of 6 months. Subsequently, soft tissue flaps were raised and the root surfaces were carefully scaled and planed. The crowns of the test and control teeth were resected and the mucosal flaps were repositioned and sutured in such a way that the roots were properly covered. Immediately prior to suturing, membranes (Millipore filter or Gore-tex membrane) were placed over the denuded root surfaces of the test teeth in order to prevent granulation tissue from the soft tissue flaps from reaching the roots during healing. The monkeys were sacrificed 3 months later. The jaws were removed and histological sections of test and control roots including their periodontal tissues were produced. New cementum with inserting collagen fibers was observed on the previously exposed surfaces of both test and control roots. However, the test surfaces exhibited considerably more new attachment than the control surfaces, indicating that the placement of the membrane favoured repopulation of the wound area adjacent to the roots by cells originating from the periodontal ligament.

Alveolar Process↗

Connective tissue reattachment as related to presence or absence of alveolar bone.

The present study was designed to examine if alveolar bone, located adjacent to a root surface deprived of its periodontal ligament and cementum layer, can stimulate the reformation of a connective tissue attachment. The maxillary and mandibular incisors in 3 monkeys were extracted. Immediately after tooth extraction, the buccal root surfaces of the incisors from the left side of the jaws were planed by means of curettes to a level corresponding to half the root length. All teeth were then reimplanted into their original sockets. However, before tooth reimplantation, the buccal alveolar bone plate was removed in 2 of the monkeys to a level corresponding to half the depth of the sockets. The animals were sacrificed 6 months after the reimplantation procedure. The jaws were removed and histological sections of the experimental teeth and adjacent periodontal tissues were produced. The sections were analyzed in the microscope and subjected to histometric measurements. The results demonstrated that, irrespective of the presence or absence of alveolar bone, a fibrous reattachment failed to form on that part of the reimplanted teeth which had been deprived of their periodontal ligament. This indicates that alveolar bone located adjacent to a root surface may have limited influence on the biological conditions which determine whether periodontal healing results in connective tissue reattachment or new attachment.

Alveolar Process↗

Potentials for root resorption during periodontal wound healing.

The present study was undertaken to examine whether (1) the process of resorption, which invariably affects periodontitis involved reimplanted roots facing bone or gingival connective tissue during healing, is a transient phenomenon and, (2) root resorption can be prevented by permitting downgrowth of epithelium along the root surface. A total of 24 teeth in 2 monkeys (Macaca cynomolgus) was subjected to experimental periodontal tissue breakdown by the placement of elastic ligatures around the teeth. The ligatures were left in situ until about 50% of the supporting tissues had been lost. Following removal of the ligatures, the teeth were extracted and the denuded portions of the roots were scaled and planed. The crowns of the teeth were resected and the root canals filled with guttapercha. The roots were subsequently implanted into sockets prepared in the jaw bone in such a way that each root was embedded in bone except for a portion which was in contact with gingival connective tissue. 1 month prior to sacrifice of the animals, the cut surface of the coronal part of the roots was exposed by removal of the covering soft tissue. The epithelium was thereby allowed to migrate into the wound. Implantation of the roots was scheduled to provide healing periods of 1, 2, 3, 4, 8, 12, 16, 20 and 24 weeks before exposure of the roots. The histologic examination of the implant specimens disclosed that replacement resorption was a progressive process which eventually resulted in the elimination of the transplanted roots. It was possible to prevent root resorption in this model by permitting apical downgrowth of epithelium along the root surface during the initial phase of healing. The results are discussed in relation to procedures used in periodontal therapy.

Animals↗

Reproducibility of pocket depth and attachment level measurements when using a flexible splint.

Pocket depth, attachment level and bone level assessments were carried out using flexible splints to produce readily identifiable reference points and to standardize the probing spot and the direction of probe insertion. The pocket depth and attachment level measurements were carried out twice at intervals of 3 weeks, both before and 3 months after periodontal treatment. The level of alveolar bone was measured by transgingival probing ("sounding") and again following elevation of a mucoperiosteal flap. The measurements were made with a periodontal probe to the nearest higher millimeter. Complete agreement was found between the first and second measurements of pocket depths and attachment level for approximately 60% of the examined surfaces, both before and after periodontal treatment. A deviation of 1 mm or less was found for approximately 95% of the surfaces, and the difference between the first and second measurement never exceeded 3 mm. When transgingival probing measurements were compared to the measurements of the periodontal bone level assessed after elevation of a mucoperiosteal flap, complete agreement was found for 60% of the surfaces, and a deviation of 1 mm or less was found for 90% of the surfaces. No discrepancy exceeding 3 mm was observed. The results of this study indicate that readily identifiable reference points can be produced by flexible splints in assessments of pocket depth, attachment level and bone level alterations in studies on the effect of periodontal treatment.

Adult↗

The effect of root planing as compared to that of surgical treatment.

This study was undertaken in order to evaluate the effect of root planing as compared to that of surgical periodontal treatment in patients with advanced periodontal disease. 17 patients with advanced periodontal disease participated in the study. After the initial examination, the teeth were scaled and the patients were given instruction in performing proper oral hygiene. The hygienic phase for the individual patient was continued until less than 20% of the tooth surfaces demonstrated plaque at 2 succeeding appointments. After re-assessment of the periodontal status, 1 side in both the maxilla and mandible was treated with modified Widman flap surgery. In 1 of the remaining quadrants, in the maxilla or mandible, reverse bevel flap surgery was used. Bone contouring was not performed in any of the surgical procedures. The last quadrant was subjected to meticulous root planing under local anesthesia. Subsequently, the patients were recalled every second week for professional tooth cleaning. The periodontal status of each patient was assessed 3 and 6 months following treatment. Root planing resulted in considerable reduction in pocket depth, although more shallow pockets were obtained following modified Widman flap and reverse bevel flap surgery. Clinical gain of attachment was obtained following all 3 modalities, but root planing resulted in slightly more gain of attachment than the 2 surgical procedures.

Adult↗

Blocking of the cell division by stress-inducing electrical stimulation. A study in rat oral epithelium.

The purpose of the present study was to localize in the cell cycle, the site of the stress-induced blockage of cells entering the mitotic phase, and to estimate the length of time this block is effective. A total of 140 rats were subjected to electrical stimulation applied by a live metal grill in the bottom of their cages. Forty animals left undisturbed in the cages were used as controls. At various intervals after the start of electrical stimulation, groups of animals were killed and histologic sections were prepared of the palatal mucosa. The number of prophases, metaphases, and ana/telophases was counted in the epithelium in three sections of each animal. Electrical stimulation for 1 min resulted in a blocking of the entrance of cells into mitosis, followed by a transient increase in the number of mitotic figures to a level much higher than that of the controls. Electrical stimulation for 10 min resulted in the maintenance of the blocking effect for approximately 45 min. By renewed electrical stimulation the period of blockage was extended for a further 35 min. In each experiment the number of prophases decreased immediately after the start of electrical stimulation, indicating that the site of the blockage of the entrance of cells into mitosis is located near the G2/M transition.

Anaphase↗

The effect of environmental stress stimuli on cell division in rat palatal epithelium.

The effect on cell proliferation of procedures commonly used in studies in laboratory animals was examined in the palatal epithelium of rats. Groups of rats were exposed to ether anaesthesia, immobilization in the supine position or to cage change. Animals left undisturbed in the cages during the experiment were used as controls. At intervals of 30 min, four animals of each group were killed and histological sections of the palatal mucosa were prepared. The number of prophases, metaphases and ana/telophases in the epithelium was counted and related to 1 mm2 of the surface. Thirty minutes after the various procedures the number of metaphases and ana/telophases were extremely low. After a further 30 min a high number of prophases was observed. The number of metaphases rose within the following 30 min, during which time the number of ana/telophases also reached a maximum. These observations indicate that the environmental stimuli have blocked the entrance of cells into mitosis and have resulted in an accumulation of cells, which, following the raising of the blockade, pass through the various stages of the mitotic phase. In studies of cell population kinetics the blockade of cell division as a result of environmental stress stimuli may lead to misleading results.

Animals↗

Scaling and root planing in shallow pockets.

The present study was undertaken to enable histological assessment of attachment level alterations following repeated scaling and root planing in periodontal sites with "normal" sulcus/pocket depth. Two monkeys (Macaca cynomolgus) were used. During a period of 6 months, scaling was carried out once every 2 weeks at the buccal surfaces of premolars and molars on the right side of the jaws. The contralateral teeth served as untreated controls. Six months after the completion of treatment (1 year after the start of the experiment), the animals were sacrificed and histological sections of all test and control teeth were produced. In these sections the distances between the cemento-enamel junction (CEJ) and the apical extent of the junctional epithelium (JE) and between the JE and the alveolar bone crest (BC) were measured. The results revealed that repeated scaling and planing resulted in an average loss of connective tissue attachment amounting to 0.39 mm and in a corresponding recession of the alveolar bone crest. The findings are discussed in relation to recent observations from clinical trials demonstrating loss of clinical attachment following repeated scaling and root planing in sites with shallow gingival pockets.

Animals↗