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PubMed1990

Histological differences between teeth with adult periodontitis and prepubertal periodontitis.

Thirty-nine permanent teeth from three siblings aged 11 to 14 years were extracted because of generalized prepubertal periodontitis (PP) and studied histologically with light microscopy. Twenty healthy teeth (HT) removed for orthodontic procedures from 10 children of similar ages and 22 teeth affected by adult periodontitis (AP) extracted from patients over 50 years old were used as controls. The cementum of the PP teeth was much thicker than that of the healthy teeth. A high percentage of resorption, unrelated to inflammation, was found in all the teeth studied. In 24 PP teeth the cementum was infiltrated by microorganisms and bacterial substances. All PP teeth showed a cuticle ranging from 10 to 80 microns in thickness on the diseased cementum. No similar structure was noted on the diseased cementum of the AP teeth. The PP teeth did not show any structural changes which could account for the severity of the periodontal lesions.

Adolescent↗
PubMed2001

Immunohistological and morphometric analysis of inflammatory cells in rapidly progressive periodontitis and adult periodontitis.

The purpose of this study was to localize, characterize, and quantify in situ the inflammatory cells in the gingival connective tissue prior and subsequent to the initial therapy of ten patients with rapidly progressive periodontitis (RPP) and five patients with adult periodontitis (AP). Using immunohistological techniques, the amount of T lymphocytes, alphabeta-T lymphocytes, gammadelta-T lymphocytes, B lymphocytes, and plasma cells was determined at the beginning of the periodontal therapy (baseline) and at the time of periodontal surgery. Furthermore, the distribution of collagen types I, III, V, and VI was investigated using transmission electron microscopy. At baseline, patients with RPP revealed much higher numbers of inflammatory cells than patients with AP. During initial therapy of patients with RPP, the amount of T cells, alphabeta-T cells, and gammadelta-T cells was reduced significantly (P<0.05). Biopsies of patients with AP revealed a statistically significant reduction of all cell types, except alphabeta-T cells and gammadelta-T cells in the deep connective tissue. The transmission electron microscopy of biopsies from patients with RPP and AP with severe inflammation taken at baseline revealed that collagen types I and III were destroyed nearly completely in areas with leukocyte infiltration, whereas collagen types V and VI revealed a more pronounced labeling reaction. The results revealed that, during initial therapy, the amount of inflammatory cells was reduced significantly more in biopsies of patients with AP than in patients with RPP. At baseline, the inflamed gingival tissue consists mainly of collagen types V and VI in areas with infiltrates of inflammatory cells.

Adult↗
PubMed1979

The absence of proprioceptive nerve endings in the human periodontal ligament: the role of periodontal mechanoreceptors in the reflex control of mastication.

A review of the literature was conducted to determine the presence or absence of proprioceptive nerve endings in the human periodontal ligament. A histologic review of the periodontal ligament innervation concluded that nerve endings found were those mediating pain, pressure, or touch and that there is no histologic evidence of any "classic" proprioceptive nerve ending in the periodontal ligament. A summary is given concerning the precise role of nerve endings in the periodontal membrane, their afferent pathways, and the role of masticatory muscle proprioception, jaw reflexes, and the temporomandibular joint in the coordinated control of mastication and mandibular proprioception.

Afferent Pathways↗
PubMed2000

Periodontal treatment of rapid progressive periodontitis in 2 siblings with Papillon-Lefèvre syndrome: 15-year follow-up.

AIMS: This paper reports the treatment of the periodontal component of the Papillon-Lefèvre syndrome in 2 siblings (case A, born 1974; case B, born 1976). METHOD: The initial treatment, in 1982, consisted of extraction of all primary teeth, scaling and rootplaning of the erupted permanent teeth and systemic antibiotic therapy. During 15 years, continuous and intensive periodontal treatment consisted of chlorhexidine 0.2% rinses, bi-weekly professional prophylaxis, scaling and rootplaning or surgery if indicated. Systemic antibiotics often accompanied mechanical therapy after bacteriological analysis. RESULTS: In case A, a favourable number of permanent teeth could be maintained, but in case B, all permanent teeth were lost in spite of the intensive treatment. Darkfield microscopy at different intervals revealed high numbers of spirochetes and motile rods in both siblings. Only in case A were they temporarily reduced to zero after scaling and rootplaning combined with metronidazole. Anaerobic cultering revealed high numbers of Actinobacillus actinomycetemcomitans (A.a) in both patients. In 1994, 2 years after combined amoxicillin/metronidazole therapy, no A.a could be detected in case A. In case B, A.a could still be detected and was found to be resistant to metronidazole. One year after extraction of all permanent teeth, could no A.a be detected in case B. CONCLUSION: Intensive periodontal treatment combined with antibiotic therapy was not able to prevent complete tooth loss in case B. In case A, the treatment was more effective, resulting in preserving a number of permanent teeth in a stable clinical situation. In these 2 cases, no attempt was made to create an edentulous period between the periodontally-diseased mixed dentition and the eruption of the remaining teeth, which may have contributed to treatment failure.

Aggregatibacter actinomycetemcomitans↗
PubMed2004

Sensory neuropeptide mRNA up-regulation is bilateral in periodontitis in the rat: a possible neurogenic component to symmetrical periodontal disease.

Periodontal disease is a common multifactorial chronic inflammatory disease in humans. In inflammatory conditions that are known to be associated with changes in nociception, such as arthritis, the neuronal expression of the proinflammatory neuropeptides, substance P and calcitonin gene-related peptide is altered. In this study the expression of these neuropeptides' mRNAs has been studied in an inflammatory model that shows no behavioural evidence of altered nociception. Periodontitis was induced in male rats by intragingival injection of lipopolysaccharide adjacent to the second right mandibular molar. The animals were killed at various times after lipopolysaccharide injection and right and left trigeminal ganglia and brain were processed for in situ hybridization for beta-preprotachykinin and alpha-calcitonin gene-related peptide mRNAs. Expression of both neuropeptide mRNAs was significantly increased only in small neurons in the mandibular division of the trigeminal ganglion ipsilateral to the LPS injection from 3 to 10 days postinjection. Neuropeptide mRNA expression was also significantly increased in the contralateral trigeminal ganglion at day 10. No significant changes in neuropeptide mRNA levels were seen in the maxillary and ophthalmic divisions of the trigeminal ganglia or in the trigeminal mesencephalic nucleus. The up-regulation of substance P and CGRP mRNAs in periodontal disease suggests that this is associated with the inflammatory process rather than nociception, as this disease does not appear to result in altered nociception in either rats or humans. The contralateral alteration in neuropeptide mRNA expression suggests a role for neurogenic mechanisms in the development of periodontal disease.

Animals↗
PubMed1976

The healing potential of the periodontal tissues following different techniques of periodontal surgery in plaque-free dentitions. A 2-year clinical study.

A clinical trial was undertaken to study the healing capacity of the periodontal tissues following different modes of periodontal surgery in patients whose oral hygiene was professionally maintained at an optimal level. Fifty patients, distributed into five groups, participated in the study. Following an initial examination and presurgical treatment, the various patient groups were subjected to one of the following surgical procedures: 1) the apically repositioned flap operation including elimination of bony defects, 2) the apically repositioned flap operation including curettage of the bony defects but without removal of bone, 3) the "Widman flap" technique including elimination of bony defects, 4) the "Widman flap" technique including curettage of the bony defects but without removal of bone, 5) gingivectomy including curettage of the bony defects but without removal of bone. After surgery, all patients received oral hygiene instruction and professional cleaning of the teeth once every 2 weeks during a 2-year period. The results showed that periodontal disease can be cured and further destruction of the periodontal tissues avoided irrespective of the surgical technique utilized for pocket elimination. Different surgical techniques, however, promoted varying degrees of regeneration of the supporting tissues. The most favourable healing was obtained when resection of bone was avoided and when complete coverage of the alveolar bone was ensured.

Adult↗
PubMed1985

The microbial morphotypes associated with periodontal health and adult periodontitis: composition and distribution.

Subgingival plaque samples were obtained from 162 sites in 27 adult periodontitis patients and 162 sites in 27 healthy patients using a standardized lavage technique. The distribution of 10 different microbial morphotypes was determined by darkfield microscopy. The lavage technique selectively samples the loosely adherent plaque at the base of the periodontal pocket and not the tooth-associated, adherent plaque. This standardized technique permits quantitative comparisons of numerical density of morphotype composition at different sites, in addition to qualitative comparisons or relative proportions. There was a significant positive association between the numerical density of each morphotype within the non-adherent plaque and the number of sites at which the organism was detected in both healthy and diseased subjects. A previously undescribed darkfield morphotype, has been detected with this method. This morphotype, a small motile coccobacillus (S-MO-CB) has been found to be the numerically dominant species in both health and disease. This morphotype has been recovered in pure culture following passage through a 0.4 mu filter and includes organisms of the Wollinella and Campylobacter genus. Non-motile organisms comprised less than 1-2% of the sample from healthy and diseased sites. Motile forms, such as spirochetes, had a high frequency of detection in healthy individuals. Analysis of pooled plaque samples revealed that the prevalence of cocci and fusiforms was significantly elevated in patients with healthy periodontium, as compared to patients with adult periodontitis. In adult periodontitis patients, the frequency of occurrence of medium spirochetes, filaments and small nonmotile rods was significantly elevated in pooled plaque. Analysis of individual sites indicated that the proportion and numerical density of most morphotypes within the non-adherent plaque were not significantly different in disease as compared to health. Disease is characterized by an increased % of small spirochetes and fusiforms at each site. At diseased sites which harbor small spirochetes, the numerical density is elevated four-fold, as compared to healthy sites which have small spirochetes. The numerical density of other morphotypes is not significantly different comparing healthy sites to diseased sites. Thus, the increase in the % of small spirochetes in disease in due to a site-localized four-fold increase in numerical density within the non-adherent plaque.

Adult↗
PubMed1996

Source of suspected periodontal pathogens re-emerging after periodontal treatment.

To clarify the source of re-emerging periodontal pathogens after treatment, we compared the ribotypes of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia/Prevotella nigrescens group and Campylobacter rectus before and after treatment in 7 periodontitis patients and in 6 of the spouses. The patients harbored A. actinomycetemcomitans, P. gingivalis, P. intermedia/P. nigrescens group or C. rectus in their subgingival or salivary samples before treatment. The respective bacterial species were not detected 1 month after treatment, but reappeared by 6 months later. When available, 4 random colonies of each of the 4 species were isolated from both subgingival and salivary samples at each sampling occasion, the isolates were subcultured, identified and typed applying pheno- and genotypic intraspecies characterization methods. Altogether 90 strains of A. actinomycetemcomitans, P. gingivalis, P. intermedia/P. nigrescens group and C. rectus were available from 2, 3, 2 and 4 patients, respectively. The pre- and post-treatment ribotypes of A. actinomycetemcomitans-, P. gingivalis- and P. intermedia/P. nigrescens group-isolates were identical in all respective patients. The pre- and post-treatment ribotypes of C. rectus were identical in 1 of 4 patients, whereas 2 patients harbored a previously not detected post-treatment ribotype and 1 patient harbored the initial and a previously not detected post-treatment ribotype. To study the possibility that periodontitis patients may acquire strains from the spouse after treatment, isolates of A. actinomycetemcomitans, P. gingivalis, P. intermedia/P. nigrescens group and C. rectus (n = 95) from the patients' spouses were ribotyped and compared with those of the patients. The patient exhibited his own post-treatment ribotypes, different from those of the spouse, of A. actinomycetemcomitans and P. gingivalis in 1 couple and of P. intermedia/P. nigrescens group and C. rectus in 1 couple. In the 2 patients who harbored a previously not detected post-treatment ribotype of C. rectus, one patient shared the new ribotype with the spouse, whereas the other one did not. Although an exogenous source cannot be fully ruled out, the patient's own oral flora seems to be the main source of re-emerging periodontal pathogens after treatment.

Aggregatibacter actinomycetemcomitans↗
PubMed2004

Periodontal repair in dogs: effect of recombinant human bone morphogenetic protein-12 (rhBMP-12) on regeneration of alveolar bone and periodontal attachment.

OBJECTIVES: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been shown to stimulate alveolar bone and cementum formation in periodontal defects but not a functionally oriented periodontal ligament (PDL). Subcutaneous and intramuscular implants of BMP-12 have been shown to induce tendon formation and ligament-like tissue. The objective of this study was to evaluate rhBMP-12 for periodontal regeneration, in particular PDL formation. METHODS: Six young adult Hound Labrador mongrel dogs were used. Routine supraalveolar periodontal defects were created around the mandibular premolar teeth. Three animals received rhBMP-12(0.04 mg/ml) in an absorbable collagen sponge (ACS) carrier vs. rhBMP-12(0.2 mg/mL)/ACS in contralateral defects. Three animals received rhBMP-12(1.0 mg/ml)/ACS vs. rhBMP-2(0.2 mg/ml)/ACS (total implant volume/defect approximately 1 ml). The animals were euthanized 8 weeks postsurgery and block biopsies were processed for histometric analysis. RESULTS: Bone regeneration appeared increased in sites receiving rhBMP-2/ACS compared to sites receiving rhBMP-12/ACS. Cementum regeneration was similar comparing sites implanted with rhBMP-2/ACS to sites implanted with rhBMP-12/ACS. In contrast, sites receiving rhBMP-12/ACS exhibited a functionally oriented PDL bridging the gap between newly formed bone and cementum whereas this was a rare observation in sites receiving rhBMP-2/ACS. Ankylosis appeared increased in sites receiving rhBMP-2/ACS compared to those receiving rhBMP-12/ACS. CONCLUSIONS: The outcomes of this study suggest that rhBMP-12 may have significant effects on regeneration of the PDL. Additional preclinical evaluation is needed to confirm these initial observations prior to clinical application.

Alveolar Bone Loss↗
PubMed2006

Loss of molars in periodontally treated patients: a retrospective analysis five years or more after active periodontal treatment.

OBJECTIVES: Evaluation of tooth loss in molars and prognostic factors for molar survival. MATERIAL AND METHODS: Five hundred and five molars in 71 patients (mean age 46 years; 40 females) were evaluated. The following inclusion criteria were required: periodontal therapy of at least one molar, at least 5 years of supportive periodontal therapy, and baseline assessment of furcation involvement (FI). RESULTS: At baseline 200 of 505 molars exhibited no FI, 116 degree I, 122 degree II, and 67 degree III FI. Twenty-seven molars did not receive periodontal treatment; 127 molars were subjected to non-surgical therapy, and 227 to flap surgery. Tunnel preparation was performed on 14 molars, root resection on 20, regenerative therapy on 57 teeth, and 33 molars were extracted. During the average follow-up period of 107 months 38 molars were lost additionally. Molars with degree III FI had the highest mortality. A multi-level proportional hazard model revealed smoking, baseline bone loss, number of molars left, and degree III FI as risk factors influencing the retention time of molars. CONCLUSION: Overall periodontal therapy results in a good prognosis of molars. Degree III FI leads to a significant deterioration of prognosis. Beyond FI smoking, baseline bone loss, and number of molars left influence molar survival.

Adolescent↗
PubMed1996

Putative periodontal pathogens, antibody titres and avidities to them in a longitudinal study of patients with resistant periodontitis.

OBJECTIVE: To study changes in antibody titres and antibody avidities to putative periodontal pathogens in patients with resistant periodontitis and to compare these findings with the result of culture of these pathogens. SUBJECTS AND METHODS: Patients meeting strict clinical criteria in whom periodontal therapy had failed to prevent disease progression were studied microbiologically and immunologically over a 75-week period. Particular reference was made to the isolation of Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) together with changes in antibody titres and avidities to these organisms between baseline examination and week 75. RESULTS: Pg was eliminated following antibiotic treatment but metronidazole and amoxycillin therapy failed to remove Aa in all cases. Antibody avidities to these pathogens were higher in patients than in matched controls but no change in avidity was noted during the course of treatment. Most antibody titres were not significantly higher in patients than in controls. CONCLUSIONS: Continued disease progression characterised these patients who, nevertheless, mounted an immune response to the periodontal pathogens but this appeared to be inadequate to stop the disease.

Adult↗
PubMed2002

Immunization with the RgpA-Kgp proteinase-adhesin complexes of Porphyromonas gingivalis protects against periodontal bone loss in the rat periodontitis model.

A major virulence factor of Porphyromonas gingivalis is the extracellular noncovalently associated complexes of Arg-X- and Lys-X-specific cysteine proteinases and adhesins designated the RgpA-Kgp complexes. In this study we investigated the ability of RgpA-Kgp as an immunogen to protect against P. gingivalis-induced periodontal bone loss in the rat. Specific-pathogen-free Sprague-Dawley rats were immunized with either formalin-killed whole P. gingivalis ATCC 33277 cells with incomplete Freund's adjuvant, RgpA-Kgp with incomplete Freund's adjuvant, or incomplete Freund's adjuvant alone. The animals were then challenged by oral inoculation with live P. gingivalis ATCC 33277 cells. Marked periodontal bone loss was observed in animals immunized with incomplete Freund's adjuvant alone; this bone loss was significantly (P < 0.05) greater than that detected in animals immunized with formalin-killed whole cells or RgpA-Kgp or in unchallenged animals. There was no significant difference in periodontal bone loss between animals immunized with formalin-killed whole cells and those immunized with RgpA-Kgp. The bone loss in these animals was also not significantly different from that in unchallenged animals. DNA probe analysis of subgingival plaque samples showed that 100% of the animals immunized with incomplete Freund's adjuvant alone and challenged with P. gingivalis ATCC 33277 were positive for the bacterium. However, P. gingivalis ATCC 33277 could not be detected in subgingival plaque samples from animals immunized with formalin-killed whole cells or with RgpA-Kgp. Immunization with formalin-killed whole cells or RgpA-Kgp induced a high-titer serum immunoglobulin G2a response. Western blot analysis of RgpA-Kgp using pooled protective antisera taken from rats immunized with RgpA-Kgp revealed immunodominant bands at 44, 39, and 27 kDa. In conclusion, immunization with RgpA-Kgp restricted colonization by P. gingivalis and periodontal bone loss in the rat.

Adhesins, Bacterial↗
PubMed2003

Favorable healing following space creation in rhBMP-2-induced periodontal regeneration of horizontal circumferential defects in dogs with experimental periodontitis.

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) is believed to be capable of inducing periodontal regeneration. However, the risk of aberrant healing events, such as root resorption and ankylosis, has been reported. We hypothesized that implantation of BMP-containing carriers directly on the root planed surface may be the cause of unfavorable healing. The purpose of this study was to evaluate the influence of a 1 mm spacer membrane, which separated the rhBMP-2 in polymer-coated gelatin sponge (PGS) and the root surface, on periodontal regeneration of experimentally induced horizontal defects in dogs. METHODS: Horizontal circumferential periodontal defects were surgically created, and experimental periodontitis was induced in 72 maxillary and mandibular premolars of four male beagle dogs. The recipient sites of each quadrant received: 1) rhBMP-2/PGS (B group) (rhBMP-2 at 1.0 mg/ml, total implant volume/ site approximately 7.2 microl) (n = 24); 2) rhBMP-2/PGS with a spacer membrane (PB group) (n = 24); and 3) physiological saline (PS)/PGS as a control (P group) (n = 24). One quadrant was left untreated. Dogs were sacrificed at 12 weeks post-surgery, and healing was evaluated histologically. RESULTS: Both groups treated with rhBMP-2/PGS demonstrated enhanced new bone formation and connective tissue attachment with cementum regeneration when compared to the control group. Sites treated with rhBMP-2/PGS showed a greater degree of bone formation than sites treated with rhBMP-2/PGS and spacer membrane, although the latter sites showed no ankylosis. CONCLUSIONS: Implantation of rhBMP-2/PGS enhances bone formation and connective tissue attachment in horizontal circumferential defects. In addition, the use of a spacer membrane reduces the degree of bone formation, but minimizes ankylosis.

Alveolar Bone Loss↗
PubMed2004

Effect of periodontal therapy in smokers and non-smokers with advanced periodontal disease: results after maintenance therapy for a minimum of 5 years.

BACKGROUND: Longitudinal clinical studies show smoking is a risk factor for periodontal disease progression. It has also been documented that smoking impairs healing after periodontal therapy. However, the longitudinal effect of smoking on treatment results in patients who undergo long-term maintenance therapy has not been extensively investigated. This study clinically and radiographically compared smoking and non-smoking patients who had been treated for advanced periodontal disease and who received maintenance therapy for a minimum of 5 years. METHODS: Twenty-nine patients were selected over a 6-month period when they presented for a regularly scheduled visit in a private office. Patients were selected on the basis of initially having lost 50% of bone support on 50% of their teeth; had received follow-up therapy for at least 5 years; were compliant at 75% of the appointments; and had plaque scores < 20% in 75% of the visits. All patients had received non-surgical and surgical therapy as required for pocket elimination. Fourteen were active smokers during the entire maintenance period. Clinical measurements of probing depths and presence of plaque and gingivitis and a new set of standardized radiographs were taken. RESULTS: Smokers had higher mean radiographic bone loss values prior to treatment (7.52 +/- 1.39 versus 6.65 +/- 1.39) and at the final examination (7.32 +/- 1.42 versus 6.29 +/- 1.29) mean radiographic bone loss as well as initial, immediate post-therapy, and final percent of pockets > or = 6 mm (1.42% +/- 1.87% versus 0.60% +/- 1.11%). Differences were not statistically significant. Over 5 to 8 years, seven sites in four non-smokers and 11 sites in six smokers exhibited radiographic bone loss > or = 2 mm. One tooth in a non-smoker and three teeth in two smokers were lost. In a logistic regression analysis, smoking increased the odds ratio 10.7 times of having > or = 1 site with bone loss > or = 2 mm. CONCLUSION: The present study on a small group of patients treated for advanced periodontal disease and well maintained over 5 to 8 years showed no statistically significant differences between smokers and non-smokers in clinical probing depth and radiographic bone loss measurements.

Adult↗
PubMed2003

Diagnostic value of the use of lateral and occlusal radiographic views in comparison with periodontal probing for the assessment of periodontal attachment of the canine teeth in dogs.

OBJECTIVE: To determine the diagnostic value of 2 intraoral bisecting angle radiographic views in comparison with periodontal probing for the assessment of periodontal attachment of the canine teeth in dogs. STUDY POPULATION: 466 canine teeth from 117 dogs. PROCEDURE: Periodontal probing measurements were recorded, and clinical attachment levels (CAL) were calculated at the mesial, buccal, distal, and lingual (or palatal) surfaces on each canine tooth. Occlusal and lateral radiographs of the canine teeth were obtained. Alveolar margin height (AMH) was measured at the same 4 surfaces. Values for AMH and CAL were compared on the basis of tooth surface, dental arch, and radiographic view. RESULTS: The AMH at the mesial and distal surfaces of the mandibular canine teeth was measurable on the lateral view and was significantly correlated with CAL. Similar results were found for the mesial and distal surfaces of the maxillary canine teeth. Buccal and lingual AMH were measured on the mandibular occlusal radiographic view, and values were significantly correlated with CAL, but only the buccal AMH could be assessed on the occlusal radiographic view of the maxilla with values that correlated significantly with CAL. CONCLUSIONS AND CLINICAL RELEVANCE: The lateral radiographic view is suitable for evaluating periodontal attachment at the mesial and distal surfaces of the canine teeth in dogs. The occlusal radiographic view is suitable for assessing buccal surfaces as well as the lingual surface of mandibular canine teeth but not the palatal surface of maxillary canine teeth in dogs.

Alveolar Bone Loss↗
PubMed1978

Oral hygiene, periodontal health and need for periodontal treatment among institutionalized mentally subnormal persons in Norway.

Oral hygiene, periodontal health and periodontal treatment needs were studied in the dentulous patients (n = 328) of a sample selected to be representative of all institutionalized mentally subnormal persons in Norway aged 5--45. The average oral hygiene and periodontal health was poor except for patients in a few institutions where the nurses were trained to clean teeth regularly. Increased age, epilepsy, Down's syndrome and a high degree of mental deficiency were all elements that apparently contributed to impairment of periodontal health and to increased treatment requirements. The preventive programs used in some institutions seemed to be effective. Still better results, however, could probably be obtained by the use of dental hygienists.

Adolescent↗
PubMed1976

Histometric study of healing of periodontal tissues in rats after surgical injury. II. Healing events of alveolar bone, periodontal ligaments and cementum.

A standardized surgical periodontal injury was performed in 67 male Wistar rats 9 weeks of age. An osteotomy was made with a burr through the vestibular bone plate and the periodontal ligaments and into the superficial part of the root surface of the mandibular first molar. The rats were sacrificed with observation periods ranging from 1 day to 2 years postoperatively. A histometric registration was made of the repair of alveolar bone, periodontal ligaments and cementum. Bone repair was found after 7 days and included a bony alkalosis. On the period from 7 to 14 days after surgery this ankylosis was removed by resorption process. Argyrophilic reticulin fibers were present 3 to 5 days after surgery. Precollagen fibers were found after 4 days, whereas mature collagen fibers inserting in new formed cementum, was seen after 14 days. The number of collagen fibers increased substantially until 28 days after surgery. Initial cementum repair was found after 14 days and increased substantially with increasing observation periods tending to reach the thickness of the contralateral control tooth. Based on these findings a new concept of healing of the surgically injured periodontium in rats is presented. According to this the healing occurs in three successive phases. 1. Bone repair with formation of an ankylosis. 2. Repair of the periodontal ligament including removal of the established ankylosis. 3. Repair of Cementum.

Alveolar Process↗
PubMed2000

[Changes of elastase in gingival crevicular fluid after periodontal treatment of adult periodontitis patients].

OBJECTIVE: To examine the changes of elastase in the supernatant (EA-s) and in the pellet (EA-p) after centrifuge in gingival crevicular fluid (GCF) before and after periodontal treatment. METHODS: GCF was sampled with filter paper strips by intra-pocket method to determine EA levels. Forty-three teeth of eight subjects were included. EA-s and EA-p were determined separately using the subtract Meosuc-ala-ala-val-pro-NA. RESULTS: EA-s per site and per ml, EA-p per site and the ratio of EA-s/EA-p (S/P) decreased significantly after non-surgical periodontal treatment (P < 0.001), while EA-p concentration didn't change (P > 0.05). CONCLUSIONS: GCF-EA-s and EA-p could act as objective parameters to evaluate the effect of periodontal therapy, especially EA-s and S/P, which may be sensitive diagnostic parameters for determining periodontal disease activity.

Adult↗