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Blood volume in human bicuspid periodontal ligament determined by electron microscopy.

The microvascular volume of periodontal ligament is reported to range from 1.63 to 3.5% in man, whereas that of animals varies from 7.5 to 11.5%. This transmission electron-microscopic investigation was undertaken to determine stereologically the volume in human periodontal ligament. The hypothesis tested was that the ligament blood volume in man is similar to that in animals. Left and right segments of mandible containing first and second premolars came from an adult burns' victim who underwent jaw reconstruction. The segments were immersion-fixed in 2.5% glutaraldehyde, demineralized at 4 degrees C in 0.1 M EDTA and processed for microscopy. Segments of distal periodontal ligament were sectioned at 150-micron intervals from the alveolar crest to the root apex and random tissue quadrats recorded for point counting and data analysis using a generalized linear-regression statistical model. Mean adjusted microvascular luminal volume was 9.52 +/- 2.28% (SEM) and the abluminal volume 12.91 +/- 2.76%; the wall volume was 3.39%. Significant differences existed between the luminal and abluminal volumes of the different vessel type (p < 0.05) and their distribution across the circumferential thirds of the ligament (p < 0.05). Total length density of the blood vessels was 149.84 x 10(3) cm/cm3 and the surface density 330.19 cm2/cm3. Postcapillary-sized venules held 69.1% of the total blood volume and provided 49.3% of the luminal surface area. Venous capillaries were the most common vessel, comprising 48.5%, and they contributed 71.5% of the overall length density. This study confirmed the hypothesis for the blood volume in the periodontal ligament in man. Blood volumes do not reflect the configurations of microvascular beds.

Adult↗

Extraction of maxillary first bicuspids and mandibular lateral incisors, combined with orthognathic surgery to correct a severe class II skeletal malocclusion.

This is a case report of a 21-year-old female with a Class II Division 1 malocclusion. The maxillary arch was constricted with an associated anterior open bite. The lower facial height was excessive, and the mandibular plane angle was high. The treatment options were limited due to a previously extracted mandibular right lateral incisor. The patient was successfully treated by a surgical rapid palatal expansion procedure, extraction of the mandibular left lateral incisor, extraction of the maxillary first premolars at the time of a 3-piece Lefort 1 maxillary osteotomy procedure, and a bilateral sagittal split osteotomy advancement procedure.

Adult↗

Root resorption in bicuspid intrusion. A scanning electron microscope study.

Apical root surfaces covered by cellular cementum are rapidly subjected to resorption under orthodontic loads of varying magnitude and duration. Within the experimental parameters employed, the intrusive forces applied to the teeth produced a striking increase in root resorption compared with the control teeth. The amount of resorption increased markedly with the duration of the force, and to a lesser extent with the magnitude of the appliance activation. After 70 days, cellular cementum repair accompanied the continuing resorption. Little variation was detected in the susceptibility of different patients to root resorption in the experimental teeth. The same intrusive load applied for the same duration to similar teeth produced a corresponding degree of root resorption in various individuals. On the other hand, there were individual differences in the amount of resorption on untreated control teeth. There is a need to extent our understanding of the periodontal ligament and its associated tissues which provide the basis for our professional services. Clearly, root resorption and the capacity for repair are orthodontic facts of life. In the current climate of technological innovation great emphasis has been given to cephalometrics and appliance mechanics, which provide the orthodontist with the clinical stimulus of visual and tactile involvement. This paper is presented as a contribution to our knowledge of the unseen biological consequences which accompany that orthodontic treatment.

Adolescent↗

Occurrence and distribution of interdental gingival clefts following orthodontic movement into bicuspid extraction sites.

Forty patients in active retention following orthodontic tooth movement into premolar extraction sites were examined for the occurrence and distribution of interdental gingival clefts, defined as an invagination of interproximal tissue with definite mesial and distal peaks having a depth of at least 1 mm. Fourteen of the forty orthodontic patients demonstrated clefts in one or more of the premolar extraction sites. No clefts were observed in premolar areas of orthodontic patients who did not require premolar extraction or in patients without previous orthodontic treatment. Interdental clefts occurred most frequently at the buccal aspect of mandibular first premolar extraction sites. The presence of the cleft appears to have clinical implications, both in terms of orthodontic relapse, and maintenance of gingival health.

Adolescent↗