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[The systemic circulation and microcirculation of the periodontium vital microscopy and histological studies of incisors of rats (author's transl)].

A new classification of the angioarchitecture and blood flow is proposed in light of the results of vital microscopy studies of the windowed periodontium and gingiva of the incisors of rats. The flow pattern and the rate of blood flow are different in different vessels. The flow of blood in segmented and interconnected arterial and venous vascular sections in the alveolar and marginal periodontium corresponds to what is known as systemic circulation, whereas that in arterioles, capillaries, and venoles must be considered as belonging to what is referred to as microcirculation. Subepithelially, the microcirculatory elements constitute a nutritive, typically ordered capillary network as contrasted with the random spatial arrangement of capillary loops in the alveolar periodontium. Numerous anastomoses provide the basis for possible functional adaptation, leading to the formation of polygonal ring closures in the alveolar region. The interpretations of functional findings are based upon histotopological reexaminations.

Alveolar Process

A continuous-flow culture system for organ culture of large explants of adult tissue: effect of oxygen tension on mouse molar periodontium.

A modified continuous-flow culture system (CFCS) was developed to maintain large explants of periodontium from adult mouse in organ culture. The culture medium was stored in a reservoir outside of the incubator, pumped via polyvinyl tubing into small glass culture chambers that were placed in the oxygenator and then collected in a waste flask. Medium was analyzed for pO2, pCO2 and pH during the culture period. Three-molar and single-molar explants of periodontium were maintained for 48 hr in the CFCS at two different pO2 ranges: 100 to 120 mm Hg and 400 to 420 mm Hg. [3H]Proline was added 24 hr prior to sacrifice. Light-microscope morphological and radioautographic observations suggested that cell viability and incorporation of [3H]proline, probably into newly synthesized protein, increased with an increase in pO2 and was related to a pO2 gradient extending from the periphery to the center of the explants.

Animals

Study of the noncollagenous components of the periodontium.

Periodontal ligament and gingivae of bovine and porcine periodontium were analyzed for relative amounts of carbohydrates, collagen, and acid mucopolysaccharides. The sugar content was 3.6% and 3.4% of dry weight in bovine and porcine periodontal ligament, respectively. The values were lower in the gingivae being 2.34% and 2.30%, respectively. Approximately 50% of hexosamine in gingivae was present in acid mucopolysacchrides as compared to 36% in periodontal ligament. Relative to collagen there was a considerable amount of non-collagenous glycoproteins present in the periodontium as judged by carbohydrate content of the tissue.

Animals

[The collection and evaluation of sulcus fluid in the juvenile periodontium].

On the collection and the evaluation of the crevicular fluid from the child's periodontium. In a methodological study on the collection of crevicular fluid, we used in 50 children with clinically healthy gingivae a method for the collection of crevicular fluid that we had modified. Small amounts of fluid could be collected in all instances, also during different periods of eruption, in the regions of deciduous and permanent anterior teeth, and in the molar region. It is planned to employ this method (after further improvements) in investigating the possible effects of changes in the crevicular fluid composition on the developmental and regenerative processes in the juvenile periodontium.

Gingival Crevicular Fluid

Inflammatory lesions and bone resorption induced in the rat periodontium by lipoteichoic acid of Streptococcus mutans.

Severe inflammatory lesions were induced in the periodontal tissues of the rat following the intragingival injection of lipoteichoic acid (LTA) from Streptococcus mutans. There was no difference in the severity and distribution of the lesions between nonimmunized rats and animals immunized against LTA after antigenic challenge. The lesions are characterized by the occurrence of granulation tissue, massive infiltration of PMNs, abscess formation, bone resorption, and new bone formation. Deacylated LTA and saline caused relatively mild inflammation, and no significant bone resorption or new bone formation was evident. The peak response was reached after 3 intragingival infections. The mechanisms by which LTA caused the pathological alterations in the rat periodontium and the possible relations of this experimental model to periodontal disease in the human are discussed.

Animals

The induction of new bone and cementum formation. IV. Microscopic examination of the periodontium following human bone and marrow allograft, autograft and nongraft periodontal regenerative procedures.

This retrospective study based on histologic evaluations of 100 human block sections and extracted teeth taken from sites treated via bone and marrow autograft, allograft and nongraft regenerative procedures revealed the following findings: 1. Graft procedures yielded new cementum formation in 66 of 79 sites evaluated while nongraft approaches yielded new cementum formation in only 7 of 21 sites. Two of the grafted sites not yielding new cementum were only 14 days duration. 2. Block section evaluation revealed new bone formation in 33 of 39 graft sites and in 7 of 21 nongraft sites. 3. When regeneration did occur, as seen in the block sections, the nature of the new attachment was similar in all graft approaches and was comparable to healthy functioning periodontium. 4. The potential for regeneration of a functional attachment apparatus including new cementum, bone and functionally oriented periodontal ligament has been demonstrated in autograft and allograft approaches. 5. Adverse immune response to bone and marrow allografts could not be detected at a clinical, histologic or chemical level. 6. No ankylosis or root resorption was noted with fresh intra-oral donor material and with frozen iliac autografts or allografts. Root resorption was noted in two cases treated with nongraft methods and in 16 of 275 sites treated with fresh iliac autograft material.

Alveolar Process

Physiologic dimensions of the periodontium significant to the restorative dentist.

When treating patients, the objectives of restorative therapy must be clear. The first and most basic objective is preservation of the teeth. The attainment of this objective would be far less complex if it could be considered independent of restoration of function, comfort and esthetics, but such is not the case. The latter objectives usually require sophisticated restorative dentistry and often include restorations with intracrevicular margins. Although it is widely accepted that the best restorative margin is one that is placed coronal to marginal tissue, most restorations have margins in the gingival crevice, and permanent tissue damage is common. In attempting to reach his objective, the restorative dentist must remember the fundamental precept of the health professions, which is: Do no harm. Daily observation of the three physiologic dimensions permits the therapist to restore teeth with minimal injury to the periodontium.

Connective Tissue

[Rheography in the periodontium. Preliminary report].

The authors describe rheography as a method for assessing the blood circulation in the periodontium. With regard to material expenditure, electrode design and application to the alveolar ridge and the data obtained, the experimental arrangement presented by the authors proved to be a rapidly applicable and informative method of investigation, the results from which will be reported later on.

Humans

[The marginal periodontium of impacted upper canines. Evaluation following various methods of surgical approach and orthodontic procedures].

The marginal periodontium of 29 impacted upper canines and several aspects of their treatment have been studied. The situation has been analysed after treatment according to 3 methods of surgery and orthodontics: a) excision and active eruption, b) excision and passive eruption and c) replaced flap and active eruption. Many aspects regarding the choice and course of treatment depend primarily on individual data of the patient and on the location of impaction. With surgical exposure by excision some mucogingival problems seem to appear, especially for vestibular impactions. In those cases the surgical techniques using replaced or deplaced flaps seem to be more indicated to preserve the periodontal tissues.

Adolescent

[The pathophysiologic reactivity of the endodontium and periodontium].

The plaque-linked caries and gingivitis are attended by phlogogenic attacks to the endodontium and the periodontium. The knowledge of the morphology and pathomorphology as well as of the fundamental physiopathological reaction patterns leads to a reasonable organ-oriented diagnosis from which the regenerative power must be deducible. Experimental results are illustrated by the examples of vascularity and blood circulation. Further damage must be reduced to a minimum by sparing and safe conservative therapy.

Adult

[Relationship between endodontium and periodontium].

1. The dental pulp and periodontium have developmental connections. 2. Many of their functions intersect and are common to both tissues. 3. Their highly developed defence systems enable either to survive when the other has been destroyed.

Dental Cementum

[Reaction of the periodontium to the wire ligature splint (Stout-Obwegeser)].

The direct traumatising effect of the Stout-Obwegeser wire ligature splint on the marginal periodontium is minimal and need not be considered. The increase in depth of pockets, in the index of sulcus bleeding and in tooth mobility is due to poor oral hygiene. In 16 patients (orthodontic operation and jaw fractures) periodontal measurements were obtained on 369 teeth in 30 jaws before application of the splint, 1 and 6 weeks later and as 6 weeks after removal of the splint. All gingival indices determined were at first raised. The last measurements however showed, better values than those at the beginning of treatment. Inflammatory changes regressed near all teeth whether they were included in a ligature or not. This appears to prove that oral hygiene alone is decisive. The question whether the "curettage" effect of splint application has a therapeutic action is left open.

Dental Hygienists