Diagnosis of periodontal diseases--changing concepts. A challenge for the future.

Periodontal research conducted over the last ten years has dramatically changed concepts relating to the assessment and diagnosis of periodontal diseases. These concepts have challenged the clinician to discard long accepted theories regarding the diagnosis and progression of periodontal disease transforming this area into a critical and important aspect of current periodontal research. Currently accepted theories regarding the progression of human periodontal disease (gingivitis and adult periodontitis), will be briefly reviewed, and current and potential new techniques for diagnosing periodontal disease activity will be discussed.

Diagnosis of periodontal diseases. Changing concepts. A challenge for the future.

Dental researchers have made great advances in our understanding of the progression and diagnosis of human periodontal disease. Standardized electronic probes promise to improve accuracy in measuring probing attachment levels and one such probe is being marketed to the dental profession. Improved techniques for radiographs such as subtraction radiography will continue to aid in the diagnosis of small changes in attachment. The isolation of an enzymatic diagnostic marker may allow for an in-office diagnostic kit for predicting site specific periodontal disease activity before it occurs. These trends portend well for the practice of periodontics and the management of our patients.

Refractive index of some mammalian tissues using a fiber optic cladding method.

The index of refraction n of the many mammalian tissues is an important but somewhat neglected optical constant. Archival and oral papers have quoted the use of values of n for tissue generally ranging from 1.35 to 1.55. However, these values are frequently without experimental basis. They have arbitrarily used values near that of water, which is a major component of mammalian tissue, or have calculated a theoretical n from the weighted elemental composition of tissue. Since these values have not been precise and little information is available on specific indices for each tissue, a study was undertaken to develop a simple, rapid, and reliable method for the experimental determination of n. This was done using the ubiquitous quartz optical fiber. By substituting the usual cladding found on commercial quartz optics by the tissue in question and utilizing the principle of internal reflection, the value of n for the specific tissue can be calculated. This is done by utilizing the known indices for air and quartz and measuring the angle of the emergent cone of light from the output of the optical fiber. A number of indices for mammalian tissue (bovine, porcine, canine, and human) have been determined at 632.8 nm. With few exceptions, for tissues at this wavelength, n was in the 1.38-1.41 range. The species type did not appear to be a factor. Bovine muscle showed normal dispersion characteristics through the visible wavelengths. The denaturation of tissue was shown to alter significantly the refractive index.

Effects of mercury on human polymorphonuclear leukocyte function in vitro.

A variety of heavy metals are recognized as environmental pollutants, and although a significant body of literature exists on the acute toxicity of these metals in various tissues, little is known about the effects of metals such as mercury on host defense. Therefore, the effect of mercuric chloride (HgCl2) on human polymorphonuclear leukocytes (PMN) function in vitro was evaluated. The acute toxicity of HgCl2 for human PMN was calculated initially using vital dye exclusion (trypan blue), and lactate dehydrogenase (LDH) release. Concentrations of HgCl2 less than or equal to 10(-6) M did not induce significant LDH release, or uptake of trypan blue. Additionally, HgCl2 at less than or equal to 10(-7) M produced no ultrastructural alterations in the PMN. The effects of HgCl2 on human PMN functions involved in host defense were evaluated next. HgCl2 consistently suppressed human PMN adherence, polarization, chemotaxis, and erythrophagocytosis at concentrations between 10(-6) and 10(-17) M. Because of the established role of oxygen metabolites in host defense, the effects of HgCl2 on human PMN chemiluminescence and H2O2 production were evaluated next. These studies demonstrated that low concentrations of HgCl2 (ie, 10(-9)-10(-15) M) significantly enhanced chemiluminescence, as well as stimulated H2O2 production by the PMN. These studies clearly demonstrate the ability of extremely low levels of HgCl2 not only to suppress various PMN functions involved in host defense, but also to stimulate oxygen metabolism. In vivo, these HgCl2 effects would not only compromise host defense but also promote tissue injury via the local production of oxygen metabolites.