Is Intentional Replantation Appropriate for Treatment of Extensive Endodontic-periodontal Lesions Related to Palatogingival Groove?

This report describes the cases of two patients with a maxillary lateral incisor with palatogingival groove and extensive endodontic-periodontal lesions. Although it is reported that acceptable periodontal status is of great importance in case selection in intentional replantation, it is suggested in this report that intentional replantation could be chosen instead of immediate extraction if extensive endodontic-periodontal lesions exist in a tooth with palatogingival groove. The gingival margin position and gingival papilla were well preserved and the bone defect was almost completely repaired. This was beneficial to the aesthetic prosthodontic treatment and implantation, although external root resorption was observed.

[Characteristic of sample banks isolated from EDTA-blood by sedimentation method].

OBJECTIVE: To assess the characteristics of establishing the different sample banks of plasma, leukocytes and DNA by sedimentation method of isolating from ethylene diamine tetraacetic acid(EDTA)-blood and to clarify the sedimentation method of leukocyte isolation and plasma volume by comparative data and recommended procedures for applicability. METHODS: In the study, 29 EDTA-bloods were obtained, the total amounts of leukocytes and the percentage of neutrophile granulocytes, and lymphocytes in the EDTA-blood detected as a control group and then assigned equally into 4 EP tubes with 1 mL EDTA-blood per tube as 4 test groups, then the 4 tubes were placed with the EDTA-blood at room temperature and the plasma layers were isolated at 0.5, 1, 2 and 3 h, receptively. The total amount of leukocytes and the percentage of neutrophile granulocytes, and lymphocytes were detected by automated hematology analyzer at the clinical laboratory. The volume of the plasma was also measured at the same time. RESULTS: The plasma volume at 0.5 h [(241.72 ± 101.52)µL] was substantially lower than those at 1 h[(317.24 ± 97.50)µL], at 2 h[(371.03 ± 91.66)µL], and at 3 h [(408.97 ± 97.43)µL] , P < 0.05. The plasma volume at 1 h was substantially lower than those at 2 h and 3 h (P < 0.05). The total amount of leukocytes in the plasma layer at 0.5 h (2.50 × 10(6) ± 1.48 × 10(6)) group was substantially higher than the amount of 2 or 3 h groups respectively (1.47 × 10(6) ± 7.19 × 105,1.21 × 10(6) ± 7.41 × 105), P < 0.05. Significant difference was not found between 0.5 h group and 1 h group (2.29 × 10(6)± 1.17 × 10(6)), P > 0.05. The total amount of leukocytes in the plasma layer in 1 h group was substantially higher than that in 2 h and 3 h groups (P < 0.05). There was no significant difference between 3 h group and 2 h group (P > 0.05). The total amount of leukocytes in the plasma layer of the 4 test groups was substantially lower than that in the control group (P < 0.05). The percentage of neutrophile granulocytes (54.14% ± 11.65%) in the plasma layer in 0.5 h group was substantially higher than those in 1 h, 2 h and 3 h groups (46.66% ± 12.70%,39.17% ± 12.33%,43.25% ± 14.54%), P < 0.05, respectively, which was the substantially lower than that in the control group (60.53% ± 8.46%), P < 0.05. The average value of the percentage of neutrophile granulocytes in the plasma layer in 1 h group was substantially higher than that in 2 h group (P < 0.05). There was no significant different between 3 h group and both 1 h, 2 h groups (P > 0.05). The mean percentage of lymphocytes in the plasma layer in 0.5 h group (35.09% ± 10.84%) was substantially lower than those in the plasma layer in 1 h, 2 h and 3 h groups, respectively ( 41.48% ± 12.20%, 47.96% ± 12.27%, 45.50% ± 13.71%), which was significant higher than that in the control group(30.98% ± 7.33%), P < 0.05. The average value of the percentage of lymphocytes in the plasma layer in 1 h group was substantially higher than those in the control group and 0.5 h group, but was substantially lower than those in 2 h and 3 h groups (P < 0.05). The average value of percentage of lymphocytes in the plasma layer in 2 h group was substantially higher than those in the control group, 0.5 h and 1 h groups (P < 0.05). There was no significant difference between 2 h and 3 h groups (P > 0.05). CONCLUSION: The best period of time in obtaining leukocytes is 0.5-1 h sedimentation of EDTA-blood. Both the plasma layer and leukocytes can be separated and obtained at the same time from the same sample by the sedimentation method of EDTA-blood. The sedimentation of EDTA-blood has the least interference of both chemical and physical factors, as well as a ready operation, which can establish the plasma, leukocytes and DNA sample banks for various aspects of research.

Treatment of generalised aggressive periodontitis: a 4-year follow-up case report.

Aggressive periodontitis comprises a group of rare, often severe, rapidly progressive forms of periodontitis mostly characterised by an early age of clinical manifestation and a distinctive tendency for cases to aggregate in families. This case report presents a 16-year-old female patient with clinical and radiographic evidence of severe attachment loss, whose mother was also a patient with severe periodontal destruction. The girl was diagnosed with generalised aggressive periodontitis and received full-mouth scaling and root planing, bone graft surgeries and guided tissue regeneration on intrabony defects mesial of the mandibular first molars. Microbiological and immunological tests were performed on five selected sites before and at 2 months after initial therapy. Clinical and radiographic findings reported up to 4 years postoperatively indicated good effects and stability of treatment outcome.

[Effects of emdogain on human periodontal ligament cells in vitro].

OBJECTIVE: To investigate the effects of emdogain, enamel matrix derivative (EMD), on the proliferation, cell cycle, mineralization and ultrastructure of human periodontal ligament (PDL) cells in vitro. METHODS: The influence of cell growth on PDL cells was evaluated by Cell Counting Kit-8 (CCK-8) in the presence and absence of emdogain, after 1, 3, and 5 d of culture. DNA synthesis and ultrastructure of PDL cells were observed by flow cytometry(FCM) and transmission electron microscopy (TEM) in the presence and absence of emdogain after 3 d of culture. The increasing of osteogenic capacity was verified by the expression changes of osteogenic differentiation markers of bone sialoprotein (BSP) and osteopontin (OPN) in emdogain-treated PDL cells by immunohistochemicl staining. RESULTS: Incubation of PDL cells with emdogain after 3 d significantly stimulated cell growth and DNA synthesis. Emdogain enhanced the osteogenic potential of PDL cells by high expression of osteogenic differentiation markers of BSP and OPN. CONCLUSION: The data indicate that Emdogain enhances cell proliferation and promotes differentiation of PDL cells, which contributes to periodontal tissue regeneration .

[Effect of periodontal surgery on the subgingival periodontal microbiota in artificial class III furcation defects: an experimental study in monkeys].

OBJECTIVE: This study was to longitudinally evaluate the change of prevalence of five periodontal putative pathogens in the subgingival plaque of artificial class III furcation defects at the three time-points, including before the establishment of furcation defects, before and 6 months after periodontal surgery. METHODS: Eighteen chronic infected class III FI defects were created at the mandibular first molars, second molars and second premolars of three adult male Macaca fascicularis. The samples of subgingival plaque were obtained from the subgingival area of furcation defects in buccal and lingual sites before the establishment of furcation defects, before and 6 months after periodontal surgery. 36 samples were obtained at one time-points. Five periodontal putative pathogens, including Porphyromonas gingivalis (Pg), Tannerella forsythensis (Tf), Treponema dinticola (Td), Actinobacillus actinomycetemcomitans (Aa) and Fusobacterium nucleatum (Fn), were detected with 16SrRNA based PCR. RESULTS: 1. The prevalence of Pg, Tf, Td and Fn was gradually increased, from 58.3% to 69.4% to 88.9%, 47,2% to 69.4% to 83.3%, 13.9% to 36.1% to 61.1% (P<0.01), and 69.4% to 91.7% to 91.7% (P<0.05), respectively during the experimental period. The prevalence of Fn was higher than Pg, Tf and Td. The prevalence of Aa was the lowest and no obvious difference among the three samplings(from 25.9% to 13.9% to 33.3%)was detected. 2. The prevalence of more than 3 species simultaneously detected was increased from 38.9% to 61.1% to 83.3% (P <0.01). The red complex (Pg + Tf + Td) was detected from 8.3% to 27.8% to 44.4% (P<0.01) at the different time point. 3. The combined detection frequency of red complex in the inflammatory sites (87.5%), which were histologically defined as inflammatory cells infiltrated in furcation area 6 months post-surgery, and the same sites pre-surgery (62.5%) was more than that in pre-creation of furcation defects (P<0.01). But there were no significant differences compared to that in non inflammatory area (60.0%, 40.0%), respectively. CONCLUSION: The prevalence of periodontal pathogenic bacteria correlated with the severity of local inflammation. The increase of coexistent rate of red complex at the second and third sampling times suggests that the red complex play important role in the pathogenesis of periodontitis. Fn may be a resident bacteria in the subgingival plaque, play a bridge role on the biofilm formation and maturation. Aa may not be a major causative bacteria in the clinical periodontitis.

[FBAT analysis of polymorphisms of vitamin D receptor (Taq I and Fok I) in aggressive periodontitis families].

OBJECTIVE: To analyze the correlation between polymorphisms of the vitamin D receptor gene (Taq I and Fok I) and the aggressive periodontitis by FBAT method. METHODS: 93 AgP nuclear families including 93 probands and their 155 relatives were recruited. The genotype frequency and polymorphism for VDR for the patients and their pedigree were detected by using polymerase chain reaction (PCR) combined with restriction fragment length polymorphism (RFLP). RESULTS: The frequency of allele T and t accounted for 94.6 % and 5.4 % in the total populations. No tt genotype were detected. The fathers of probands carried more allele t than the mothers(9.8% vs 1.6%, P=0.005). The frequency of allele F and f accounted for 57.1 % and 42.9 % in the total populations. The result of family based associated test (FBAT) including additive model, dominant model and recessive model showed that different alleles of Taq I and Fok I had no correlation with the onset of AgP(P>0.05). CONCLUSION: This was the first time to detect the VDR gene polymorphisms in Chinese families. The result of FBAT analysis can not show the correlation between vitamin D receptor gene polymorphisms (Taq I and Fok I) and the onset of AgP.

[Correlation analysis between plasma levels of 25-hydroxy vitamin D3 and osteocalcin in patients with aggressive periodontitis].

OBJECTIVE: To explore the relationship between plasmatic 25-hydroxy vitamin D3 (25OHD3) level and plasmatic osteocalcin level in patients with aggressive periodontitis (AgP). METHODS: Thirty four AgP patients and 29 healthy controls were included in this study. 25OHD3 and osteocalcin levels in plasma were measured using commercially available radioimmunoassay kits. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured using a standard hospital analytical technique. RESULTS: Plasmatic 25OHD3 level was significantly higher in AgP patients than that in healthy controls (8.65 microg/L vs 3.10 microg/L; P<0.01). Osteocalcin level was also significantly higher in AgP patients than that in healthy subjects (1.0 microg/L vs 0.8 microg/L; P=0.028). AST level was significantly lower in AgP patients than that in healthy controls(20.0 U/L vs 23.0 U/L). No correlations between the plasmatic levels of 25OHD3 and osteocalcin were detected in AgP patients or in healthy controls (r=0.271, P=0.12; r=-0.356, P=0.58). CONCLUSION: Plasmatic 25OHD3 and osteocalcin concentrations were not correlated but might be influenced by AgP.

[Clinical and radiographic evaluation of class III furcation defects in the treatment using autogenous periodontal ligament cells with or without enamel matrix derivatives].

OBJECTIVE: To evaluate whether the use of periodontal ligament cells(PDLC) with or without enamel matrix derivatives(EMD) influences periodontal tissue repair in class III furcation defects. METHODS: Three adult male Macaca fascicularis monkeys were used. Class III furcation defects were created at the mandibular second pre-molars, first molars and second molars. The autogenous PDLC were cultured in vitro with Bio Oss Collagen. Six furcation defects in the 3 monkeys were divided as follows, Group A (one second molar): PDLC/Bio Oss Collagen+EMD; Group B (another second molar): Bio Oss Collagen+EMD; Group C (one first molar): PDLC/ BiojOss Collagen; Group D(another first molar): Bio Oss Collagen; Group E (one second pre-molar): EMD; Group F (another second pre-molar): the empty control. All sites (including buccal and lingual side) were covered with collagen membranes. The monkeys were euthanized at the end of 6 months. The periodontal depth (PD) and clinical attachment level (AL) at the buccal and lingual furcation defects were examined before and 6 months after the implantation. X-rays were also obtained at the same time points. RESULTS: PD and AL were decreased in most sites, the reductions in groups E and F (the second pre- molars) were the most significant, and then in turn were in groups A, C, B and D. The repaired alveolar bones were almost full of furcation area in the second pre-molars, and the relatively clear lamina dura was also found. The alveolar bones in the other sizes only had a little repair, and the obviously low density area still remained in the coronal of the defects. CONCLUSION: The results of this study indicate that class III furcation defects can not be predictably resolved even with the combination of autogenous PDLC and EMD, although they may increase the repair of periodontal tissue in the area of class III furcation defects separately. The sizes of furcation defects and the coverage of gingival flap would influence the outcome of the treatment of class III furcation defects.