Spontaneous correction of pathologic migration following periodontal therapy.

Two case reports illustrate spontaneous correction of pathologic migration following periodontal therapy. In one case, the displaced teeth were repositioned without orthodontic appliances after nonsurgical and surgical periodontal treatment. In the other case, closure of a diastema occurred following only nonsurgical therapy. The predictability of these findings needs further investigation. A discussion of possible reasons for this type of tooth movement is included.

Drug-induced gingival overgrowth.

Certain anticonvulsants, cyclosporine, and a variety of calcium channel blockers have been shown to produce clinically and histologically similar gingival enlargements in certain susceptible patients. These drugs appear to be similar with respect to their pharmacologic mechanism of action at the cellular level. The primary target tissue is the most essential difference among them. Therefore it is tempting to speculate that these agents may act similarly on a common secondary target tissue, such as gingival connective tissue, and cause a hyperplastic response. This tissue reaction may involve a disturbance of calcium ion influx into specific cell populations with a resulting alteration in collagen metabolism and other host cell response mechanisms. A connection between ion exchange, folate uptake, collagenase activation, and bacterial inflammation may exist. Until a more effective approach can be developed from future research results, treatment should continue to emphasize plaque control, professional debridement, and resective gingival procedures to improve function, esthetics, and access for home care.

Sensitivity of Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus to oxidative killing.

We examined the killing of Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus by oxygen metabolites generated by the xanthine-xanthine oxidase (X-XO) system. This system generates a mixture of oxidants, including superoxide radical, hydrogen peroxide, hydroxyl radical, and possibly singlet oxygen. Differential sensitivity to the X-XO system was observed among strains of A. actinomycetemcomitans; notably, 2 catalase-deficient strains and 2 strains representative of serotypes b and c were the most susceptible. H. aphrophilus was not sensitive. The amount of oxidants produced by the X-XO system more closely correlated with killing than the ratio of oxidant production. Cytochrome c, superoxide dismutase, catalase, dimethyl sulfoxide, and desferrioxamine were used to determine the role of superoxide radical, hydrogen peroxide and hydroxyl radical in the bactericidal process. Hydrogen peroxide was the major bactericidal agent against A. actinomycetemcomitans. Superoxide anion participated in killing of A. actinomycetemcomitans to varying but lesser degrees. The intracellular generation of hydroxyl radical was implicated in the killing of several strains. We conclude that (i) strains of A. actinomycetemcomitans are differentially sensitive to the bactericidal effects of the X-XO system and (ii) of the oxidants produced by the X-XO system, hydrogen peroxide is the most bactericidal against A. actinomycetemcomitans.