β-Lipoprotein, which is located at β-globulin in terms of electrophoresis, has been known for many years. Centrifugally, this substance belongs to low-density β-Liporotein and its own density is established at twofold measurement of 1.019-1.063 and 1.006-1.019. However, the particle size falls the midway between α-Lipoprotein and pre-β-Lipoproten. Being a complex protein made up of fatty substance and protein as its main components, β-Lipoprotein is generally held to play an important part both in the transfer and metabolism of fatty substance. A full-scale research on β-Lipoprotein can be said to have begun just recently because of difficulties involved in its storage, unstability of its molecules and analytical methods. Yet, by way of clinical implications, the anomaly of β-Lipoprotein has been reported in the blood serum of patients suffering from the cases of arterioscleosis, liver complaints, and other diseases, and the level of β-Lipoprotein is given much importance in determining a diagnosis. In the oral realm, on the other hand, research efforts on β-Lipoprotein are still rather scanty except those by Miyamoto and others, who reported that, as compared with controls, the level of β-Lipoprotein in an experimental group of the periodontal patients was somewhat higher. In the present study, the author conducted the measurement of values of β-Lipoprotein in the blood serum in association with the progree of chronic cases of marginal periodontitis. At the same time, further effort was made to look into changes, that occurred both before and after the treatment of these cases, so that some interesting correlations might be found. By way of study material, a total of 330 subjects was carefully selected. The subjects thus selected consisted of 124 male and 122 female patients diagnosed as the casese of chronic marginal periodontitis in the Department of Periodontology, Nihon University School of Dentistry from January 1971 to October 1973, and 42 healthy males and 42 healthy females of the same age, the latter serving as controls. As and experimental method employed, the value of β-Lipoprotein of a given periodontal patient was measured on his or her initial examination and, subsequently, a treatment was undertaken. An operative or conservative treatment was effected to the group P1 patients, whereas surgical treatments were effected to the groups of Pa and P3 patients for the upper and lower jaws. At time-points where the wound surfaces of first operations appeared to be nearly healed, that is, in 20 to 40 days post-operatively, the blood was collected for the second time. With these blood samples, the values of β-Lipoprotein were measured with the Heparin-Ca sedimentation method. On the strength of the findings, the author arrived at the following conclusions. 1. As for the values of β-Lipoprotein, there was no statistical significance between the male and the female. 2. The values of β-Lipoprotein revealed a tendency of increase proportionally to the age both in the normal subjects and patients of chronic marginal periodontitis. 3. When examined in different degrees of the disease (P1→P2→P3), the level of β-Lipoprotein was observed to increase in proportion to the aggravation of the disease. Compared postoperatively, all these three groups showed a tendency of decrease than preoperatively. 4. From the findings given above, it is to be concluded that the chronic marginal periodontitis has some kind of correlation to the level of β-Lipoprotein in the blood serum.
Although there have been published many methods for the measurement of the degree of tooth mobility, the majority of them are far from practical. In the present study, the author developed a new measuring apparatus for the same purpose, where two cylinders having different internal diameters were applied. The results of the study, in which various degrees of the tooth mobility were measured by this new apparatus, were as follows. 1. A high accuracy of the new apparatus was confirmed. That is, when the measuring part A was used, the measurement precision was about 5 times as high as that of the Periodontometer and, when the measuring part B was used, it was about twice as high. 2. As for the record of the new apparatus for the subjects in possession of normal periodontal tissues, coefficient of variation was 0.20 with the measuring part A, and it was 0.79 with B. This fact showed that the variation is extremely small. 3. When the new apparatus was applied to the subjects in possession of normal periodontal tissues, respective degrees of tooth mobility were 106 by the former and 114 by Periodontometer. A high statistical difference was observed between the degrees of the tooth mobility subjected to various loads. 4. When the new apparatus and the Periodontometer were used at the same time for the measurement of the same teeth to which different loads of 50g, 100g, 200g and 300g were exerted, it was seen that a pronounced difference took place between the two when a load of 50g was applied, with the measurement value by the new apparatus being larger. With loads of 200g and 300g, however, there were no appreciables defference between the sets of values by the new apparatus and the Periodontometer. 5. A high degree of correlation was establisheb between the degrees of alveolar bone resorptionobtainedby Bjorn's method and the degree of tooth mobility as measured by the present apparatus. 6. When the present appartus was used to measure the degree of tooth mobility under a load of 500g, the following values were obtained. That is, with the subjects in possession of normal periodontal tissues the degree of tooth mobility was below 150 those teeth which were diagnosed as P1 were from 150 to 250, those of P2 were from 250 to 400, and those of P3 were from 400 to 1500. As were confirmed by the results given above, it is to be concluded that the present apparatus, which is simple in its structure and is capable of making precise measurements, may be readily adopted for clinical purposes.
β-Glucuronidase activities in gingival fluid from patients with periodontal disease were measured by a modified Fishman's method (Kaizu's method), and compared with various clinical findings such as PMA-index by Schour and Massler, DI-score and CI-score by Green and Vermillion, pocket depth (mm) by a pocket marker, alveolar bone loss (%) by Schei et al., quantity (mg) of gingival fluid and salivary pH. The following results were obtained: 1. The β-glucuronidase activities in gingival fluid were able to demonstrate and measure in all subjects. 2. Statistically significant correlations were shown between β-glucuronidase activities and the following clinical findings; PMA-index (P<0.05), DI-score (P<0.01), CI-score (P<0.05), pocket depth (P<0.001), alveolar bone loss (P<0.001) and quantity of gingival fluid (P<0.01), except salivary pH. 3. The β-glucuronidase activities of periodontal disease groups were remarkably higher than that of clinical healthy group (P<0.01), and had a tendency to increase according to the progression and aggravation of the disease. It is concluded from these results that the β-glucuronidase activity in gingival fluid is closely related to each clinical finding and process of periodontal disease.
The histamine contents in whole saliva and gingival fluid collected from patients with periodontal disease were measured fluorometrically by Anton-Sayre's method, and compared with various clinical findings such as PMA-Index, OHI-score (debris score+calculus score), pocket depth (mm) and bone loss (%). The gingival fluid was collected from gingival sulcus by paper strips. The following results were obtained; 1. Anton-Sayre's fluorometric method was able to measure histamine in concentrations from 0.05 to 10.0μg/ml. 2. The histamine contents in whole saliva were showen to have marked correlations with pocket depth (P<0.001) and bone loss (P<0.001), but no significant correlation was found with other clinical findings. 3. The histamine contents in gingival fluid from all clinically healthy subjects were able to be measured. 4. Statistically significant correlations were showen between histamine contents in gingival fluid and following clinical findings; pocket depth (P<0.001), bone loss (P<0.001) and fluid quantity (P<0.001), except PMA-Index and OHI-score. 5. A statistically significant correlation was showen between histamine contents in whole saliva and gingival fluid (P<0.001). 6. In the group of patients that were examined on the basis of clinical findings and X-ray photos, the histamine contents in whole saliva and gingival fluid had a tendency to increase according to the progression of periodontal disease. It is concluded from these results that the histamine contents in whole saliva and gingival fluid are closely to the occurence and process of periodontal disease.
In relation to clinical and histological findings of gingiva, local microcirculatory system of hamster gingiva was studied on its morphology and the blood flow according to the 133Xe clearance method under the four different thermal irritations. The results were as follows: 1) No change on the morphology of blood vessels and the amount of blood flow was observed in the control group, 37°C (preliminary experiment) group, which exhibited no abnormal clinical and histological findings of gingiva. 2) 45°C group exhibited similar findings to the control group, i. e. no changes were observed in its clinical and histological findings of gingiva and the morphology of blood vessels as well as the amount of blood flow. 3) 55°C group showed normal gingival findings clinically, however, a slight disturbance was observed histologically, and morphological changes of blood vessels together with the persistent decrease of blood flow were recognized. 4) 65°C group and 75°C group showed considerable disorders on clinical and histological findings of gingiva and, in accordance to those, morphological changes of blood vessels and the decrease of the amount of blood flow were observed. From these results, it may be concluded that the amount of blood flow decreases when gingiva is suffered from some pathologic conditions such as inflammation. Even in the clinically normal gingiva, the changes in blood flow were found when pathologic conditions were observed histologically.
1. The author deviced an apparatus for measuring tooth-mobility in which a small electromicrometer is applied. This apparatus is composed of several parts, such as a detector, the supporting device by which the detector is fixed in oral cavity, an amplifier, and an automatic pen-recorder. 2. As this apparatus is compact and light in weight, it can be fixed easily in oral cavity and be used conveniently. 3. The most characteristic efficiency of this apparatus as compared with the tooth-mobility tester applied a dialgage is that not only the quantity of the displacement by load (tooth-mobility) can be measured but also the changes of displacement with the lapse of time (the phase of tooth-movement) can be observed. 4. However the range of measurement of this tester is within ±250μ, severe moving tooth can not be tested. And also it is unsatisfactory for the measurement of molar teeth.
About 35 upper central incisors having different periodontal conditions, the returning phase of the tooth from labial to the original position after sudden removal of labial forces (50g, 100g, 200g) was observed by using the tooth-mobility measuring apparatus applied a electromicrometer which was reported previously. The results are as follows: 1. Two different aspects was observed in returning phase of the tooth and designated as rapid return phase and slow return phase. 2. The author classified various types of returning phases of the teeth into four types. 1) Gradual perfect return type: the tooth return perfectly to the original position in about 180 seconds. 2) Quick perfect return type: the tooth return quickly and perfectly to the original position in about 60 seconds. 3) Imperfect return type: the tooth can not return perfectly to the original position even after the lapse of 180 seconds and leaves the displacement of several microns. 4) Lingual displacing type: the tooth displaces lingually beyond the original position.
Inflammatory changes of hexosamine and collagen in the human gingival tissues were studied quntitatively. Careful comparison was made between the free gingiva as a severely diseased tissue and the attached gingiva as a least diseased one. It has been demonstrated that hexosamine in a higher level and collagen in a lower level were present in the free gingival tissue by comparison with the attached gingival tissue.
One hundred and six extracted upper first premolars with one root were examined for the incidence of the lateral grooves on each root surface, and their length and their form on the mesial surface. The results were as follows: 1. The incidence of lateral grooves on both mesial and distal surfaces was 73.6%, on mesial was 17.9%, and on neither surface was 6.6%. 2. As regard to the length of the groove, half of the grooves that originate from between the neck of the root and one-third of the root run across the one-half of the root. 3. The form of the groove was divided into three categories by bucco-lingual ground sections of plastic tooth casts-flat type in 46.5%, shallow concaved in 39.4% and narrow V-shaped in 14.1%.
This study was carried out to compare the effects in open interproximal areas on the plaque-removing ability of 1) toothbrushing plus the use of the interdental brush (Denticator Co.), and 2) toothbrushing plus the unwaxed dental floss (Gudebrod Bros. Silk Co.). Ten adults, without prosthetic restorations within or adjacent to the test areas and abnormal arrangement of the teeth, were devided into two groups. The participants performed either interdental cleaning procedure alternately at one week interval. The test teeth were consisting of first molars, lateral incisors and were in contact normally with neighbouring teeth and had open interdental spaces. The bucco-menial surfaces of the test teeth were estimated. The toothbrushing alone by modified Stillman's method removed 58% of interproximal plaque deposited at test areas, however notciable reduction of dental plaque were achieved by additional use of interdental cleaning devices (interdental brush 95%, dental floss 86%). There was no statistically significant difference between two. It has been concluded that it is difficult to clean the interproximal areas only using the toothbrush, and that the use of interdental brusn is effective for the interdental cleaning in open interproximal areas.
This investigation was designed to study whether mutanolysin and chlorhexidine gluconate using a water pressure irrigating device was effective in removing or preventing formation of dental plaque. The nine subjects were devided into three groups of three subjects each according to a Latin Square design. Each subject took part in three cycles of oral prophylaxis, mouthwash assignments and accumulated plaque evaluation for a three week period. The results of an analysis of variance showed statistically significant difference at 1 percent level between the chlorhexidine gluconate group and placebo group and at 5 percent level between the mutanolysin group and placebo group. The difference between chlorhexidine gluconate group and mutanolysin group was also significant (p<0.05). Chlorhexidine gluconate was more effective on dental plaque than mutanolysin. The plaque control effect of chlorhexidine and mutanolysin was more striking in labial surface than in any other surfaces of the teeth.
The pattern of bone destruction in periodontal disease is classified to horizontal and vertical bone resorption. To explain the causes of vertical bone resorption, various theories have been proposed and they may be classified as follows: 1) Occlusal traumatism with local irritation 2) Food impaction However, detailed process of vertical bone resorption by those individual factors has not been clarified yet. The purpose of this study is to get fundamental facts of vertical bone resorption. For this clinical examination, 21 patients with 51 vertical bone resorption were examined. The sites were limited in molar areas and front teeth were excluded. As the result of this study, the following conclusions were observed. 1) The majority (40%) of vertical bone resorption were seen in mesial site of the first molars of the maxilla and mandible. 2) Within 51 vertical bone resorptions, 28 (55%) were associated with food impaction, 35 (69%) with traumatic occlusion, and 20 (39%) with both. 3) Within of 28 food impaction, 9 (32%) were vertical food impaction and 19 (68%) were lateral food impaction.
Mouth breathing is an important etiological factor of chronic gingivitis and chronic marginal periodontitis as well as dental plaque and calculus. However, mechanism of mouth breathing for the initiation of gingival inflammation has not been clearly demonstrated. The purpose of this study is to observe the effect of oral screen and lip seal tape for mouth breathers, during sleeping. Ten patients suffering from chronic marginal periodontitis with habitual mouth breathing were used for this study and experimental periods were 30 days. Before, during and after experimental periods, oral findings were examined and biopsy specimens of the gingiva were taken. Consequently we obtained the findings of clinical changes, pocket depth, thickness of the gums and histopathologic changes of the gingiva. Results were as follows: 1. Halitosis and unconfortable feeling in mouth were decreased clearly. 2. Depth of periodontal pocket and labio-lingual width of the gingiva were improved. They were mainly seen at labial side of maxilla. 3. The histopathologic examination showed that vacuolar degeneration of epithelial cells were reduced, but inflammations of connective tissue were not improved clearly.
A system of using a new refractory die material was introduced to fabricate a permanent splint for mobile teeth with the indirect method and one-piece casting. This technic was clinically applied for three female patient mouth stabilizations and has produced favorable results. Far less time, labor and skill than other technics are required by this die-investing technic.
The measurement of the oral cavity in dynamic conditions at the time of periodontal surgery was conducted for a total of 64 patients with periodontal disease ranging in age from 18 to 54 and the operative space was studied numerically. The results were as follows. 1) The mean width of the dental arch was 64.4mm in the upper jaw and 61.2mm in the lower jaw. The mean length of the dental arch was 54.6mm in the upper jaw 51.2mm in the lower jaw. The mean width and height of the palate were 38.1mm and 15.3mm, respectively. 2) When the mouth was opened naturally, i. e., without feeling fatigue, the same pause of the mouth could be maintained consciously for 15 to 20 minutes as an average. In this condition, the mean distance between the cutting edges of the upper and lower jaws was 44mm, the mean distance between the cusps of the second molar teeth was 25mm, the mean distance between the upper and lower lips was 34.5mm, the mean opening of the mouth was 42.7mm, and the mean internal circumference of the lips was 122.2mm with the mean space of 1, 088.7mm2. 3) In order to obtain an operative space in the vestibular fornix and the proper cavity, it is required to pull and expand the tongue and the buccal mucosa. The space thus obtained was 20mm in mean. 4) In the palatal gum, the mean height of the palate was 15.3mm, the mean length of the crown of the second molar teeth was 7.0mm and the mean distance between the cusps of the upper and lower third molar teeth was 25.0mm. However, in consideration of the floating of the tongue by 5.0mm in mean, the actual distance would be 20.0mm in mean. Consequently, the palatal space available would be the sum of these values, i. e., 42.3mm multiplied by the width of the palate 38.1mm. 5) The capacity of the operative field in the oral cavity as the mouth is opened naturally would be 20mm (space obtained by oppressing the tongue and the buccal mucosa)×42.3mm (mean space of the palatal region)×38.1mm (width of the palate). 6) Accordingly, maneuvers in periodontal surgery should be considered within the extent of such an operative field in the oral cavity as numerically descriebed above.
Because of the special anatomical morphology of the oral cavity, it is difficult in surgical operation to attain every part of the oral cavity by the use of an ordinary straight blade handle. Moreover, the sharpness of the blade is often damaged during the operation since the edge of the blade touches not only the mucous part but also the teeth and alveolar bone. Recently disposable blade developed as surgical knife has been used frequently in periodontal surgery since a sharp blade is available constantly and readily. However, the use of the disposable blade is limited in terms of area since some areas of the oral cavity cannot be attained by the edge of the blade. There have been some types of knives for periodontal surgery such as Ishikawa type and Kirkland type. These types are provided with some angle between the handle and the blade resulting in respective merits. However, one of the demerits is that the blade is apt to become dull during the operation and it may result in an irregular incision and consequently in unsatisfactory prognosis. Moreover, the blade needs to be sharpened before another use. At that time, the sharpening is complicated requiring highly professional skill since the handle and the blade are in a single unit. We have devised a disposable blade handle providing some angle between the handle and the blade mounting part for operation in the oral cavity. The disposable blade handle was clinically applied in periodontal surgical procedure and it proved to be satisfactory.
This is a report on a measurement of tooth-mobility of maxillary left central and lateral incisor after an endodontic endosseous implantation. The absorption of the roots of the teeth was so evident that they should have been extracted, if not implanted. After the implantation, the tooth-mobility of the respective tooth has been measured four times by using a Tooth-mobility meter. The findings are: 1) Right after the implantation, the mobility of the teeth showed on remarkable decrease. 2) After three manths, the teeth began to show a little increase of mobility in comparison to that of right after the implantation. 3) After six months, the left lateral incisor showed an increase of mobility to little extent, while the left central incisor showed almost none. 4) After one year, at the final measurement, the left central incisor had become quite well stabilized, and showed almost no increase of mobility. However, the lateral incisor that had shown a little increase of mobility at the measurement in the third month started to show a tendency of decrease of mobility at the time. Nonetheless, I would say, this phenomenon shoulb be observed and measured for a further study.
A report was made about a long-term clinical observation on a hemisection of the lower first molar or the lower second molar which were obviously destroyed the periodontal tissues located in one of roots. A mandibular molar above were treated by endodontic, flap operation and hemisection. The post operative course as the above has been uneventful without signs of recurrence for 3 years.