The interleukin 1 (IL-1) -activity, and partially the interleukin 2 and 3 (IL-2, 3) -activity of gingival crevicular fluids (GF) were analized to examine the role of immunological kinetics in marginal periodontitis. And peritoneally elicited macrophages of mice (PEC M.O) were stimulated with several bacteria to estimate the ability of bacteria to induce the production of IL-1 by macrophages. Extracellular and intracellular IL-1 activity were separately measured.
The results were as follows:
All of GF examined had IL-1 like (GFIL-1) activity. A significant linear relationship was obtained between the pocket depth and GFIL-1 activity, when defined the samples from the pockets under 8mm. Analysis of two samples which had high GFIL-1 activity, revealed that the molecular weight of this activity was 13.5-17 KD.
None of GF samples examined had IL-2 and IL-3 activity.
The ability to induce the production of IL-1 by PEC M.O was high in such bacteria that had high endotoxic activity. This relationship was also found in the case of bacteria which were thought to be pathogenic in periodontitis.
Findings suggest that the analysis of endotoxic activity of bacteria which exist predominantly in inflamed periodontal tissue, and of actual status of IL-1 producing cells, might give support to the understanding of marginal periodontitis.

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The purpose of this study was to evaluate the relationship between gingival condition and malpositioned teeth in low level. The degree of malposition of upper lateral incisors and lower second premolars of 365 dental students was examined using a new malalignment index (new MPI). Probing depth, sulcular bleeding index, plaque accumulation and width of attached gingiva were assessed and compared between malpositioned and non malpositioned teeth. The tooth brushing methods of scrubing and rolling were choiced for the experiments of plaque elimination.
Clinical parameters except width of attached gingiva of malpositioned teeth having new MPI score of above 3 were higher than that of non malpositioned teeth. The rate of plaque elimination of the teeth having new MPI score of above 3 was lower than that of non malpositioned teeth.
These data suggested that the teeth having new MPI score of above 3 were difficult to remove the plaque satisfactorily by routione tooth brushing methods and susceptible to gingival inflammation.

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Previous studies have shown that periodontally diseased exposed roots have biologic toxicity. The purpose of this study was to clarify that water soluble substances eluted from exposed roots, show biologic toxicity.
19 periodontally diseased teeh and 3 normal teeth were bisected and half was rinsed in PBS using a magnetic stirrer. Furthermore, 12 normal teeth were bisected and half was immersed in the solution obtained by rinsing periodontally diseased teeth. These treated teeth were incubated in a culture medium with fibroblasts, and after 48 hours, the number of adherent cells on the root was calculated. 21 periodontally diseased roots were rinsed in PBS. One half of this PBS solution was concentrated (P), the other half was treated with (NH4) 2SO4, centrifuged and divided into supernatant (Psp) and precipitation (Ppt). 12 normal roots were rinsed in PBS and the PBS was concentrated (N). As control, PBS was prepared. Each of the solutions were added to the culture medium with fibroblasts, and after 48 hours, adherent cells on the glass were calculated and were examined by light microscope. Furthermore, concerning each of the 5 solutions, the Limulus lysate assay was performed.
The results were as follows;
1. Of the 17 periodontally diseased teeth, more cell adherence was seen in the rinsed group than the non-treated group, but of the 3 normal teeth, there was no significant difference between the rinsed and the non-treated.
2. Of the 12 normal teeth, less cell adherence was seen in those immersed in the solution.
3. Concerning cell adherence, there was no significant difference between cells added to (N) and the control, but less cell adherence was seen in cells added to the other 3 solutions.
4. As to endotoxin value, (P) was 10 times as much as (N), and the value of (Psp) was less than (N).
This experiment showed that the biologic toxic substances are capable to be eluted from periodontally diseased roots by PBS rinsing, and it is strongly suggested that one of the substances is endotoxin.

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The purpose of this study was to evaluate the periodontal response following implantation of differ-ent types of hydroxyapatite granules (size: 400630μ) in experimental periodontal defects of two mon-keys. 3-wall wide periodontal osseous defects with exposed root surface were prepared for this experi-ment. After surgical debridement of these periodontal defects, 3 types of hydroxyapatite (HA) granules 1) B type porous HA fabricated by H₂O₂ bubbles method 2) F type porous HA fabricated by polyurethane form method 3) dense HA granules, were implanted res-pectively. Non-implanted, surgically debrided defects served as controls. During the experimental period, plaque control was performed 3 times a week. Then, monkeys were sacrificed at 12 weeks postoperatively.
The results were as follows:
1. Clinically, the healing process was uneventful in four groups. 2. Histologically, new bone formation was found in four groups. In the HA implantation groups, new bone deposited on the surface of HA granules directly without a lining of fibrous connective tissue. In B type porous HA group, HA granules were usually conjugated each other by new bone.
3. The B type HA group showed the greatest amount of connective tissue attachment in four groups and significantly greater than control group.
4. The “defect fill” of three implantation groups (filled with new bone and HA) were significantly greater than the “defect fill” of control group (filled with new bone) and B type porous HA group showed the greatest “defect fill” in four groups.
From these results, it suggest that B type porous HA granules may be more favorable to use in perio-dontal treatment than others two types of HA.

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The purpose of the present study was to design mainly a histopathologic evaluation following tricalcium phosphate (TCP) graft into experimental-ly diseased bony defects.
Eighteen two-and one-walled vertical bone defects were involved plaque accumulation for 3 months using wire ligature with resin in 5 dogs. TCP was implanted into these 9 defects and other 9 defects were left for no implantation of TCP after curettage of granulation tissue and root planing.
To evaluate osseous repair of alveolar bone, a three-colour labelling method with Tetracycline, Calcein and Alizarin red S was used immediately, 5 and 10 weeks after surgery.
Eleven weeks after surgery re-entry surgery was performed and the depth of defects was measured. Fifteen weeks after surgery the animals were sacri-ficed for histological evaluation.
The results were as follows:
1. In experimental site where TCP was implanted, osseous repair occurred in length of 4.9±1.9mm, while bone formation of control site was found in length of 1.7±1.1mm. The former was significantly superior to the latter.
2. In control site newly formed bone was observed in layered architecture, while in implanted site bone remodeling extended from the base of defects to the alveolar crest and surrounded the TCP resorbed from inside and outside.
3. New attachment was observed in both of experimental and control sites.

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The purpose of this study was to investigate the effects of topically app±lied specific antibody on the gingiva of Actinomyces viscosus Nyl R2 infected rats in experiment 1 and the effects of anti-A. viscosus Nyl R2 antibody on the peritoneal phagocytic func-tion in experiment 2.
In experiment 1, 27 wistar rats after ablactation were divided into 3 groups, antibody-, PBS-, chlorhex-idine applied groups. At 4 weeks of age, A. viscosus Nyl R2 was inoculated in three groups. All groups fed powdered diet throughout experimental period.
At 2 months and 2 weeks old, 0.2 ml of anti-A. vis-cosus Nyl R2 gamma globulin, PBS and 0.2% chlo-rhexidine was topically applied into oral cavity of antibody-, PBS- and chlorhexidine-applied rats for 21 days, respectively. After the rats were sacrificed and the maxilla was excised, the left side was used for bacterial count and the right for histological evalua-tion.
In experiment 2, 17 weaned rats were divided into 2 groups, antibody-and PBS-injected groups. A. viscosus Nyl R2 was injected in these groups. Six hours after injection, peritoneal exudate was collected for bacterial count and phagocytic activity.
In experiment 1, colony forming unit of A. viscosus Nyl R2 was 7.10±0.53, 6.88±0.65, 6.53+0.47 in PBS-, antibody- and chlorhexidine-applied groups, respectively. In histological analysis, there was no significant difference in polymorphonuclear leukocytic count among 3 groups. In experiment 2, peritoneal cell count increased in antibody-injected group com-pared to PBS-injected group. However, no increase in phagocytic activity was observed in antibody-in-jected group.
It is suggested that anti-A. viscosus Nyl R2 anti-body activated chemotaxis of peritoneal cell and showed a slight inhibitory effect on A. viscosus Nyl R2.

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Subsets of T-cell and B-cell from peripheral blood of normal individuals and patients with adult chronic marginal periodontitis were analyzed by means of flow cytometry system. The proportions of OKT-3, OKT-4, OKT-8, Leu-12 positlive cells and OKT-4/ OKT-8 ratio of patients were 61.25±11.40%, 40.83±7.22%, 21.73±5.70%, 8.25±3.12% and 2.01±0.71, respectively, while those of normal individuals were 64.40±8.69%, 36.39±4.47%, 27.30±4.56%, 10.19±2.73% and 1.29±0.22. Distribution of OKT-8 positive cells and OKT-4/OKT-8 ratio had significant differences between normal individuals and patients. Increase of B-cell was recognized as corresponding to the increase of OKT-4/OKT-8 ratio in patient's peripheral blood. High proportion of B-cell is predicted to bring about the destruction of T-T or T-B interaction by a decrease of OKT-8 positive cells. And the conversion of a stable T-cell lesion to a progressive B-cell lesion may be caused by alteration of regulation of the immune response.

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The effect of in vivo administration of disodium ethan-l-hydroxy-1.1-diphosphonate (EHDP) on the mitogenic response of thymocytes or spleen cells were studied in young rats. When rats (2-3 weeks of age) were injected with EHDP (10mg/kg/day) subcutaneously for more than 6 days or injected once with EHDP (100mg/kg) subcutaneously or intraperitoneally, lipopolysaccharide-induced proliferative response of spleen cells were diminished. The in vivo administration of EHDP did not affected the proliferative response of thymocytes or spleen cells to concanavalin A. These results indicated that the in vivo administration of EHDP did induce the dysfunction of splenic B lymphocytes but not that of T lymphocytes.

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The purpose of this study was to investigate the effect of periodontal disease on microhardness of human root dentin. Microhardness of root dentin was measured by the microhardness tester with knoop diamond indenter. The measurement points were from cement-enamel junction to pulp side at 10, 30, 60, 90, 120, 150, 200μm distance.
The results were as follows:
1. The microhardness of root dentin beneath exposed cementum under 20μm of the thickness was significantly lower than unexposed one at 10μm distance from cement-enamel junction.
2. The effect of periodontal disease on microhardness of root dentin was different at different root levels. At the cervical root level, the microhardness of dentin beneath exposed cementum under 20μm of the thickness was significantly lower than unexposed one. No significant microhardness differences were found in the dentin at the middle or apical root levels.

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Fasting blood sugar (FBS), glycosylated hemoglo-bin (HbA₁), time elapsed from the initiation of the disease, the type of undergoing treatment, complica-tions, body mass index and blood pressure are said to reflect the degree of control over diabetes. The aim of this study is to examine the relationship between the degree of control over diabetes and the periodontal condition.
One hundred forty seven diabetic patients of the 3rd department of internal medicine, Tohoku Univer-sity Medical School Hospital were the subjects of this investigation. The amount of gingival fluid measured by the “Periotron”, bleeding index, pocket depth, O'Leary's plaque control record were also obtained to evaluate their periodontal condition.
Poorly controlled diabetic patients to have rather advanced periodontal disease.

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Seventy six severely disabled patients taking di-phenylhydantoin (DPH) hospitalized in 2 institute in Miyagi Prefecture were the subjects of this investi-gation. The relationship between the gingival hyperplasia and the DPH dose, as well as periodontal status was estimated. The degree of gingival hyper-plasia was measured using 5 grades of classification of Stern (1943).
The group having higher gingival hyperplasia score possessed deeper probing pocket depth (PD) and larger plaque index (P1 I). Any significant relation-ship was not detected between the grade of gingival hyperplasia and the amount of gingival bleeding (bleeding index and salivary occult blood level).
Although there were no significant difference in age level, body weight, daily DPH dose and the period of receiving the DPH, higher gingival hyper-plasia group took larger amount of daily DPH dose per unit body weight than the other group.

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Sixty five severely disabled patients hospitalized in 2 institutes in Miyagi Prefecture were the subjects of this investigation. Oral hygine procedures as well as the meaning of plaque control were taught to the nurse who took care of the patients. The periodontal status of the patients have been manitored for 2 years.
The brushing of 3 times a day using an ordinary tooth brush was adopted in one institute. Gingival bleeding (bleeding index; BI, salivary occult blood level), plaque index (P1 I) and probing pocket depth (PD) were remarkably improved by the brushing. The decrease of PD in patients taking diphenylhy-dantoin (DPH) was larger than those who took no DPH.
In another institute, more improvement in BI and P1I, was observed using electric toothbrush.
Combined application of the electric toothbrush and the interdental brush is effective for the severely disabled patients.

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This study was carried out to investigate epidemiological survey of periodontal disease of the middle and old age people in Fukuoka Region. 107 subjects who took a medical health examination were divided to three groups, according to the age (40-49, 50-59, 60-69). The clinical survey including the number of remaining teeth, modified-Periodontal Disease Index (m-P.D.I.), Gingival Bleeding Index (G.B.I.) and the condition of the calculus deposition, was carried out. Furthermore, it was investigated the effect of oral hygiene training.
The results obtained were as follows.
1. The average number of remaining teeth and the ratio of the persons with dental calculus were decreased as increasing of age.
2. The average index of m. P.D.I. and the number of the persons who represent deep periodontal pockets were increased as increasing of age.
3. The increasing ratio of the persons to be required the complex treatment including the periodontal surgery were observed as increasing of age.
4. In 50-59 age group, the score of the G.B.I. was significantly lower than those of the other groups. 5. About a quarter of the subjects have been instructed in oral hygiene technique in the past, but these experience brought no significant differences in the average of the m-P.D.I. and the G.B.I..

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The purpose of the present investigation was to evaluate the usefulness of clinical parameters of periodontal disease in predicting or detecting destructive periodontal disease activity. Periodontal disease activity was determined by measureing the change of alveolar bone loss in period of 21.3 months on the average (study I) or the change of probing depth in period of 4.4 months on the average on the average (study II). Study I was performed on 48 patients ranged from 24 to 59 years old, and study II was performed on 15 patients ranged from 29 to 59 years old. The number of sites that showed or did not show disease activity and the absence or presence of clinical parameters before or after the monitoring period were computed.
The results were as follows.
1. The incidence of sites which showed disease activity was 18.5% in study I and 1.9% in study II, respectively.
2. Statistical analysis revealed that almost all of clinical parameters investigated in this study did not correlated the disease activity.
3. Clinical paramentes which correlated disease activity were loss of contact, restoration at gingival margin, caries at gingival margin, bone loss over 50%, and gingival redness or swelling in study I, and molar, restoration at gingival margin, and caries at gingival margin in study II.
4. When disease activity of individual diseased site was diagnosed by the clinical parameters, the diagnostic probability was ranged from 0% to 40%. These results suggested that the clinical parameters were not able to predict or detect disease activity at individual sites.

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The purpose of the present study (Report 1) was to investigate the effect of diameter of toothbrush bristle and that of form of toothbrush tip on the toothbrushing pressure and plaque removal in Scrubbing method.
Six different kinds of toothbrushes were developed, which were different in diameter (0.18mm, 0.25mm, 0.33mm) and in form of toothbrush bristle tip (round cut, straight cut). Twelve subjects participated in this experiment. Plaque scores were measured before toothbrushing and after toothbrushing, and plaque removal rates were calculated.
The toothbrushing pressure was determined by Watanabe's method.
The results were as follows: Toothbrushes of bristle in larger diameter showed significantly more higher plaque removal (p<0.01), and significantly more larger brushing pressure (p<0.01). Toothbrushes of round cut tip showed more larger toothbrushing pressure than those of straight cut. Toothbrushes of round cut tip had a tendency of showing higher plaque removal than those of straight cut.

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In an attempt to determine how the degree of the experimental stain removal and roughness of the metallic plate would be affected by air scaler and airpower abrasive system instrumentation, quantitative measurement and morphological observations were made.
The results obtained were as follows:
1. On the stain removal, larger effect was obtained by air-power abrasive system than by air scaler.
2. On the roughness of the metallic plate, larger defect was observed by air scaler than by air power abrasive system.
3. Rippling waves were observed under air scaler scanning electron microscopically.

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The purpose of this study is to develop a reliable stereoradiographic system to observe teeth and their supporting structures. A film holder, a bite wing, and a pointer were the main components of thecollimting device. Two x-ray tubes and a stretching pointer were assembled which was mounted on the 5 joint arm. The distance between the foci of the two tubes was 9.6cm. The main beams of the 2 tubes cross to each other at 55cm from the mid point of the foci. The angle made by the 2 beams was 10 degree. The geometric relationship between the x-ray tubes and the collimator was maintained by adjusting both pointers. Two films were used to obtain a stereo-image. A film was mounted on the film holder and irradiated by a x-ray tube, then the film was changed and the irradiation was made by another tube.
A stereoscope (Topcon Co. Ltd.) was used to observe the stereo-image. If the observer was accustomed to it, stereognosis of the image was also possible by unaided eye observation.
Extracted teeth, dry human upper and lower jaws were used to evaluate the system. A few clinical investigations were also made. A Piece of wire was inserted to the periodontal pocket to indicate the bottom.
The stereoradiographic system described here is useful to obtain 3-dimensional image of teeth and their supporting structures.

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A basic study was made to examine what extent of radiographic changes pertaining to early periodontal disease. The standardized radiography was used to assure geometrically identical radiographs. Artificial bone defects were produced by stages at the proximal bone crest using humane dry mandible. And as to when changes occurring in the bone on dental film can be recognized, visual assessment was made by the use of diagnostic accuracy curre and contrast measurement by means of microdensitometry. A study was also made as to whether the changes in the edge of the crestal cortical plate and the entire changes in the creastal part of the alveolar bone can be recognized by identiying them visually.
The result showed that contrast of 0.03 was required to identify changes in the crestal part of the alveolar bone visually on dental film. However, it was difficult to discriminate the bony changes which occur in the edge of the crestal cortical plate from those on the lamina dura.

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Granular hydroxyapatite (HAP) was applied clinically to periodontal therapy as a bone graft material. HAP was implanted into periodontal osseous defects following root planing and defect debridement in full thickness flap operation. Twenty-nine lesions of twenty-two patients affected by marginal periodontitis underwent flap operations and were observed postsurgically for six months. Redness and swelling of gingiva, postsurgical pain and increase of tooth mobility appeared transiently, but they recovered in short time. Open wounds in fifteen lesions and discharge of HAP in eighteen disappeared in first two weeks. After postsurgical six months, the average number of clinical attachment gain was 3.1 mm and it was impossible to discriminate between HAP and repaired alveolar bone on dental X-ray films. These above-described results indicate that HAP has a definite potential as a bone graft material in periodontal therapy.

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Several instruments to obtain the gigiva from the palate have been developed. In order to obtain wide graft, it is necessary that the curve of the blade fit to the shape of individual palate.
But the shape of the palate differs from person to person, so obtaining the grafts which is wide and thick as required, is not easy. It is ideal, if there is an instrument which can change the curve of the blade according to the shape of the palate.
We have developed an instrument which can change the curve of the blade by rotating the handle. The blade of this instrument can fit to the shape of the palate which differs from person to person and it can obtain easily the widest palatal gingiva and furthermore, it is easy to manage in the oral cavity.

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Using newly developed automatic constant-force periodontal probe (probie) and equipped with computer system, the computerized charting of the pocket depths for every tooth surface and for both arches of the periodontal diseased patient was accomplished observing 6 points on each tooth.
Results were summarized as follows.
1. Computerized charting of gingival level, pocket depth, attachment level and gingival recession for every tooth surface of both arches were able to measured easily, accurately and quickly.
2. It took a 10.32 min. for measurement of a patient and a 20.38 min. was required for developing the date in colored figure and also 6 values of each point of the observation.
From the computerized charting of probing depths the progress condition of periodontal pocket can be observed. This method is most useful for the diagnosis, treatment planning, prognosis and reevaluation of treatment of periodontal disease. It is the best method of examination and evaluation.
Beside, it can also be useful for the motivation of the patient and recall system.

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The Odontoson 4N Special® (Goof Co.), an ultrasonic scaler equiped with a pressure tank, allows scaling inside periodontal pockets while washing with a medical fluid. In the present study, we compared the effects of iodine using this ultrasonic scaling method with results using a manual scaler or the usual ultrasonic scaler. The subjects were five patients who visited our clinic department (two men and three women ranging in age from 32 to 45 years). The teeth examined were anterior teeth and premolars with a probing depth (PD) of 4mm or more. Physiological saline was used for 78 teeth, iodine for 168 teeth, and a maunal scaler for 54 teeth.
All subjects were sufficiently instructed in oral hygiene prior to scaling. The teeth were examined for P1I, PD, GBI and AL before scaling and one, two and three months interval after scaling. As a result, a marked improvement in PD was found one month after scaling withiodine, the improvement rates rates being in the order of iodine (34.8%) >manual scaler (30.0%) >physiological saline (27.4%). Although the conditions were similarly improved in all groups of teeth at three months, the results tended to be particularly favorableafter scaling with iodine.
The PD was decreased to 1-3 mm at three months in almost all teeth in each of groups: 99.4% in the iodine group, 98.7% in the saline group, and 94.4% in the manual scaler group.
The marked decrease in PD was attributable to gingival recession, with concomitant AL gain in some cases.

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