The distribution and mode of appearance of fibrous long-spacing (FLS) -type fibrils in collagen fibers in tissues of radicular cysts obtained from 25 patients at the Department of Oral Surgery, Osaka Dental University Hospital, and the Department of Dentistry, Kyoto First Red Cross Hospital were investigated by electron microscopy.
1. Around slightly distended venules within the edematous granulation tissue rich in mucoproteins, FLS-type fibrils were sporadically found in direct proximity to the medial smooth muscle cells and fibroblasts, as well as between these cells. They were also observed around some activated macrophages, intermingled with disintegrating or decomposing collagen microfibrils. In other ataas, they ran in nearly parallel arrays along, and sporadically in contact with, the basement membranes of endothelial or smooth muscle cells, which often adopted a granular to fluffy appearance in transition to these fibrils. In certain highly edematous areas, they adopted a sheetlike structure in some instances, they were observed in association with spiny collagen microfibrils, intermingled with disintegrating collagen microfibrils.
2. All of these FLS-type fibrils were regarded as belonging to Randall's FLS III, and the sites of their occurrence within the granulation tissue suggested the participation of type V collagen, besides that of type III, I and IV collagens.
3. Dialysis of guinea-pig acid-soluble collagen against water (4.. for 24hr) after addition of a Tyrode extract of finely ground, granulation tissue of radicular cysts resulted in the formation of Randall's FLS I collagen in a loose arrangement, besides that of the D-periodic symmetric (DPS) structures.
4. After incubation of minute slices of the guineapig carotid artery and surrounding tissue with bacterial collagenase, large amounts of FLS III collagen were observed in association with adventitial collagen microfibrils. In the case of guinea-pig acid-soluble collagen after incubation with bacterial collagenase, dialysis against water at 4.. for 24hr yielded no clearly defined FLS collagen, while DPS structures were observed in various loose arrangements.
5. After incubation of minute slices of the guineapig carotid artery and surrounding tissue with chondroitin sulfate, spiny collagen microfibrils were observed in groups between the smooth muscle cells, but no FLS collagen was formed. Dialysis of guniapig acid-soloble collagen against water (4.. for 24 hr) after addition of chondroitin sulfate resulted in the formation of FLS I collagen.
6. From these findings, formation of the FLS-type fibrils in radicular cysts was presumed to occur and to proceed by taking advantage of the subacute inflammatory processes, involving breakdown and new formation of the collagen fibers in irregular succession.

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The purpose of the present study was to predict periodontal pocket depths from dynamics in the subgingival microflora or the clinical parameters using methods of multivariate analyses. 3 adult periodontitis patients on maintenance therapy participated in the study. In each patient, 6 sites were selected and investigated both microbiologically and clinically every 2 months through 16 months.
Thus, in aggregate, 158 sites were examined microbiologically and 162 sites were evaluated clinically. Samples of subgingival plaque were taken by sterilized paper points and they were incubated under anaerobic or aerobic conditions for 7 days. We isolated and identified the predominant micro-organisms according to the methods in the V.P.I. manual. The percentage composition of motile organisms was estimated by phase contrast microscopy. Clinical parameters were evaluated as follows: plaque index, bleeding on probing, suppurative index and probing pocket depth. The statistical analysis on microbiological data was carried out as follows: First, in calculating the Spearman rank correlation coefficient between pocket depth and percentage of each micro-organism, total numbers of micro-organisms, we selected 7 high ranking coefficients submitting to explanatory variables. And then we analysed relationships among 8 explanatory variables including pocket depth using principal component analysis. Finally, we determined micro-organisms which correlated with pocket depth using stepwise multiple regression analysis. Clinical data were analysed as follows: First, we provided pocket depth for criterion variable, and plaque index, bleeding on probing and suppurative index for items, and then analysed correlation between pocket depth and clinical parameters using'Quantification theory (I) ' .
Results are stated below:
1. Stepwise multiple regression analysis revealed that about 47 percent of all periodontal pocket depths could be predicted from the three factors of subgingival microflora, i. e. percentages of motile organisms and anaerobic Gram-negative rods, and total numbers of anaerobic cultivated bacteria.
2. 'Quantification theory (I) ' revealed that about 50 percent of all periodontal pocket depths could be predicted from the three factors of the clinical parameters, i. e. plaque index, bleeding on probing and suppurative index.
3. It was also suggested that percentage of anaerobic Gram-negative rods and bleeding on probing were useful parameters to predict periodontal disease activity. But, to clarify this point, longitudinal or quantitative study is further required.

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This study was designed to investigate the influence of the oral flora on the host'simmune mechanism.
After human periodontopathic bacterial antigens were inoculated into the inter-T cell and B cell subpopulations of peripheral blood lymphocytes and serum antibody titer were measured proliferation and the kinetics of T cell and B cell in the site of inoculation was observed.
Haemophilus actinomycetemcomitans, Bacteroides gingivalis, Actinomyces viscosus, Fusobacterium nucleatum and Capnocytophaga ochracea were selected as test bacteria and the supernatans from their ultrasonic disintegration were used as antigens which were inoculated into Balb/c mice divided into the initial inoculation group and the booster group.
Peripheral blood lymphocyte subsets were analyzed by flow cytometry using monoclonal antibodies, and serum antibody titers and tissue lymphocytes were measured by the ELISA method and the immunohistochemical technique using biotin-streptavidin, respectively.
Peripheral blood lymphocyte subsets showed a transistory diminution in T cell in the initial inoculation group. Determination of the helper/suppressor T cell ratio as a parameter of the immunoregulatory function made clear the coexistence of a high-value group and a low-value group. Specific antibody titers showed an interbacterial group difference. Statistical analysis of tissue lymphocyte subsets did not reveal a distinct difference.
The results suggest that inoculation of a bacterial antigen causes a disturbance the immunoregulatory network.

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The purpose of this study was to clarify the effects of oral immunization on the implantation of Actinomyces viscosus (A. viscosus) in hamsters. A. viscosus T14VR (Streptomycin resistant, 1mg/ml) was used for infection and oral immunization. Golden hamsters were given formalinized A. viscosus whole cells by gastric intubation for 16 weeks. Elevated anti-A. viscosus IgA and IgG antibody values in saliva were obtained 4 weeks after beginning of immunization. The elevated antibody activities were kept until the end of experiment (16 weeks). A. viscosus T14VR was introduced into hamsters' oral cavities 7 weeks after immunization and implantation of this microorganism was checked 1, 5 and 9 weeks after inoculation. A significant decreased ratio of implantation of A. viscosus was observed in orally immunized group.
These findings suggested that oral immunization with periodontopathic bacteria might be useful to prevent implantation of these bacteria in oral cavities.

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The process of wound healing after a flap operation, regeneration of the gingival epithelium and gingival connective tissues, was investigated.
Seventy male Wistar rats weighing approximately 90g were used The full thickness of the palatal gingiva was elevated by the operation from M₁ to M₃ in the left maxilla, the right side was the control.
The intervals of observation after the operation were 2, 4, 16, 32, 64 and 128 hrs.
The methods of observation were as follows:
1. The healing process was observed by histopathological examination (H-E staining).
2. Labeled silver grains present in basal cells the gingival epithelium were detected by DNA activity measured by ³H-thymidine autoradiography.
3. The density of silver grains during collagen metabolism was determined by ³H-proline autoradiography.
4. The labeling index of epithelial basal cells was calculated for labeled cells from the elevated flap margin.
The following results were obtained:
1. Judging from histopathological findings, regeneration of the gingival epithelium occurred from 64 to 128 hr after the flap operation.
2. ³H-thymidine autoradiography revealed that in early regeneration of the gingival epithelium, the activity of epithelial basal cells increased in the portions distant from the flap margin and gradually proceeded to the healing wound, whereas the activity of fibroblasts was increased on the root surface in the epithelium after 64 hr.
3. ³H-proline autoradiography revealed that after the wound edges in the gingival epithelium, recovered, activity of fibroblasts increased during the collagen metabolism, continuing throughout the 128 hr.
4. Laveling indicies showed a tendency to be higher from to 128 hr, with a peak at 14 hr.

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The effects of different treatments on periodontal healing after flap surgery in rats were determined. A mucoperiosteal flaps were raised on the maxillary molar teeth. After lead foil and a sponge were inserted between the root surface and palatal flap, they were ligatured with nylon thread, and the flaps were sutured. Two weeks later, the same operation was carried out at this site again, producing experimental periodontal pockets which remained for two weeks after removal of the lead foil and the sponge.
Flap surgery was performed on these experimental periodontal pockets. In group I, root planing was carrid out completely, but in group II, there were received no treatment. Animals were sacrificed immediately before surgery, and 3 days and 1, 2, 4 and 6 weeks after surgery, and sections were examined in light and electron microscopes.
In group II, histological examination showed a dense layer on the root surface, and epithelial downgrowth was revealed in this layer. The reduction in inflammatory cells and the regeneration of gingival connective tissue were delayed as compared with group I. In addition, the collagen fibers were prevented from extending from the periodontal ligament, and extreme root resorption was seen on the root surface. There was no difference in regeneration of the alveolar bone between group II and group I, and the degree of regeneration of the cementum was greater in group II than group I, at the ealy healing stage.

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This study was undertaken to determine the ability of some root filling materials to permeate the dentin of extracted teeth, and the effects of these root filling materials on healing after mucoperiosteal flap surgery.
In the first experiment, fifty-four freshly extracted dogs' teeth which were enlarged with hand reamers and files up to No. 70 were prepared as test pieces. The test pieces were filled with gutta-percha (Group 1) and Neotriozinc paste (Group 2) and the ends of the test pieces were sealed with wax. In the control group, the teeth were left empty. After the test pieces were tested by the agar diffusion method by placing them on a culture plate containing L-929 cells, and incubated for 24 hours. The dimensions of the clear colorless zones of dead cells around the test pieces were measured to determine their permeability.
In the second experiment, sixty mandibular premolars in mature dogs were examined. After pulp extirpation, the root canals were enlarged with hand reamers and files up to No. 70 in groups 1 and 2 (experimental group). The root canals were filled with warm gutta-percha in group 1, and with Neotriozinc paste in group 2. In the control group, the pulp of the teeth were not disturbed. Then mucoperiosteal flap surgery was carried out in all three groups. The animals were sacrificed at periods of 1, 2, 4, 8 and 12 weeks after the surgery, and examined histopathologically by light and electron microscopes.
The results were as follows:
1. In the first experiment, permeability of the extracted teeth to the materials was observed in group 2.
2. In the second experiment, the histologic findings showed that healing of the periodontium were delayed for one or two weeks after the surgery in the experimental group, and that healing was similar in the experimental groups and the control group 12 weeks after the surgery.

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This investigation was undertaken to study the effects on periodontal tissue due to differences in degree of compression and forms of diet on experimental food impaction in rats. The experimental food impaction was produced in the interdental space between the upper 1st (M₁) and 2nd (M₂) molars by creating a fossa on the adjacent marginal ridge, and then a high carbohydrate diet or solid diet was fed to the animals. In the shallow fossa group the sections were examined histopathologically at 1, 3, 5, 7 and 10 days and 2, 4, 8 and 12 weeks after the start of feeding, while in the deep fossa sections were examined at 12 hours and 1, 3, 5, 7 and 10 days and 2 weeks.
The results were as follows:
1. In the shallow fossa group, the inflammatory changes in periodontal tissue were slight, and these changes were localized in the lamina propria under the epithelial cell layer.
2. In the deep fossa group, there were destruction and disappearance of the epithelium at 1 day after feeding of solid diet. With time, the interdental papilla was gradually compressed and migrated in the apical direction, and alveolar bone showed extreme resorption. In addition, epithelial regeneration was seen 10 days after the start of feeding.
3. In the deep fossa group in rats which were fed a high carbohydrate diet, the interdental papilla was slightly compressed and migrated in the apical direction with the passage of time, but the lamina propria was covered by the epithelium.

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The purpose of this study was to examine the effects of immunosuppressive and immunoenhancing agents on rat experimental periodontitis.
Twenty seven Wistar male rats were employed. Their maxillary second molars were wire-ligated at 13 weeks of age, and the rats fed powder diet during subsequent experimental period. At 25 weeks of age, blood, crevicular lymphnodes and maxilla were sampled.
Rats were devided into 3 groups. The immunosuppressive group (IS, n=10) were administered Cyclophosphamide at a dosage of 15 mg/kg/week by intraperitoneal injection, and in immunoenhancing group, (IE, n=7) Levamisole of 1 mg/kg/week was used in the same way, and control group (C, n=10) was untreated.
The serum IgG titers against rat oral bacteria and E. coli LPS were determined by ELISA method, and blastogenesis of lymphocytes was assessed by ³Hthymidine uptake. Maxilla was used for histological examination and alveolar bone level scoring.
The IgG titers and blastogenic responses did not change dramatically in both groups, but tended to decrease in IS group, and in IE group a tendency for their increase was recognized. Alveolar bone loss was decreased significantly in palatal side of maxillary second molars of IE group. However, gingival inflammatory infiltrate was slight and did not differ in 3 groups.

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The aim of the present study was to evaluate the effect of topical application of ofloxacin (OFLX) on the progression of ligature-induced periodontitis in Wistar rats infected with Eikenella corrodens 1073-R (Ec).
A sterilized silk ligature was placed around the cervix of the maxillary second molar of rats. The rats were divided into six groups and were given presterilized drinking water containing ampicillin sodium (1mg/ml) for two days. Rats in five groups were orally inoculated twice daily with 3.5.×10⁸ colony forming units of live Ec on Day 3 and 4. Ofloxacin was provided as the methacrylic acid copolymer S (MAC-S) gel containing 0.5% OFLX or 5% hydroxy propylcellulose (HPC) gel containing 0.5% OFLX. Six groups were assigned as follows: Group A, Ec (-), OFLX (-) ; Group B, Ec (+), OFLX (-) ; Group C, Ec (+), MAC-S gel containing 0.5% OFLX; Group D, Ec (+), MAC-S gel without OFLX; Group E, Ec (+), 5% HPC gel containing 0.5% OFLX Group F, Ec (+), 5% HPC gel without OFLX. MAC-S gel was applied at 0.1 m^l/head on Day 5 and 8, and 5% HPC gel was daily applied at 0.1 m^l/head from Day 5 to the end of experiment . Rats were sacrificed on Day 11, and the molar segments were dissected. The left maxillary jaws were used for estimation of bacterial recovery and the degree of alveolar bone loss, and the right ones for histological examination.
The number of cultivable bacteria recovered from HPC containing OFLX-applied group (Group E) was lower than that from the OFLX (-) groups (Groups B and F), whereas there was no significant difference in the number of cultivable bacteria between MAC-S containing OFLX-applied group (Group C) and OFLX (-) groups (Groups B and D). A significant number of Ec was recovered from the mouth of Ec-infected and OFLX (-) rats (Groups B, D and F), but not from Ec-infected and OFLX (+) rats (Groups C and D) or Ec-noninfected rats (Group A). Alveolar bone resorption of OFLX (+) rats (Groups C and E) was significantly lower than OFLX (-) rats (Groups B, D and F), and the bone level gained similar to that of Group A.
These results suggest that the topical application of ofloxacin inhibited the bone resorption in ligatureinduced rat periodontitis infected with E. corrodens.

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The purpose of this study was to investigate the significant correlations of the traumatic occlusion and the forms of alveolar bone resorption.
The traumatic occlusion was observed on three factors which were Occlusal Contact Area (OCA), Luminosity Grade 1 (LG1..), and position of the premature contact. OCA and LG1.. were measured by IMAGE PC system, and position of the premature contact was marked by articurating paper in the intercuspal position, and the forms of alveolar bone resorption were observed by Shonic-GA system.
The subjects were twenty-one including premolars and molars of mandibular which were shown the premature contact in the intercuspal position.
And the results were as follows.
1. The forms of alveolar bone resorption were processed of image from the standard dental radiogram by using of Shonic-GA system, and the forms were divided into four types on the premolar or five types on the molar.
2. In cases of premolar, the premature contact, OCA and LG1.. were observed on the bone resorption of type I and III. And it was suggested that the traumatic occlusion was connected to the forms of the alveolar bone resorption.
3. In cases of molar, type I and II had a tendency to contact on the near of alveolar bone resorption side, but type III and IV had no connection with the correlation of traumatic occlusion and the forms.
4. The position of premature contact, the maximum OCA and the maximum LG1.. were shown on the same position.

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The purpose of this study was to investigate the effects of sodium tripolyphosphate (TPP) on the crystal formation of calcium phosphate and on dental calculus formation in rats in comparison with sodium pyrophosphate (PP). Both TPP and PP inhibited the precipitation of calcium phosphate from solution, the phase transformation of calcium phosphate (amorphous calcium phosphate. hydroxyapatite), and the crystal growth of hydroxyapatite.
In the precipitation of calcium phosphate from solution, TPP was more effective than PP.
Deposition of calculus in rats was reduced by the application of toothpaste slurries which contained TPP or PP. In particular, TPP toothpaste significantly reduced calculus scores in rats.
These results suggested that TPP toothpaste would inhibit dental calculus formation clinically.

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The effects of NaCl on gingival blood flow were evaluated. A high concentration of NaCl (more than 1mol/^l) caused a dose-dependant increase in the gingival blood flow of rabbits, as detected by a laser Doppler flowmeter. Saturated NaCl solution (5.4mol/ ^l) produced a 100% increase in flow. Treatment with a dentifrice containing NaCl also caused an increase in gingival blood flow. A dentifrice containing 15w/ w% NaCl, part of which was not dissolved, had both higher dehydrating activity and increased blood flow more than dentifrice containing 15 w/w% NaCl which was completely dissolved. These results suggest that NaCl caused an increase in gingival blood flow at least partially by dehydration.

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Phellodendron amurense has been used as external application for the purpose of anti-inflamatory in traditional Chinese medicine. Our purpose was to apply Phellodendron amurense in a dentifrice. We examined the anti-inflammatory actions of Phellodendron amurense extract in vitro and in vivo.
As a result, it was found that the extract had stabilizing activity on erythrocyte membrane and astringency effect. On the other hand, it was found that the extract had the anti-acute and anti-chronic inflammatory effect on works of carragenin-induced paw-edema model and cotton pellet granuloma model.
And then we evaluated the effect of dentifrice containing 0.05% of Phellodendron amurense extract (T dentifrice) on the improvement of periodontal disease comparing with placebo (P dentifrice).
T dentifrice was significantly superior to P dentifrice on the improvement of PMA index (p<0.01) and redness (p<0.05). On the other hand, there was no significant difference on the improvement of swelling, pocket depth and dental plaque between T dentifrice and P dentifrice.
No particular side effects were observed on this clinical study.

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The purpose of this study was to evaluate the effect of dentifrice containing Phellodendron amurense extract (P. amurense ext.), tranexamic acid, tocopherol acetate and β-glycylrhetinic acid (K dentifrice) on the improvement of periodontal disease comparing with active placebo (A dentifrice) excepted Phellodendron amurense extract from K dentifrice. The subjects were 151 students of Meikai University, School of dentistry who had no serious oral disease. They were performed tooth-brushing twice a day for four weeks. The PMA index, redness, swelling, bleeding and dental plaque accumulation were examined as indices for clinical evaluation of periodontal disease state. This study was conducted with double blind method.
The results obtained were as follows:
1. The number of subjects used for statistical analysis was 151 students (K dentifrice group: 76, A dentifrice group: 75).
2. K dentifrice was significantly superior to A dentifrice on the improvement of PMA index (p< 0.05) and redness (p<0.05). On the other hand, there was no significant difference on the improvement of swelling, bleeding and dental plaque accumulation between K dentifrice and A dentifrice.
3. The mean reduction rates of K dentifrice and A dentifrice were 37.1% and 30.4% in PMA index, 39.6% and 28.6% in redness respectively.
4. No particular side effects were observed on this clinical study.

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The purpose of the present study was to evaluate longitudinally the effects of orthodontic and periodontic therapy on periodontal health in ten patients with the malposed anteriors and high gingival inflammation. Periodontal conditions were evaluated according to the amount of gingival crevicular fluid (GCF), Gingival Index, Plaque Index, Gingival Bleeding Index and pocket depth before, during and after treatment.
GCF was used for assay of protein, collagenase, acid and alkaline phosphatase activities. Number of GCF leucocyte was also evaluated and the following results were obtained.
GCF amount measured by Periotron in anterior incisors at first visit was 1, 147±412 (unit, Mean±S. D.). After initial therapy and in maintenance phase the amount of GCF decreased 328+97 and 256±133. Two forms of collagenase, active and latent forms were found in GCF. Total collagenase activity before therapy was 43, 457±22, 934 (cpm, Mean±S. D.) and decreased 13, 302+6, 125 and 18, 273±9, 155 after initial therapy and in maintenance phase. Ratio of latent/active collagenase activity was 1.39 before therapy, 1.87 after initial therapy and 1.92 in maintenance care. Changes in total collagenase activity and latent/active collagenase might be an indicator of ortho-perio therapy in children with malposed anteriors. Acid and alkaline phosphatase activities were also decreased 90% and 82% smaller than initial examination. Number of GCF leucocyte decreased 70% smaller than initial examination.
Gingival index decreased from 1.55±0.68 to 0.42±0.64 and Plaque Index also significantly decreased from 1.53±0.65 to 0.38±0.53 in maintenance phase.
Gingival Bleeding Index decreased from 82.5±10.8 (%) to 13.6±11.4 (%). Pocket depth decreased from 2.29±1.23 (mm) to 1.72±0.76. (mm). In conclusion, it was revealed that long term maintenance care of periodontal tissue was prerequisite for patients in orthodontic treatment and regeneration of tissue would be expected by co-operative orthodontic and periodontic therapy.

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Clinical, bacteriological and immunological findings were evaluated in three individuals with juvenile periodontitis systemically treated with Minomycin (100 mg/day) for 30 days. Gingival crevicular fluid volume, gingival index and pocket depth were reduced in all three patients after Minomycin adminsitration. The percentages of motile rods and spirochetes in the subgingival microflora estimated by phasecontrast microscopic examination were lower than those before treatment. The counts of the subgingival microflora including Haemophilus, Capnocytophaga and black pigmented Bacteroides in selective media were also markedly decreased. Quantities of immunoglobulins (IgG, IgM, IgA) and peripheral blood lymphocyte subsets showed no significant changes after treatment. These results indicate that systemic Minomycin administration may be effective against clinical symptoms and periodontpathic microorganisms withont affecting the immune system.

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The purpose of this study was to investigate clinically the healing events of periodontitis after subgingival debridement with an ultrasonic probe-type tip scaler. 213 surfaces of 74 non-instrumented teeth with periodontitis in 12 patients were studied. All subjects received oral hygiene instruction and supragingival scaling. After each patient was found to maintain a good oral hygiene condition, the experimental period began. As a baseline, ultrasonic subgingival debridement with the newly designed device was performed on 128 experimental root surfaces until the operator was convinced of completing the debridement, and the remaining 85 surfaces served as a non-instrumented control. Plaque index, probing depth, clinical attachment level, gingival crevicular fluid and bleeding on probing were evaluated at the baseline and 1, 2 and 4 weeks after instrumentation.
The results were as follows: The mean plaque index remained constantly low in both experimental and control groups. Inflammatory indicies (bleeding on probing and gingival crevicular fluid) were markedly reduced in the experimental group. Experimental sites with initial probing depth of . 4 mm showed marked reduction in probing depth and an increase in attachment level although those parameters in the control sites remained unchanged.
The results demonstrate that subgingival debridement with the new device is efficient for periodontal treatment in patients with good oral hygiene.

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The purpose of this study was to determine the prevalence of periodontal disease and the relationship between the subjective periodontal symptoms and the actual periodontal condition in Japanese teenagers.
The examination was carried out in two parts. In tht first, a questionnaire concerning periodontal disease was conducted on 4, 292 junior and senior high school students (12 to 18 year of age) living in Kawagoe, Japan. The quetionnaire mainly inquired into typical periodontal subjective symptoms. Secondly, pocket depth was measured by the circumferential method on those 1, 333 individuals who had one or more subjective periodontal symptoms.
The following results were obtained:
1. Of those students examined for pocket depth 10.0% showed a depth of 4mm or greater. Whereas, this percentage is only 3.1 for the general population in this age range.
2. With respect to the relationship between the frequency of subjects who had periodontal pockets 4 mm or deeper and their age, the frequency decreased with increasing age. And males had a higher frequency of deeper pockets than females.
3. The subjective symptom of the highest frequency was gingival bleeding during tooth brushing (17.8%), and the second was food impaction (16.7 %).
4. Students examined for pocket depth were divided into two groups, one having periodontal pockets 4mm or deeper, and the other less than 4mm. The results of questionnaire for the two groups were compared.
There was a significant difference between two groups in terms of gingival swelling, gingival bleeding on tooth brushing, feeling of malaise in the mouth, foul breath, and diagnosis of periodontal dise-ase by a dentist. The group with a periodontal pocket 4mm or deeper showed a higher frequency for each of the above items. Whereas regarding the symptoms of tooth mobility showed the inverse result. There was no significant difference between the two groups in terms of food impaction.
5. Significantly, the frequency of subjects diagnosed by a dentist as having periodontal disease increased with increasing age, but that of subjects who felt malaise of the mouth and had foul breath decrease with increasing age.

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This study was carried out to investigate the relation between the severity of periodontal disease and the dietitic condition of patient. Subjects were 330 periodontal patients, aged 18 to 74, averaged 42.6 years, 131 males and 199 females, who visited our hospital in three years from 1983 to 1985. The dietary condition as for food between meal, carbohydrate, protein, phosphorus, calcium, sugar, vitamins, alcoholic drinking and ciggarette consumption were examined by analysing the questionnaires from the periodontal patients.
The results were as follows.
1. As periodontal disease advanced, it seemed that the patients had less carbohydrate, animal protein, P, vitamine A but no significant differences were recognized.
2. Statistical significance was observed at 5% level between the patients who had less calcium and more calcium. There was a tendency that the patients who took less calcium from milk and cheese had severe periodontal disease.
3. Statistical significance was observed at 1% level between the patients who had less calcium and more calcium. There was a tendency that the patients who took more suger had severe periodontal disease.
4. As for vitamin C, the patients who took less vitamin C had severe periodontal disease. But statistical significance was not observed.
5. As for alcoholic drinking, statistical significances were not recognized.
6. Statistical significance was recognized at 1% level between cigarette consumption group and non cigarette consumption group. Cigarette consumption increased as periodontal disease advanced.

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955 The present case report describes the outcome of an extremely advanced case of periodontal destruction. A 40-year-old male with a noncontributory medical history appeared for an initial periodontal examination in April of 1983. His chief complaint was a gingival pain. A complete oral examination showed the presence of an advanced destruction of the supporting tissues in most parts of the dentition. The average of clinical attachment loss was 5.92mm and that of bone loss was 60.86%. The teeth 14, 15, 22, 23, 24, 25, 45, 44, 33 exhibited increased mobility. Both the plaque and bleeding scores were 100%. The patient was diagnosed as advanced adult periodontitis.
Following completion of the initial therapy phase, the surgical approach for a pocket elimination was carried out on the maxillary anterior, maxillary posterior, mandibular teeth except for the teeth 47, 46, 43, 33, 34, 35, 37 and 38. After the healing of periodontal tissue, orthodontic treatment was applied on the maxillary anterior and mandibular anterior teeth. Vestibular extention with a free gingival graft was added on the teeth 22 and 26. After completion of the orthodontic treatment, adhesion bridge was cemented on the anterior teeth of maxillary, mandibular and the posterior teeth of maxillary, right mandibular.
Following reevaluation of both the periodontal condition and the mandibular position, the patient was recalled for maintenance care every month for about 5 years from an initial visit. Alveolar bone level was remarkably improved, especially the teeth 17, 16, 25, 26, 28, 36, 43, 44 and 46. Clinical attachment was gained in most teeth and the average of it was 4.95mm.

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This report presents two cases of complications during the maintenance care phase of osseointegrated implants.
Case I: A 72-year-old female patient presented gingival hyperplasia formation around the abutment 19 months after abutment setting. We performed excision of the hyperplastic gingiva and apically positioned flap. Probing depth (PD) could not determin because of gingival hyperplasia formation pre-operatively, however post-operatively, there was marking reduction of probing depth. The gingival bleeding index (GBI) improved and the amount of gingival crevicular fluid (GCF) reduced postoperatively. In pre-operative anaerobic culture, the proportions of Capnocytophaga species and Haemophilus actinomycetemcomitans were rich. Post-operatively, Capnocytophaga sp. did not find but H. actinomycetemcomitans was unchanged.
Case II: A 47-year-old male patient presented gingivitis around the abutment 13 months after abutment setting. We performed cleaning of the abutment surface with the flap procedure. Furthermore, a joint screw between the fixture and abutment adapted due to loosening post-operatively, PD unchanged, GBI improved and GCF slightly reduced. In pre-operative anaerobic culture, Bacteroides intermedius was rich. Post-operatively, B. intermedius did not find.
In conclusion, we advocate that maintenance care of osseointegrated implants is the most important factor in the procedure.

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