Transforming growth factor-β (TGF-β) is a polypeptide biologic mediator considered to play a role in the wound healing processes including cell proliferation and migration. The purpose of this study was to clear if TGF-β world stimulate the proliferation of fibroblasts and futher enhance tissue regeneration in vivo.
Standardized 3 x 5 mm buccal fenestration defects were made at midroot level in five beagle dogs. The exposed root surfaces were planed and each defect received either (1) PBS solution (C group), (2) a collagen piece soaked in PBS solution (P group) or (3) a collagen piece soaked in TGF-β solution T₂₀ group : 20 ng/10, μl and T₄ group : 4 n (g/10 μl in concentration) prior to flap replacement. Each dog underwent the four different treatments at random. Animals were sacrificed at 3, 8 and 21 days after the procedure and prepared for light microscopic examination.
Proliferating cell nuclear antigen (PCNA) positive cells were counted to determine the proliferative activity of fibroblast-like cells in each of the following histologic compartments of the periodontal ligament (PDL) at the apical border level of the fenestration adjacent to the root surface and the wound proper.
Although no significant differences were seen in terms of either inflammation or fibronectin deposition, the use of collagen with silicon membranes (P, T₂₀, T₄ groups) suppressed fibroblast-like cell proliferation when compared to the group without membrene (C group). Significant differences were noted on the 3rd day in the T₄ group, as reflected by increased migration of PCNA positive cells to the defect from the adjacent periodontium. Furthermore, on day 8 in the T₂₀ group proliferation was decreased, as compared to the T₄ group. The 8-day specimens exhibited compartments containing a great number of fibroblast-like-cells at the proliferating level in each group, while the T₄ group demonstrated marked numbers of fibroblast-like cells. The 21-day specimens of the T₄ group had abundant fibroblast-like cells and collagencomponents and a low bone formation rate in the wound compartments.
The present study suggests that PDL tissue supplies cells to periodontal wounds containing a surgically created periodontal space and that TGF-β enhances fibroblast-like cell migration and proliferation in early periodontal wound healing in combination with collagen as a carrier of TGF-β and a barrier-membrane. Moreover an effect of TGF-β was recognized in fibroblast-like cells, which differentiated into mature fibroblasts in the PDL and prepared the new collagen components, while there was no evidence of an effect on the osteoblast-like cell differentiation associated with the production of new bone.

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This study was designed to examine the effects of oxygen tension in periodontal pockets on clinical symptoms and oral bacterial flora. We divided teeth with periodontal pockets in the initial preparation phase into a high-O₂ group, a low-O₂ group and a control group. At 0, 1, 2, 3, 4, 6 and 8 weeks after the start of the study, teeth in the high-0₂ group were irrigated within the periodontal pockets with 0.25% Povidone-lodine solution including high tension oxygen. Teeth in the low-0₂ group were irrigated with the 0.25% Povidone-lodine solution only. Controls were treated only by scaling and root planing. Thereafter, we observed these three groups and compared the 0₂ group with the non-0₂ and control groups by examining clinical parameters and bacterial flora in periodontal pockets before the irrigations for each week.
Consequently, tendencies for an improved Plaque Index, Gingival Index, Gingival Crevicular Fluid, Probing depth and Bleeding on probing, as well as reduced oxygen tension and numbers of bacteriological findings, were noted for each group. In particular, the high-O₂ group showed a significantly reduced number of bacteria as identified by DNA probe in comparison with the low-O₂ and control groups when examined for bacterial flora.

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In order to clarify the roles of Langerhans cells (LCs) associated with host defense mechanisms, LCs were identified in Phenytoin (PHT) -induced overgrown gingival tissues using rabbit anti-human S-100 protein antibody and compared with those in tissues from age- and sex-matched adult periodontitis (AP) patients with systemically good health. Five patients in each group were randomly selected and all gave informed consent to take part in this study. After the samples were carefully taken during periodontal surgery, the serial specimens were embedded in paraffin and routinely processed. The specimens were immunostained with anti-S-100 protein polyclonal antibody followed by histological analysis of the positive cells in gingival epithelium. The S-100 positive cells specimens from both groups were scattered in both the basal and the spinous layers. The positive cells per square mm unit in gingival epithelium were counted and then the percentage of positive cells per total ephithelial cells were then calculated. In the PHT group, the positive cells were significantly increased in both number and frequency as compared with those in the AP group (p<0.01). In addition, numerous CD 3 positive cells were infiltrated in the connective tissues beneath the oral epithelium containing a significant number of S-100 positive cells and this tendency was remarkable in the PHT group specimens. These findings suggest enhancement of the pathophysiological roles of LCs in PHT-induced gingival overgrowth.

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The present experiment was designed to assass the diagnostic value of examining the thickness, keratinization and attachment characteristics of gingiva in the maintenance of a healthy marginal complex. The initial experimental procedures were as follows: Ultrasonic gingival thickness measuring equipment was applied to periodontal diagnosis (SDM, Krupp, Germany) and used for the test. This device met the regurements of the standardized measuring method. The transducer head of the SDM, bonded to a cylinder 5 mm in diameter by an ultrasonic echo-ranging technique, was oriented at a 90 degree angle to the underlying bone and was carefully balanced up to a load of 5 mg/cm² to the gingiva.
The measurements were obtained in healthy mouths (96 mandibular canine and molar buccal sites), the thickness of the gingiva was determined with the SDM in an area with a zone of attached gingiva, the width of which was measured with slide calipers, for comparison with the needle sticking measurement into the gingiva. The results showed the clinical effectiveness of measuring the thickness of gingiva by SDM to be conveniently demonstrated and to sufficiently determine the mean value in an area of gingiva.
In a total of 8 patients who had undergone free autogenous gingival grafting, 36 sites were evaluated in this study. Clinical examinations, measurements of the thickness and width of attached gingiva were carried out during a maintenance period ranging from 1 to 18 years. Results were evaluated in terms of data from healthy gingiva, which were obtained from the persons described above. No significant differences were seen in either the thickness or the width of attached gingiva between patients and healthy persons, related to gingival health.
Although considerabe controversy persists as to the need for an adequate thickness and width of attached gingiva, for the maintenance of good gingival health, it is useful to clinically ascertain gingival thickness and the width of attached gingiva using SDM and calipers, in order to detect those at risk for periodontal disease and as a diagnostic procedure prior to periodontal therapy.

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The purpose of this study was to compare the effectiveness of electric and manual toothbrushes on the periodontal condition when used for toothbrushing instruction and home care of patients with periodontal disease.
Thirty-six patients were divided into two groups and each group was instructed to use either a manual or an electric toothbrush. For the manual toothbrush instruction, a dental hygienist brushed all of the teeth of each patient (Professional tooth cleaning) using the manual toothbrush (Butler # 211 ®). The patients used the manual toothbrush for the next 4 weeks at home.
For the electric toothbrush instruction, patients brushed their own teeth using an INTERPLAK ® (BAUSCH & LOMB, USA) by themselves under the supervision of a dentist. Following the instruction, patients were asked to use the INTERPLAK for 4 weeks at home.
In both toothbrusing instructions, the importance of the interdental area was emphasized to the patients. Clinical assessments (PCR, probing depth, bleeding on probing) were made at baseline and after 4 weeks.
The amount of bleeding on probing, using either manual or electric toothbrushes was significantly reduced at 4 weeks. A subjective feeling of being refreshed by the brushing seemed likely to have motivated the patients.
It was suggested that the electric toothbrush is as effective as the manual toothbrush for improving the periodontal condition of patients.

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The authors developed an enzymatic method designated Periocheck ® firstly designated SK-013 (Sunster Inc., Osaka) in order to know the colonizations by specific periodontopathogens in periodontal lesions. This method was found to be highly sensitive of trypsin-like activity and specificity for Porphyromonas gingivalis, Treponema denticola, Bacteroides forsythus and some Capnocytophaga strains. The effect of initial preparation, which was changed in clinical parameters, on adult periodontitis was evaluated by the Periocheck ® . Subgingival plaque samples were taken from 28 sites of 19 adults periodontitis patients. The diseased sites were examined in Probing depth (PD), Gingival index (GI) and Plaque index (PI) at first examination before treatment. After 3 weeks, these sites were examined again. The sample mixture was incubated for 15 min at 37.., and an absorbance at 666 nm was measured in spectrophotometer. Positive criteria was 0.2 Try unit/ml that another study had reported. When the treatments such as scaling and root planing were carried out, the rate of samples showing positive reaction significantly decreased after 3 weeks (from 100% to 25%, p<0.05). The clinical parameters in positive sites of Periocheck ® after initial preparation were significantly higher than those in negative sites (PD; 5.87mm vs 4.30 mm, p < 0.05, GI ; 1.87 vs 1.15, p<0.05). The reduction of PD in negative sites of Periocheck ® after initial preparation were higher than those in positive sites (1.6mm vs 0.5mm, p<0.05). We concluded that Periocheck ® is useful not only detecting specific periodontopathogens but also monitoring the efficacy of initial preparation.

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The purpose of this study was to investigate the influence of local periodontal environmental factors associated with periodontitis on subgingival plaque reformation after scaling and root planing.
A healthy site and a periodontitis site were selected from each of 10 periodontitis patients for this experiment. In both sites, scaling and root planing were performed with an ultrasonic scaler and, if required, by hand curettes, at baseline. In each pocket or sulcus site a dentin strip was inserted and fixed with Super-bond ® . After two weeks, the dentin strips were removed and examined by scanning electron microscopy.
The following results were obtained:
The average length of accumulated subgingival plaque was 2.5±0.9mm in all periodontitis sites and 0.6±0.6 mm in all healthy sites, showing a significant difference. The average length percentage of accumulated subgingival plaque by probing depth was 26.7±23.0% in healthy sites and 50.0±29.1% in periodontal sites among 6 paired cases. This difference was also significant. The microflora of the subgingival plaque were mainly cocci and short rods, but spirochetes were occasionally observed at healthy sites. On the other hand, the microflora in periodontitis sites showed cocci, different sized rods, filaments and spirochetes. Leukocytes were also observed in high numbers.
The above results suggest that subgingival plaque reformation and the associated microflora may be markedly influenced by the local periodontal environment.

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The aim of the present study was to evaluate whether new attachment, gained following guided tissue regeneration (GTR) therapy, can be maintained over 5 years of maintenance therapy. Fourteen sites in 14 patients (average age 40.9 years, 21-57 years of age, 3 males and 11 females) with adult periodontitis were treated with the GTR technique (GTR group) and 14 sites in 14 patients average age 39.6 years, 23-54 years of (age, 5 males and 9 females) with adult periodontitis were treated with flap debridement (FOP group). Lesions in the GTR group included 1 site with a single wall defect, 11 sites with 2 intrabony wall defects and 2 sites with 3 intrabony wall defects. Lesions in the FOP group included 2 sites with a single wall defect, 9 sites with 2 intrabony wall defects and 3 sites with 3 intrabony wall defects. The sites which had undergone both procedures demonstrated improved gingival conditions including probing pocket depth (PD), clinical attachment level (CAL) and marginal tissue recession (MR) at 5 years after surgery. In the GTR and FOP groups, there were decreases in PD of 3.9±1.6mm and 2.9±1.5mm, gains in CAL of 3.2±1.8mm and 1.1±1.4mm and increases in MR of 0.7±1.3mm and 1.8±1.5mm, respectively. A significant attachment gain was obtained in the GTR group and this gain was significantly longer than that in the FOP group. During the 4 years of maintenance between the 1 and 5 year examinations, PD and CAL in both groups remained stable. These results demonstrate that CAL, obtained as the result of GTR therapy, can be maintained for periods of up to 5 years.

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The aim of the present study was to analyze the possible relationship between osteoporosis and the degree of periodontal disease in postmenopausal women. Thirty-five female patients with osteoporosis (group O, mean age 63.0±1.5) and 20 normal women with periodontitis (group P, mean age 63.6±0.6) were selected and examined clinically. Bone mineral density (BMD) of the lumbar spine (n=18) and forearm (n=17) was determined by dual energy X-ray absorptiometry. All subjects in group O were of average build, but they had low BMD (percentage to peak bone mass: 60.5±1.3%). No significant correlation was found between the BMD level and periodontal clinical parameters in group 0. Numbers of present teeth and percentage of treated teeth were 23.0±1.3, 60.0±4.1% in group 0, 22.6±1.5, 53.2±6.2% in group P, respectively, Percentage of periodontally diseased teeth and bleeding on probing were 46.2±6.3%, 37.5±4.2% in group O and 39.6±6.3%, 24.6-±-4.4% in group P, respectively. Periodontal conditions in group O were more severe than those in group P. These results suggest that severe osteoporosis may be associated with periodontal breakdown, but further investigation will be necessary.

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