Revascularization Following the Lateral Sliding Flap Procedure

T wo young adult rhesus monkeys , with an average weight of 12 pounds were used. Anesthesia with Nembutal ( r ) 30 mg/kg of body weight was given to perform the surgeries. Artificial defects were created by raising a flap and removing about 5×7 mm of the buccal alveolar plate and suturing the flaps exposing the alveolar crest. These defects were left untreated for 2 months. Then, mucogingival lateral sliding flaps were performed to cover the recessions. Postoperative periods of 1, 9, 14, 21, 28 and 35 days were obtained when the animals were killed. A combined solution of Pelikan carbon black and 10% buffered formalin was perfused through the exposed and cannulated external carotid arteries to evaluate revascularization. After killing, blocks, including the operated teeth and the surrounding tissues, were fixed in 10% formalin and then partially decalcified in EDTA. Two blocks per time interval were obtained. One of the blocks was processed for regular histology, and sectioned bucco‐lingually. In these sections it was found that the new attachment to the root was mediated by a combination of connective tissue attachment and a long junctional epithelium. The other blocks were cut cross‐sectionally at about 1‐mm thickness. Sections were selected from three different areas: (a) at the most coronal part of the laterally displaced flap, (b) at the middle of the localized defect and (c) at the bottom of the defect. They were cleared following the Spalteholtz method. Initially, at 1‐day postoperatively, a network of perfused vessels was seen marginally and the flap was well adapted to the tooth surface and the tissue bed, with a thin blood clot interposed. Healing progressed uneventfully and by 28 days the surgically treated area depicted a completely reestablished vascularization, which grew from the displaced flap, surrounding periodontal membrane and tissues. Similar results, but with faster healing, were observed in areas (b) and (c).