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The Effect of Different Treatment Modalities on Connective Tissue Attachment
Author(s) -
Lai Hongmin,
O'Leary Timothy J.,
Kafrawy Abdel H.
Publication year - 1986
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.1986.57.10.604
Subject(s) - connective tissue , cementum , saline , medicine , beagle , chlorhexidine , periodontitis , citric acid , dentistry , surgery , pathology , chemistry , dentin , organic chemistry
This study compared the effect of four treatment modalities on connective tissue attachment. Ligature‐induced periodontitis was established around the mandibular premolare of five young beagle dogs over 8 weeks. Following a 2‐week period without ligatures, a reference dog was sacrificed to estimate the extent and nature of the disease. Three dogs received flap procedures in one mandibular posterior segment, and the six experimental roots were treated with citric acid (pH 1) for 3 minutes; the contralateral mandibular segments received flap procedures and the roots were treated with 4% Chlorhexidine gluconate in the Hibiclens® preparation for 3 minutes. One segment of the control dog received flap procedures, and the roots were treated with sterile normal saline; the contralateral segment received closed root planing. The experimental dogs were sacrificed 1, 2 and 3 months after treatment. The control dog was sacrificed 3 months postoperatively. One week before sacrifice each dog received a Procion dye injection. At sacrifice the study segments of all four treated dogs were clinically healthy, with no observable differences between the different treatment modalities. Histologically, the 1‐ and 3‐month Chlorhexidine, the 3‐month saline and 3‐month root planed specimens had long junctional epithelial adhesions with little connective tissue attachment. The 2‐month Chlorhexidine and all citric acid‐treated sections showed appreciable amounts of new connective tissue attachment. Some 2‐month and 3‐month citric acid and 2‐month Chlorhexidine sections showed cementum over the apical portion of the long junctional epithelium. The frequency of occurrence and the length of cementum overlapping epithelium increased appreciably over time. Chlorhexidine was less predictable than citric acid in enhancing connective tissue attachment. When compared with the size of the periodontally involved area in the reference dog, all new connective tissue attachment could have occurred on uninvolved surfaces denuded by the root planing or flap procedures. The finding of cementum overlying the junctional epithelium indicates that coronal migration of connective tissue attachment is possible.