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Histologic Evaluation of New Attachment Apparatus Formation in Humans
Author(s) -
Bowers Gerald M.,
Chadroff Brian,
Carnevale Robert,
Mellonig James,
Corio Russel,
Emerson Jane,
Stevens Mark,
Romberg Elaine
Publication year - 1989
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.1989.60.12.683
Subject(s) - cementum , connective tissue , dentistry , junctional epithelium , regeneration (biology) , periodontal fiber , bone formation , gingival margin , chemistry , medicine , pathology , microbiology and biotechnology , biology , dentin , endocrinology
T here is still controversy as to the role of bone grafting materials in the formation of a new attachment apparatus and component tissues (bone, cementum, and periodontal ligament). The purpose of this study was to compare the healing of intrabony defects with and without the placement of decalcified freeze‐dried bone allograft (DFDBA) in a nonsubmerged environment in humans. The most apical level of calculus on the root served as a histologic reference point to delineate root surfaces exposed to the oral environment and to measure new attachment apparatus and new component tissue formation. Free gingival grafts were placed over grafted and nongrafted defects to retard epithelial migration. Biopsies were obtained at 6 months and regeneration was evaluated histometrically. Data from 12 patients with 32 grafted and 25 nongrafted defects were submitted for statistical analysis. Results indicate that in nongrafted defects, a long junctional epithelium formed along the entire length of exposed root surfaces and often extended apical to the calculus reference notch. Free gingival grafts did not enhance regeneration of a new attachment apparatus, new cementum, new connective tissue, or new bone in nongrafted defects. The formation of a new attachment apparatus was observed when intrabony defects were grafted with DFDBA (x1.21 mm); significantly more new attachment apparatus ( P <.005), new cementum ( P <.005), new connective tissue (P <.05), and new bone ( P <.0001) formed in intrabony defects grafted with DFDBA than in nongrafted defects. There was a greater chance for regeneration of a new attachment apparatus and component tissues in grafted defects than in nongrafted defects. New cellular cementum formed on old cementum and dentin but more often formed over both in the same defect). The periodontal ligament was more frequently oriented perpendicular to the root; there was greater loss in alveolar crest height in nongrafted than grafted defects ( P <.05); and extensive root resorption, ankylosis, and pulp death were not observed in grafted or nongrafted defects. ( Journal of Periodontology , 1989;60:683–693)