New attachment - reattachment following reconstructive periodontal surgery

Abstract

The present study was designed to evaluate if the conditions for reformation of a connective tissue attachment are less favorable on root surfaces which have lost their fibrous attachment because of periodontal disease than on root surfaces surgically deprived of their attachment apparatus. In each of 4 Green monkeys. 2 maxillary and – mandibular teeth were selected for experimentation. Periodontal breakdown was produced and allowed to progress to the mid-root level around one of the experimental teeth in both the maxilla and mandible by placing elastic ligatures around the neck of these teeth. 3 months after removal of the ligatures, the crown of the teeth was resected and the epithelium and the subjacent granulation tissue were removed. Using a diamond bur. circumferential defects similar to those obtained by the ligature induced destruction were then produced around the remaining 2 experimental teeth following resection of the crown. The root cementum on both groups of teeth was removed to the level of the reduced bone height. Finally, all roots were submerged to complete coverage by a mucosal flap. After 3 months of healing, the animals were sacrificed and the jaws removed and placed in fixative. After decalcification. histological sections of the experimental roots and their surrounding periodontal tissues were produced. No histological differences in the result of healing were discernible between the specimens of previously periodontitis-affected roots and roots with surgically created defects. New cementum with inserting collagen fibers had formed in the apical part of the instrumented surface in both groups of teeth. The length of the new fibrous attachment on the root surfaces surgically deprived of their periodontal ligament tissue was 0.7 mm (mean) with a range from 0.1 to 1.9 mm. On the root surfaces exposed by ligature-induced periodontal breakdown, the newly formed cementum had an average length of 1.0 mm with a range between 0.1 mm and 2.6 mm. This difference between the groups was not statistically significant. The results indicate that the potentials for reformation of fibrous attachment are similar on planed root surfaces previously exposed to periodontal disease and on surfaces surgically deprived of their attachment apparatus.