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Background: One endpoint of periodontal therapy is to regenerate the structure lost due to periodontal disease. In the periodontium, gingival epithelium is regenerated by oral epithelium. Underlying connective tissue, periodontal ligament, bone, and cementum are derived from connective tissue. Primitive connective tissue cells may develop into osteoblasts and cementoblasts, which form bone and cementum. Several procedural advances may support these regenerations; however, the regeneration of alveolar bone does not always occur. Therefore, bone stimulating factors are a main topic for periodontal reconstructive research. The present study was designed to examine histopathologically whether the application of an electrical field could demonstrate enhanced alveolar and cementum regeneration and modify tissue factors., Methods: Seven beagle dogs were used for this experiment. Mandibular left and right sides served as control and experimental sides, respectively, and 4-walled intrabony defects were created bilaterally between the third and fourth premolars. The experimental side was treated with a capacitively coupled electrical field (CCEF) (sinusoidal wave, 60 kHz, and 5 V peak-to-peak), applied for 14 hours per day. The following measurements were performed on the microphotographs: 1) the distance from the cemento-enamel junction to the apical notch (CEJ-AN) and from the crest of newly formed bone (alveolar ridge) to the apical notch (AR-AN); 2) the thickness of new cementum in the apical notch region; and 3) the length of junctional epithelium. The following histopathologic parameters were assessed by a semiquantitative subjective method: 1) inflammatory cell infiltration (ICI); 2) cellular activity of the periodontal ligament; 3) number and morphology of osteoclasts; 4) resorption lacunae; and 5) osteoblastic activity., Results: The results showed that the quantity of new bone fill and the mean value of the thickness of the cementum were significantly higher for the experimental side (P < 0.01). The location of the base of the pocket was positioned more coronally with respect to the apical point of the coronal notch in the experimental side (statistically significant P < 0.01). The length of the junctional epithelium and the number of osteoclasts were higher in the stimulated side than the coronal side; these findings were also statistically significant (P < 0.01). The comparison of the electrically stimulated versus non-stimulated mandibles with the semiquantitative subjective method demonstrated statistically significant differences in defined histopathologic parameters, except for osteoclast morphologies (P > 0.05)., Conclusions: This study demonstrated that the CCEF method has the potential to produce reconstructive effects and bone deposits. Further investigations with respect to the theoretical determination of local field parameters of the periodontal tissue complex, such as permittivity, conductivity, strength of the field electrical stimulation applied to the periodontal field current density, wavelength, and signal frequency appropriate for this field, should be undertaken. Using different electromotive forces alone or in combination with bone graft materials, guided tissue regeneration techniques, and dental implants may achieve a new dimension in periodontal therapy in the near future.

Background: The aim of the present study was to evaluate the regenerative potential of autogenous periodontal ligament (PDL) grafts in the treatment of Class II furcation defects., Methods: Twenty mandibular Class II furcation defects from 10 systemically healthy patients with chronic periodontitis were selected. In experimental defects, flaps were coronally positioned following placing autogenous PDL grafts that were obtained from third molars; in controls, coronally advanced flap procedure without graft was applied. Clinical measurements including plaque index, gingival index, probing depth (PD), vertical and horizontal clinical attachment level (CAL), and gingival recession (GR) were obtained at baseline and after 3 and 6 months postoperatively. Vertical and horizontal defect fill was evaluated with open clinical measurements at initial surgery and reentry after 6 months. Gingival biopsies from the experimental and control defects were obtained at reentry and evaluated histopathologically in order to examine the soft tissue response towards PDL grafts., Results: Sites treated with PDL grafts demonstrated significant improvement in vertical and horizontal defect fill, PD, and CAL at 3 and 6 months compared to presurgical values. The difference determined for the PD values of both groups at a statistically significant degree in favor of grafted sites was maintained at all observation periods. No foreign body reaction was observed in PDL grafts., Conclusions: These short-term results point to the potential of PDL grafts in promoting healing of furcation lesions. This preliminary study suggests that the use of PDL grafts may have beneficial effects in the treatment of furcation defects.

Background: The present study was designed to assess histopathologically whether the systemic administration of aminobisphosphonate (alendronate), 0.5 mg/kg body weight, is effective in preventing alveolar bone resorption following mucoperiosteal flap surgery, and whether alendronate modulates tissue factors., Methods: The effect of alendronate on bone resorption was evaluated in mucoperiosteal flaps used as a resorptive model. The animals were given subcutaneous injections of either saline (control group) or 0.5 mg/kg of alendronate (experimental group). The alendronate or saline was administered subcutaneously 1 week prior to surgery, immediately prior to surgery, and 1 week after surgery. The parameters determined with a semiquantitative subjective method for histopathological evaluation were as follows: inflammatory cell infiltration (ICI) of adjacent periodontal tissue, degree of fibrosis and collagen bundle formation, number and morphology of osteoclasts of the alveolar bone and interdental septum, resorption lacunae (osteoclast surfaces), and osteoblastic activity (forming surfaces)., Results: There were no statistically significant differences between the saline and alendronate groups with regard to inflammatory cell infiltration, number of osteoclasts, and osteoblastic activity. Fibrosis and collagen bundle formation, osteoclast morphologies, and resorption lacunae formation were significantly different between the two groups, in favor of the alendronate group., Conclusions: The systemic administration of 0.5 mg/kg alendronate was effective in preventing alveolar bone loss and in modulating tissue factors. These findings indicate that alendronate would be a valuable addition to the therapeutic armamentarium available for the treatment of periodontal diseases, either alone or in combination with regenerative components such as anti-inflammatory drugs, bone graft materials, and guided tissue regeneration techniques, and even with dental implants.

Background: Hereditary gingival fibromatosis (HGF) is a fibrotic enlargement of the gingiva. The mechanism that leads to the accumulation of abnormal amounts of gingival tissue in HGF is still unknown. The aim of this report was to present the clinical and histopathologic characteristics of a patient with gingival fibromatosis and to evaluate the proliferation of HGF fibroblasts., Methods: We examined the proliferation rate of fibroblasts in this case by using Ki-67 immunohistochemical staining and compared the rate to fibroblasts of non-fibromatosis gingival tissues from 5 healthy patients serving as controls., Results: There were no Ki-67-positive cells in the lesional tissue, and the control gingiva revealed no immunostaining. The number of Ki-67 antigen-positive epithelial cell nuclei was observed to be low in the basal cell layers of hyperplastic gingival epithelia, similar to the control group., Conclusions: In the present case, there was no increase in the proliferation rate of lesional fibroblasts observed by Ki-67 immunohistochemical staining as a proliferation marker; only the epithelium was stained. It seems likely that the underlying mechanism of HGF may be an increase in the biosynthesis of collagen and glycosaminoglycans rather than cell proliferation.

Background: The present study was designed to examine histopathologically whether local delivery of aminobisphosphonate (alendronate) could be effective in preventing the alveolar bone resorption associated with mucoperiosteal flaps., Methods: Following mucoperiosteal flap elevation in the molar region of the rat mandible, a surgical pellet soaked with aminobisphosphonate was locally applied on the exposed bone surface and covered by flap. The determined parameters with a semi-quantitative subjective method for the histopathological evaluation were as follows: existing inflammatory cell infiltration of the related periodontal tissue; fibrotic component content and bundles of collagen fibers; the number and morphology of osteoclasts of the alveolar bone and interdental septum; existing resorption lacunae (osteoclast surfaces); and existing osteoblastic activity (forming surfaces)., Results: The results showed that while there were no detectable statistically significant differences between the saline and alendronate-treated groups on the existing inflammatory cell infiltration (ICI), number of osteoclasts, and osteoblastic activity, the results for the fibrotic and collagen component, osteoclast morphologies, and existing resorption lacunae were statistically significant., Conclusions: These results suggest that local application of the aminobisphosphonate alendronate can be used as an adjunct in therapy for reducing bone resorption following surgery. It can also be suggested for consideration that, even for the surgical approaches in dentistry where bone graft materials and/or dental implants are needed, using bisphosphonate may achieve a new dimension in periodontal therapy in the near future.

Generalized membranous gingival enlargement due to accumulation of amyloid or fibrin-like material is a rare, destructive and poorly defined disease entity. Some patients also show extraoral manifestations. The lesion is an involvement of periodontal tissues caused by the same process as ligneous conjunctivitis. In this report, 3 new cases, two of whom are siblings, are presented. Defective fibrinolysis and abnormal wound healing seem to be the main pathogenetic mechanism of this unusual disease, which should be evaluated systemically considering other mucosal involvement.

Gingival fibromatosis is frequently an isolated condition, but rarely associated with some uncommon syndromes. This paper describes an 11-year-old patient with pronounced gingival enlargement, cherubic facial appearance, and psychomotor retardation and discusses the major aspects of the case. The most striking finding orally was the presence of grossly hyperplastic gingiva, which completely covered all teeth except the occlusal surfaces of some teeth. The swelling in the lower part of the face and the appearance of sclera beneath the iris suggest cherubism. The diagnosis was confirmed by the detection of giant cell regenerative granuloma and perivascular eosinophilic particles and osteoclasts after biopsy of the mandible. In this case, surgery was the only effective way to treat the patient. A full-mouth gingivectomy procedure was performed under general anesthesia in 2 stages. The case was followed for 12 months and no recurrence was seen. An appropriate oral hygiene regimen was established.

Langerhans' cells (LCs) are intraepithelial immunocompetent cells. Changes in the number of LCs occur in inflammatory and autoimmune diseases. In this study, the number of gingival LCs in patients with type I diabetes mellitus was compared with those of normal individuals using immunohistochemical methods. Gingival biopsies were obtained from 20 type I diabetics and 10 healthy individuals. Anti-CD1 positive LCs formed an intraepithelial network and showed a marked increase in type I diabetics. This increase was not related to diabetic age. The number of LCs was proportional to the density of subepithelial inflammatory cells. Our findings suggest that LCs may play a role in the development of diabetic gingivitis.

This article describes the occurrence of numerous calcifications, amyloid deposits, and islands of odontogenic epithelium in the gingiva of 3 siblings with familial gingival fibromatosis. These microscopic features have not been reported previously in patients with this condition.

In this article, a case of odontogenic myxoma with deceptively bland radiographic findings and a clinical impression of periodontal abscess is presented.