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In a study on three dogs 12 two-rooted premolars with reduced periodontia were intruded to reestablish marginal attachment. In eight roots intrusion into the basal cortical bone of the nasal sinus was found. The histological findings showed that in these cases a possible gain of new attachment in the interradicular space may be impaired by a loss of bone support in those sites where the root intruded into the sinus. The greater the extent of intrusion into the sinus the higher the expected loss of periodontal attachment.

Toothache occurs as a result of pulpal and periodontal diseases. Due to the nature of their innervation pain is the only means for both pulp and dentine to react to all kinds of external stimuli. The actual mechanism of sensory transmission, however, has not been clarified, yet. In contrast to this, the innervation of the periodontium offers a wide range of mechano-sensitive receptors. Chronic dental pain is mainly the result of inflammatory reactions. Nerve sprouting, summation, convergence in the trigeminal system and regional inflammatory conditions modulate the local pain process, thus complicating diagnosis. The differential diagnostic clarification with regard to neuralgiform and ENT-diseases therefore requires special care with case history and status. Although there have been advances in pain research over the last few years, no fundamental development in dental diagnosis has been brought about, yet. Probing, sensitivity- and percussion testing as well as x-ray exposure are still the most important diagnostic tools for the dental practitioner.

In the present review, the composition of the gingival crevicular fluid (GCF) as well as its important role in the diagnosis of periodontal disease have been discussed. Furthermore, the different sampling methods and the subsequent analytical procedures have been described. Some of the GCF-components, such as elastase, prostaglandin, arylsulphatase and beta-glucuronidase, are examined for their use as suitable markers of future disease activity. At the present time, the interest of research is focussing on the host-parasite interaction, the prediction of disease activity, and the identification of risk groups of patients. Therefore, GCF is considered a valuable research subject and a possible diagnostic marker.

In a first experiment the proliferation and growth kinetics of periodontal ligament fibroblast monolayers generated from human healthy (HPDL) and diseased (DPDL) periodontia were compared. In a second experimental series a periodontal ligament-like space was developed by laying a root slice inside a bony ring slice on the bottom of a tissue culture petri dish and leaving a space of about 0.5 mm between both structures. HPDL cells showed a higher proliferation rate than DPDL cells. Growing into the space between the slices, the PDL cells built up a matrix which was composed of cells and fibrils. HPDL cells built up the matrix more rapidly than DPDL cells.

The influence of age, inflammation intensity, tooth surface quality (caries, fillings), as well as mucogingival conditions on the loss of attachment was examined in 2000 probands. The loss of attachment was subdivided into periodontal pocket-formation and recessions. Determining cause is not the age but the inflammatory degree even if there is a significant increase of the attachment loss from age group to age group. The main part of the attachment loss increasing with advancing age is caused by recession development. Then, the individual dispersion is very high. Incorrect restorations, caries but also correct fillings increase periodontal disease. Mucogingival conditions show importance only in extreme case. There are less inflammations with pocket-formation than recessions. A preventive oriented basic care of the population is necessary to reduce irreversible damages of the periodontium.

In 57 Moscow adolescents aged 15 to 19 years gingival bleeding and periodontal pocketing was recorded. In addition to this functional parameters of Rheoperiodontography and Polarography were documented and immunological investigations were carried out. The clinical parameters of the test group showed a higher level of periodontal diseases compared with a random selected control group. A correlation between clinical and functional parameters in early periodontal destruction was not detected. This study demonstrates the importance of prevention of periodontal diseases in adolescents.

The presence of a reduced periodontal attachment has three fundamental effects on orthodontic tooth movement: the diminished resorptive bone surface necessitates a reduction in the magnitude of force applied; the apical shift of the center of resistance requires an adaptation of the force systems used; (moment/force ratio); the limited anchorage quality of periodontally susceptible teeth has to be considered biomechanically. Orthodontic movement of teeth with reduced attachment therefore requires differented planning and application of force systems in order to avoid root resorption and further bone loss.

In the sense of relation pathology, the local peripheral blood supply plays a decisive role also in periodontal diseases. Thus, the differentiation of local circulatory disturbances is of great importance in diagnosis and early detection as well as in therapeutical decisions. Photoplethysmography is well suited for this purpose, especially in evaluating the curves by determining the time of inclination and the plateau index (if necessary, with resort to the nitrangin test). The indicated method also permits to assess the success of therapeutical measures.

By means of clinical and experimental control studies in partly adjustable individual articulators, it was tested how exact an apparatus has to be in order to ensure a reliable clinical diagnosis of periodontal disease. In the clinical as well as the experimental part of the studies, it was possible to demonstrate that the intra-alveolar movement of the tooth plays the most important role in allfunctional disturbances of traumatized periodontal diseases.

The effects of vaso-active drugs on the inclination time and the plateau index in the plethysmogram were determined on different days and at different hours of the day. A first evaluation of the limits of performance and of the diagnostic possibilities, based on 1,500 measured values, permits to conclude that this technique is suited for differentiating between normal and disturbed periodontal microcirculation, and between functional and organic vascular changes.

With the aid of the measurements of tooth mobility the treatment success of grinding was evaluated in 208 upper incisors of 54 patients, and the results were set into correlation with different factors. The results show that decreased tooth mobility following grinding was observed both in healthy periodontium and in diseased periodontium.