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IN RECENT YEARS mucogingival surgery has established itself as a very satisfactory approach in the treatment of advanced periodontal disease. Correlated with the clinical techniques in mucogingival surgery, various histologic studies were undertaken to better understand the response of the tissues subjected to these clinical techniques. The findings of these investigations soon demonstrated the destructive effects of some techniques, in contrast to other techniques which were far less destructive to the tissues and gave more satisfactory results.In December 1959 at Glenwood Springs, Colorado,! Staffileno reported the histologic findings of an experimental study of a surgical technique that was seldom employed in mucogingival surgery at that time. This surgical technique was a split thickness mucogingival flap which left the periosteal connective tissue intact on the bone. Simultaneously at this same meeting Ochsenbein presented a double flap procedure which involved separating the alveolar mucosa from the periosteum and then stripping the periosteum from the bone. Thereafter this same periosteum would be sutured over

OBJECTIVE:To investigate the possible associations between sleep apnea syndrome, hyperinsulinemia=insulin resistance and hyperleptinemia in subjects with different degrees of body mass index. DESIGN: To test for the presence or absence of sleep apnea syndrome in association with hyperinsulinemia=insulin resistance and hyperleptinemia. SUBJECTS: Twenty subjects with different body mass index (mean BMI 30.9 AE 4.2). MEASUREMENTS: Insulin action and plasma soluble leptin receptor were measured by euglycemic hyperinsulinemic glucose clamp and by ELISA method, respectively. Occurrence of sleep apnea syndrome was assessed by clinical and nocturnal monitoring using a validated sleep apnea recorder. RESULTS: The apnea=hypopnea index (AHI) was positively correlated with plasma soluble leptin receptor (0.76; P < 0.001) and negatively with the degree of insulin-mediated glucose uptake (r ¼ 7 0.73; P < 0.001). In a multivariate analysis AHI was associated with plasma soluble leptin receptor and insulin mediated glucose uptake independently of age, gender, BMI, plasma leptin levels and PaCO 2 . CONCLUSION: Sleep apnea syndrome is associated with plasma soluble leptin receptor and insulin resistance independently of BMI.

Rheumatoid factor (RF) was detected by latex‐slide agglutination in subgingival plaque, inflamed gingival tissue, stimulated pooled saliva and serum of patients suffering from chronic moderate periodontitis. The etiology of rheumatoid factor and its possible homeostatic role in periodontal disease are discussed, in relation to the reported association of Gram‐negative bacterial endotoxin and the chronic antigenic stimulating nature of periodontal disease.