This study was conducted to determine the possible influence of diabetes on the pathogenesis of periodontal disease. A total of 148 patients, 120 females and 28 males, were surveyed. Their ages ranged between 9 and 50 years, with an average age of 30. The experimental group consisted of 83 diabetics and there was a control group of 65 nondiabetics. Both groups were divided into patients under and over the age of 30. The results showed: 1. Loss of attachment was higher in the over-30 diabetic group in the presence of similar local factors. 2. A higher Gingival Index was reported in diabetics of the combined age groups than in the controls (P less than 0.05). 3. The Plaque and Calculus Indices did not differ significantly between the diabetic and control subjects. 4. The correlation between the Plaque Index and loss of attachment in diabetics was the most relevant of the correlation analyses. The correlation between the gingival inflammation and loss of attachment indices in the combined diabetic group was also significant. 5. In both groups, diabetics and controls, periodontal destruction increased significantly with age. 6. Juvenile diabetics with severe periodontal disease, as well as others with normal periodontal structures, were found in the course of this study. These findings coincided with the presence or absence of local factors.
V ARIOUS surgical techniques have been advocated in the last decade attempting to create attached gingiva when this is missing or greatly reduced. 1 " 4 The reasons for the need of a wide band of attached gingiva, according to Friedman 5 are to eliminate the tension and pull on the marginal gingiva and to provide sufficient vestibular depth and freedom from frena for efficient tooth brushing and reflection of food in mastication. Some authors claim that the periosteum must be removed because attached gingiva will form only to cover areas where bone is denuded during the operation. 1 ' 6 Others believe that the periosteum should not be disturbed. 7 In a histologic study in dogs, Wilderman et al 8 have found that the denudation of bone during mucogingival surgery produces a loss of marginal bone. The present investigation was undertaken to study quantitatively the periodontal response to bone denudation in mucogingival surgery. MATERIAL AND METHODSThe study was made on four healthy adult mongrel dogs. The animals were anesthetized with Nembutal by intraperitoneal injection and the following procedure was performed:(1) A small cavity was drilled with a No½ round bur in the buccal aspect of the lower incisors and cuspids so as to have a fixed point from which to make the measurements.(2) The distances from the fixed point to the gingival margin and the mucogingival line were measured by means of a compass and millimetered ruler (Fig. 1).(3) The mucogingival fold was deepened by sharp dissection with a Bard-Parker knife to a depth of about 20 mm. and extending laterally beyond the distal aspect of both cuspids (Fig. 2, B).'^Faculty of Dentistry University of Buenos Aires.(4) A vertical incision was made between the two central incisors and to the bottom of the deepened fold.(5) The bone corresponding to the incisors and cuspid of the left side was denuded of periosteum by the use of curettes and scalers (Fig. 2, C).(6) The remaining unattached gingiva on the left side was also completely removed and the periosteum eliminated as thoroughly as possible.(7) The remaining attached gingiva on the right side was eliminated with scissors and periodontal knives, but the periosteum was allowed to remain in place (Fig. 2, D).(8) The area was covered with surgical periodontal pack maintained in place by an acrylic stent wired to the teeth (Fig. 2, E).One month after the operation the animals were anesthetized, the periodontal pack removed and the distances from the fixed point to the gingival margin and the mucogingival line again measured. At this time one animal was sacrificed and the operated area prepared for histologic study. The remaining three animals were left unpacked and again anesthetized and measured two and three months postoperatively. RESULTSThe findings to be presented consist only of the statistical study of the measurements done in three animals. Table I shows the differences between the preoperative measurements obtained on each tooth and the one, two and three months measurements.For the statistical analysis...
Previous studies have shown that tactile occlusal perception is not eliminated when teeth are anesthetized. Based on the suggestion that such perception could be influenced by other receptors in the masticatory system, the possible role of the temporomandibular joint receptors was considered in this study. The minimal thickness (in units of 8 microns) detected between opposing teeth initially and after anesthesia of both temporomandibular joint capsules, was determined in 15 subjects. Results showed a mean difference for the group of 2·0 units with a standard error of 0.54 which was highly significant (p < 0·001). However, 40% of the subjects did not show any variation after anesthesia. It is concluded that receptors from the temporomandibular joint capsule may play an important role in determining the tactile occlusal perception.
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