SUMMARYThe pathogenesis of avascular necrosis of bone (ANB) was investigated in 111 patients with systemic lupus erythematosus (SLE) (24 with ANB, 87 without ANB); patients' ages, corticosteroid treatment, clinical and laboratory features associated with SLE, and haemostatic profiles were all taken into account. The mean ages of patients with and without ANB at the time of diagnosis of SLE was 24-1 and 31*2 years respectively. The mean maximal daily dose of prednisolone in the group with ANB was 50*8 mg, which was significantly higher than the dose (41*8 mg) in the group without ANB. Disease features of SLE, such as Raynaud's phenomenon, hyperlipidaemia, nephrotic syndrome, hypertension, and disease activity, were not found to be related to ANB. The percentage of patients who had lupus anticoagulant as well as a shorter activated partial thromboplastin time was greater in those with ANB than in those without. Multiple factors may be involved in the pathogenesis of ANB in SLE, and it is suggested that haemostatic abnormalities, which could be influenced by corticosteroids and young ages, play some part in the development of ANB.Since 1960 when Dubois and Cozen suggested an association of avascular necrosis of bone (ANB) with systemic lupus erythematosus (SLE),1 ANB has continued to be one of the major problems during the course of SLE. Corticosteroids, which are used for most patients with SLE, have been implicated as one cause of ANB, 6 but multiple factors, such as vasculitis,7 8 fat emboli,9 10 Raynaud's phenomenon,6 11 and young ages,12 13 must contribute to its development. As ANB may result from interference with the blood supply,7 haemostatic abnormalities and factors which induce them could also contribute to its occurrence.In this study we attempted to determine the predisposing factors for ANB in SLE, considering particularly patients' ages, corticosteroid treatment, and haemostatic state.

A significant improvement in oral health-related QoL was noted between phases I and III in the surgery and non-surgery groups. Such improvement was less pronounced in the non-surgery vs. the surgery group. From phase II to III, neither surgery nor non-surgical treatment yielded significant improvement in oral health-related QoL.

Within the limitations of the study, application of the SAP hydrogel promoted healing of surgical periodontal defects by enhancing cell recruitment and possibly angiogenesis.

Objective. In root coverage treatment, periodontal regeneration in gingival recession-type defects is an important challenge for the periodontist. The aim of this study was to histometrically investigate the effect of combined use of basic fibroblast growth factor (FGF-2) and beta tricalcium phosphate (β-TCP) on root coverage in dogs. Materials and methods.Sixteen adult beagle dogs were used. Buccal gingival recession defects were surgically created bilaterally in the maxillary canines. The defects in each animal were randomly assigned to: 1) an FGF-2 alone (control) group or 2) FGF-2/β-TCP (experimental) group. At 2, 4 or 8 weeks following surgery, specimens were obtained and subjected to microscopic examination and histometric assessment.Results. Inhibition of epithelial downgrowth was observed in both groups. At week 2, in the newly formed connective tissue at the coronal portion, FGF-2/β-TCP group showed significantly greater numbers of proliferating cell nuclear antigen -positive cells than the FGF-2 group (55.8 ± 4.8 versus 12.0 ± 1.4, P < 0.01). In the FGF-2/β-TCP group, new attachment was observed at 8 weeks, and the extent of new bone and cementum formation was significantly greater in the FGF-2/β-TCP group than that in the FGF-2 alone group. In both groups, the dentin surface beneath the new cementum presented minor irregularities, but no replacement resorption was observed.Conclusions. FGF-2 used in combination with β-TCP enhances formation of new bone and cementum without significant root resorption in root coverage in this dog model. This combination warrants further investigation in periodontal regeneration in root 3 coverage treatment.

The clinical importance of IgG anticardiolipin antibodies was investigated in systemic lupus erythematosus (SLE) in PBS 50 ,ul of serum which were to be tested (diluted to 1/50 with PBS containing 0-05% Tween-20 and 10% FCS) were added to each well and incubated for two hours at room temperature. After five washes with PBS 100 1d of alkaline phosphatase-labelled mouse monoclonal antihuman IgG (Miles, Naperville, Illinois, USA) was added to each well, and the plate was incubated for one hour at room temperature, followed by the addition of 100 RI of p-nitrophenyl phosphate (Sigma) in 1 M diethanolamine buffer (pH 9-8). After incubation for 30 minutes the optical absorbance was measured at 405 nm by Easy Reader (Laboscience, Tokyo, Japan). The values of IgG anticardiolipin antibodies were expressed as units compared with those of the standard serum. A positive result indicated a value in units more than 3 SD over the mean value obtained with control sera (106 healthy volunteers).

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Here, we report a case of gingival fenestration requiring periodontal plastic surgery. The patient was a 32-year-old man presenting with the chief complaint of esthetic impairment and gingival twitching due to gingival fenestration. Baseline examination revealed localized periodontal breakdown, including gingival fenestration in the lower right central incisor (#41). Periodontal examination revealed 3% of sites with a probing depth of ≥4 mm and 8.9% with bleeding on probing. Radiographic examination revealed vertical bone loss in #15 and 36, together with buccal fenestration in #41. Based on a clinical diagnosis of chronic periodontitis with gingival fenestration, initial periodontal therapy comprised plaque control and scaling and root planing. Following suppression of inflammation, occlusal adjustment was performed in the anterior teeth. As plastic surgery, combined use of an elevated flap and a connective tissue graft was applied at #41. Following reevaluation, the patient was placed on maintenance care. The patient's periodontal condition has remained stable over a 6-month period.