Immunohistochemical investigation of the presence and distribution of cementum‐associated lipopolysaccharides in periodontal disease

Abstract

An immunohistochemical technique was used to investigate the distribution of cementum‐associated LPS in 14 human teeth extracted because of periodontal disease. Autologous affinity purified anti‐LPS antibodies were obtained against a preparation of oral LPS types bound to an epoxy‐activated Sepharose 6B‐polymyxin B column. The concentration of immunoglobulin classes G. M and A in the prepared sera was assayed by rocket immunoelectrophoresis and the reactivity of the sera was checked using an ELISA to the LPS preparation. Ground sections of the teeth were prepared and incubated with prepared autologous antiserum, followed by detection of Ig binding by a rabbit PAP system. LPS was detected on cementum which had been previously exposed to a periodontal pocket and extended to within I mm of the previous level of connective tissue attachment. LPS was only detected on the surface of cementum and on no occasion was LPS seen penetrating into sub‐surface cementum. These results suggest that extensive removal of sub‐surface cementum is not necessary in order to render root surfaces free of bacterial endotoxins during root planing procedures.

Cell Attachment Activity of Cementum Proteins and Mechanism of Endotoxin Inhibition

“…Experiments were performed to examine whether this is due to inhibition of attachment by bacterial endotoxins, which are present on diseased roots (Aleo et al, 1974;Olson et al, 1985;Hughes and Smales, 1986). These experiments were done using endotoxin obtained from A. actinomycetemcomitans.…”

“…New connective tissue cannot form on diseased roots, since they contain bacterial endotoxins that do not support the attachment or growth of fibroblasts (Aleo et al, 1974;Fernyhough and Page, 1983;Pitaru and Melcher, 1983;Olson et al, 1985). Therefore, roots are subjected to extensive root-planing during therapy in order to remove toxic bacterial substances, which are present on the root surfaces (Aleo et al, 1974;Hughes and Smales, 1986;Cheetham et al, 1988). To facilitate connective tissue formation and attachment, attempts have been made to supplement planed roots with molecules such as fibronectin and growth factors; however, these substances have met with only a limited and variable degree of success (Caffesse et al, 1988;Nyman et al, 1988;Wikesjo et al, 1988;Lynch et al, 1989).…”

Histopathology of Root Surface Caries

“…There is, however, no agreement on whether bacteria invade cementum and peripheral dentin. Using histological methods, some workers observed bacterial invasion (Daly et al, 1982;Adriaens et al, 1988;Schiipbach et al, 1989), whereas others using histochemical methods did not (Hughes and Smales, 1986; Moore et al, 1986). Since basic knowledge of the development of initial lesions in cementum and peripheral dentin is a prerequisite for the choice of treatment of root surface caries, this investigation was undertaken to assess the histological features of such lesions.…”

A new ultrasonic device in maintenance therapy: perception of pain and clinical efficacy

“…Recent studies have shown that endotoxins are located on the periodontally diseased root surface and not within it (Hughes & Smales 1986, Nakib et al 1982). These studies have led to the sugg-estion that the root surface should be treated less aggressively during periodontal therapy and that simple procedures such as washing and brushing a periodontally diseased root render the surface virtually endotoxin free (Blomlöf et al 1987, Moore et al 1986).…”