Abram I. Chasens

Periodontosis with periodontitis: A study involving young adult males

T e clinical entity called periodontoti can be identified by early mobility and/ or migration of teeth in young persons (from puberty to the age of 30 years) who are in apparent good health. There is appreciable alveolas bone loss, with little inflammation of the gingiva at first. Only somewhat later is there gingival inflammation with rapid development of deep periodontal pockets. At that time the periodontosis is considered to be complicated by peri0dontitis.l Although there is some general agreement that periodontosis is a clinical entity, there is less agreement on some of the clinical findings and still less on the histopathologic aspects of the condition. The majority of investigators, however, have found histopathologic changes in which degeneration is the dominant feature.l There is no known etiologic factor common to all cases of periodontosis, and there is no uniformity of opinion concerning the course of the disease or its reaction to therapya The incidence of periodontosis, as reported, varies from 0.1 to 22 per cent of the population, but it is generally considered to be less than 2 to 3 per cent. It is, therefore, a rather rare manifestation and must be distinguished from clinically obvious primary occlusal trauma, which is much more common.* Cases of periodontosis in young men serving in the United States Armed Forces have been described by Orban’? 3 and Whinston4 Mindful of these reports, we undertook a study to investigate the clinical entity of “periodontosis with periodontitis” in young male recruits (aged 19 to 27) who entered the Army Basic Training Center at Fort Polk, Louisiana, during the 2-year period from

Acute myeloblastic leukemia with oral manifestations: Report of a case

Abstract This article reports the case of a 36-year-old man whose only complaints at the time of his initial examination were pain in the maxillary right premolars and gingival bleeding in the same area. These symptoms had been present for approximately 1 week. This case is presented to show that mild and innocuous oral symptoms may be manifestations of a serious underlying disease.

Bradykinin Activity in Gingival Fluid: A Pilot Study

It may be possible to determine the degree of inflammation in gingival tissue by measuring the bradykinin levels in gingival fluid. Lewis (Ann NY Acad Sci 104:236, 1963) has demonstrated that bradykinin is a likely mediator in the inflammatory response. Salivary kallikrein activity (SALLAY and NADOR, J Dent Res 29: 232-236, 1950) and kininase activity (EIGEN ET AL, IADR Program and Abstracts of Papers, No. 301, 1966) increase with an increase in the severity of periodontitis. A positive relationship exists between gingival tissue bradykinin activity and degree of chronic gingivitis and periodontitis (RODIN ET AL, J Periodontol 43:476480, 1972). In patients with periodontosis, salivary kallikrein activity has been observed to be five to six times greater than in control patients of the same age (SALLAY and NADOR, 1950). The present study is a double-blind investigation to show the degree of bradykinin activity in gingival fluid from regions of periodontitis and periodontosis in humans. Periodontosis was complicated by periodontitis and was defined as a condition with appreciable radiographic alveolar bone loss around the permanent teeth of an apparently healthy young adult. Advanced bone loss could not be accounted for adequately by local factors. Clinical evaluations of gingival inflammation were based on the Gingival Index of Lde (J Periodontol 38:610, 1967). All gingival fluid was taken from posterior maxillary interproximal regions, which were isolated carefully to prevent contamination by saliva. The method of fluid collection and equipment have been described previously (KASLICK ET AL, J Dent Res 47:1192, 1968). Glass capillary tubes* with an internal diameter of 0.635 mm and outer diameter of 1.219 ± 0.025 mm were used for fluid collection. After collection, the undiluted supernatant gingival fluid was expelled immediately from the collection tubes and infused directly into a muscle bath preparation. The rat uterus contraction technique was used to determine bradykinin activity with a physiograph and an iso-

Quantitative Analysis of Inorganic Phosphorus and Magnesium in Gingival Fluid

Measurements of chemical constituents in gingival fluid can provide a precise evaluation of the degree of inflammation in the surrounding tissues. An assessment of the extent of inflammation can help in the diagnosis, prevention, and treatment of periodontal disease. Sodium, potassium, and calcium concentrations in gingival fluid have been reported previously (R. S. KASLICK ET AL, J Periodontol 40:93-97, 1970 and R. S. KASLICK ET AL, J Dent Res 49:887, 1970). Menkin (Biochemical Mechanisms in Inflammation, 2nd ed, 1956, pp 86-89, 93-95) has shown that inorganic phosphorus is increased and that magnesium is decreased in concentration (relative to serum levels) in exudates from acutely inflamed tissues. The concentrations of inorganic phosphorus can be higher in gingival fluid from chronically inflamed gingiva than they are in serum (E. WEINSTEIN ET AL, Periodontics 5:161-166, 1967). This study provides preliminary data on the concentration of inorganic phosphorus and magnesium in gingival fluid. The method of gingival fluid collection by use of glass capillary tubes* has been described previously (R. S. KASLICK ET AL, J Dent Res 47:1192, 1968). The inorganic phosphorus concentration was analyzed colorimetrically by the Chen, Tori Bara, and Warner method (Analyt Chem 28: 1756, 1956). An atomic absorption spectrophotometert was used to determine the con-

Tissue Plasminogen in Normal and Inflamed Human Gingiva

The purpose of this investigation was to determine the level of plasminogen in normal and inflamed human gingival tissue. Plasminogen, a naturally occurring serum globulin, is the precursor of the fibrinolytic enzyme, plasmin, and has been found in gingival crevicular fluid (G. T. GUSTAFSSON and I. M. NILSSON, Proc Soc Exp Biol and Med 106:277-280, 1961). It is converted into plasmin by a variety of bacterial, tissue, and serum activators. With inflammatory insult, the basement membrane of the endothelium permits plasma proteins to enter the injured area. Under normal conditions, the clotting mechanism is activated and fibrin is deposited in the pores of the basement membrane, sealing off the injured area. In the presence of plasmin in high concentration, fibrin is dissolved, and the unsealed pores allow the spread of local edema. It has been shown, however, that plasmin, in suitably low concentration, activates prothrombin into thrombin, thereby promoting fibrin deposition and the localization and subsidence of tissue inflammation and edema (I. INNERFIELD, G. R. ROWLEY, P. ZWEIL, and J. PORPORA, Thromb Diath Haemorrh, 18:447-455, 1967). The gingival tissue obtained for study was divided into four histologic and clinical categories: Group 1, normal; Group 2, mild chronic inflammation; Group 3, moderate chronic inflammation; and Group 4, severe chronic inflammation. After excision, the gingiva was washed, a section was taken for histologic study, and the remainder of the tissue was weighed and homogenized. To determine the amount of both plasminogen and plasmin, the following method was used. A control mixture containing 0.6 ml of 0.07 M saline-0.06 M phosphate buffer pH 7.5, 0.2 ml of bovine fibrinogen,* and 0.1 ml of streptokinaset (1,000 units/0.1 ml) was clotted with 0.1 ml of bovine thrombint (1,000 NIH units/vial). The noncontrol tubes contained, in addition, 0.1 ml of gingival homogenate. To test for plasmin alone, 0.1 ml of the same