David A. Baab

Effects of Le Fort I osteotomy on human gingival and pulpal circulation

The maxillary blood flow during the first 24 h following Le Fort I osteotomy was evaluated by laser Doppler flowmetry. Pulpal blood flow was recorded from two maxillary incisors and gingival blood flow was assessed from a site slightly apical to the interdental papilla of the maxillary central incisors of 12 patients receiving Le Fort I osteotomy, nine control patients receiving mandibular osteotomy, and 10 nonsurgical control subjects without orthodontic appliances. Measurements were made before surgery and at time intervals between 0-8, 8-16, and 16-24 h after surgery. The nonsurgical controls were tested at similar intervals. Gingival and pulpal blood-flow measurements did not change over time in the nonsurgical control group. Presurgical blood-flow values did not differ between the two surgical groups. Following surgery, mean gingival (but not pulpal) blood flow was significantly lower for patients treated with Le Fort I osteotomy than for patients treated with mandibular osteotomy. Follow-up examinations revealed that one patient receiving Le Fort I osteotomy experienced loss of gingiva and bone around both central incisors. This patient had one of the largest reductions in gingival blood flow.

Caries and periodontitis associated with an unerupted third molar

Radiographic, gross, and histologic evidence is provided to demonstrate the development of caries and periodontal disease over a 5-year period in an unerupted tooth. The authors speculate on the pathogenesis of these disease processes.