Paul N. Baer

Comparative pathology of periodontal disease: I. Gorilla

Abstract A total of 292 gorilla skulls were examined for periodontal disease as evidenced by resorptive lesions of the alveolar bone. Osseous periodontal lesions consisting of horizontal resorption, furcation involvements, interproximal craters, fenestrations, and buccal vertical defects were observed in 76.4 per cent of the specimens. The roots of the maxillary first molar appeared to be most often involved with a fenestration defect. Measurements of the alveolar bone lesions appear to indicate that a severe vertical loss of buccal bone (dehiscence may result from a confluence of the increasing horizontal and fenestration types of alveolar bone resorption.

A Histologic Study of the Effects of Several Periodontal Dressings on Periosteal-covered and Denuded Bone

During the past several years there has been an increasing emphasis on alveolar-bone exposure and involvement in periodontal surgical techniques. The postoperative periodontal dressings that traditionally have been used over exposed soft tissue are now being applied to operative sites where bone is exposed. Although the reaction of soft tissue to many of the dressings used and ingredients therein have been studied by histologic methods (D. F. Mitchell, J.A.D.A., 59:954, 1959; C. M. Dixon and U. G. Rickert, J.A.D.A., 20:1458, 1933; T. D. Schaad et al. [abstr.], J.A.D.A., 34:11, 1956), the only reports of bone reaction have been of the effects of eugenol (Lillian Lindsay, Fauchards Surgeon Dentist [London: Butterworth & Co., 1946], p. 94; E. D. Coolidge, J.A.D.A., 19:747, 1932). Eighty Sprague-Dawley rats were divided into four groups of twenty rats each. The following periodontal surgical dressings were used as the test materials: (1) eugenol dressings: powder portion-zinc oxide, rosin powder, zinc bacitracin, liquid portion-expressed almond oil, eugenol, rosin powder; (2) non-eugenol dressing: powder portion-same as above, ointment portion-zinc oxide, hydrogenated fat; (3) a synthetic perforated dressing;* and (4) zinc oxide and eugenol. The method used for testing was as follows: Under intraperitoneal Nembutalt anesthesia, the heads of the rats were shaved, semilunar incisions were made anterior to the ears, and flaps were retracted, exposing approximately 1 cm. of the underlying bone. In half the animals in each group (ten) the dressing to be tested was placed directly on the periosteum, while in the remaining half of the animals the periosteum was removed from the bone prior to placement of the dressing materials. The flap was then returned to place and secured with several sutures. Half the animals in each subgroup (five) were sacrificed after 7 days, and the remaining half (five) after 14 days. The heads were fixed in 10 per cent formalin and decalcified in 5 per cent formic acid. The excised tissue of the operated site was halved in a sagittal direction, imbedded in paraffin, sectioned at 6 g, stained with hematoxylin and eosin, and examined microscopically. Ten sham-operated and five normal unoperated specimens were included for comparison. Periodontal dressings, when placed against bone denuded of periosteum, provoked a greater inflammatory response with less evidence of repair than when placed against periosteal-covered bone. Eugenol-containing dressings elicited a greater inflammatory response with less evidence of organization than non-eugenol-containing dressings against denuded bone. The Telfa dressing caused the least inflammatory response, with more rapid repair in all instances. Sham-operated animals showed the same picture histologically as normal unoperated specimens. The site of biopsy was anterior to line of incision in areas of previously denuded bone. While it is always dangerous to draw clinical implications from work done on animals, nevertheless the following conclusions might be applicable. A periosteal covering should be left intact when doing periodontal surgery which involves the bone. In cases where alveolar bone is denuded of its periosteum, of the dressings tried, a non-eugenol-containing dressing will provoke the least harmful response. Clinical trials which demonstrate the safety of a non-eugenol-containing periodontal dressing have been reported previously (P. N. Baer et al., Oral Surg., Oral Med., Oral Path., 11:712, 1958).

Rat virus and periodontal disease

Abstract Dental abnormalities associated with a virus infection have been produced in the Syrian hamster. These abnormalities consist of the following: 1. 1. Severe osteoclastic resorptions and bony ankylosis of the roots of the first molars and incisors. 2. 2. Although resorption and ankylosis are less severe in the second molars, their roots are more distorted in shape and much shorter in length, as compared with the first molar in the same animal or the second molars in control animals.

TUBEROUS SCLEROSIS WITH ORAL MANIFESTATIONS. REPORT OF TWO CASES.

Abstract Two cases of tuberous sclerosis with oral manifestations have been reported. One patient had multiple lesions on the tongue, and the other had lesions on the gingiva.

Wegener's granulomatosis: Report of a case involving the gingiva

Abstract A case of documented Wegeners granulomatosis which first manifested itself as a painful, infiltrative granulomatous lesion of the gingiva has been presented. Because of the nonspecific character that the granulomatous lesions manifested, the diagnosis in this case was in doubt until an autopsy had been performed. However, as has been described in other cases of Wegeners granulomatosis, there was a rapid fulminating downhill course which ended in death due to acute renal failure.

Necrotizing ulcerative gingivitis in drug addict patients being withdrawn from drugs: Report of two cases

Abstract It seems reasonable to conclude that the occurrence of acute necrotizing ulcerative gingivitis in drug addicts undergoing drug withdrawal may be due to the acute psychological disturbances that accompany the abstinence syndrome. However, not all patients undergoing drug withdrawal will react in this way.

Rat virus and periodontal disease: IV. The aged hamster

Abstract In 12- to 18-month-old hamsters which had been inoculated with rat virus at 5 days of age, the following changes were observed: 1. 1. Odontogenic “tumors” were present within the body of the mandible and about the apical portions of the incisors in the maxilla. 2. 2. The roots of the first molar were thickened by a large number of concentric layers of osteocementum. No true periodontal membrane was present. The roots were separated from the surrounding alveolar bone by a thin band of connective tissue. 3. 3. In all of the animals the roots of the second molars were short, thick, and composed largely of an osteocementum. Severe periodontal involvement with loss of half or more of the surrounding alveolar bone occurred in one half of the animals. 4. 4. The third molars, with the exception of those engulfed by the odontogenic “tumors” or growths, demonstrated severe alveolar bone loss, which resulted in exposure of approximately three-fourths of the root length. The apical third of the root was bulbous and consisted of many concentric layers of osteocementum. In the control animals the findings were as follows: 1. 1. Odontogenic growths were never seen. 2. 2. Periodontal disease was not a common finding, but it did occur in 10 per cent of the animals. The periodontal lesions, when seen, were limited to the interproximal areas and were associated with gross impaction of hair, food, and debris. 3. 3. The roots, with the exception of the apical portion, were covered with a thin, uniform layer of noncellular cementum. The apical portion of the root was covered by an osteocementum but lacked concentric layers and was not bulbous.

Esterase activity associated with formation of deposits on teeth.

Abstract 1. 1. Esterase activity was found in bacteria, polymorphonuclear leukocytes, macrophages, and epithelial cells associated with deposit formation on teeth. 2. 2. It is suggested that enzyme activity in tooth deposits it correlated with a saponification process, ultimately leading to calcifications.

Thiophene Compounds that Reduce Calculus Accumulation and Inhibit Bone Resorption

The biological actions of thiophenes are poorly understood and their therapeutic use has been limited. Previous results showed that some thiophene analogues have a hypocalcemic effect in rats, inhibit resorption of bone in culture, and reduce calculus accumulation in rats when added to a calculus producing diet. In a search for agents to prevent or reduce pathological loss of alveolar bone, the present studies examined the effects of various thiophene analogues on some in vivo and in vitro aspects of bone metabolism and on calculus accumulation and alveolar bone resorption in rats. In rats, thiophene has a hypocalcemic effect that can be enhanced and prolonged by various additions to the thiophene ring. The most potent hypocalcemic analogues appear to be 5-bromine-2-thiophenecarboxylic acid (BrTCA) and 5-methyl-2-thiophenecarboxylic acid (MTCA). Results, thus far, support the idea that these compounds inhibit bone re-

Studies on Dilantin Hyperplastic Gingivitis the Role of Magnesium

The incidence of hyperplastic gingivitis has been reported to occur in 57 per cent (0. P. KIMBALL, J. Amer. med. Ass., 112:1244, 1939), 21 per cent (I. GLICKMAN and M. LEWITUS, J. Amer. dent. Ass., 28:199, 1941), and 63 per cent (S. I. FRANKEL, J. Amer. dent. Ass., 114:1340, 1940) of patients undergoing dilantin therapy. The etiology of such changes is not understood, and the therapy of such patients has not been satisfactory. As the drug is often essential for the control of epilepsy, it was thought pertinent to investigate the possibility of a deficiency states playing an etiological role in such patients. A lowered serum magnesium has been reported in convulsive patients (V. G. HAURY and A. J. CANTAROW, J. Lab. andldin. Med., 27:616, 1942), and experimental hyperplastic gingivitis has been produced in magnesium-deficient rats (H. KLEIN, E. R. ORENT, and E. V. MCCOLLUM, Amer. J. Physiol., 112:256, 1935). This latter finding has recently been confirmed by A. A. Rizzo and H. R. Stanley, of the National Institute of Dental Research (to be published). The purpose of this study was to determine whether any correlation existed between the serum-magnesium level and hyperplastic gingivitis. Epileptic patients under dilantin therapy were divided into two groups of ten patients eachGroup 1, those with hyperplastic gingivitis; Group 2,