Influence of tooth instrumentation roughness on gingival tissue reactions
The purpose of this study was to evaluate inflammatory reactions in the gingival tissues facing plaque accumulation at curet- and diamond- instrumented root surfaces.
Five beagle dogs were utilized in this experiment. At the buccal surfaces of the maxillary and mandibular canines, a periodontal defect measuring 6 mm in height (from the CEJ to the margin of the bone) and 5 mm wide was created. A root surface instrumentation was performed. Root surfaces in group 1 were instrumented with fine-grained, flame-shaped diamond point. Root surfaces in group 2 were scaled and root planed with a sharp cures. Next the dogs were fed a plaque-inducing diet for 70 days, then sacrificed. Tissue blocks containing teeth, bone, and soft tissue were removed. A histomorphometric analysis was carried out. Epithelium and connective tissue analysis demonstrated no differences between the two instrumentations. Junctional epithelium cell point counts demonstrated an increased proportion of inflammatory cells in specimens adjacent to diamondversus curet-instrumented defects. An increased percentage of inflammatory cells existed within the coronal versus the more optical area of the junctional epithelium for both methods (P < 0.05).
A significant difference in inflammatory cell density between instrumentations was noted for noninfiltrated (P < 0.05) and infiltrated (P < 0.01) connective tissue.The infiltrated connective tissue's inflammatory cell density was sign)ficantly and definitively related to the junctional epithelium's inflammatory cell density (r = 0.75) and to area measurements of inflammatory connective tissue.
These findings show that the character of the subgingival root instrumentations sign)ficantly contributes to gingival inflammatory reactions, possibly by promoting subgingival plaque formation. [I.S.]
Lekness, K.N., T. Lie, U.M.E. Wikesjo, O.K. Boe, and K.A. Selvig, J Periodont, 67:197,1996