The Intermediate Plexus of the Periodontal Ligament: History and Further Observations

Application of biologics for ridge preservation/reconstruction after implant removal

BACKGROUND

The purpose of this review was aimed at providing the rationale supported with a series of cases to apply biologics to enhance orchestrating the healing process at implant removal sites.

SUMMARY

Implant removal is commonly applied on a daily basis, in particular, in cases that exhibit esthetic failures linked to inadequate implant position or in cases of advanced peri-implantitis. Implant removal sites differ substantially from tooth extraction sockets. Implants are ankylosed within the alveolar bone, which therefore have neither mechanoreception nor the elasticity provided by periodontal ligament fibers. As a result, the bone-to-implant contact must be disrupted by means of using a reverse-torque device to minimize trauma. It is possible that the surrounding bone provides limited vascularity, which may interfere with the healing and bone forming process within the socket. Therefore, the use of biologics may enhance this healing and accelerate bone formation in sites where implants are removed due to hopeless functional or esthetic prognoses.

CONCLUSION

The use of biologics, in particular autologous blood-derived products, may enhance and boost the healing process to potentiate bone availability at a later stage during implant placement.

Quantitative characterizations of the Sharpey's fibers of rat molars

BACKGROUND AND OBJECTIVE

The Sharpey's fibers of periodontal ligament (PDL) anchor the PDL to alveolar bone and cementum and are essential for the function of PDL. While qualitative analyses of the Sharpey's fibers have been widely explored, a comprehensive quantitative characterization of the Sharpey's fibers is not available. In this work, we selected rat molars as a model and comprehensively characterized the PDL Sharpey's fibers (diameter, density, length, embedding angle, and insertion angle).

MATERIALS AND METHODS

A total of 24 rat mandibular molars, eight maxillary first molars, and their surrounding alveolar bone were harvested, fixed, rendered anorganic and observed under scanning electron microscopy (SEM). The mandibles and maxillae (n = 4) were harvested, processed, sectioned, and stained with Sirius red for histological observation. SEM images were used for quantitative analyses of diameters and densities of the Sharpey's fibers, while Sirius red staining images were used to measure lengths and angles. The Sharpey's fibers were comprehensively characterized in terms of positions (cervical, middle, and apical thirds), PDL fiber groups (alveolar crest, horizontal, oblique, apical, and interradicular groups), sides (cementum and bone sides), and teeth (mandibular first, second, third molars, and maxillary first molar).

RESULTS

Our results showed that the characteristic parameters of the Sharpey's fibers varied in different positions, fiber groups, sides, and teeth. Specifically, the median diameter of the Sharpey's fibers on the bone side was significantly greater than that on the cementum side, while the median density of the Sharpey's fibers on the bone side was significantly lower than that on the cementum side, regardless of the positions and teeth. For the same tooth, the median length of the embedded Sharpey's fibers on the bone side was more than two times greater than that on the cementum side. Among all fiber groups, the alveolar crest group had the maximum length of the Sharpey's fibers on the bone side and the minimal length of the Sharpey's fibers on the cementum side. There is an approximate 5-15° difference between the embedding angle and the insertion angle in each group. The oblique group had the smallest embedding angles on both the bone and cementum sides.

CONCLUSION

This study provides a comprehensive and quantitative characterization of the Sharpey's fibers using rat molars as a model. Overall, these parameters varied according to different vertical positions, fiber groups, teeth, and jawbones. The quantitative information of the Sharpey's fibers presented in this work facilitates our understanding of PDL functions and advances the development of biomimetic materials for periodontal tissue regeneration.

Gingival stippling in dogs: clinical and structural characteristics

Diagnosis of periodontal disease, a frequent disorder in dogs, rests mainly upon the assessment of changes affecting the gingiva. Loss of gingival stippling, one of the early symptoms of periodontal disease in the human, could also indicate early periodontitis in the dog. The aim of this study was to determine the presence of gingival stippling in dogs, its location on alveolar processes, its association with age and inflammation, and its relation to the microstructure of the gingiva. The study concerns clinical, scanning electron and light microscopic examination of the gingiva of 48 dogs. Stippling, i.e. the granular appearance of the gingiva resembling irregularly distributed crater-like depressions of varying sizes, was present in adult but absent in young and senescent dogs. Stippling was most prominent at the level of the canine and the carnassial teeth. In contrast to the human gingiva, depressions and elevations of the stippled gingiva of the dog were not distributed uniformly. Presence of stippling indicates the presence of well developed mucosal layers and extensive interdigitation of epithelial rete pegs and papillary layer. Interaction of inelastic collagen fibres and a high hyaluronan content within papillary layer resulting in a high turgor of tissue due to the extensive water binding capacity of hyaluronic acid could also play a role in shaping of the gingival surface. The significance of gingival stippling in the diagnosis of periodontal disease in dogs is limited, as stippling occurs in healthy but also slightly inflamed attached gingiva of adult individuals.

The fibrous architecture of the rat periodontal ligament in cryosections examined by scanning electron microscopy

Cryosections through the incisor and molar teeth of the rat mandible were examined, with and without hyaluronidase pretreatment, in the scanning electron microscope. In the fully erupted molar teeth the fibres of the periodontal ligament were organized into bundles which crossed the space from the alveolus to the cementum and inserted into the associated mineralized tissues. In the erupting incisor teeth, three distinct zones were evident. The outer alveolar and cemental zones were composed of coarse fibre bundles which inserted into the adjacent mineralized tissues, while the middle zone was composed of collagenous laminates running along the axis of the tooth. These observations confirm a proposed model for the structure of the erupting periodontal ligament and suggest that the method used will provide further information about the role of the ligament in tooth support and eruption.

Paravascular cells in endosteal spaces of alveolar bone contribute to periodontal ligament cell populations

Endosteal spaces of alveolar bone communicate with the periodontal ligament and may contribute to its cell populations. We examined cell proliferation and migration in endosteal spaces and in the periodontal ligament contiguous with these spaces. Radioautographs of mouse mandibular molar were prepared from animals pulse-injected with 3H-Tdr and sacrificed in groups of 22 mice each at 1 h, 1, 3, and 7 d after labeling. Cell counts, labeling indices, grain counts, and progenitor cell ratios were determined. The data indicate that endosteal spaces are enriched with 3H-Tdr-labeled progenitor cells whose progeny rapidly migrate out of the compartment. The periodontal ligament contiguous with the endosteal spaces exhibited 5 times as many labeled cells as other sites in this tissue. Thickened areas of cementum were coincident with the openings of endosteal spaces in over 64% of observations. The data are consistent with the hypothesis that cells migrate from endosteal spaces into the periodontal ligament and there express the phenotype for osteoblasts or cementoblasts.

Collagen fibre architecture in the periodontal ligament

Images