Published in November 1989
GUIDED PERIODONTAL REGENERATION WITH AN AMNIOTIC MEMBRANE AND FIBRIN GLUE
Physician and Surgeon specializing in Dentistry. Periodontist.
Piazza Repubblica 4, 09129 Cagliari, Italy.
tel ++39 070 498159, fax ++39 070 400164
web site www.gustavopetti.it
|Fig. 29 The specific dye shows up a thin layer of amorphous material at the cement-new gingival connective tissue interface. At some points it appears to be dissociated in fascicles of fibres (picro-sirius-hematoxylin dye).||Fig. 30 Polarized light affords better definition, starting from the root and proceeding outwards the layer of cement with the characteristic arrangement of fibres in fascicles parallel and orthogonal to the root surface, the intermediate layer of amorphous tissue and finally the arrangement of woven fibres of the subepithelial connective tissue (picro-sirius-hematoxylin).|
|Fig. 31 The apical region: at the centre of the photograph we see the step that marks the deepest point reached with radicular curettage; the periodontal connective tissue appears clearly detached from the dentine and there are no signs of the formation of new cement. On the lower right we can see the cavity left by the bone reproducer (Interpore 200) following decalcification treatment (Azan-Mallory).||
Fig. 32 The stronger enlargement shows the step where the apical cement stops and the lack of amorphous material between the cement and the periodontal connective tissue. Signs of the presence of the bone inducer show up as white (picro-sirius-hematoxylin).
|Fig. 33 The previous preparation observed under polarized light confirms the lack of newly-formed cement between the periodontal connective tissue and the cement picro-sirius-hematoxylin).|
|Fig. 34 Histological section of the control tooth in which the bone defect was induced but left untreated: we find no short attachment, new cement, new bone apposition or organization of connective fibres at the root.|
|The histological pictures presented
show the premises for a return to integrity of periradicular periodontal
tissue and that the biological process leading to new attachment developed
more quickly at the coronal rather than apical level. This can be explained
both by the presence of the amniotic membrane, which in all probability
delayed apical migration of the epithelium, thus favouring the formation
of a short attachment, and supplied the trophic material for the deep connective
tissue, and because at the apex tissue and vascular regeneration was probably
delayed by the bone inducer-reproducer.
It is beyond doubt that with this technique it is possible to create the conditions for the formation of a short epithelial attachment, the formation of new cement, a new periodontal ligament and new bone formation around and inside the canaliculi of Interpore 200, thus obtaining the new attachment.