Studies on Pyorrhea Alveolaris at Department of Oral Surgery, Okayama University Medical School.

Studies were made on 327 pyorrhea alveolaris cases, 16-29 years of age, who had been found out of 2496 healthy unmarried women with the following results: (1) Pyorrhea alveolaris was found in 13% of them with increasing positive rates in advancing age. (2) Inflammatory type was found in 69% , combined type 29% , and atrophic type 1% with a general trend of mildness. (3) Traumatic occlusion was found in 10.4% . (4) The capillaries of nail grooves in pyorrhea alveolaris cases are very often abnormal in their arrangement, winding and thickness. (5) Pyorrhea alveolaris cases were found in 81% of uterine hypoplasia cases due to hormone disturbances. (6) R.B.C., W.B.C., hemoglobin, E.S.R., and red corpuscle resistance of pyorrhea alveolaris case, were normal; reticulocytes were slightly decreased, acidophil leucocytes were slightly increased, blood sugar was the maximum with in a normal range, γ-globulin in serum widely ranged, respiration of the R.B.C. slightly diminished, and cholinesterase of the R.B.C. and plasma slightly decreased. (7) Function of the reticuloendothelial system was decreased. (8) Basal metabolism, slightly elevated, being +12.60% on an average. Specific dynamic function of proteins was clearly decreased in 70% of the patients observed. (9) Gingivae of pyorrhea alveolaris cases showed three times increase in histamine. (10) On improvement of pyorrhea alveolaris, the lesser appearance of acidophils, degenerated epithelia, and spirochetae was observed in the exudate of gingival pockets with the appearance of the more nnmbers in small phagocytes and lymphocytes. (11) Iodine preparations, chlorophyl agents, local and general external application of vitamin K were found favorable in treating pyorrhea alveolaris

TISSUE FLUID FLOWING INTO GINGIVAL POCKET

The tissue fluid flowing into 129 human gingival pockets of upper anterior teeth in 15 minutes was collected on strips of alter paper. The tissue fluid from each pocket was weighed and the ninhydrin positive substance or free amino acids contained in it was estimated. These results were compared with clinical and histological findings. The weights of tissue fluid and the amounts of ninhydrin positive substance from all clinically healthy gingival pockets were found to be almost the same. There was a correlation between the tissue fluid weight and the amount of the ninhydrin positive substance in every type of periodontal disease. The amount of ninhydrin positive substance tended to increase with the progress of this disease. In many cases the amount of the ninhydrin positive substance increased where inflammatory cell infiltration and degeneration in subepithelial tissue and/ or cell infiltration and roughness in pocket epithelium were recognized. The small amount of free amino acids per mg of tissue fluid was recognized in the case of gingivitis. The amount increased sharply in the case of slight periodontitis, but in the case of severe periodontitis, decreased slightly on the contrary of increase in the total ninhydrin positive substance

CARBOHYDRATE IN PUS AND EXUDATE FROM GINGIVAL POCKETS -including investigation with regard to relationship of blood sugar level to glucose concentration in gingival pocket fluid of periodontitis associated with diabetes mellitus-

First of all, the free sugars in pus from the gingival pockets of periodontitis, and pus of alveolar and gingival abscess were observed by paperchromatography. Secondly, the relation between total weight, glucose content in pus and exudate from gingival pockets and the severity of periodontitis, the pocket depth, sex and age was quantitatively analyzed. Furthermore, the effect of blood sugar level upon the glucose concentration in gingival pocket fluid of periodontitis associated with diabetes mellitus was examined. As the results, glucose spot was detected in all cases of periodontitis, alveolar and gingival abscess. Besides glucose, ribose and desoxyribose spots also were found in some cases of involvement mentioned above. The amount of pus was proportional to the severity of periodontitis and an increase of pocket depth. In addition, the weight of exudate was more increased in periodontitis than in clinically healthy gingiva. A characteristic finding was not obtained from sex and age differences. In glucose concentration per 1mg of gingival pocket fluid it was found that in clinically healthy gingiva it was approximately equal to the blood sugar level of healthy person (70-110 mg%) and it was increased slightly in periodontitis than in clinically healthy gingiva. And in periodontitis the tendency to decrease gradually proportionally to the severity of inflammation was shown. In the cases of periodontitis involving diabetes with hyperglycemia glucose content in gingival pocket fluid was increased, as the blood sugar level was increased. It is pointed out that an increase of glucose consumption in gingival tissue may be related to an increased severity of diabetes. Finally, there was a close correlation between the glucose concentration per 1 mg of pus and that of exudate in the same patient of periodontitis. This finding is regarded as evidence that tissue fluid may always exude through the gingival pocket epithelial layer into the gingival pocket