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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (5): 927-935. doi: 10.19723/j.issn.1671-167X.2022.05.020

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Healing of the dento-gingival junction following modified crown lengthening procedure in beagle dogs

Min ZHEN1,Huan-xin MENG1,Wen-jie HU1,*(),Deng-cheng WU2,Yi-ping WEI1   

  1. 1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
    2. Central Laboratory, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
  • Received:2022-05-31 Online:2022-10-18 Published:2022-10-14
  • Contact: Wen-jie HU E-mail:huwenjie@pkuss.bjmu.edu.cn
  • Supported by:
    the Capital Foundation for Clinical Characteristics and Application Research(Z131107002213174)

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Abstract:

Objective: To evaluate the type of wound healing following modified crown lengthening surgery in dog model to provide a biological basis for its clinical application. Methods: Flap surgery, traditional crown lengthening procedure and modified crown lengthening procedure were performed on the right maxillary central incisor, the left maxillary central incisor and the left maxillary first lateral incisor respectively of five male beagle dogs. The right maxillary first lateral incisors with no surgical intervention were used as controls. Thirty-six weeks after the experimental procedure, tissue blocks were harvested and prepared for histological examination and analysis. Results: Histometric examination of buccolingual sections stained with hematoxylin-eosin demonstrated that the type of wound healing in the flap surgery group was re-attachment, similar to the control group. For the traditional crown lengthening surgery group, all of the five beagle dogs had lamellar cementum defects on root surface, the wound healing of four beagle dogs was new attachment accompanied by new cementum formation at cementum defect areas and the suprac-restal connective tissue was functionally oriented perpendicular to the new cementum. The wound healing of the other beagle dog was long junctional epithelial attachment, in which the junctional epithelium extended to the apical terminus of the cementum defect. In the modified crown lengthening surgery group, four beagle dogs had cementum defects on root surface (two lamellar cementum defects and two shallow platform-like cementum defects), the wound healing of three beagle dogs was new attachment, however, the supracrestal connective tissue was parallel to the root surface. The type of wound healing of another one beagle dog was long junctional epithelial attachment. Wound healing of one beagle dog in this group could not be characterized due to incomplete dissection. Conclusion: Wound healing in the modified crown lengthening surgery group was similar to the traditional crown lengthening surgery group, and two types of wound healing were observed: new attachment and long junctional epithelium attachment. Neither type of root treatment procedure (root planing or root reshaping) nor root surface defect pattern (the lamellar cementum defect or shallow platform-like cementum defect) influenced the observed type of wound healing.

Key words: Crown lengthening, Periodontium, Wound healing, Osteotomy

CLC Number: 

  • R782.1

Figure 1

Labial view of the operation area in beagle dogs 36 weeks after operation"

Table 1

Comparison of the clinical indices before and 36 weeks after operation in 5 beagle dogs"

Items Probing depth/mm, ${\bar x}$± s Bleeding index Keratinized gingiva width/mm, ${\bar x}$± s
Preoperative Postoperative P# Preoperative Postoperative P# Preoperative Postoperative P#
Control 2.2±0.45 2.2±0.76 NS 3 4 NS 3.8±0.45 4.2±0.76 NS
Flap 2.2±0.45 2.2±0.45 NS 3 4 NS 3.5±1.00 4.3±0.84 NS
Traditional 2.4±0.55 2.2±0.45 NS 3 4 NS 3.7±0.97 4.7±0.97 NS
Modified 2.6±0.55 2.3±0.45 NS 3 4 NS 3.7±0.67 4.8±1.35 NS
P* NS NS NS NS NS NS

Table 2

The types of wound healing of the 5 beagle dogs in each test group"

No. Flap Traditional Modified
1 RA NA NA
2 RA NA NA
3 RA NA NA
4 RA NA -
5 RA LJE LJE

Figure 2

Labial site of #1 beagle dog of control group (buccolingual section, HE staining) A, dento-gingival tissue of labial site (×12.5); B, a large number of inflammatory cells infiltrated in the gingival tissue (×200); C, cementum on root surface was intact, the supracrestal connective tissue was functionally oriented perpendicular to the root surface and the junctional epithelium was attached to the cementum surface (×200)."

Figure 3

Labial site of #1 beagle dog of flap surgery with re-attachment findings (buccolingual section, HE staining) A1 and A2, dento-gingival tissue of labial site (×40); B, a large number of inflammatory cells infiltrated in the gingival tissue (×200); C, cementum on root surface was intact, the supracrestal connective tissue was functionally oriented perpendicular to the root surface and the junctional epithelium was attached to the cementum surface (×200)."

Figure 4

Labial site of #1 beagle dog of traditional crown lengthening group with new attachment findings (buccolingual section, HE staining) A, dento-gingival tissue of labial site (×12.5); B, a large number of inflammatory cells infiltrated in the gingival tissue (×200); C, junctional epithelium extended to the coronal terminus of the cementum defect (×200); D, at high magnification, the lamellar cementum defect area was filled with new cementum, which was covered by a mono-layer of cementablast-like cells, the supracrestal connective tissue was functionally oriented perpendicular to the new cementum (×200); E, supracrestal cementum on root surface was intact, the supracrestal connective tissue was functionally oriented perpendicular to the root surface (×200)."

Figure 5

Labial site of #5 beagle dog of traditional crown lengthening group with long junctional epithelium findings (buccolingual section, HE staining) A, dento-gingival tissue of labial site (×40); B, the junctional epithelium extended to the apical terminus of the cementum defect (×200); C, supracrestal cementum on root surface was intact, the supracrestal connective tissue is functionally oriented perpendicular to the root surface (×200)."

Figure 6

Labial site of #1 beagle dog of modified crown lengthening group with new attachment findings (buccolingual section, HE staining) A1 and A2, dento-gingival tissue of labial site (×40); B, a large number of inflammatory cells infiltrated in the gingival tissue (×200); C, new cementum was seen in part of lamellar cementum defect, and remaining cementum defect surface was attached with collagen fibers, the supracrestal connective tissue was parallel to the root surface (×200)."

Figure 7

Labial site of #3 beagle dog of modified crown lengthening group with new attachment findings (buccolingual section, HE staining) A, dento-gingival tissue of labial site (×40); B, the cementum defect area was filled with new cementum, and the supracrestal connective tissue was parallel to the root surface (×200); C, the cementum appeared platform-like defect (×200)."

Figure 8

Labial site of #5 beagle dog of modified crown lengthening group with long junctional epithelium findings (buccolingual section, HE staining) A, dento-gingival tissue of labial site (×40); B and C, the junctional epithelium extended to the apical terminus of the cementum defect, the cementum appeared platform-like defect (×200); D, supracrestal cementum on root surface was intact, the supracrestal connective tissue was functionally oriented perpendicular to the root surface (×200)."

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