Biologic preparation of diseased root surfaces.

Untreated periodontally-involved teeth contain cementum-bound endotoxin, that may prevent periodontal new attachment during healing after pocket therapy. The purpose of this study was to restore biocompatibility to diseased root surfaces by a non-invasive treatment. Untreated human teeth removed for severe chronic periodontal disease were split buccolingually, the level of connective tissue was scribed on the roots, the specimens cleaned of plaque and visible calculus, and autoclaved. Cementum removal was not attempted. One member of each pair was treated with phosphate-buffered saline as a control. Sodium desoxycholate (2%), Cohn plasma fraction IV1 (5%), or deoxycholate followed by plasma fraction were applied for one minute. Roots were incubated in a suspension of gingival fibroblasts for 48 hours, then rinsed, fixed, and stained. Counts were made of the number of attached cells at 40 x magnification using an ocular grid. There was a significant increase (p less than 0.01) of the combination treatment over controls. All treatments provided a biological surface for attachment of fibroblasts, in vitro, compared to untreated roots.