Differences in cAMP levels in the gingival fluid of diabetics and nondiabetics.

Gingival fluid from eight control subjects and ten diabetics was collected and the content of cAMP and protein in the fluid was assayed to determine the nature of the biochemical changes occurring in the gingival fluid due to diabetes. The gingival fluid of the control subjects had a cAMP concentration of 2.4 X 10(-6) M, which was a hundredfold greater than that seen in serum, thus suggesting that the cAMP in the fluid resulted from active synthesis by the gingival cells and was not merely a transudate from the blood. The gingival fluid of the diabetics contained only one-seventh the level of cAMP seen in the control group. It is suggested that the decreased level of cAMP seen in the givgival fluid of diabetics may be a manifestation of a defect in the cAMP forming mechanism of the gingival tissue, which may reflect the systemic etiology of diabetes. It was also found that in the control subjects the content of cAMP in the gingival fluid was in inverse proportion to the volume of exudate in the gingival crevice. No such relationship was seen in the diabetic group. It appears that the level of cAMP present in the gingival fluid of normal individuals without any generalized endocrine deficiencies may be used as an additional indicator of the inflammatory status of the gingival tissues, along with the clinical evaluation based on gingival index.

A comparison of mandibular lingual surgical flaps with and without a vertical releasing incision.

The purpose of this study was to evaluate the short-term postoperative pain for surgical flaps with mandibular lingual vertical releasing incisions (ML-VRI) compared with envelope flaps and to observe the postoperative clinical healing of ML-VRI. Using a split mouth design, 12 adult periodontal patients received bilateral posterior mandibular surgery with an envelope flap on one side and a flap with an ML-VRI on the contralateral side. Surgical procedures were performed at separate appointments, varied in order, and performed an equal number of times on the right and left sides. Postoperative pain was scored by the patients, and scores for each technique were compared using an analysis of variance and covariance with repeated measures. Photographs were used to assess postoperative clinical healing of ML-VRI with various degrees of initial closure. Results indicated no significant statistical difference (P greater than 0.05) between pain levels for the two surgical techniques. There was complete clinical healing despite variations in the degree of closure of ML-VRI. The findings of this study support the use of ML-VRI. They are indicated in areas with flat contours or with slight ledges and inferior concavities. ML-VRI are contraindicated in areas with prominent ledges and inferior concavities and in areas with exostoses. Suturing the vertical incision is unnecessary and may be detrimental to the tissues. A "step down" incision that preserves attachment levels in nondiseased sites is discussed.

The value of the nuclear medical scan in the diagnosis of temporomandibular joint disease.

A total of 125 patients with TMJ complaints underwent nuclear medical scans of their joints as part of their diagnostic work-ups. The scan results were compared with the radiographic and arthrogram findings of these patients. The results suggest that the nuclear medical scan is not a highly reliable diagnostic aid for the majority of temporomandibular joint patients.