Healing following devitalization of sites within the periodontal ligament by ultralow temperatures

Healing of specific rat periodontal ligament (PDL) sites following freezing injury was monitored histologically to evaluate repair potentials of this tissue. Buccal alveolar plates supporting the first mandibular molar in 15 adult rats were surgically exposed. The coronal 3 mm of plate covering the buccal surface of the mesiobuccal root and underlying periodontal ligament and cementum were subjected to ultralow temperature using a gas expansion micro/cryoprobe, diameter 2 mm, cooled to -81 degrees C for 5 seconds. Tissues were repositioned and sutured in layers. Animals were sacrificed at 1, 24 and 72 hours and at 2, 5 and 7 weeks following surgery and mandibles removed for histologic analysis. Microscopic evaluation of 24-hour specimens showed loss of cellular vitality in the PDL, adjacent bone and cementum at experimental sites. Cellularity of the gingiva coronal to the crest, and of the PDL apical to the experimental zone, appeared to be within normal limits. Transition between experimental and nonexperimental sites was abrupt. After 72 hours cells from the PDL and gingiva appeared to migrate into and repopulate the noncellular PDL. Few capillaries surrounded by mesenchymal cells and limited polymorphonuclear neutrophil infiltration were observed within the injured PDL site. Marginal gingival inflammation was minimal. At 14 days, collagen lysis, resorption of alveolar bone and root resorption were evident. In the PDL space, nonfunctionally oriented, cellular connective tissue elements were abundant. At 5 and 7 weeks, root resorption was marked. At this time interval, osteogenesis at seams of nonvital bone, repair cementum at sites of root resorption, and at times, ankylosis, were noted.(ABSTRACT TRUNCATED AT 250 WORDS)