Effect of root surface alterations on periodontal healing. I. Surgical denudation

The present study was undertaken to evaluate the effect of root surface denudation on periodontal healing. Twelve teeth, distributed in four squirrel monkeys, were extracted and reimplanted after surgically denuding the coronal root surface of connective tissue fibers and cementum by root planing. The reimplantation schedule provided three teeth for histologic analysis at 1, 3, 7 and 21 days after reimplantation. One day after reimplantation a zone of fibrin enmeshing erythrocytes and inflammatory cells was interposed between th root surface and the remaining periodontal fibers attached to the alveolar bone. Epithelium migrated rapidly along the denuded root, had reached the alveolar crest at 3 days, and was within the ligament space at 7 days. At 21 days, the epithelium was at the apical limit of root instrumentation, which corresponded to the level of attached connective tissue fibers on the root surface. No evidence of new connective tissue attachment was observed on the denuded root surface. It was concluded that the absence of fibers on the root surface resulted in apical migration of the epithelium, and precluded formation of new connective tissue attachment.