Inflammatory effects of periodontally diseased cementum studied by autogenous dental root implants in humans

The inflammatory potential of diseased cementum was studied by implanting 70 autogenous fragments from periodontally involved roots into the mucosa of 56 patients. The implants were divided into groups depending upon the type of preparation the root received prior to implantation. Fifteen healthy root fragments implanted into 15 patients served as controls. Histologic results showed that implanted fragments from roots that had been scaled caused the most response with acute inflammation up to 14 days and chronic inflammation to 21 days. In cases in which these fragments were autoclaved the acute inflammation was not as severe. In the cases in which the roots were planed and autoclaved, even less acute inflammation was seen in the 7-day specimens while some chronic inflammation persisted in the 21-day specimens. Implants from healthy roots evoked no response. The inflammation caused by the autoclaved diseased cementum was attributed to thermo-stable endotoxin. It was concluded that in advanced periodontal disease it is necessary to remove all of the cementum exposed to the pocket to eliminate its potential for inducing inflammation.