2,8
by new attachment to the tooth. Still others do not
A Clinical and Histologic Study
of Healing following the
Excisional New Attachment
Procedure in Rhesus Monkeys*!
by
R A Y M O N D A. YUKNA, D.M.D., M.S.J
PERIODONTISTS HAVE long sought methods of achieving
pocket elimination by soft tissue new attachment in the
common suprabony pocket. The literature is replete both
with techniques to gain "reattachment" of the pocket
soft tissue wall to the tooth and wound healing studies
that assess their efficacy and success. In reviewing these
previous works, one needs to determine the exact nature
of the intent, techniques, and results in each case.
1
Utilizing the classification set down by Ratcliff in 1966,
these studies can be classified as follows: healing by scar
2 8 9 18
(reattachment); " new attachment; " both of the
19,20 21*23
above; or those of an intermediate nature.
This investigation will concern itself with the problem
of new attachment in suprabony pockets. The clinical
and histologic definitions of new attachment, problems in
the concept and possibility of achieving new attachment,
criteria for proper tissue preparation, and the unreliabil­
27
ity of current therapy are presented elsewhere.
The many opinions on the feasibility, technique, and
healing of new attachment procedures leaves the clinician
as confused as ever. Many of the cited previous studies
seem to be prone to defects, inconsistencies, unwarranted
conclusions, and other problems. Several do not utilize
naturally occurring pathologic pockets, but instead use
surgically created defects (occasionally including the
removal of large amounts of healthy periodontal struc­
tures) that may heal spontaneously. 6-8,14
Others mistak­
enly deal with surgical incisions or detachments through
the gingival and periodontal tissues which heal by first
intention (scar) to the remaining soft tissue, rather than 1
* From the Periodontics Department, National Naval Dental Center
and the Dental Sciences Department, Naval Medical Research Insti­
tute, National Naval Medical Center, Bethesda, Md. 20014.
Supported by NGDS Research Project No. M R 041.20.02.6052 B 3
ID and N M R I Project No. M4305.04.3007AG13.
† The opinions or assertions contained herein are the private ones of
the writer and are not to be construed as official or reflecting the views
of the Navy Department or the naval service at large.
The animals used in this study were handled in accordance with the
provisions of Public Law 89-44 as amended by Public Law 91-579, the
"Animal Welfare Act of 1970" and the principles outlined in the
"Guide for the Case and the Use of Laboratory Animals," U.S.
Department of Health, Education, and Welfare Publication No. (NIH)
72-23.
X Formerly, Lieutenant Commander, Dental Corps, U.S. Navy.
Reprint Address: Periodontics Department, Louisiana State Univer­
sity School of Dentistry, New Orleans, La. 70119.
701
have conclusive proof of long-standing, completely epi-
6,22
thelialized experimental pockets. Many fail to con­
sider innate differences in certain animal tissues and
pathologies from human ones by using poorly selected
models for new attachment studies. 24,26
The present study seeks to eliminate these problems,
first, by using Rhesus monkeys, whose dentition, perio­
dontal structures, oral flora, and masticatory function
26
are very similar to humans. Secondly, thoroughly
epithelialized, nonregressive, suprabony pockets with
pathologic (rather than surgical) horizontal bone loss will
be induced. Finally, a particular therapeutic regimen, the
Excisional New Attachment Procedure (ENAP), which
is a definitive subgingival curettage performed with a
27,28
knife, will be utilized.
The healing sequence will be studied clinically and
histologically to assess the formation of a new attach­
ment.
MATERIALS AND M E T H O D S
The incisor teeth of five healthy male Rhesus monkeys
were used in this study. The animals were controlled by
the use of Sernalyn,§ 0.10 mg/kg, and atropine, 0.4 mg,
i.m.; and Nembutal || titrated intravenously as required
for the various procedures. Supplemental xylocaine local
anesthesia with vasoconstrictor was utilized during sur­
gery.
The initial periodontal condition of the incisors was
assessed by means of the Navy Periodontal Disease
29
Index (NPDI), amended to evaluate all eight teeth
under study. Small amalgam restorations with central
depressions were placed on the midfacial and midlingual
tooth surfaces, and vertical grooves were made parallel to
the long axes of the teeth at the mesiofacial and
distolingual line angles to provide reference points for
clinical measurements. India ink tattoos were placed
at the mucogingival junction in line with the amalgams.
Documentation consisted of Kodachrome photo­
graphs, periapical radiographs taken with a Fixott-
Everett grid, caliper measurements from the amalgams
or incisal angles to the free gingival margin and mucogin­
gival junction, and No. 15 endodontic silver point
determinations of the distance from the gingival attach­
ment to the amalgams or incisal angles. All measure­
ments were taken parallel to the long axes of the teeth or
in line with the proximal grooves (Fig. 1). Caliper
distances were imprinted into paper charts while silver
point distances were scratched into the point itself at the
level of the central pit of the amalgams. Both systems
were later scored with a grid eyepiece in a measuring
30
microscope by an independent investigator. Gross
pocket depth measurements were made with a calibrated
Glickman periodontal probe to serve as a clinical guide
during the study.
§ Sernylan—Bio-Certic Laboratories Inc., St. Joseph, Mo.
|| Nembutal—Abbott Laboratories, North Chicago, 111.

702 Yukna
FIGURE 1. Line drawing showing the location of reference
points for clinical measurements.
Suprabony periodontal pockets were induced utilizing
the technique of Caton, Crigger, and Zander. 31,32
This
involved the placement of doubled, one-eight inch, heavy,
intraoral orthodontic elastic bands into the sulci of the
teeth. The bands were slipped onto the wedged teeth and
gently pushed into the sulcus with a plastic instrument.
The elastic bands were changed and the pockets were
probed every 2 weeks until satisfactory pocket depth had
been obtained around a given tooth, at which time
banding of that tooth ceased. At the time of final band
removal from the mouth, Kodachrome slides and radio­
graphs were taken in addition to the standard measure­
ments of tissue position, pocket depth, and amended
NPDI.
Also at the time of final band removal, oral hygiene
procedures were instituted. These consisted of twice
weekly cleanings with toothbrush, dental floss and
pumice. Any supragingival hard debris was removed by
hand scaling. These procedures were continued until the
tissue tone of the previously banded areas resembled the
remainder of the mouth.
One week prior to each surgery (and at least 2 weeks
after final band removal), photographs were taken of the
gingival condition. This was followed by ultrasonic
debridement and polishing of all of the teeth with rubber
cup and pumice.
At surgery, the amended NPDI score and all measure­
ments of free gingival margin height, mucogingival
junction tattoo position, and pocket depth were again
made and documented with radiographs and photo­
graphs for all incisor teeth. Two experimental teeth were
randomly selected for treatment in each anterior segment
at the time of surgery, with the remaining incisors left as
unoperated controls.
J. Periodontol.
December, 1976
27
The E N A P procedure was performed in the selected
experimental areas with the following modifications:
1. The distance from the cementoenamel junction to
the reference points was measured at the standard sites
after access had been gained by removal of excised tissue.
2. An attempt was made to create a definite notch at
the apical extent of the root planing for use in histologic
evaluation.
3. Immediate postsurgical measurements of tissue
position were made.
4. No periodontal dressing was used.
Oral hygiene procedures were continued, but with
special regard for the recently surgerized sites during the
first 4 weeks of healing. Amcill-S* 250 mg i.m., b.i.d.,
was administered for 10 days postoperatively for plaque
33
suppression. The hard monkey chowf of the regular
diet was softened with water for the 3 weeks after
surgery. Sutures were removed at 1 week postopera­
tively. Photographic records and clinical measurements
of free gingival margin height and mucogingival junction
tattoo position were made at monthly intervals and/or at
time of sacrifice. Radiographs were taken just prior to
sacrifice.
No pocket depth measurements were made until 90
days postoperatively. For the 90 and 180 day segments,
measurements with silver points were made at the usual
locations 1 week prior to sacrifice. During all the
postoperative documentation procedures, no attempt was
made to identify the experimental sites.
The monkeys were sacrificed to yield healing periods
of 0, 30, 90 and 180 days. The jaws were prepared for
histologic examination by fixing with formalin perfusion
at sacrifice and decalcification in E D T A . The specimens
were embedded in paraffin or celloidin, stained with
Hematoxylin and Eosin or Masson's Trichrome, and
serially sectioned. Sections were made in both mesiodis-
tal and faciolingual planes in order to study both the
interproximal and facial and lingual aspects of healing.
RESULTS
The formation of adequate periodontal pockets was
monitored by clinical probing and intraoral radiographs.
The average time to achieve at least 4 mm of pocket
depth was about 4 months. Clinical and radiographic
evidence of established periodontal disease is illustrated
in Fig. 2a, b.
Clinical results following the E N A P are tabulated for
the two 6 month animals in Table 1. Of particular
interest is the amount and percentage of pocket elimina­
tion due to the clinical new attachment of the tissues to
the root surface in the experimental group of incisors.
Also of interest is the finding that the untreated control
pockets demonstrated a continuing loss of attachment
and a tendency to deepen with time.
* Sodium ampicillin, Parke, Davis and Company, Detroit, Mich,
t Ralston Purina Co., St. Louis, Mo.
 Volume 47
Number 12 New Attachment Procedure in Rhesus Monkey7 0 3

It will be noted that only 14 teeth rather than 16 are

evaluated due to the loss of two teeth during the period
of pocket formation. Measurements presented reflect
values for absolute pockets only: i.e. detachment or loss
of tissue as related to the root surface, not the crown.
There are fewer control group values because the exact
location of the cementoenamel junction (CEJ) could not
be determined in some nonsurgerized sites.

FIGURE 2. A , photograph demonstrating the clinical periodon­

tal condition after pocket formation and before surgery in
anterior segments of monkey; B, Radiographic appearance of FIGURE 3. Interproximal region of maxillary central incisor
monkey anterior segments at initial examination (left), after illustrating the elimination of the pocket epithelium and
pocket formation and prior to surgery (center), and 6 months smoothness of the cementum immediately after surgery (Mas-
postsurgically (right). son Trichrome. Original magnification x40).
T A B L E 1. Clinical Evaluation: Excisional New Attachment Procedure
(Rhesus monkeys—14 incisor teeth)*

Pocket depth
Initial Final Decrease
No. of New decrease
pocket pocket in pocket Recession‡
samples attachment‡ due to new
depth‡ depth‡ depth‡
attachment

mm mm† mm† mm† mm† %

Experimental
Midfacial 8 3.45 ± 1.10 1.74 ± .98 1.71 ± .91 0.20 ± .65 1.51 ± .96 88.3
Midlingual 8 4.65 ± 1.15 2.67 ± .93 1.98 ± .48 0.85 ± .72 1.13 ± .47 57.0
Proximal (line angles) 16 6.00 ± 1.31 3.44 ± 1.68 2.47 ± 1.26 0.61 ± .63 1.86 ± 1.16 75.3
Grand mean 32 5.02 ± 1.57 2.82 ± 1.51 2.16 ± 1.05 0.57 ± .68 1.59 ± 1.00 73.6
Control
Midfacial 4 3.52 ± .60 3.60 ± .22 -0.08 ± .67 -0.15 ± .51 0.08 ± .24 —
Midlingual 4 3.62 ± .68 3.83 ± .86 -0.20 ± .76 0.40 ± .51 -0.60 ± .54 —
Proximal (line angles) 8 4.84 ± 1.44 5.13 ± 1.34 -0.29 ± .59 0.05 ± .47 -0.29 ± .34 —
Grand mean 16 4.20 ± 1.25 4.42 ± 1.24 -0.22 ± .61 0.09 ± .50 -0.28 ± .43 —

* Values derived for portion of gingiva at or apical to C E J .

† Six month postoperative measurements.
‡ Mean ± S.D.
 J. Periodontol.
704 Yukna December, 1976

The NPDI values were found to parallel the differ­
ences between the treated and untreated areas, i.e., the
NPDI scores decreased in the treated areas, but
remained high in the nontreated regions. The distances
from the amalgams to the mucogingival junction re­
mained fairly constant at all time periods. Findings for
the 3 month animal were similar to those in the table.
The other animals were not probed (according to the
protocol) and thus do not share a basis for comparison
clinically.
Microscopic evaluation of serial sections at the various
time periods revealed the following:
A. 0 days (immediately postoperative) (Fig. 3). These
sections showed that the epithelial lining of the pocket
was completely eliminated by the incision. The root
surfaces were smooth, but not devoid of cementum in
most instances. An intervening fibrin clot could be seen
occasionally between the cut connective tissue surface
and the root.
B. 30, 90 and 180 days postsurgery. (Fig. 4a, b;
5a, b; 6a, b, c). All sections demonstrated a long, thin
junctional epithelium (usually less than eight cells thick).
An intraepithelial split was evident in a majority of
the sections, with a layer of epithelial cells remaining
attached to the root. The thin junctional epithelium had
no rete ridges extending into the lamina propria and
exhibited no ulceration. There was minimal round cell
inflammatory infiltrate evident in the corium subjacent
to the junctional epithelium. The re-formed lamina
propria demonstrated abundant, dense connective tissue
bundles or a more loosely arranged, spindly fiber
arrangement. In the latter type of healing connective
tissue the fibers were well formed, but few in number, and
the stroma was very cellular. Both conditions generally
exhibited a fiber alignment parallel to the root surface
(Figs. 4a, b; 5a, b; 6a). Occasionally, areas of apparent
new connective tissue attachment were seen apical to the
junctional epithelium with evidence of new cementoid-
acellular cementum formation (Fig. 6b), but the relation­
ship of these areas to the surgical field could not be
determined definitely because of the lack of a consistent
histologic marker denoting the depth of the incision and
root planing. Rarely, areas of root resorption were seen,
and these were apposed with both epithelium and connec­
tive tissue in various sections (Fig. 6b, c).
C. Control areas (Fig. 7a, b). Control pockets at all
time frames (i.e., 0, 30, 60, 90, and 180 days) demon­
strated uniform histologic appearances. The pocket epi­
thelium was quite thick (usually greater than 10 cells in
depth), extensively ulcerated, and had many rete ridges

FIGURE 4. A , Six month postoperative specimen from facial of maxillary lateral incisor showing the long, thin junctional epithelium
extending to point (JE) and the reparative connective tissue of lamina propria (LP). Note the suggestion of the incision line reflected
by the density differences in the corium (arrow) (H & E. Original magnification x 6.8). B. Greater magnification of inset of Figure 4
A. Small area of intraepithelial split; thinness of junctional epithelium; loose, spindly fiber arrangement in corium; and virtual
absence of inflammation are demonstrated. (H & E. Original magnification x 63.)
Volume 47
Number 12
FIGURE 5. A . Specimen from palatal of maxillary lateral incisor of another 6 month animal. Appearance is similar to Figure 4 A, but
exhibits increased density of lamina propria fibers and a more coronal intraepithelial split (inset) (H & E. Original magnification x
10). B. Inset of Figure 5 A. A layer of epithelial cells is seen attached to the tooth. This was a commonfindingin various areas along
the tooth surfaces (H & E. Original magnification x 160).
extending deep into the lamina propria. Moderate to
severe round cell inflammatory infiltration and edema
were noted in the epithelium and corium. In addition,
polymorphonuclear white cells were noted in the epithe­
lium. There was a decrease in the number, thickness, and
regularity of the connective tissue fibers in the subjacent
lamina propria, particularly in areas infiltrated by the
lymphocytes and plasma cells. Occasionally tooth accu­
mulated materials (both calcified and noncalcified) were
seen on the root surface extending to the depth of the
pocket.
DISCUSSION
The consistent finding of a long, thin epithelial attach­
ment and a minimal amount of connective tissue attach­
ment does not fulfill the histologic criteria for new
27
attachment established previously. However, the strik­
ing absence of inflammatory cells; the thinness and
adherence of the epithelial cells to the tooth; and the
dense, supportive gingival collagen found in almost all
treated areas was felt to present a picture of tissue health.
This histologic appearance is almost identical to that
32
considered pathologic by Caton and Zander in animals
with similarly created, but untreated, pockets. In the
present study, however, only the surgerized areas demon­
New Attachment Procedure in Rhesus Monkey
705
strated this situation. The untreated "control" areas all
demonstrated severely hyperplastic, ulcerated, pocket
epithelium with a heavy inflammatory infiltrate in an
edematous lamina propria.
Moreover, the apparent histologic health of the E N A P
areas is reflected clinically by the fact that measurements
and probing demonstrated a consistent new attachment
of the soft tissues to the treated teeth for the experimental
period of 6 months. This difference between the histo­
logic sulcus and the clinical sulcus has been expounded on
34
by Listgarten. He stated that the determined depth of
the clinical sulcus will depend on such factors as thick­
ness of the probe, the pressure applied, degree of inflam­
matory cell infiltrate in both junctional epithelium and
adjacent connective tissue, degree of connective tissue fi­
ber destruction, thickness of the junctional epithelium,
and curvature of the root surface. In the present situa­
tion, even the presence of a long epithelial attachment did
not allow penetration of a thin silver point down to con­
nective tissue attachment.
The frequent appearance of intraepithelial splits in
experimental sections may be accounted for by problems
in obtaining intact biopsies cited previously by Listgart­
34 35 36
en. Both Listgarten and Frank, et a l . , have shown
the regenerated postsurgical epithelial attachment to be
 J. Periodontol.
706 Yukna December, 1976

FIGURE 6. A . Facial of maxillary central incisor 6 months after surgery presents similar appearance to Figure 4A and 5A. In
addition, areas ofcementoid deposition (C), apparent root resorption (RR), and parallel gingival fiber arrangement (GF) are seen (H
& E. Original magnification x 10). B. High magnification of inset of Figure 6 A. Apical end of junctional epithelium (JE), area of
cementoid (C), apparent root resorption (RR), and parallel fiber arrangement (GF) are seen more clearly (H & E. Original magni­
fication x 25). C. A different site on same tooth demonstrating an area of root resorption apposed by junctional epithelium (H & E.
Original magnification x 160).
 Volume 47
Number 12
FIGURE 7. A . Interproximal of control specimen showing characteristics of nonregressive pocket formation. Thick, ulcerated pocket
epithelium, deep rete ridges, dense inflammatory infiltrate, and sparseness of connective tissue fibers are depicted (H & E. Original
magnification x 6.3). B. Dense inflammatory cell infiltrate in area of ulceration of untreated pocket. Compare with Figure 4B. (H &
E. Original magnification x 63).
of normal structure with hemidesmosomal attachment to
34
dentin and cementum. In addition, Listgarten stated
that the junctional epithelium is readily disrupted by
clinical periodontal probing and that this disruption
generally occurs within the epithelium rather than at the
dentoepithelial junction. Our findings seem to corrobo­
rate this because whatever stresses and manipulation
may have caused epithelial disruption, there is still a
layer of epithelial cells remaining on the tooth, suggest­
ing an intact epithelial attachment prior to sacrifice. A s
an added consideration, the perfusion technique em­
ployed may have forced the fixative through the tissues
and caused the disruption of the junctional epithelium.
The usual limitation of an adequate animal model
system appeared to be overcome by the method of pocket
formation utilized in this study. The pockets created
yielded the classic clinical, radiographic and histologic
evidence of periodontal disease as described in the
37
human, but may possess biochemical differences due to
the physical rather than microbial nature of induction. In
addition, the created defects seemed to be progressive
and active as evidenced by the further loss of attachment
with time (Table 1).
There are many limitations in a study of this type.
Several teeth were lost during the pocket formation
phase due to too rapid apical progression of the elastic
bands. Even though the progress of pocket formation was
New Attachment Procedure in Rhesus Monkey707
closely monitored, isolated teeth would suddenly become
severely involved and exfoliate. This is a problem occa­
sionally seen clinically in patients who initiate self-
38
orthodontics.
Proper plaque contol is particularly difficult by
mechanical means in animals. Twice weekly prophylaxis
does not appear to be sufficient to create the proper oral
environment for ideal healing. Chemical methods of
plaque control may be experimentally superior, but were
not used in this study as an attempt was made to
duplicate the prevalent clinical situation.
Surgical technique may be a limiting factor. Proper
tissue manipulation and root surface treatment seem
essential to success, and this may not always have been
accomplished under these experimental conditions
despite the efforts of the operator. Clinician bias in data
gathering was somewhat minimized by measuring tissue
height and pocket depths at the different time periods
without prior knowledge of animal number or of which
sites were experimental.
Regulation of animal habits is another chronic prob­
lem. Monkeys are notoriously adept at manipulating
tissues, surgical sites, and appliances. In fact, most
sutures were lost during the first postoperative week, and
the animals could be seen fingering the surgical sites
while in their cages. These manipulations may well have
jeopardized the minimal blood clot and tight tissue

708 Yukna
adaptation that is felt to be necessary for optimum
success of this procedure.
The Excisional New Attachment Procedure, on cur­
sory examination, may appear to be identical with the
39 40
unrepositioned flap, the Widman flap, replaced
41 42
graft, or mini-flap; but several important differences
exist. The E N A P is restricted to the keratinized gingiva;
it is not intended to be used whenever edematous pockets,
pockets extending beyond the mucogingival junction, or
osseous defects are to be treated; and vertical or relaxing
incisions are not utilized since no apical positioning of the
tissues is planned. The E N A P however, can be extended
into a flap if the need arises.
It is interesting to note that the clinical results in Table
1 parallel the findings in a 1 year clinical study in
27
humans. Although the human values may have been
enhanced by the consistently good plaque control pract­
iced by the patients, the monkey results indicate that the
new attachment can withstand the adverse conditions and
limitations mentioned above.
SUMMARY
Experimental suprabony periodontal pockets were
established around the incisors of Rhesus monkeys and
subsequently were treated by the Excisional New Attach­
ment Procedure. Healing was evaluated clinically and
histologically for up to 6 months. Clinical examinations
demonstrated an overall mean pocket depth reduction
from 5.02 mm to 2.82 mm, of which 0.57 mm was
recession and 1.59 mm (73.6%) was clinical new attach­
ment. Histologic evaluation of experimental sites consist­
ently revealed a long, thin junctional epithelium with a
minimal amount of inflammatory infiltrate in the subja­
cent, densely fibered, lamina propria. Control areas
demonstrated the classic histologic picture of periodontal
disease and tended to be progressive in nature clinically.
ACKNOWLEDGMENTS
The author wishes to extend his sincere appreciation to Drs.
G. M . Bowers, J. J. Lawrence, and J. E. Williams of the
Periodontics Staff of NGDS for their guidance and suggestions;
DTI D. Morgan, U S N , DT2 R. Harbaugh, U S N , DT2 P.
Yukna, U S N R and Mr. H . Luebbing for their assistance in
animal handling; Mr. G. Armstrong and DT2 T. Mikels, U S N ,
for their histopathology support; the Audiovisual Departments
of NGDS and N M R I for illustrations; and Mrs. Nam Dayhoff,
N M R I , and the Publications Division, NGDS, for their clerical
and editorial help with this manuscript.
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Number 12 New Attachment Procedure in Rhesus Monkey
709

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Announcement
UNIVERSITY OF SOUTHERN CALIFORNIA SCHOOL Professor and Chairman
OF D E N T I S T R Y Department of Periodontics
The University of Michigan
The University of Southern California School of Dentistry an­
nounces the following continuing education course: Sunday, January 30, 1977

Flap Management in Periodontal Surgery MODERATOR:

January 29 and 30, 1977 J O H N C O S T L E Y , B.S., D.D.S.

Director of Peridontics and Chief of Dental Service
Saturday, January 29, 1977 Veterans Administration Hospital,
MODERATOR: Salt Lake City, Utah
J O H N S. SOTTOSANTI, B.A., D.D.S.
A.M.
Assistant Professor of Periodontics, 8:30 N A T U R E OF SOFT TISSUE REPAIR IN PERIODONTAL SURGERY
Loma Linda University; PERRY A . RATCLIFF, D.D.S., F.A.C.D., F.I.C.D.
A.M. Private Practice, Phoenix, Arizona
8:30 PERIODONTAL H E A L I N G : REPAIR OR REGENERATION?
10:30 BIOLOGIC BASIS OF GINGIVAL RECONSTRUCTION
S. SIGMUND S T A H L , D.D.S., M . S . , F.A.C.D. MORRIS P. R U B E N , B.S., D.D.S., F.A.C.D., F.I.C.D.
Professor and Chairman Professor and Chairman of Oral Biology
Department of Periodontics Assistant Dean for Graduate Studies
New York University Dental Center Boston University School of Graduate Dentistry
10:30 T H E A P I C A L L Y REPOSITIONED F L A P : A N A T T E M P T TO OBTAIN
12:00 Lunch
Z E R O S U L C U S D E P T H OR M U S T WE A L W A Y S COMPROMISE?
RICHARD W. CHAIKIN, D.D.S., M . SCD., F.I.C.D., F.A.C.D. P.M.
Clinical Instructor 1:30 A CLINICAL AND HISTOLOGIC ASSESSMENT OF L A T E R A L PEDI­
CLE FLAPS E M P L O Y E D IN M U C O G I N G I V A L SURGERY
Harvard University Department of Histopathology
JAY S. SEIBERT, D.D.S., F.A.C.D.
12:00 Lunch Department of Periodontology School of Dentistry
University of Pennsylvania
P.M.
1:30 C E L L U L A R AND M O L E C U L A R BIOLOGY OF H U M A N GINGIVAL 3:30 SUMMATION OF T H E SYMPOSIUM
HEALING RICHARD OLIVER, D.D.S., M.S., F.A.C.D., F.I.C.D.
H A R O L D C . S L A V K I N , D.D.S. Dean and Professor
Professor, Department of Biochemistry and Nutrition School of Dentistry
School of Dentistry University of Southern California
University of Southern California
For further information contact: Department of Continuing Educa­
3:30 MODIFIED WIDMAN AND C O R O N A L L Y REPOSITIONED FLAPS tion, University of Southern California School of Dentistry, 925 West
SIGURD P. RAMFJORD, L.D.S., Ph.D., F . I . C D . , F.A.C.D. 34th Street, Los Angeles, Calif. 90007.