300 i. reichborn-kjennerud 



The Relation between Circulatory Disturbances in 

 THE Periodontium and Loss of Alveolar Bone 



Gingival inflammations are the most common cause of circulatory 

 disturbances in the periodontium. An increased amount of blood 

 must be transported to and from the inflamed gingiva through the 

 alveolar bone. 



Clinical and x-ray observations indicate that a chronic gingivitis 

 very often is accompanied by a breakdown of alveolar bone. Elimi- 

 nation of a gingivitis through successful treatment usually stops the 

 resorption, and sometimes it is followed by an apposition of alveolar 

 bone visible on x-rays. 



In histological sections it can also be seen that alveolar bone re- 

 sorption is related to periodontal circulatory disturbances. If they 

 are confined to the supra-alveolar connective tissue, a horizontal 

 septum resorption occurs. When the vessels passing through the 

 marginal part of the pericementum are involved, vertical septum 

 resorption takes place. 



In cases of gingival inflammation, a breakdown of the central 

 part of the septa frequently is observed on x-rays. This resorption 

 may extend from the margin to the base of the septa, and not seldom 

 the lamina dura of the adjacent teeth is broken down in some places 

 (Figs. 1 and 9). According to Haupl and Lang (1927), these resorp- 

 tions are due to a remote effect of a gingivitis. When an increased 

 amount of blood is transported to an inflamed gingiva through the 

 interalveolar arteries, they will be dilated and compress the veins in 

 the alveolar bone marrow more or less (Fig. 2). The effect of this 

 is an increase of the permeability of the vessels in the septa, and 

 that again enlarges the amount and changes the quality of the 

 transudate to the bone marrow. 



In histological sections it can be observed that the alterations in 

 the transudation lead not only to alveolar bone resorption, but also 

 to fibrosis of the alveolar bone marrow. The latter process, called 

 bone phlegmasia according to Recklinghausen (1891), very often 

 can be seen in the whole length of the septa (Fig. 1). Circulatory 

 disturbances in the interalveolar vessels may also extend through 



