Regeneration of the connective tissue attachment on surgicaily exposed roots using afibrin- fibronectin adhesive system. An experimentai study on the baboon (Papio ursinus) U. Ripamonti, J.-C. Petit, J. Lemmer and J. C. Austin Department of Oral Medicine and Periodontology, Department of Orai Pathology, and Centrai Animal Service, University of the Witwatersrand, Johannesburg, South Africa Ripamonti U, Petit J-C, Lemmer J and Austin JC: Regeneration of the connective tissue attachment on surgically exposed roots using a fibrin-fibronectin adhesive system. An experimental study on the baboon (Papio ursinus). Journal of Periodon- tal Research 1987; 22: 320-326. To evaluate the regeneration of the connective tissue attachment promoted by a fibrin-fibronectin adhesive system, the buccal, interradicular and interproximal alveolar bone to one half of the length of the roots was removed from the maxillary molars and premolars of 2 chacma baboons. The exposed roots were planed and demineralized with citric acid. On flap closure a fibrin-fibronectin adhesive system (Tisseel®) was introduced between the root surfaces and the mucoperiosteai fiaps in the experimental quadrants. To avoid immunological reactions, Tisseel prepared from baboon plasma was used. Histometrical analysis was performed on a total of 13 experimental and 12 control specimens obtained 95 d post-operatively. The analysis of variance demonstrated significant differ- ences between the experimental and control specimens with regard to the length of connective tissue attachment or adaptation (p = 0.0234), the extent of newly formed cementum with inserted connective tissue fibers (p = 0.0033) and the amount of bone regeneration (p = 0.0068). This limited study indicates that the potential for connective tissue attachment and bone regeneration may be enhanced by the use of specific attachment glycoproteins and plasma factors. Accepted for pubiication September 24, 1986 introduction Specific attachment glycoproteins (Ter- ranova & Martin 1982, Fernyhough & Page 1983) and plasma factors may be the essential substrata for the basic cellular and molecular interactions be- tween fibroblasts and root surface. The non-collagenous glycoprotein fibronec- tin functions as a primary matrix for organization of collagen during the tis- sue repair process (Kurkinen et al. 1980) promoting migration, adhesion, attach- ment, orientation and synthetic activity of activated fibroblasts (Ali & Hynes 1978, Yamada & Olden 1978, Mosher 1980, Kleinman, Klebe & Martin 1981, Hynes & Yamada 1982). In clotting, plasma fibronectin serves as a substrate for activated factor XIII, forming cova- lent linkages with fibrin and collagen (Mosher, Schad & Kleinman 1979). Fibrin and factor XIII stimulate fi- broblast adhesion and growth (Grin- nell, Feld & Minter 1980); a stabilized fibrin structure is essential for fibroblast migration and for the deposition of pro- ducts synthesized by fibroblasts (Grin- nell, Billingham & Burgess 1981). Thrombin induces the synthesis of fi- bronectin (Mosher & Vaheri 1978) and stimulates growth of fibroblasts and col- lagen synthesis (Zetter et al. 1977). Fibroblast migration, attachment and orientation on exposed root sur- faces seems to be a prerequisite for con- nective tissue attachment regeneration following periodontal surgery (Pol- son & Proye 1983). Root surface demin- eralization by exposing cemental or dentinal collagen (Garrett, Crigger & Egelberg 1978, Boyko, Brunette & Mel- cher 1980) has been shown to provide an optimum substratum for migrating fibroblasts and collagen deposition (Pi- taru et al. 1984a, 1984b). In periodontal surgery, surface adhesion of fibronectin on exposed and demineralized roots and its interactions with fibrin and collagen via factor XIII could enhance depo- sition of collagen by migrating fibro- blasts along the root surface, regenerat- ing the connective tissue attachment during healing. The aim of this study was to evaluate histoiogicaliy the healing of the interfa- ce between root and soft tissue, and