Eruption of teeth into crowded position, loss of attachment, and downgrowth of subgingival plaque.

The role of crowded teeth in the etiology of attachment loss was studied in thirty teeth extracted for orthodontic reasons from eight children 12 to 13 years of age. Following extraction, the teeth were stained in a 1 percent solution of water blue and examined under the stereomicroscope. In one third of the thirty teeth, a 0.9, 2.0, and 3.5 mm. loss of attachment was observed on surfaces adjacent to which another tooth had erupted into an extremely crowded environment. On the same surfaces, subgingival plaque had grown down to the area of the cementoenamel junction. The premature loss of attachment was assumed to be mediated by collagenase derived from the regressing dental organ or from the junctional epithelium surrounding the erupting teeth. The premature downgrowth of subgingival plaque to the area of the cementoenamel junction was facilitated by the development of an irregular contact line within the interdental papilla, rather than a contact point above the papilla.