Variability of histologic criteria in clinically healthy human gingiva

Abstract

After prophylaxis, 5 dental hygienists performed optimal oral hygiene under supervision for 6 months. At months 0, 1, 4 and 6, Plaque Index, Gingival Exudate Flow Rate and Gingival Index were assessed, and a buccal biopsy of their gingiva taken. Point counting procedures were performed at 2 different levels of magnification to estimate the volume densities of epithelium, infiltrated and non‐infiltrated connective tissue, and collagen. The percentages of fibroblasts, polymorphonuclear neutrophilic granulocytes, lymphocytes, plasma cells and macrophages were estimated by counting the number of profiles of these cells in the connective tissue area close to the apical end of the junctional epithelium. All the changes inside the tissue occurred slowly. During the 6‐month period there was a continuous increase of the volume density of the epithelium in the gingiva. An increase in the percentage of fibroblasts was observed between months 1 and 4 together with a decrease in the percentage of lymphocytes and in the volume density of the infiltrated connective tissue. Between months 4 and 6 an increase of the volume density of the collagen was found together with a further increase in the percentage of fibroblasts and a further decrease in the percentage of lymphocytes. After 6 months of perfect oral hygiene no more plasma cells were visible. This study has shown that, even in presence of clinically healthy gingiva, subclinical changes may take place. It appears realistic to accept the presence of a very mild gingivitis localized in an area adjacent to the attachment as compatible with gingival health.

Gingival tissue transcriptomes in experimental gingivitis

“…The ‘antigen processing and presentation’ pathway was in fact stronger regulated during the first four days of gingivitis resolution than in the final week of induction (impact factor 106.2), possibly due to the inoculation of the host with bacteria and their products in conjunction with mechanical prophylaxis. These transcriptomic findings are largely in agreement with earlier histologic observations of the initial and early gingival lesions, first described in detail by Page and Schroeder (1976) primarily based on animal experiments, but also with subsequent human histo-morphometric studies (Seymour et al, 1983, Brecx et al, 1987, Moughal et al, 1992). Nevertheless, it must be recognized that considerable heterogeneity in the histological features of experimental gingivitis lesions has been reported in the literature.…”

Human Memory B Cells in Healthy Gingiva, Gingivitis, and Periodontitis

“…One could speculate that endothelial PNAd and ICAM-1 may be responsible for a sustained recruitment of memory B cells in clinically healthy gingiva. This memory B cell trafficking may take place along with the well-documented polymorphonuclear cell emigration, a well-recognized phenomenon in a clinically healthy sulcus (44,45). Such gingival memory B cells were obviously functional, as they were able to secrete IgG and IgA after in vitro polyclonal stimulation in the current study.…”

Clinical course of chronic periodontitis

“…Even with shorter professional maintenance intervals (3–5 months), 1.5% of the randomly observed sites in periodontally treated individuals may lose some attachment, although they were not bleeding on probing at any recall visit (Lang et al 1986). Such sites may show the presence of a slight, subclinical inflammation on microscopic inspection (Brecx et al 1987a), which may be enough to elicit the processes responsible for the loss of collagen and the initiation of a periodontal pocket.…”