MICROVASCULAR ANGIOPATHY IN ADVANCED PERIODONTAL-DISEASE

Previous studies have shown a perivascular hyaline thickening affectin g restricted regions of the microcirculation in gingivitis and moderat e periodontitis and in the pulpal vessels in chronic pulpitis, In the present study of the lesion of advanced periodontitis, immunostaining for type IV collagen and laminin demonstrated widespread deposition of basement membrane material, with manifest involvement of the venous n etwork, Some vessels were associated with an increased deposition of b oth basement membrane proteins, while others showed preferential depos ition of either laminin or type IV collagen, Immunostaining also revea led an extensive trabecular network of type IV collagen throughout the affected gingival tissue that nas not related to recognizable vessels but was co-extensive with less intense staining for laminin, This net work was not associated with viable endothelial cells demonstrable by staining with the endothelial marker Ulex agglutinin (UEA-1). The resu lts indicate extensive vascular pathology in advanced periodontitis th at could explain the attenuation of the inflammatory reaction and the restricted ability to develop reparative granulation tissue in this di sease.