HISTOPATHOLOGICAL INVESTIGATION OF GINGIVAL TISSUE FROM PATIENTS WITHRAPIDLY PROGRESSIVE PERIODONTITIS

IN THIS STUDY, FINE STRUCTURAL FEATURES of the pocket walls in rapidly progressive periodontitis (RPP) and adult periodontitis (AP) in 20 ca ses were compared using light and transmission electron microscopy. Gi ngiva was also obtained from a control group of periodontally healthy teeth. Clinical parameters were assessed in bath RPP and AP patients a nd in controls. Bone destruction and attachment loss were more marked in RPP than in AP. Light microscopical observations of inflamed RPP ti ssue as compared to AP showed gross histological distortions in the po cket walls. Micro-ridges within the epithelium and large intercellular spaces between the epithelial cells were observed in most RPP biopsie s. Epithelial cells surrounding the microclefts and adjacent keratinoc ytes were found to produce interleukin-1 beta (IL-1 beta). Prevotella intermedia and Porphyromonas gingivalis were identified in the RPP bio psies using immunohistological methods. These microorganisms were loca lized outside the epithelium and inside intercellular spaces. Furtherm ore, the effect of inflammation on the distribution of collagen types I, III, IV, V, and VI in the human gingiva was studied after staining them with antibodies to these proteins. In RPP and AP tissues, the sta ining was sparse in areas of inflammation and leukocytic infiltration. Collagen type I and III were almost entirely lost at sites of inflamm ation. Type V and VI collagen antibodies were retained in inflamed are as. Type IV collagen was restricted to basement membrane structures. T hese observations demonstrated numerous structural features indicative of more pronounced degenerative changes in RPP than in AP.