Moskow B S, Polson A M
Columbia University, School of Dental and Oral Surgery, New York, NY 1002.
J Clin Periodontol. 1991 Aug;18(7):534-42. doi: 10.1111/j.1600-051x.1991.tb00086.x.
This study was undertaken to re-examine early and recent morphologic descriptions of gingival and periodontal inflammation based on a study of gingival biopsies and block sections of human jaws. A collection of 350 autopsy and surgically retrieved jaw sections containing multiple teeth and displaying various stages of periodontal inflammation were subjected to routine histologic preparation and analyzed with step serial sections. 105 gingival biopsies, serially sectioned, including 15 clinically normal specimens, were also studied. The results of these investigations suggest that the inflammatory lesion extends into the alveolar process and elicits a response, often before evidence of crestal resorption or connective tissue attachment loss has occurred. Similarly, deep penetrations of inflammatory cells into the alveolar bone, periodontal ligament and periapical tissues, along with fibrosis and enlargement of the marrow spaces, were common findings with advancing disease. More widespread distributions of inflammatory cells than previously described were found in clinically normal gingiva, while in more inflamed gingiva, the inflammatory cell types found and their pattern of distribution varied greatly from individual to individual. These observations cast doubt on the perception of human periodontitis as a localized and marginal disease and suggest that its effects may be much more pervasive than previously thought.
本研究旨在通过对人类颌骨的牙龈活检和组织块切片进行研究，重新审视牙龈和牙周炎症的早期及近期形态学描述。收集了350份尸检和手术获取的颌骨切片，这些切片包含多颗牙齿并呈现出牙周炎症的各个阶段，对其进行常规组织学制备，并采用连续切片进行分析。还研究了105份连续切片的牙龈活检样本，其中包括15份临床正常样本。这些研究结果表明，炎症病变常常在嵴顶吸收或结缔组织附着丧失的证据出现之前就已扩展至牙槽突并引发反应。同样，随着病情进展，炎症细胞深入牙槽骨、牙周膜和根尖周组织，同时伴有骨髓腔纤维化和扩大，这些都是常见的表现。在临床正常的牙龈中发现了比以往描述更为广泛分布的炎症细胞，而在炎症更严重的牙龈中，所发现的炎症细胞类型及其分布模式在个体之间差异很大。这些观察结果对将人类牙周炎视为一种局限性边缘性疾病的观念提出了质疑，并表明其影响可能比以前认为的更为广泛。
