Sharma A K, Mirza F D
J Prosthet Dent. 1986 Nov;56(5):574-82. doi: 10.1016/0022-3913(86)90424-5.
These histologic observations of the epithelium and connective tissue are in close agreement with a host of earlier workers. The striking feature is an increase in thickness of epithelium due to an increase in constituent cell layers, but a decrease in keratinization, with keratin mainly of the parakeratinized variety. There is a definite reduction of collagen fiber network in regions of stress where the fibers present an irregular arrangement in contrast to the normal wavy pattern. Marked chronic inflammatory exudate is also seen. Histochemical investigation of the connective tissue under dentures revealed the presence of a highly elastic and resistant oxytalan fiber network, especially in regions that showed a reduction in collagen fibers. Thus the connective tissue response under dentures is in sharp contrast to what is expected. This abnormal behavior of the connective tissue is probably a reaction to the changes in epithelium. As a result of reduction in keratinization, a highly resistant and protective layer, the connective tissue exhibits altered metabolism and function. We hypothesize that connective tissue takes up a more dominant role of protection and absorption of stress, a role hitherto fulfilled by the epithelium. Thus stresses exerted by dentures on connective tissues are prevented from reaching the bone where they could cause resorption. We therefore feel that denture wear not only results in change within the epithelium, but in an equally significant reaction of the connective tissue. This reaction results in the appearance of a highly resistant and elastic oxytalan fiber system, which assists the connective tissue to react successfully to the stresses exerted on it.
上皮组织和结缔组织的这些组织学观察结果与许多早期研究者的结果高度一致。显著特征是上皮厚度增加，这是由于组成细胞层数增多，但角化程度降低，主要为不全角化型角蛋白。在应力区域，胶原纤维网络明显减少，与正常的波浪状排列不同，此处纤维排列不规则。还可见明显的慢性炎性渗出物。义齿下方结缔组织的组织化学研究显示存在高度弹性且坚韧的氧化弹力纤维网络，尤其是在胶原纤维减少的区域。因此，义齿下方结缔组织的反应与预期形成鲜明对比。结缔组织的这种异常行为可能是对上皮变化的一种反应。由于作为高度抗性和保护层的角化程度降低，结缔组织表现出代谢和功能的改变。我们推测结缔组织在保护和吸收应力方面发挥了更主要的作用，而这一作用以前是由上皮组织完成的。因此，义齿对结缔组织施加的应力被阻止传递到可能导致吸收的骨组织。我们因此认为，佩戴义齿不仅会导致上皮组织内的变化，还会引起结缔组织同样显著的反应。这种反应导致出现高度抗性和弹性的氧化弹力纤维系统，该系统有助于结缔组织成功应对施加于其上的应力。
