title: Histological characteristics associated with suppurating periodontal pockets.
abstract: The purpose of this study was to characterize histologically the gingival lesion associated with suppuration in advanced periodontitis. Thirty-three bleeding, suppurating (S) and 23 bleeding, nonsuppurating (NS) interproximal biopsies were obtained from nine patients and processed for light microscopy. Pocket depths (mean +/- SD) were 6.7 +/- 1.6 mm (S) and 5.4 +/- 2.2 mm (NS). Six-micron serial sections were stained with (1) hematoxylin/eosin and (2) van Gieson. Quantitative cell types were determined by a grid intersection counting technique at x 1000. Volumetric analysis of collagen-poor (inflammation) areas was conducted using a computer biometric system that revealed three histologic patterns: Type I sites showed mild to moderate inflammation (less than 50% infiltrate, S = 15, NS = 20); Type II sites showed intense inflammation (greater than 50% infiltrate, S = 17, NS = 3); and only one (S) site had a large connective tissue abscess (Type III). The mean percentage of collagen-poor area was significantly larger in suppurating (42.1 +/- 25.5%) versus nonsuppurating (27.7 +/- 20.4%) sites (P = 0.02). In both S and NS sites, plasma cells (means = 66%) and lymphocytes (means = 27%) predominated in the inflammatory infiltrates. Histologically, suppuration appeared to be associated with increased gingival inflammation and a slight increase in connective tissue neutrophils.
authors.affiliation: Department of Periodontics, University of Nebraska Medical Center, College of Dentistry, Lincoln.
authors.forename: S A
authors.initials: SA
authors.lastname: Passo
authors.forename: R A
authors.initials: RA
authors.lastname: Reinhardt
authors.forename: L M
authors.initials: LM
authors.lastname: DuBois
authors.forename: D M
authors.initials: DM
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002452:Cell Count; D002908:Chronic Disease; D005260:Female; D005884:Gingival Hemorrhage / Q000473:pathology*; D006801:Humans; D008214:Lymphocytes / Q000145:classification; D008297:Male; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000473:pathology*; D010514:Periodontal Pocket / Q000473:pathology*; D010518:Periodontitis / Q000473:pathology*; D013492:Suppuration