Inflammatory lesions in the gingiva following resective/non-resective periodontal therapy.
BACKGROUND
Findings from previous experiments have revealed that inflammatory cell infiltrates may remain in the gingiva following clinically successful non-surgical periodontal therapy.


OBJECTIVE
To investigate the presence of inflammatory lesions in the gingiva following a periodontal treatment procedure that included either soft-tissue resection [gingivectomy (GV)] or non-resective open-flap debridement (OFD).


METHODS
Fifteen patients with advanced generalized chronic periodontitis were recruited. Following oral hygiene instruction and supragingival debridement, one tooth site in each quadrant (non-molar, probing pocket depth>5 mm, bleeding on probing(+) and >50% bone loss) was selected and a soft-tissue biopsy was obtained and prepared for immunohistochemical analysis. Using a split-mouth design, two quadrants were randomly selected for periodontal therapy including GV, while the two remaining quadrants were exposed to non-resective OFD procedure. Six months after completion of surgical treatment, a new set of biopsies was obtained from GV and OFD sites.


RESULTS
The inflammatory lesions residing in the gingival biopsies obtained prior to surgical therapy were 1.33-1.41 mm(2) large and contained similar proportions of CD19(+)- (B-cells, 15%), CD3(+)- (T-cells, 7%) and elastase(+)- (polymorphonuclear cells, 2%) cells in the two treatment groups. The corresponding lesions identified in the soft-tissue specimens obtained after 6 months of healing were twice as large at OFD as at GV sites (0.19 versus 0.08 mm(2), p=0.002). The densities of CD19(+)- and elastase(+)-cells in these lesions were significantly greater at OFD than at GV sites.


CONCLUSIONS
The findings of the present study indicate that surgical therapy including soft-tissue resection results in regenerated gingival units that contain smaller lesions with lower densities of immunocompetent cells when compared with the lesions remaining in sites treated by non-resective means.
Zitzmann
N U
NU
Department of Periodontology, Box 450, Göteborg University, SE-405 30 Göteborg, Sweden. n.zitzmann@unibas.ch
Berglundh
T
T
Lindhe
J
J
D000328:Adult; D000368:Aged; D001706:Biopsy; D002908:Chronic Disease; D005260:Female; D005881:Gingiva / Q000473:pathology* / Q000601:surgery; D005890:Gingivectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000473:pathology* / Q000601:surgery; D014945:Wound Healing