Premium
Inflammatory lesions in the gingiva following resective/non‐resective periodontal therapy
Author(s) -
Zitzmann N. U.,
Berglundh T.,
Lindhe J.
Publication year - 2005
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/j.1600-051x.2005.00649.x
Subject(s) - medicine , gingivectomy , debridement (dental) , soft tissue , chronic periodontitis , quadrant (abdomen) , periodontitis , molar , biopsy , dentistry , bleeding on probing , pathology
Background: Findings from previous experiments have revealed that inflammatory cell infiltrates may remain in the gingiva following clinically successful non‐surgical periodontal therapy. Purpose: 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). Material and 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. Conclusion: 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.