Tore Kristoffersen

Deposits of immunoglobulins, complement, and immune complexes in inflamed human gingiva

Gingival biopsy specimens from 20 patients with moderate to advanced periodontitis were obtained from inflamed sites with pockets of 5 mm or more. Sections were studied by an immunofluorescence technique, using polyclonal rabbit or goat anti-IgG, anti-IgM, anti-C1q, anti-C3a, and anti-C3c and mouse monoclonal anti-C9. Prewashed ethanol-fixed and nonwashed ethanol-fixed or frozen specimens showed many plasma cells staining for IgG or C3a, suggesting the possible occurrence of a receptor for C3a in plasma cells. Plasma cells containing IgM were also seen. Deposits of IgG and IgM with C1q, C3a, and C3c, suggesting immune complexes, were demonstrated by a double staining technique, combining fluorescein (FITC) or rhodamine (TRITC)-labeled anti-immunoglobulins with TRITC- or FITC-conjugated antibody to C3a, C3c, and C1q. The complexes were located mainly within or around vessel walls. Deposits of C3a and C1q were found in vessel walls, in the basement membrane zone of oral gingival epithelium, or diffusely distributed in the tissues. Deposits of C3c were found to a lesser extent and only in vessel walls. Mouse monoclonal anti-C9, visualized with FITC-labeled rabbit anti-mouse and swine anti-rabbit antiserum, showed granular deposits of C9, mainly in the basement membrane zone of oral gingival epithelium. The study indicates the involvement of immune complex vasculitis in inflammatory periodontal lesions. Also, our observations of the occurrence of deposits of complement factors support the hypothesis that complement factors play an important role in the immunopathology of the periodontal lesion.

In situ characterization of mononuclear cells in marginal periodontitis of patients with Down's syndrome

An indirect immunofluorescence technique on cryostat sections was used to study the cellular composition in chronic marginal periodontitis (CMP) of patients with Downs syndrome (DS). The findings were compared with CMP lesions in otherwise normal patients (NP). The distribution and amount of CD22+ cells (B lymphocytes), CD3+ cells (pan T lymphocytes), CD4+ cells (helper T subset), CD8+ cells (suppressor/cytotoxic T subset), and CD11c+ cells (in tissue, mainly monocytes and macrophages) were investigated. Morphologic studies showed a denser inflammatory infiltrate in DS than in NP. Countings showed significant differences in cell distribution (p = 0.0003) and cell profiles (p = 0.0273) between the two groups. The median CD4+/CD8+ ratio in DS (2.73) was significantly higher (p = 0.0024) than found in gingival inflammatory lesions from NP (1.08). The present study shows that DS patients have a different, more pronounced, immune response in CMP than NP.

Periodontal Disease and Oral Hygiene in an Alaskan Eskimo Population

Periodontal tissues and oral hygiene conditions of 75 inhabitants of an inland Alaskan village population were studied. Living habits had changed considerably since dental examinations and dietary studies were done eight years previously. Periodontal disease was severe and followed the same pattern as that in other populations, except that the influence of age alone was not so pronounced.

Ultrastructural Study of Induced Keratinization in Sulcular Gingival Epithelium in Rhesus Monkeys

Gingival sulcular epithelium--which in primates normally does not keratinize--can be induced to undergo keratinization by prolonged intensive antibacterial therapy. Three months before biopsy the teeth of two adult male rhesus monkeys were scaled and polished, and for 5 days the monkeys were given intravenous injections of 75 mg Achromycin daily. Their teeth were subsequently subjected to daily cleaning and polishing. The presumably in-situ-keratinized sulcular epithelium was examined by transmission electron microscopy. It was also compared with oral gingival epithelium from the same two animals and with oral and sulcular epithelium from a rhesus monkey that had not been exposed to local or systemic antibacterial therapy. The results confirmed earlier histological studies, which have shown that under the conditions described the sulcular epithelium becomes parakeratinized. In addition, several other ultrastructural changes were observed, some of which suggest that the treatment given may result in the formation of a more efficient permeability barrier in the sulcular area. The possible clinical significance of such a barrier is briefly discussed.