辺縁性歯周炎におけるポケット上皮の透過性と防衛機構に関する病理組織学的ならびに組織化学的研究

Abstract

The present histopathological and histochemical study was performed on the periodontal tissues of 100 teeth from autopsy materials and gingivae removed operatively from the 55 patients with marginal periodontitis to investigate a permeability and defense mechanism of the crevicular epithelium in marginal periodontitis. In addition, histochemical reaction was carried out on the lingual and buccal mucosa of rats and mice on which Zinc chloride (4%) had been topically applied to investigate the change in dehydrogenase activity of the epithelium and subepithelial insoluble collagen. The following results were obtained:1) Subepithelial inflammation of the pocket in marginal periodontitis may consist of subepithelial nonspecific inflammatory reaction (vascular dilatation, slight and moderate exudation of serous fluid and leucocyte) and of adjacent immunological response (diffuse infiltration of plasma cell and lymphocyte). 2) There is rather close correlation between intensity of subepithelial inflammation as well as disappearance of the insoluble collagen fiber and increase in intercellular space of the pocket epithelium as well as amount of bacterial plaque in the pocket. 3) The increase in intercellular space of the crevicular epithelium is attributed to serous exudation and responsible for increase in the permeability of the crevicular epithelium. 4) The crevicular epithelial cells may be able to prevent the dilated intercellular space from invasion of plaque bacteria. 5) The crevicular epithelium had high activity of acid phosphatase even in the epithelium with inflammatory change such as increased intercellular edema and desquamation. 6) These findings suggest that the lysosomal enzyme of the epithelial cell contributes to defense mechamism of the crevicular epithelium by hindering bacterial invasion and reducing a harmfull effects of endotoxin, antigenic substance and bacterial products on the pocket wall.