Epithelial changes in gingivitis

Abstract

The changes in epithelial structure due to inflammation were studied with the electron microscope. The material comprised biopsies from inflamed gingivae in 12 adult patients. The first change noticed in the epithelium was a widening of the intercellular spaces. When the widening was of moderate degree intermediate junctions, tight junctions and desmosomes were still observed. With increased widening the intermediate junctions disappeared first, then the tight junctions and, as a subsequent change there was a reduction in the number of the desmosomes. Leucocytes of different types were often present between the epithelial cells. In some areas, the lamina densa was diffuse or completely absent. Whether this was a real breakdown or an artefact is difficult to decide. In the cytoplasm of the epithelial cells there were numerous glycogen granules and swollen mitochondria with reduced numbers of cristae. More advanced changes consisted of localised disintegration of cytoplasm and other changes of the type that precede cell death. The possible effects of these morphological changes upon epithelial permeability are discussed.