Bacterial penetration in the apical pocket wall of advanced human periodontitis

Abstract

The presence of bacteria in the apical wall of periodontal pockets has been observed in 8 cases of advanced human chronic periodontitis out of a total of 14 patients studied. The apical junctional epithelium and the underlying connective tissue were removed under general anesthesia. Filaments, rodshaped and coccoid microorganisms with predominant Gram‐negative cell walls were observed in the enlarged epithelial intercellular spaces. In the connective tissue, these microorganisms were found among badly damaged cellular fragments and collagen fibrils. Between the apical sub‐gingival plaque and the junctional epithelium of the pocket wall, several layers of polymorphonuclear leukocytes were observed with numerous phagosomes showing engulfed bacteria. Bacterial invasion of the apical wall of the pockets is possible in the final stages of human chronic periodontitis.