A modern view of morphological changes in the gums in the course of inflammatory processes
The study of a modern view of morphological changes in the gums in the course of inflammatory processes. Identification of the causes and features of epithelial keratinization disorders and the development of parakeratosis and acantholysis in gingivitis.
| Рубрика | Медицина |
| Вид | статья |
| Язык | английский |
| Дата добавления | 28.09.2023 |
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Poltava State Medical University
A modern view of morphological changes in the gums in the course of inflammatory processes
Popovich I.Yu.
Annotation
The purpose of the study was the analysis of literature sources with the study of a modern view of morphological changes in the gums in the course of inflammatory processes.
Materials and methods. Review and analysis of scientific and medical literature based on databases such as Scopus, Web of Science, MedLine, PubMed, NCBI, the study of which does not exceed 10 years, including literature reviews and clinical trial results.
Results and discussion. The analysis of the literature indicates significant morphological changes in the gums in the course of chronic catarrhal gingivitis, which occurs in both the epithelium and their own plate. Thus, the epithelium responds with signs of keratinization disorders. In the course of inflammatory processes in gums, changes of the morphological organization both in epithelial and connective tissue component have been observed. The cytoplasm of the cells of the spiny layer contains granularity, the nuclei are pyknotic and hyperchromic, the boundaries between the cells lose clarity. There is a sharp increase in the amount of glycogen in the cells of the spiny layer. Connective tissue undergoes changes in the form of disorganization, which manifests itself in focal or diffuse gamma metachromasia. The focus of inflammation is clearly separated from the surrounding connective tissue by fibrous bands, which is accompanied by the accumulation of PAS-positive substances and glycosaminoglycans. Changes in the microcirculatory tract of the gums are manifested by dilation of capillaries, venules with diapedetic hemorrhages, endothelial proliferation, swelling of the basement membrane, and the appearance of pericellular oedema. There is moderate fibrosis of the own plate of a mucous membrane in deep layers and the phenomenon of sclerosis. There is also leukocyte infiltration with localization of cells between epitheliocytes, their necrobiotic changes in the form of accumulations of granular basophilic substance.
Conclusion. Based on the literature sources, it should be noted that there are only a few sources that characterize the change of the epithelium and its own plate in the course of inflammatory processes, and they are not enough to fully understand the morphological rearrangement of gums at the histological and ultrastructural levels. Special studies of mast cells and their impact on the occurrence and course of the inflammatory process in the gums have not been conducted. Until now, the question of the secretion type of tissue basophils in the course of inflammatory processes in the gums remains open.
Keywords: gums, gingivitis, periodontitis, periodontal pocket, infiltration.
Анотація
morphological inflammatory epithelial gingivitis
СУЧАСНІ УЯВЛЕННЯ ПРО МОРФОЛОГІЧНІ ЗМІНИ В ЯСНАХ при запальних процесах
Попович І. Ю.
Резюме. Мета дослідження. Аналіз літературних джерел з вивченням сучасних поглядів на морфологічні зміни в яснах при запальних процесах.
Матеріали і методи. Огляд та аналіз наукової та медичної літератури на основі баз даних Scopus, Web of Science, MedLine, PubMed, NCBI, вивчення яких не перевищує 10 років, включаючи огляди літератури та результати клінічних випробувань.
Результати дослідження та обговорення. Запальні захворювання пародонта мають високу поширеність серед населення та представляють серйозну проблему, особливо серед дорослих, де відзначається тенденція до їх зростання, досягаючи 98% випадків. Проведений аналіз літературних джерел вказує на істотні морфологічні зміни ясен при запальних процесах, які відбуваються як у епітелії так і власній пластинці. При цьому епітелій реагує ознаками порушення зроговіння. При гінгівіті спостерігаються порушення зроговіння епітелію і розвивається явище паракератозу та акантолізу. Цитоплазма клітин шипуватого шару містить зернистість, межі між клітинами втрачають чіткість, ядра пікнотичні, гіперхромні. Визначається різке збільшення кількості глікогену в клітинах шипуватого шару. Відмічається дезорганізація сполучної тканини, що проявляється у вигляді вогнищевої або дифузної гамма-метахромазії. Вогнище запалення чітко відмежоване від оточуючої сполучної тканини фіброзними тяжами, що супроводжується накопиченням PAS-позитивних речовин і глікозоаміногліканів. Зміни мікроциркуляторного русла ясен проявляються розширенням лімфатичних судин, капілярів, венул з діапедезними крововиливами, з проліферацією ендотелію, набуханням базальної мембрани та появою перицелюлярного набряку.
Висновки. Виходячи із даних літератури, спеціальних досліджень, присвячених вивченню тучних клітин та їх впливу на виникнення та перебіг запального процесу в яснах, не проводилося. До цього часу остається відкритим питання типу секреції тканинних базофілів при хронічному катаральному та хронічному гіперпластичному гінгівіті.
Ключові слова: ясна, гінгівіт, пародонтит, пародонтальна кишеня, інфільтрація.
Connection of the study with planned research works
The paper is a fragment of the research project “Pathogenetic prevention development in pathological lesions in the oral cavity of individuals with internal diseases”, state registration No. 0121U108263.
Introduction
Inflammatory diseases of periodontal tissues are widely spread among people and are a serious problem, especially for adults, where there is a tendency to their increase, reaching 98% of cases [1]. The presence of clinical forms, accompanied by severe disorders of the dental system, that affect the reactivity of the whole organism, makes periodontal disease one of the important problems of modern dentistry, indicating insufficient effectiveness of preventive and curative measures [2, 3, 4].
Establishing the main causes and mechanisms of inflammatory periodontal disease largely determines the basic principles and directions of finding the most effective methods of treatment and prevention of periodontal disease.
The purpose of the study
Analysis of literature sources with the study of a modern view of morphological changes in the gums in the course of inflammatory processes.
Materials and methods
Review and analysis of scientific and medical literature based on databases such as Scopus, Web of Science, MedLine, PubMed, NCBI, the study of which does not exceed 10 years, including literature reviews and clinical trial results.
Results and discussion of research
The analysis of the literature indicates significant morphological changes in the gums in the course of chronic catarrhal gingivitis, which occurs in both the epithelium and their own plate. Thus, the epithelium responds with signs of keratinization disorders. The cytoplasm of prickly cells acquires signs of vacuolar dystrophy, the nuclei are pyknotic and hyperchromic, the boundaries between cells lose clarity; there is a sharp increase in the amount of glycogen metabolite [5, 6].
Depending on the topographic areas of the gums, the changes in their own plate will be appropriate.
Thus, signs of intercellular oedema are more intense in the area of the epithelial attachment. There is disorganization of connective tissue, which manifests itself in the form of focal or diffuse gamma metachromasia. Infiltration of connective tissue with plasma proteins is somewhat less common, and the response to fibrin is determined. In the course of mild to moderate stages of gingivitis, argyrophilic fibres become dense. Collagen fibres in the area of inflammatory infiltrate, thicken, merge into dense bundles and lose tortuosity [7, 8, 9].
The site of inflammation is clearly separated from the surrounding connective tissue by fibrous bands. The process of fibrous degeneration of the gingival papilla is accompanied by the accumulation of PAS-positive substances and glycosaminoglycans.
In inflammatory infiltrates, the most frequent representatives of cellular elements were histiocytes and lymphoid cells, less often - plasma cells, as well as segmented, in some cases - eosinophilic leukocytes. Significantly increased is the number of mast cells that give a bright gamma metachromasia [10, 11].
Degranulating forms and free placement of granules predominate. Infiltrates are located mainly in the area of sulcular epithelium as well as attachment epithelium, and are focal in nature [12, 13].
Significant changes are observed in the vessels of the microcirculatory tract of the gingival plate, which manifests itself in the form of dilation of lymphatic vessels, capillaries, venules with diapedetic hemorrhages; there is endothelial proliferation, oedema of the basement membrane with pericellular oedema emergence.
In the course of more severe gingivitis, hyaline thrombi in the vessels of the microcirculatory tract as well as productive vasculitis are subepithelially determined [14, 15, 16].
In the course of histoenzymatic research, in the basal layer of an epithelium, the high content of succinate dehydrogenase, lactate dehydrogenase and acid phosphatase is noted; moderate quantity of these enzymes is observed in cellular infiltrates. The activity of glucose-6-phosphate dehydrogenase in infiltrates of vascular walls and epithelium is low. Thus, in the course of catarrhal gingivitis there is a picture of chronic non-specific inflammation [17].
Morphologically, hypertrophic gingivitis is characterized by intense invagination of the epithelium into its own plate. Prickly cells contain pyknotic nuclei, vacuolated cytoplasm. The processes of keratinization are disturbed, glycogen is unevenly distributed, a significant amount of it is observed in the deep parts of the cells of the spiny layer [18].
In the own plate of the mucous membrane of the gums, symptoms of oedema, degenerative changes in the fibres in the form of mucoid oedema, sometimes with a positive reaction to fibrin in the walls of blood vessels are expressed.
The number of vessels is increased; there is their fullness and dilation of the lumen. The expansion of the venous chain of the microcirculatory tract predominates for the most part. Swelling and sometimes endothelial proliferation are noted [19, 20].
It is noteworthy that a characteristic and constant change in the morphological organization of the gums in the course of hypertrophic gingivitis is the infiltration of their own plate by lymphoid and plasma cells, with predominantly perivascular localization of the latter. In addition, a constant and inherent morphological feature in the gums, for this type of gingivitis - “mast cell” reaction with degranulation and metachromasia of the components of their own plate [21,22] has been established.
There is moderate fibrosis of the own plate of a mucous membrane in deep layers and the phenomenon of sclerosis. In addition, there is leukocyte infiltration with localization of cells between epitheliocytes, their necrobiotic changes in the form of accumulations of granular basophilic substance. In some cases, against the background of the above-mentioned changes, areas of necrosis are observed, with a corresponding inflammatory reaction, the phenomena of abscessing and growth of granulation tissue [23, 24, 25].
Conclusion
Thus, concluding the analysis of the literature, it should be noted that there are only a few sources that characterize the change of the epithelium and its own plate in the course of inflammatory processes, and they are not enough to fully understand the morphological rearrangement of gums at the histological and ultrastructural levels. In addition, no highly specific studies have been performed on mast cells investigation and their effects on the occurrence and course of inflammation in the gums. Until nowadays, the question of the secretion type of tissue basophils in the course of chronic catarrhal and hypertrophic gingivitis remains open.
Perspectives of further research. Further research should focus on studying the level of cytokines in the oral fluid in the dynamics of the use of fixed prostheses.
References
1. Radchuk VB, Hasyuk NV, Yeroshenko HA. Analiz struktury ortopedychnoyi patolohiyi ta chastoty povtornykh zvernen pislya protezuvannya metalokeramichnymy konstruktsiyamy [Analysis of the orthopedic pathology structure and the frequency of repeated visits after dental prosthetics with metal-ceramic structures] Svit medytsyny ta biolohiyi. 2019;4(70):138-142. [Ukrainian]. https://doi.org/10.26724/2079-8334-2019-4-70138-142
2. Radchuk V, Hasiuk N, Bozhyk S, Dzetsiukh T, Antonyshyn I. Initiating factors of complications development during prosthetics of teeth with fixed prostheses. Wiadomosci Lekarskie. 2021;74(5):1164-1168. PMID: 34090284. https://doi.org/10.36740/WLek202105122
3. Slots J. Periodontitis: facts, fallacies and the future. Periodontology 2000. 2017;75(1):7-23. PMID: 28758294. https://doi.org/10.1111/prd.12221
4. Danylevskyy MF, Borysenko AV, Antonenko MYu, Sidelnikova LF, Nesyn OF, Dikova IH. Terapevtychna stomatolohiya: u 4 tomakh: pidruchnyk. Tom 3. Zakhvoryuvannya parodonta. 2-e vydannya, pereroblene i dopovnene [Therapeutic dentistry: in 4 volumes: textbook. Volume 3. Periodontal disease. 2nd edition, revised and supplemented]. K: Medytsyna; 2018. 624 p. [Ukrainian]
5. Radchuk VB, Hasyuk NV, Hasyuk PA. Osoblyvosti reaktyvnykh zmin klitynnoho skladu yasen v dynamitsi klinichnykh sposterezhen zalezhno vid vydu odontopreparuvannya pid metalokeramichni konstruktsiyi [Features of reactive changes in the cellular composition of the gums in the dynamics of clinical observations depending on the type of odontopreparation for metal-ceramic structures]. Klinichna stomatolohiya. 2018;4:69-75. [Ukrainian]
6. Thilagar S, Santhanakrishnan M, Rao S. Expression of protease-activated receptors 1 and 2 in individuals with healthy gingiva and chronic periodontitis. J Indian Soc Periodontol. 2018;22(1):12-17.
7. Hasyuk PA, Hasyuk NV. Osoblyvosti morfolohichnoyi budovy yasen v normi y pry khronichnykh hinhivitakh: navch. posibn. dlya studentiv vyshchykh medychnykh zakladiv III-IV rivniv akredytatsiyi [Features of morphological structure of gums in norm and at chronic gingivitis: textbook. manual for students of higher medical institutions of III-IV levels of accreditation]. Ternopil; 2014. 92 p. [Ukrainian]
8. Hasyuk NV. Patohenetychni mekhanizmy tsytolohichnoyi perebudovy slyzovoyi obolonky porozhnyny rota u khvorykh na heneralizovanyy parodontyt [Pathogenetic mechanisms of cytological rearrangement of the oral mucosa in patients with generalized periodontitis]. Visnyk naukovykh doslidzhen. 2015;1:63-66. [Ukrainian]
9. Ahuja R, Almuzian M, Khan A, Pascovici D, Dalci O, Darendeliler MA. A preliminary investigation of short-term cytokine expression in gingival crevicular fluid secondary to high-level orthodontic forces and the associated root resorption: case series analytical study. Prog Orthod. 2017;18(1):23. PMID: 28762151. PMCID: PMC5545179. https://doi.org/10.1186/s40510-017-0177-x
10. Wang SS, Tang YL, Pang X, Zheng M, Tang YJ, Liang XH. The maintenance of an oral epithelial barrier. Life Sci. 2019;227:129-136. PMID: 31002922. https://doi.org/10.1016/jJfs.2019.04.029
11. Groeger S, Meyle J. Oral Mucosal Epithelial Cells. Front Immunol. 2019;10:208. PMID: 30837987. PMCID: PMC6383680. https://doi.org/10.3389/fimmu.2019.00208
12. Yeroshenko HA. Kharakterystyka kariometrychnykh pokaznykiv mizhzubnoho yasenevoho sosochka v normi [Characteristics of karyometric parameters of the interdental gingival papilla are normal]. Visnyk problem biolohiyi i medytsyny. 2012;3:134-135. [Ukrainian]
13. Almubarak A, Tanagala K, Papapanou PN, Lalla E, Momen-Heravi F. Disruption of Monocyte and Macrophage Homeostasis in Periodontitis. Front Immunolog. 2020;11:330. PMID: 32210958. PMCID: PMC7067288. https:// doi.org/10.3389/fimmu.2020.00330
14. Doroshenko OM, Doroshenko MV. Otsinka stanu marhinalnoho parodontu v zalezhnosti vid metodyky preparuvannya opornykh zubiv pid chas vyhotovlennya neznimnykh konstruktsiy zubnykh proteziv [Assessment of the condition of the marginal periodontium depending on the method of preparation of abutment teeth in the manufacture of fixed structures of dentures]. Zbirnyk naukovykh prats spivrobitnykiv NMAPO imeni PL Shupyka. 2013;22(3):42-48. [Ukrainian]
15. Palyvoda II. Vplyv shtuchnykh koronok na stan marhinalnoho parodonta opornykh zubiv [Influence of artificial crowns on the condition of the marginal periodontium of abutment teeth]. Ukrayinskyy stomatolohichnyy almanakh. 2011;3:49-51. [Ukrainian]
16. Surboyo MD, Ernawati DS, Budi HS. Oral mucosal lesions and oral symptoms of the SARS-CoV-2 infection. Minerva Dent Oral Sci. 2021;70(4):161-168. PMID: 34269548. https://doi.org/10.23736/S2724-6329.21.04493-9
17. Engstrom M, Eriksson K, Lee L, Hermansson M, Johansson A, Nicholas A, et al. Increased citrullination and expression of peptidylarginine deiminases independently of P. gingivalis and A. actinomycetemcomitans in gingival tissue of patients with periodontitis. J Translat Med. 2018;16(1):214. PMID: 30064459. PMCID: PMC6069803. https://doi.org/10.1186/s12967-018-1588-2
18. Tang L, Zhou X. D, Wang Q, Zhang L, Wang Y, Huang D. M. TNF receptor-associated factor 6 suppression inhibits inflammatory response to Porphyromonas gingivialis in human periodontal ligament cells. Quintessence Int. 2011;42(9):787-796.
19. Borenstein A, Fine N, Hassanpour S, Sun C, Oveisi M, Tenenbaum HC, et al. Morphological characterization of paraand proinflammatory neutrophil phenotypes using transmission electron microscopy. J Periodont Res. 2018;53(6):972-982. PMID: 30079509. https://doi.org/10.1111/jre.12595
20. Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Periodontol. 2018;89(1):28-45. PMID: 29926945. https://doi.org/10.1002/JPER.17-0163
21. Zhang P, Fan Y, Li Q, Chen J, Zhou W, Luo Y, et al. Macrophage activating factor: A potential biomarker of periodontal health status. Arch Oral Biol. 2016;70:94-99. PMID: 27341461. https://doi.org/10.1016/j.archoralbio.2016.06.010
22. Kazmierczyk-Winciorek M, N^dzi-Gora M, Stotwinska SM. The immunomodulating role of probiotics in the prevention and treatment of oral diseases. Cent Eur J Immunol. 2021;46(1):99-104. PMID: 33897290. PMCID: PMC8056348. https://doi.org/10.5114/ceji.2021.104412
23. Zorina OA, Amkhadova MA, Khamukova AA, Aleskerov ES, Ajrapetov GA, Demidova AA. Osobennosti osteoimmunologicheskikh aspektov osteorezorbtsii pri periimplantite, khronicheskom parodontite i rake al'veolyarnogo otrostka i al'veolyarnoi chasti chelyustei [Osteoimmunological aspects of periodontal inflammatory destructive changes at periimplantitis, chronic periodontitis and oncological diseases of the oral cavity]. Stomatologiia. 2020;99(4):27-32. [Russian]. PMID: 32692516. https://doi.org/10.17116/stomat20209904127
24. Tatakis DN, Chambrone L, Allen EP, Langer B, McGuire MK, Richardson CR, et al. Periodontal soft tissue root coverage procedures: a consensus report from the AAP Regeneration Workshop. J Periodontol. 2015;86(2):5255. PMID: 25315018. https://doi.org/10.1902/jop.2015.140376
25. Carvalho CV, Saraiva L, Bauer F, Kimura RY, Souto M, Bernardo CC, et al. Orthodontic treatment in patients with aggressive periodontitis. Am J Orthod Dentofacial Orthop. 2018;153(4):550-557. PMID: 29602347. https:// doi.org/10.1016/j.ajodo.2017.08.018
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