Electron microscope quantitation of inflammatory infiltrates in childhood gingivitis

Quantitation of inflammatory cell infiltrates in gingival connective tissues was carried out on 12 gingival biopsies from the deciduous dentition of 11 children aged 4–8 years. The tissue was prepared for electron microscopy and from ultrathin sections mounted on 200 mesh grids, cells in one third of the grid squares enclosing infiltrated connective tissue were counted.
The infiltrate displayed large numbers of small and medium lymphocytes and was moderately vascular. A distinct population of peripherally distributed plasma cells was present and pathologically altered fibroblasts together with marked collagen loss were notable features. Small numbers of macrophages, mast cells and polymorphonuclear neutrophils were recorded but T-blasts (immunoblasts) were very rarely encountered.
The childhood lesions have much in common with the early lesion of adult gingivitis which is considered to be a cell-mediated immune phenomenon. However, the lack of T-blasts and rather larger proportion of plasma cells suggest that the lesion of childhood gingivitis represents a position between the early and established phases of gingival disease described in older individuals. A more exact interpretation of these, the earliest stages of human gingival disease should be achieved when the lymphocytes contributing to the childhood infiltrates can be assigned to the T- and B- cell lines.