Stereological observations on long-term experimental gingivitis in man

The purpose of the present investigation was to study stereologically the histopathologic changes in the gingiva during 6 months of abolished oral hygiene and to study the development of chronic gingivitis in man. After a thorough prophylaxis procedure, 5 dental students performed optimal oral hygiene under supervision for a period of 3 weeks. At the end of this pre-experimental phase, they were asked to abolish all oral hygiene procedures for 4 (2 individuals) to 6 months (3 individuals). At day 21, and after 2, 3, 4, 5 and 6 months, the gingival exudate flow rate and the gingival index were assessed, and buccal gingival biopsies taken. Semi-thin histologic sections were stained with basic fuchsine and methylene blue. By point counting at 2 different levels of magnification, the volume densities of epithelium, infiltrated (ICT) and non-infiltrated connective tissue, and collagen were estimated. The %s of fibroblasts, PMN's lymphocytes, plasma cells and macrophages were estimated in a predetermined standardized area close to the apical termination of the junctional epithelium. With increasing time, the volume densities of the ICT rose concomitantly with a decrease in the volume densities of the collagen. In spite of great interindividual variations, a slow shift in the proportions of some cell populations was consistently observed. While the fraction of PMN's, lymphocytes and macrophages remained stable, a decrease of fibro-blasts (57 to 39%) and an increase of plasma cells (0.2 to 10%) was observed. This study has, therefore, demonstrated that, in 6 months of plaque accumulation, a chronic gingivitis with a predominance of PMN's and lymphocytes develops.(ABSTRACT TRUNCATED AT 250 WORDS)