The phenomenon of leukopedesis in gingival and periodontal tissues was measured by counting the number of orogranulocytes migrating into the mouth during repeated intervals of 30 seconds. Measurements were carried out with a computerized electronic cell grading system and classified as a nonsubjective laboratory routine for indexing oral inflammation. For orogranulocytic migratory rate (OMR) readings above 1.2 X 10,/30 sec, a minimum of three determinations is required for reliability. Single readings suffice for OMR's below 0.5 X 106/30 sec, which indicates that the system is suitable for mass screening purposes.Polymorphonuclear granulocytes become extravascular after penetrating the walls of capillaries, venules, and lymphatic vessels. Through this process of leukopedesis, a constant number of polymorphonuclear granulocytes is maintained throughout the tissues. The epithelial attachment and the tissues forming the gingival crevice appear to be the only tissues in the human mouth that provide the pathway for extravascular polymorphonuclear granulocytes to continue their migration into the mucus that covers all free surfaces of the oral cavity (Fig 1).The rate at which the granulocytes emerge into the mucus is proportional to the rate of leukopedesis. In the presence of an infiammatory reaction in the periodontal tissues, the rate of leukopedesis is increased and leads not only to the formation of a cellular infiltrate but also to an increase in the rate of granulocytic migration. Living polymorphonuclear granulocytes in the oral mucus have been designated "orogranulocytes" (OGC's). The mucus, which is elab-
The gingival index (GI) and the Orogranulocytic Migratory Rate (OMR) were determined for 86 subjects. The statistical analyses revealed a highly significant correlation between the two parameters. An analysis of regression demonstrated that the correlation of GI and OMR changed with low to high values of GI, probably because GI is not a true parametric index.
Benzidine dihydrochloride in the presence of dimethylsulfoxide reacts with myeloperoxidase contained within the granules of polymorphonuclear leukocytes obtained from the oral cavity. A blue meriquinoid oxidation product is formed in the presence of hydrogen peroxide, which can be extracted from the granules with a combination of methyl alcohol and dimethylsulfoxide. A stable yellow-brown pigment is formed which can be measured spectrophotometrically. The values are expressed in optical density units and correlate with the Orogranulocytic Migratory Rate units obtained by other means. Consequently, the spectrophotometric method is an additional non-subjective technique available for the evaluation, monitoring, and indexing the inflammatory periodontal disease.
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