Using scanning electron microscopy, bacteria were found invading the epithelial wall of deep periodontal pockets in five out of eight cases. In one case, bacteria had reached the connective tissue. The following bacterial morphotypes were identified: cocci, short rods, filaments and spirochetes. A corncob-like formation with a few scattered spirochetes was found in one case between the junctional epithelial cells. Numerous cocci, rods and filaments were found in intercellular spaces of the epithelium in the lateral wall of the pocket and accumulating on the epithelial side of the basement lamina. Bacterial invasion of gingival tissue may have important pathogenic and therapeutic implications.
This transmission and scanning electron microscope study documents the invasion of microorganisms into the gingiva and along resorbing alveolar bone surfaces in a 15-year-old patient with localized juvenile periodontitis. The invading bacteria were mainly Gram-negative fusiform, coccobacilli and spirochetes. Microorganisms identified as Mycoplasma were also found to invade in some areas. Polymorphonuclear neutrophils (PMNs) were seen in association with the bacteria. The majority of bacteria were covered by PMNs and enclosed by the phagocyte but did not appear to lie within phagosomes. High numbers of PMNs were found in the gingival connective tissue inflammatory infiltrate and in the pocket epithelium. Invasion into the gingiva and alveolar bone by bacteria and Mycoplasma in localized juvenile periodontitis may be importance in the therapy of this infection.
The presence of bacteria within the gingival oral epithelium and adjacent connective tissue in cases of periodontitis and localized juvenile periodontitis have been described using scanning and transmission electron microscopy. The following bacterial morphotypes were identified: cocci, short rods, filaments and few spirochetes in periodontitis and mainly coccobacillary-shaped bacteria in localized juvenile periodontitis. Also Mycoplasma-like structures were identified in the localized juvenile periodontitis cases. Tunnel-like formations at different depths of the oral epithelium contained higher numbers of bacteria than those seen on the adjacent oral surface. Identification of specific bacteria in the oral epithelium may have important pathogenic and therapeutic implications.
Mycoplasma have been identified in one case of juvenile periodontitis by size, morphology, hemadsorption and cultural techniques. These microorganisms were found on the surface of the tooth, on the surface of pocket epithelium and invading the gingival epithelium and adjacent connective tissue. These observations suggest the need for further studies on the role of Mycoplasma in the pathogenesis of advanced periodontal infections. The role of Mycoplasma in periodontal disease is discussed.
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