A Modern View of Morphological Changes in the Gums in the Course of Inflammatory Processes

Abstract

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