Some effects of non-surgical therapy on gingival inflammatory cell subsets in patients with early-onset periodontitis associated with Actinobacillus actinomycetemcomitans

Aim of the study

To describe the local immune response at the cellular level in patients suffering from early onset periodontitis (EOP), with and without the presence of Actinobacillus actinomycetemcomitans (A. a.) and to evaluate the effect of scaling and root planing on inflammatory cell populations.

Materials and methods

Ten subjects suffering from EOP with A. a. and 10 others without A. a. were recruited for this study. All the clinical parameters were recorded before and 6 weeks after manual scaling and root planing at sites of probing depth greater than 4 mm. Two gingival biopsies were also taken from each patient and subject to immunohistochemistry in order to detect and quantify B and T cells, plasmacytes as well as IgA, IgG and both intra- and extra-plasmacyte IgM. Microbial sampling and culture were undertaken in order to detect A.a.

Results

Before treatment, there were much greater numbers of all cell phenotypes in the EOP-A. a. group compared with the EOP-non A. a. group. After treatment, the numbers of inflammatory cells decreased in both groups but, if one compares the data before and after treatment in the EOP-A. a. group, one observes that the results are only statistically significant in the group positive for the CD30 (plasmacytes). In the EOP-non A. a. group, the difference is significant for all cell types, except for the IgM marker cells. In other respects, the reduction in probing depths and the gain in attachment are only significant after 6 weeks in the EOP-non A. a. group.

Conclusion

Patients suffering from EOP-A. a. have 2 to 3 times as many inflammatory cells as patients with EOP-non A.a. Scaling and root planing causes a significant reduction in all cell types in the case of EOP without A. a. but in the case of EOP with A. a., the reduction is only significant for plasmacytes.

Commentary

The results of this study can be explained by the fact that A. a. has the capacity to penetrate the periodontal tissues. The only treatment undertaken here was scaling and root planing without any other adjuvant.