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Chronic inflammation around painless partially erupted third molars
Mikael Laine1, Irja Ventä, Tapio Hyrkäs
1Department of Medicine, University of Helsinki Hospital, City of Helsinki, Finland.
Summary
Chronic, symptomless pericoronitis involves increased macrophages and T lymphocytes, indicating a smoldering infection. This chronic inflammation, rather than acute infection, may lead to long-term complications and tooth extraction.
Area of Science:
- Oral pathology
- Immunohistochemistry
- Microbiology
Background:
- Pericoronitis is inflammation of the gum tissue around a wisdom tooth.
- Chronic pericoronitis often presents without acute symptoms.
- Understanding the host response is crucial for managing this condition.
Purpose of the Study:
- To evaluate the histologic host response in chronic, symptomless pericoronitis.
- To identify specific immune cells involved in the inflammatory process.
Main Methods:
- Gingival mucosal and dental follicle samples were collected from patients with pericoronitis and healthy controls.
- Immunohistochemistry was used to detect macrophages (CD68), natural killer cells (CD56), T cells (CD2, CD4, CD8), and neutrophils (lactoferrin).
Main Results:
- Macrophages were the most abundant cells in pericoronitis tissues.
- Increased CD2+ T lymphocytes with a normal CD4/CD8 ratio were observed.
- Neutrophils were not elevated and showed no signs of activation; dental follicles lacked increased inflammatory cells.
Conclusions:
- Chronic, symptomless pericoronitis represents a smoldering infection, not an acute one.
- The persistent, low-grade inflammation may contribute to long-term sequelae.
- These sequelae can ultimately necessitate tooth extraction.