Morphologic and histochemical characteristics of the dental cuticle in teeth affected by prepubertal periodontitis

A study was undertaken to determine the nature and composition of the cuticle found in teeth with generalized prepubertal periodontitis (PP). This was accomplished by using histological and histochemical methods on decalcified specimens. Forty-six permanent teeth which were extracted from three prepubertal periodontitis patients (siblings) were used. Nineteen of the 46 teeth were obtained with the facial or interdental gingiva. As a control, 20 healthy teeth extracted from 10 children for orthodontics reasons, and 22 teeth affected by terminal adult periodontitis (AP), were used. All the teeth with PP showed a thick coat covering the root surface from the cemento-enamel junction to the junctional epithelium. In some teeth the cuticle extended a few microns coronally to the cemento-enamel junction. The cuticle had a thickness which varied between 10 to 80 microns. It usually presented a very regular surface in the coronal portion of the root, and showed laminations suggesting appositional growth. In the middle and apical portions of the root exposed to the pocket, the cuticle was lobular with a very irregular surface and was covered with a thick microbial plaque. The staining reactions indicated that the cuticle was made of proteins probably derived from the inflammatory exudate. None of the healthy teeth examined nor those affected by AP showed a cuticle similar to those with PP. The cuticle formed on the teeth with PP appears to be an abnormal structure of proteinaceous nature, characteristic of these teeth, and may possibly play a role in the pathogenesis of the disease.