Morphological and immunophenotypical differences between chronic periodontitis and peri-implantitis - a...

Area of Science:

• Oral pathology
• Periodontology
• Implant dentistry

Background:

• Chronic periodontitis (CP) and peri-implantitis (P-I) are inflammatory conditions affecting periodontal and peri-implant tissues, respectively.
• Histopathological examination is crucial for understanding disease mechanisms and differentiating between these conditions.

Purpose of the Study:

• To compare the morphology and immunophenotype of inflammatory infiltrate in CP and P-I lesions.
• To assess the diagnostic agreement among pathologists in distinguishing CP from P-I lesions based on histopathology.

Main Methods:

• Observational cross-sectional study involving 15 CP and 15 P-I gingival biopsies.
• Semiquantitative assessment of inflammatory infiltrate intensity and cellular composition (lymphocytes, plasma cells, monocytes/macrophages, granulocytes).
• Immunohistochemical analysis for CD45, CD38, CD68, myeloperoxidase (MPO)-positive cells, and vessel count.
• Evaluation of inter-observer diagnostic agreement using Kappa statistic.

Main Results:

• Peri-implantitis lesions exhibited significantly more severe inflammatory infiltrate and a higher percentage of plasma cells compared to chronic periodontitis lesions.
• Immunohistochemistry showed generally lower leukocyte subset percentages in CP (CD38: 32.05%; CD68: 6.45%; MPO: 8.62%) versus P-I (CD38: 61.13%; CD68: 9.09%; MPO: 7.47%).
• Inter-observer diagnostic agreement for differentiating CP from P-I lesions was poor to slight (Kappa = -0.18 to 0.13).

Conclusions:

• While peri-implantitis shows more severe inflammation and plasma cell infiltration, reliable differential histopathological features between CP and P-I soft-tissue lesions are difficult to establish.
• Low inter-observer agreement highlights challenges in histopathological diagnosis for distinguishing these conditions.
• Further research may be needed to identify more definitive diagnostic markers.