Cells and cellular interactions in gingival crevice washings from patients with juvenile periodontitis

The cells and the cellular interactions in the gingival crevices of three patients with juvenile periodontitis (JP), three patients with adult periodontitis (AP) and one healthy control were studied using light and scanning electron microscopy (SEM). The cells were collected by the washing method. The washings were either 1) fixed for 30 min in 2.5% glutaraldehyde (GA), or 2) cytocentrifuged onto a Melinex-polyester film and fixed in GA. On the films the cells of interest were identified and light photomicrographs were taken before processing for SEM. Four types of cellular interactions were seen in SEM: between polymorphonuclear leukocytes (PMN) and epithelial cells, between PMNs and bacteria, between PMNs and between bacteria. Based on morphologic and structural interpretation, the PMNs in the local lesion in JP seemed 1) to have a different morphology from the PMNs of AP lesions, 2) to be capable of ingesting bacteria, 3) to accumulate in gingival pockets in numbers as high as in AP, and 4) to be overwhelmed by the challenge of bacteria and bacterial aggregates.