The rests of Malassez and chronic marginal periodontitis

The structure of the rests of Malassez and the relationship which they bear to the junctional epithelium in the marginal region of pigs' molars was investigated. A 3-dimensional picture of the marginal rests and their relationship to the junctional epithelium was built up by means of standardized photomicrographs made from serial sections. In teeth involved in chronic marginal inflammation, the rests in this region appeared to form a continuous network and we confirmed the original suggestion of Grant & Bernick that, at frequent intervals, the junctional epithelium"... seemed to be continuous with the epithelial rests in the upper third of the root...". If the anatomical relationship of the rests in man resembles that seen in the pig and they form a continuous network communicating at intervals with the junctional epithelium, this relationship must inevitably lead to speculation about the effects of any potential for reactive proliferative equivalent to that which is frequently seen in the apical region. It is possible that the rests might be acting as the "thin end of the wedge", augmenting and facilitating apical migration of the junctional epithelium during the pathogenesis of the periodontal pocket.