성인의 자연발생 초기 치주염 시 치은조직의 전자현미경적 연구

Abstract

[한글]저자는 정상치은과 염증상태의 치은의 미세구조를 관찰하기 위하여 연세대학교 치과대학 부속병원 치주과에 내원하여 초기치주염으로 진단된 5명에서 얻은 염증치은과 2명의 건강한 치은을 절제하여 전자현미경으로 관찰한 결과 다음과 같은 결과를 얻었다.

1. 치주낭상피세포의 세포간격은 건강 치은열구상피보다 넓어져 있으며 교소체의 수도 현저히 감소되어있으며 어느 곳에서는 상피간 간격이 세포의 넒이보다도 넓어져 있었다.

2. 치주낭상피세포간격에는 상피세포의 잔사로 보이는 microvilli, 떨어진 교소체 조각, 무정형의 솜털같은 침전물 모양의 물질들이 흩어져 있었다.

3. 치주낭상피세포내의 소기관의 공포화를 관찰할 수 있으며 심한 경우는 세포질들의 붕괴로 세포가 괴사되어 가는 경우가 관찰되었다.

4. 치주낭상피세포의 지저판은 연속성을 잃고 군데 군데 불연속성을 나타내고 있었다.

5. 결체조직내의 섬유아세포는 건강조직내의 섬유아세포보다 그 방추형모양의 특성을 잃고 세포질, 사립체 등의 변화를 보이며 심한 경우에는 세포막이 파괴되어 세포질만 산만하게 흩어져 있는 경우가 발견되었다.

6. 염증세포는 대부분 형질세포이며 어떤 경우에는 형질세포도 병변을 보이고 있으며 그외 임파구, 다형핵백혈구, 대식세포 등도 보이며 비만세포도 가끔 발견되었다.

7. 교원섬유의 양도 치주염의 치은에서는 많이 감소 되었다.

[영문]The purpose of this study was to investigate the ultrastructural features of normal and inflammed gingival tissues.

The tissue specimens were taken from five patients with early periodontitis who came to Dept. of periodontology, the Dental College of Yonsei Univ. And from two dental students with healthy gingiva.

The tissues for electron microscopic observation were prefixed with 3% glutaraldehyde in phosphate buffer solution for 24 hours. Tissues were rinsed with phosphate buffer solution (pH 7.4) and postfixed in 1% osmium tetroxide for 2 hours. After tissues were dehydrated with graded ethanol series, they were embedded in Epon 812, each specimen was sectioned 500A in thickness by means Sorvall MT-2B Blum ultramicrotome, doubly stained with uranyl acetate and lead citrate and exmained with Hitachi Hu-500 electron microscope.

The results are so follows;

1. Intracellular spaces between periodontal pocket epithelium showed widening and had more reduced number of desmosomes than number of desmosomes in healthy gingiva. In some places between epithelium appeared wider than the cell width.

2. In the interdental spaces between periodontal pocket epithelium there were microvilli which seems like epithelium debrides, particles of fallen out desmonsomes and precipitation from of floculent substance as were scattered around.

3. There is the vacuolization of the cell organell in the periodontal pocket epithelium. In the severe case we also could see the dying cell with disintegration of cytoplasm.

4. The basal lamina of the periodontal pocket epithelium had lost it's continuity and appreared discontinuity in some areas.

5. The fibroblast in the connective tissue of the inflammed gingival tissue appeared lost the spindle shape characteristic and showed cytoplasmic and granular changes. In severe case the cell membrane had broken and cytoplasms were scattered.

6. Most of the inflammed cells were plasma cells.

In some cases the plasma cells also seemed to be diseased. And lymphoctye, P.M.N., macrophage could be seen and often there were mast cells.

7. In the periodontitis, the amounts of gingival collagen fiber were reduced significantly.