The Pathogenesis of Desquamative Gingivitis : a Disturbance of the Connective Tissue Ground Substance

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Abstract
Some of the intimate changes in desquamative gingivitis were studied using histochemical methods. Gingival biopsies were made on 8 patients with desquamative gingivitis, of whom 6 were women. A comparable control series was also studied. The tissues were immediately fixed by the freezing-drying method. After dehydration they were infiltrated with paraffin and sectioned. Following removal of the paraffin some sections were denatured in alcohol; others were denatured in alcohol and then extracted with water or extracted with water and then denatured. The sections were then stained for carbohydrate-containing substances by the periodic acid-leuco fuchsin procedure. The connective tissue ground substance was profoundly altered; large portions of it were dissolved; the basement membrane was either gone or attentuated. When compared to normal tissues the ground was shown to obtain increased quantities of water-soluble glycoprotein and alcohol-insoluble, water-soluble glyco-protein residues. In some areas the cementing substance between the epithelial cells was dissolved. It is suggested that these changes are in part due to the production of abnormal quantities of enzymes by the connective tissue cells which de-polymerize the ground substance and cementing substance. The possible influence of the female sex hormones on the enzymatic activity of the connective tissue cells is considered.
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