Immunosuppression and periodontal disease in man

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Abstract
Gingival biopsies were taken from three main categories of patients. One group (IS) comprised 19 patients of whom 16 had received renal allografts. All were treated with immunosuppressive agents. A second group (UH) consisted of 19 patients who suffered from chronic renal failure. Control specimens were obtained from 30 systemically healthy subjects with plaque‐free teeth and healthy gingiva. Samples were also taken from 30 other systemically healthy persons with less efficient oral hygiene. Their gingival index was 1. All specimens were examined by light microscopy. In addition, eleven selected biopsies were processed for electron microscopy. Beneath the dento‐gingival epithelium the control group with plaque had a significantly higher number of cells than the other groups (p < 0.05). Residual cell infiltrates were always found in the samples from the plaque‐free healthy subjects and the uremic patients, whereas scaling and an adequate plaque control virtually eliminated inflammatory cells from the IS specimens. Lymphocytes predominated in the lesions of the UH and IS patients with clinical loss of attachment and persistent inadequate oral hygiene. It is concluded that immunosuppression does not abolish the host reaction to dental plaque, but the inflammatory and/or immune responses are different from those in otherwise healthy persons.