Periodontal tissue morphology in children with abnormal occlusion and connective tissue dysplasia syndrome

Abstract

The study involved an analysis of the data gum biopsies obtained through light microscopy and polarization microscopy in order to identify pathomorphological features and the collagen Type I & Type III ratio in 56 children with occlusion issues, periodontal diseases and various undifferentiated connective tissue dysplasia (UCTD). 32 healthy children with intact periodontium served as a control group. For the histological examination of gum biopsies, the respective sections were stained with hematoxylin and eosin, while Picro-Sirius Red Stain Kit reagents were used to assess the Type I and Type III collagen distribution in the gum connective tissue. The image processing was performed in the ImageJ 1.47 software, while when analyzing the color histograms, the ratio of the red pixels (Type I collagen) and the green pixels (Type III collagen) was identified. The Type I/III collagen ratio (1.41±0.09) in children with chronic catarrhal gingivitis, occlusion issues and a “prominent” degree of UCTD was found to be significantly lower (p≤0.05) the similar ratio observed in patients with clinically healthy periodontium (2.01±0.09), as well as in patients with “mild” and “moderate” UCTD (1.63 ± 0.17) with homogeneous clinical and morphological dental manifestations. The effectiveness of the developed comprehensive dental treatment program for periodontal issues in children with abnormal occlusion associated with UCTD, including conservative anti-inflammatory treatment, pharmacological correction and orthodontic treatment, is justified by an increase in the amount of mature Type I collagen, a decrease in the developing immature Type III collagen, and inflammation in the periodontal tissues. A sufficient degree of maturity and differentiation of connective tissue was also achieved.