Cell populations involved in the processes of local mucosal defense in extended partially edentulous and completely edentulous patients. Clinical and immunohistochemical study.

Considering the fact that extended partial edentation and complete edentation have high incidence rates worldwide, the necessity for correct prosthetic treatment is very important. We performed a clinical study on 37 extended partially edentulous patients and completely edentulous patients, who were divided into three groups. We also performed a morphological study using classic techniques of histology and immunohistochemistry methods on sections obtained from oral mucosa fragments collected from these patients and processed by paraffin embedding technique. To identify the cell populations present in the inflammatory processes, we used the CD20, CD8, CD3 and CD68 markers. In the studied cases, we found the presence of changes that have interested both the epithelium and lamina propria. Epithelium showed in particular epithelial hyperplasia aspects, with orthokeratinization and parakeratinization areas and, in some sections, areas of ulceration. We found the inflammatory process present in the lamina propria to be chronic and it consists in particular of lymphocytes, plasma cells and macrophages. This process was differentiated in intensity from one case to another, but varied even within the same case, from one area to another. Inflammation was determined by the local microbial flora enhanced by the action of prosthetic appliances or by the prolonged edentulous state. We observed more intense changes in denture wearers patients. The inflammatory response indicates the reactivity of the edentulous mucosa in response to local aggression, the specific defense mechanism coexisting with the nonspecific defense mechanism, with predominance of cellular immune defense.