Local and systemic immune responses in gingivitis and periodontitis

ObjectiveThe aim of this study was to determine the effect of gingivitis and periodontitis on white blood cell (WBC) count and differential WBC count in gingival microvascular blood (GMB) and in venous blood (VB).Material and methods102 systemically healthy adult patients — 32 with gingivitis, 36 with periodontitis, and 34 controls — underwent evaluation of the total WBC count, and the count of different types of WBC in VB and GMB.ResultsInflammation of periodontal tissues was persistently associated with a systemic (in VB) elevation of the WBC count (p<0.05 in gingivitis and p<0.01 in periodontitis), compared to that in control group subjects, and with elevated systemic and local lymphocyte counts (p<0.05), compared to the analogous cell count in the control group. Patients with periodontitis were found to have reduced polymorphonuclear leucocyte (PMN) counts in GMB, compared to patients with gingivitis.ConclusionPersistent chronic bacterial infection affects the systemic elevation of WBC in subjects with gingivitis and periodontitis. A local decrease in PMN in periodontitis patients and a systemic increase in lymphocytes in gingivitis and periodontitis patients may indicate the inability of these patients’ organisms to defend against periodontopathic bacteria — and thus susceptibility to disease.