Local immune alterations in oral mucosa of the edentulous patients; possible cause of teeth loss?

UNLABELLED: Edentulous patients represent a difficult group of patients, especially in those cases when restorative prostheses are tempted on few remaining elements that eventually will be lost. MATERIAL AND METHOD: We performed a comparative histopathological and immunohistochemical (IHC) analysis of 20 oral mucosa biopsies in total edentulous patients (15 cases - group A) and ofnontumoral mucosa in oncologic patients (5 cases - group B, control). RESULTS: In group A the inflammatory infiltrate was dominated by the presence of numerous plasma cells (80%) and in 60% of the cases more numerous T cells than B cells were identified. We noticed various aspects of inflammatory infiltrate distribution in cases with epithelial ulceration (either CD8+ T cells intraepithelial and CD4+ T cells beneath the epithelium and perivascular or both CD4+ and CD8+ T cells in both lamina propria and intraepithelial location). 5 of seven cases which included salivary gland tissue revealed moderately to severe inflammatory infiltrate consisting of lymphocytes and plasma cells with lymphoepithelial lesion stage 1 aspects (71.42%). The control group (group B) presented plasma cell inflammatory infiltrate in one case (20%). None of the control cases had lymphoepithelial-like lesions within the salivary tissue. CONCLUSIONS: Presence of intraepithelial T citotoxic cells (CD8+) is correlated with presence of ulceration of the alveolar crest covering mucosa in the edentulous patients. Lymphoepithelial-like lesions of the minor salivary tissue in edentulous patients suggest an autoimmune response in local mucosa.