Bacterial invasion of periodontal tissues in advanced periodontitis in humans.

Bacterial invasion of the pocket epithelium and underlying connective tissue was found in seven cases of advanced human periodontitis. Four cases showed invasion of the epithelium as well as the connective tissue while in the other three cases bacterial invasion was limited to the pocket epithelium. The microorganisms observed included cocci, rods, filaments, fusiforms and spirochetes and these were morphologically similar to those observed in the apical zone of the subgingival plaque. Most bacteria showed typical Gram-negative cell walls. Bacteria were seen in enlarged epithelial intercellular spaces and among debris of disintegrated epithelial cells. In the connective tissue the bacteria were seen among remnants of collagen fibers and degenerated fibroblasts. Identification of the invading microorganisms may assist in understanding the pathogenesis of chronic periodontitis.