PATHOGENESIS
 Subgingival plaque is the initiating factor her- the microorganism in it release toxins
 Our immune system sends response in the form of white blood cells, cytokines,
prostaglandins, Matrix Metalo Protein (mmp)
 Then cause tissue distruction

BLOOD CELLS
All born / formed in bone marrow

RBC
 No nucleus
 Life span is 120 days

PLATELETS
 No nucleus
 Below 80,000 — no surgery possible
 Below 50,000 — no injury at all
o 50,000 cells/mg — critical count of platelets

WBC
 GRANULOCYTES
o NEUTROPHIL
 Predominant inflammatory cells in pdl pockets
o BASOPHIL
 Allergy
o EOSINOPHIL
 Allergy
 Least abundant WBC
 AGRANULOCYTES
o T
o B – plasm cells

1. NEUTROPHIL
a. POLYMORPHO NEUTROPHIL LEUKOCYTES
b. PMNL cells present in acute infection and suppurative cases-pdl abcess , while
chronic lymphocytes.
c. Most abundant WBC in pdl pockets
d. Acute inflammatory cell
e. It is the cell that will become defective in diabetes mellitus
f. Destroys PDL membrane in periodontitis
g. Diabetes condition, weak activity of PMNL
h. Action – phagocytosis eg: macrophage

OTHER NEUTROPHIL DEFECTIVE CONDITIONS:-
i. Neutropenia
j. Granulocytosis
k. Chediak – Higashi syndrome
l. Papillon – Lefevre syndrome
m. Leukocyte adhesion deficiency
n. DM most importantly!

Phagocytosis is the process of engulfing particles.

Chemotaxis is attraction of neutrophils to site of local injury.
2. CELLS OF SPECIFIC RESPONSE
a. T cells
b. B cell or Plasma cells
i. Produce immunoglobins Ig G A M E
ii. Most dominant in perio pockets.

3. INNATE IMMUNE CELLS
a. Neutrophils
b. Monocytes
c. Macrophages
d. Mast cells
e. Dentrite cells
4. LANGERHANS CELL DISEASE
a. Eosinophil infiltrate to pdl — cause early loss of 1° tooth