Page and Schroeder Histopathogenesis of Periodontal Lesion

This table summarizes the findings of the Page and Schroeder 1976 study. You can read more on the Page and Schroeder 1976 study in this post.

Stage

Key Features

Initial Lesion
2-4 days
After 2 to 4 days of plaque accumulation, inflammation develops.
Neutrophils and macrophages develop.
Although the cellular response develops in 2 to 4 days, the gingival looks healthy.
Early Lesion
1 week
After 1 week of plaque accumulation, the lesion progress to a greater level of inflammation.
The inflammatory infiltrate dominated by lymphocytes and neutrophils.
Rete peg proliferation and some coronal epithelium is gone.
There is vascular proliferation.
Established Lesion
14-21 days
Occurs at 14 to 21 days.
10% to 30% plasma cells.
Extravascular IgG is present.
Rete pegs distribute to connective tissue.
Pocket epithelium is leaky because of the junctional epithelium is now pocket epithelium.
Advanced Lesion
Plaque further extends into the pocket.
Plasma cells predominate.
Loss of connective tissue and alveolar bone.
True periodontal pocket develops.
Irreversible clinical attachment loss.
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