Orofacial Swellings Research Articles

Orofacial masses in domestic rabbits: a retrospective review of 120 cases from 2 institutions, 2000-2023.

Orofacial masses or swellings are a common presenting complaint in lagomorphs. Similar gross appearances of the masses can complicate clinical interpretation, and histologic review often provides the final diagnosis. Underlying causes vary from infectious to neoplastic. Although inflammatory changes are most commonly reported, various neoplasms occur, although the prevalence of specific tumor types is relatively unknown. We reviewed retrospectively 120 cases (87.5% biopsy, 12.5% autopsy) of neoplastic and non-neoplastic orofacial masses received from January 2000-February 2023 at 2 institutions: University of Guelph, Canada (Animal Health Laboratory and Department of Pathobiology), and Finn Pathologists, United Kingdom. All final diagnoses were achieved through histologic assessment. We included masses or mass-like swellings from the oral cavity, including the mandible and maxilla, and surrounding skin and soft tissues of the oral cavity and jaw. Submissions included pet and commercial (meat and fur) rabbits. Neoplastic lesions were most common (60%), including trichoblastomas, papillomas, melanocytic neoplasms, sarcomas, round-cell tumors, carcinomas (including squamous cell carcinoma), lipomas, odontogenic neoplasms, polyps, osteoma, neuroma, peripheral keratinizing ameloblastoma, and apocrine adenoma. Inflammatory diagnoses (30%) included abscesses, osteomyelitis, dermatitis, and sialadenitis. Other diagnoses (7%) included cysts, as well as hyperplastic skin and proliferative bone lesions. Three cases had no definitive diagnosis. The importance of histologic assessment in diagnosing orofacial "masses" in rabbits is highlighted, given that the most common diagnostic category overall was neoplasia.

Public healthcare practitioners' knowledge, attitudes and practices related to oral antibiotic prescriptions for dental use in Pietermaritzburg, KwaZulu-Natal.

BackgroundThere is limited published evidence on health workers’ perspectives on trends in oral antibiotic prescription for dental conditions in the public health sector.AimThis study set to determine healthcare practitioners’ knowledge, attitudes and practices related to oral antibiotic prescriptions for dental use.SettingThis included two public hospitals in Pietermaritzburg.MethodsThis was a cross-sectional study using quantitative data. Purposive sampling was used to select medical and dental practitioners from Institution A and B (n = 122). A self-administered questionnaire was developed using open and close-ended questions. Data were collected and analysed using the Statistical Package for Social Sciences (IBM SPSS version 25R).ResultsThe response rate for the study was 72.1%. The majority of study participants (n = 72, 81.8%) indicated awareness of an antibiotic stewardship programme in their respective institutions. However, a significant number (n = 42; 47.7%) of participants were unsure of whether this programme was active. Most participants (n = 80, 90.9%) indicated the need for improving oral antibiotic prescription for dental conditions. Participants indicated prescription of antibiotics for orofacial swellings (n = 52; 59.0%) and dental pain related to irreversible pulpitis (n = 29; 32.9%), reversible pulpitis (n = 33; 37.5%) and dental fillings (n = 15; 17.0%). Antibiotics were also prescribed for pericoronitis (n = 58; 65.9%), periodontitis (n = 57; 64.7%) and impacted teeth (n = 21; 23.8%). All dental practitioners (n = 14) supported the need for antibiotic cover for pericoronitis and periodontitis.ConclusionThe results indicated inconsistencies in healthcare practitioners’ reported knowledge, attitudes and practices related to antibiotic prescription patterns.ContributionThis study highlights the need for clear evidence-based guidelines for antibiotic prescription for dental conditions.

Accuracy of fine needle aspiration cytology in the preoperative diagnosis of malignant non-odontogenic tumors of the orofacial region.

This study aims to determine the association between preoperative cytopathological diagnosis and the histopathological diagnosis of orofacial non-odontogenic tumors. It is also, to determine the sensitivity, specificity and accuracy of fine needle aspiration cytology (FNAC) in the preoperative diagnosis of orofacial malignant non-odontogenic tumors in a Nigerian population. A 9-month prospective study in which preoperative FNAC followed by open biopsy for confirmatory histopathological evaluation was performed for consenting patients with orofacial swellings. Patients histopathologically diagnosed as non-odontogenic tumors were selected for the study. There were 40 (83.3%) histopathologically diagnosed non-odontogenic tumors. The female to male ratio was 1.7:1 and the patients' mean age was 36 + 21.9 years. The mandible (n = 4, 10.0%) and the preauricular area (n = 4, 10.0%) were the most common sites affected. The cytopathological diagnosis showed 28 (70.0%) of the lesions were malignant, 7 (17.5%) were benign neoplasms and 5 (12.5%) were reactive/inflammatory swellings. The histopathological diagnosis was predominantly malignant (n = 29, 72.5%), consisting mostly of non-Hodgkin's lymphoma (n = 12, 30.0%). There was significant association (P = .000) between cytopathological diagnosis and histopathological diagnosis of the malignant orofacial non-odontogenic tumors. The sensitivity of FNAC to detect malignant orofacial nonodontogenic tumors was 93.1%, the specificity was 90.9%, the positive predictive value was 96.4%, the negative predictive values was 83.3% and the accuracy was 92.5%. The accuracy of FNAC in the diagnosis of orofacial malignant non-odontogenic orofacial tumors is high and hence recommended as a routine preoperative diagnostic tool.

Evaluation of Carious Primary Teeth that Causes Swelling In Children Visiting a Private Dental Institute - An Observational Study

The worldwide incidence of ECC was found to be 1.76 billion. If left untreated, these carious lesions have high possibility to progress into oro-facial swellings. The purpose of this study was to evaluate the carious teeth in primary dentition, which causes oro-facial swelling. This observational study is carried out by observing the oro-facial infection in children and describing the associated carious teeth using GV Black's classification, ICDAS Criteria for carious teeth and also categorizing the caries index of the patient using dmft index. A total of 189 case sheets were reviewed, and cross-verification was done by photographs. Among the 189 case sheets, a total of 70 cases were selected after proper review. Out of 70 patients, 51 patients had Class 1 carious lesion, and 19 had Class 2 carious lesion all the teeth were categorized under ICDAS score 5 and 6, the mean dmft score was 8.64. Class 1 carious lesions with visible dentin were most commonly associated with Oro-facial Swelling in children. The carious teeth, which were ICDAS-6, were treated by extraction and which were ICDAS-5, were rendered pulp therapy.

Efficacy of ultrasound in the diagnosis of swellings of orofacial region: An original research

Introduction: Accurate diagnosis of a head and neck swelling is of paramount importance. Various disease processes may affect head and neck regions which present clinically as swellings. Aims and Objectives: This study aimed to evaluate the efficacy of ultrasonography (USG) in the diagnosis of swellings of the head and neck regions. The objectives of this study were to assess the reliability of USG in differentiating various swellings of head and neck region and to correlate between diagnosis of swellings by clinical, histopathological, and by USG. Materials and Methods: A total of 70 patients with an age range of 15–70 years and clinically obvious swellings in the head and neck region were included. After clinical examination, all the seventy patients were subjected to ultrasonographic investigation. Features like shape, boundary, echo intensity, presence of necrosis and calcifications, and posterior echoes were considered in describing the ultrasonographic images of swellings. Following clinical and ultrasonographic diagnosis, surgical intervention was carried out. The obtained biopsy specimens were submitted for histopathological examination and a final diagnosis was made. Statistical Analysis: The collected data were subsequently processed and analyzed using the SPSS statistical package version 17. Results: The diagnostic accuracy of ultrasound was found to be 98% in the diagnosis of cystic lesions, 98.47% in benign tumors, 98.57% in malignant tumors, 100% in lymphadenopathies, and in muscle origin and 94.29% in space infections and abscesses. Conclusion: It can be concluded that, together with clinical and histopathological examinations, USG works out as a valuable adjunct in the diagnosis of orofacial swellings.

Beauty is only mucosa deep: a retrospective analysis of oral lumps and bumps caused by cosmetic fillers.

Introduction The injection of dermal fillers into orofacial tissues is becoming increasingly popular for cosmetic purposes, in particular for lip augmentation. Both natural and synthetic filler materials are available, producing a spectrum of clinical and histological appearances.Aims The aim of this study was to review the clinicopathological characteristics of dermal filler cases from 2006 to 2016, reported at a specialist oral pathology unit.Methods An archival search of the pathology database was performed to retrieve cases reported as being consistent with cosmetic fillers.Results Ten cases of orofacial cosmetic fillers were retrieved. Of these cases, 100% were from female patients and the mean age of presentation was 47.6 years (range 24-68 years). The lips were the most frequently involved site (80%, n = 8). The majority of provisional diagnoses were related to salivary gland disease, including neoplasms (30%, n = 3), cysts (20%, n = 2) or inflammatory disease (10%, n = 1). Only two cases (20%) were clinically thought to be related to previous cosmetic injections. A variety of filler materials were seen, including collagen, hydroxyapatite and silicone. However, hyaluronic acid-based materials were the most common (50%, n = 5).Conclusions Complications of cosmetic dermal fillers are becoming more common and should be considered within a differential diagnosis for unusual orofacial swellings.

Efficiency of Ultrasonography in Swellings of Orofacial Region.

Introduction:Ultrasonography (USG) is found to be important in identifying various soft-tissue pathologies in the orofacial region. Therefore, its features should be studied and documented in these lesions so that a more appropriate provisional diagnosis can be made.Aim:This study aims to study ultrasonographic features in various kinds of swellings in the orofacial region.Materials and Methods:The study grouped consists of 30 patients of both sexes (20 males and 10 females) with an age range of 15–70 years complaining of swellings in the orofacial region. All the patients in the study were explained the need of tests and subjected to clinical, ultrasonographic, and histopathologic examination. Sonosite Micromaxx sonography machine was used with a linear array transducer of 13-6 MHz frequencies. Ultrasonographic diagnosis is then correlated with clinical and histopathologic diagnosis. Chi-square test and contingency coefficient tests were used.Results:A significant association was observed between clinical and ultrasonographic diagnoses (contingency = 0.872, P < 0.05) and between ultrasonographic and histopathologic diagnoses (contingency = 0.904, P < 0.05). There was 100% congruency between clinical diagnosis and ultrasonographic diagnosis in all the cases except in cases of cysts, abscess, and sialadenitis. Reliability of USG was found to be 97% in diagnosing all the cases with respect to histopathological diagnosis, while it was 90% with respect to clinical diagnosis.Conclusion:USG was found to be a reliable diagnostic modality in the diagnosis of orofacial swellings.

Orofacial Cysticercosis: A Review

Cysticercosis is a common healthcare problem, especially in developing countries. Orofacial presentation of the disease is rare. It usually manifest as an asymptomatic nodular swelling that is difficult to differentiate clinically, from other orofacial swellings. Diagnosis of cysticercosis is usually not possible clinically owing to its rarity and asymptomatic presentation in orofacial region. Ultrasonography (USG) is the initial and most reliable diagnostic modality for cysticercosis. This review discusses the various oral manifestations, differentials and investigations for oral cysticercosis.

Ultrasonography as a diagnostic tool in orofacial swellings

Introduction: For several years, ultrasonography has played a major role as a diagnostic and therapeutic tool in various medical fields. Only recently has it been used for maxillofacial imaging. Aims and Objectives: To evaluate the reliability of ultrasonography as an alternative tool in the diagnosis of swellings in the orofacial region. Materials and Methods: Ultrasonographic examination of 30 patients of both the sexes aged between 8 and 70 years with swelling in the orofacial region was conducted. Doppler investigation was done in some cases to evaluate the vascularity. The following six sonographic parameters were recorded: shape, boundary echo, internal echo, distribution of internal echoes, posterior wall echoes, and vascularity. Following the clinical and ultrasonographic diagnosis, the lesion was subjected to histopathological examination and a final diagnosis was made. The ultrasonographic diagnosis was correlated with the clinical and histopathological diagnosis. Results: A significant association was observed between both clinical and histopathological diagnosis and ultrasonographic diagnosis (contingency = 0.888, P value = 0.000). Conclusion: Along with clinical and histopathological examinations, ultrasonography works out as a valuable adjunct in the diagnosis of orofacial swellings as it provides several advantages like it is non-invasive, easily reproducible, widely available, rapid, and inexpensive.

A CLINICOPATHOLOGICAL STUDY OF OROFACIAL SWELLINGS (A PROSPECTIVE STUDY)

INTRODUCTION: The etiology of orofacial swellings could be attributed to the presence of inflammation, congenital developmental malformations and neoplasia. Orofacial swellings may occur in the nasal cavities, paranasal sinuses, ear, eye, facial skin, oral cavity and salivary glands. Swellings of the orofacial region include cysts and tumors. Cysts are divided into developmental and inflammatory types. Tumors are divided into benign and malignant types. OBJECTIVES: Perform clinicopathological correlation of orofacial swellings and assess the frequency of incidence regarding age, sex, site, and type of lesion. MATERIALS AND METHODS: A clinicopathological prospective study was conducted on 100 patients suffering from swellings in the orofacial region attending the outpatient clinic of the oral and maxillofacial surgery department. The histopathological examination was done. Statistical analysis was carried out on the tabulated data using (IBM SPSS 20.0) software. RESULTS: It was found that the incidence of all swellings in males was slightly more than females. The incidence of all swellings in the second and third decades of age. The mandible was the most frequently affected site. Using the histological classification of the World Health Organization (WHO), 32% were classified as cysts, 26% as odontogenic tumors, 25% as non-odontogenic tumors, 11% fibro-osseous lesions and 6% as salivary gland tumors. CONCLUSIONS: Cysts are the most common oral swellings, followed by odontogenic tumors. The treatment modalities were: marsupialization, enucleation, resection, segmental mandibulectomy and hemimandibulectomy. Following surgical removal of jaw swelling, the entire surgical specimen should be examined histopathologically

To evaluate the efficacy of ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings

AimTo evaluate the efficacy of Ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings. Material and methodsThe study was conducted on forty-five patients with maxillofacial swellings. The clinical diagnosis, radiographic diagnosis and ultrasonographic diagnosis were made which was compared to the histopathological diagnosis. The maxillofacial swellings included cystic lesions, benign swellings, malignant swellings, lymphadenopathies and abscesses and space infections. ResultsThe diagnostic accuracy and contingency coefficient was evaluated considering histopathology as gold standard. The diagnostic accuracy of ultrasound was found to be 92.30% in the diagnosis of cystic lesions, 87.5% in benign tumors, 81.8% in malignant tumors, 100% in lymphadenopathies and 90% in space infections and abscesses. The contingency coefficient of 0.934 was obtained when ultrasonography was compared to the histopathology, which was highly significant. Similar significant results were obtained comparing ultrasonography with clinical diagnosis (0.895) and radiographic diagnosis (0.889). ConclusionUltrasonography provides accurate imaging of the head and neck region and provides information about the nature of the lesion, its extent, and relationship with the surrounding structures. As the conventional and digital radiography enable the diagnosis of the presence of the disease, but do not give any indication of its nature. So, together with clinical and histopathological examinations, real time ultrasound imaging works out as a valuable adjunct in the diagnosis of orofacial swellings.

Ultrasonography of Swellings in Orofacial Ragion

Objectives: To assess the reliability of ultrasonography as a diagnostic aid for diagnosis of swellings in orofacial region. Study design: The study consisted of 40 patients with orofacial swellings, and all these patients were subjected to clinical, ultrasonographical and histopathological examination and respective diagnoses were obtained. Ultrasonographic diagnosis correlated with clinical and histopathological examinination. Chi-square test and contingency coefficient tests were used for statistical evaluation. Results: A significant association was observed between clinical and ultrasonographic diagnoses (contingency = 0.938 and p< 000) and between ultrasonographic and histopathological diagnoses (contingency = 0.943 and p< 000). Conclusion: Ultrasonography revealed as a valuable adjunct in the diagnosis of orofacial swellings.

Ultrasonographic evaluation of inflammatory swellings of buccal space

The main objective of the study was a) to differentiate cellulitis and abscess in buccal space region, b) to study the ultrasonographic anatomy of cheek region and c) to investigate the use of ultrasound in the diagnosis of inflammatory swellings of cheek region. The study consisted of 25 patients with unilateral buccal space inflammatory swellings of odontogenic origin. The contra lateral side was used as control. Toshiba ultrasonographic device with a linear array transducer (5-8 MHz) was used. The areas of interest were scanned under both transverse and longitudinal sections and were interpreted by a single observer. The clinical diagnosis of cellulitis or abscess was confirmed by the absence or presence of pus respectively both sonographically and by aspiration. Also various anatomical structures present in buccal space were studied. Clinically 23 (92%) were diagnosed as buccal space abscess and 2 (8%) were cellulitis. Ultrasonographically and therapeutically 24 (96%) were buccal space abscess and 1 (4%) was cellulits. The sensitivity of clinical criteria over ultrasonographic diagnosis was 96% with a specificity of 100%. Also the cheek thickness in males and females varied from 8.2 to 17.1 mm with a mean of 11.6 mm+/-2.1 (SD) and 8.2 mm to 14.2 mm with a mean of 11+/-1.8 (SD). The subcutaneous tissue appeared moderately echogenic, buccinator--highly echogenic, deep adipose tissue--less echogenic and parotid duct was appreciated as a thin hyperechogenic band crossing the buccinator muscle. Buccal space, masticator space and parotid space were appreciated. This study supports the ultrasonographic method of imaging of orofacial inflammatory swellings with high sensitivity and specificity. This imaging modality can also help in aspiration of pus in different spaces. We have described the ultrasonographic anatomy of the above mentioned spaces which can help a beginner in this field.

Tumours and tumour-like lesions of the lower face at Korle Bu Teaching Hospital, Ghana – an eight year study

BackgroundThe oro-facial region including the jawbones, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla, especially, in West African children. We report results from a retrospective study spanning eight years on the frequency, clinical presentation, sites and character of lower face tumours seen in the main referral hospital in Ghana.Patients and methodsRecords of consecutive patients of all age and sex seen by the first author's team at the Department of Oral and Maxillofacial Surgery, Korle-Bu Teaching Hospital with tumours affecting the lower part of the face from January 1996 to December 2003 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology.ResultsA total of 394 patients with oro-facial swellings were retrieved from the registry out of which 210 had lower face tumour and tumour-like lesions. The complete data set was obtained for 171 patients, comprising 99 (58%) males and 72 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), pain (41%) and ulceration (29%). The tumours were predominantly found in the right (43%), anterior (19%) and left (18%) aspects of the lower face. The remainder making up 20% were found in the floor of the mouth, tongue and lips. Seventy eight (45.6%) of the patients presented with lesions that were classified as malignant of which 54 (62%) were diagnosed as squamous cell carcinoma (SCC). Sixty-two (36.3%) had benign odontogenic tumours and thirty-one (18.1%) had non-odontogenic tumour-like lesions. Fifty-four (62%) of malignant tumours were squamous cell carcinoma; 58 (93.6%) of the benign odontogenic tumours were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged between 11 and 30 years. Malignant tumours were more commonly detected in patients between 41 and 70 years (63%).ConclusionTumours and tumour-like lesions of the lower face comprising the mandible, tongue and adjacent structures are a diverse group of neoplasm and are seen commonly in practice of Maxillofacial surgery. Both malignant and benign tumours are seen in the Ghanaian population. In the present study, SCC and ameloblastoma were the commonest malignant and benign odontogenic tumours seen respectively; the two representing more than 65% of all tumours.

Effectiveness of small-volume, intralesional, delayed-release triamcinolone injections in orofacial granulomatosis: a pilot study

BackgroundOrofacial granulomatosis (OFG) is an idiopathic disorder characterized by chronic orofacial swellings causing significant cosmetic and functional problems. Treatment with high-volume triamcinolone injections has been shown to be effective but requires nerve block anesthesia and causes a dramatic temporary increase of lip swelling. ObjectiveWe have performed a noncomparative open-label pilot study in 7 patients with OFG in order to evaluate the effectiveness of small volumes of extended-release high-concentrate triamcinolone injections in reducing lip swelling and preventing recurrences. MethodsSeven patients with OFG were studied. Small-volume, intralesional, high-concentrate, extended-release triamcinolone was injected on the basis of a weekly schedule. A standard cycle consisted of 2 or 3 injection sessions over 14 or 21 days, depending on the clinical response. ResultsAfter cycle completion, all patients remained without recurrences or with cosmetically acceptable slight lip enlargement for a mean time of 19 months (range, 8-30 months). No side effects were observed, except in one patient with hypopigmentation of the skin of the upper lip. ConclusionsSlow-volume, intralesional, high-concentrate, extended-release triamcinolone injections appear to be effective in reducing lip enlargement in patients with OFG and do not require nerve block anesthesia or cause a temporary troublesome increase of swelling. A long disease-free period is generally obtained.

Orofacial disease: update for the dental clinical team: 5. Lumps and swellings.

This article discusses the more common conditions presenting with orofacial lumps or swellings. The first article in this series presented several general observations on diagnosis and treatment which should be borne in mind in relation to this article.

Melkersson-Rosenthal syndrome--a challenge for dermatologists to participate in the field of oral medicine.

Melkersson-Rosenthal syndrome (MRS) is a neuro-muco-cutaneous disorder involving remittently both the oro-facial innervation and muco-cutaneous tissues in a pathosis of complex origin characterized by recurrent edema, facial or other palsies, and nerval dysfunctions frequently associated with plicated tongue. Biopsies taken from the edematous tissues often reveal a temporary pattern of moderate epitheloid granulomatous inflammation scattered scarcely within remarkable tissue edema. However, this histological pattern is not a prerequisite for the diagnosis of MRS. The disease usually runs an intermittent and unpredictable course over years or decades and may have, if the edemas involve the tongue or the central nervous system, an ambiguous outcome. Greatly disfiguring oro-facial swellings often result from secondary persistence of the primarily recurrent edemas. A classification on grounds of different 'major' and 'minor signs' of MRS is proposed in the present paper. In recent years, novel therapeutic approaches involving either oral clofazimine or laser beam acupuncture (according to the principles of traditional Chinese medicine) have proven to be successful in some cases of MRS. Dermatology could play a larger role in oral medicine by taking diseases such as MRS into account in studies among specialties dealing with oro-facial pathoses.

Orofacial granulomatosis and Crohn's disease.

Orofacial granulomatosis is a clinical entity of either unknown or specific causation. Specific causes include sarcoidosis, chronic infective granulomas, and Crohn's disease. The remainder of cases are idiopathic, but the clinical presentations of orofacial swellings and intraoral mucosal lesions are similar. So, too, are the histopathologic findings of noncaseating granulomas, edema, and chronic lymphoproliferative infiltrate. Crohn's disease is not responsible for all forms of orofacial granulomatosis, but the orofacial manifestations of the disease may herald its diagnosis.

Long-term Results after Surgical Reduction Cheiloplasty in Patients with Melkersson-Rosenthal Syndrome and Cheilitis Granulomatosa

Cheilitis granulomatosa in patients with Melkersson-Rosenthal syndrome has proven difficult to treat, and various forms of symptomatic treatment of orofacial swellings have been used with varying success. To evaluate long-term results after surgical reduction cheiloplasty in patients suffering from persistent lip swellings, a follow-up study was performed on 13 patients after 16 years (median). The operations were performed after unsuccessful conservative treatment and regardless of disease activity. Pre- and postoperative medical histories were updated and a clinical examination evaluated the following criteria for a good result: symmetry of the lip, a normalized anterior projection, dimensional harmony between upper and lower lip, no disfiguring cicatrices, and no sensory disturbances. In spite of postoperative disease activity in 6 patients, all 13 patients were satisfied with the long-term result. Clinically, the results in 12 patients were considered good. We therefore recommend lip resection as described when a stationary swelling becomes associated with permanent aesthetic deformity or functional disturbances and conservative measures are unsuccessful.

Sensitization via IgE-mediated mechanism in patients with chronic periapical lesions

Past studies have identified several classes of tissue immunoglobulins within human periapical granulomas. It has recently been determined that elevated serum IgE levels occur in conjunction with acute orofacial swellings related to pulpally involved teeth. We theorized that pulpally involved teeth could elicit a sensitization reflected in elevated blood serum IgE values. To test this hypothesis, this study quantitated blood serum IgE levels of patients exhibiting asymptomatic necrotic teeth and compared these with values obtained from an equal number of volunteer controls. Although the IgE levels varied considerably within both groups, Student's t test showed a significant difference (p≤0.01) between mean IgE levels of experimental (190.5±216.9) and control (46.5±44.5) patients. These results might have clinical implications, with increased IgE formation representing an aberrant immunological response enhancing the potential for an immediate hypersensitivity reaction. Past studies have identified several classes of tissue immunoglobulins within human periapical granulomas. It has recently been determined that elevated serum IgE levels occur in conjunction with acute orofacial swellings related to pulpally involved teeth. We theorized that pulpally involved teeth could elicit a sensitization reflected in elevated blood serum IgE values. To test this hypothesis, this study quantitated blood serum IgE levels of patients exhibiting asymptomatic necrotic teeth and compared these with values obtained from an equal number of volunteer controls. Although the IgE levels varied considerably within both groups, Student's t test showed a significant difference (p≤0.01) between mean IgE levels of experimental (190.5±216.9) and control (46.5±44.5) patients. These results might have clinical implications, with increased IgE formation representing an aberrant immunological response enhancing the potential for an immediate hypersensitivity reaction. Estudios anteriores han identificado varias clases de inmunoglobulinas tisulares dentro de granulomas periapicales humanos. Recientemente se ha determinado que hay niveles séricos elevados de IgE en conjunción con edemas oro-faciales agudos referidos a dientes no vitales. Nuestra hipótesis es que los dientes no vitales pueden desencadenar una sensibilización que se ve reflejada en los niveles séricos de IgE. Para probar esta hipótesis, este estudio determinó los niveles séricos de IgE de los pacientes con dientes necróticos asintomáticos y los comparo con los valores obtenidos en un número igual de-controles voluntarios. A pesar que los niveles de IgE variaron considerablemente dentro de ambos grupos, las diferencias de acuerdo a la prueba t de Student fueron estadísticamente significativas (p≤0.01) entre la media de IgE para el grupo experimental (190.5±216.9) y para el grupo control (46.5±44.5). Estos resultados pueden tener implicancias clinicas y la producción incrementada de IgE puede representar una respuesta inmunológica aberrante que puede a su vez reforzar el potencial para las reacciones de hypersensibilidad inmediata. Estudios anteriores han identificado varias clases de inmunoglobulinas tisulares dentro de granulomas periapicales humanos. Recientemente se ha determinado que hay niveles séricos elevados de IgE en conjunción con edemas oro-faciales agudos referidos a dientes no vitales. Nuestra hipótesis es que los dientes no vitales pueden desencadenar una sensibilización que se ve reflejada en los niveles séricos de IgE. Para probar esta hipótesis, este estudio determinó los niveles séricos de IgE de los pacientes con dientes necróticos asintomáticos y los comparo con los valores obtenidos en un número igual de-controles voluntarios. A pesar que los niveles de IgE variaron considerablemente dentro de ambos grupos, las diferencias de acuerdo a la prueba t de Student fueron estadísticamente significativas (p≤0.01) entre la media de IgE para el grupo experimental (190.5±216.9) y para el grupo control (46.5±44.5). Estos resultados pueden tener implicancias clinicas y la producción incrementada de IgE puede representar una respuesta inmunológica aberrante que puede a su vez reforzar el potencial para las reacciones de hypersensibilidad inmediata.