Periapical Lesions In Teeth Research Articles

Cone-beam computerized tomographic, radiographic, and histologic evaluation of periapical repair in dogs' post-endodontic treatment

To evaluate the periapical repair after root canal treatment in the teeth of dogs using CT and conventional radiography and to compare these findings with the gold standard microscopic evaluation. The animals were divided into three groups according to endodontic treatment performed: Group 1, single-visit endodontic treatment in teeth without apical periodontitis; Group 2, single-visit endodontic treatment in teeth with apical periodontitis; and Group 3, endodontic treatment in teeth with apical periodontitis using calcium hydroxide as a root canal dressing. Group 4 consisted of teeth with apical periodontitis not submitted to root canal treatment and Group 5 consisted of healthy teeth without periapical disease. Radiographic, tomographic, and microscopic evaluations were performed by blind examiners. At 180 days experimental time, CT and radiographic measurements of periapical disease were compared with the gold standard microscopic measurement using intraclass correlation coefficient. Intergroup comparisons considering different methods of periapical lesions measurement or different clinical protocols of root canal treatment were performed by Kruskal Wallis test followed by Dunn. Integrity of lamina dura, presence of radiolucent areas, and presence of root resorption were analyzed by Fisher's exact test. There was discontinuity of the lamina dura and CPD in all teeth from Groups 2, 3, and 4 evaluated by tomography and radiography 45 days after CPD induction. Radiographically, 180 days after root canal treatment, there was no periapical lesion in teeth from Groups 1 and 3, different from groups 2 and 4 (p < .05). The highest reduction in the CPD size was observed on Group 3 (p < .05). According to the tomographic results, there was decrease of the size of the CPD on Group 3 but not on Groups 2 or 4. However, in all groups the periapical lesions presented larger mesio-distal extension if compared with radiography, both 45 days after CPD induction and 180 days after root canal treatment. At 180 days, CT measurements were closely related to microscopic results (ICC = 0.95) differently from radiographic evaluation (ICC = 0.86). CT Scan evaluation of periapical repair following root canal treatment provided similar information than that obtained by microscopic analysis, whereas radiographic evaluation underestimated the size do periapical lesion.

Histology of Periapical Lesions Obtained During Apical Surgery

The aim of this was to evaluate the histology of periapical lesions in teeth treated with periapical surgery. After root-end resection, the root tip was removed together with the periapical pathological tissue. Histologic sectioning was performed on calcified specimens embedded in methylmethacrylate (MMA) and on demineralized specimens embedded in LR White (Fluka, Buchs, Switzerland). The samples were evaluated with light and transmission electron microscopy (TEM). The histologic findings were classified into periapical abscesses, granulomas, or cystic lesions (true or pocket cysts). The final material comprised 70% granulomas, 23% cysts and 5% abscesses, 1% scar tissues, and 1% keratocysts. Six of 125 samples could not be used. The cystic lesions could not be subdivided into pocket or true cysts. All cysts had an epithelium-lined cavity, two of them with cilia-lined epithelium. These results show the high incidence of periapical granulomas among periapical lesions obtained during apical surgery. Periapical abscesses were a rare occasion. The histologic findings from samples obtained during apical surgery may differ from findings obtained by teeth extractions. A determination between pocket and true apical cysts is hardly possible when collecting samples by apical surgery.

Cytomegalovirus and Epstein-Barr virus active infection in periapical lesions of teeth with intact crowns

Cytomegalovirus and Epstein-Barr virus active infection in periapical lesions of teeth with intact crowns

Microbiota of Periapical Lesions Refractory to Endodontic Therapy

The periapical microbiota of 36 teeth with refractory apical periodontitis was investigated. None of the teeth had responded to conventional endodontic or long-term (> 6 months), calcium-hydroxide treatment. Eight patients had received antibiotics systemically. After anaerobic culture, a total of 148 microbial strains were detected among 67 microbial species. One of the 36 lesions was culture-negative. Approximately half (51.0%) of the bacterial strains were anaerobic. Gram-positive species constituted 79.5% of the flora. Facultative organisms, such as Staphylococcus, Enterococcus, Enterobacter, Pseudomonas, Stenotrophomonas, Sphingomonas, Bacillus, or Candida species were recovered from 27 of the lesions (75%). Sulfur granules were found in 9 lesions (25%). In these granules Actinomyces israelii, A. viscosus, A. naeslundii, and A. meyeri were identified. Other bacterial species, both gram-positive and gram-negative, were detected in the granules as well. Two sulfur granules did not contain Actinomyces. Scanning electron microscopy demonstrated rod- and spirochete-like cells in the granules, and transmission electron microscopy revealed organisms with copious amounts of extracellular material. Outer membrane vesicles were also seen. Some of the granules were calcified. This study demonstrated a wide variety of microorganisms, particularly gram-positive ones, in the periapical lesions of teeth with refractory apical periodontitis.

Periapical lesions and dental wear in the early Maori

Dental wear and intrabony lesions were evaluated in a sample of 225 skulls (136 male) of pre-contact New Zealand Maoris. The degree and direction of surface wear was scored according to the method of Molnar (Molnar 1971. Human tooth wear, tooth function and cultural variability. American Journal of Physical Anthropology34: 175–190) and revealed severe surface loss in both males and females with horizontal wear being the dominant pattern (62.4% male, 57.5% female). The width of coronal tissue above the pulp chamber, as well as the maximum depth and width of periapical lesions, was measured from both standard radiographs and digital images. The high prevalence of periapical pathology in the Maori underlined the extreme nature of dental wear in these people. It is postulated that this degree of tooth loss may be attributable to a change in diet from large birds to marine-dependence, the introduction of the kumara to New Zealand, dental erosion and finally, to the excessive masticatory forces exerted by a robust facial complex on normally sized teeth. Fenestrated lesions were highly prevalent (83% of skulls) and were centered mostly on the maxilla, with an even distribution among tooth classes. The finding of periapical lesions in teeth with minimal observable wear was attributed to traumatic occlusion. Copyright © 2001 John Wiley & Sons, Ltd.

Periapical lesions and dental wear in the early Maori

AbstractDental wear and intrabony lesions were evaluated in a sample of 225 skulls (136 male) of pre‐contact New Zealand Maoris. The degree and direction of surface wear was scored according to the method of Molnar (Molnar 1971. Human tooth wear, tooth function and cultural variability. American Journal of Physical Anthropology34: 175–190) and revealed severe surface loss in both males and females with horizontal wear being the dominant pattern (62.4% male, 57.5% female). The width of coronal tissue above the pulp chamber, as well as the maximum depth and width of periapical lesions, was measured from both standard radiographs and digital images. The high prevalence of periapical pathology in the Maori underlined the extreme nature of dental wear in these people. It is postulated that this degree of tooth loss may be attributable to a change in diet from large birds to marine‐dependence, the introduction of the kumara to New Zealand, dental erosion and finally, to the excessive masticatory forces exerted by a robust facial complex on normally sized teeth. Fenestrated lesions were highly prevalent (83% of skulls) and were centered mostly on the maxilla, with an even distribution among tooth classes. The finding of periapical lesions in teeth with minimal observable wear was attributed to traumatic occlusion. Copyright © 2001 John Wiley &amp; Sons, Ltd.

Demonstration of Bacteroides intermedius in periapical tissue using indirect immunofluorescence microscopy

The presence of bacteria in periapical lesions of teeth with necrotic pulp has been demonstrated by microbiological sampling of periapical lesions during endodontic surgery. The purpose of this study was to confirm the presence of Bacteroides intermedius in a periapical granuloma using an indirect immunofluorescence technique. Histologic sections of a periapical granuloma were incubated with a rabbit antiserum to B. intermedius. After incubation with secondary antibody (fluorescein-conjugated goat anti-rabbit IgG), an intense fluorescent staining was observed in areas of the tissue sections. Control tissue sections that were incubated without the antibody remained unstained. The results obtained with the indirect immunofluorescence technique supported our cultural findings that microorganisms, e.g. B. intermedius, were present in the tissue of the periapical granuloma.