Chronic Disease ; Cone-Beam Computed Tomography ; Humans ; Periapical Abscess ; pathology ; Periapical Granuloma ; pathology ; Periapical Periodontitis ; diagnostic imaging ; pathology ; Problem Solving ; Prognosis ; Radicular Cyst ; diagnostic imaging ; pathology

Acute Disease ; Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Disinfectants ; therapeutic use ; Humans ; Periapical Abscess ; diagnosis ; therapy ; Periapical Granuloma ; diagnosis ; therapy ; Periapical Periodontitis ; classification ; diagnosis ; pathology ; therapy ; Problem Solving ; Prognosis ; Root Canal Irrigants ; therapeutic use ; Root Canal Therapy

OBJECTIVEThis study aimed to detect the immunoexpression of interleukin-21 (IL-21) and receptor activator. of nuclear factor KB ligand (RANKL) in periapical granulomas (PGs) and radicular cysts (RCs). The interaction of IL-21 with RANKL and its role in periapical pathogenesis were also speculated.

METHODSA total of 32 PGs and 23 RCs were selected as experimental samples. Lesion size and occurrence of tenderness were recorded. Up to 10 healthy gingival tissues were collected as normal control samples. All tissues were subjected to immunohistocheincal analysis with anti-human IL-21 and RANKL polyclonal antibodies. The correlations of IL-21 with RANKL, lesion size, and the occurrence of tenderness of the PGs and RCs were evaluated.

RESULTSIL-21-positive cells were detected in all periapical lesion tissues but not in normal tissues. In the cyst group and granuloma group, the corresponding expression levels of IL-21 were 59.92±6.57 and 36.80± 6.81, whereas those of RANKL were 68.81±18.59 and 36.12±14.87, respectively. Moreover, t-test revealed a significantly higher expression of IL-21 and RANKL in RCs than in PGs (P<0.05). IL-21 and RANKL were positively correlated in both PGs and RCs (P<0.05). Furthermore, IL-21 was correlated with lesion size (P<0.05).

CONCLUSIONThis study demonstrated that IL-21 is potentially involved in the pathogenesis of apical periodontitis lesions. A role in the exacerbation of chronic inflammation, as well as in bone resorption, is suspected. Further studies are required to elucidate the specific functions of IL-21 in periradicular inflammatory processes.

Humans ; Inflammation ; Interleukins ; physiology ; NF-kappa B ; metabolism ; Periapical Granuloma ; metabolism ; Periapical Periodontitis ; RANK Ligand ; Radicular Cyst ; metabolism

Chronic periapical periodontitis is characterized by destruction of periapical tissue and demonstrates translucent feature under X-ray examination. In this article, a localized mineralized structure, which showed high density under X-ray examination, was reported in a patient with chronic periapical periodontitis of left maxillary first premolar. Possible causes of the structure were analyzed and relevant literatures were reviewed.
Bicuspid ; Humans ; Maxilla ; Periapical Periodontitis ; Periodontitis

OBJECTIVETo examine the expression of interleukin-17F (IL-17F) in apical periodontitis lesions.

METHODSHuman apical periodontitis lesions were collected after periapical surgery from November 1, 2009 to August 1, 2011. After histological processing, serial sectioning, HE staining, and microscopic analysis, 33 periapical cysts and 18 periapical granulomas were selected for immunohistochemical analysis for IL-17F. Five alveolar bone samples were obtained from a group of impacted third molars recommended for extraction. These bone samples did not show any inflammation and were used as normal samples. Differences in IL-17F expression between the tissues with periapical cyst and periapica granuloma were subsequently analyzed by rank-sum test.

RESULTSIL-17F was expressed in epithelial cells, lymphocytes, fibroblast and endothelial cells of both types of lesions. Both types of lesions presented increased IL-17F expression when compared to healthy periapical alveolar bone. The expression of IL-17F in apical cyst (0.2365 ± 0.0708) and apical granuloma (0.8852 ± 0.0576) was significantly different (Z = 3.735, P < 0.01).

CONCLUSIONSIL-17F could be observed and might be involved in the inflammatory response and bone resorption of periapical tissues. The expression of IL-17F in periapical cyst and periapical granuloma was significantly different.

Adult ; Endothelial Cells ; metabolism ; Epithelial Cells ; metabolism ; Female ; Fibroblasts ; metabolism ; Humans ; Interleukin-17 ; metabolism ; Lymphocytes ; metabolism ; Male ; Periapical Granuloma ; metabolism ; pathology ; Periapical Periodontitis ; metabolism ; pathology ; Radicular Cyst ; metabolism ; pathology

This study was performed to prepare the quantitative method of judging the sensitive prognosis of chronic apical periodontitis as early as possible. The subjects were 25 cases with periapical radiolucencies of which were treated with endodontic treatment. Serial radiographs were taken by standardized method longitudinally. The density slice function of digital radiographic system were employed for quantitative and longitudinal assessment of the radiolucent area and the condensing osteitis simultaneously. Obtained results were as follows: 1. The amount of bone repair after endodontic treatment could be detected quantitatively by the density slice function of digital radiographic system. 2. Within the 6-week period after root canal filling, the prognosis could be evaluated by assessment both radiolucent area and condensing osteitis on digital radiographic system. 3. The pattern of bone repair showed peripheral type in most cases from the 6th week after root canal filling. 4. In longitudinal change, bone repair showed two patterns; the succeeding reduction of radiolucent area showing the increase of condensing osteitis in size till 6th week and following by static state or reduction tendency and the reduction following the initial increase of both areas. 5. Cases with pulpitis by trauma showed initial increase of condensing osteitis at 2nd week, marked reduction of radiolucent area and condensing osteitis at 6th week, and approximately normal bone state at 8th week after root canal filling.
Dental Pulp Cavity ; Osteitis ; Periapical Periodontitis ; Prognosis ; Pulpitis ; Radiography*

Chronic Disease ; Humans ; Paranasal Sinus Diseases ; etiology ; Periapical Periodontitis ; therapy

Apical periodontitis is a biofilm-mediated infection. The biofilm protects bacteria from host defenses and increase their resistance to intracanal disinfecting protocols. Understanding the virulence of these endodontic microbiota within biofilm is essential for the development of novel therapeutic procedures for intracanal disinfection. Both the disruption of biofilms and the killing of their bacteria are necessary to effectively treat apical periodontitis. Accordingly, a review of endodontic biofilm types, antimicrobial resistance mechanisms, and current and future therapeutic procedures for endodontic biofilm is provided.
Bacteria ; Biofilms ; Disinfection ; Homicide ; Lactobacillus ; Microbiota ; Periapical Periodontitis ; Virulence

There is a high incidence of chronic periapical periodontitis of deciduous teeth, however, there is a low incidence of the apical cyst. This paper reports a 7-year-old child with deciduous periodontitis caused by chronic periapical periodontitis of deciduous teeth. Through literature review, the etiology, imaging characteristics, diagnosis, differential diagnosis, and treatment methods were discussed to provide the basis for clinical diagnosis and treatment.
Child ; Humans ; Cysts ; Diagnosis, Differential ; Periapical Periodontitis/therapy* ; Tooth, Deciduous

periodontitis, advanced caries, oral ulcer, gingivitis, mucositis, periapical abscess and periodontal abscess were next in order of freguency. In the care group of oral complications, the most freguent incidence(28.9%) was showed in the endodontic treatment(primary endodontic drainage), and followed by scaling, incision and drainage, only medications, restoration, ointment application onto the ulcer and daily dressing in order.]]>
Acute Kidney Injury ; Bandages ; Diagnosis ; Drainage ; Female ; Gangwon-do ; Gingivitis ; Hemorrhage ; Humans ; Incidence ; Insurance, Health ; Kidney Failure, Chronic ; Male ; Mucositis ; Oral Ulcer ; Periapical Abscess ; Periodontal Abscess ; Periodontitis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Ulcer