Cytotoxicity of root canal sealers: a study using HeLa cells and fibroblasts.
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Biomedical subjects
Publications and source records attributed to M Torabinejad.
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The serum concentrations of circulating immune complexes, immunoglobulins G and M, and the C3 complement component of thirty patients with one to three large periapical lesions were measured and compared with those of patients with no periapical lesions. The results indicate that there is no statistical difference between the two groups, and it appears that chronic periapical lesions cannot act as a focus to cause systemic diseases via immune complexes.
Activation of the epithelial cell rests of Malassez by various means, results in proliferation of these cells and formation of apical periodontal cysts. Several theories for the genesis of apical periodontal cysts have been suggested which are not satisfactory. Available evidence indicates that development and destruction of these lesions are mediated by immunological reactions.
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Clinical and histologic observations were made on three dogs at postextrusion intervals of 2, 4, and 7 weeks. At 2 weeks radiolucent areas were seen surrounding the roots. Histologically, however, these areas contained new immature bone or osteoid and a periodontal ligament of normal width. By the seventh week the radiographic picture was essentially normal, and this was confirmed histologically.
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Ten cats were immunized with subcutaneous injections of keyhole limpet hemocyanin (KLH). After it was determined that the experimental animals had developed circulating antibodies to KLH, challenge doses of KLH were administered via the root canal system. The radiographic and histologic findings suggest that antigen-antibody complex reactions can occur in periapical tissues of teeth, and that they can play a role in the pathogenesis of periapical lesions. In contrast, no radiographic and histologic changes were noted in non-immunized cats.
The similarity of squamous cell carcinoma of the gingiva to periodontal or periapical disease poses problems in diagnosis and management. A case of squamous cell carcinoma of the gingiva is described. It was initially diagnosed as a periodontal lesion and then as a lesion of pulpal origin. This case demonstrates the importance of being highly suspicious of oral conditions, especially those that do not respond promptly to conventional therapy, and shows the value of microscopic examination of all tissues removed during any oral surgical procedure.
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The pathogenesis of periapical lesions has not been fully elucidated. Currently, the possibility of its being an immunologic phenomenon is receiving much attention. This article presents a review of the literature concerning immunologic reactions which may involve periapical lesions. It appears that antigen-antibody complexes and IgE-mediated reactions can initiate preliminary changes in periapical tissues. It is also likely that delayed hypersensitivity participates in the perpetuation and progression of periapical disease.
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