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Immunohistochemical analysis of CD1a-labeled Langerhans cells in human dental periapical inflammatory lesions--correlation with inflammatory cells and epithelial cells.

OBJECTIVE: Distribution and density of CD1a-labeled Langerhans cells (LCs) were examined in human dental periapical inflammatory lesions, and compared with inflammatory cell infiltration or epithelial cell proliferation. MATERIALS AND METHODS: Eighty three periapical lesions (26 apical granulomas (AGs), 8 epitheliated granulomas (EGs), 34 radicular cysts (RCs), 15 residual radicular cysts (RRCs)) were collected. As control, specimens of periodontal ligaments including Malassez epithelial rests were curetted from 21 teeth. LC densities were measured and various degrees of inflammatory cell infiltration were examined immunohistochemically. Labeling indices for the cellular proliferation markers Ki-67 antigen and DNA topoisomerase II alpha were calculated in the epithelial components. RESULTS: LCs were found in all periapical lesions but not in Malassez epithelial rests. LCs were more abundant in epithelial components than in subepithelial layers. Intraepithelial LCs were more frequent in RCs than in RRCs, whereas subepithelial LCs were less frequent in RRCs than in AGs and EGs. T lymphocytes consistently outnumbered macrophages, plasma cells and B lymphocytes. The range of the CD4/CD8-positive cell ratio differed according to the lesions. Increased LC density was associated with the severity of CD3-positive cell infiltration. Ki-67- and Topo II-LI showed various degrees of epithelial immunoreactivity. There was a significant correlation between LC density and proliferative potential of the epithelium in periapical lesions. CONCLUSION: These findings suggested that LCs appeared to be associated with T lymphocyte infiltration and proliferative potential of the epithelial tissue in periapical lesions.

Adult↗

Tissue response to an epoxy resin-based root canal sealer.

The objective of the present study was to evaluate two different types of root canal sealers: AH Plus (an epoxy resin-based sealer) and Fill Canal (a zinc oxide-eugenol based sealer). A total of 34 root canals with vital pulp from dogs' premolars were used. After instrumentation, the root canals were filled with gutta-percha and AH Plus or gutta-percha and Fill Canal sealers using a classical technique of lateral condensation. After histological processing, the sections were stained with hematoxylineosin or Mallory's trichrome stain. Inflammatory cells or areas of necrosis were not associated with AH Plus. Hard tissue formation apically to the material was observed in 14 specimens. The Fill Canal sealer presented an inflammatory response of moderate intensity in the periapical region, mainly adjacent to the material.

Animals↗

A combination of platelet-derived and insulin-like growth factors enhances periodontal regeneration.

The combination of platelet-derived growth factor (PDGF) and insulin-like growth factor one (IGF-1) has previously been shown to enhance repair of soft tissue wounds. Here we report initial observations following application of PDGF and IGF-1 to periodontitis-affected teeth in beagle dogs. 1 micrograms of PDGF and IGF-1 in an aqueous gel was applied to the root surfaces of test teeth following open flap debridement. Control sites received the gel alone. Block biopsies of the teeth and surrounding bone were taken 2 weeks after treatment. Histologic analyses of control specimens revealed a long junctional epithelial attachment, and no new bone or cementum formation. In contrast, growth factor treated sites exhibited significant amounts of new bone and cementum formation. A nearly continuous layer of osteoblasts lined the newly formed bone, and there was a dense cellular "front" at the coronal extent of the new bone. These preliminary results suggest that in vivo application of the combination of PDGF and IGF-1 may enhance regeneration of the periodontal structures.

Alveolar Process↗

Quantification of periapical bone destruction in mice by micro-computed tomography.

Bacterial infections of the dental pulp result in tissue destruction and periapical bone resorption. The availability of genetically engineered mouse strains is a major advantage in the use of this model system for studies of periapical pathogenesis. The main limitation of the mouse model is its small size, and the necessity for laborious histologic analyses to quantify periapical bone destruction. In the present study, we evaluated the use of a new technology, high-resolution micro-computed tomography (micro-CT), for the rapid and non-invasive quantification of periapical bone destruction. Periapical lesions were induced in the lower first molars of mice by exposing the pulp to the oral environment. Mandibles were harvested on day 21 after pulp exposure, and were subjected to micro-CT analysis, with 17-microm-thick radiographic sections. Samples were then decalcified, embedded, and sectioned for histology. The cross-sectional area of periapical lesions was determined by image analysis of corresponding micro-CT and histologic sections. The results showed a highly significant correlation between micro-CT and histology (p < 0.0001), with mean differences of 4. 1% (range, 0.9 to 7.2%) between the two methods. The mean error associated with image analysis was 4.9% for images obtained by both micro-CT and histology. The variability of replicate (n = 5) independent micro-CT determinations was 3.4%, less than that associated with the image analysis error. These results demonstrate that micro-CT imaging is a rapid, reproducible, and non-invasive method, that gives results that are closely comparable with those obtained by histology. Micro-CT appears to have utility for the accurate quantification of changes in bone architecture in small biological specimens.

Animals↗

The effect of the filling material in the tissue reactions following apical plugging of the root canal with dentin chips. A histologic study in monkeys' teeth.

The object of the present work was to observe whether the root canal filling material has some influence in the periapical healing process after apical plugging with dentin chips. Monkeys' teeth were filled with nine different filling materials in use today. Ninety days after the treatment, the histologic data showed no differences in the results with the nine materials studied. This fact suggests that the filling material does not influence the healing process when the plug is present.

Animals↗

Perspectives on periradicular healing using Sealapex: a case report.

The use of the calcium hydroxide-containing root canal sealer, Sealapex, has been questioned regarding its predisposition to solubility and subsequent effect on the root canal seal and periradicular healing. This case report demonstrates, radiographically, dissolution of excess sealer in the periradicular tissues with subsequent osseous repair which was similar to healing in periradicular tissues where there was no extruded sealer.

Adolescent↗

Periradicular healing in response to Diaket root-end filling material with and without tricalcium phosphate.

The healing of the periradicular tissues was evaluated when the polyvinyl resin Diaket with and without tricalcium phosphate was used as surgical root-end filling material. Non-surgical root canal treatment was performed on 56 mandibular premolar roots in mongrel dogs. Following root-end resection, root-end cavity preparations were filled with Diaket, the comparative material, or Diaket in combination with tricalcium phosphate, the experimental material. Postsurgically, healing of the tissues adjacent to the filling materials and in the surrounding surgical site were evaluated at 30 and 60 days. There was virtually no statistically significant difference between the experimental and comparative group at or within the 30- or 60-day period with regard to inflammation, connective tissue formation, root-end encapsulation, cementum formation, or bone apposition. Findings suggest that cementogenesis occurred over both materials. The overall healing of the periradicular tissues was favourable.

Animals↗

Immunolocalization of CD44 adhesion molecules in human periradicular lesions.

OBJECTIVE: The hyaluronate receptor CD44 is a cell surface protein that is involved in several functions. To elucidate whether CD44 plays a role in periapical lesions, an immunohistochemical technique was used to study its distribution. STUDY DESIGN: Twenty periapical lesions-16 periapical granulomas and 4 radicular cysts-constituted the sample. Formalin-fixed/paraffin-embedded tissue sections were studied by means of immunohistochemistry for the presence of the standard CD44H form and its V3 splicing variant. RESULTS: Immunohistochemical staining for CD44H and CD44V3 was observed on epithelial, endothelial, and connective tissue cells. The cells of the fibrous lining around each granuloma were positive, showing an immune reactive pattern directly correlated with the dimension of the lesion. Epithelial rests of Malassez were strongly positive; the reaction product was also evident in the epithelial lining of the cysts. Blood vessels, mainly observed around the lesion, were immunoreactive for CD44. CONCLUSIONS: Our findings demonstrate that CD44H and its V3 variant are expressed in at least 3 different tissue types of periapical lesions. These glycoproteins may be involved in different steps of periapical lesion pathogenesis and evolution.

Chronic Disease↗