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[Effect of formalin-creosote on the rat periapical tissues after pulpectomy].

The purpose of the present study was to investigate histologically, histometrically and immunohistochemically the effect of formalin-creosote (FC) on the periapical tissues after pulpectomy in rats. Experiment I. Seventy-five rats were divided into 3 groups. In all Groups, the mesial root of the right mandibular first molar was removed. After pulpectomy, in Group A, a paper point containing saline was inserted into the root canal. In Group B, a paper point containing FC was inserted, whereas, in Group C, FC was applied and then a paper point containing FC was inserted. The access cavity was sealed with amalgam. The animals were killed at 1, 3, 7, 14 and 28 days. The periapical tissues were examined histologically. The vertical length and the area of the apical periodontal ligament were measured histometrically. The inflammatory cells and the fibroblasts per unit area in the apical granulation tissue were counted. Experiment II. Eighteen rats were divided into 3 groups. In all Groups, pulpectomy was performed as in the experiment I. In Group a, a paper point containing saline was inserted into the root canal. In Group b, a paper point containing FC was inserted, whereas, in Group c, FC was applied and then a paper point containing FC was inserted. The animals were killed at 14 and 28 days. The presence of macrophages in the granulation tissue was examined using polyclonal antibody to lysozyme immunohistochemical techniques. The results were as follows. Experiment I. Histologically, in Group A, severe inflammation was observed in the periapical tissues at 1 and 3 days. Inflammation became moderate and fibrous tissue proliferation was observed in the periapical tissues at 7 days. Inflammation became slight and fibrous tissue increased at 14 and 28 days. In Group B, severe inflammation was observed in the periapical tissues at 1 and 3 days. Inflammation became moderate at 7 and 14 days. Resorption of alveolar bone was observed after 7 days. Fibrous tissue proliferation and resorption of the apical root were seen after 14 days. Inflammation became slight at 28 days. In Group C, severe inflammation was found in the periapical tissues at 1, 3 and 7 days. Resorption of alveolar bone was seen after 7 days. Moderate inflammation remained and fibrous tissue proliferation was seen at 14 and 28 days. Resorption of the apical root was observed after 14 days. Histometrically, vertical length and area of the apical periodontal ligament in Groups B and C increased significantly compared with those in Group A at 14 and 28 days.(ABSTRACT TRUNCATED AT 400 WORDS)

Alveolar Bone Loss

The periapical tissue reactions to a calcium phosphate cement in the teeth of monkeys.

A calcium phosphate cement, Grossman sealer, and Sargenti N2 were compared under conditions where root canals of monkey incisors were deliberately overfilled and the apical tissue responses were evaluated histologically. The periapical tissues exposed to Sargenti N2 revealed severe irritation at all times through the 6-month experimental period. The reactions to Grossman sealer were milder but persisted throughout the observation period. The calcium-phosphate-cement treated animals showed mild tissue irritation after 1 month, but thereafter the adverse tissue reactions were minimal. New bone formation adjacent to the cement was also observed. These results point to the possibility that calcium phosphate cement might be used in simplified endodontic procedures. The compatibility of calcium phosphate cement with the periapical tissue suggests that the cement may have other applications in dentistry and medicine.

Animals

Tumor necrosis factor identified in periapical tissue exudates of teeth with apical periodontitis.

Root canal samples, taken from periapical tissue exudates during routine root canal treatment procedures, were processed for identification of tumor necrosis factor using a mouse anti-human monoclonal antibody and enzyme-linked immunosorbent assay. Detectable levels of tumor necrosis factor were identified in periapical tissue exudates in chronic apical periodontitis.

Antibodies, Monoclonal

[Evaluation of the periapical tissue lesions by roentgenogram].

Most of the periapical tissue lesions appear as radiolucent areas in a reontgenogram. However, several lesions of pulpal and periodontal origin as well as lesions caused by benign or malignant tumors appear in the roentgenogram as radiopaque areas. This article deals in detail with the classification, differential diagnosis and treatment of oral diseases which appear radiopaque in an X-ray film. Special attention is given to apical condensing osteitis, hypercementosis, chronic osteomyelitis and odontogenic tumors. These lesions are fairly common and the general practitioner should be familiar with their diagnosis and treatment.

Diagnosis, Differential

Periapical tissue reaction to root fillings with Sealapex.

The histological response of periapical tissues to root canal fillings with Sealapex, pure calcium hydroxide and gutta-percha points was studied in dogs' teeth. After pulpal extirpation the root canals were enlarged, irrigated and dried. Teeth in the first group were filled with gutta-percha points alone, those in the second group were filled with pure calcium hydroxide and gutta-percha, and those in the third group were filled with Sealapex and gutta-percha. The animals were killed after 7, 30 and 90 days and histological sections of each specimen were prepared. It was concluded that hard tissue formation was more pronounced after root filling with Sealapex than with calcium hydroxide or gutta-percha points.

Animals

Periapical tissue response to two calcium hydroxide-containing endodontic sealers.

One-hundred twenty root canals of dog teeth were cleaned, shaped, and obturated with gutta-percha and sealers using a lateral condensation technique. The sealers used were Sealapex, CRCS, and zinc oxide-eugenol. The animals were killed after 30 or 180 days and the specimens were examined histologically. Sealapex and CRCS caused a periapical tissue response similar to that found with the zinc oxide-eugenol. An ingrowth of connective tissue infiltrated with chronic inflammatory cells was noticed in cases where the filling material reached the apical stops. Regardless of sealer used, deposition of new hard tissue along the apical root canal walls was observed, which caused the partial closure of the apical opening. In the Sealapex and CRCS groups, sealer particles were found at a considerable distance from the apices. All overfilled specimens caused chronic inflammatory reactions in the periapical tissues.

Animals

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.

Adult

Periapical tissue reactions after pulp exposure in rat molars.

Apical periodontal lesions were produced in the rat molar by exposing the pulp to the oral environment. The natural history of the undisturbed lesion was studied at time intervals ranging from 2 days to 1 year postoperatively. The earliest reactions were usually inflammatory infiltration at the apex. The severity of the lesions was related to the amount of vital pulp still present in the tooth rather than to the time lapse after exposure. After 1 month most pulps has undergone necrosis and the lesions about the apices which followed showed two main types of reaction. In the case of the suppurative reaction, pus drained along a root surface, destroying the periodontal ligament and interradicular bone until it emerged at the gingival sulcus. The sinus tract could become lined with oral epithelium. In the reparative type of reaction, suppuration was absent or minimal and the apices were surrounded by fibrous connective tissue. The fiber bundles occasionally formed a collagenous scar, but they were usually replaced by cementum and bone with a new periodontal ligament. The width of the periodontium was never restored to its normal dimensions. Secondary destruction of the teeth occurred by fracture of cusps followed by caries which started in the exposed pulp chamber. Despite the predominance of destructive factors, spontaneous repair indicated good healing potential of the apical periodontal tissues.

Animals