Silver accumulations in periapical granulomas: report of five cases using the scanning electron microscope, the electron microprobe, and other complementary methods.

A series of cytologic imprints obtained from periapical granulomas were studied with the conventional light microscope, the scanning electron microscope, and the electron microprobe to analyze the chemical composition of several black deposits that were randomly observed near or in the cytoplasm of macrophages and multinucleated giant cells. These granulomas had been removed from endodontically treated human teeth in which the root canals had been obturated with silver cones and Grossman's sealer 3 to 5 years previously. To investigate whether corrosion had occurred on the silver cones, the cones were also examined with the scanning electron microscope and the electron microprobe. Our observations revealed that all the examined silver cones showed different degrees of corrosion on their surfaces, whereas different concentrations of silver, sulfur, and chlorine were detected at the same sites in the cytologic imprints. However, it is impossible to determine from this study whether the presence of corrosive by-products in the periapical tissues is responsible for the development of a pathologic reaction at these sites.