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[The results of treating periapical periodontitis with ultraviolet irradiation of the root canal and the use of gentamycin].

Intracanal UV irradiation combined with the use of gentamycin 0.1% solution was tried in the treatment of 151 teeth diagnosed as acute and exacerbated chronic periodontitis. The method reduces duration of the course of treatment 1.6-fold as compared to conventional drug therapy, ensuring a favourable outcome of treatment in 90% of observations. Besides, this treatment option is well tolerated by the patients; it is harm-free, with no contraindications being known.

[Experimental study on the effect of replantation of immature permanent teeth on the periapical and periodontal tissues].

Replantation and semi-rigid fixation were performed on canine immature permanent teeth, and one week after replantation the teeth were treated by root filling with calcium hydroxide. The root apex and periodontium of the teeth with replantation were examined for changes regularly during the experiment by microradiographic, fluorescence microscopic, polarizing microscopic and X-ray observation of undecalcified horizontal continual ground sections. The results obtained were as follows: 1) Immediately after replantation, root formation was observed, but its formation was found to cease at a relat

Correlation between Transforming Growth Factor-β and Periapical Lesions in Patients with Chronic Apical Periodontitis.

OBJECTIVE: To examine the expression of transforming growth factor-β (TGF-β) in the periapical granulation tissue and serum of patients with … rum of patients with chronic apical periodontitis has a certain correlation with the progression of periapical periodontitis. The correlation between TGF-β at the mRNA level and the degree of early stage disease as well as the high expression of TGF-β in inflammatory cells in immunohistochemistry have confirmed that TGF-β promotes bone resorption in early periapical perio …

Classification of Periapical and Bitewing Radiographs as Periodontally Healthy or Diseased by Deep Learning Algorithms.

Objectives The aim of this artificial intelligence (AI) study was to develop a deep learning algorithm capable of automatically classifying periapical and bitewing radiography images as either periodontally healthy or unhealthy and to assess the algorithm's diagnostic success. Materials and methods The sample of the study consisted of 1120 periapical radiographs (560 periodontally healthy, 560 periodontally unhealthy) and 1498 bitewing radiographs (749 periodontally healthy, 749 periodontally ill). From the main datasets of both radiography types, three sub-datasets were randomly created: a tr

Role of Resistin in Various Diseases with Special Emphasis on Periodontal and Periapical Inflammation - A Review.

Resistin is a small adipocyte-specific secretory hormone molecule. It has been associated with a number of cellular and metabolic processes. … olism, and inflammation. Periodontitis is a widespread inflammatory disease affecting human beings. Periapical periodontitis is an inflammatory disease that manifests as a sequela of untreated dental caries. Therefore, in this article, we summarize the divergent physiological roles played by resistin and its association with the mechanism of various pathologies. Moreover, …

Periapical actinomycosis of the mandible: A diagnostic challenge mimicking conventional apical periodontitis- A case report.

Actinomycosis is a rare, chronic suppurative infection caused by filamentous, Gram-positive anaerobic bacteria, primarily Actinomyces israelii, with cervicofacial involvement being the most common presentation. Periapical actinomycosis, a rare central subtype of cervicofacial actinomycosis accounting for approximately 1-2% of central cases, is characterized by an indolent, less invasive course. This case report describes an unusual presentation of mandibular periapical actinomycosis in a 26-year-old immunocompetent female with no history of trauma or predisposing comorbidities. The patient pre

A potential role for the silent information regulator 2 homologue 1 (SIRT1) in periapical periodontitis.

AIM: To investigate the role played by silent information regulator 2 homologue 1 (SIRT1) during angiogenesis of periapical periodontitis. METHODOLOGY: Periapical granulomas were subjected to dual-colour immunofluorescence imaging and real-time polymerase chain reactions assaying the expression levels of SIRT1, vascular endothelial growth factor (VEGF) and VE-cadherin. The association between Ki-67 and SIRT1 expression was also examined. Human umbilical vein endothelial cells (HUVECs) were treated with a combination of lipopolysaccharide and resveratrol (a SIRT1 activator) or sirtinol (a SIRT…

Effect of different root canal sealers on periapical repair of teeth with chronic periradicular periodontitis.

Teeth with induced chronic periradicular periodontitis in dogs were root canal treated. After the biomechanical preparation, using K files and 5.25% sodium hypochlorite as the irrigant solution, all root canals were dressed with an antibacterial dressing based on calcium hydroxide, which was left in place for 7 days. After this time, the root canals were obturated with lateral condensation of cold gutta-percha with either a calcium hydroxide root canal filling material (Sealapex) or a zinc oxide-eugenol sealer (Fill Canal). After 270 days, histopathological analysis showed better apical and pe

Engineering Smart Bimetallic Ionic-Site MOF Nanozyme Nanocomposites for Microenvironment-Responsive Dynamic Therapy of Periapical Periodontitis.

Periapical periodontitis (AP) is an inflammatory disease caused by persistent endodontic biofilms, and its treatment remains challenging because conventional root canal therapy sometimes fails to achieve effective disinfection and tissue regeneration. Herein, a multifunctional bimetallic ion-modified metal-organic framework (MOF) nanozyme composite, MOF-FeAg-AMP@HA, was engineered for synergistic AP therapy. Incorporation of Fe3+ and Ag+ ions into a UiO-67 MOF scaffold endowed the nanozyme with pH-responsive dual enzymatic activities. Under acidic inflammatory conditions, strong peroxidase (PO…

Clastic cells are absent around the root surface in pulp-exposed periapical periodontitis lesions in mice.

INTRODUCTION: Clastic cells, originating from the monocyte-macrophage lineage, resorb mineralized tissues. In periapical periodontitis, alveolar bone around the tooth apex becomes resorbed; however, the roots of the teeth are often left intact by yet unknown mechanisms. Here, we examined the status of clastic cells in a periapical periodontitis model in mice. METHODS: Periapical periodontitis was induced by performing pulp exposure on the maxillary first molar. The contralateral maxillary first molar was used as a control. The maxillae were harvested, fixed, and subjected to μCT scanning and …

Loop-mediated isothermal amplification combined with PCR and immunohistochemistry for detecting Porphyromonas gingivalis in periapical periodontitis.

Porphyromonas gingivalis is important in the development of marginal periodontitis. However, the precise role and localization of P. gingivalis in chronic periapical periodontitis remain unclear. Thus, methods that can detect P. gingivalis in formalin-fixed and paraffin-embedded (FFPE) tissue samples are needed. We assessed a technique combining loop-mediated isothermal amplification (LAMP) with PCR (PCR-LAMP) for detection of P. gingivalis, using 110 FFPE tissue samples of chronic apical periodontitis. PCR-LAMP specifically detected P. gingivalis with high sensitivity in FFPE tissue samples, …

Inflammaging in periodontal, periapical, and malignancy-associated disease: drivers of alveolar bone loss and repair.

BACKGROUND: Aging significantly impacts bone metabolism through altered osteoblast/osteoclast dynamics, reduced stem cell regeneration, and chronic inflammaging. This narrative review explores how these age-related changes influence alveolar bone loss and regeneration in the oral cavity. METHODS: The review investigates key mechanisms-including immunosenescence and inflammasome activation-across three specific pathological contexts: (1) periodontitis, (2) periapical bone resorption, and (3) malignancy-associated osteolysis. Preclinical and clinical evidence were integrated to analyze the bone

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… Periapical bone resorption due to pulp infection (endodontic lesions) In chronic periapical periodontitis, bone metabolism and immune responses are closely intertwined. …

Rev-erbα attenuates refractory periapical periodontitis via M1 polarization: An in vitro and in vivo study.

AIM: Rev-erbα has been reported to regulate the healing of inflammatory lesions through its effect on the immune system in a variety of inflammatory disease. Moreover, the balance of macrophages polarization plays a crucial role in immune response and inflammatory progression. However, in refractory periapical periodontitis (RAP), the role of Rev-erbα in inflammatory response and bone resorption by regulating macrophage polarization remains unclarified. The aims of the present study were to investigate the expression of Rev-erbα in experimental RAP and to explore the relationship between Rev-e…

Periapical bacterial disinfection is critical for dental pulp regenerative cell therapy in apical periodontitis in dogs.

BACKGROUND: Application of pulp regenerative cell therapy for mature teeth with periapical lesions is a critical clinical challenge. The bacterial infection in inaccessible location within the root canal system and in the periapical lesions could cause resistance and impediment, leading to limitations in successful therapy. Thus, the aim of this study was to examine the effect of residual bacteria on the outcome of pulp regeneration in mature teeth with apical periodontitis in dogs. METHODS: Periapical lesions were induced in 32 root canals of 4 dogs in two different models in severities, mod

Human Umbilical Cord Mesenchymal Stem Cells-Derived Extracellular Vesicles for Rat Jawbone Regeneration in Periapical Periodontitis.

Extracellular vesicles derived from mesenchymal stem cells (MSCs-EVs) have great potential for bone remodeling and anti-inflammatory therapy. For the repair and reconstruction of inflammatory jawbone defects caused by periapical periodontitis, bone meal filling after debridement is commonly used in the clinic. However, this treatment has disadvantages such as large individual differences and the need for surgical operation. Therefore, it is of great significance to search for other bioactive substances that can promote jawbone regeneration in periapical periodontitis. Herein, it is found that …

A case of primary diffuse large B-cell non-Hodgkin's lymphoma misdiagnosed as chronic periapical periodontitis.

Lymphoma is a malignant neoplasm of component cells of the lymphoid system which is very rare in the jaws. Here we report a case of primary diffuse large B-cell lymphoma located in the periapical region of a mandibular molar which was misdiagnosed as chronic periapical periodontitis. The present case was diagnosed at an early stage and effectively managed by chemotherapy. Although lymphoma of the mandible is rare, it must be considered in the differential diagnosis of radiolucent lesions in this region. Lack of knowledge of this rare presentation may lead to delays in diagnosis and poor progno…

Evaluation of Radiographic and Clinical Outcomes in the Use of Bone Substitutes in Periapical Surgery and Periodontal Regeneration.

BACKGROUND: Periapical surgery and periodontal regeneration are essential dental procedures aimed at restoring the integrity of the tooth and surrounding tissues. Bone substitutes, including synthetic materials, xenografts, allografts, and autografts, play a pivotal role in enhancing healing and promoting tissue regeneration. This study evaluates the clinical and radiographic outcomes associated with the use of these bone substitutes. METHODS: The study involved 60 patients aged 18-60 years who were randomly assigned to three groups: synthetic bone substitute, autograft, and xenograft (20 pat

Periapical cemento-osseous dysplasia masquerading as asymptomatic chronic apical periodontitis in a Chinese woman: A case report.

KEY CLINICAL MESSAGE: Cemento-osseous dysplasia (COD) belongs to a group of fibrous osseous disorders that can masquerade as periapical inflammatory conditions in the jawbones. We present a rare case of COD occurring in a patient who also had periapical periodontitis concurrently. When faced with a patient exhibiting no symptoms, diagnosis may be challenging. ABSTRACT: COD is a fibrous osseous disorder similar to periapical chronic inflammatory conditions and other cysts in the jaw bones on the radiograph. There is a rare case of COD occurring in a 49-year-old Chinese woman who also had chron…

Six-year clinical evaluation of iRoot BP Plus as apical barrier in permanent teeth of periapical periodontitis.

The apical barrier technique in permanent teeth with extensive destruction of the periapical tissue and a long infection time is much more difficult to succeed, which is a clinical challenge. This study aimed to evaluate the long-term effects of iRoot BP Plus as an apical material in adult teeth. Fifty incisors and premolars were chosen for this study. All teeth were performed apical barrier with the same operator. After treatment, the teeth were clinically and radiographically evaluated at 1, 2 and 6 years. At the 1-year follow-up, 35 teeth had healed, and three patients developed an apical a