Immunological Study on the Establishment of Human Chronic Periapical Periodontitis

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Recent observations suggested that human periapical lesions developed as a result of immunopathological responses to continuous antigenic stimuli from infected root canals. The purpose of this study was to clarify the involvement of immune mechanisms in the pathogenesis of periapical lesions.First, we investigated the property of infected root canal contents from a clinical point of view in terms of antigenicity. It revealed that some qualities of root canal contents, namely wet condition, black pigmentation and foul odors, were closely related to existence of periapical lesions. These findings suggested that bacteria might be the crucial antigenic substance in the canal contents. Therefore microorganisms in the root canals were investigated. Results showed anaerobic gram-negative rods including bacteroides species had closely relation to the existence of periapical lesions. Consequently, anaerobic gram-negative rods were important as the antigenic stimuli in development of periapical … More lesions.Second, we characterized the immunocompetent cells in periapical lesions by using immunohistochemical methods, and examined their correlation with clinical findings. Results showed the proportion of these immunocompetent cells related to some clinical findings. These observations suggested that immune responses closely related to the pathosis of periapical lesions.Finally, we measured the concentration of immunoglobulins and Interleukin-1(IL-1) in the periapical exudates of infected root canals by enzyme-linked immunosorbent assay and examined the correlation of these immune components to clinical findings. Results showed that IL-1 and immunoglobulines detected in periapical exudates were related with some clinical findings. Moreover, as the healing of periapical lesions, an increase of the level of IL-1 and a decrease of the levels of IL-1 , IgG and IgA were observed. Consequently immune responses in periapical lesions varied according to the pathosis of periapical lisions.Above findings suggested immune responses played a important role in the pathogenesis of the periapical lesions. Less