Role of bacterial aggregation in the periapical lesions

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In the periapical lesions, especially the refractory one, some specific bacteria are known to produce biofilms. They are also known to make the treatment more difficult. Recently, it is reported that Fusobacterium nucleatum is associated with flare-ups (acute phase after treatment), and the importance of the bacterium is often discussed. On the other hand, host conditions are also considered to be the important factor of flare-ups.We examined the role of TGF-・1 in the development of periapical lesions. When ofloxacin was applied to the rat periapical lesions, macrophages manifesting TGF-・1 increased and decreased thereafter. Bone formation was observed at the periapical area. Decrease of expression of IL-1・ and IL-1・・ were observed in ofloxacin-applied group. On the other hand, macrophages continued to express these cytokines in control group. From these results, the duration and amount of TGF-・1 expression is considered to affect the healing process. It is also considered that temporary increase of macrophages expressing TGF-・1 is playing an important role in the bone formation at the healing of periapical lesions.We also reported a case with halitosis associated with inappropriate endodontic treatment. We are now performing an experiment with clinical isolates from periapical periodontitis lesions, and the ability of coaggregation of the clinical isolates are being compared with the laboratory strains. We will reveal the host responses in periapical lesions. We did a work with probiotics, which changed the oral flora and improved the general health.