• Restorative Dentistry and Endodontics
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• v.17 no.1
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• pp.83-94
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• 1992

This study was executed to measure the biosynthesis of arachidonic acid metabolic products in chronic periapical lesions, to compare the products among periapical granuloma, periapical cyst and chronic periapical abscess, and to understand the pathogensis of chronic periapical lesions. Tissues from 33 chronic periapical lesions of human teeth were enucleated during endodontic surgery. large part of each tissue was contained in liquid nitrogen immediately and the other was examined histologically. In histologically diagnosed 8 cases of periapical granuloma, 9 cases of periapical cyst and 8 cases of chronic periapical abscess. the tissues were homogenatecl and incubated with $_{14}C$-arachidonic acid. Lipid solvent extracts were separated by thin layer chromatography to be analyzed by autoradiography and TLC analyzer. 1. $TXB_2$, 6-keto-$PGF_1{\alpha}$ and $PGE_2$, $LTB_4$, HETEs, and unidentified product which are metabolic products of arachidonic acid were measured in the tissues of chronic peripaical lesions. 2. In all of periapical granuloma, cyst and abscess, the conversion rate of HETEs among all products was the highest(P<0.05), and the percentage of HETEs in total converted products was also the highest(P<0.05). 3. The concentration of each arachidonic acid product was higher in chronic periapical absecss than in periapical granuloma and cyst(P<0.05). The concentration of $TXB_2$ and HETEs in periapical cyst were hight than in periapical granuloma. 4. The relative amounts of total products from lipoxygenase pathway to those from cyclo-oxygenase pathway were about 7 fold in chronic periapical lesions. There was no difference among periapical granuloma, cyst and abscess(P<0.05). The total amount of products from each pathway were higher in chronic periapical abscess than in periapical cyst and granuloma.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.55-70
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• 1995

Periapical lesions develop as a result of immunopathologic response to irritants from infected root canal systems. Removal of these irritants from the root canal system and sealing the root canal space may induce he31ing of the periapical lesions. 83 periapical lesions diagnosed as periapical abscess, periapical granuloma, chronic nonspecific inflammation, fibrosis and periapical Cyst were evaluated for the distribution of immunoglobulin containing cells. The influence of the state of root canal treatment on the distribution of immunoglobulin containing cells has evaluated. All lesions were divided into a group with no treatment, a group with canal enlargement, a group filled with gutta percha, and a group filled with Vitapex(calcium hydroxide). The distribution of immunoglobulin-containing cells according to the presence of pain and fistula was also evaluated. The following results were obtained. 1. Statistically significant difference in the distribution of immunoglobulin-containing cells among periapical abscess, periapical granuloma, chronic nonspecific inflammation/fibrosis and periapical cyst were found.(Kruskal-Wallis analysis, P<0.05) The number of immunoglobulin-containing cells in fibrosis was remarkably lower than that of periapical abscess, granuloma and cyst. 2. IgM and IgA containing cells were predominantly observed in periapical abscesses and periapical cysts, respectively. 3. All periapical lesions showed a large number of IgG containing cells followed by IgM, IgA and IgE containing cells. 4. There was a decrease in all Ig-containing cells in the group with canal filling compared to groups without treatment or with enlargement. That is, there is a decrease in Ig-containing cells as treatment progresses. 5. No significant correlation existed between the presence of pain and fistula and the distribution of immunoglobulin containing cells in periapical lesions.(t-test) Results appear to support that immune response are actively involved in the development and progress in periapical lesions. The fact that distribution of immunoglobulins differ according to the state of endodontic treatment suggests that root canal treatment may alter the humoral immune response of the periapical lesions.

• Journal of Veterinary Clinics
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• v.19 no.2
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• pp.253-255
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• 2002

A 10-year-old, female mixed breed dog and a 3-year-old, female chihuahua which had swelling below lower eyelid were refered to Veterinary Medical Teaching Hospital, Seoul National University. The plain maxillary oblique view revealed radiolucency at periapical area in maxillary fourth premolar. The 2 cases were diagnosed as periapical abscess by clinical sign and radiographs, and apicoectomies were performed for resetting the lesions and preserving the teeth. Under general anesthesia with isoflurane, periapical abscess was resected by burs and the defect was filled with zinc phosphate cement. Radiograph was perfomed at 1 week and 1 year after apicoectomy and there was no evidence of recurrence.

• The Journal of the Korean dental association
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• v.51 no.1
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• pp.33-38
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• 2013

Traumatic bone cyst is known as a symptomless, radiolucent bony les ion incidentally found during routine radiographic examinations. The main characters of traumatic bone cyst are asymptomatic and unicystic radiolucent bony lesion with vital tooth. This case is a confusing case of a traumatic bone cyst with sudden gingival swelling and appearance like a periapical abscess. After surgical exploration and drainage, clinical and radiographic examination showed bony healing with pulpal vitality preserved after 7 months postoperatively.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.21 no.1
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• pp.109-118
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• 1991

The author studied the age distribution, etiology, affected site and several radiographic features of periapical granulomas, cysts, and abscesses. The material consisted of 928 films obtained from the patients who were diagnosed and treated under the diagnosis of periapical granulomas, cysts, and abscesses during the past 8 years (1979-1986) at the Infirmary of Dental School, Chosun University. The obtained results were as follows: 1. The order of incidence was as follows: periapical abscess (67.2%), granuloma, and cyst. 2. The age distribution revealed the highest incidence around the age of 30 and relatively higher incidence over the age of 60 in the case of periapical abscess and granuloma. 3. In the frequency of location: Periapical abscesses occured most frequently in the mandibular molars. Granulomas showed relatively higher incidence in maxilla than in mandible. Cysts were most common in the maxillary anterior teeth. 4. The mean diameter of dental granuloma was 5.9㎜, however, all dental granulomas were less than 9.3㎜ in diameter. The mean diameter of periapical cyst was l3.8㎜. 5. Periapical cyst revealed well circumscribed radiolucent lesions and 77.8% of the lesion showed white line. 86.0% of dental granuloma showed well circumscribed border, 54.5% sclerosis on surrounding bone and 38.5% partial white line. Periapical abscess revealed diffuse radiolucent lesion, 89.6% of the lesions had sclerosis on surrounding bone, and 38.0% sinus tract.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.200-211
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• 1999

The periapical response to injury is a complex interaction of inflammatory, immune, neural, vascular and synthetic activity. TGF-${\beta}$ is a potent modulator of proliferation and differentiation in various tissue, seems to lead to an increase in extracellular matrix. MMP are a family of proteolytic enzyme that mediate the degradation of extracellular matric macromolecules, but little is known about theirs possible role in periapical tissue. The purpose of this study is to investigate the differential expression of TGF-${\beta}$ and MMP-1 in tooth follicle, periapical abscess, granuloma and cyst. The expression of TGF-${\beta}$ and MMP-1 in Periapical tissue was evaluated by immunohistochemical staining and Western blot analysis. Correlationship among the periapical lesions were stastically analyzed. The degree of MMP-1 expression in periapical abscess was higher than in any other periapical lesion, and stastically significant. TGF-${\beta}$ expression is the prominent in granuloma than other periapical lesion, which was stastically significant. The increased expression of MMP and TGF-${\beta}$ was not co-related with inflammatory cell infiltration degree of the periapical cyst. The expression degree of MMP and TGF-${\beta}$ was not co-related with periapical abscess and cyst, but expression of MMP and TGF-${\beta}$ showed strong positive co-relationship with periapical granuloma, which was stastically significant. TGF-${\beta}$ expression by Western blot analysis was prominent in granuloma and cyst, and similar to the results by imunohistochemistry. MMP-1 expression is less than TGF-${\beta}$, but there is not extreme difference between periapical lesion. These results suggest that TGF-${\beta}$ and MMP may be involved in tissue remodeling and has an important role in progress or mediation of periapical lesions.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.212-221
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• 1999

The periapical response to injury is a complex interaction of inflammatory, immune, neural, vascular and synthetic activity. Nitric oxide(NO), synthesized by nitric oxide synthetase(NOS) from L-arginine, is becoming recognized as an important bio-regulatory molecule in a variety of tissue, but little is known about its possible role in periapical tissue. The purpose of this study was to investigate the expression of nitric oxide synthetase(NOS) in tooth follicle, periapical abscess, granuloma and cyst. The expression of NOS in periapical lesions was evaluated by immunohistochemical staining for $NOS_2$, and $NOS_3$. The immunoreactivity was evaluated by staining intensity, and inflammatory cell infiltration. Correlationship between the periapical lesion in immunoreractivity were statistically analyzed by SPSS. The degree of $NOS_2$ and $NOS_3$ expression in periapical abscess was higher than in any other periapical lesions, and stastically significant. The expression degree of $NOS_2$ and $NOS_3$ was not correlated with periapical abscess and granuloma, but expression of $NOS_2$ showed very significant in periapical cyst. The increased expression of $NOS_2$ and $NOS_3$ was correlated with inflammatory cell infiltration degree of the periapical cyst. These results suggested that NO should play an important role in progress and/or mediation of periapical lesions.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.232-237
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• 2001

The purpose of this study was to find the clinical features of periapical lesions. A total of 130 periapical lesions which were obtained from biopsy and diagnosed histopathologically as periapical cyst, periapical abscess, and periapical granuloma at the Department of Dentistry in Hanyang University Hospital were throughly analysed according to the distribution and incidence of age, sex, location, and so on. The following results were obtained : 1. Out of 130 periapical lesions, 88 cases(67.7%) were periapical cysts, 30 cases(23.1%) were periapical abscesses, and 12 cases(9.2%) were periapical granulomas. 2. The periapical lesions occurred most frequently in the third decade, and followed by the fourth, fifth, sixth, and second decade. The periapical cysts occurred most frequently in the third decade(26.1%), the periapical granulomas in the fourth decade(33.3%) the periapical abscesses in the sixth decade(26.7%). 3. The periapical lesions were more frequent in men than in women with the ratio of men to women of 1.4 : 1. The radio of men to women of periapical cysts was 1.6 : 1, that of periapical granulomas was 0.5 : 1, and that of periapical abscesses was 1.3 : 1. 4. The periapical lesions were more frequent in maxilla than in mandible with the ratio of 1.2 : 1. The ratio of maxilla to mandible of periapical cysts was 1.5 : 1, that of periapical granulomas was 0.5 : 1, that of periapical abscesses was 1 : 1. 5. The most commonly involved location of the periapical lesions was maxillary anterior teeth(40.8%), and followed by mandibular molars, mandibular premolars, and mandibular anterior teeth and maxillary molars. The most frequent location of the periapical cysts was maxillary anterior teeth(48.9%), that of periapical granulomas was mandibular molars(50.0%), that of periapical abscesses was mandibular molars(40.0%).

• Journal of Veterinary Clinics
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• v.23 no.4
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• pp.476-479
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• 2006

A 9-year-old, female Yorkshire terrier and a 10-year-old, female Maltese were referred to the Veterinary Medical Teaching Hospital of Konkuk University. The dogs were presented with severe swelling and cutaneous sinus tract on the left suborbital lesion. Under general anesthesia, we performed physical, intraoral examinations and survey radiography, and diagnosed as periapical abscess in a left fourth premolar tooth. They were treated with tooth extraction, and the sinus tracts were drained with 0.05% chlorhexidine solution. After teeth extractions, medication applied by the result of antibiotic sensitivity test. During follow-up 10 months later, the left suborbital swelling had completely resolved.

• The Journal of the Korean dental association
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• v.50 no.4
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• pp.196-202
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• 2012

Radiographic diagnosis of periapical lesions is based on many factors, including anatomical limitations such as thickness of the cortical bone; positioning of the apical abscess to the cortical bone; and is complicated by proximity to other anatomical structures and neighboring teeth. With conventional radiographs, these structures are often superimposed. Dental CBCT with its associated geometric accuracy offers accurate visualizations of the complex relationships and boundaries between teeth, related anatomical features, and their associated pathology. Its images also provide us internal tooth morphology, periodontal ligament space, the presence or absence of periapicl lesions in association wi th critical anatomical structures and maxillary sinus involement. Using 3 D imaging makes it easier for clinicians to detect, diagnosis, and develop highly effective treatment plans. Now, 4 cases of periapical and periodontal pathosis with CBCT images are to be presented including periapical abscess, furcation involvement, periapical pathosis involving maxillary sinus, and osteomyelitis. CBCT analyze specific area of interest and provides the highly detailed anatomical information. It also facilitates earlier and more accurate diagnosis, and treatment planning decisions and more predictable outcome.