Therapy-resistant foreign body giant cell granuloma at the periapex of a root-filled human tooth

Journal Article · Sat Dec 01 00:00:00 EST 1990 · Journal of Endodontics; (United States)

DOI:https://doi.org/10.1016/S0099-2399(07)80202-0· OSTI ID:5397418

Nair, P N; Sjoegren, U K; Krey, G; Sundqvist, G ^[1]

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1. Dental Institute, University of Zurich (Switzerland)

Although the primary etiological factor of periapical lesions is microbial, there are other independent factors that can adversely affect the outcome of endodontic treatment. In this communication, we present morphological evidence in support of the role of a foreign body reaction of periapical tissue to root-filling materials. The specimen consisted of a surgical biopsy of an asymptomatic periapical lesion which persisted after a decade of postendodontic follow-up. The biopsy was processed for correlated light and electron microscopy and was analyzed by various microtechniques. The unique feature of the lesion was the presence of vast numbers of large multinucleated cells and their cytoplasmic inclusion bodies. Morphologically, these multinucleated cells resembled foreign body giant cells. They contained characteristic birefringent cytoplasmic inclusions which on electron-probe x-ray microanalysis consistently revealed the presence of magnesium and silicon. The magnesium and silicon are presumably the remnants of a root-filling excess which protruded into the periapex and had been resorbed during the follow-up period. These observations strongly suggest that in the absence of microbial factors, root-filling materials which contain irritating substances can evoke a foreign body reaction at the periapex, leading to the development of asymptomatic periapical lesions that may remain refractory to endodontic therapy for long periods of time.

• OSTI ID: 5397418
• Journal Information: Journal of Endodontics; (United States), Vol. 16:12; ISSN 0099-2399
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
GRANULOMAS
ETIOLOGY
MAGNESIUM
BIOLOGICAL EFFECTS
ORAL CAVITY
SILICON
BIOPSY
CYTOPLASM
DENTISTRY
ELECTRON MICROPROBE ANALYSIS
MAN
ALKALINE EARTH METALS
ANIMALS
CELL CONSTITUENTS
CHEMICAL ANALYSIS
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
ELEMENTS
MAMMALS
MEDICINE
METALS
MICROANALYSIS
NEOPLASMS
NONDESTRUCTIVE ANALYSIS
PRIMATES
SEMIMETALS
VERTEBRATES
550602* - Medicine- External Radiation in Diagnostics- (1980-)