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Effects of Stress on Physiological Conditions in the Oral Cavity
Published in Eli Ilana, Oral Psychophysiology, 2020
Other cases are described with regard to symptoms of vertigo, blurred vision, nausea, tension, and irritability.140 Three cases were presented in which removal of a suspected dental pathology (e.g., periapical granuloma) resulted in rapid and permanent cure of symptoms earlier diagnosed as “psychogenic.”
The gastrointestinal system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Sharon J. White, Francis A. Carey
The periapical tissues are the site of a variety of lesions related to the root apices of teeth. The most frequent of these arise from the spread of infection from pulpitis, through the apical foramina of the tooth, to reach the periodontal ligament. This can result in an acute periapical abscess, a very painful condition that may be accompanied by cervical lymphadenopathy and generalized fever and malaise. Pus can track through the adjacent bone and, after the periosteum is breached, a soft-tissue abscess develops and later discharges. More frequently, after low-grade pulpitis, a periapical granuloma develops. This consists of a mass of granulation tissue heavily infiltrated with chronic inflammatory cells. There is resorption of the surrounding bone, seen radiologically as a periapical radiolucent lesion (Figure 10.2). Acute exacerbation may result in a secondary acute periapical abscess and, conversely, a periapical granuloma can develop after an acute periapical abscess has pointed and drained. Remnants of odontogenic epithelium that persist in the periradicular tissue after tooth development proliferate within a periapical granuloma, and these give rise to the most common cyst of the jaws, the inflammatory radicular cyst.
Pathogenesis of Odontogenic Cysts
Published in Roger M. Browne, Investigative Pathology of the Odontogenic Cysts, 2019
The periapical granuloma is a circumscribed mass of chronic inflammatory tissue containing plasma cells, macrophages, lymphocytes, polymorphonuclear leukocytes and mast cells, in addition to fibroblasts and vessels. The predominant class of immunoglobulin secreting plasma cell is IgG,104,108 although IgA, IgM, and IgE is formed in lesser amounts. Complement fixation in periapical granulomas has also been demonstrated by several workers104,109–111 suggesting that antigen-antibody complexes have formed, leading to the activation of complement. Complement activation could also occur independently of immune complex formation from the presence of bacterial endotoxin112 and probably other components. The presence of mast cells and IgE-containing cells may result in anaphylactic hypersensitivity type reactions, although it is not known that these play any role in promoting epithelial proliferation. In addition to antibody-producing cells, most periapical granulomas also contain T lymphocytes.113,114 Both complement activation and activation of T lymphocytes result in the activation of macrophages. Such activation results in the release of interleukin-1, which has, among other effects, the property to stimulate epithelial cell proliferation. The formation of interleukin-1 has been demonstrated in the wall of radicular cysts.115
In vitro treatment of Enterococcus faecalis with calcium hydroxide impairs phagocytosis by human macrophages
Published in Acta Odontologica Scandinavica, 2019
José Burgos Ponce, Raquel Zanin Midena, Karen Henriette Pinke, Paulo Henrique Weckwerth, Flaviana Bombarda de Andrade, Vanessa Soares Lara
In summary, our data indicated that the microenvironment may influence the interaction between some strains of enterococcal bacteria and macrophages, since the enterococci submitted to alkaline-stress appeared to have escaped from efficient phagocytosis by human macrophages, reflecting the capacity of E. faecalis to elude immune defenses. However, according to our findings, this impact caused by alkaline stress did not result in changes in NO production by human macrophages challenged in vitro with E. faecalis, irrespective of strain. Considering the importance of these two processes for bacterial clearance [45], the impaired phagocytosis of alkaline-stressed E. faecalis could contribute to their persistence in root canal systems that were previously treated with CH, irrespective of NO production, since large amounts of this reactive are generated within the phagosomes. Worth noting is that phagocytosis is a complex process whose success may involve other microbicidal molecules apart from NO. Thus, impaired phagocytosis, although accompanied by unchanged NO production, may be related to survival of the internalized microorganisms. In this sense, evidence have shown an association between the apically colonizing bacteria and the immune response present in the periapical granuloma, with macrophages being one of the main types of cells found in these lesions [46,47]. Moreover, macrophages challenged with root-canal strains did not produce amounts of NO as large as those generated in the presence of bacteria from urine. Possibly, NO poorly produced in response to root canal strains of E. faecalis could be crucial to the persistence of apical periodontitis.
Human cytomegalovirus is present in the odontogenic epithelium of ameloblastoma
Published in Journal of Oral Microbiology, 2021
Mohammed Amjed Alsaegh, Sudhir Rama Varma, Alaa Muayad Altaie, Shengrong Zhu
Both viral DNA and protein was investigated in the current study. Accordingly, HCMV-DNA was detected as a non-significantly different in AB, DC, and OKC. The prevalence of HCMV-DNA in our odontogenic lesion samples is comparable to other studies that conducted in the odontogenic cysts and periapical granulomas [4,7]. However, a more frequent detection was observed when the odontogenic cyst has a history of previous episodes of acute infection [4] and in symptomatic and large periapical granuloma [6,7]. Despite its comparable PCR results, the current study showed a significant difference in the HCMV-gB expression in the odontogenic epithelium of the different groups of the studied lesions. This could be attributed to the fact that detection of HCMV-DNA is reflecting the total cellular presence of the virus in the studied lesions rather than its real infection of the odontogenic epithelium of the studied cysts and tumours. In fact, HCMV is the most common herpes virus that causes infection for human where it infects 50–100% of the general adult population[1]. Inside host, HCMV infects different immune cells like monocytes/macrophages, polymorphonuclear leukocytes, and T lymphocytes[2]. Consequently, the HCMV infected leukocytes could invade the odontogenic cysts and tumours leading to the on par PCR recognition of HCMV-DNA in these studied odontogenic lesions. In accordance to this opinion, Sabiti et al. found that HCMV has infected mainly the inflammatory cells in dental periapical lesions, where 40% of the virus was detected in the monocyte/macrophage and 54% in the T lymphocytes using multicolour flow cytometry[12]. Leukocytes are heavily infiltrating the periapical granuloma. This could be the reason behind the detection of HCMV-DNA in the periapical lesions of the previous studies using PCR assay [6,7].