carmen d. cohn pulpal and periapical immune responses to infection

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Carmen D. Cohn Pulpal and Pulpal and periapical periapical immune responses immune responses to infection to infection

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Carmen D. Cohn 78 monkey teeth with aseptically necrotized pulps 78 monkey teeth with aseptically necrotized pulps 26 bacteria-free 52 bacteria infected 7 months Apical periodontitis No apical inflammation Moller & Fabricius 1981

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Page 1: Carmen D. Cohn Pulpal and periapical immune responses to infection

Carmen D. Cohn

Pulpal and Pulpal and periapical immune periapical immune

responsesresponsesto infection to infection

Page 2: Carmen D. Cohn Pulpal and periapical immune responses to infection

Carmen D. Cohn

There is no evidence that necrotic pulp tissue

per se can elicit periapical inflammation,

in the absence of bacteria.

Page 3: Carmen D. Cohn Pulpal and periapical immune responses to infection

Carmen D. Cohn

78 monkey teethwith

aseptically necrotized pulps

26 bacteria-free

52 bacteria infected

7 months

Apical periodontitis

No apical inflammation

Moller & Fabricius 1981

Page 4: Carmen D. Cohn Pulpal and periapical immune responses to infection

Carmen D. Cohn

Periapical responses to pulpal infection

Page 5: Carmen D. Cohn Pulpal and periapical immune responses to infection

Carmen D. Cohn

Bacterial products

IL-1IL-2

MF

Th

B

Periapical inflammation and bone destruction

IL-2

+

MHC-II

IL-1, IL-6TNFαPGE

Ag

Page 6: Carmen D. Cohn Pulpal and periapical immune responses to infection

Carmen D. Cohn

productsproductsMicrobial Microbial

Periradicular lesions - barrier

Complement

Granulomatous tissue

Defence elements

PMNs

Epithelialplugs

Antibodies

MicroorganismsMicroorganisms

Very few endodontopathogens can advance through the barrier.

Page 7: Carmen D. Cohn Pulpal and periapical immune responses to infection

Carmen D. Cohn

Abscessed AP Actinomyces spp, Propionibacterium

propionicum Infected radicular cysts Infected material displaced into the

periapical tissues

Extraradicular microorganisms

Possible factor in the failure of the endodontic therapy.