Carmen D. Cohn
Pulpal and Pulpal and periapical immune periapical immune
responsesresponsesto infection to infection
Carmen D. Cohn
There is no evidence that necrotic pulp tissue
per se can elicit periapical inflammation,
in the absence of bacteria.
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
Carmen D. Cohn
Periapical responses to pulpal 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
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.
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.
