Epithelial attachment at diseased human tooth‐apex

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Abstract
Periapical granulomas may contain proliferating epithelium which in some instances may grow into the entrance of the root canal. It was hypothesized that an “epithelial attachment” may possibly exist at the apices of such diseased teeth. Spontaneous periapical lesions obtained with tooth extraction were prepared for light‐ and electronmicroscopic observations. Out of 45 periapical lesions examined, six showed the presence of epithelium at the root canal entrance. The interface between this epithelium and the dentinal root surface consisted of a basal lamina, hemidesmosomes, and an electron dense cuticular structure resembling the dental cuticle. This apical cuticle was most probably serum‐derived. Coronal to the epithelium, the root canal contained numerous neutrophils and a mixed bacterial flora. The epithelium with its “attachment” to the dentinal root canal surface appeared to block the advancing bacterial front against the periapical tissues.