Characterization of inflammatory cell infiltrate in dental periapical lesions

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Abstract
Summary: Sixty‐three dental periapical lesions were investigated in order to study the involvement of inflammatory and immunologic reactions in the pathogenesis and maintenance of chronic apical periodontitis. Of 61 wellpreserved specimens, 38 were classified as granulomatous, 3 as exudative periapical granulomas and 20 as periapical scars. The quantitative composition of T‐lymphocyte subpopulation and macrophages, the proportion of lgE‐producing cells compared with other immunoglobulin producing plasma cells, and the tissue distribution of IgE‐producing plasma cells compared with that of mast cells were determined in the granulomatous types of granulomas using immunofluorescent, immunohistochemical and enzymehistochemical methods. The results indicated a decreased ratio of helper/inducer versus cytotoxic/suppressor T‐lymphocytes, a remarkably high proportion of macrophages, a low frequency of IgE‐ producing plasma cells with different localization when compared with that of mast cells. These observations suggest that T‐lymphocytes and macrophages may play an important role in the complex events of tissue destruction and repair taking place in the periapical region.