Objective: The purpose of this study was to evaluate 50 human periapical lesions for bacteria and epithelium in a case study in dental practice.
Study Design: Specimens were obtained from the extraction of 50 untreated teeth that had lesions attached to their apices. The specimens were histologically evaluated using serial sections.
Results: Bacteria were found in all teeth, colonizing necrotic tissue in the main canal, dentinal tubules, or apical ramifications, and in the body of the periapical lesion in 18 abscesses or cysts. Twenty-one lesions were epithelialized; 14 abscesses, 20 granulomas, and 16 cysts were distinguished. In 18 root canals inflamed tissue was found in the apical part of the canal. A single foramen was present in 13 cases while apical ramifications were found in 37 cases.
Conclusions: Granulomas were most common, and most epithelialized lesions were cysts. Bacteria were only detected periapically in abscesses or cysts. Inflamed tissue was present in the apical root canal in one third of cases.
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