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Pulpal and periapical immune responses to infection . There is no evidence that necrotic pulp tissue per se can elicit periapical inflammation, in the absence of bacteria. Moller & Fabricius 1981. No apical inflammation. 26 bacteria-free . 7 months. 78 monkey teeth with
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There is no evidence that necrotic pulp tissue per se can elicit periapical inflammation, in the absence of bacteria.
Moller & Fabricius 1981 No apical inflammation 26 bacteria-free 7 months 78 monkey teeth with aseptically necrotized pulps 52 bacteria infected Apical periodontitis
+ IL-2 Bacterial products IL-1, IL-6 TNFα PGE MF MHC-II Th IL-1 IL-2 Ag B Periapical inflammation and bone destruction
Epithelial plugs Antibodies Periradicular lesions - barrier products Microbial Complement PMNs Microorganisms Granulomatous tissue Defence elements Very few endodontopathogens can advance through the barrier.
Extraradicular microorganisms • Abscessed AP • Actinomyces spp, Propionibacterium propionicum • Infected radicular cysts • Infected material displaced into the periapical tissues Possible factor in the failure of the endodontic therapy.