Abstract：
Apical periodontitis (AP) is featured by a persistent inflammatory response and alveolar bone resorption initiated by microorganisms, posing risks to both dental and systemic health. Nonsurgical endodontic treatment is the recommended treatment plan for AP with a high success rate, but in some cases, periapical lesions may persist despite standard endodontic treatment. Better comprehension of the AP inflammatory microenvironment can help develop adjunct therapies to improve the outcome of endodontic treatment. This review presents an overview of the immune landscape in AP, elucidating how microbial invasion triggers host immune activation and shapes the inflammatory microenvironment, ultimately impacting bone homeostasis. The destructive effect of excessive immune activation on periapical tissues is emphasized. This review aimed to systematically discuss the immunological basis of AP, the inflammatory bone resorption and the immune cell network in AP, thereby providing insights into potential immunotherapeutic strategies such as targeted therapy, antioxidant therapy, adoptive cell therapy and cytokine therapy to mitigate AP-associated tissue destruction.
摘要：
根尖周炎（AP）的特征是持续的炎症反应和由微生物引起的牙槽骨吸收。对牙齿和全身健康都有风险。非手术牙髓治疗是AP的推荐治疗方案，成功率高，但在某些情况下,尽管进行了标准的牙髓治疗，但根尖周病变仍可能持续存在。更好地理解AP炎症微环境可以帮助开发辅助疗法以改善牙髓治疗的结果。这篇综述概述了AP的免疫前景，阐明微生物入侵如何触发宿主免疫激活并塑造炎症微环境，最终影响骨骼稳态。强调了过度免疫激活对根尖周组织的破坏作用。本文旨在系统地讨论AP的免疫学基础，AP中的炎性骨吸收和免疫细胞网络，从而提供潜在的免疫治疗策略的见解，如靶向治疗，抗氧化疗法,过继细胞疗法和细胞因子疗法，以减轻AP相关的组织破坏。
