根管起源的根尖病变可分为肉芽肿或囊肿。在极少数情况下,呼吸道上皮可以增殖并包裹病变,形成囊肿.此外,根尖病变的神经支配以前仅在根尖牙周炎的动物模型中报道过。该报告显示了一个不寻常的病例,其中15号牙齿最初采用非手术根管治疗。尽管如此,手术后患者持续处于中度至重度疼痛数天.接下来,进行了有意的再植,其中根尖周囊肿从肺泡中刮除。患者在手术后立即缓解疼痛。组织学分析显示根尖囊肿完全由呼吸道上皮排列,免疫组织化学分析显示它被密集神经支配。此外,这些神经纤维表达LPS受体,TLR4。这是根尖周囊肿神经支配模式的首次证明。需要进一步的研究来评估根尖病变的神经支配及其与术前和术中症状的相关性以及它们在根尖牙周炎发病机理中的参与。
Apical lesions of endodontic origin can be classified as either granulomas or cysts. In rare cases, respiratory epithelium can proliferate and encapsulate a lesion, forming a cyst. Moreover, the innervation of apical lesions has only been previously reported in animal models of apical periodontitis. This report demonstrates an unusual
case in which tooth #15 was initially treated with nonsurgical root canal therapy. Still, the patient remained in moderate to severe pain for several days following the procedure. Next, an intentional replantation was performed in which a periapical cyst was curetted from the alveolus. The patient experienced immediate pain relief following the procedure. Histological analysis revealed that the periapical cyst was lined entirely with respiratory epithelium, and immunohistochemical analysis showed it to be densely innervated. In addition, these nerve fibers expressed the LPS receptor, TLR4. This is the first demonstration of the innervation pattern of a periapical cyst. Further studies are warranted to evaluate innervation in apical lesions and its correlation with pre- and intra-operative symptoms and their participation in the pathogenesis of apical periodontitis.