皆さんこんにちは。

今回も歯根囊胞に関する文献です。

歯根囊胞を難治性にしているものは細菌だけでなく

内因的な要素もあるということです。

Apical periodontitis is caused primarily by microorganisms residing in the root canals of affected teeth. Nevertheless, there is convincing evidence implicating other independent factors that adversely affect the outcome of conventional root canal therapy. In this paper, morphological evidence is presented in support of the potential role of two endogenous factors that may interfere with post-endodontic healing of the periapex. The specimens consisted of a surgical biopsy of an asymptomatic periapical lesion which persisted for a follow-up period of 44 months. The biopsy was processed for correlated light and electron microscopy. The lesion was characterized by the presence of a large central lumen lined by a stratified squamous epithelium. The most striking feature of the lesion was the presence of vast numbers of cholesterol crystals which congregated in the connective tissue surrounding the cyst cavity. Extensive light and electron microscopic investigation of the apical part of the root canal and the lesion failed to reveal the presence of microorganisms. These findings strongly suggest that intrinsic factors like the accumulation of certain tissue break-down products such as cholesterol crystals, and the cystic condition of the lesion itself, can adversely affect the healing process of the periapex following root canal therapy. Consequently, such apical lesions can remain refractory to conventional endodontic therapy for long periods of time.

つまり

歯根囊胞壁の結合組織中に多数のコレステロール結晶が

光子電子顕微鏡で観察され

これらが内因性の異物として

歯根囊胞を難治性にしている要因の一つだと

述べられています。

引用文献

Nair PN, Sjögren U, Schumacher E, Sundqvist G.

Radicular cyst affecting a root-filled human tooth: a long-term post-treatment follow-up.

Int Endod J. 1993 Jul;26(4):225-33.