M2 macrophages coexist with a Th1-driven profile in periapical cysts.

AIM: To evaluate the participation of both Th1 and Th2 responses in periapical cysts by assessing the presence of M2 macrophages, as well as acute IL-1 ß, TNF-α and IL-6 cytokines. METHODOLOGY: Twenty-four cases of periapical cysts were selected. Immuno-expressions of IL-1 ß, IL-6, TNF-α and CD163 were analysed in the cystic capsules in both superficial and deeper regions. Data were analysed with paired Wilcoxon test and Spearman correlation coefficient (P ≤ 0.05). RESULTS: There was a higher expression of IL-1ß, IL-6, TNF-α and M2 macrophages in the superficial region (P < 0.001) of cystic capsules. All acute cytokines had significant positive correlations amongst them regardless of the cystic capsule region. Regarding CD163, positive correlations occurred only with TNF-α (P = 0.007; r = 0.537) and IL-6 (P = 0.018; r = 0.478) in the superficial regions of the cystic capsule. CONCLUSIONS: M2 macrophages participated actively in the inflammatory response of periapical cysts and correlated with the expression of certain acute Th1-related cytokines. This illustrates the coexistence of an acute and chronic Th2-driven immune response in these lesions. Although M2 macrophages favour the healing process, their presence is not sufficient for periapical cyst regression, once an acute active response has occurred due to an infectious stimuli.

Inflammatory follicular cysts associated to necrotic primary teeth.

BACKGROUND: Cysts are pathological cavities lined by epithelium and supported by connective tissue, containing fluid or semi-fluid substances and presenting developmental or inflammatory origins. CASE REPORT: This study aimed to evaluate a case series of inflammatory follicular cysts in children to clarify their nomenclature, diagnosis, clinical implications and treatment outcomes. Prevalence, aetio-pathogenesis, clinical, radiographic and microscopic findings, treatments and sequelae of this condition were assessed by using the records of patients treated between 2000 and 2015. Data were analysed and presented descriptively. FOLLOW-UP: This was performed periodically for 2 years to monitor lesion regression and complete eruption of impacted permanent teeth. All of the involved permanent teeth erupted naturally. Twelve cases of asymptomatic lesions with volumetric bone expansion were identified through radiographic findings or delayed tooth eruption in patients aged between 8 and 14 years. After establishing the diagnosis of inflammatory follicular cyst, necrotic primary teeth extraction was followed by decompression of the cystic lesions. CONCLUSIONS: The investigated cases were consistent with inflammatory follicular cyst diagnoses. The proposed treatment was considered to be appropriate, that was revealed by the maintenance of the permanent teeth involved during the patients follow-up.