Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/S1807-25772013000200005
Revista de Odontologia da UNESP
Original Article

Relationship between the presence of clefts of cholesterol crystals in periapical lesion and serum cholesterol level

Relação entre presença de fendas de cristais de colesterol em lesão periapical e nível de colesterol sérico

Silva, Vanessa Tavares da; Piva, Marta Rabello; Souza, Liane Maciel de Almeida; Amorim, Klinger de Souza; Groppo, Francisco Carlos

Downloads: 1
Views: 1292

Abstract

A chronic infection in periapical tissue can trigger a periapical lesion due to stimulation and proliferation of epithelial rests of Malassez. On microscopic study, it is possible to detect the presence of clefts of cholesterol crystals within cysts and granulomas. According to some studies, the source of cholesterol inside the periapice lesions may be partially due to the condensation and crystallization of cholesterol in the cyst wall. Yet another part, can be derived metabolic products local or vascular circulation. Objective: This study aimed to analyze the relationship between the clefts of cholesterol crystals found in periapical lesions and cholesterol levels in the blood circulation. Material and method: An observational study of a descriptive nature that included 70 patients with periapical lesions (according to radiographic examination) at the Department of Dentistry, Federal University of Sergipe. These patients underwent extraction of the affected tooth unit and removal of the periapical lesion, and this number sent for pathological examination. At the same query was asked a lipid profile to assess rates of serum cholesterol of patients. Result: Clefts of cholesterol crystals were present only in cysts (larger than 1.5 cm in diameter, approximately), and therefore older. Conclusion: The presence of cholesterol crystals is rare in periapical lesions. The study suggests a relationship between the presence of cholesterol crystals and the rate of cholesterol serum levels in large and old injuries.

Keywords

Radicular cyst, periapical granuloma, cholesterol.

Resumo

Uma infecção crônica nos tecidos periapicais pode desencadear uma lesão periapical em função da estimulação e da proliferação dos restos epiteliais de Malassez. Ao estudo microscópico, é possível detectar a presença de fendas de cristais de colesterol no interior de cistos e granulomas. De acordo com alguns estudos, a origem do colesterol no interior de lesões no periápice pode ser, parcialmente, por causa da condensação e da cristalização de colesterol dentro da parede do cisto. Outros estudos afirmam que a presença de colesterol pode ser derivada de produtos metabólicos locais ou da circulação vascular. Objetivo: O presente estudo teve por objetivo analisar a relação entre as fendas de cristais de colesterol encontradas nas lesões periapicais e os níveis de colesterol sérico. Material e método: Estudo observacional de natureza descritiva, que incluiu 70 pacientes portadores de lesões periapicais, de acordo com exame radiográfico, atendidos no Departamento de Odontologia da Universidade Federal de Sergipe. Esses pacientes foram submetidos à exodontia da unidade dentária acometida e à remoção da lesão periapical, sendo esta peça encaminhada para exame anatomopatológico. Na mesma consulta, era solicitado um lipidograma para avaliação das taxas de colesterol sérico dos pacientes. Resultado: Fendas de cristais de colesterol estavam presentes apenas em cistos grandes (maiores que 1,5 cm de diâmetro, aproximadamente) e, portanto, mais antigos. Conclusão: A presença de cristais de colesterol é rara nas lesões periapicais. O estudo sugere uma relação entre a presença dos cristais de colesterol e o índice de colesterol sérico elevado, em lesões grandes e antigas.

Palavras-chave

Cisto radicular, granuloma periapical, colesterol.

References



1. Lin LM, Huang GT, Rosenberg PA. Proliferation of epithelial cell rests, formation of apical cysts, and regression of apical cysts after periapical wound healing. J Endod. 2007; 33:908-16. PMid:17878074. http://dx.doi.org/10.1016/j.joen.2007.02.006

2. Carrillo C, Penarrocha M, Ortega B, Martí E, Bagán JV, Vera F. Correlation of radiographic size and the presence of radiopaque lamina with histological findings in 70 periapical lesions. J Oral Maxillofac Surg. 2008; 66:1600-5. PMid:18634946. http://dx.doi.org/10.1016/j.joms.2007.11.024

3. Peters E, Lau M. Histopathologic examination to confirm diagnosis of periapical lesions: a review. J Can Dent Assoc. 2003; 69:598-600. PMid:14653936.

4. Nair PNR, Pajarola G, Schroeder, HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol. 1996; 81:93-102. http://dx.doi.org/10.1016/S1079-2104(96)80156-9

5. Ricucci D, Pascon EA, Pitt Ford TR, Langeland K. Epithelium and bacteria in periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101:239-49. PMid:16448928. http://dx.doi.org/10.1016/j.tripleo.2005.03.038

6. Schulz M, Von Arx T, Altermatt HJ, Bosshardt D. Histology of periapical lesions obtained during apical surgery. J Endod. 2009; 35(5):634-42. PMid:19410074. http://dx.doi.org/10.1016/j.joen.2009.01.024

7. Lin HP, Chen HM, Yu CH, Kuo RC, Kuo YS, Wang YP. Clinicopathological study of 252 jaw bone periapical lesions from a private pathology laboratory. J Formos Med Assoc. 2010; 109(11):810-8. http://dx.doi.org/10.1016/S0929-6646(10)60126-X

8. Çaliskan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod. 2004; 37:408-16. PMid:15186249. http://dx.doi.org/10.1111/j.1365-2591.2004.00809.x

9. Suzuki, M. A biological chemistry study on the nature of jaw cysts on the maintenance of homeostasis in jaw cyst fluid. J Maxillofac Surg. 1975; 3:106-18. http://dx.doi.org/10.1016/S0301-0503(75)80027-0

10. Smith G, Matthews JB, Smith AJ, Browne RM. Immunoglobulin-producing cells in human odontogenic cysts. J Oral Pathol. 1987; 16:45-8. PMid:3104565. http://dx.doi.org/10.1111/j.1600-0714.1987.tb00675.x

11. Bhullar RPK, Kler S, Bhullar A, Kamat MS, Singh K, Kaur S. Cholesterol granuloma in the wall of dentigerous cyst. Indian Journal of Dentistry. 2012; 3(2):106-9. http://dx.doi.org/10.1016/j.ijd.2012.03.004

12. Cheng J, Saku T, Okabe H, Furthmayr H. Basement membranes in adenoid cystic carcinoma. Cancer. 1992; 69:2631-40. http://dx.doi.org/10.1002/1097-0142(19920601)69:11<2631::AID-CNCR2820691103>3.0.CO;2-P

13. Cheng J, Irie T, Munakata R, Kimura S, Nakamura H, He RG, et al. Biosynthesis of basement membrane molecules by salivary adenoid cystic carcinoma cells: an immunofluorescence and confocal microscopic study. Virchows Arch. 1995; 426:577-86. PMid:7655738. http://dx.doi.org/10.1007/BF00192112

14. Yamazaki M, Cheng J, Hao N, Takagi R, Jimi S, Itabe H, et al. Basement membrane type heparan sulfate proteoglycan (perlecan) and low-density lipoprotein (LDL) are co-localized in granulation tissues: a possible pathogenesis of cholesterol granulomas in jaw cysts. J Oral Pathol Med. 2004; 33(3):177-84. PMid:15128060. http://dx.doi.org/10.1111/j.0904-2512.2004.00087.x

15. Nair PNR, Sjogren U, Sundqvist G. Cholesterol crystals as an etiological factor in nonresolvingchronic inflammation: an experimental study in guinea pigs. Eur J Oral Sci. 1998; 106: 644-50. PMid:9584911. http://dx.doi.org/10.1046/j.0909-8836.1998.eos106206.x

16. Neville BW, Damm DD, Bouquot JE, Allen, CM. Patologia oral e maxilofacial. Rio de Janeiro: Guanabara Koogan; 2009.

17. Nair PNR, Kohli A, Krishna G, editors. Pathobiology of apical periodontitis, in art and science of endodontics. Oxford: Oxford University Press; 2008.

18. Natkin E, Oswald RJ, Carnes LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surg Oral Med Oral Pathol. 1984; 57: 82-94. http://dx.doi.org/10.1016/0030-4220(84)90267-6

19. Shear M. The histogenesis of dental cysts. Dent Pract. 1963; 13: 238-43.

20. Kirkevang LL, Vaeth M, Horsted-Bindslev P, Bahrami G, Wenzel A. Risk factors for developing apical periodontitis in a general population. Int Endod J. 2007; 40: 290-9. PMid:17284267. http://dx.doi.org/10.1111/j.1365-2591.2007.01224.x

21. Nobuhara W, Del Rio C. Incidence of periradicular pathoses in endodontic treatment failures. J Endod. 1993; 19: 315-8. http://dx.doi.org/10.1016/S0099-2399(06)80464-4

22. Egea JJS, Moreno EJ, Monroy CC, Santos JVR, Ortega EV, Domínguez BS, et al. Hypertension and dental periapical condition. J Endod. 2010;36: 180-4.

23. Bautista LE, Vera LM, Arenas IA, Gamarra G. Independent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-alpha) and essential hypertension. J Hum Hypertens. 2005; 19: 149-54. PMid:15361891. http://dx.doi.org/10.1038/sj.jhh.1001785

24. Casella Filho A, Araújo RG, Galvão TG, Chagas ACP. Inflamação e aterosclerose: integração de novas teorias e valorização dos novos marcadores. Rev Bras Cardiol Invas. 2003; 11(3): 14-9.

25. Albuquerque LC, Narvaes LB, Hoefel Filho JR, Anes M, Maciel AA, Staub H, et al. Vulnerabilidade da doença aterosclerótica de carótidas: do laboratório à sala de cirurgia - parte 1. Braz J Cardiovasc Surg. 2006; 21(2): 127:35.
588019527f8c9d0a098b50ca rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections