Green T L, Walton Richard E, Clark Jeffrey M, Maixner David
College of Dentistry, University of Iowa, Iowa City, Iowa 52242, USA.
J Endod. 2013 Aug;39(8):977-9. doi: 10.1016/j.joen.2013.02.002. Epub 2013 Apr 25.
Condensing osteitis is a radiographic finding, but with no reported histologic investigations in humans. The objectives of this study were to evaluate and describe histologically condensing osteitis in human cadaver jaws. Patterns of bone formation and presence/absence and nature of inflammation were examined.
Specimens of mandibles and maxillas were obtained from cadavers and examined radiographically. Those periapical areas with characteristics of condensing osteitis were removed en bloc, decalcified, and processed for light microscopy. For comparison, specimens that showed normal apical radiographic anatomy were also removed for examination.
Normal apical regions showed an intact periodontal ligament and a thin layer of alveolar bone proper surrounded by cancellous bone with fatty marrow. In contrast, areas of condensing osteitis exhibited areas of inflammation or no inflammation, occupied by connective tissue. This area was bordered by a rim of varying widths of dense lamellar-type bone replacing the cancellous bone and marrow.
The histologic changes of condensing osteitis consisted of the replacement of cancellous bone with compact bone. Areas of fibrosis and an inflammatory infiltrate were seen in some but not all specimens. All teeth exhibiting condensing osteitis had an identifiable etiology that likely resulted in degenerative pulp disease.
致密性骨炎是一种影像学表现，但尚无关于人类组织学研究的报道。本研究的目的是对人类尸体颌骨中的致密性骨炎进行组织学评估和描述。研究了骨形成模式以及炎症的存在与否和性质。
从尸体获取下颌骨和上颌骨标本并进行影像学检查。将具有致密性骨炎特征的根尖区域整块切除，脱钙后进行光学显微镜检查。为作比较，也切除显示正常根尖影像学解剖结构的标本进行检查。
正常根尖区域显示牙周膜完整，薄层固有牙槽骨被含有脂肪骨髓的松质骨包绕。相比之下，致密性骨炎区域表现为有炎症或无炎症的区域，由结缔组织占据。该区域由不同宽度的致密板层骨边缘界定，取代了松质骨和骨髓。
致密性骨炎的组织学变化包括松质骨被密质骨替代。在部分而非所有标本中可见纤维化区域和炎症浸润。所有表现为致密性骨炎的牙齿都有可识别的病因，这可能导致牙髓退行性疾病。
