Karteva Teodora, Manchorova-Veleva Neshka
Operative Dentistry and Endodontics, Faculty of Dental Medicine, Medical University - Plovdiv, Plovdiv, Bulgaria.
Folia Med (Plovdiv). 2020 Jun 30;62(2):238-243. doi: 10.3897/folmed.62.e39599.
The immune response is a complex, dynamic and strongly individual biologic network that plays an essential role in the pathogenesis of chronic apical and marginal periodontitis. Recent research in the field of periodontology has indicated that the major determinant of susceptibility to disease is the nature of the immunoinflammatory response as marginal periodontal tissue damage is thought to be primarily mediated by the host reaction. Whether the same rules apply for the development of apical periodontitis, however, remains largely unexplored. This review aims to draw parallels between the pathogenesis of chronic periodontitis of endodontic and marginal origin, outline the evidence for the destructive role of immune response in chronic marginal periodontitis and raise questions about its role in chronic apical periodontitis. It would be worthy to further explore the impact of the immune system on the characteristics and progress of these diseases and transfer some of the scientific models from the field of periodontology to the field of endodontics. Research in this area could lead to a more comprehensive understanding of the dynamics of apical and marginal periodontitis and lay the foundation of new personalized treatment strategies.
免疫反应是一个复杂、动态且极具个体差异的生物网络，在慢性根尖周炎和边缘性牙周炎的发病机制中起着至关重要的作用。牙周病学领域的最新研究表明，疾病易感性的主要决定因素是免疫炎症反应的性质，因为边缘性牙周组织损伤被认为主要由宿主反应介导。然而，根尖周炎的发展是否遵循相同的规律，在很大程度上仍未得到探索。本综述旨在比较牙髓源性和边缘性慢性牙周炎的发病机制，概述免疫反应在慢性边缘性牙周炎中破坏作用的证据，并对其在慢性根尖周炎中的作用提出疑问。进一步探索免疫系统对这些疾病的特征和进展的影响，并将牙周病学领域的一些科学模型应用于牙髓病学领域，将是很有意义的。该领域的研究可能会使我们对根尖周炎和边缘性牙周炎的动态有更全面的理解，并为新的个性化治疗策略奠定基础。
