IgG4-positive plasma cells are more often detected in chronic periapical lesions arising from permanent rather than primary teeth.

AIM: To characterize plasma cell subsets in chronic periapical lesions affecting permanent and primary teeth. METHODOLOGY: Only chronic periapical lesions without root canal treatment were selected. Twenty-one radicular cysts and 7 periapical granulomas affecting permanent teeth and 19 radicular cysts and 4 periapical granulomas affecting primary teeth were assessed for immunoglobulin (Ig) light chain (kappa and lambda), Ig heavy chain (IgG, IgG4, IgA, IgM and IgD) and plasma cell immunohistochemical markers (MUM1/IRF4, EMA and CD138). The data acquired were analysed by Student's t test, Mann-Whitney U, Friedman test followed by Dunn's multiple comparison test and Spearman's rank correlation. RESULTS: All cases were polyclonal (having similar kappa/lambda light chain ratios). IgG was most abundant compared to other Ig heavy chains (all, P < 0.001); like Ig light chains, but unlike IgA, there was greater expression of IgG in the primary compared to the permanent dentition, for both radicular cysts (P < 0.001) and periapical granulomas (P = 0.53). Notably, IgG4 expression was greater in the permanent than the primary dentition, for both radicular cyst (P < 0.05) and periapical granuloma (P = 0.65). IgM and IgD expression was scarce and variable, whereas plasma cell populations were detected efficiently through EMA, CD138 and MUM1/IRF4 markers, the latter being more sensitive in both dentitions. CONCLUSIONS: There were slight variations in the Ig light and heavy chain profiles in chronic periapical lesions when comparing the permanent and primary dentitions. The ability of IgG4+ plasma cell infiltration to modulate inflammatory responses in chronic periapical lesions arising from permanent as opposed to primary teeth should be considered in future studies.

Immunophenotypic quantification of M1 and M2 macrophage polarization in radicular cysts of primary and permanent teeth.

AIM: To quantify M1 and M2 macrophages in radicular cysts of permanent (n = 14 cases) and primary teeth (n = 15 cases). METHODOLOGY: All patients who attended the School of Dentistry Ribeirão Preto, University of São Paulo with primary teeth or permanent molars that were scheduled for extraction and fulfilled the inclusion criteria: absence of pain; presence/absence of fistulae; extensive coronal destruction due to caries lesions without possibility of restoration; pulp necrosis; radiographically visible apical periodontitis; and no previous treatment, were selected. The radicular cysts were removed and subsequently submitted to histopathologic analysis in order to classify the type of inflammatory infiltrate. In addition, CD68 (M1+, M2+) and CD163 (M1-, M2+) markers were quantified through an immunohistochemistry analysis. The data acquired were submitted to a Mann-Whitney test, with a 5% significance level. RESULTS: The patients had a mean age of 38.6 years and 5.9 years for cysts associated with permanent and primary teeth, respectively. In the histopathological analysis, no significant difference (P = 0.87) was found between radicular cysts in primary and permanent teeth regarding the intensity of the chronic inflammatory infiltrate. A significantly greater prevalence of M2 macrophages (P < 0.05) was observed in the lesions of both permanent and primary teeth, even though both M1 and M2 macrophages were detected. No significant difference (P > 0.05) was found for M1 and M2 macrophages associated with the cysts of primary and permanent teeth. CONCLUSION: M1 and M2 macrophages were present in radicular cysts associated with primary and permanent teeth, with a greater quantity of M2 cells. The immunophenotypic quantification of M1 and M2 macrophage polarization in radicular cysts associated with primary and permanent teeth were similar.