Edition V04N02 | Year 2014 | Editorial Endo in Endo | Pages 18 to 25
In case of overflow of filling material with controlled or absent microbiota, periodontal ligament and periapical bone reconstruction do not occur immediately around fragments. These fragments are considered as foreign bodies for inducing inflammatory, yet non-immune response. Macrophages and fibroblasts enclose fragments and form foreign body periapical granuloma. Dental granuloma is known as “periapical granuloma” of immunogenic and inflammatory nature. Although foreign body periapical granuloma does not produce further systemic results and have a low risk of anachoresis, it does not restore normality of periapical tissues after endodontic treatment. Should material be calcium hydroxide-based, macrophages phagocytize, migrate and remove it. As a result, foreign body periapical granuloma disappears within a few months. However, should filling material be resin or glass ionomer-based, foreign body periapical granuloma remains at the site for an indefinite period of time. Preventing overflow would be ideal; however, should it be unavoidable, it would be best if material easily removed by macrophages were used so as to ensure restoration of normality even though, from a systemic and clinical point of view, foreign body periapical granuloma does not cause relevant clinical problems.