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Periapical actinomycosis: a clinicopathologic study.

Abraham Hirshberg1, Igor Tsesis, Zvi Metzger

  • 1Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. hirshmdpost.tau.ac.il

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
|May 10, 2003
PubMed
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Periapical actinomycosis, a rare finding in dental biopsies, typically presents favorably after surgical curettage and antibiotics. Further research is needed to understand its link to cervicofacial actinomycosis.

Area of Science:

  • Oral pathology
  • Microbiology

Background:

  • Actinomycosis can manifest in various forms, including cervicofacial and periapical infections.
  • Histologic examination of periapical lesions may incidentally reveal actinomycotic colonies.

Purpose of the Study:

  • To determine the incidence of actinomycotic colonies in periapical lesions.
  • To evaluate the clinical outcomes of patients with incidental periapical actinomycosis.

Main Methods:

  • Retrospective analysis of 963 periapical biopsy specimens from 1997-2000.
  • Histologic examination using hematoxylin and eosin, periodic acid-Schiff, and Gram stains.
  • Identification of typical branching filamentous bacteria indicative of Actinomyces.

Main Results:

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  • Actinomycotic colonies were found in 1.8% (17/963) of specimens.
  • The mean patient age was 42, with a male predominance (65%).
  • Maxillary lesions were most common; most were radiolucent, and 15 were epithelialized, including radicular and residual cysts.

Conclusions:

  • Periapical actinomycosis is an uncommon finding with a favorable prognosis.
  • Treatment involves surgical curettage and short-term antibiotics.
  • Further investigation into the relationship between periapical and cervicofacial actinomycosis is warranted.