Identification of cellulose fibers in oral biopsies

Oral biopsies comprising five periapical cysts, three cases of exuberant granulation tissue in extraction sockets and one case of a mandibular radiopaque structure, all displaying material consistent with cellulose fibers on routine histologic examination, were subjected to histochemical, polarization, fluorescence and scanning electron microscopical, energy dispersive X-ray and chemical investigations. Routine screening of periapical lesions with polarization microscopy and identification of possible cellulose fibers with Calcofluor White is advocated. Further, attention is drawn to endodontic paper point material as an etiologic factor in postendodontic periapical inflammatory processes.