Host mediators in endodontic exudates. I. Indicators of inflammation and humoral immunity

Exudate is often found in the root canal when entering the chamber and canal of teeth with periapical lesions. The aim of this study was to determine possible relationships between clinical or radiographic findings and the concentrations of different host mediators in endodontic exudates. Thirty-two nonvital teeth with periapical symptoms were included in the study. A Clinical Periapical Index was developed to quantify clinical findings. Endodontic exudates were collected with methylcellulose filter paper strips every 3 min, after opening of the pulp chamber. The concentrations of the lysosomal acid glycohydrolase beta-glucuronidase, IgG, IgA, IgM, and interleukin-1 beta in the endodontic exudates were analyzed. The results demonstrated that exudates collected from teeth with suppuration (cloudy exudates), and teeth with higher periapical index scores (Orstavik et al., 1986) contained higher concentrations of beta-glucuronidase and interleukin-1 beta. Furthermore, when the periapical index indicated severe involvement, higher IgG was observed in the first samples. The exudates from patients who presented with a sinus tract or swelling contained higher concentrations of IgM, compared with the patients with only periapical sensitivity. Data showed that endodontic exudates from patient with endodontic lesions can be analyzed for host mediators, and differences in the mediators were seen with different clinical and radiographic symptoms.