Histology of periapical lesions obtained during apical surgery

Schulz, Malte; von Arx, Thomas; Altermatt, Hans Jörg; Bosshardt, Dieter (2009). Histology of periapical lesions obtained during apical surgery. Journal of endodontics, 35(5), pp. 634-42. Hagerstown, Md.: Elsevier 10.1016/j.joen.2009.01.024

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The aim of this was to evaluate the histology of periapical lesions in teeth treated with periapical surgery. After root-end resection, the root tip was removed together with the periapical pathological tissue. Histologic sectioning was performed on calcified specimens embedded in methylmethacrylate (MMA) and on demineralized specimens embedded in LR White (Fluka, Buchs, Switzerland). The samples were evaluated with light and transmission electron microscopy (TEM). The histologic findings were classified into periapical abscesses, granulomas, or cystic lesions (true or pocket cysts). The final material comprised 70% granulomas, 23% cysts and 5% abscesses, 1% scar tissues, and 1% keratocysts. Six of 125 samples could not be used. The cystic lesions could not be subdivided into pocket or true cysts. All cysts had an epithelium-lined cavity, two of them with cilia-lined epithelium. These results show the high incidence of periapical granulomas among periapical lesions obtained during apical surgery. Periapical abscesses were a rare occasion. The histologic findings from samples obtained during apical surgery may differ from findings obtained by teeth extractions. A determination between pocket and true apical cysts is hardly possible when collecting samples by apical surgery.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Oral Surgery and Stomatology

UniBE Contributor:

Schulz, Malte; von Arx, Thomas and Bosshardt, Dieter








Eveline Carmen Schuler

Date Deposited:

04 Oct 2013 15:10

Last Modified:

25 Jan 2017 12:16

Publisher DOI:


PubMed ID:


Web of Science ID:



https://boris.unibe.ch/id/eprint/31006 (FactScience: 195386)

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