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Discontinuous vertical gel electrophoresis was applied to samples of root canal aspirate, periapical blood, and control blood from twelve periapical lesions. The periapical sample from ten of the twelve lesions showed an additional band in the alpha 1 globulin area which was not present in the control. By means of Grabbar-Williams immunoelectrophoresis to specific antisera, the band was subsequently identified as alpha 1 antitrypsin. The results suggest that the regulation of proteolytic activity afforded by alpha 1 antitrypsin plays an important role in the pathogenesis of periapical lesions.

A case of adenomatoid odontogenic tumor in which trauma was apparently a significant causative factor is presented. Consultation with an oral pathologist prevented unnecessary radical surgery.

A case is reported because of the infrequency with which tumors metastasize from the kidney to the maxilla. It is of special interest because it presented as a periapical pathosis associated with a nonvital tooth and emphasizes the value of routine histopathologic examination of tissue.

It is well established that a periapical lesion may be the first presenting form of more serious disease. A case of malignant fibrohistocytoma has been presented. It is of special interest because of the rarity of the disease, especially in the jaws, and because it presented as periapical disease associated with nonvital teeth. The case emphasizes the value of routine histopathologic examination of tissue and the need for maintaining a high "index of suspicion" when dealing with clinically atypical behavior. The value of consultation with an oral pathologist has also been stressed.