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An apexification procedure is performed on a maxillary left central incisor tooth of a fourteen years old girl who has chronic apical periodontitis and undergoing active orthodontic treatment. After a one-year clinical and radiological follow-up, formation of apical closure is observed. As a result, apexification can be suggested as a successful treatment procedure in such cases.

The authors make a general survey of the immunopathological mechanisms involved in odontogenic cysts and granulomas. The dental pulp and the sound periapical tissues contain neither inflammatory nor immunoglobin-producing cells. Dental decay associated with bacterial aggression of the dental pulp and periapical tissues might induce a nonspecific inflammation which subsequently becomes more specific. Immunoglobulins are present in fluid aspirates from odontogenic cysts and granulomas. Several investigations have pointed out nonspecific inflammatory mediators (including the C3 complement components), T lymphocytes (helpers and suppressors), B lymphocytes, protein S-100 + cells (Langerhans cells). The presence of immunoglobulins, immunocompetent cells and C3 complement components confirms that all constituents of both humoral and cell-mediated immunological reactions might play an essential role in the pathogenesis of osteolysis.