The periapical granuloma is an inflammatory and immune response that is elicited by anaerobic infection of the dental pulp as a consequence of caries, tooth fracture, and traumatic operative dental procedures. This inflammatory process ultimately results in destruction of the alveolar bone surrounding the tooth.Interleukin-1 (IL-1) is a potent bone-resorptive cytokine that is strongly up-regulated following pulpal infection (20). IL-1 mRNA and protein are markedly increased in infiltrating macrophages and polymorphonuclear leukocytes (23), and IL-1 levels generally correlate with the extent of bone destruction (15,22). Most bone-resorptive activity present in periapical granulomas is neutralized by anti-IL-1 antibodies, and bone resorption is significantly inhibited in vivo with IL-1 receptor antagonist (16,22).Both proinflammatory Th1 and antiinflammatory Th2 cytokines are also induced by pulpal infection and may modulate IL-1 expression and activity by macrophages (10). Th1 cytokines (IL-12 and gamma interferon [IFN-␥]) and bone-resorptive cytokines (IL-1 and tumor necrosis factor alpha [TNF-␣]) were up-regulated in a linear fashion over 4 weeks following infection, and resorptive cytokines were positively correlated with Th1 cytokine expression. In contrast, Th2 cytokines exhibited increased expression up to 2 weeks after infection, with a decline in levels thereafter. These data suggest that Th1 cytokine-mediated proinflammatory pathways generally predominate in inflammatory bone lesions and are therefore expected to potentiate inflammation and bone resorption adjacent to sites of infection.At the same time, the central Th1 cytokine IFN-␥ as well as the IFN-␥-inducing cytokines IL-12 and IL-18 also possess osteoclast-inhibitory properties, at least in vitro. These three cytokines have been reported to directly or indirectly reduce osteoclast differentiation and bone resorption (7,8,18,21,25). As a consequence of these opposing activities, the overall role of Th1 cytokines in inflammatory bone resorption in vivo is difficult to predict.In this study, we therefore determined the individual function of IL-12, IL-18, and IFN-␥ in the pathogenesis of infection-stimulated bone destruction, using a well-established in vivo periapical lesion model and appropriate knockout mice. The modulatory effect of these three cytokines on endodontic pathogen-stimulated IL-1 expression by macrophages was also assessed in vitro.