Identification of cellulose fibers in oral biopsies

Abstract

Koppang HS, Koppang R, Solheim T, Aarnes H, Stolen SO: Identification of cellulose fibers in oral biopsies. ScandJ Dent Res 1987; 95: 165-73.Abstract -Oral biopsies comprising five periapicai cysts, three cases of exuberant granulation tissue in extraction sockets and one case of a mandibular radiopaque structure, all displaying material consistent witb cellulose fibers on routine histologic examination, were subjected to bistochemical, polarization, fluorescence and scanning electron mieroscopical, entrgy dispersive X-ray and chemical investigations. Rontine screening of periapicai lesions v^ith polarization microscopy and identification of possible cellulose libers with Calcolluor White is advocated. Further, attention is drawn to endodontic paper point material as an etiologic factor in postendodontic periapicai inflammatory processes.

Pathogenesis of Apical Periodontitis and the Causes of Endodontic Failures

“…Apical periodontitis developing against particles of predominantly cellulose-containing materials that are used in endodontic practice (White, 1968;Koppang et al, 1987Koppang et al, , 1989Sedgley and Messer, 1993) has been denoted as 'cellulose granuloma'. The cellulose in plant materials is a granuloma-inducing agent (Knoblich, 1969).…”

Paper points revisited: risk of cellulose fibre shedding during canal length confirmation

“…All observations were performed with a polarized light microscope ( Fig. 1), making the optically birefringent cellulose fibres clearly distinguishable from the background and other nonbirefringent material (Koppang et al 1987). The artificial root canal block was mounted on the microscope stage with the terminal well of the canal centred in the field of view and the magnification set to fill the field of view with the well.…”

“…Two case series (Koppang et al . , ) demonstrate a foreign body giant cell (FBGC) reaction associated with cellulose material in periapical biopsies from teeth that had previously been treated endodontically. Further case reports demonstrate chronic inflammatory or FBGC reactions associated with paper points or cellulose fibres (White , Nair et al .…”

“…Cellulose fibres are known to be associated with an intense chronic persistent inflammation and have been implicated in treatment failure (Nair et al 1990). Two case series (Koppang et al 1987(Koppang et al , 1989) demonstrate a foreign body giant cell (FBGC) reaction associated with cellulose material in periapical biopsies from teeth that had previously been treated endodontically. Further case reports demonstrate chronic inflammatory or FBGC reactions associated with paper points or cellulose fibres (White 1968, Nair et al 1990, Sedgley & Messer 1993.…”

Non‐microbial etiology: foreign body reaction maintaining post‐treatment apical periodontitis

“…Cellulose granuloma is the term used specifically for pathological tissue reaction to particles of predominantly cellulose‐containing materials that are used in endodontic practice (71–74). Endodontic paper points are utilized for microbial sampling and drying of root canals.…”