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FISH Described The Reaction of The Periradicular Tissues To Bacterial Products

Fisch theorized that apical periodontitis occurs due to the body's reaction to bacterial products and tissue necrosis from the root canal. He described four zones of reaction: 1) a zone of infection characterized by neutrophils and bacteria, 2) a zone of contamination characterized by lymphocyte infiltration, 3) a zone of irritation characterized by macrophages and osteoclasts, and 4) a zone of stimulation characterized by new bone and collagen formation. According to Fisch, removing the source of infection in the root canal would resolve the inflammatory reaction in the surrounding tissues.

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Mohamed Faizal
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1K views2 pages

FISH Described The Reaction of The Periradicular Tissues To Bacterial Products

Fisch theorized that apical periodontitis occurs due to the body's reaction to bacterial products and tissue necrosis from the root canal. He described four zones of reaction: 1) a zone of infection characterized by neutrophils and bacteria, 2) a zone of contamination characterized by lymphocyte infiltration, 3) a zone of irritation characterized by macrophages and osteoclasts, and 4) a zone of stimulation characterized by new bone and collagen formation. According to Fisch, removing the source of infection in the root canal would resolve the inflammatory reaction in the surrounding tissues.

Uploaded by

Mohamed Faizal
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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PATHOGENESIS OF APICAL PERIODODNTITIS AS EXPALAINED BY FISH

FISH described the reaction of the periradicular tissues to bacterial


products, noxious products of tissue necrosis, and antigenic agents from
the root canal

FISH in 1939 theorized that the zones of infection are not an infection by
themselves but the reaction of the body to infection.

Thus he concluded that the removal of this nidus of infection will result in
resolution of infection.

Four well defined zones of reaction were found during the experiment

a. Zone of infection or necrosis (PMNLs)

b. Zone of contamination (Round cell infiltrate lymphocytes)

c. Zone of irritation (Histiocytes and osteoclasts)

d. Zone of stimulation (Fibroblasts, capillary buds and Osteoblasts

Zone of Infection

Infection was confined to the center of the lesion.

This zone is characterized by polymorphonuclear leukocytes and


microorganisms along with the necrotic cells and detructive components
released from phagocytes.

Zone of Contamination
PATHOGENESIS OF APICAL PERIODODNTITIS AS EXPALAINED BY FISH

Area of cellular destruction.

This zone was not invaded by bacteria, but the destruction was from toxins
discharged from the microorganisms in the central zone.

This zone is characterized by round cell infiltration, osteocyte necrosis and


empty lacunae.

Lymphocytes were prevalent everywhere.

Zone of Irritation

FISH observed evidence of irritation further away from the central lesion as
the toxins became more diluted.

This is characterized by macrophages, histocytes and osteoclasts.

The degradation of collagen framework by phagocytic cells and


macrophages was observed while osteoclasts attack the bone tissue.

The histologic picture is much like preparatory to repair.

Zone of Stimulation

FISH noted that, at the periphery, the toxin was mild enough to act as
stimulant.

This zone is characterized by fibroblasts and osteoblasts.

In response to this stimulatory irritant, fibroblasts result in secretion of


collagen fibers, which acted both as wall of defense around the zone of
irritation and as a scaffolding on which the osteoblasts synthesize new
bone.

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