Cytomegalovirus in periapical granuloma in routine oral pathology service

Abstract

Background Periapical granulomas develop as chronic inflammatory lesions primarily in response to microorganisms from an infected root canal system. Human cytomegalovirus (HCMV) has been identified in some apical lesions and may modify the local inflammatory response, although immunohistochemical evidence remains limited. Aim This study aimed to determine the frequency and distribution of HCMV protein expression in histologically confirmed periapical granulomas by immunohistochemistry. Methods This cross-sectional study included 27 formalin-fixed, paraffin-embedded periapical granuloma specimens from adults undergoing extraction of teeth with chronic periapical lesions at Taibah University Dental Hospital. Detection of HCMV was performed using a mouse monoclonal antibody cocktail composed of clones 8B1.2, 1G5.2, and 2D4.2. Two experienced pathologists independently reviewed the slides and categorized staining as negative, focal positive, or generalized positive. The frequency of HCMV expression was summarized using counts and percentages, and prevalence was reported with an exact binomial 95% confidence interval.