Study of the Focal Aggregations of Cholesterol Crystals and Foamy Macrophages in the Chronic Periapical Lesions of Young and Elderly Patients

Background: Cholesterol crystals and foamy macrophages can delay the healing of inflammatory periapical lesions. The purpose of this study was to evaluate the relationship between age and the presence of focal aggregations of cholesterol crystals and foamy macrophages in these lesions. Methods: In this descriptive-analytic study, 770 samples of inflammatory periapical lesions including 335 periapical granulomas, 329 radicular cysts, and 106 residual periapical cysts were evaluated histopathologically in order to find at least two focal aggregations of cholesterol crystals and foamy macrophages in two age groups of young (20-35 years old) and elderly (over 50 years old) adults. Finally, the data were entered into SPSS version 23.0 and analyzed using chi-square and Fisher’s exact tests. Results: In the present study, 74.3% of the samples lacked at least two focal aggregations of foamy macrophages, and 84% of the samples lacked at least two focal aggregations of cholesterol crystals. The frequency of focal aggregations of cholesterol crystals was not significantly different between the two age groups (P=0.14). However, the frequency of foamy macrophages was significantly higher in the age group of young adults than in elderly adults (P=0.002). Conclusions: According to the obtained results, it does not appear that the healing rate of periapical lesions in young and elderly adults has necessarily significant difference; and whereas, it is lower in the elderly adults than in young adults, probabely relates to factors other than the accumulation of cholesterol crystals or foamy macrophages.