{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:55:21Z","timestamp":1790085321979,"version":"4.0.1"},"reference-count":23,"publisher":"Korean Academy of Conservative Dentistry","issue":"2","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["rde.ac"],"crossmark-restriction":true},"short-container-title":["Restor Dent Endod"],"published-print":{"date-parts":[[2026,5,31]]},"abstract":"Objectives: This study evaluated and correlated the immune expression of hypoxia and angiogenesis with macrophages in periapical granuloma (PG), radicular cyst (RC), and healthy pulp (HP).Methods: An observational study was performed on 51 tissue blocks equally divided among the groups, stained immunohistochemically for hypoxia-inducible factor (HIF)-1\u03b1, vascular endothelial growth factor (VEGF), and CD68, and the mean expression was calculated. Data were analyzed using Kruskal-Wallis, Mann-Whitney, Spearman correlation tests (<i>p<\/i> < 0.001), and multiple linear regression analysis (<i>p<\/i> \u2264 0.05).Results: HIF-1\u03b1 expression was highest in PG than RC and HP (<i>p<\/i> < 0.001). Significant differences were found between HP, PG, and RC (both <i>p<\/i> < 0.001). VEGF expression was highest in RC than in PG and HP (<i>p<\/i> < 0.001), with significant differences between HP and both PG and RC (<i>p<\/i> < 0.001); pairwise comparisons were significant between all groups (<i>p<\/i> < 0.001, <i>p<\/i> < 0.001, <i>p<\/i> = 0.018). Correlation analysis showed significant correlations between VEGF and CD68 in HP and PG (<i>p<\/i> = 0.007 and <i>p<\/i> = 0.028, respectively). Linear regression showed that study groups were significantly associated with mean scores of HIF-1\u03b1, VEGF, and CD68 (<i>p<\/i> = 0.002, <i>p<\/i> = 0.001, <i>p<\/i> < 0.001).Conclusions: HIF-1\u03b1, VEGF, and CD68 showed increased expression in PGs and RCs, suggesting an association between hypoxic conditions, enhanced angiogenic activity, and macrophage presence within the periapical inflammatory microenvironment. Future studies exploring HIF-1\u03b1 and VEGF inhibitors as potential treatment modalities for periapical lesions are warranted.<\/jats:p>","DOI":"10.5395\/rde.2026.51.e22","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T23:30:38Z","timestamp":1776900638000},"page":"e22","update-policy":"https:\/\/doi.org\/10.5395\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Interplay of hypoxia, angiogenesis, and macrophages in pulp and periapical lesions: an immunohistochemical cross-sectional study"],"prefix":"10.5395","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3220-9537","authenticated-orcid":true,"given":"Puja","family":"Chatterjee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-2622","authenticated-orcid":true,"given":"Mala","family":"Kamboj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7923-9860","authenticated-orcid":true,"given":"Shweta","family":"Mittal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7468-7886","authenticated-orcid":true,"given":"Anjali","family":"Narwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6715-6497","authenticated-orcid":true,"given":"Anju","family":"Devi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3349","reference":[{"key":"ref1","volume-title":"Anatomy, head and neck, dental pulp [updated 2025 Dec 9]. 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